# Sammi & balance issues/front leg partial paralysis.



## kherrmann3 (Nov 30, 2010)

Yesterday, I took Sammi to the vet. I had her out for playtime, and I noticed that she was losing her balance more than before. I don't think I posted it here, but she had some "minor" balance issues from earlier in fall. I don't remember when, exactly, but it has been going on since late August (at the earliest). 

To make a long story short: She had been running around for her playtime in the bedroom and Toby got out somehow. When I went into the room (for whatever random reason) I saw Toby out. I hurried and got Toby back to his cage. Then, Sammi hopped out from under the bed and fell over. I checked and double-checked both of them for bites, scratches or hunks of skin missing. Nothing on either of them. Sammi just kept falling over like she was drunk. I called Will at work (I was hysterical with guilt at this point) and he said he would check her out when he got home. When he got home, she wasn't doing it as much anymore. Being that she is his bunny, it was his call as to what to do. He wanted to leave her alone and see how she was in the morning. She still would fall over on occasion, but overall she was doing well. She was bright-eyed and bushy-tailed and still ate, drank, and used the litter box just fine. 

A little after that, I had her out for run time in the apartment. This would have been around November 9-11. She would hop around, then list to the side and fall. It was like a "plopping" motion, but she would do it while she was mid-run. She would thrash around to right herself, and then she would be fine. 

Getting back to yesterday, I took her out for some run time, and she fell over more-frequently than she did the last time. I couldn't get a hold of Will while he was at work, so I did what any good bunny co-parent would do: Skipped out of a study group and took her to the vet. The vet that was available isn't an exotics specialist, per se, but he does see rabbits (and he's the owner of the clinic). Sammi was probably 75% worse at the vet. I don't know how it happened, but she wasn't hopping anymore. She just scooted herself around with her back legs. He looked in her ears, and they were fine. He could see her tympanum (eardrum) OK, and they were not inflamed. He checked for nystagmus (involuntary eye movement) by rolling her on her side and watching her eyes while she was lying and once she righted herself. She had no recent history (or any history of) nasal discharge or weepy eyes (minus the corneal ulcers that she had). So, other than the balance issues, she has been healthy. He said that it didn't sound like E. cuniculi, head-tilt, or an ear infection based on the exam. To him, it looked more like a spinal cord injury. 

Being that she is almost seven, I did not want to do any more testing, for the moment. He was kind enough to prescribe some Baytril and Panacur for her. I am supposed to give her both of those twice a day for two weeks. If symptoms improve, he will give us a refill to finish the full course of the antibiotics/dewormers. I am also supposed to give her Metacam twice a day. Her dosages are as follows: 

Baytril: 1.0ml (15mg/ml suspension) \
Panacur: 0.3ml (100mg/ml suspension) ---> All medications are twice a day. 
Metacam: 0.3ml (1.5mg/ml suspension) *** /

*** I had leftover Metacam from before, and the suspension is probably different than the one that this vet would have prescribed. I am following the dose that is on the old bottle, which is 0.17ml. 

Luckily, she likes the flavoring of all three medications, so I just have to put it on her evening salad. I don't think she would eat soggy pellets, so now she gets a little piece of lettuce in the morning instead of just the pellets. 

As of right now, it looks like her front legs are not really working. Her back legs work fine, and she can "hop" with them, but the front legs do not work well. She can hold weight on them, groom with them, and hop into her little box, but she can't hop in a line with them, if that makes sense. The toes on her left front paw are somewhat contracted into a little "bunny fist". When at rest on a smooth surface, her front legs slide away from her. She sticks her right front leg out straight in front of her, but she keeps the left closer. When she falls, it is usually to her right. I've seen her fall both ways, but 90% of the time, it's towards the right. I will try to post more videos to let you guys get a better feel for what is happening.

Will and I are shopping for things to make her cage more "handicap-friendly" tonight, so we will be picking up some of that lambswool-like fleece to pad her cage with (mostly around the wire pen so she doesn't fall and hurt her eye or head) as well as a lower litter box. We are also planning on moving her cage around so it is not as long and narrow. If she's having mobility issues, I would think a pen with a more evenly-distributed floor plan would be better. (Example: Instead of a 2-4 NIC panel pen, a 3x3 panel pen.) That way, there would be less turning around to get to things. If anyone has any other ideas as to how to fix-up a bunny pen for a rabbit with mobility issues, I would love to read about them! 

