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Hi,

This is a tough situtation but I wanted to add a couple of thoughts and a request for more info. First, exactly what drugs is Carmel on? Names, dosing and times per day. I am also sort of stunned by the blood panel and everything normal. Do you have a copy of the lab report? If it is possible, I would like to take a look at that. I know what the "book" says the values should be. But I see a lot of these labs and have noticed a trend or twoand I am starting to see some "markers" of things that are technically within accepted limits....but. I know you have spent a lot of money and we all know that diagnostic testing isn't cheap by any means....but has a urinalysis been performed? If this were my rabbit....I would be very interested in what this test would show. I would prefer it be done by a procedure called "cystocentesis" (hope I spelled that correctly). It is a somewhat challenging procedure in which a small needle is inserted thru the abdominal cavity and draws a virgin urine specimen directly from the bladder.

As far as your vet, it never hurts to get a second opinion. From what I have seen in my travels, I suspect the vet you are using now is probably pretty good. Most vets won't even consider giving rabbits lasix. And there is not a lot of good information to do a lot of known effective treatments....vets are really in a tough spot sometimes since there is very little true research with rabbits. That is why I do so many of the "outside the box" treatments.

And having said that....I am going to mention one of my "outside the box" treatments here. I am not suggesting you to do this. As with any type of treatment, there is risk involved. And remember that I am not a vet.This is something to discuss with your vet. Many things have to be considered....including overall health and the medicationsCarmel is now taking.But we have had some rabbits to have fluid retention like this. It is difficult to deal with. But I have had some success by acidifying the urinary tract.Changing the pH can sometimes have anegative effect on certain drugs. Now, I suspect that every piece of material in the references available to vets are very specific to not do this. But....and there is that word again....I have used this method in several rabbits with urinary issues secondary toE Cuniculi. Ascorbic acid is the best way I have found to do this. It's Vitamin C. It's water soluble....and boy have we had success with passing fluids when using it. It's something that needs to be introduced very gradually since it can also upset the GI...like anything else that is changed too quickly. We have used the C supplements for guinea pigs and most of our rabbits that we used this on ate them without problems. But all of our buns love oranges....and that is an excellent source of Vit C. Another option is to use cranberry extract. I think Oxbow makes one of these and they can also be purchased at health food stores...but again, moderation and in small increasing amounts.

Something else we have used is cool humidity. Remember that cool air has more oxygen molecules than an equal amount of hot air. We use either a cool mist humidifier or a cool evaportive humidifier and it really seems to help their breathing. Steam vapor seems to make things worse. Especially in winter...and depending on where you live and how cold it is....the humidity can be very low. Adding some humidity might be helpful for any breathing concerns. I know that might sound strange since fluids are the problem...but.

We all wish the best for Carmel and I hope my suggestions will help. Discuss them with your vet. If nothing else, it might trigger a better response from him. Never hurts to bring up possible options. And please don't try these without consulting with your vet as many things need to be considered especially in this case.

Randy
 
Well, Carmel is still here holding her own the best she can. She's stopped eating and the vet directed me to begin force feeding. I'm giving pumpkin, Nutri-Cal and pedialyte. Force feeding, along with giving her the meds is stressing her out even more, she hates it and fights it. She's lying around quite a bit, and still in unusual locations. :?

It just seems that she's actually gotten alot worse since she was in hospital yesterday. I don't know if it's the meds or just the disease. It seemed that Buddy's downward spiral really kicked into high gear once we started all of the meds. But then again, his case was apparently more advanced than Carmel's when treatment was started.

Randy, thank you for all of this info and advice. I want to get her labs from the vet, as they did not send me home with a copy. I was expecting something to be abnormal in them, but he claimed that everything was normal. Buddy's labs were a mess when he had his done so I thought that it was strange with Carmel's being "fine".I was planning to call and ask for them. She is on 1cc furosemide bidand .5 ml of Enalapril qd. They did not perform a urinalysis. At least I don't think they did, I will double check though.

Thanks again to all, your prayers and good wishes mean so much to us. :hug:
 
:(
 
Many more :pray: and:hug: for Carmel...and for you...

