How to help our sweet little elderbun to live his best life

[Meg]

Hey all!  🙂

I’m wondering if more experienced bunny parents have any advice on how to take the best care of an elderbun.

Our Teddy (whom some of you know of) is 11, and has been a total sweetie ever since we adopted him at 3 months old, in 2009.  From that time until the fall of 2018 he was with his BFF, Athena (on the left in the photo), until she passed away.  We all miss her greatly, but he’s adapted very well and we’ve actually gotten to see his personality come out more (she was the more social and outgoing of the two).  While I have looked for another senior bun as a partner for him, I haven’t found any viable candidates, and our vet thinks he might be among the bunnies who prefer to be a “lone ranger” after losing their bonded companion, rather than getting another one.  I work from home, and his room is where I both work and relax, so I spend the vast majority of each day with him.  He has free reign in there, with a maze-like hideout under the bed, several hidey houses, and a Cottontail Cottage.

In any case, he generally seems like a happy little guy, playful and with a terrific sense of comedy.  He has a varied repertoire of funny races for his hay in the morning, and will do headshakes or even a binky when he’s happy.  He’s come around to being petted (mostly) and I’m SO grateful to have recently read (here, I think?) about grinding your teeth back when your bunny does — it’s given us a way to talk to each other.  My partner and I love Teddy more than I could ever put into words.  🙂  And best of all, I think he knows it, at least in part.  🙂

While he does seem happy and healthy generally, he’s had more rough patches over the past year and a half.  He was diagnosed with spondylosis last January, and though it doesn’t seem to affect his mobility, he does stretch more and seems stiff on some (rainy) days.  He’s been on daily meloxicam (with famotidine to protect his tummy) since then (well, initially gabapentin but it didn’t sit well so we switched to meloxicam), and I give him a Sherwood Joint Support tablet once a day which seems to help.  I also try to keep an eye on the barometric pressure and give extra meloxicam if it’s taking a sudden dive.

But the other thing is, he’s much slower to recover from stasis, and needs to be weaned off cisapride at a glacial pace now.  Last year he was on it (and other stasis treatments) for two and a half months (mid-Jan to early April).  (However, his bloodwork in both January and October were normal, he had just a small molar trim in January, and x-rays didn’t show anything either.)  This year he got stasis in early/mid April and has not yet come fully off the cisapride — he keeps doing great (seeming normal) for weeks as we slowly wean meds, but then taking a step back, usually when we try reducing the dosage further.  The vet said some (elder) bunnies need to stay on cisapride indefinitely, and I wonder if Teddy’s getting to be in that camp. (He’s been prescribed 0.3 CCs twice a day for stasis, and we haven’t had success keeping him on less than 0.15 when trying to wean him off it.)  I also wonder if he might need to stay on a higher daily meloxicam dosage — we had been doing just 0.35 CCs once a day (he’s 3.5 pounds), but lately have been adding an extra 0.5 CC dose each day (so he gets it twice, 12 hours apart), along with more famotidine.  I of course don’t want to overdo it, but don’t want to underdo it either if he’s uncomfortable.  (The great thing is that, unless he’s in full stasis, he will lick his medicines off a plate, so it’s low-stress for everyone. Like JerseyGirl says, he is a doll!) 🙂

Parenthetically, I would be more worried about another underlying condition except that he did this last year and then recovered, with nothing else indicated by all the exams we did.  And he does *very* poorly with car/vet trips, getting at least a week of acute stasis after each one (which now could turn into months of treatment), so I have to really weigh that before taking him back to the vet.

Beyond these specifics, I’m wondering what else we could be doing to make his day-to-day life the best it can be, and keeping the rough patches at bay.  Is there any other food/supplement/anything that might help with the spondylosis/stiffness?  (In the colder months we keep a space heater on in his room since he likes to lay next to it sometimes.  The room is warm, but he likes the extra heat.)  Years ago I trained him that if he goes up to the upstairs of his Cottontail Cottage he gets treats (Flopper’s Garden leaves and/or dried clover buds), so he usually does that at least a few times a day.  But though I fastened a patch of carpet onto the ramp for traction, he kind of just jumps up it, catapulting himself — I had thought this would be good for exercise but wonder if it’s too much of a strain now?  (He still does it — I just don’t want him to hurt himself.)  Or any other tips for keeping senior buns comfortable, happy, and healthy as much as we can?