Here is that video I mentioned before. This is the kind of loss-of-balance that she has. Unfortunately, it's worse now (her front feet are not working as well as they did in this video). I will try to get more video later to show how she's moving now.




Any ideas?

Thanks in advance!


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## tonyshuman (Dec 1, 2010)

Poor little precious. I meant to comment on your blog about it but hadn't had time to think in detail about what might be going on.

Often a balance issue can get worse with stress, which is probably why she was worse at the vet.

Did they do an x-ray on her? With the front leg problems I wonder if a pinched nerve in the spinal cord might be happening, or maybe some kind of issue with the very deep inner ear structures. Those inner ear structures could be located close to the motor areas of the brain that control the forelimbs, and if a big infection or some trauma were there, it could explain the combo of loss of balance and leg problems.

Are you sure that the loss of balance isn't just her not being able to use her front legs properly? In the videos, and from your description of how she moves, it seems like she only falls over because she's expecting her front legs to hold her up in a certain situation and they just aren't working correctly.

She could have run into something and hit her head or spine causing trauma, which is another reason to get an x-ray. The left toes thing you describe sounds a lot like bunny arthritis, which can also affect the spine and cause bone spurs to grow, which can pinch nerves and such.


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## Nancy McClelland (Dec 2, 2010)

ray:


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## kherrmann3 (Dec 2, 2010)

*tonyshuman wrote: *



> Often a balance issue can get worse with stress, which is probably why she was worse at the vet.


That's what I thought. I figured that the stress (and disorientation) of the car ride could have done it. I hate how they look so much worse when they are at the vet. It makes me feel like a negligent bunny parent when the vet is examining this poor, weak, and in this case - wobbly, bunny. 



> Did they do an x-ray on her? With the front leg problems I wonder if a pinched nerve in the spinal cord might be happening, or maybe some kind of issue with the very deep inner ear structures. Those inner ear structures could be located close to the motor areas of the brain that control the forelimbs, and if a big infection or some trauma were there, it could explain the combo of loss of balance and leg problems.


No, I didn't consent for x-rays... Yet. I figured that because she's almost 7, and I don't have the funding that I normally would if I was still working, that we would wait on the x-rays. We are going to see if her balance is bacterial or a worm of some sort by treating with the antibiotics/dewormer. If her symptoms improve, we will continue the treatment, if not, we know it's spinal/neural. Unfortunately, I don't see much of a point in diagnosing what is exactly wrong with her spine (if that's the case), because I can't see myself putting her through any surgery (if it's bone related or something like that). 



> Are you sure that the loss of balance isn't just her not being able to use her front legs properly? In the videos, and from your description of how she moves, it seems like she only falls over because she's expecting her front legs to hold her up in a certain situation and they just aren't working correctly.


She falls when she's running, too. It's hard to tell why she falls sometimes, because they move so fast. It normally seems like her rump falls to the side. I see her falling a lot when she turns, too.



> She could have run into something and hit her head or spine causing trauma, which is another reason to get an x-ray. The left toes thing you describe sounds a lot like bunny arthritis, which can also affect the spine and cause bone spurs to grow, which can pinch nerves and such.


I'm thinking that's what may have happened. She used to run around like a speed-demon, and I think she may have run into a box or something under the bed (they're right behind the bedskirt, so if she was running to get under the bed, she may have rammed right into it). 

Thank you for the replies, both of you.


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## tonyshuman (Dec 2, 2010)

That is a good point--what you're doing for her is what you'd do for a spinal injury as well--giving the anti-inflammatory meds (metacam). If the antibiotics and antiparasitic don't help, I would just consider her a special needs bunny suffering from some arthritis.


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## kherrmann3 (Dec 3, 2010)

Yeah, that's pretty much where we are with the situation. Will and I have decided that if she doesn't get better, we aren't going to put her down unless it's on her terms. If she still shows interest in food and her surroundings (basically, bright-eyed and bushy-tailed), then we will give her the benefit of the doubt and let her be. If she stops enjoying her food, looks listless all the time, etc., then we'll know it's time. We are going to fix-up her cage soon, too. She is still able to get around OK in the set-up she has (it's all one level), so we aren't super-pressed to do it ASAP. 

