Pain Medicine

[Moonshadow]

I found out this morning that my dad accidentally stepped on my rabbit. Min-Min squiggled away before my dad put his full weight down but I think he knocked his chin on the ground and has tooth pain.

One of his bottom teeth is slightly loose and pushed forward a little. He is very gingerly ate a bit of lettuce but hay and pellets seem too much for him at the moment.

Other than tooth pain he seems perfectly fine, hopping around, curiously following us, and licking my leg.

We can take him to the vet but it may be a couple of hours before that is possible if we can even get him an appointment today. Does anyone know if there’s any over the counter medication I can give him for pain in the meantime so he can eat more easily?

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[Wick & Fable]

Unless you have a leftover prescription of meloxicam/metacam, there is no pain medication you can administer at home that would be safe/adviseable. Definitely focus on getting your rabbit to the vet as soon as possible.

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.

[Moonshadow]

We took him to the emergency vet and he was scheduled for a CT scan in the morning. Unfortunately everything went sideways and now he can only get the scan Monday.

He has been put on pain medication but won’t be syringe fed by the vets. We plan to try to take him home for the weekend ourselves to see if the home environment will make him more willing to eat.

If you have any advice, I’d love to hear it. The situation keeps dragging out and seems to keep getting worse.

[Moonshadow]

Thanks for the advice. We ended up taking him to an emergency vet in Massachusetts since every emergency vet in NH we called “wasn’t equipped to deal with rabbits.”

It was a good thing we took him in because he apparently has a broken jaw. He is being held overnight and will have a CT scan in the morning. From there the doctors said they’ll determine whether he needs surgery or can recover naturally with pain medication and a mush food diet for the foreseeable future.

 

[Moonshadow]

The doctor called because he found out they are too short staffed and cannot due the CT scan tomorrow. Apparently the doctor who was going to check him was exposed to covid. The hospital called a bunch of other hospitals around the area and none can do the scan either since they’re all booked and short staffed.

Min-Min apparently hasn’t been eating at the vets office with a syringe so they’ve been giving him nutrition through ivs or something. The earliest they can now do the cat scan is Monday. They’re going to keep trying to feed him and will give us an update in the morning.

At the moment, my family thinks the best course of action will probably be to bring him home with pain medication and try to feed him in a place he’s comfortable with people he knows. We would bring him back to Bulger veterinary hospital on Monday for the CT scan. The alternative would be to leave him at the emergency vets for the weekend when they may not be able to syringe feed him either.

2022 is not turning out to be a good year

[LBJ10]

Oh dear, I’m sorry this happened. I think it would probably be best to try to syringe feed him yourself, as long as his pain is being sufficiently managed.

[Moonshadow]

Thank you, that is what my family thinks too. The vets said if we did bring him home, they’d give us oral medication to give him.

Do you happen to have any ideas on what types of mash a bunny might like?

[Bam]

The easiest food to syringe feed is Oxbow Critical Care or other recovery food. It has both fiber and all the nutrients a rabbit needs. You can soak pellets in water and feed the resulting mush, but it is trickier to make it smooth enough to easily feed with a syringe. I had to do this when Critical Care was out of stock at the onset of the pandemic, so it is doable, but messy.

You can mix for example canned plain pumpkin (not pie filling) with the Critical care or pellet mush. Baby fruit puree is another thing you can mix the CC/mush with, but although there’s no added sugar, the fruit sugar content is high, so only use a little bit.

Pain control is obviously very important, so make sure you get a prescription.

 

[Moonshadow]

We ordered critical care like you suggested it should get here at some point today. I’ll just hope for the best and see if he eats with us. As long as he eats he’ll have a chance.

Of course, I found out we are getting a 10 inch snowstorm on Monday when the new ct scan would theoretically be scheduled. We’re just going to take everything one day at a time…

Really hope he can bounce back. Min-Min is only one year old as of December 20, healthy, and had no issues prior to this incident.

[Bam]

It all depends on how bad the break is. If it’s an uncomplicated break, it could heal, we have had examples of that here before. As you’re saying, getting him to eat is the most important thing now, and one day at a time is a very good principle!

[Moonshadow]

We finally have good news. The vet called and said she was able to get him to eat. She feeds him and he’ll eat for a few minutes before getting tired of it, then they’ll wait about ten minutes and he’ll be ready to eat again. We are going to drive down and they’ll show us what they are doing then we’ll bring him home. Thank goodness he doesn’t mind car rides it’s about a 45 minute drive.