Anyway, I’d never had bunnies before Athena and Teddy, so this is my first senior-bun rodeo.  I’d love any thoughts you might have!  And thank you so much for being such an incredible resource over all these years (including before I first adopted)!!  I can’t imagine how I would have managed without you all, and I’m deeply grateful.  🙂

[DanaNM]

Aww Teddy <3

Bertha got pretty stiff in her last year, and I started giving her this supplement called Myristol. It was recommended to me by one of the ladies at the rescue who found it helped her elder buns. It was originally developed for race horses but now they make a rabbit formula. It’s in a rabbit pellet formula but use just give a tiny amount in addition to normal pellets. It seemed to have helped?

I struggled with her set up too, because I felt there was a tradeoff between exercise and wear and tear on her joints. I ended up removing the levels from her condo because I felt jumping down was just a bit too much for her. I also got a litter box with one low side that was designed for cats, and she did much better with that.

Bertha was also on metacam which helped a lot. Other than that I just gave her lots of cuddles and massages. 🙂 I spent a lot of time laying on the floor with her. <3

Bun Jovi is currently 12 (I think??) but you wouldn’t know it. He’s a wild man! LOL He just gets an oxbow joint support treat daily (or when I remember). He didn’t really like the myristol so I stopped giving them to him. I also try to keep really on top of things with his grooming, because about a year ago he went into stasis during a molt and we almost lost him.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Meg]

Thank you so much, DanaNM!!  That’s so great about Bun Jovi the wild man, haha.  And I’m so glad he pulled through last year!!  What a relief.

Thank you so much for the tip about Myristrol.  I’ll have to think it over because of the cow, pig, and shellfish ingredients, as I’m personally on the extreme end of the vegetarian spectrum (i.e., I can’t even order non-veg food for other people).  And the Sherwood joint support pellets, which are vegan, provide some of the same things… But on the other hand if Teddy seems to be suffering I will have to revisit that.  The manufacturer says to give 1.5 scoops per 10lbs but I’ve read elsewhere (just now) to just give 1-2 pellets twice a day.  What do you recommend?

That’s a good point about the tradeoff… I think maybe I’ll keep an eye on him and if he stops choosing to leap into his litterboxes (he has a lower side entry available but doesn’t usually use it), etc., then we’ll change the upstairs cottage routine.  (In front of his upstairs cottage doorway he has those little stairs with the fake sheepskin cover that are designed to help little dogs get onto a couch, and he uses them to get back down, but never climbs up them. 😉

Teddy’s generally been wary of humans touching him, but he’s been coming around slowly (I always ask if I can pet him first, using the same phrase and tone of voice each time, and then holding my hand tentatively over him, and he’ll either stay and let me, or turn away).  So I’m always trying to learn how and when and where he would appreciate being petted — it’s been a journey and I feel so dense that it’s taken me over a decade to even partially figure it out, haha! 😉  Sometimes he likes little back massages and other times not.  One thing I wonder if you’ve seen before, that he does and Athena did too: if I do a gentle massage over their lower back / hip area, they’ll start licking anything in sight (or their own shoulder) for a little while, but then after maybe 10-20 seconds of that, hop away with maybe a foot flick.  To this day I’m still not sure if they like it or find it annoying!  If you or anyone has a clue on this, I’d be all ears.  🙂

Thank you so much again!!  🙂 🙂

[DanaNM]

You’re welcome!

I felt weird about the collagen ingredients too as I’m also vegetarian…. but I know that most collagen products are made from by-products that are normally discarded. But it does feel yuck to be feeding something like that to an herbivore. So yeah, I was conflicted as well.

So the “scoop” they include is TINY. So 1.5 scoops of the scoop they give you ends up just being a few pellets if you get the rabbit formula. A container of probably only 1-1.5 cups of pellets is supposed to last months. I’ve seen some people giving the horse formula before the rabbit formula was available, and then you end up giving closer to a teaspoon because it’s not as concentrated.

I also think ramps can be easier and lower impact than steps, so eventually you might consider modifying his cottage to a ramp entry.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Meg]

Thank you so much, DanaNM!!  That’s all really helpful. And great idea about the ramp!  He kind of jumps down the stairs, not super comfortable with him, so we’ll probably do that soon.

Thanks again!!