:hearts
 
I feel this needs to be updated too, so if you don't feel up to it...

Here's the latest from the blog:

Carmel's Journal

1/30/08

Well, we are just taking it one day at a time still. Carmel has her ups and downs. There's not good days and bad days...there's good moments and rough ones for her. She still fights like a cat in a bag when it comes to her meds. I'm thinking of taking video of it and posting it to see if I can get any suggestions to do it better.

Her appetite has gotten somewhat better but not by much. She tires easily and is still laying down in spots that she's never laid in before. That is so strange, I wonder if there's something to that.

I've been having a hard time dealing with guilt over Charlie as well. With Carmel being so sick and with these very wellpossibly being her last days, I don't let him out for run time for as long as normal. Because when I let him out, Carmel has to go in the hallway. It's not a bad setup, but I just like for her to be able to choose where she wants to be right now. So Charlie's been getting about 5 hours a day out of his pen. Then he looks all bummed when I put him back in. :sigh:

Tonight has been a little rough for her. She was doing pretty good this afternoon, followed me outside onto the deck a few times and such. But now she's having some trouble breathing and her heart's beating pretty hard.

I talked to the vet yesterday when he called for an update. He said he'd like to re-check her in a week and see about adjusting her meds. I dunno about him, but what can I do right now. When I go seehim though, I'll be asking for written scripts for her medsso that I can order them from the pet pharmacy that I used for Buddy. Much more reasonably priced.

Anyway, here's acouple of pics from a few nights ago when she was feelingsomewhat spry. Chewing up the papers in my hubby's "reading room" hehe.

 
and my response:

Hey Beth,

Glad to know it's going okay:?. I'm thinking the reason the vet wants to see her again is to possibly lower the dosage, of Enilapril anyway (which is used to try to open up the blood vessels to allow more oxygen through), maybe Lasix too. Once it starts working, dosage should be lowered (depending on their weight and how it works for that rabbit and what side effects there are and how severe. My vet didn't seem concerned when I kept asking about bloat and loud gut sounds that I could hear across a room:shock:, thisand that and told me to not read horror stories on the net:?).

I noticed upset stomach with Bun Bun, he had mushy poos, very loud gut sounds (gas) and there wasn't much I could do about that:(. (Wish I knew then what I know now:?.) Plus, when we let him out, he'd lay down, get up and move, and lay down again, but the Lasix makes them pee and they can't help it. It happens to humans too, it 's thefluid being taken off the heart:?.

Keep us posted, Beth.

Remember, pm me anytime.:hug:

Crystal

Fight as hard as you can Carmel. I'm praying for you, sweetie, and your mommy.:pray:


 
Thanks for putting my blog post over here for me Crystal. I didn't even think to do that.:headsmack

Carmel hasn't had any mushy poos, they've mainly just been really tiny and mis-shaped. I haven't heard any loud noises from her belly or anything...gosh I hope that doesn't happen. Thank you so much for sharing what happened with Bun Bun because--as I'm sure you already know--there just isn't much info on heart failure in bunnies out there. I've read everything I can get my hands on but to be able to hear from someone who's gone through it themselves (other than my one experience with Buddy) makes all the difference.

Can I ask: did they have Bun Bun on nitro? With Buddy they had me swiping the nitro cream inside of his ear. But he was pretty bad off. The vet said at the last visit that he wasn't going to have me do that as of right now. I was somewhat relieved because I felt terrible when his ears started to get a red irritation rash.

Not to mention, they tell you to use gloves and NEVER touch the nitro, but that is kind of hard when you're having to handle the bun several times a day to give him the other meds. It was inevitable that I got it on me. Nitro headaches are fierce. :yuck

Anyway, I don't know if he'll do that yet so we'll see.

Thanks again for your keeping us in your thoughts and prayers.:hug:
 
I've not been on this board long, so I don't know Carmel very well, but I do know what you are going through. I lived through congestive heart failure with one of my rats years ago, and it was very stressful.

So though I can't offer much more than thoughts, prayers, & support...I am offering those. Hugs to you & Carmel.
 

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