NEED ADVISE euthanasia decision

[jorie]

HI everyone, I’m new here and I hate for my first contribution to be as depressing as this one. My rabbit Peter is a 5-year-old unaltered flemish giant. about 4 weeks ago he presented to me with a slight head tilt to the right and his hind legs were giving out on him, specifically his left side. I didn’t notice him having any sort of seizures or anything leading up to this but it is possible because i do work nights as well as being in nursing school. I brought him to my vet where we did a workup of an x-ray, blood work and the horribly expensive e.cunniculi test. His x-ray in the vet terms was boring, there was no tumors or masses and nothing wrong with any joints or his spine that he could see. His blood work also came back, all in the normal range and we got the e. cuniculi test back from Miami which was also negative.

 for the next two weeks, he was placed on meloxicam 0.85mg BID (twice a day) and it helped a little bit. his head tilt resolved and he was more active but was still struggling with his hind left leg. 

we went back to the vet after the two weeks for a checkup and because we didn’t do cytology, he was placed on a antibiotic that would cross the blood-brain barrier to try and see if it was meningitis which I understand is not well studied in rabbits.although, my vet believes and is leaning towards it being more neurological. he was also placed on another round of the same meloxicam dose. 

however, this time around I have noticed that the antibiotic isn’t really doing anything for him and neither is the meloxicam. Peter tries to move around but it’s like his left hind leg is not there to him and now it is affecting his right hind leg. Sometimes he is able to wobbly hop to me and other times he cannot get his back legs to move and sort of gives up a lies down. He has also started to not use his litter box and I have been having to frequently clean his back left side of cecotropes that he has lied down on. He also seems to have given up on grooming himself because he cannot balance well enough to do so. He is eating and drinking fine.

Its a dilemma to me because I see my lovely boy eating and drinking and being affection but physically there is not much there for him. my vet suggested seeing another vet 1.5 hours away but because of nursing school during the day and working night shift, I do not have the time or the money to see another vet. I know that the life expectancy for flemish giants is 5-7 years, less if he is unaltered so my poor little old man is definitely up there. Im not sure what to do. he doesnt give any indicators to me that he is in pain but im not quite sure really how to tell if he is. I dont want to see my once active baby like this, its not a goood quality of life but i also dont want to put him down. 

I need to hear opinions of what you all would do in this situation. He has another appt in 1.5 weeks to decide where we are headed with treatment and what not.

[Muchelle]

Hello, welcome. Sorry you’re going through this.

Just to be sure your vet has excluded every other possible cause than a neurological disorder: have inner or middle ear infections been ruled out? X-ray was showing healthy cartilage tissue in his joints?

[foreverfluffle]

On Facebook there is a page called “The Fluffy Group” starring three bunnies (Arnie, Grizi and Maple). I don’t know the details, but something very similar sounding happened to Arnie. You might want to check it out and maybe message them; I’m sure they will have good advice.

[LBJ10]

Oh no, poor baby. Did you try treating for EC just in case? EC tests are notorious for producing false negatives. I only ask because we have witnessed cases here on BB where EC was suspected but the test came back negative. They treated for EC anyway and the bunny improved. If you’re running out of options, so to speak, then it wouldn’t hurt to at least try.

[jorie]

Posted By Muchelle on 3/18/2018 7:04 PM

Hello, welcome. Sorry you’re going through this.

Just to be sure your vet has excluded every other possible cause than a neurological disorder: have inner or middle ear infections been ruled out? X-ray was showing healthy cartilage tissue in his joints?

The vet inspected his ears and ruled out infection as he well as him not showing any signs of an ear infection. he reviewed the xrays at both visits to make sure but there is nothing wrong with his cartilage or bones. he does not have any inflamed joints anywhere. the vet believes it is more neurological but he doesnt have the ability to do an mri nor am i able to pay for one

[jorie]

Posted By LBJ10 on 3/18/2018 11:02 PM

Oh no, poor baby. Did you try treating for EC just in case? EC tests are notorious for producing false negatives. I only ask because we have witnessed cases here on BB where EC was suspected but the test came back negative. They treated for EC anyway and the bunny improved. If you’re running out of options, so to speak, then it wouldn’t hurt to at least try.

we did not treat for the EC because his symptoms didn’t completely fall in line. and because it came on so suddenly, the vet was leaning towards him having a stroke. i can ask at the next appt whether to try and treat in case of a false negative though but currently he does not show any symptoms of EC besides the hind leg partial paralysis.