[Hazel]

I haven’t tried this with rabbits, but I’ve been giving CBD to my elderly ferret for close to a year now. He has age related spinal issues, an old hip injury as well as Insulinoma. It seems to help keep him comfortable (and I’m hoping it slows down the cancer as well). Similar to the Meloxicam, the medication he is on to combat the effects of the cancer can be somewhat hard on the stomach, he has to take it with food and the CBD is supposed to help with that too. He doesn’t like the taste of it very much, but after a few tries he usually ends up eating it, probably just so I will stop bugging him. 😉  Can’t really blame him, he’s a carnivore, rabbits might like the taste more I imagine.

I did take his three level condo apart and made a large one level cage for him because like your Teddy, he would climb/jump up and down the levels more enthusiastically than I was comfortable with. 🙂

[Meg]

Good to know — thank you so much, Hazel!  CBD has helped me with my own joint pain, so I’d be interested in seeing if it could help Teddy!  🙂 What form do you give it in?  I wonder if anyone else has tried CBD for bunnies?

[Hazel]

He gets plain CBD oil (Green Roads). It’s a formula with high CBD content (37mg/ml) so I only have to get a couple of drops into him each day.

[Meg]

That’s great to know — thanks, Hazel!!

[Hazel]

You’re welcome! If you decide to give it a try, let us know how it goes. 🙂

[Meg]

Hi everyone!  I’ve been giving Teddy CBD oil for about a month or so, so I wanted to come back here and report.  Thank you for the suggestion, Hazel!  (BTW, Teddy and your bunny look like they could be cousins!)

I Googled all I could to find bunny CBD dosage, but there’s not much out there.  The only guideline that I found mentioned more than once was about 0.25mg per pound.  I give Teddy 1 drop of a CBD oil that’s a 30mg/mL strength, and it says that 1 drop has 1mg of CBD (so, just slightly more than the guideline as Teddy’s about 3.5 pounds).

When I give Teddy his daily small amount of pellets, I save 1/4 or less and put them into a small cup.  I drop the drop of CBD oil onto the pellets in the cup and swirl/shake them till it’s relatively evenly distributed.  Teddy took a couple days to warm up to them but he likes them fine now.  The first day, I tried mixing CBD oil in simethicone (Teddy will gladly eat cisapride if it’s mixed into simethicone) but that was a hard no from him.  Maybe it was the wrong combination of flavors, like garlic salt on frosting, haha. 😛   The next day I tried mixing it into the pellets as well as a little of the Flopper’s Garden Old Bones herb mix that Teddy loves, and he ate it from then on.

Oh, also: We don’t give this at the same time as his medicine — apparently CBD can slow/inhibit liver metabolism of certain medicines to some extent, especially if given with or up to 4 hours prior to those medicines (I don’t know more details than that). I have no idea whether this applies to his medicines, but just to be safe, we give them like 6 hours apart, and haven’t noticed any negative effects.

Keeping in mind all this is just one person’s observation: I’d say this has been a positive addition to Teddy’s life.  The most notable difference is that he’s drinking a healthier amount of water, which I think is really helpful especially for when he’s shedding, etc.  He hadn’t been drinking much out of his bowl the past couple years, and now he’s regularly drinking 1-2 ounces a day, which is a good amount for him.  It doesn’t look like the unhealthy over-drinking I’ve seen in an unwell bunny; it seems healthy.  Apparently, if what I’ve read is correct, cannabis generally doesn’t cause dehydration but it can temporarily suppress the salivary glands somewhat for a few hours, causing the “dry mouth” feeling that motivates drinking more water.  So in my view, it’s a net positive.  I haven’t noticed Teddy grooming himself less or showing any other signs of discomfort.

Other than that, I also think he sleeps more soundly when he naps.  I haven’t noticed dramatic differences in his behavior otherwise, but he was acting pretty happy before.  (I got him the Cottontail Cottage ramp but he ignores it, haha, and still leaps upstairs and hops down the doggy stairs he’d been using.)  Not to jinx it, but so far he’s been more reliable with his eating habits than the prior few months, even though he’s going through a shed.  It’s possible I’m not giving him enough to have a bigger effect (Hazel, how many pounds is your ferret?).  But in summary, I’m happy with the CBD oil knowing that it could make him more comfortable, and that in any case, sleeping better and drinking more water is likely good for him.

