July 2011 - Spinal Trauma in a Rabbit
Case Study: Noodle the Rabbit
Noodle Hemingway, a 4 year old, neutered female, domestic rabbit , was presented as an emergency to Great Western Exotic Vets, the Exotic Department of Vets Now Referrals, at the beginning of April. She had jumped from her owner’s arms and she was not able to use her back legs. A complete physical and neurological examination were performed and it was immediately decided to perform an MRI scan.
MRI (Magnetic Resonance Imaging) is an advanced non invasive imaging technique which can be used to visualize in details internal structures of the body. It is extremely useful especially to obtain images of the brain, spine, joints, muscles, heart, various tumours and abdominal organs. The images from Noodles showed that there was rather severe damage affecting her spine but it was not possible to predict whether those changes could have been reversible with time.
Unfortunately what had happened to Noodle is commonly seen in pet rabbits as a result of trauma to the back. If the rabbit struggles whilst being restrained, for example, it may kick out with the back legs, resulting in spinal damage. The prognosis usually depends on the site and the severity of the lesions which have occurred. It is difficult to understand if rabbits are in pain because signs of pain may be subtle. Rabbits are in fact prey species and they tend to mask clinical symptoms. Performing a neurological examination is also challenging in rabbits because they tend to freeze, as a response to fear, and do not respond to stimulations as a dog or a cat would. Results are therefore sometimes difficult to interpret. Pinching the rabbit toes, as part of the neurological examination, is a way of assessing the presence of “deep pain”. The absence of deep pain is usually associated with a poor prognosis in all these cases of spinal trauma.
When Noodle was initially assessed, deep pain was not present. In dogs and cats with similar lesion, a long recovery period is usually expected. A rabbit is a more challenging patient though. Noodle’s owner where informed of the results and together it was decided to give her a chance. Noodles was not able to pass urine on her own at that time, as a result of the spinal trauma so manual expression of the bladder at regular times was necessary. Three different types of pain medications were started. Acupuncture sessions were also initiated. The perseverance of the owner made the difference for Noodle. Mrs and Mr Hemingway gave her that TLC that only dedicated and loving owners are able to give. We kept Noodle under intensive care treatment for many weeks during which they patiently and caringly supported her. They continued with the intense medical and physical therapy even after when she was sent back home. After more than seven weeks from the initial trauma Noodle started to use her back legs and urinating by herself. It is long for her the way towards the complete rehabilitation but these case shows how the combination of appropriate and specialistic care for these “special species” and the compliance of their owner can make the difference for our pets.
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