It seems like it gets better and worse. Yesterday, Will saw her hopping normally in her cage, but when I watched her eat some hay last night, she would stretch for the hay (stretch a little in front of her) then pull back to eat the hay. She was kind of wobbling from side-to-side when she would pull back (like she was trying to balance). When I was petting her, she plopped over on her side (I accidentally petted her "too hard" and knocked her off balance). I think we're just going to have to see how it goes.


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## Dragonrain (Dec 3, 2010)

Aw good luck with her. She reminds me a lot of my Berry. She had front end paralysis after her stroke at the beginning of this year - it mostly effected her front legs and for awhile her shoulder/neck muscles. The poor dear couldn't even lift up her own head for awhile. She slowly made improvements - now, almost a year later, she's improved so much! The only problems she has now, is her front legs are still a bit wobbly. It worse on one side than the other. Once in awhile she'll loose her balance and fall over a bit. She's also blind in one eye. But otherwise she's a happy, healthy bunny who is still clearly enjoying life.


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## Maureen Las (Dec 3, 2010)

*Dragonrain wrote: *


> Aw good luck with her. She reminds me a lot of my Berry. She had front end paralysis after her stroke at the beginning of this year - it mostly effected her front legs and for awhile her shoulder/neck muscles. The poor dear couldn't even lift up her own head for awhile. She slowly made improvements - now, almost a year later, she's improved so much! The only problems she has now, is her front legs are still a bit wobbly. It worse on one side than the other. Once in awhile she'll loose her balance and fall over a bit. She's also blind in one eye. But otherwise she's a happy, healthy bunny who is still clearly enjoying life.


I also wondered while reading this if this could be a serie of strokes :?


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## kherrmann3 (Dec 9, 2010)

Well, as of this morning, she's not doing very well. Will fed the rabbits their evening salads last night and went to bed. Sammi didn't eat it by this morning. I picked up the area she likes to hide under (expecting the worst), but she was there, just slumped over. She must have fallen overnight (or yesterday) and wasn't able to get back up. I picked her up and put her in the little pet bed in her cage. She drank a ton when I put the water bowl by her. I had to give her a butt bath, too, because she had soiled herself after I sat her in the litter box. I moved some stuff around in her cage and rolled up some towels to put along the bottom of the cage (in case she rolls over, she has something soft to fall on). I also rolled up some towels for some extra padding on the sides of the cage. I wish I knew what to do. She is eating hay and lettuce right now, and she is still trying to move. Am I just making her suffer by keeping her around?


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## kirbyultra (Dec 9, 2010)

Sorry, Kelly. This is so tough.


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## Dragonrain (Dec 9, 2010)

I'm sorry.

It's hard to make a decision, I'm sure, without knowing exactly what is going on. When we found out Berry's paralysis was because of a stroke, we decided to take a 'wait and see' approach, because the vet told us that she wasn't in any pain and that there was a good chance that, with time, she would be able to gain back some of her mobility. Also Berry herself was a fighter and her attitude told me that she wasn't ready to give up yet. She still had a healthy appetite, and attempted to groom herself and eat on her own and all that despite her severely limited mobility. 

When caring for Berry - she was at first restricted to a small plastic carrier. We lined it with blankets and hay and I fed and gave her water by hand every few hours, day and night. That was when she could barely move at all and couldn't get to her food/water on her own. After a few weeks, as she gained some mobility back, we moved her into a 1 story cage that I lined with blankets and pet beds and lots of soft stuff in case she fell over she wouldn't get hurt. We used a water bottle instead of a dish so she couldn't fall into her water, a very low entry litter box (I think they are made for senior rabbits?) and 4 times a day I hand fed her water and food (Just in case - but she was eating on her own at that point). Lots of butt baths and I gave her as much love and attention as I could. I think the most important thing at this stage is just keeping them as comfortable and happy as possible.


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## Dragonrain (Dec 9, 2010)

Oh I wanted to add...I think you said Sammi isn't that friendly? So this might be hard for you to do... But Berry's vet told us to give her 'bunny physical therapy" on her front legs to attempt to help her regain some muscle function.