Thank you so much again!!  🙂

[Hazel]

That’s so great to hear, I’m glad it seems to be helping! 🙂

I know it’s so hard to find information about dosage, I have the same problem. Different animals process medications at different speeds as well. I started out with what other ferret owners had success with, and tweaked it from there. I’ve seen much the same results as you, he eats a lot, drinks a lot and seems to sleep deeply and comfortably. Something a little more exciting I’ve noticed recently is that it seems to actually be reducing the size of his tumors. I tried reducing the amount of Prednisolone I was giving him because it caused a lot of water retention, and I was able to go down to half his original dose before he showed signs of low blood sugar. There’s no way to be sure without having tests done but since the tumor size directly relates to Insulin production, as far as I can figure, the tumors have gotten smaller.

Bubbles weighs around 2.5 lbs, but it’s hard to get his “true” weight because of the water retention. The good news is that CBD isn’t toxic so I think you could experiment with a higher dose without causing any harm.

Thanks for the info about CBD affecting the metabolism of some medications, I didn’t know about that. From now on I’ll make sure to give it exactly in-between his two daily Pred doses. 🙂

The bun in my avatar is my bridge bunny Sam, he was a Lion Head/Jersey Wooly mix. They definitely could be twinsies! 😀  Figures Teddy wouldn’t use the ramp, such a bunny thing to do. You buy something nice for them and they just ignore it! 😆

Thank you for providing such a detailed report, it’s really helpful. Hopefully things keep going well with Teddy, we would love to see more pictures of the little guy! 🙂

[Meg]

Hi Hazel, and thank you so much for your generous reply!  🙂  That’s really great about your ferret’s doing so well with CBD!  🙂

You make a good point about experimenting with higher dosages since one can’t overdose on CBD.  These days I don’t know what more I could ask of Teddy’s health, since thankfully he seems to be doing well (and has basically all good days now since the CBD, knock on wood) 🙂 but I’ll keep it in mind as time goes by.

I found one article that did give a little more info on CBD and medications: https://www.healthline.com/health/cbd-and-drug-interactions-what-you-need-to-know  It says this:

“Although studies are still ongoing to determine potential interactions between CBD and specific medications, there’s one rule of thumb that can help consumers in the meantime: Avoid CBD if your medications have a grapefruit warning on the label.

This warning indicates that people taking the medication should avoid consuming grapefruit or grapefruit juice.

According to the Food and Drug Administration, consuming grapefruit while on one of these medications can lead to a higher concentration of the medication in the bloodstream and adverse side effects or even an overdose.

More than 85 drugs interact with grapefruit and some closely related citrus juices — like Seville oranges, pomelos, and tangelos. That’s because chemicals in grapefruit known as furanocoumarins inhibit CYP3A4, in a similar fashion as CBD. The result is a slowed metabolization of medications.”

Grapefruit warnings are common in several types of medications, but not all medications within a category will require the avoidance of grapefruit. Check your medication’s insert information or ask your doctor.”

I suppose we’d need to Google pet medications for that info since few would anticipate bunnies or ferrets eating grapefruit  😉

I love Sam’s fluffitude!!  I always thought Teddy was a Lionhead/Jersey Wooly mix too and only just learned he might be a “cinnamon Lionhead” (which I didn’t know was a thing; he came from a shelter).  🙂  Here are some photos — thank you so much for asking!  🙂

[Hazel]

Oh my, he’s so fluffy and adorable! Like a cuddly Teddy bear. 😀  Love the picture with all the stuffies, it looks like he’s asking them to groom him. I didn’t know there was a cinnamon Lionhead either, but he certainly looks the part! 🙂

Thank you for the article, that’s so interesting about the grapefruit. I’ll definitely look into that. If it applies to the Pred I guess it should have that warning since it’s also prescribed to humans, I’ll check the bottle.

[Meg]

Awesome, thank you so much, Hazel!!  🙂  Your Sam’s photo is super adorable as well.  🙂  Yes, it took me a week to name Teddy and I was planning on some more dignified name but he looks just like a Teddy bear (especially the nose — same with Sam I bet!) and he has a very laid-back and comical personality, so I think it fits better than Aloysius or other fancy names I’d had in mind.  😉

Teddy was always more of a bunny’s bunny during the 9 years he had his BFF, Athena, with him, but he’s since opened up more to humans and lets us pet him more.  He even started (sometimes) letting me kiss him on the forehead!!!  I know I could never replace a bunny but try to do all I can to give him a form of grooming and companionship.

Thank you so much again — I so appreciate your suggestions and encouragement!  🙂

[Hazel]

I think Teddy suits him perfectly! I had a bun named Teddy as well. Of course in hindsight, I should have saved the name for Sam! 😆  Aloysius is a pretty cool name though, I might have to put that on my short list.

