The Stray Rabbit: Bartholomew

Bartholomew - herby referred to as Bart - has a story that seems to have touched everyone who came into contact with him. Up until he was, thankfully, found as a stray, it was clear Bart's life had been filled with nothing but horrendous neglect. The neglect had a huge impact on his daily living and required intensive medical intervention to resolve.

Despite all he'd been through, he had a large personality and plenty of fight in him to try and tackle his ill health. He was a grumpy rabbit but always tolerated medical treatment well (even though you could tell he despised you for it).

The Day He Was Found:

Bart was handed into Wright and Mortem in Macclesfield on the 28th of April 2020. 

Image from Wright and Mortem's Facebook Page

After conversing with them, it was mutually agreed that Bart would be transferred to us. We agreed to appeal for his owner for 7 days. 

Non-essential medical treatment wouldn't be started until after the appeal, but Bart required essential medical treatment immediately as you could argue it would've been a welfare issue to postpone treatment.

Sadly, Bart had severe flystrike, urine and faecal scalding, what was initially diagnosed as a rectal prolapse, a pendulous scrotum, he was obese, he had internal and external parasites, and was presenting with mobility issues. No one was sure if Bart would pull through.

Bart was introduced to a lot of medication right off the bat. He was given Panacur SID, Fibreplex BID, oral Baytril BID, oral Metacam SID, topical Ivermectin, and topical Flamazine. Bart also had a gentle bath SID to continue to wash away any maggots.

Medical Treatments and Investigations:

Throughout the evening when Bart arrived. we noticed concerning symptoms. He had abnormal faeces suggestive of malnutrition, gut damage, or even gastric ulceration.

By morning, we really weren't happy with the issues Bart was presenting. He was reluctant to eat and had developing ileus/GI stasis. We believed it was within his best interest to be admitted to the vets for at least the entire working day for intravenous fluids and clinical investigation. 

Bart was discharged late the same day. The vets anaesthetised Bart and gave him an extremely thorough clean and removed as many maggots as they could. An intraoral exam showed that Bart had minor molar spurring, but not severe enough to warrant intervention. He was given fluids, GI prokinetics, and a subcutaneous Panomec injection. 

Whilst Bart was at the practice, he started passing healthier faeces and was eating again.

Offering Bart Sanctuary Status:

It wasn't too surprising to us that Bart's owner never came forward to claim him. We cannot confirm, but we strongly suspect he was intentionally released.

After a few more days here with us, we could see Bart was still struggling with his movements and, despite clearing his case of flystrike, he still had a suspected rectal prolapse.
The vet was curious about spondylosis, kyphosis, or osteoarthritis. So, we decided that Bart should be admitted for x-rays, grooming/shaving fur mats, and another review of his rectal issue.

There was a ventral bridging lesion between Bart's L4 and L5 vertebrae which may have contributed to his mobility issue, but we cannot be certain.

The vet noted that Bart had great sphincter tone. The vet was also curious about an anorectal papilloma as Bart's mass didn't appear to be typical of a rectal prolapse. The vet wanted to discuss Bart's case with leading rabbit specialist at RWAF, Dr Richard Saunders.

X-Rays also showed a small amount of solid material in his urine - referred to as calcium bladder sludge - which can be considered normal in rabbits. Rabbits have higher levels of calcium in their urine when compared to other animals. A diet high in calcium can, therefore, predispose them to blockages, cystitis, urolithiasis, and urinary tract infections.

We highlighted that we were also concerned about Bart's gut-function. As Bart was unable to digest his cecotropes (it's essential rabbits digest their food twice), we wondered if this was contributing to abnormal faeces. We decided to introduce Bart to veterinary strength ProC probiotic to his daily drinking water. We fed him special burgess pellets to promote healthy gastrointestinal function.

We'd been applying topical Flamazine BID to Bart's sensitive skin. Unfortunately, when we shaved more fur, we could see the issue affected a lot of his skin. The vet wanted to try a topical steroid cream - Isaderm. 

Finally, we increased Bart's daily Metacam dose to help with pain management. 

The Next Steps:

Bart appeared to be improving. We hoped to be booking him in for admission so the vet could perform a scrotal ablation, resect any additional loose skin, and radiosurgery or cyrodebridement of the anorectal papilloma.

This would likely improve Bart's personal hygiene and skin issues - making him more independent as a result.

Then, when Bart was in better shape, we could introduce him to vaccinations against myxomatosis and RHD strain 1 and 2.

We noticed the Isaderm cream was slightly less effective than Flamazine, so we were able to swap creams again.

Sudden Decline and Passing:

We noticed when gently bathing Bart that his respiratory effort had increased. He seemed a little lethargic and his skin was causing him a lot of discomfort. After a vet exam, we agreed to introduce oral Baytril BID to hopefully resolve any underlying infection, and oral Vetergesic BID to help with the pain. 

The following morning, Bart appeared to be responding well to the opioids and his breathing was no worse.

By the evening, (several hours after he'd been given opioids) Bart was unable to walk without falling over or running into objects. 

Of course, Bart was rushed into the vet. The vet believed there were several causes; neurological, cardiovascular, or viral being the most likely three. Sadly, Bart's new symptoms meant he was no longer a candidate for any of the surgery he desperately needed.

On top of that, Bart was now entirely dependent on us to move, eat, drink, sleep, and bathe. His quality of life was very poor.

We all decided the kindest thing for Bart was humane euthanasia.

Bart passed away on the 21st of May 2019.