Shadow Becomes Very Ill – The Diagnosis and Recovery

Watch out for one ear up one ear down

Watch for ear positions that regularly stay like this!

This is part two of the story of Shadow’s early illness that I wrote about on Thursday. After nursing Shadow through a rough Sunday, we loaded him up first thing Monday morning to head off to meet the new vet who had so kindly returned our call Sunday afternoon to provide assistance by phone even though we weren’t current patients.

One of the first questions the vet had asked us on the phone the day before about Shadow was whether he was an outdoor or indoor pet rabbit. She told us later on in our first visit that was a key question for her in deciding what / how much help to offer us. Her experience was that owners who kept their rabbits outdoors usually did not want to pay for or follow through with treatment if the rabbits became ill, while owners who kept their rabbits indoors were more likely to accept and follow her treatment suggestions.

When the vet started to look Shadow over, she noticed something right away that we had missed. He was holding his ears funny, one was partially up with the other flat down against his head. I was used to the “rabbit ears” of a rabbit sometimes having one ear up and one down as they rested, but at the same time sometimes tuned in to things around them. I hadn’t really paid any attention to watching Shadow’s ear positions on a regular basis as a guide signalling that something more sinister might be going on. Even before taking a look inside his ears, the vet believed we were dealing with an ear infection.

Looking inside Shadow’s ears, the vet saw that both eardrums were extremely red and one was bulging. It was clear he had an inner ear infection. She didn’t stop there though and gave him a thorough head to toe exam making sure that seemed to be the only problem point on a physical exam. Not finding anything else that seemed wrong, she wanted to put him under anesthesia to poke a hole in the bulging eardrum allowing it to drain and to get an x-ray of Shadow’s head to try to determine if the infection was confined to his ears or perhaps had spread beyond the ears into the brain which would be much more serious. Knowing that anesthesia can be tricky for rabbits and that Shadow was very weak, we agreed knowing that he might not wake up. We recognized he needed a good diagnosis for the best treatment and hopefully a recovery.

Fortunately all was good news with the anesthesia and x-ray. There didn’t appear to be any spread of infection beyond the ears and the vet was also able to relieve the pressure on the bulging eardrum. When the vet learned I had trained and worked as a pediatric nurse in the past, she suggested that we start out his treatment with daily antibiotic injections at home to give him the strongest early treatment possible. I was terrified. It had been years since I had worked as a nurse and given any shots. The smallest patients I had given shots to were twice Shadow’s size and baby human anatomy isn’t disguised in layers of thick fur. I did want to give him the best chance, so the vet showed us how Blaine needed to hold Shadow and where I needed to give the shot. We went home with a plan for daily shots for a week with a follow-up visit.

Initially, Shadow was still very weak, so the first two days of giving the shots weren’t too hard. Then he started to feel a little better and even with Blaine holding him flat on the table, Shadow was able to flex his muscles hard enough to bend the needle when I gave him the shot. I called the vet and said I thought we were risking having a needle break in him if we continued on with the shots. So she had us switch to oral doses for the remainder of the week. Shadow continued to gain strength and by the end of the week seemed normal again and his checkup went well. So far so good, but not for long. Within a week, his bad balance was back and he was staggering around and weaving looking like a drunk bunny.

We headed back to the vet for Plan B. It was clear that the first antibiotic had not fully knocked out the infection. So the vet switched to another and said the plan this time would be to keep Shadow on antibiotics for two weeks past the time symptoms disappeared. That turned out to be a very long time. It took two months of watching Shadow staggering around looking drunk. We wondered all the time whether we were doing the right thing, whether this was as good as he would ever be again, or whether he would develop resistance to the antibiotic or a stronger infection from being on the antibiotics so long.

It was hard to watch Shadow struggle to stay balanced. He had been such an active athletic rabbit. Watching his difficulty and not knowing if that struggle would now perhaps be permanent for the remainder of his life was tough. Then at the two months into the second set of antibiotics, the symptoms cleared up and Shadow was able to stand and move without any loss of balance or staggering in his movements. We began the plan to keep him on the antibiotics for another two weeks to try to be more certain that the infection had been fully cleared this time.

It was looking really good for Shadow to come off the antibiotics and be fully returned to normal and then we noticed that Tigger was holding her ears funny like Shadow had been when he was first diagnosed. It was off to the vet with both rabbits. Sure enough, just as Shadow was ready to come off antibiotics, Tigger had developed an inner ear infection. We had kept Shadow and Tigger in separate side by side cages to allow them to see each other, but had kept separate run times. Shadow’s illness had rendered him really irritable and the one and only time we had tried to allow them to play together, he had growled at Tigger and chased her away.

So now the vet proposed Plan C. This was the really hard one. The vet wanted Tigger and Shadow to be housed in completely separate areas of the house with no contact until Tigger was clear of infection. She wanted Shadow to stay in the area he was used to since he was the weakest and that area had the most run area to allow him the best exercise ability to try to fully regain his strength. Shadow would come off the antibiotics as planned and Tigger would be on them until her infection cleared. The vet told us if we didn’t do this, it was likely we would be facing an endless round of the rabbits passing the infection back and forth. Even doing this, repeat ear infections were still a possibility since rabbits like some humans can have a genetic tendency to that type of infection.