That’s very interesting about him opening up more after losing his mate. I had a similar experience with my pair. After Teddy passed away, his mate became much more friendly and seeking out human interaction, whereas before he was more of a “bunny’s bunny” as you said. 😉

How sweet that Teddy accepts kisses from you! I try to put a quick one on Oscar sometimes, but it’s a little scary. Depending on his mood, it might be fine or it might turn ugly. 😆

[DanaNM]

That’s so sweet!

Bun Jovi loves kisses and will tooth purr while getting them, but then again she pretty much loves any kind of attention as long as he’s not being picked up! He always comes back from the bunny sitter’s house with lipstick all over him LOL

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[Bam]

Teddy is so like my Vilde, they could be brothers 😃

 

[LBJ10]

Glad to hear the CBD is helping! Never would have thought it would be something to try with a bunny.

[Meg]

Thank you so much, everyone!  Teddy and I really appreciate it.  Bam, they really could be brothers!!  I almost thought you had posted a picture of Teddy.  I love the name Vilde!

DanaNM, hearing about Bun Jovi coming back from the bunny sitter’s house with lipstick all over him made my day.  😆  That’s the cutest!!  He sounds like a wonderful character.  🙂 🙂

Hazel, I can’t believe you had a bunny named Teddy too!  That’s amazing.  And yes, I have to be very careful in approaching Teddy (not that he’d bite, but he’d run away), since he can be skittish at times and even after 11 years together I’m still not great at reading his mood, unfortunately.  Even just for petting him I always ask “can I pet you a little?” in the same tone of voice, and hold my hand above him tentatively, and then wait for his response.  If he doesn’t feel like it, he’ll shift a bit and/or get ready to hop away as his “no thank you” signal, and then I won’t.  I’ve only tried forehead kisses a few times, and that’s just when he’s really relaxed, like with his chin on his paws.

Overnight Teddy had another episode of not eating, unfortunately.  🙁  He’s shedding and won’t let me brush him, so that could be part of it, and/or we just went down another tiny notch in our glacial-pace weaning of his cisapride a few days ago.  Thankfully when I offered full-dosage meds on a plate in the morning he ate them, and he’s been nibbling since.  If he doesn’t eat more very soon I’ll proceed with the rest of the stasis stuff.  He’s done this before in recent months/years and sometimes can bounce back in a day or two without needing too much intervention, if we go back to full dosage of meds and make sure he gets enough food.  So I’m not too worried about this episode yet, but I am wondering what if anything we could do to stop these episodes from happening.  Maybe he needs to stay on a pretty full dose of cisapride?  He always seems to take a step back like this at some point after going down another notch in the weaning process.  And we’ve tried weaning just about as slowly as humanly possible: like reducing by .02 CCs every 2 weeks or so till his poops have been normal for a while.  Have you seen this kind of thing before?

Thank you all so much again!!

[Hazel]

Poor Teddy, I’m sorry he’s not feeling quite right. 🙁  Maybe it’s gas? Oscar often gets gassy when he’s shedding and Simethicone always does the trick. I don’t have any experience with cisapride, unfortunately. I hope he snaps out of it quickly.

That’s so cute how he tells you if he’s in the mood for you to pet him or not, I’m sure he appreciates how you’re letting him call the shots. If I catch Oscar at a bad time he’ll give me a nasty grunt. I’m glad I don’t speak bunny because I’m sure whatever he says isn’t very nice.  😆

[Meg]

Thank you so much, Hazel!  Haha that’s funny about Oscar’s grunts 😆  And I so appreciate your company in this.

Teddy has always been his own man and lets us know that he needs a strong sense of autonomy, haha.  He even doesn’t necessarily like being offered food (like if I put something in front of his face), except for his verrry favorite treats, because he doesn’t like being told what to do — he’ll sometimes wait till we’re gone to eat it. 😆  This makes me laugh because it reminds me of my brother when he was a kid: if we were out to dinner and someone else ordered what he wanted ahead of him, he would change his own order so as to be “independent”. 😉

And yes, it sure could be that!  Teddy gets regular simethicone these days since it’s what we mix his cisapride into to get him to eat that, and I gave him an extra dose of it this afternoon.  Then he had a nice nap and ate some pellets when he woke up.  I’m keeping a close eye to make sure he’s getting enough food, but so far so good (knock on wood).

