Care of the recumbent or paralysed rabbit
Rabbits may become recumbent or paralysed for a variety of reasons, but their basic nursing requirements will be similar.
What causes recumbency/paralysis?
Rabbits have extremely delicate spines and can readily fracture their spine through incorrect handling or by kicking out with their powerful hindlimbs if they are not supported correctly. Sadly, often these rabbits will need euthanising. Occasionally spinal surgery may be indicated.
Rabbits that have active symptoms of E. cuniculi (a parasite that affects the brain and kidneys), may present as recumbent or paralysed. This can sometimes resolve or lessen in severity with appropriate medication and nursing care.
Other causes of paralysis and recumbency may include central nervous system disease, seizures, severe arthritis and complications following surgery, etc. Although all of these possible causes will need specific veterinary treatment, the nursing requirement for the rabbits recumbency/paralysis is similar.
How can I help my rabbit?
It may seem obvious but always ensure that food and drink is within easy reach. If the rabbit is unable to move very far then they won't be able to move to get food or fluid. Encourage the rabbit to eat by offering a selection of fresh foods, eg herbs, freshly picked grass, sweet smelling hay, greens, etc. Supportive syringe feeding, with or without fluid therapy (either intravenous or subcutaneous) may also be required. Your veterinarian will be able to advise this on a case specific decision based on the rabbits presenting signs and clinical diagnosis.
Keep the rabbit at an ambient temperature, which doesn't fluctuate too much. Rabbits that are unable to move around much may lose heat since the muscles are not moving to create heat. A room temperature of around 20°C is a comfortable temperature for a recumbent rabbit as they are not generating heat by moving around.
Rabbits that are paralysed or recumbent are unable to move away from urine and faeces, often leading to urine or faecal build up around their back legs, tail and back end.
It is important to bed the rabbit on suitable bedding that will allow the urine to wick away and keep the environment clean and dry; Vetbed is good for this purpose and should be changed regularly. Do not allow the rabbit to chew and swallow the bedding though, as this is likely to cause a blockage in the digestive tract.
It is also important to provide enough padding to prevent pressure sores. Rolling up towels and placing them around the rabbit will help to support them in sternal recumbency (on their chest).
Apply a barrier cream to the inside of the rabbits back legs (such as Vaseline or Sudocrem). This will help to ensure that any urine in contact with the skin doesn't create scalding of the skin.
Cleaning any urine or faeces off the rabbit and ensuring they are thoroughly dry will also help to prevent urine scalding. The rabbit is unlikely to be able to reach and eat their caecotrophs, so these are likely to have to be collected and fed to the rabbit.
Most rabbits appreciate having their coat groomed, and their eyes and ears wiped with warm water if they are unable to groom themselves.
It is important to medicate the rabbit correctly, but this must be done with great care. Wrapping the rabbit in a towel to prevent injury is advisable, and if possible, ask someone else to help with this. Ensure that you have everything ready before starting, so you can lessen the stress caused to the rabbit.
There are some cases where physiotherapy should not be performed. These are normally instable spinal injuries or after spinal surgery. Your vet should be able to advise you on this.
If advised by your vet, physiotherapy should be performed at least twice daily. It is important to keep the rabbit's limbs supply to help prevent spasms and muscle wastage. It is important to have this demonstrated to you by your vet or veterinary nurse prior to attempting; otherwise further damage may be done.
In some cases, hydrotherapy may be recommended.
Breaking the boredom
It is important to try and keep the rabbit mentally stimulated. Move them around to different areas several times a day, and if they are in lateral recumbency try and turn them onto their other side every 2 hours. This will help prevent pressure sores and fluid accumulating in the chest.
What is the long-term prognosis?
This greatly depends upon the cause of the recumbency/paralysis and the severity. The rabbit's quality of life must always be assessed and be paramount in everybody's mind.
Some rabbits may cope well with their health problems, others may not. Each rabbit needs to be assessed as an individual. Some rabbits may recover sufficiently to go on to lead relatively normal lives, others may have minimal or no improvement despite extensive nursing care.