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Friday, August 31, 2012

Rabbit, Heart So Bright: Caring for a Disabled Rabbit

 Glenna the Good


Caring for a Disabled Rabbit

Rebecca had to wear diapers during the time she was disabled because she was incontinent. She was very comfortable in them.
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Recently I was conducting an adoption through the shelter where I volunteer and brought up the subject of what it's like when a rabbit becomes disabled and how to care for them at that point. The adopter asked, in all innocence, "Is that really humane?" That question had never really entered my mind. So many of the 'rabbit people' I know have dealt with disability in their rabbits with so much success that I had never really stopped for a minute and thought about this question.

So I did stop that minute and thought about it. Yes, of course there are times when we must carefully weigh the quality of life for our companion animals but quality of life is measured in many different ways. When you have companion rabbits or 'house rabbits' (as opposed to hutch rabbits or livestock rabbits) and they start getting older and possibly become disabled, this happens most often because you have invested a lot of time and energy and usually money into their welfare and well being and they have the luxury of growing old (see my article on extending the life of your rabbit) - something a wild rabbit does not usually experience.

Measuring the Will to Live

A rabbit who is happy and has a will to live is one who eats with gusto. A rabbit who is sick or has given up on life, does not eat and simply waits to die which happens quickly when their intestinal tract shuts down. Many times during a long-lived rabbit's life will an owner find themselves force feeding or 'assist feeding' their rabbit through a period of illness. However, a rabbit who truly has lost their will to live cannot be successfully assist fed; they just let their mouths hang open and as soon as you syringe feed some food into their mouths, they just let it come right back out. When this happens, you know your rabbit has given up and does not want to live. Critical Care, manufactured by Oxbow Hay Company, is a special prescription formula food designed for assist feeding rabbits and other herbivores during periods of convalescence - usually before and after surgery. This formula contains special appetite stimulants and probiotics (as opposed to antibiotics) to encourage the rabbit to begin eating on his own again. If a rabbit has truly 'signed off,' this will be unsuccessful. A rabbit who cannot be encouraged to eat will take his own path to the other side and there's not usually much the best veterinarian or most caring owner can do about it.

So if you find yourself with a disabled rabbit who eats his hay and veggies heartily every day, maybe needing to be assist fed for dental reasons or possibly a temporary tummy ache, then you know that your rabbit has a will to live and wants to stick around and enjoy whatever special accommodations can be arranged for him. So, yes, it's humane and in fact, it's an implicit contractual understanding called domestication. The mutual benefit of domestication is what we have to remember here. For domesticated companion rabbits, the benefit to humans is that we have a steady and faithful, often entertaining, friend, whom we love. The benefit to the rabbit is longevity achieved through safety from predators; basically, we remove them from the food chain and put them on a pedestal. They like this, even relish it and their eating habits are the main indicator of this.

When Rebecca started to regain the use of her hind legs, I extended her quarters to include a waterproof-padded area with additional litter boxes.
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When is Life Extension Not Justifiable?

Now that I've established that life extension for a disabled rabbit is humane, I should add that it can be taken too far which was most likely the concern that my adopter was expressing. This adopter is a great and wonderful rabbit lover but she also has the presence of mind to be able to stop and think for a second, 'wait, is this a good idea or would I just be doing it for my own emotional needs and disregard the desires of my animal?' After all, the thing about death is that it usually is a long, drawn out process involving much suffering and many people and animals show signs of wishing there was a way to ease the transition involved and minimize the pain. That's why veterinarians practice euthanasia after all, to bring dignity to this process. Deciding when it's time to call it quits is an art form many of us spend a lifetime learning.

For the most part, rabbits who are suffering and have no will to live usually pass pretty quickly without any need of assistance. Many rabbit owners have experienced the horror of sudden death - a phenomenon in rabbit keeping - and have not had the luxury of practicing life extension for their rabbits because, as prey animals, they hide the symptoms of their illness so skillfully. With the exception of a few conditions, rabbits will pass pretty quickly once they've contracted a painful, terminal condition. One condition, however, that rabbits do tend to struggle with causes partial paralysis and this is the protozoan blood parasite, e. cuniculi. The very initials, e. c., strikes dread into the heart of a rabbit lover. It is estimated that half of all rabbits carry this parasite in their blood but not all of them show symptoms of infection which include paralysis and other neurological signs such as head tilt, rolling eye, and wobbly gait. The ones who show no symptoms are said to have a sub-clinical infection or one that is unobservable through symptoms; aka 'asymptomatic.' Many rabbits stricken with clinical infection from this disease find themselves with no or very limited hind end mobility or partial paralysis. We will focus on mainly this type of disability in this article for it is by far the most common.