But I wonder if anyone else has seen/heard of an elderbun who needs to stay on cisapride?  We just haven’t had any luck getting him off it this time, since April!  He can have a slightly smaller than normal dose, if we reduce it gradually, but that’s the most we can do.

[Hazel]

Omg, that’s hilarious! 😆  “I will decide when I eat what, thank you very much human!” Sounds like he’s part cat. 😉

Glad to hear he’s eating some pellets!

[Meg]

Thank you so much, Hazel!!  Haha, that is totally him.

Unfortunately last night he stopped eating altogether so we started full treatments and then decided to take him to the vet today.  He hadn’t had bloodwork in almost a year so we thought it’d be good to check at this point.  Thankfully they found him pretty stable and the first round of bloodwork came back great!!  No liver or kidney issues, or any other concerns — the vet said he looked really good for a bun of his age.  We’re still waiting for the full panel to come back in another several days, but I’m really encouraged and sooo grateful for this good news so far!!  He may need stasis treatment for a while yet but it’s so reassuring to know there’s no new underlying problem that they could find so far.  He’s shedding now so it could be just all that extra fluff.  😉  (We brush him when we give him his treatments now, since he can’t escape.) 😉  Like my partner likes to say, he’s a strong bun!  😀

[Hazel]

Oh no, I’m sorry you had to take him to the vet. 🙁  I’m glad they didn’t find anything concerning. Fingers crossed it’s just from the shedding. I’ve never had much luck using brushes, I usually just pluck by hand. You could also try wetting your hands and petting him to get the loose fur off. Just be careful not to get him too wet or he might ingest more fur trying to clean himself off.

He’s a stubborn little guy, this won’t keep him down for long. 🙂

[Meg]

Those are good points — thank you so much, Hazel!  🙂

And I really like how you said that.  Not to jinx it, but he seems to be on the upswing already!  😀

[Meg]

p.s. Circling back to the CBD discussion in case others read this: I just read that there may be reason to avoid CBD while taking cisapride.  The Canadian Drugbank.ca says ” The risk or severity of adverse effects can be increased when Cannabidiol is combined with Cisapride.”  After more research online, it seems that what they’re referring to is a potentially serious heart arrhythmia called “torsades des pointes” that usually resolves on its own but *can* lead to cardiac arrest (!), and that this (uncommon) side effect is the reason cisapride was pulled from the human market (as I just read).  If I understood right, cisapride hasn’t been proven to incite torsades des pointes in rabbits except in those that already had heart failure (but that study was small: Kijtawornrat et al. 2006).  However, apparently CBD — and definitely grapefruit — can lead to higher levels of cisapride in the bloodstream than the patient would have otherwise, increasing the risk of adverse side effects, of which torsades des pointes would be a salient possible one.  So, though this is kind of a daisy chain of potential risks, it sounds concerning.

By the way, milk thistle, which is often given as a liver protectant, can have a similar effect in terms of raising levels of cisapride (and its risks).  Our vet prescribed it (in a lactulose compound as part of the stasis treatment) on the same order as the cisapride!  Anyway, I’m thinking I’ll ask our vet before resuming CBD alongside cisapride… though I really liked how it helped Teddy to drink more water and sleep better.  Man!  I’ll update after I’m able to talk with the vet.

[jerseygirl]

Oh Teddy! Sending him warm hugs!

Meg, I’m behind is what has happening & have bookmarked this thread to come back and read tonight. My apologies for short reply but I didn’t want to just read & run. xx

[Meg]

Thank you so much, Kate!  You’re the best!!

I’m still waiting for a vet callback about the medicine interactions, but meanwhile some great news: the full panel of bloodwork came back normal!! 😀  Plus Teddy’s been eating much much better since last night.  We’re so grateful!!

[Hazel]

Yay, go Teddy! 😀

I totally get your concern, that’s too bad about the potential side effects. 🙁 Odd that the vet prescribed milk thistle together with the cisapride if it might create a problem. Maybe he didn’t know? I’m interested to hear what he says about the CBD as well.

So glad he’s feeling better today! 🙂

[Meg]

Thank you so much, Hazel!!  🙂

I’ll be sure to share what the vet says once I hear from her.  Because we’re in the US, they can’t officially give any advice on CBD (apparently it’d have to be legalized at a federal level before the veterinary board would be able to incorporate it into standards of care) but I’m hoping to get at least some sort of information (though research is scarce).

