I need of some advice and/or ideas. Still relatively clueless after seeing two different vets.

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Aug 26, 2021
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Hello everyone,

I am desperately in need of some advice or ideas which I would be very grateful for as two visits to two different vets so far have not really provided any conclusive answers as to what is wrong with my little boy. So, I am hope that perhaps one of you might have an idea or had perhaps a similar experience with one of your buns in the past. I also apologise in advance for the rather long post but I thought it is probably best to provide as much detail as possible...

My little boy Mr. Bun Bun is a Dutch dwarf rabbit of about 8 years old, weighing about 1.25kg, which according to the vet is within the optimal weight range and who has been in very good health until recently. his diet consists of 32 grams of pellets (Supreme Science Selective Mature) and about 60 grams of greens (mostly parsley and coriander/cilantro). He gets the pellets first thing in the morning, as mentioned earlier, and the greens later in the afternoon, when the pellets are finished. He also has unlimited access to hay at all times, most of which he usually eats in the evening, and he gets water from bowls. He is free to roam around the house and is only confined to an enclosure at night when I am asleep.

However, about a month ago, on a Saturday, he suddenly started eating his pellets much more slowly during the day finishing them at around 8 pm and barely touched his leafy greens. To put this in context, he would normally finish his pellets, which I give him at around 7am each morning, between 11am and 1pm. He also spent most of the day in the cage avoiding me, which is not normal. This continued into Sunday and on Monday I took him to the vet.

After a full examination, the vet came to the conclusion that it was probably a digestive problem. So we were prescribed Metacam (also known as Meloxicam) for pain relief and Emeprid (I believe also known as Metoclopramide) which I gave him for about 4-5 days during which time he gradually improved eating his greens and eating his pellets at his usual time.

However, after about 7 days of being fine and off the medication, he started to develop the same problem again. So, I put him back on the meds and went to the vet again, only this time to a different vet at the same clinic. After another thorough examination, the vet came to the conclusion that he was probably suffering from back pain and/or arthritis as he twitched when the vet examined his back.

So, I was asked to keep him on the same prescription for three days and then just continue with the Metacam for the pain. This process worked quite well and he even began to regain an even stronger appetite, much more like his usual self compared to the previous 7 days when he was off the meds after his improvement.

Once again, after about two weeks on Metacam alone, he began to eat more slowly and to avoid and be picky about his greens. Although this time he was not avoiding me and his general behaviour was relatively normal, unlike when the problem first occurred on that one Saturday. At first, I thought it was probably just a bad day, as can happen with chronic pain, and so I just continued to observe, but as this continued well into the next day and I noticed some small deformed pieces of poo in his litter box, I put him back on Emeprid to help with his digestion, in addition to the Metacam.

During this third episode I noticed two behavioural changes in particular. One was that he seemed to have gas and/or an upset stomach as he would put more pressure on his tummy than usual and when I gave him tummy rubs he really enjoyed them and almost immediately after one he would go and eat a bit. The other change I have noticed is that, especially during the day, he would largely avoid jumping into his cage to get his pellets, but when I would offer him his pellets at intervals of 30 minutes to an hour, he would happily run up to me and eat a considerable amount out of my hand, indicating that his appetite had not gone away, just slower or less intense. I am torn as to whether this change is due to him avoiding the cage as I usually pick him up from the cage when it is time for his meds, or perhaps if he has chronic pain during the day it makes him feel more pain when he jumps in to eat, yet again he still randomly jumps in to eat during the day.

Consequently, after this third episode, I took him back to the vet on Monday and after another physical examination and explanation of what had happened, the vet came to the conclusion that it was probably indeed indigestion and/or gas from eating too much and too quickly once he was feeling better. So, the vet asked me to keep him on Emeprid and Metacam until he was better and perhaps reduce the amount of greens as they could irritate his stomach as he could react negatively to having too much at this stage due to his age, and then just resume with the Metacam once he is better.

So, since Monday I have been following this plan combined with tummy massages and he seems to be slowly improving. Yesterday I also gave him 0.5ml of Infacol (a brand of simethicone drops), but I am not sure if this helped as it just made him a bit more uncomfortable for a while, but today he seems to have less need to put pressure on his tummy.
It's possible that there's a different underlying health issue causing the ongoing lack of appetite, and it's not due to a primary digestive problem. Was a blood test done, or any xrays? Was a thorough dental exam done, under sedation or not? Does he seem like he wants to eat but has difficulty chewing? Any odd chewing behavior, dropping food from his mouth, drooling, approaching food eagerly to eat but then soon stops after only trying to eat a little bit or soon after trying to chew?

Medirabbit: dental issues

Or is he acting like his stomach is bothering him following eating? There may be signs of eye squinting, belly pressing, frequently shifting position, sitting hunched, grinding teeth, within an hour after eating something that may be causing digestive upset due to a sensitivity.
I agree with @JBun here, I think I would be asking the vet to check all his teeth... Miley has quite severe dental issues and this in turn occasionally causes bouts of stasis due to her not eating, or being picky with her eating. It may even be the roots of his teeth, as opposed to the crowns above the gum line. Miley has in the past had pockets of infection around the roots of certain teeth which wouldn't necessarily be visible to the naked eye but were very painful for her and prevented her eating properly.
Best of luck!
One of my girls has some kind of digestive issue too, yet to be identified, but I just wanted to mention that an ulcer might be something else to look for with an ultrasound.

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