Kidney Failure and Arthritis

[Cheeko&Abby]

I have 2 bunnies, Cheeko (10.5 years, black/brown) and Abby (9.5 years, white), I have had them both since they were around 1 year old. Until February of this year, they were both in great health. I noticed Cheeko was developing cataracts and I know that can be a sign of E Caniculi so I took him to the vet for a checkup just to confirm they were nothing to be concerned about. The vet said they were normal cataracts but noticed some arthritis in his hips and suggested lowering his litter box to make things easier on him, which I did.

Fast forward to July, Cheeko’s head began to tilt, he became completely blind from the cataracts and he started to look really stiff when trying to move around. He would struggle to hop into the lower litter box (it’s a large litter box for incontinent small dogs) and was constantly stepping in his cecotropes and poop, meaning I had to start routinely bathing his feet (which he hates). I took him back to the vet and they tested his blood, urine and stool. They found yeast in his stool from a gut fungus, said the head tilt was from an ear infection and told me he has chronic renal failure. We were given Enrofloxacin for the ear infection, Fluconazole for the gut fungus and Meloxicam for the arthritis. I understand that Meloxicam can cause kidney damage over time, but the vet and I agreed that our goal is to keep him comfortable, since he’s already a senior.

At our check-up 2 weeks later, the head tilt had not improved, so the vet gave us another round of Enrofloxacin and also Panacur just in case it might be E Caniculi (7 days on, 7 days off, 7 days on). After those treatments ended, Cheeko has just been on the Meloxicam and it seems to help with his mobility. He still has the head tilt, but only slightly. He is still very stiff and pees all over their pen instead of in the litter box like he used to, so I lay towels in the pen to add some cushion for his joints and they are easy to replace multiple times per day when they get soiled.

My reason for posting on here is over the last few days I have found him lying on his side, unable to get up. Once I pick up his back end, he is ok standing and can maneuver his way around and even make it into the litter box. This morning he was lying in a puddle of pee and poop which made me really sad. I know he is declining but I thought we’d lose him to kidney failure before the arthritis got worse. It’s so hard watching his little boney body slow down and I don’t want to euthanize him since he still has a great appetite and he and Abby still groom each other. I think he still WANTS to live but I don’t want to be unfair to him.

Has anyone else had any experience with kidney failure and/or arthritis in elderbuns? I know 10.5 is a great age for a rabbit and I can’t expect him to live many more years, but I was wondering if there is something more I can give him to ease his pain other than just the Meloxicam. Any input or advice is appreciated. Abby is 9.5 and although the vet said she’s a little underweight, she still hops around happily and has no health concerns.

[DanaNM]

Oh I’m so sorry.

Are you sure EC isn’t at the root of these problems? I also believe the Panacur treatment for EC is 28 days. I’m not too sure on any additional medications, but others will hopefully chime in.

I think it’s important to consider quality of life, as you are doing. I know of some paralyzed buns that still seem quite happy. Our shelter has one in sanctuary care that lives in a play pen filled with hay and soft bedding, that she can burrow around in. She gets cuddles on the couch every night and seems quite happy and relaxed. The fact that he’s eating well and grooming with his mate makes me think he is still doing OK.

There are ways to make his environment more comfortable for him. You can add rolled towels as bolsters for him to lean on, and line his area with puppy pee pads to absorb his urine.

Check out this site: they have lots of housing ideas (and other advice) for disabled buns: http://www.disabledrabbits.com/

Again, so sorry you are having to go through this. My bunnies are seniors too, so I know some day I’ll may have make similar decisions

. . . 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]

I’m so sorry to hear about your bunnies’ struggles. It sounds like they’ve been lucky to have such a caring human all this time.

When my bunny had kidney failure, the vet took her off Meloxicam and put her on Tramadol, so that might be something to ask about. (Admittedly I don’t know how long the vet planned to keep her on that or if it was just to get her through till she recovered from stasis – she was in extra pain.) They also gave a lactulose / milk thistle solution for her kidney and liver failure, and saline solution to give subcutaneously as she wasn’t drinking enough.

She also had arthritis according to the X-ray but she responded well after I started giving her 1 Sherwood Joint Support tablet each evening. It wasn’t as severe though — I just noticed about a year ago that she looked slightly stiff when she hopped, and then after starting on this she seemed more normal.

My experience is pretty limited, so I’m sorry I can’t be more helpful. I know some bunnies get little carts when their hindquarters are no longer mobile? In any case, sending much love and healing vibes to you and Cheeko.

[Cheeko&Abby]

Thank you both for your replies, I have been reading so many things about kidney failure that I didn’t really research the stages of arthritis. I will definitely check out the Disabled Rabbits website, thank you so much! This morning I have been shopping for bed pads for him to help his joints. I haven’t tried puppy pee pads since I’m worried Abby might chew them up since she’s a lot more mobile than Cheeko, but I will try hiding them under the towels I’ve been using.