Not to jinx it, but Teddy’s eating his greens so nicely now and some pellets too, we may be done with subq fluids now/soon, and then I’ll be back to the drawing board on how to get Teddy to drink water (if we can’t give CBD).  I wonder if anything else causes an increase in water intake without actually dehydrating?

[jerseygirl]

Yay Teddy!  I hope this was just a short episode and he continues to improve. I was happy you reported some positives you were seeing with the CBD oil. As I was reading, I had wondered if it was something you could increase dose of after vet visits since they seem to stress him and prolong gi stasis. Then by the end of the thread I see you had to take him into the vet. 🙁  Very glad to see the trip didn’t have a negative effects this time.

I know we joke about bunny PMS (pre moult syndrome) but I truly think moulting can really play havoc with some rabbits, and not from the increase change of ingesting fur. It’s just speculation on my part but I have to wonder about the hormones that trigger moulting and how they might interfere with other other systems. So many bun owners will report about a bun having an “off day” (seeming unwell or acting out in behaviours) – then looking back they’ll see it coincides with a moult.

You mentioned famotidine in an earlier post. Does Teddy still receive this or is it only when he is on Metacam? I ask because I wonder if this (or similar) is something you could give or increase instead of cisapride. In the past, Ranitidine (zantac) has been used to aid in motility, not just as an antacid. Unfotunately, it is off the market now but some other antacids work the same.  I *think* famotidine might be one of them.

I still have some Zantac syrup I had for rabbits and Ive actually found 1 dose turned around both my bunny boys on a couple occasions in the past 6 months.  I still try simethicone first but after seeing that didnt help and how quickly Zantac did, I tend to want to go straight to that. It depends on how uncomfortable the bunny seems.

[jerseygirl]

To your original question and spondylosis, some additional therapies that might help are cold laser therapy or even acupunture.  It would be ideal if a  practitioner could give the therapy in the home, so you can avoid stressing an animal taking them to a clinic. During a pandemic, home visit are obviously not an option!  Or with cold laser, it would be great if there were some courses for home use. Anyway, here’s a little about cold laser from Georgia House Rabbit Society. https://www.houserabbitga.com/cold-laser-therapy-rabbits

ETA: Very interesting about the grapefruit thing!! I’d never heard about that before. Good to know.

ETA2: ” One thing I wonder if you’ve seen before, that he does and Athena did too: if I do a gentle massage over their lower back / hip area, they’ll start licking anything in sight (or their own shoulder) for a little while, but then after maybe 10-20 seconds of that, hop away with maybe a foot flick.  To this day I’m still not sure if they like it or find it annoying!  If you or anyone has a clue on this, I’d be all ears.  🙂” 

This might be the Lick reflex…  I do not know if this is an official “thing” but I do know it’s been mentioned on the forum a time or two. There is a spot around the hind end that if you scratch it, it can often make the bun lick things or even groom you.

 

[Ollie’s mom]

Oh wow I’m beyond grateful I read through this!!!
I have been giving my dog meloxicam for months for his arthritis and added CBD in the mix for pain relief (and gave Olive that combo yesterday as well)

After clicking one of the links above and a quick google search Meloxicam should NOT be given with CBD!!! I had no clue! Both the dog and rabbit vet said nothing about the possibly fatal effects of this. I’ll be stopping the CBD ASAP.
I wish I could figure out if there was a safe time I could give it between doses but I can’t quite figure that out.

[Meg]

Thank you soooo much, Kate!!  It makes me so happy to hear from you, and I so appreciate your kind encouragement and advice.

That’s great about your Zantac syrup!  Teddy’s always on meloxicam (due to spondylosis) so he’s always on famotidine too (now that we can’t get Zantac around here).  I think someone had commented that yes, famotidine can also have a synergistic effect with motility meds, though I’m not sure if it’s as much as Zantac’s.  The thing is, we haven’t had success weaning Teddy off cisapride since April.  It could be a coincidence, but he’s slowed or temporarily stopped eating each time we’ve attempted to taper it off — and that’s with the continuation of famotidine.  I’m not ruling out that it was a coincidence — we did wean verrrrrry slowly so there was plenty of time for coincidences in there.   Or maybe that’s just age per se, but it’s not like him to do that so often (every few weeks).

I’d never heard of cold laser therapy — so cool!  You’re right about the restrictions that covid and Teddy’s extra-strong car aversion bring.  But I found some not-too-crazy-priced home devices on Amazon.  I haven’t had time to sort through the reviews (which so far sound too good to be true) but will revert once I have a chance to do that.

