by Mary Edwardsen

My rabbit Charles twisted his back, causing his right hip to become dislocated. The emergency room vet, after numerous attempts, could not get the joint to stay in the socket. He underwent a femoral head osteoectomy, in which the socket was removed. The hope was that the muscles, or tendons, would take over the job of the joint. However, three days after the operation, the left hip became dislocated. What followed was a month of intensive home care and eventually, sadly, a quiet death.

During my last month with Charles I learned a lot about keeping a rabbit who could no longer hop about clean, happy and as healthy as possible. There is a lot to think about and do, but if you have the time - and this sort of care does take time - it is well worth the effort. The bond with your rabbit will deepen and you will never doubt how much you are loved and appreciated. And while my story had an unhappy ending, many partially paralyzed rabbits have lived happy lives for much longer periods of time, from several months to several years.

Rabbits can become paralyzed for many reasons; from injuries such as I mentioned to neurological problems such as those related to e. cuniculi (pronounced 'e. koo-nik-u-lie'). So - after you and your rabbit have gotten the very best vet to give you a prognosis that you and your rabbit can live with, the at-home nursing care begins.

WHAT DO I DO NOW?
Initially, the hardest part for both the rabbit and you is the psychological pain and adjustment. House rabbits tend to be very independent, and your rabbit is now dependent on you on ways that neither you nor your rabbit has ever known. Though cute, we know that rabbits are not children and that many don't like to be picked up and "told what to do" - and most don't want you to be in their faces, prodding them, hand (syringe) feeding them, moving their poop, cleaning their private parts, etc. Most house rabbits like their spots and like you in your spot. You will find, however, that after you and your rabbit get adjusted to this new way of living, he or she will understand what you are doing and will be accepting and grateful.

ACCOMMODATIONS
At this point your rabbit may not be able to use his litter box, be able to clean himself, and he may be not even be able to move around. You need to quickly get used to the fact that he can't do these things for himself. I wasted a lot of time and probably made Charles even more frustrated by trying to create some sort of litter box that I kept hoping he could use. I tried puppy pads so he wouldn't have to hop over a three-inch side of a normal litter box; I tried putting litter in a corner of his x-pen. Charles would have none of it. He simply peed all over himself whenever and wherever he was.

Charles had never before been confined and now he had to be, because he could barely move without tripping over himself and he had no control of his bladder. To accommodate your newly disabled bunny, you'll need to do the following immediately:

• You will need to set up accommodations according to your rabbit's needs and abilities, sometimes this is a matter of trial - and error.
• You will want and need to have constant access to your rabbit
• You also need to find a place where your rabbit is still part of the family, as keeping him engaged in life is a big part of the nursing care

Since Charles could only scoot - indeed, he could barely lift himself up off the ground, we set up a corner of the kitchen that was about 5' by 4'. We put up movable walls, using sections of the x-pen. I did not use the entire x-pen, because I wanted to have easy access, but some people use the entire pen to allow the rabbit more scooting room. You will need to decide the best way to accommodate your bunny. Some things to keep in mind while figuring out the best set up for you:

• How much can your rabbit move about?
• How will he access the food and water?

FLOORING
After much fussing around, we worked out the following:

• First, one layer of newspaper (may or may not be needed)
• Second, a plastic tarp (large enough to cover the entire space)
• Third, a padded undersheet that is about 4'x 3' and is made by Pampers for the bed of one who is incontinent
• Last, a synthetic wool covering that covers the entire area

The synthetic wool can be purchased by the yard at most fabric stores. You can also purchase smaller synthetic coverings at PetCo, PetSmart, or other larger pet supply stores. Some synthetic wools have rubber backings. We put the smaller coverings over the synthetic wool yardage coverings. Even with all of these layers, we had urine on the floor, which we cleaned with white vinegar and Nature's Miracle.

This synthetic wool is your best friend when you are dealing with an incontinent rabbit. It draws the urine down to the bottom and the top stays dry, thus the urine is kept away from your rabbit's body, keeping him relatively dry. It also gives him some cushioning, helping with possible pressure sores, another thing to look for with a rabbit who must scoot or drag himself around. You can wash the synthetic wool and it dries very quickly. You'll want to have enough on hand so that when you are washing one set/piece, there will be more available.

KEEPING BUNNY CLEAN
We bathed Charles's bottom almost every day. It is important to keep your rabbit's genital area clean and dry, so it does not become raw or infected. It is important that you wash only the bottom part of your rabbit or those areas that must be washed.