 

We are going to try scheduling the ct scan for Tuesday instead of Monday so we don’t get caught in the blizzard or have them cancel on us. I’ll keep everyone posted.

[Moonshadow]

We brought him home and on the drive back he kept flopping over in his carrier. When we arrived he “bunny slept” for about 15 minutes then spent his time re-chinning everything.

His first syringe feeding was successful, he didn’t really try to struggle at all. Then he went on to try to chew some cardboard and did eat a strand of hay with a Timothy head on one side of his mouth.

 

[LBJ10]

Oh good! I’m glad to hear he’s doing OK, considering the circumstances. Hopefully the break isn’t bad and will start healing on it’s own.

[DanaNM]

I’m so sorry this happened but very glad he’s improved!

He may eat the critical care off of a plate or spoon as well, since it sounds like he took it willingly!

. . . 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.  

[Moonshadow]

Our bunny got through the weekend well and continued eating from apples,  crushed pellets, and a few strands of hay. (He has never really liked veggies for some reason only ever eaten them as a last resort after regular pellets and hay).

He ended up hating syringe feeding from the apple-banana critical care the doctor gave us so we switched to a papaya flavored one which he likes way better. He had been pooping and peeing a bit every day which we’re very encouraged by and his poop looks like pretty normal round balls. Unfortunately we haven’t noticed him drinking water out of his bowl or bottle so we have been syringe feeding him water or dousing the apple with water.

The snow storm was too heavy Monday morning so we cancelled the cat scan and hoped the vet would get back to us for a reschedule (they never did). More importantly, my rabbit ran out of pain meds yesterday and despite calling a couple times yesterday with the receptionist saying the doctor would call us back, it never happened. So today he is without pain meds. At this point, I don’t know if the CT scan will ever actually happen with the vets not calling us back and reception telling us the doctor “will give us a call.” Even if we got him to another emergency vet, I’m guessing we’d probably get the same treatment with trying to schedule a scan. My dad thinks we’re on our own, and I’m inclined to believe him.

Despite that he is still eating apple and chewing a bit of hay on his own. He is a little more mellow then when he was on the medicine but still hopping around and he didn’t mind eating the papaya critical care. The swelling has also gone down around his mouth.

It have been about 5 days since the accident (Thursday 3am) and Minyeong seems to be doing well overall. I looked at his front teeth yesterday and they also look like they’re in closer alignment than the day of the accident. Hopefully he continues to improve.

Here is a photo of his teeth from yesterday (when he was still on medicam). It’s a little blurry.

[Moonshadow]

Vet finally called and said we could do the scan tomorrow morning. My dad doesn’t want to do it because our bunny has improved and he’s afraid he’ll die if he’s sedated for the scan. I feel it will be good to do the scan to see possible damage and how it will heal in the future but am afraid of sedation too especially because of how my dad’s against it…

[DanaNM]

Usually the sedation for scans is pretty light, so I wouldn’t worry too much about that.

One thing you could ask the vet is, “how would the treatment change depending on the results of the CT scan?”.

Sometimes the treatment may change, and in those cases I think the CT scan is important to do. Looking at your previous post, you said the scan would show whether or not he needs surgery. With jaw issues, the concern would be healing incorrectly, which could lead to dental issues down the road if his molars don’t line up. That would involved being sedated regularly for dental burring.

 

. . . 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.  

[LBJ10]

Is it general anesthesia? Or just a twilight sedation? Either way, the risk is low, especially with a rabbit savvy vet.

His tooth alignment does look better, but I would advise getting the CT scan just to make sure things are able to go back together. He also still needs pain meds. It’s only been 5 days.

[Moonshadow]

I looked at the paper they gave us and it said general anesthesia.

We’ve decided we will take him in and just hope he gets through it fine. At the very least he needs the pain meds for longer though he was a champ today. Eating like normal and bounding around.

[Moonshadow]

He made it through the cat scan well and we have the results.

Min-Min has a symphyseal fracture (incisor separation) to his lower jaw which is why his lower teeth looked misaligned. He also had two fracture lines in his left jaw bone (no broken back teeth). The doctor is not worried about the fracture lines because his jaw bones should hold those together while they heal.

For the incisor separation there were two options. The vet first told us the one she was “required to mention” since their vet hospital is an “innovator and advancer in medical technology (and in magazines and stuff).” The second is one my dad asked about and the one we went with.

First- He’d need surgery and would have a wire keeping his incisors perfectly aligned but they’d be sticking out and kept in for at least 3 weeks. He’d have an attachment between his shoulder blades to keep the alignment, a tube up his nose, and the thing between his should blades would also allow for a daily injection of pain medication. (I heard it second hand from my dad so am not sure if I’m reporting it exactly right but did hear “wires in jaw, tube in nose, shoulder, and daily injection in the phone conversation”).

