Help! My rabbit is sick and I can’t reach my vet!

Mary E. Cotter, Ed. D., in consultation with Gil Stanzione, D.V.M.

Broken Or Bleeding Toenails

If your bunny has broken a nail, or if you have cut too close to the blood vessel, apply pressure with a clean towel for a couple of minutes, until the bleeding stops. If you like, you can use styptic powder (available in drug stores), plain flour, or even a bar of soap rubbed on the end of the nail to help stop the bleeding. If the nail breaks off right at the base, clean the area thoroughly with Nolvasan (you can get it through your vet), and apply a thin coat of regular triple antibiotic ointment, such as Neosporin (not Neosporin Plus, or any other product that contains cortisone!!!) Try to keep your bunny in as clean an environment as possible until you can see your vet — to prevent dirt from contaminating the injury site. Be sure to see your vet for follow-up care to this second kind of break, since bacterial infection can travel to the bone and cause serious problems.

Broken Bones

Take your bunny to any emergency clinic, so that the bone can be stabilized until you can see your regular rabbit vet. If the emergency clinic needs to anesthetize your bunny to do x-rays or to stabilize the leg, isoflurane is the preferred anesthesia for rabbits. If you cannot get to an emergency clinic, do your best to severely restrict your bunny's movement until you can get to your vet. This will help to prevent further injury. Make sure your bunny has easy access to food and water so that he does not have to move around to get to it.

Runny Eyes

Runny eyes do not usually constitute an emergency, but if your rabbit sustains trauma to the eye, resulting in a serious corneal scratch or ulcer, you should get veterinary treatment as soon as possible. If you can get to a veterinary emergency clinic, the eye can be stained to assess the damage, and the emergency vet can administer antibiotic drops (usually tribiotic ophthalmic drops) or ointment, to tide you over until you can see you own vet. Do not put any medication into your bunny's eye unless it is given to you by a qualified vet for that purpose. Many people attempt to treat their rabbit's eyes with leftover dog/cat/human drugs, often with disastrous consequences. If your bunny's eye is oozing or sticky (often appearing glued shut), you can use warm compresses to loosen the gunk and clean the external area around the eye. Bunnies are usually very appreciative of this effort, and will often tilt their heads to cooperate with you.

Anorexia

The most common causes of anorexia are: 1) teeth problems, 2) gas pain, 3) gastrointestinal problems. When you cannot reach your vet, you can attempt to differentiate the cause of your bunny's anorexia by carefully watching his behavior.

1. Teeth problems:
   
   Your bunny approaches food -- maybe even picks it up and starts to eat it-- but then backs off or drops the food without finishing it. He seems hungry, but unable or unwilling to eat -- even treats. His activity level is more or less normal. When you rub his cheeks, you might see a pain response from spurs on his upper molars. If the problem is not accurately diagnosed and corrected soon, your bunny may start to exhibit symptoms of gas pain or gastrointestinal problems (see below) — simply from not eating normally.WHAT YOU CAN DO TIL YOU GET TO YOUR VET: You can force-feed him (canned pumpkin, baby-food veggies, eg.) by using a feeding syringe. You can give him subcutaneous fluids. If he develops gas from not eating properly, follow the suggestions below.
2. Gas pain:
   
   Your bunny is sitting hunched and still. In some instances, he may stretch out fully, giving the appearance that he is trying to press his belly to the floor. You offer him treats, and he is totally uninterested. Sometimes (though not always) you can hear very loud gurgling sounds coming from his belly — even from across the room. In fact, his gut sounds, heard through a stethoscope, can be deafening. You may hear loud tooth grinding — a sure sign of pain (this sounds quite different from the soft grinding that indicates pleasure; it can sometimes be heard clear across a room). His stomach may (or may not) feel overly-stretched and taut. A bunny with gas pain often has a low body temperature (e.g. 97; normal is 101-103).WHAT YOU CAN DO TIL YOU GET TO YOUR VET: Take his temperature!! If his temp is lower than normal, warm him up! You can do this by offering him a wrapped hot-water bottle or a heating pad, set on low — as long as the wire is well-protected so he cannot chew it, and as long as he can easily move off the heating pad if he gets too warm. (WARNING: Heating pads can cause severe burns and injury when misused. Some vets, who see these injuries frequently, discourage the use of heating pads altogether for this reason. Do not use any setting other than low for your rabbit. The pad may not feel warm to you, but it will to your rabbit!! ) You can also warm him with you own body heat: hold him in your arms, close to your body, for extended periods of time (an hour, or even longer). Give him Phazyme (pediatric simethicone) — two or three 1-cc doses, one hour apart. Give him frequent and long (10 - 15 mins., or as long as he will tolerate) tummy massages, at least part of which can be with his hindquarters raised (as demonstrated at this conference). Take his temperature periodically to monitor the effects of your efforts to warm him.Whatever else you do, fuss over him. There is ample anecdotal evidence (from many HRS fosterers and others) to suggest that bunnies who are fussed over do better than those who are not. You can also give subcutaneous fluids, as discussed by the vets in this conference— around 30 cc for a two pound rabbit, 50cc for a four pound rabbit — two or three times a day — until you can get to your vet. Sub-Q fluids will help to keep him well-hydrated. You can warm the sub-q fluids by putting the bag into a pan of water, bringing the water to a boil, and cooking the fluid bag for several minutes. Test the temperature on your wrist before administering the fluids. Lukewarm is best.
3. Gastrointestinal problems:
   
