It is time for another very difficult decision. This time its little Dolly, a 1 year old, steel grey uppy eared girl.
Dolly was brought in by the RSPCA inspector - taken out of a tragic, filthy hutch, she was skinny, scared, and had considerable hair loss on her stomach and legs. The skin worsened daily, with the skin flaring up, red and sore, then giving way to crusting, finally flaking off. The skin cracked in places and weeped. She sat, hunched, all day. On the upside, she ate well. Her condition was too fragile to risk a spay but, to give her company, she was bonded with the very wonderful Bramley, who had previously bonded with intact females. Dolly was too unwell to really care and they became partners the same day. Bramley respected her condition, never mounted her or showed any aggression towards her.
Our final conclusion was that her condition was auto-immune and our last treatment port of call were steroids. She had one injection and the next day her skin was clear - smooth, no inflammation, and she seemed far happier, even hopping around. After 5 days it wore off and the skin started to reddened again. Another injection, another 5 days. Long- term steroids are not possible for rabbits as they do not tolerate them well. The drug leads to increased water intake, which leads to diabetes and other side-effects. She was put onto an oral steroid - half a tablet every 3 days. This really didn't work as well. She started to stay in a hideaway box all day, only coming out to eat. It was increasingly hard to administer as she was a bag of bones, and hated being touched, obviously finding it very uncomfortable. She wouldn't hand feed and the only way to get a crushed tablet into her was to mix it in warm honey and squirt in her mouth via syringe. I found this fairly easy, Dolly found it traumatic.
Last week I noticed that Bramley was sitting alone and also that Dolly was always in the dark hideaway box. She would come out to eat and then go back to sitting, hunched away in it. The last few days Bramley has taken up residence in the furthest corner from her, behind the hayrack. In earlier days he would lay out on the floor and she would sit next to him, still hunched, but at least with the comfort of her partner. With her skin still not great, and a few more bald areas re-appearing, there were two choices for her; go back to the injections for a few months and then have her put to sleep, or ....... put her to sleep sooner.
How do you weigh quality of life?
I know she never had a great one. She never lay out, or was curious in new things added to her home. Bramley would be all over a new box or toy, Dolly would be hiding in the box. When the shed was opened to the run area Bramley would be out exploring, Dolly came out after her first steroid injection for the week, but not after.
So, this is my though process. By measuring Dolly's daily action alongside a healthy rabbit's. I have no other way to measure the quality of her life.
Morning: eat, potter around, sniff stuff, eat, scratch, gnaw something, groom.
Afternoon: Groom, stretch out and snooze. Eat. Scratch, groom, snooze
Evening: stretch, mad charge around, eat, groom, nose around, eat, sit with pal, eat etc etc
Sit in box. Eat. Drink. Sit in box. Eat. Sit in box.
Because of her dry, scurfy skin I am assuming that there is some amount of discomfort during her day.
And then, to measure how much the steroids can improve her life.
On her last day, it didn't go how I wanted. It wasn't as peaceful as I wanted, but I won't recall it here. She hated being touched so it was always very hard to inspect her body. At the end I was able to have a careful look and it was worse than before. She had nasty ulcerations in her ears and the steroids were no longer helping her.
Dolly's legacy will be the knowledge she gave me on rabbit skin conditions, the signs to look for, the tests which can be done, possible diagnoses and how to rule the out. With this I hope I can help another rabbit, another day, another time.
Rest in peace, little girl.