Saturday, March 17, 2012

Spinal Injuries and Rabbits

Over my years of dealing with rabbits and the public I've had people ask me about spinal injuries in rabbits.
When people buy pet rabbits from me I emphasize to them that it is easy for rabbits to break their backs and therefore then need to be careful not to let bunny jump out of their hands or to run into walls and such like.

Recently on the meat rabbits board this issue came up and Pam (one of the moderators there) posted a series of three posts.  I asked if I could take that information and post it up on my blog.  She said sure, but asked that I consolidate them into one post.   So this is what I came up with. :)
 
There are many ways in which the spinal column can be damaged. There can  be an outright fracture with complete severance of the spinal cord; these  animals can never and will never improve to any sort of function. In my  own experience, it is best to euthanise these animals as they are rarely in possession of an owner who will actually give them the quality of care  and of life which is necessary.
 
 There can also be fractures where only a portion of the spinal cord is damaged or it is simply bruised; these animals usually improve with  corticosteroid treatment and then plateau to a certain level of function.   What the owner chooses to do will depend largely on finances and ability.
 
 A non-fracture situation where the spine has been traumatized but not  actually broken is the most likely to result in some approximation of  normal function, even full recovery. Corticosteroids and close  confinement, peace and quiet, can have amazing results. However, I have  also seen some of these which deteriorated to the point of requiring  euthanasia; the vet felt it may have been a disc rupturing or perhaps even  a tumor of some kind.

In a nut shell;
  • INJURY: Rabbit can't use hind end properly, or cannot use it at all. May or may not have control of excretory functions.
  • IMMOBILIZATION: Confine that rabbit in a normal SITTING position (no sprawling or sideways position) and bolster with hay or towels.
  •  INSPECTION/ASSESSMENT: Get x-rays and see just what's happening in there if at all possible. Evaluate excretory function control and reflex presence/absence.
  •  TREATMENT: Corticosteroid and pain medication administration to minimize pain and inflammation. Liberal and generous application of Tincture Of Time in immobility housing until progress is made, is totally absent, or a decision is made to euthanize.
  • PHYSICAL THERAPY: Once there is notable improvement, VERY SMALL STEPS can be taken to help the rabbit rebuild nerve pathways and regain more function. VERY SLOW, and don't push it.
  • RECOVERY of function sufficient for a good quality of life, if not as a show or breeding animal.

If you suspect your rabbit has broken it's back or injured it's spinal column you need to immobilize your rabbit.  In other words you want to sit it up on it's tummy with it's legs underneath it.  You'll want to surround it with towels and or hay so that it can not move or even think about moving.   A tight packed, well secured bunny.   Try to keep the animal packed in such a way that urine and feces can drop away with packing under the bunny to cause additional problems.


Keep hay and water right in front of them.  Consider giving them parsley as a nice green treat.


DON'T MOVE HIM. Do NOT let him out to move around or to 'check' and don't mess around except to gently express his bladder if it is required.   Three hole carriers work really well for this.    When you need to change the cage, simply move the rabbit in one fuzzy lump to the next compartment and clean the first. You can give the bottom  a quick look and swift brush on the way by but I do NOT advocate bathing,  grooming, turning over or anything else unless absolutely,   kiss-your-elbow-and-hope-to- die necessary. Cornstarch will take care of  any damp bits quite adequately.

You can pinch his toes to see if he has any feeling in the legs; you don't want a violent reaction, so use as little pressure as possible and work up if need be. This is a decent way to gauge improvement.

If he becomes soiled or his poop does not drop freely through the floor, prepare another hole just as you did the first, then lift him all of a piece, so that his spine is NOT MOVING (one hand under the rear end, the other under the chest usually works--if not, slip a hand between the front legs and support him on your forearm as you lift), and gently place him in the new clean hole.

Get him to a vet ASAP. The use of corticosteroids has proven to be of much help in minimizing damage due to swelling, but more importantly, this rabbit needs an X-ray of his spine. The vet MUST MUST MUST understand that there should be NO stretching or extension of the rabbit during this procedure!!!! If the spinal cord is not severed, it can easily happen during this time, either as the animal is handled or if the animal panics. Shoot that sucker as it sits and use good handling to get a lateral view. 