[jerseygirl]

Im sorry to hear this Jorie. {{{Peter}}}

Is the 0.85mg metacam the full dose or is this 0.8mg/lbs or kgs? I wonder if there is room to increase the anti-inflammatory med? Or if you and the vet think a few shots of a corticosteroid would be worthwhile? (Not while on the NSAID) Care needs to be taken using steroids as they can suppress the immune system. The commonly used med for EC also has risks. So it’s a bit of a balancing act using these in the hopes of treating the condition but not over-using where it will cause damamging side effects.

[jorie]

Posted By jerseygirl on 3/18/2018 11:49 PM

Im sorry to hear this Jorie. {{{Peter}}}

Is the 0.85mg metacam the full dose or is this 0.8mg/lbs or kgs? I wonder if there is room to increase the anti-inflammatory med? Or if you and the vet think a few shots of a corticosteroid would be worthwhile? (Not while on the NSAID) Care needs to be taken using steroids as they can suppress the immune system. The commonly used med for EC also has risks. So it’s a bit of a balancing act using these in the hopes of treating the condition but not over-using where it will cause damamging side effects.

the metacam is the full dose of 0.85mg twice a day so in total he is receiving 1.7mg a day. he currently weighs 14.5 pounds so im not quite sure the safe dose range for his weight. We have not discussed a corticosteroid but I do not want to put him at risk of further disease by lowering his immune system.

[LBJ10]

We have had abnormal cases here on the forum as well. For example, there have been bunnies with EC infections and their only symptoms were urinary. I would definitely discuss it with your vet. It might be an option if you’re running out of options, if you know what I mean.

[Deleted User]

I totally agree with LBJ! Please don’t rule it out as a possibility. Bombur just finished a 28 day course of Oxibendazole for EC, and his only symptom was that he would take out the hay from his hay rack and pee in it, then sit in it all day. We tried two weeks of antibiotics, that didn’t work, so my vet tested for EC and it came back very positive. She told me that often times it still will come back negative, even if it truly is positive, so she’d prefer to treat it anyways. You could ask about doing a 28 day course of Panacur or the Oxibendazole. The Oxibendazole actually crosses the blood-brain barrier. We saw amazing results in Bombur after only 1 week on treatment.

[Gordo and Janice]

So sorry you are going through this. It does appear you still have some options from all those above. Very knowledgeable they are! Thank goodness. But in the event they do not achieve satisfactory results then you do start thinking of the end game. Very agonizing we know.

I was told simply that if they continue to eat and drink, continue to give and/or receive affection, and show interest in their environment then there is strong reason to believe there is still significant enough of quality of life. Especially if they are not in pain.

It is disconcerting at the least to have to watch your little one gradually lose quality of life a little at a time. And it becomes more work to have to continually clean there bottoms and cages on a regular basis as their health deteriorates. But at the end of our time with our little girl those delicate moments of holding her and cleaning her (my wife did that, because little Icey didn’t allow me to pick her up, that was definitely her thing with Mommy) and more holding her, we actually became even closer to her and it seemed her to us, as if that was even possible. Janice cherishes those times because Icey was so endearing with her mannerisms as Janice worked to clean her up and dry her afterward.

We were told that as her parents we knew her better than anyone and would know when the time was right. And even though it’s not necessarily that clear cut, because there were a couple of times close to the end we really wondered and almost made the decision, I think you will know. Fortunately she kind of made the decision for us. We all do our best and with love being the overall guiding factor it will be the right thing at the right time.

My heart goes out to you. It seems like just the other day, just last week, one month ago everything was fine. Life was good for everyone then all of a sudden everything has changed.

Thanks for being so good to Peter. It sounds like you are doing all you can. No one could ask for more.

[LittlePuffyTail]

Sorry to hear your bun is poorly. I can share my own experience which may be of some help. My Mini-Lop Bindi came up very suddenly with a very slight tilt and wobbliness. He was also eye scanning. Vet suspected EC and told me (which I’ve also heard from numerous other sources) is that EC tests are not very conclusive so she opted to skip the test and start the treatment. Within a couple of weeks he was back to normal.

I would def mention it to the vet. I don’t think the treatment would cause him any harm, at least.

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