blood work results

Question
We have 9.5 year old spayed Holland lop, kept indoors. She looks really good for her age. Recently, I took her to local vet for checkup. She was 3 oz. lighter than normal (usually 4#)Vet said her back teeth were slightly over grown. He suggested a blood work also. The results from
the lab were not straight forward and the vet stated the ranges from the lab were not specific for a rabbit. This was her first blood work done.  According to what he considers the correct ranges for rabbits, he says
that blood showed possible early fatty liver disease or possible kidney problems as 2nd possible cause.

WBC 5.9
RBC 5.5
HGB 12.5
HCT 40
MCV 73
MCH 22.8
MCHC 31
Anisocytosis + 3

Heterohil 3127
Lymphocytes 2419
Monocytes 177
Eonsinphils 59
Basphils 118
Platelet Estimate - Increased
Platelet count 571
Total Protein 6.5
SGPT(ALT) 31
Alkaline Phosphatase 49
Total Bilirubin .1
Bun 14
Creatinine 1.1
Phosphorus 3.0
Glucose 231
Calcium 12.8

She gets ~1/3 cup of Oxbow Bunny Basics daily and unlimited Timothy hay and unlimited Mineral trace salt wheel.  Carrots and parsley EVERY evening (sometimes broccoli and kale.) She also gets treats usually 3-4
times a week from this list:  Oxbow Papaya Fruit Plus, Oxbow Organic Barley Biscuits, Vitakraft Bonbinos (very rarely), and sometimes steam rolled oats. I think she got oats the night before her blood work. Since the blood work was returned, we have cut out all treats. She has a
history of front malocclusion when she was much younger that has appeared to be corrected after early trimmings. She is kept in a large bunny cottage. She is let out when we can watch her. We know that she could use more time outside of the cottage for free roam exercise.

Please help us with these questions;
1) What are the normal blood result ranges for Rabbits?
2) Is the result of Alkaline Phosphatase alarming?
3) Any other results cause for concern?
4) What do you think probable cause of raised Alkaline Phosphatase? What treatment options do I have? What is likelihood or recovery? What are probable outcomes? Prognosis?
5) Is she in good enough condition to undergo sedatition to trim/file her back teeth? If she does have fatty liver disease or kidney problems, would sedatition cause more problems?
6) The Dr. wants to retest her blood. It this a good idea? The vet knows rabbits but the test is expensive for just the blood work.
7) What other changes do you recommend?

I really appreciate your response. We realize that she is a elder bunny nearing her time with us, but we want her quality of life to be high as possible and free from any discomfort.

Thank you.


Answer
Dear Misti,

You can find a good table of rabbit blood serum chemistry values here:

http://www.medirabbit.com/EN/Hematology/blood_chemistry.htm

Note that the blood report you've written here does not include *units* for the values, so some of these could be drastically different if the units are not the same.  If you can find out the units, it would help.

Your questions:

1) What are the normal blood result ranges for Rabbits?

Please see the web site above, but let me know if any of the values are not clear in comparison with your bunny's.

2) Is the result of Alkaline Phosphatase alarming?

Not if the units are the typical ones.  Range can be from 10-70 IU (international units) per liter, so that value is right in the middle.

3) Any other results cause for concern?

I don't see anything terribly abnormal at first glance here.

4) What do you think probable cause of raised Alkaline Phosphatase? What treatment options do I have? What is likelihood or recovery? What are probable outcomes? Prognosis?

Liver enzymes can become elevated for any number of reasons, from parasitic infection to chronic bacterial infection.  But I don't think your bunny's ALK PHOS is unreasonably high, if the units are in IU/L.


5) Is she in good enough condition to undergo sedation to trim/file her back teeth? If she does have fatty liver disease or kidney problems, would sedation cause more problems?

From the bloodwork, no obvious problems appear.  No anesthesia is 100% risk free.  But if she has molar spurs causing stress and pain, it might be wise to have them filed.

6) The Dr. wants to retest her blood. It this a good idea? The vet knows rabbits but the test is expensive for just the blood work.

Not sure why the vet wants a re-test.

7) What other changes do you recommend?

Ummmm...I really am at a loss to know why the vet thinks these values are abnormal.  But then, the units of the values are not listed, and this is important information.

I hope this helps, though.

Dana