Rebecca was a stray rabbit who lived outside for several years. By the time we caught her, she was ill and soon became disabled.
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On the Road Again

There are several companies who manufacture pet wheelchairs for animals with no hind end mobility. When my Sanctuary rabbit, Rebecca became partially paralyzed with e. cuniculi, I special ordered a wheelchair for her (see photo) from Doggon' Wheels. Other companies who manufacture similar products include K9carts, and Dewey's Wheel Chairs for Dogs. It can be difficult to accurately measure a partially paralyzed rabbit for one of these carts because they often tend to be very skinny in the butt. I have known of several rabbits who did very well with these carts and get around famously. Rebecca did not like hers although she was able to get around pretty well with it. She hated it for the most part but it inspired her to get better, which she did. If, in the future, I have another rabbit become disabled in this way, I will get them another cart.

While Rebecca was not in her cart, I made her a special habitat which she would be comfortable lounging in. An inexpensive under bed storage bin from Walmart became an extra long litter box. I put about 2 inches of aspen bedding in it and then placed artificial sheepskin atop the litter. The purpose for doing this was to keep her from being stuck in the same spot she had just peed in. The artificial sheepskin is porous and liquid flows right through it while remaining dry. So it made an excellent diaper surface for the litter box and protected her sensitive skin from urine scald which is a big concern for incontinent rabbits. She did suffer some urine scald at first while I was learning how to best care for her and also required daily butt baths for a while.

I bought her a baby bathtub for the sink and every day I would wash her bottom in warm water using a bit of hand soap and gently clean off the urine and poop that would become stuck to her bottom. I used a hair dryer on cool setting, so as not to burn her skin, to dry her bottom and also used lots of plushy towels. Sore, chapped skin on her bottom was soothed with Aveeno Diaper Rash Cream. It was easy to see the look of relief cross her face when the cooling diaper rash cream was spread on her tissue-thin skin.

This special litter box was setup to accomodate Rebecca's needs. The fake sheepskin allowed urine to pass through while it stayed dry.
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Living Large in the Litter Box

In case she didn't feel like lounging in the litter box all day, I special ordered her a waterproof bed pad which was originally manufactured for elderly incontinent persons. This was the not the cheap waterproof padding you can find at Target or Walmart, I ordered it from a medical supply website. The pads are washable over and over again and protected my wood floors from accidents. When she felt like coming up on the bed to watch a movie with me, she donned a size 1 (4-6 months) Huggies diaper. She poops quite a lot and so the poops in the diaper protect her bottom from urine scald.

Along with providing Rebecca with supportive care during her paralysis, I provided her with the absolute best in exotic veterinary care (see my article on selecting an exotic veterinarian for your rabbit) and I also complemented this top care with alternative medicine by working with a master herbalist (who also has rabbits) who designed an immune system boosting formula which helped Rebecca fight the dreaded e. cuniculi. In addition to both of these, I also performed physical therapy.

During the partial paralysis that so often accompanies e. cuniculi, muscle atrophy takes its toll on the rabbit's powerful hind legs and decimates them. To counter this as best I could, I would lie Rebecca atop a waterproof pad on my bed on her side and stretch and pull her hind legs. I stretched them out as long as they would go and tickled the tips of her toes while I did so to stimulate her nerves and cause involuntary muscle reactions. She made every effort to work with me during this process. Then I would push her leg back in toward her body with the palm of my hand, encouraging her to try and push on my palm with any strength that she had. She slowly developed some strength in her muscles from pushing on my palm. After about 6 weeks of antibiotics, herbal formula, physical therapy, and some inspiration from the hated wheelchair, Rebecca started taking little hops on her own. Two months later, she was hopping on the bed unassisted and proudly surveying the room from her perch.

Hoppily Ever After

She would go on to hop all over the house, albeit a little clumsily, for another two years and then she had another bout with e. cuniculi; this time causing head tilt. She was put on double antibiotics, steroids and herbal formulae again and again she triumphed, now no longer showing any signs of head tilt. However she does clomp around a bit more clumsily and her hind end mobility is again on the decline. She has developed a pressure point on her right hip from leaning just a bit to the right when she hops. This hip hits the floor each time she does her little old lady hop. An abscess nearly developed on the site of this pressure point and so she occasionally wears diapers now to cushion her bony butt and protect this pressure point from callusing and developing an abscess.

Here, Rebecca has hopped on the bed on her own and kisses her human daddy.
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I imagine old Rebecca, who had been living as a stray for several years in our backyard when we bought our house, and another few more until we caught her, still has quite a few hops left in her. Through all of this, she has eaten heartily and with gusto. She is an inspiration and is a dear friend. We like to watch chick flicks together. We like happy endings. It is all very humane.

P.S. IMPORTANT POSTSCRIPT: When caring for a rabbit in this manner, it's imperative that they be assist fed their cecals if they are unable to reach for them on their own.

 -Thumper S. Thompson
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