I have been giving both bunnies the Oxbow Joint Support hay tabs daily and Cheeko seems to like those, but the only difference I really see is shortly after I give him the meloxicam in the mornings. I will ask the vet about Tramadol and the lactulose / milk thistle solution, I wonder why those options weren’t suggested by the vet. I live near Phoenix and there is only one rabbit vet locally (about a 30 min drive) and they are an avian and exotic pet vet, so they get a lot of reptiles and birds. I know they are knowledgeable about rabbits but I feel like they have more interesting cases to work on and since he’s old they might not put as much effort into his care as some of the other animals. I’m sure that’s just my perception of it, but after his head tilt didn’t fully get better they didn’t recommend ear drops or anything else to help – like oh well, his ear is still messed up but he’s old so it’s ok.

Dana, I read the same thing about Panacur – that it was a month long treatment…unless that’s what it was technically (7 days on, 7 days off, 7 days on, 7 days off)? Does that sound right to you? He shakes his head sometimes which is why I think it’s still his ear, I will call the vet and ask if they can give me anything else without me having to stress him out by driving all the way back there.

Meg, I’m so sorry to hear about your bunny I am dreading the day I have to say goodbye to mine. Fortunately Cheeko is drinking a ridiculous amount of water (another reason I originally took him to the vet and got the kidney diagnosis) so we haven’t had to do the sub q fluids.

I also weighed him yesterday since the vet recommended I weigh him periodically to make sure he doesn’t lose a lot more weight and he’s lost 500g (approx. 1 lb) in the last 3 weeks. That alarmed me since he’s been eating and drinking normally so I don’t understand how that could happen. I am kind of hoping he slips away peacefully one night so I don’t have to torment him with more car rides and vet visits when he’s already fragile, but I’ve read that as kidney failure progresses they can start having seizures and you end up having to euthanize them. Meg, didn’t your bun pass away at home?

Thank you again for your replies, it helps me feel less alone in this.

[DanaNM]

Hmmm, that could be correct regarding Panacur, I’m not familiar with it personally. Maybe a member who’s had an EC bun can chime in.

Since you notice an improvement after his Meloxicam dose, you might ask you vet if you can split the dose and give 1/2 every 12 hours instead of once every 24. The residence time of the medicine is I believe somewhere around 8 hours, so some vets will prescribe a lower, but more frequent dose.

The wet loss is something to pay attention to. You can try giving him extra critical care to try to keep his weight on and make sure he’s getting enough nutrition.

(((Vibes for Cheeko)))

. . . 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.  

[Cheeko&Abby]

Thanks for the tips. He loves the apple and banana critical care so I’ll start giving that to him. The paralyzed bunny you talked about sounds like she has a pretty good life! Is she a senior who slowly became paralyzed or has she been that way for a while? Is she on any pain meds?

If I can get the pain under control Cheeko might start to gain some weight back. I feel so helpless watching him decline and I keep trying more things to make him comfortable. In February, the vet also recommended giving him alfalfa pellets instead of timothy and adding some alfalfa hay to the litter box with the timothy hay to help him gain weight. He did gain some weight initially then it leveled out. I have also read that the protein in alfalfa is damaging to the kidneys, so it seems like everything I’m doing for his weight gain and pain is pushing his kidneys even more They still get their morning greens, romaine, parsley, cilantro and a baby carrot but this morning he didn’t eat as much as usual, usually he clears both bowls leaving Abby hungry lol.

I just called the vet’s office and asked about Tramadol, they said they will talk to the vet and call me back. Maybe a combination of both meloxicam and tramadol might help with his pain more. They tried lowering the meloxicam dose after his first 2 weeks on it and the half dose didn’t seem to do anything, even for a short period of time so it seems like he needs the higher dose even if its twice a day.

[DanaNM]

The paralyzed bun has/had EC. She is really a sweet heart, was even snuggling into me petting her even though she had just met me. I’m not sure how old she is, but I don’t think she’s a senior.

Her foster mum does keep a close eye on her quality of life, they definitely don’t want her to suffer. You can tell by her relaxed ears, breathing, and facial expressions that she isn’t in pain or in discomfort, and is very content to snuggle with her mom.

. . . 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.  

[LittlePuffyTail]

I’m so very sorry for what you and your bunny are going through. I dealt with a situation where my elder bunny was declining and it’s very hard.

Dana is right in that Panacur is a 28 day treatment. My bunny with EC did the treatment and it cured his head tilt. I was giving him the meds everyday. Never heard of a vet prescribing 7 days off and then on again.

