Caring For the Critically Ill

PARESIS/PARALYSIS

• Make sure the room is warm enough; sometimes paralyzed bunnies will have low blood pressure and may become cool.
• Watch for urine burn–may have to express bladder and bathe bunny’s bottom.
• Bag Balm or A & D ointment is good for urine burn after chlorhexidene shampoo is used to clean the bunny and he/she is thoroughly dried
• You may have to use diapers for incontinence.
• Keep all food within reach and in a dish that is shallow.
• Keep all water within reach and also in a shallow dish to prevent bunny from falling into bowl and possibly drowning.
• Make certain the setting is comfortable–if the room is carpeted, cotton towels spread on the floor are better than synthetic carpet which may cause burns if the bunny is able to drag him/herself around.
• Move the bunny around so his/her view changes if he/she is totally paralyzed.
  Keep a paralyzed bunny in a room where there is plenty of interaction with people, but also where he/she can rest, and if this bunny has a mate (preferable) keep both together.

Click here for more about paresis/paralysis

HEAD TILT

• It’s best to keep head tilt bunnies in a padded area so they won’t hurt themselves when they fall and roll. The combination of bedding I use for these bunnies is: cover carpet with a plastic tarp to prevent urine from soaking through get some “egg crate” Styrofoam and fold it in half (I use the twin bed size) on top of the Styrofoam, place a large piece of fleece material on top of the fleece, spread cotton towels out to absorb urine. These will need to be changed at least twice a day.
• Surround the bed with pillows.
• Sleep with your bunny if at all possible. I fix a bed on the floor in which the bunny can come and ‘visit’ me if she wants. It is comforting for the bunny to know someone is there and cares. When they are rolling due to loss of equilibrium, they often become terrified.
• Water may need to be syringe fed, or if the bunny isn’t drinking, subcutaneous fluids may need to be administered by your vet.
• Later, when the bunny is better, you may need to rig up a water bottle close to the ground so he/she can drink. It’s best to place bottles in several locations around the edge of the bed so the bunny will know exactly where everything is. Keep this
  as consistent as possible. I treat head tilt bunnies as if they are blind, and a blind person needs their environment to stay the same as much as is possible.
• Keep all food within reach. Sometimes I put pellets in a bowl, and sometimes I scatter them on a towel so the bunny can reach them easier. I keep a constant supply of fresh vegetables and hay to encourage him/her to eat.
• Some head tilt bunnies cannot tolerate being picked up or held because the movement throws their equilibrium off even more. For these cases, it’s best to administer medicines with the bunny lying on his/her bed, if possible. If you need to pick the bunny up, stay close to the ground and be very careful because they will have a tendency to roll and sometimes thrash.
• Some head tilt bunnies are not affected by being picked up; for these cases, I try to hold them as much as possible. Pepe, one head tilt bunny I nursed for 10 months did much better when he was carried around for long periods of time. He ate better and his attitude was greatly improved when he was held or petted. When I had to leave for work, he became easily depressed.
• For any critically ill bunny, petting is extremely important. Let them know you care.
• Watch for the slightest change-heart rate; respiration rate; change in dietary preference; presence of gas in the gastrointestinal system; a change in cecals and fecals; urinary changes. All of these may indicate a potential problem that needs to be dealt with immediately by your veterinarian.
• Watch for signs of pain; often critically ill bunnies will have abdominal pain from gas because they are eating less and the gastrointestinal system tends to be somewhat slower than normal.
• Cleanliness is important; help the bunny stay clean around the mouth and anal area; keep them brushed so they feel better. A sponge bath may help for some areas.
• Watch for proper hydration. It is great if you as the caretaker can learn to give Lactated Ringers Solution subcutaneously at home so the bunny will not be stressed from traveling. Your veterinarian can show you the amount of fluid to give and how to administer it.
• Often with head tilt bunnies, the “down” eye will become too dry and artificial tear ointment will be needed.
• Some head tilt bunnies will at some point during their illness stop eating. Syringe feeding may be necessary. Canned plain pumpkin is good and also a pellet mush, when mixed in a blender is easy to feed the bunny. Dr. Susan Brown also has some people feed their ill bunnies small amounts of a liquid nutrition called Deliver 2.0.
• Many chronically ill bunnies will have both good and bad days. Don’t give up too soon. It has been my experience that a chronically ill bunny can recover even if they remain ill for months. Helping them have a good outlook is paramount to their recovery. Talk to them; pet them; love them; and most of all, expect them to get better. Remember, they will pick up on your thoughts and feelings.
•  Try to remain as positive as you can