   Very similar in presentation to gas pain: your bunny sits in a bread-loaf position, unwilling to eat and often unwilling to move. His fecal production will change: his stool will become much smaller in size or he will stop producing stool altogether. His body temperature will usually drop. There may be either loud gut sounds, or an almost total absence of gut sounds through a stethoscope.WHAT YOU CAN DO TIL YOU GET TO YOUR VET: Follow suggestions for addressing gas pain (above): warmth, belly massage, gas-relief if necessary, subcutaneous fluids. For further information, please read the a rticle on GI stasis by Dana Krempels: http://fig.cox.miami.edu/Faculty/Dana/ileus.html WARNING: If there is any chance your bunny has a GI blockage, do not attempt to force-feed him! This will only make the problem worse. Your most important job is to monitor his body temperature, and to keep him as comfortable and as well-hydrated as you can until you can see your regular bunny vet.

Head Tilt

Your bunny loses his balance, and his head starts twisting toward the ceiling; he looks like something out of The Exorcist. He is dizzy, unable to regain coordination. If he tries to walk or hop, he falls over and starts rolling around. In some cases, his eyes dart back and forth very rapidly, and the iris appears to be almost vibrating.

WHAT YOU CAN DO TIL YOU GET TO YOUR VET: PAD YOUR BUNNY'S ENVIRONMENT!!! Your main job until you can get to your vet is to prevent your bunny from hurting himself while he's seriously uncoordinated and/or rolling. Prepare a box (or other carefully restricted environment) for him, thickly padded with towels or fake sheepskin. The idea is to provide him with a totally cushioned and absorptive environment that will restrict his rolling and uncontrolled movements until he can get full treatment.

A head-tilt presentation can be very frightening for owners. Many dog-and-cat vets will tell you that a head-tilt bunny should simply be euthanized. The experience of many excellent rabbit vets, however, has shown that, with a dedicated owner (treatment may extend over a period of months) and a bunny who is a fighter, head tilt can be treated very satisfactorily, and many (if not most) bunnies can make a full, or close-to-full, recovery. NB: Head-tilt bunnies often continue to have lusty appetites, but their lack of coordination makes it very difficult for them to eat or drink. Help your bunny to eat or drink in any way you can: hold the water bottle near his mouth, or carefully syringe water into him through the side of his mouth (watching to make sure he is not aspirating it!), hold his food (vegetables, hay) for him, and offer it piece by piece, etc.

Severe Diarrhea

Diarrhea, is not the same thing as soft, mushy stool, that sticks to a bunny's butt (this is usually excess cecal production). It is brown, watery discharge, which is often profuse. The bunny may be limp and very weak. Because it causes such rapid dehydration, diarrhea can be life threatening. If you can get to a veterinary emergency clinic, your bunny can receive subcutaneous fluids. If there is no such clinic near you, please ask your vet now — before an emergency arises — to teach you how to administer fluids at home. This kind of diarrhea is generally the result of parasites (coccidia) or inappropriate antibiotics administered by well-meaning (but not well-informed) vets. See your own rabbit-savvy vet as soon as possible for proper diagnosis and follow-up treatment.

Bites

Bunnies often inflict serious bites on one another, if they are not properly bonded. Bacteria introduced into the bite wound can travel through the bloodstream and seed other body areas, eventually producing abscesses. For this reason, you should definitely ask you vet to check any but the most superficial bites.

WHAT YOU CAN DO TIL YOU GET TO YOUR VET: If there is serious bleeding, apply pressure until a clot forms. Gently wash the area around the bite wound with Nolvasan (chlorhexidine) solution. Apply a very thin layer of regular Neosporin (triple antibiotic ointment); do not use Neosporin Plus! If the bites are extensive, try to get to an emergency veterinary service. The emergency vet can clean and dress the wounds.

Most superficial bunny bite wounds can be treated by shaving the hair and applying topical ointment and dressing until you can see your regular vet. If the emergency vet feels systemic antibiotics should be administered because of the extent of the bites, make sure that oral penicillin and derivatives (such as amoxicillin) are not used. Micotil and cephalosporins should also be avoided.

Some bunny-friendly antibiotics: Baytril (and other fluoroquinolones, such as Orbax, Dicural, Ciprofloxacin, Maxaquin), Trimethoprim Sulfa (aka: Sulfatrim, Bactrim, Tribrissen, TMP-SMZ), chloramphenicol (take extreme care not to touch it when administering it; it can cause aplastic anemia in some people), Gentocin (and other aminoglycosides — though these need to be used carefully to prevent ear and kidney damage). Although penicillin is not ordinarily a drug of first choice for most bunny ailments (and it should never be administered orally), injectable Pen-G Procaine can be very useful for specific kinds of problems.

Sudden Fever

If your bunny spikes a sudden, very high fever (we have seen fevers as high as 106 or 107 — literally off most thermometers), cool him down by swabbing his ears with alcohol or wet-towel-wrapped ice cubes. You can also dip your fingers into ice water, and gently stroke his ears for several minutes at a time. Try to get his temperature down to around 104 (normal is 101-103), i.e., a fever that is useful to his body, rather than harmful. Extra cooling can be achieved by taking chilled cans or frozen vegetable boxes from your refrigerator, wrapping them in towels, and packing them around your bunny. Administer subcutaneous fluids as soon as possible. See your vet, ASAP, for a thorough examination, diagnosis, and follow-up.

Heat Stroke

Cool your bunny as above, and administer sub-q fluids. See your vet ASAP.

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