The easiest way to clean a rabbit is in the kitchen sink. Put a rubber pad, used for protecting glass, in the bottom of the sink, get your bunny shampoo out, put out two towels - one for your rabbit's front paws, the other for drying; have your hair dryer near by and plugged in. Get the water to a comfortable luke-warm temperature. Lower bunny into the sink on his hind end - which will most likely need to be supported by one hand, and let his from paws rest on the towel at sink-side or against your body. You will need to adapt to whichever way is the easiest and most comfy for your rabbit. Rinse the bottom part of his torso, whatever areas are dirty and lather with bunny shampoo. I was worried about Charles' reaction to this, but he liked it. Keep talking to him, keep kissing his head, keep him calm. Many rabbits enjoy having their dirty bottoms and stiff muscles massaged and soaked in the warm bath.

Another method is to have two plastic containers, shallow enough so your rabbit can straddle the sides - backside in the container, front paws outside the container. Fill one container with warm soapy water (bunny shampoo), add more shampoo as needed and lather well. Move over to next container, with clean water (or with white vinegar in it if your rabbit has no pressure sores).

It is important that you dry your rabbit as thoroughly as he will tolerate. We generally sit the bunny on a towel, supported by one hand, and manipulate the hair under the flow of a luke-warm blow dryer set about 10 inches away. Often it is easier to set the dryer on a bunched towel, aim it at the rabbit and move him as needed. Because the rabbit's bottom can get very messy and because a rabbit's fur is quite thick, it may be wise to have your rabbit's bottom shaved. ASK YOUR RABBIT VET. Shaving also gives you a good view of any rug burns or pressure sores, and it makes the application of Desitin ointment possible. Since a rabbit's skin is so very thin, it is wise to put the ointment on the bottom after almost every bath.

When you put your clean rabbit on his just washed bedding, you will have this great moment - and your rabbit will know you have done for him - I promise.

Diapers
If your rabbit does not have to be confined in a very small area for medical reasons or if you really cannot create a safe, accessible space where your rabbit can urinate as he will, you can do diapers. I was skeptical about using diapers on my rabbit, but they work and Charles tolerated them surprisingly well. The best thing about diapers is that it permitted Charles to venture through the house as he once had. I could bring him into the den and he could scoot/drag himself to his favorite place.

How To Diaper Bunny
Unless you have a very small rabbit, you need to get diapers in size "large" (or Step Two) for newborns. I made many mistakes purchasing diapers that were too small. The diaper comes folded, and you simply cut a 1" slit in the right in the middle of the center fold - this will create a 2" slit for the tail.

• Put a towel on the counter or table, put your rabbit on the towel, facing away from you.
• Find the front of the diaper (it has the Velcro), pull the paper coverings off the Velcro tabs, open the diaper and wrap the diaper through your rabbit's back legs.
• Pull the tail through the 2" slit.
• Holding the four ends of the diaper, slightly suspend the rabbit in this "hammock" and secure the diaper snugly around his chest area or upper belly, depending on how high the diaper will go on your rabbit.
• If the tail isn't sticking out of the slit, stick your finger through the slit, find the tail, and pull it out.

Depending on how much your rabbit poops, the diaper can get very heavy. The greatest downside to diapers is your rabbit cannot get to his cecotropes (you know, the smelly stuff that looks like greenish-brown grapes), which is so nutritional. Clearly, you should recover the cecotropes from the diaper and feed it to your rabbit, if he will take them.

I used the diaper only to give Charles freedom when he was feeling well enough to roam around. I thought he would be spending all his time pulling at it - but that did not happen. It gave him freedom, and that was more important to him than the oddity of having this funny contraption on.

EXERCISE AND KEEPING BUNNY HAPPY
Keeping your rabbit happy and engaged in life is very important and you will need to find new ways of doing this.

• Daily muscle massages during cuddle sessions
• Some vets will recommend home physical therapy sessions
• Small toys he can flip about or chew, but those that won't inhibit his movements in his pen
• Bring him outside to sit on the grass with you (no chemical fertilizers/pesticides)
• Frequent visits from you, lots of pats and conversation (even just in passing by!)
• Bring bunny into different rooms so he can see what is happening
• If your rabbit has a partner, this will be very helpful in keeping him occupied and happy (and can help keep those ears groomed!). If not, you may want to talk to your vet about adopting a new friend for him, to help while away all those boring hours when YOU aren't there!
  
  

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