Don't know if that would help you at all, because your bunny might not have the same problem Berry did...but it did seem to really help Berry. Twice a day I would hold her in my lap and very gently massage her muscles. I took her front legs, and gently manipulated them through all the motions that a normal bunny leg should be able to make. I worked maybe only 5 to 10 minutes on each leg twice a day, depending on Berry's mood. My vet showed me what to do, but it wasn't really hard at all or anything. 

My vet said, that with Berry really not being able to move her front legs at all at that time, that the physical therapy would help keep her leg joints from getting stiff and her muscles from loosing too much mass, and may help reestablish connections with her legs and her brain. It's almost like how, with some human stroke victims, they have to learn how to walk all over again.

Maybe not helping in your case, since from the video you posted Sammi looks like she is able to move around way more than Berry could. Just figured I'd mention it, because it did seem to help us.


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## kherrmann3 (Dec 9, 2010)

Thank you for the replies!

That video is outdated. She doesn't move her front legs at all. She has had to have two butt baths today. She just goes all over herself. She doesn't try to move much. I wonder if it's because she's hurting because she didn't take the metacam (on the salad)?


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## tonyshuman (Dec 10, 2010)

I'm so sorry, Kelly. This sounds really hard. I agree she might be peeing on herself because of the pain, but it's best not to give metacam on an empty stomach. I would keep her restricted to small area and line it with fleece, with puppy pads or paper towels underneath. That way the urine will wick away and not get her too wet.


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## kherrmann3 (Dec 10, 2010)

Is there anything else for pain for bunnies? I am thinking of just treating her with palliative care from now on. How well does Metacam treat pain? What is Metacam equivalent to in people medicines? (Like, is it like Naproxen or other NSAIDS?)


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## Maureen Las (Dec 10, 2010)

Metacam /meloxicam would be equivalent to the NSAIDs which means thatit decreases inflammation and decreases pain. 

When I read this thread I remembered a recent thread on Lara ( RIP) in which several members elaborated on other pain meds. 

Iam attaching that thread as TF has used different meds in treating her special needs bunnies and this info is very valuable because there is experience behind it. 

tramodol is oftenrecommmened for long term use , however , if the treatment is palliative then Metacam can also be used (if it is even effective in your case.) because the fear of kidney damage is secondary 


Sammi is going to need very special 1:1 treatment right now to keep her comfortable and you are correct in attempting to determine whether she would benefit from another drug. 


http://www.rabbitsonline.net/view_topic.php?id=61760&forum_id=16&highlight=pain+meds


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## Maureen Las (Dec 10, 2010)

Dragonrain 

Thank you for such useful contribution to this thread. ..


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## tonyshuman (Dec 11, 2010)

I think metacam is good for her right now as it may decrease any inflammation, if she has swelling on the spine. She may need more pain help, though, on top of the metacam, like tramadol as angieluv said. We've been giving Benjamin metacam for inflammation in conjunction with nose issues, and it helped.


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## kherrmann3 (Dec 11, 2010)

Thank you for your replies, everyone. It really helps to have a "support system" on here when I need it. Thank you so, so much. :hug:

I will be stopping over at my old apartment today (my old roommate still lives there). I left a few things behind for storage, and one of them is the Wabbitat-style cage I was given when we "adopted" Miss Emma McFluffybottoms from someone on Craigslist. I am going to pad the heck out of that thing and try to get it so it's more comfortable. I was also going to try to get her cage up higher (closer to the window so she can look out). It would also be easier to get to her if I need to. Any suggestions for padding a cage? I was going to put towels or pads over some pellet litter (to wick moisture other than the towels). I may or may not use the actual litter underneath... I haven't decided yet. Then, I bought some lambswool cloth and was going to roll it into little neck-pillow like ropes to line the bottom of the cage where it meets the wire "walls". That way, if she falls over near the metal, it's softer for her to land on. I also have to rummage around some boxes to find an old water bottle. I know I have some, I just can't remember which box it's in.


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## kirbyultra (Dec 12, 2010)

Some folks use fake sheepskin which is supposedly machine washable. Keeps buns dry and absorbs loads. But your current plan doesn't sound bad either. You're such a thoughtful mom.