If the bone is shattered, and/or the spinal cord severed, I would strongly recommend euthanasia. Healing with any recovery is something I've never seen in that case. 

If the bone is merely out of place, and the spinal cord seems intact, it's worth trying to minimize inflammation and let the body do its thing to see if it is possible to recover any reasonable degree of function (in other words, can poop/pee on his own). 

It is possible for the spine to look normal on xray and feel normal, but for spinal cord insult to have occurred. Corticosteroids and REST--very strict REST--and pain meds are indicated.

NEVER EVER EVER EVER give a rabbit an injection into the muscles of the back!! These muscles are strong enough to pull the spine out of alignment (and the rabbit struggling against being injected won't help either). ESPECIALLY in the case of possible spinal damage, NEVER EVER EVER EVER!!!! give injections in the back muscles!

It is not unreasonable to give pain medication and anti-inflammatories and then wait. The key issue is that the rabbit is not suffering during this time. Evaluate bladder/bowel control daily; check reflexes daily. 

My personal rule of thumb is that if they do not make some sort of progress over a two-WEEK period of this intensive care and management, it's time for euthanasia. Daily, they can progress/regress, but overall there needs to be some kind of improvement. Bruising takes time to regress and inflammation takes its own sweet time leaving, especially if you keep messing around with the animal.

If during this time they make no progress at all, or regress, for two straight days, AND I'm reasonably certain that the spine is fractured, with no bladder/bowel control, I will euthanize unless I feel like they need more time.

I've seen animals in wheelchairs and was less than impressed, but some seem to do very well in them. The animal which lacks control of bladder and bowels is a VERY VERY VERY high maintenance animal, with a compromised lifespan, increased health issues, and high vet bills.


Unfortunately, I've seen far too many of these injuries over the years in  dogs, cats, and rabbits. In general:If they have control of excretory functions, this is a VERY promising sign! Doesn't mean you give up if they don't, but control is good.  Sensation in the paws and leg is good; a reflexive pull away, however  slight, to a hard pinch on the foot, is an indicator that something nerve-wise is working.  Movement is good; of course the more directed the movement, the better.  Most of these animals will begin to improve within 24-48 hours if they  are going to improve at all; the longest interval I've seen has been about  96 hours between injury and slight improvement. In general, if they don't show significant improvement in a week  despite good management, they should be euthanised. After that point  their quality of life degrades dramatically as a rule no matter how hard  one tries.
 
 When you need to change the cage, simply move the rabbit in one fuzzy   lump to the next compartment and clean the first. You can give the bottom  a quick look and swift brush on the way by but I do NOT advocate bathing,   grooming, turning over or anything else unless absolutely,   kiss-your-elbow-and-hope-to-die necessary. Cornstarch will take care of  any damp bits quite adequately.
 
 Some examples of real situations:
 One doe I had broke her spine with moderate incursion on the cord; she  wound up living out her days in shavings as she could not clean herself  sufficiently, and come winter she required euthanasia as she was in severe  pain. She healed, but I would not have called it a quality life in any  way.

 On the other hand, one of my does took a panicked header into the wall  and literally broke her neck. I gave her CPR on the way to the vet and  she revived; the spinal column immediately behind the skull was severely  displaced. We invented a cervical collar for this rabbit (it was hysterical to see) and I fed her with hemostats, one pellet at a time, for  eight long long LONG weeks. She healed completely and went on to be shown  and bred. On her second litter, she leapt into the nestbox and once again broke  her neck. No one was there this time and she died. Up until then, her  quality of life was outstanding.
 
 A very muscle-bound young Satin doe simply tensed up wrong one day  while I held her and I felt her spine crack. I immediately got a  corticosteroid shot for her and simply let her rest. She had excretory control and, some movement and  sensation in feet and tail. She continued to receive corticosteroids  every other day for 3 shots and then just cage rest. She has recovered  fully and is a gorgeous doe.
 
 So you can see, there is a HUGE variation in the kind and severity of  damage that can happen to rabbit spines....never hesitate to get a  radiograph before euthanizing if the rabbit is worth it to you and shows  the slightest potential of recovery, because you never know.

Many years ago, it was just 'broken spine=euthanasia', but we know enough  more now to be able to differentiate amongst the damages and perhaps be  able to give some of these animals a normal, happy life, and even a  functional breeding career is possible sometimes.

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