As for quality of life, my vet told me to consider the following: 1) is he interested in food? 2) is he interested in his environment? 3) is he still interested in giving/receiving affection? (if he’s normally affectionate with another bun and/or his person). Once one of these things is no longer relevant, you need to re-consider his quality of life.

[Cheeko&Abby]

The vet gave me tramadol to give with the meloxicam for his arthritis pain. Hopefully it helps him move around a little easier. I also found out the vet does house calls, although they’re more expensive and have to be planned in advance, still good to know.

I’m just not sure what to expect or how quickly he’ll decline. The chronic kidney failure was diagnosed in July and they said when the blood test shows kidney failure, the kidneys have already lost 65% of their function. With his 500g weight loss in the last 3 weeks, I really don’t know if he’s going to decline faster now or if he can bounce back.

One person said their bunny lived almost another year once kidney failure was diagnosed, but I didn’t factor arthritis into the equation. Today he seems good, and I haven’t started the tramadol yet so maybe there’s hope

[Cheeko&Abby]

Also the answer is yes to all 3 quality of life questions, which makes me feel better. I think with the weight loss and head tilt/shaking his head I’ll have to take him back to the vet, I feel like his ear infection didn’t clear up fully and that even though EC could be the problem, I’d like them to check his ears again first.

[LittlePuffyTail]

The best thing to do is to just take care of him as best as you (and your vet) can and just focus on one day at a time. Give him as much love and attention as you can and try not to think about the future. Hard to do but it’s best to stay focused on the present and just enjoy the time you have with him.

[Cheeko&Abby]

I took Cheeko back to the vet on Wednesday due to the weight loss, head shaking and because he hates the tramadol. I was hoping they could give me ear drops instead of antibiotics and maybe a different flavor of tramadol (the one he has is crushed up tramadol in strawberry daiquiri flavor) because it doesn’t seem to hide the bitterness enough.

The vet pulled a lot of wax out of both ears, but said they didn’t look too bad at the base. When doing the physical exam, the vet found a small pimple on Cheeko’s chin that he squeezed pus out of. He said his concern is if he has pus in his chin, it might be at the base of his ears as well, but since he is so old they wouldn’t recommend operating on him to remove it. He thinks it’s Pasteurella caused by his compromised immune system, combined with the kidney failure and old age. He still also thinks E Cuniculi is probably the cause of the head tilt, not necessarily an ear infection, so has put him on another round of Panacur as well as 30 days of antibiotics (on top of the meloxicam and tramadol). He said next time I get the tramadol refilled, ask for pina colada flavor to see if he likes that better. For now I’ve been mashing up a banana and putting the tramadol in that.

The last 2 mornings (Friday and Saturday) I have found Cheeko lying on his side flailing his legs like a bug that’s stuck on it’s back. He can’t get up once he lays down. I work from home, so have been lucky to be able to check on him every time I’m up and it happened again this afternoon. This time he wasn’t flailing, he was just breathing quickly. I gently helped him back up and he went back to eating and snuggling with Abby.
Now I’m feeling like any morning could be the morning I come out to find him gone I hate seeing him this way, but once I pick him up from his side, he SEEMS like he’s alright, although he’s a little wobbly, like his back right foot is too stiff and is tucked under too far.

If anyone has any input or advice on what I should do, or what I can do help him more, I would really appreciate it. He is 10.5 years old and obviously declining but the vet said he didn’t look any worse than last time he saw him in July. The vet also said I’ll know when it’s time to say goodbye, but I’m still hoping he’ll pass away one night peacefully in his sleep :'(

[LittlePuffyTail]

I’m so very sorry to hear he is not doing well. I wish I had some advice for you, but unfortunately, I don’t. But here for you during this difficult time.

[Bunny House]

Im sorry you’re going through all of this, I know how painful it is. Have you ever thought about going to a different rabbit savvy for for another opinion? Not all vets think the same, one can say its his time to go while another will say there is treatment to be done and it can save their life.

[Cheeko&Abby]

Thank you LittlePuffyTail, I appreciate your kind words.
Bunny House, I live near Phoenix and our current vet is a 30 min drive from us. I’ll check the list to see if there are other vets in the area. Our current vet seems very knowledgeable about rabbits, but I understand what you’re saying, sometimes things just need a fresh set of eyes. It’s difficult watching him decline while I’m pumping him full of 4 different drugs. There has to be a better way.

[Bunny House]

I know, when Patches got really sick right after he was deathly sick, I took him to a different vet and we were able to save him for a couple of months but his body was tired of fighting. It never hurts to get a second opinion, I always do it with my animals who have complex issues, they can think of different ways to treat incomnination to the other vets too.

[Author]

Messages