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## tonyshuman (Dec 14, 2010)

Sounds like a good plan. I know Ali had some good pictures of a setup for a lesser-abled bun, maybe from when she first got Gabriel? It wouldn't be easy to find it in her blog but if you look for something about a new head-tilt bunny, I think she had some good pics, or pm her and she can direct you to the right spot (JadeIcing).


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## Dragonrain (Dec 15, 2010)

Sounds like a good plan. With Berry I used lots of layers - at the bottom of the cage I put puppy pads, then used towels and old sheets rolled up on top of that. On top of the towels I put a dog crate pad bed for her to lay on - my rabbits all seem to really like this one type of dog bed. Everything except for the puppy pads was machine washable/dry-able, so they where relatively easy to clean. I also used a lot of hay to the cage, within her reach. Berry couldn't eat on her own at first but as she improved she would start to eat hay on her own if she could reach it without having to move much. 

Try to keep everything within reach - food/water...so that she doesn't have to move around much if she needs a drink or whatever. Maybe even try hand feeding if she's really reluctant to move.

How's she doing now?


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## kherrmann3 (Dec 15, 2010)

She doesn't seem to realize that she's "handicapped". Yesterday, Will was out on our porch (fixing our Christmas lights) and Sammi thumped at him... Twice! Right now, she's in a loaf of whole-grain disapproval. She scoots around the smaller cage pretty well. She discovered that the incontinence pads are fun to chew on, so I had to hide them under the towels. She has been eating her veggies with gusto. I was worried because she wasn't eating her pellets, but she is back to eating those, too. I let her out for some exercise, and it seems like her left limbs aren't working. At first, I thought it was just the front, but the right front one works much better than the left, and I notice that her back left leg is a little goofy, too. That would be more consistent with a stroke instead of spinal cord damage. Stroke victims can be rehabbed a bit (the glories of working at a nursing home), so that gives us a bit of an optimistic boost. Let's keep our fingers crossed!


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## kirbyultra (Dec 16, 2010)

Glad to hear Sammi is still grumpy.


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## tonyshuman (Dec 16, 2010)

*kherrmann3 wrote: *


> Right now, she's in a loaf of whole-grain disapproval.


LOL what a great description!

It sounds like you have really good ideas for helping her out too, with the rehab. She couldn't be in better hands!


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## kherrmann3 (Dec 16, 2010)

Thanks again for all the replies, everyone! :hug: This forum is awesome!*

tonyshuman wrote: *


> *kherrmann3 wrote: *
> 
> 
> > Right now, she's in a loaf of whole-grain disapproval.
> ...


Yeah, I started saying that because she always seemed to think that I did everything wrong, but showed in a more intense, curmudgeon-y way than Toby. I had to think of a way to distinguish between their reactions to my inadequacy as a slave, and because of Sammi's rich blend of brownish colors that reminded me of certain kinds of whole-grain bread, that I started to call it her "whole-grain disapproval" loaf. I will have to try and get a picture sometime. It's not often that she can loaf anymore. (On a side note, my friend Mary has a cat named Abu that sits with his feet tucked under him... She's calls him "Toaster-Kitty". He has the same "Go to Hell!" look on his face, though. ) 

Quick question regarding hay and pellets. I know she's _around_ seven-ish years old. When we adopted her, the paperwork said that she was approximately 5 years, 3 months old when she was surrendered. We got her a few months later. That was almost a year and a half ago. So, that would put her birthday, if that age estimate was even accurate, in or near January (ish). Anyway, back to the actual question: *When do you start to feed a bunny alfalfa hay and pellets again?* She's getting pretty bony from the few days of not adequately eating, and I am pretty sure that some of her muscles are atrophying. Does anyone think that I should start feeding her some alfalfa in her diet to "bulk" her up? Also: *What are good veggies that can help her get extra nutrients? *They used to only get romaine lettuce as their nightly salad, which I would occasionally add cilantro, parsley, etc. to it to shake things up a bit. I know kale has good stuff in it (because I never eat it and think it's yucky - just like spinach). I have been giving her kale in the morning and evening with her salad. Are there any other affordable veggies that are good for bunny nutrition? I want her to get a well-rounded diet so she doesn't waste away. Any ideas?