We have a tri-level home. Shadow got the second level living room, while Tigger got the office and hallway on the third floor. Over the next month, Shadow regained his strength and once again became the strong athletic rabbit he had been in the past. Tigger was miserable and it was clear it wasn’t just the infection. She was in a completely unfamiliar place and all alone. When her infection cleared after a month, we moved both rabbits back to side by side cages in the living room with separate run times. Working on bonding them again would be for a future time once we were more sure of their health.

We were very fortunate and Shadow never had an ear infection again. Tigger did have some repeat ear infections, but only about once a year for a few years which cleared up easily with antibiotics. Fortunately for us, none of the worst case scenarios ever came to be. The one thing we learned was to really pay attention to a rabbit’s ear positions. They do move their ears around a lot, but the key to spotting a problem early is if they are keeping their ears partially or fully back much longer than their normal or pawing or scratching at their ears much more than normal. The illness of Shadow and then Tigger taught us just how subtle the clues can be between normal behavior and the beginning of a serious illness. So, the best thing to maintaining good rabbit health is human caregivers who really know what their normal behavior is to recognize early when things seem off. We missed it early on because we weren’t aware to look for this problem and we had just moved into our house and were still busy getting things settled and not as observant as at other times.

I’ll write more in September about all the bonding woes we had with Tigger and Shadow, partly due to this illness.  Next week more Shadow and probably Leo stories …

Shadow Becomes Very Ill

Watch out for one ear up one ear down

The ears here hold a clue, more about that tomorrow ...

When Shadow was just a few months over a year old, we woke up one Saturday morning and realized right away that something was very wrong. He didn’t want his morning treat or to come out of his cage. We made arrangements to get him to the vet right away and felt fortunate that the vet had Saturday morning hours.  Unfortunately,  most likely since the vet was only open half a day on Saturday and we were describing what seemed like  stomach problems, the vet examined him for that and prescribed treatment for stasis.

We took Shadow home and began the recommended diet and treatments.  On Sunday morning, Shadow came out of his cage right away and at first we thought that was a good sign.  Then he bent down to eat out of a bowl and fell over on the floor and was rolling around.  It was clear that something was very wrong with his balance.  We realized then the vet had not done a full head to toe check of him the day before and the proper diagnosis needed had been missed.

We got on the phone calling every vet we could find and contacting rabbit people we knew via phone and email trying to find some assistance since we weren’t sure what was wrong or how to help Shadow.  The emergency animal clinics that were open had no exotic vets on staff or call.  The exotic vets had no Sunday hours, except for one that was more than an hour away.  The air conditioning on the car had just gone on the fritz and we hadn’t had a chance to even schedule an appointment for that yet.  We knew we could not take Shadow such a long distance in the Georgia heat with no air conditioning in the car.  We would trade one emergency for another if we tried.  We only got the answering machine for one exotic vet nearby who indicated she had emergency call back, but only for current patients.  We had nothing to lose and Blaine left her a message anyway.

The exotic vet we left a message for did call back and we were so appreciative.  She said normally she would not call non patients back, but there was something about what Blaine had said that made her decide to make an exception.  We described the problem with Shadow’s appetite and activity being off the previous day and now his falling over and rolling around when he bent his head to eat.  We were asked a lot of questions and told that it sounded like either a problem with an ear infection or a neurological problem with seizure like activity.  The vet thought it was more likely an ear problem from what we described and that the falling over was due to dizziness.  She suggested we put him back in his cage and make that as safe a space as possible since he was experiencing balance problems.  She wanted us to keep trying to get him to eat and drink and then bring him in first thing the next morning on Monday to be seen as a new patient.

Tigger and Shadow were bonded at that time and sharing a cage that was two cages linked together.  The vet suggested we separate them so that we could better monitor Shadow and so that Shadow would not be tripped by Tigger or accidentally hurt her by falling on her.  We separated the cages into two.  Then we removed things from the floor of what would be Shadow’s cage, toys and such that were loose and that could trip him or that he could fall on.  Then we put him in his new cage for one.  When he tried to eat out of his bowl, he fell over in the cage again and was rolling around trying to get back on his feet.  Shadow was wild-eyed terrified.  When he was able to get back up, he hopped to the back of the cage into the litter pan and laid down propped up against the side.  Thinking about the problem likely being dizziness, we got some freshly washed greens which would give him both food and some water and held them out to him right where he was laying so he did not have to move his head.  He was so eager to eat those, it was clear he was hungry and thirsty.

We thought some more about the problem and realized it was probably a good idea to keep him in his litter box as much as possible.  It was a safe space if he fell and the sides allowed him to prop himself up and rest his head to keep it steady.  The litter box fit the cage side to side in the back.  We realized we had three cage walls to work with surrounding him.  We moved his hay rack, water bottle and food bowl so each was on one of the walls around his pan.  We positioned each so that they were right on a level even with his head so that he did not have to move his head up or down to eat or drink.  That was a success and Shadow began eating and drinking again.  We continued throughout the rest of day and evening to also hand feed him some greens.

By evening he was still a very sick rabbit.  It seemed he was just a tiny bit stronger since he was able to eat and drink again now that we had things so that he didn’t have to move his head and risk losing his balance.  He continued resting comfortably in his litter box keeping himself propped up.  We got his carrier ready to take him in to the new vet first thing the next morning.

Tomorrow, the diagnosis and the long road to recovery …