Ollie’s mom, I didn’t know that meloxicam & CBD was that serious!  I’ve read mixed things in my search, and nothing as concrete as the cisapride thing.  If it weren’t for Teddy’s seeming to need cisapride perhaps chronically, I’d be tempted to experiment with CBD instead of meloxicam maybe.

I’m with you on wishing there were a safe way to give it!  Once I hear from the vet I’ll share what she says.

[Meg]

Hey everyone!  I finally got to talk with the vet today so I’m coming back to update. Short version: I’m not worrying about the milk thistle in this case, but am not sure when/if I will go back to CBD given the possible medication interactions.  Here are more details:

The vet explained that the milk thistle / lactulose compound they gave us has like 5% or less milk thistle, so the tiny amount is unlikely to be a problem.  Also, what research I could find indicated that while milk thistle could slow the liver enzymes that metabolize cisapride (mostly CYP3A4 , which is in the P450 family) in vitro, they actually haven’t found that in vivo.  In other words, in living beings, milk thistle doesn’t seem to have a big effect in terms of interfering with drugs (from what I understand — I’m not a physician).

There’s really not much known in terms of how CBD specifically affects cisapride in terms of side effects, so I just asked more about this arrhythmia issue re: cisapride.  The vet said she hasn’t known it to be a concern… she said they do sometimes administer cisapride prior to a surgery during which they have the bunny hooked up to an EKG.  And the dosage from that one study where the arrhythmia was induced in 2 bunnies that already had heart failure was 60% higher than what Teddy was prescribed.  My personal interpretation of this, pending any better research, is that it’s worth making sure we *really* need the CBD before resuming it.  But if it does seem really necessary, now or down the line, I wouldn’t totally rule it out (e.g., if it’s the only thing that keeps him drinking enough water, or out of stasis).

If it comes to that, I might try a much lower dosage of CBD than even the 1mg per day he had been getting.  I use it myself for my own chronic pain and I finally did the math to realize that a low dosage of 0.13mg per kg can be enough to make a difference for me (though .25mg per kg is a common dosage in humans).  Teddy is 1.5 kg, hehe, so that’d be really just 0.2mg per day (not 1mg), or 0.4 for the more common dosage — though admittedly I don’t know if it makes sense to try to convert dosages between species!  But if Teddy seems to really need CBD down the line, I’ll try mixing that 1 drop of hemp oil (which in the version we have has 1mg CBD) into like a teaspoon of pellets again, but then split those pellets into 5 servings, and see if 1 serving a day is enough.  If not, I’ll try 2 servings a day.  (If we do decide to cross that bridge, that is.)

Meanwhile, I’ll try one more time to tempt him with a little pineapple juice in his water bowl (fruit juice has had no appeal for him so far, though), and we’ll see how he does with that once he’s off fluids.  I asked the vet if anything else promotes drinking without dehydrating, but she said there had been no research on dry mouth in bunnies that she knew of. 😉  Haha, guess that makes sense!

Thank you all so much again!!  🙂

p.s. I might re-post the CBD info in a separate thread sometime soon, since the potential medication interaction issues don’t appear here until rather further down from the part where I first discussed our good experience with it.

 

[Hazel]

Thank you for the update! 🙂

I’m glad the milk thistle isn’t going to create a problem, that’s a relief. It’s too bad about the CBD, but I get why you want to hold off on it, better safe than sorry. It’s unfortunate that we can’t make use of something that could be beneficial because we haven’t done the research, and at the same time they won’t lift the restrictions so research can be done because it hasn’t been proven to be safe. 🙄

I hope Teddy will keep doing well, how is the pineapple juice working out?

[Meg]

Thank you so much, Hazel!!  I’m totally with you on that, and hope that more research is allowed soon.  Caution is good, but that much just isn’t warranted in this case.

But wonder of wonders, Teddy is drinking water on his own!  He seems recovered now, knock on wood!  😀  So I haven’t tried the pineapple juice yet.  And although he isn’t sleeping as soundly as he did on CBD, he seems pretty happy, so we’ll just hold for now (he’s off milk thistle/lactulose so now just seeing how much tapering of cisapride we can get away with, while keeping the meloxicam and famotidine which he’s on chronically, and the simethicone as the trojan horse for his cisapride).  😉

Thank you so much again!!  🙂

[Author]

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