The doctor also said even as an exotic vet she has never actually performed this surgery. If we did it with our bunny, he’d be the “pioneer,” first rabbit to ever go through that surgery since it’s a “new innovation.”

Second- My dad asked if we could take him home, keep him on pain medication, and take the ‘wait and see’ approach. He asked the vet what bad case scenario would happen if the teeth healed misaligned and she said they might have to do surgery and remove the bottom teeth.  She went on to say many rabbits can live without bottom teeth since they adapt.

We decided on the second (no need for our bunny to pioneer medical technology).

We have taken him home, we’re given pain medication, anti-inflammatory, and more critical care. A veterinary compounding pharmacy will call us tomorrow since they are making an antibiotic for us to help prevent an infection. We are buying a pet scale to monitor his weight and will be bringing him in for weekly checkups so the vets can check his teeth and general health.

He was happy to be home when we got back tonight.

[LBJ10]

I glad you did the CT scan. It was good to make sure there wasn’t any additional damage. It sounds like there was, but it was minor… so that’s good. I’m not sure what you’re describing, but it sounds like they would essentially wire his jaw shut like they do in humans. I don’t blame you for not wanting him to be a guinea pig.

I think the wait and see approach was a good choice in this case. His jaw could possibly come back together and his teeth will be OK. Worst case scenario: His incisors need to be extracted. It would have to be all of them, unfortunately. But the procedure isn’t uncommon for rabbits with severe malocclusion. Rabbits do adapt to it, but they will need their food prepared differently.

[Bam]

I don’t blame you either for not wanting him to be a guinea pig, since this seems like it could heal on its own.

Lots of rabbits have lived long good lives without their front teeth. They primarily use those to pull food into their mouth (and to snip charger cables).

 

[Moonshadow]

Thanks for the support everyone!

We were given medicam, gabapentin, more critical care (papaya flavored this time), and protein powder

Unfortunately I think they gave us too high a dose of pain medicine (gabapentin) .24mls. After we administered it the first day, he didn’t hop around or do anything for 9 hours. He just sat hunched and didn’t have much of an appetite. When he was on no meds the two days before he was active/eating etc. As such we decided to keep giving him meloxicam but not give him the gabapentin.

The day after not giving the gabapentin he pooped and peed a ton, then started running around again, had his appetite back, and lying in the sun again. We have an appointment on Friday so will talk to the doctor about the dosage then.

We ran out yesterday to get antibiotics and another pain med (tramadol) that was being made for us. Because of the sedative affect of the pain med, we’re hesitant to give him this one but may try it once. If he is still fairly active and keeps his appetite (unlike with gabapentin) we’ll continue that one to him. We’re definitely going to give him antibiotics to combat any infection.

Here’s some photos of him today munching crushed pellets (he won’t eat them if they’re wet). Only on meloxicam at the moment.

[Moonshadow]

Thought I’d give an update. Min Min is doing really well. Very active like usual and has even been chewing wood with moderate success. He has been off critical care and pain medicine for two weeks (though we still give him meloxicam). We took him to a vet appointment this past week and our doctor looked him over. She says that he’s healing as well as she could have hoped.

He may have a slight malocclusion of his front teeth in the future from the way it is healing. His upper incisors are a little overworn (where he was overcompensating) while his lower incisors are getting just a bit overgrown (since a lower mandible was where the breaks happened). He will be on antibiotics for another two weeks and meloxicam every other day now till his next follow-up appointment in a month. At that appointment he might need his front incisors ground down a bit but the extra month will give his jaw more time to heal. The vet never mentioned removing his incisors so I don’t think he will need to have that done.

He was very popular at the vets office. Doctors (even non-rabbit ones) and vet techs were asking about him. Guess he charmed them all even though he’s only been there four times~

[DanaNM]

Thank you for the update! So wonderful to hear he’s doing well!

. . . 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.  

[Wick & Fable]

So glad he’s doing well — updates are so appreciated!

Every case is different, but I’ll note that my Wick (also a nethie) has malocclusion which does lead to his upper incisors being shorter than his bottom. He has been able to maintain things fine and no longer needs teeth grinding. I do need to cut his hay shorter so it’s more manageable, and he doesn’t chew hard so he needs smaller strips of food and cannot have harder, large treats anymore (e.g., Science Select Garden Sticks — he’s hurt his mouth twice in eating them).

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.

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