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## tonyshuman (Dec 16, 2010)

I would start with the alfalfa, with hay just as a treat first, and add some pellets. You just have to judge how she looks in terms of muscle tone. I don't think she would need the extra nutrients from veggies if she's on a good pellet. The best way to get good nutrients from veggies is to feed a variety. I feed veggies mostly because I get really dirty looks if I cut back on them, and they are a good way to keep bunnies hydrated.


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## Dragonrain (Dec 16, 2010)

The one side thing makes me think stroke too. When Berry had her stroke, one side was effected more than the other. Her...left I think it was side was worse, and she went blind in her left eye as well.

I'd keep working with her! You wouldn't believe the improvement Berry made after her stroke. It's almost a year later now, and she pretty much acts like a normal bunny. She has her eye issue, and her front left leg isn't 100%, but it's not bad enough that it's really all that noticable if you don't know to look for an issue.

Have you tried the physical therapy with her at all? I lucked out I guess because my Berry is friendly and seemed to enjoy the attention. I'm sure it would be more difficult on a less friendly bunny.

My vet said that Berry wasn't in any pain after her stroke - she just couldn't control her muscles anymore. Other than that, she still wanted to eat and groom and do all the normal bunny stuff. It sounds like Sammi is still in good spirits, despite her issues. Hopefully that's a good sign!


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## kherrmann3 (Dec 16, 2010)

Actually, since she's been like this, she's been a lot friendlier. She doesn't grunt and attack (or try to) anymore. In fact, she let me do some physical therapy range-of-motion and stretches yesterday. Will is doing them with her right now. She's enjoying his attention (and craisins). We will have to see what helps the most. I just am concerned with how thin her back end is getting. It's very bony around the spine and hips. It kind of reminds me of how a cow's hips look (they're not poking out like that, but they're definitely palpable now).


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## Dragonrain (Dec 18, 2010)

Can you let her exercise her back legs at all so the muscles don't loose tone? I kind of had to hold Berry's front end up to let her hop around on her back legs a bit. Is she eating okay now? Maybe she'll gain some weight back now if she's back to eating normally.


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## kherrmann3 (Dec 19, 2010)

It comes and goes with the eating. She's OK with veggies, but not the pellets as much. She'll eat them throughout the day, but not all at once. 

I've been trying to sling her up with a towel so she can propel herself around, but she hasn't gotten used to it yet.


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## naturestee (Dec 20, 2010)

I'm just seeing this, and I just wanted to add my love and hugs. I don't have any recommendations that haven't been hit on by everyone else already.

Actually- one thing. Is she staying hydrated? Feel her skin and gently pull it up and release it. Compare it to Toby's. It should go right back to normal really fast. If it doesn't, she needs more fluids. Dehydration can add to her seeming underweight.


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## kherrmann3 (Dec 20, 2010)

Long time, no see, Stee!  :hug: 

I checked her skin and it seemed OK. We also gave her a sub-Q fluid two nights ago. We noticed that she pulls herself into the modified litter box to void.


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## kherrmann3 (Dec 23, 2010)

Sammi is not doing well. She has lost her sense of balance to the point that she can no longer stand. Whenever we see her, she's flopped down (and her head laid down, too). She's still eating, so I don't know what to do. Her fur was matted with urine and feces this morning. I had to give her an "undercarriage wash" (as Will called it) and cut her fur a little to prevent more waste stuck. It wasn't a good morning here. 

To make matters worse, Will and I are leaving for the holidays. We are driving to Michigan to have our Christmas party with Will's family, and we're leaving on Christmas Day to get there. We won't be home until New Year's Eve. I am dropping Toby, Reggie, and Noodle (hamster) off at my mum's, and Sammi is staying with our friends. I figure that because our friends our home all the time (retired), they will be home more often than my mum. That way, they'll be able to monitor Sammi, change her position, and give her more one-on-one time than my mum would be able to.


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## tonyshuman (Dec 23, 2010)

ray:

It's a matter of seeing if she's still enjoying life, now, and you know that best. I'm hoping for the best and thinking of you guys.


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## Dragonrain (Jan 12, 2011)

Wondering how Sammi is doing now? Any updates??


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