In January of 2003, Bailey was diagnosed with spinal arthritis and two ureteral stones. He was just five and a half years old. This marked the beginning of a little lop’s long battle to live, despite the odds stacked against him. It was the start of nearly four years of research and collaboration with veterinarians determined to help this brave and feisty little rabbit. It was also the beginning of an unimagined, powerful and precious bond between owner and beloved pet.
Within two days of diagnosis, Bailey had an ultrasound and was scheduled for surgery to remove the stones. The surgery was successful and Bailey recovered beautifully. However, my vet warned me that more stones could develop in the future, especially given the calcification that was occurring in his left kidney. To help with the arthritis, Bailey was prescribed Glucosamine/Chondroitin. Metacam was ruled out (at this time) due to the negative effects it could have on his already compromised kidneys.
Towards the end of 2003, during a routine check, a small mass was discovered on Bailey’s left front paw. Once again, surgery was scheduled and the mass was removed. Thankfully it was a benign basal cell tumor… a sigh of relief!
Five months later Bailey developed a case of mites and was prescribed a dose of Revolution with orders to return in two weeks for a recheck. Before the two weeks were up, we were back at the vets. Bailey was arching his back and in obvious discomfort, the same signs I had seen almost one and a half years previously. I knew in the back of my mind what it could be, especially given the presence of mites (mites usually present themselves when there is an underlying problem), but didn’t want to admit it until actually proven. Radiographs confirmed my fears - there was a large stone lodged in the opening of the ureter of the left kidney. Both kidneys also appeared smaller in size and the left kidney was now almost completely calcified. Blood work confirmed chronic kidney disease. I was faced with the decision to remove the stone, remove the entire kidney or treat it medicinally. I discussed the pros and cons of all my options with my vet, other vets and people on Etherbun (rabbit list on YahooGroups.com). Many factors contributed to my decision not to go the route of removing the entire kidney: there were no known statistics on kidney removal in rabbits (my vet offered this information after having just attended the ICE Convention the previous month where this very topic was discussed); it was an intense and invasive surgery; and, not least, the declining health of Bailey. Of course going in and removing just the stone was also just as risky. My vet felt that if we were to go in and do that, then we might as well just take the entire kidney. Beforehand, he would have had to perform an intravenous pyelogram test to see the exact percentage of function of the kidney in question. In my research, I only found one person whose rabbit had this surgery and survived. This was not enough to convince me to put Bailey through this. I also knew, as did my vet, that although he was a fighter, there was a slim chance he would survive this operation. So we went the medicinal route. He was put on Polycitra K Solution (Potassium Citrate) three times a day for life, to possibly help dissolve the stone and prevent future stones. Although there was no guarantee with that, it was worth a try. He was also put on oral Bupren (Buprenorphine) once a day or as needed to help with the pain. I wasn’t expecting too much at this point and thought I only had a few months left with Bailey.
In August of 2004 Bailey was in the worst pain since the stone was discovered. As usual, it was on a weekend and my options were limited. So I packed Bailey up and took him to Angell Animal Medical Center in Boston. Bailey was grinding his teeth so badly it was deafening to the ear and I was at a loss of how to help him. The veterinarian on-call was wonderful with Bailey (it is rare for an emergency room vet to have some knowledge of rabbits). Radiographs showed the stone was no longer lodged in the opening of the kidney, but had actually moved into its core. It was different in shape than the previous radiographs in May. There was also “gritty-like” substance in Bailey’s urine. Based on that, the vet concluded that he must have been passing tiny pieces of the stone that had “broken off” and this was causing the pain.
Over the next year, a lot had happened. The good news: we got an outstanding new rabbit savvy vet (Dr. Astrid Kruse) and Bailey found a girlfriend, Lily. The bad news: Bailey’s spinal arthritis had continually worsened, his chronic URI was still present, another basal cell tumor was growing on the left side of his body, the stone was still present in the left kidney, his right kidney was now failing and he had gone deaf. If there ever was a REAL Energizer bunny, I think Bailey was it.
At the end of 2005/beginning of 2006 Bailey’s hind leg movement became noticeably worse. It had reached the point where he couldn’t use his back legs at times and would drag himself around with his front paws. Other times he would just pivot on his “really bad” leg, but he would still get around. Although it was heartbreaking to see this little guy, with so many problems already, face yet another disability, nothing stopped this determined little lop. Thinking it was mostly related to the kidney disease, I started researching carts for bunnies and found a few companies that had actually made rabbit carts.
In January of 2006, Bailey was diagnosed with E.cuniculi and put on a 30 day course of Fendbendazole. During this time my mother came to me with something she had seen on Animal Planet: animal hydrotherapy. After discussion with my vet and the hydrotherapy vet, we opted for physical therapy only (there were concerns with the water and some of Bailey’s medical conditions). Bailey also started going to acupuncture. Dr. Kruse referred us to a wonderful colleague of hers, Dr. Bethany Innis, who also practiced animal acupuncture. Within that one week in February, both treatments were started and the difference in Bailey’s movement was amazing! He was actually hopping again, to everyone’s surprise and delight. I think we were all kind of in shock, to tell the truth.
