Back leg problems in Senior Flemish Giant

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ilikerabbits

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Probably a little over a month ago we had to take our 6 year old to the vet. We had noticed she wasn't jumping up onto boxes like she used to, so took her out and let her run around, and saw what looks like quite severe muscle wasting on one of her back legs. It's hard to describe, but when you look at a rabbit from the back, the back legs more or less form a straight line and fit in with the body, but on one leg there was a noticeable dip towards the inside.
We wanted her seen that day, and the only available vet was a dog vet, as our rabbit savvy vet was all booked in that day. He felt her back legs and said that there was rather severe muscle wasting on the leg that we had noticed, but also some on the other leg too. He kept her in for x-rays and called us back saying that she had osteoarthritis, spondylosis in the lower lumbar, and something to do with her hip, displacement I think? the person on the phone could not remember exactly what it was. He told us that he would keep her overnight so he could talk to the rabbit savvy vet in the morning, which he did. Called us back the next day and said the rabbit savvy vet had nothing to add and put her on 1ml of Metacam (Meloxicam) once daily.
We haven't noticed a huge difference when she was put on the Metacam.
But what concerns me most is that I would say over a short amount of time the leg has rapidly declined, 2 - 3 times worse in a month. Her leg was contracting so we have to do gentle stretching and massaging daily now. You can feel that the hip is actually out of the socket, and when you try to push the foot there is no resistance at all, which her other leg does have. She isn't able to itch herself with that leg very much anymore, which she was able to the day we took her in. And sometimes the toe of her foot it put at a funny angle so that it is under her.
We are going to organize an appointment with the rabbit savvy vet very soon, and if the same answer probably a second opinion. But I'm getting confused if what they said was correct, or if they needed to do more.
 
It's no wonder you didn't see any improvement. I don't know how rabbit savvy your rabbit savvy vet actually is, but 1ml of meloxicam for a Flemish Giant that has to be what, more than 6kg, is an entirely insufficient amount to have any effect on a rabbit that size. That 1ml is a dog dose, which isn't the correct dose for a rabbit. Rabbits need more than 3 times what a dog would get of equivalent size, to have any effect because they metabolize meloxicam so quickly.

Presuming you're using the 1.5mg/ml meloxicam, 1ml a day is only enough for a 1.25-2.5kg rabbit, based on the recommended 0.3-0.6mg/kg, twice a day dosing If your rabbit is around 6kg, the dose your rabbit should be getting is 2.4-4.8ml(3.6-7.2mg) of the 1.5mg/ml meloxicam suspension, per day, and this should usually be split up into twice daily dosing because of how fast rabbits metabolize meloxicam. Otherwise it's out of their system before the 24 hour mark when the next dose is given, which means they're in pain again for that time.

I would want to start at the higher dose for 3-5 days to get the pain under control, then gradually decrease the amount until you find the amount where it stops being as effective, then go back up to the lowest dose that was proving to be effective at controlling the pain and discomfort. You want the lowest effective dose for long term pain management.

To give you an idea of the appropriate dosing, my 1.7kg elderly rabbit that was on meloxicam for her arthritis and spondylosis, got 1ml per day, split into 0.5ml twice a day.

https://www.vgr1.com/metacam/
(talks briefly about hip dysplasia in giant rabbits)
Medirabbit: medical issues in Flemish giant rabbits

If the hip is out of socket, your rabbit needs surgery. Though, being an elderly rabbit, I'm not sure how this would go. But I would suggest trying to find a more knowledgeable rabbit vet for a second opinion if at all possible, and for the surgery if that is deemed to be needed to help your rabbit. If you can't find a more knowledgeable rabbit vet, maybe your current vet could consult with the vet at the Melbourne Rabbit Clinic.

http://rabbitvet.net/AustralianRabbitVets.htm
http://www.melbournerabbitclinic.com/
 
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