For the next 5 weeks we traveled to Sterling Impression Animal and Rehabilitation Center of New England in Walpole for his physical therapy sessions. His physical therapist Cathy, would gently work with Bailey each week for about 30 minutes. Specific exercises and massages were performed that focused on atrophied areas and joints. After each session we left with exercises to work on at home. At the end of the 5 weeks, Bailey was discharged, with orders to come back if need be, but to continue his therapy regimen at home. Cathy said that of all her patients, Bailey was her most difficult yet. She couldn’t believe a 4 lb. bun had that much feist and determination. I believe that’s what kept him going through it all.
The acupuncture treatments were done once weekly, then every 10-14 days. The hour-long sessions consisted of a short exam, relaxing him, then inserting about 20-25 needles into various acupuncture points in Bailey’s skin. After the needles were placed, a candle was lit, the lights turned off and the needles would remain for about 20+ minutes (or until Bailey shook them out). The acupuncture did not cure the kidney disease, arthritis, or slow the decline of old age, but it did help alleviate symptoms and discomfort.
In April, Bailey developed nystagmus in his eyes and another 30 day Fendbendazole treatment was ordered. I could also tell he was becoming more uncomfortable and didn’t think the glucosamine/chondroitin was doing enough for his worsening arthritis. My vet and I did discuss my concerns about putting Bailey on Metacam (the adverse effects to already compromised kidneys). But at this point, for Bailey, the benefits far outweighed the risks and we really had nothing to lose. My vet gently helped to remind me that it was about quality of life for my little man, not the quantity and I did agree.
Less than a month later in May, my worst fears were finally realized - blood tests confirmed Bailey was indeed in renal failure. I knew it was only a matter of time now and I vowed to treat each and every day like it was his last.
On June 3, 2006 Bailey celebrated his ninth birthday. It was a milestone, considering two years before I didn’t have much hope for his future. That same month, Bailey had another emergency vet visit due to the shifting of the stone. Radiographs showed a change in size and position. The Bupren was increased as needed to help with the pain and discomfort. Bailey also decided that the only things he was going to eat were Critical Care, cilantro and kale, and of course his treats of cranberries and banana chips. He would no longer eat pellets, no matter what pellet mush recipe I tried and he hardly ate any hay. Whatever he wanted now, he got. My promise was to keep him happy and comfortable “til the end”.
We continued to go for acupuncture treatments through July, until the entire experience of just going there proved it was becoming too much on Bailey’s frail little body. He would no longer sit still for the treatments; he was very agitated and his nausea was becoming increasingly worse. I think the traveling in the car was adding to this as well. His “gramma” was the one who would take him each time and she advised me at this point it just wasn’t worth it. I agreed.
At the end of July I went away for a few days and due to Bailey’s extensive care, I had no choice but to take him with me. He had more luggage to bring than I did! He was now on 3 medications (including an experimental medication called Mirtazapine to try and help with the nausea caused by the kidney failure), subcutaneous fluids (twice daily), Critical Care, with pumpkin and banana baby food for flavoring. He also needed daily physical therapy sessions, changing of his “bed linens” sometimes 2 or 3 times a day and regular butt baths (followed by toweling and a blow dry). It was a lot of work, but I wouldn’t have changed it for the world. By the time we left the hotel, the hotel staff knew “Bailey the bunny”.
The next few months proved just how much this little bunny wanted to live. Through it all, he remained strong, brave and determined. My love and devotion combined with his feisty attitude surpassed all obstacles that faced him. I was very scared during these months as well - terrified knowing that I was the one who may ultimately have to make the most heart wrenching decision for Bailey. However, others kept telling me that Bailey would “tell me when it was time”. I didn’t believe them though. There were a few times when I thought “this is it”, but in a few days Bailey perked right up again, like he was perfectly fine and nothing was wrong.
The week of October 2nd, things took a turn for the worse. It was indeed clear that Bailey’s little body could no longer endure all the illnesses that had invaded him. He hadn’t eaten in almost four days, although he tried so hard. He would put cranberries in his mouth and chew and chew and then just let them fall out. (When he was diagnosed with renal failure, I vowed that I would not force-feed him just to keep him alive, as I personally did not feel this was fair to him. I did not want to prolong the inevitable for my own reasons of wanting to hold on to him forever.) The pain had become uncontrollable at this point as well. The last 24 hours I was literally giving pain meds every 2 hours just to get us through to get to the vets the next morning. Despite his condition, Bailey continued to groom and snuggle with his mate Lily; he was so devoted to her.
In the early morning hours on October 7th, I brought him into bed with me to spend time with him before we went to the vet. When I would doze off, he’d nudge my chin, almost as if to say “wake up mom, keep petting me”. Then I’d start petting him again and he’d smoosh down and settle in, like he always did.
Later that morning, with my mother, Ellie (vet tech), and me at his side, Bailey was freed from all the hurt, pain and struggles he had so bravely fought the last four years. Never in my life, had I experienced such heartache and sadness, yet at the same time, such peace, knowing that now Bailey was at peace too. The others were right - I knew “it was time” and I think Bailey’s little soul did too.
Copyright 2007 Shannon Cail
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