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My Rabbit Vet Says She is at a Complete Loss Why Daisy is so Sick (II)

22 9:57:29

Question
QUESTION: i would like to also add that the vet thought she saw inflammation in daisy's bladder.  daisy also seems to be having difficulty urinating on her own.  she will squat normally, sometimes squeeking in pain when she pushes, but then only releases a small amount of urine about the size of a quarter.  other times she releases her bladder while she is napping, usually a much larger amount, soaking through 1-4 small hand towels.  lastly, my mother and i are having an awful time expressing her bladder, even though i was shown how to at the vet's and i have watched a couple of videos.  her bladder should be full, yet we can't seem to squeeze out more than a very small quarter sized amount.  the vet doesn't seem to have any trouble doing this, though.  thank you again for any information you can give me.  i am terribly concerned about daisy and am literally fighting for her life.  sincerely, michele.

ANSWER: Dear Michele,

Has the vet done any radiographs to determine whether Daisy's bladder is full of sludge (causing intermittent blockage), or whether she has a uterus so enlarged by a tumor (or pyometra) that it might be causing these problems?  If not, I'd have to ask why not.

Dana

---------- FOLLOW-UP ----------

Daisy 2009
Daisy 2009  
QUESTION: yes, they took x-rays and sonograms of everything.  there was even a recommended rabbit specialist supervising.  they have said that they can find no tumors, stones, cancer or blockages of any kind.  since this email, we have figured out the proper way to express a bunny and have been emptying her bladder 3x daily very easily.  there is a lot of dark blood, not bright red clots like two days ago (she's on day 2 of the penicillin shots), and a lot of sludge.  occasionally i will find a small, very sharp shard about the size of the head of a pin.  could these shards or improper expressing be the cause of her bleeding, rather than cancer?  i will ask my vet about the treatment you recommended, and the possibility of doing a culture & sensitivity test.  i have asked twice already but get complicated reasons why it wouldn't be helpful while on a course of antibiotics or penicillin.  thank you, you have been a tremendous help to me.  michele.

Answer
Dear Michele,

Dark clots of blood *could* be caused by very sharp stones.  But I really would suspect uterine cancer with this kind of presentation.  I would strongly recommend that Daisy be spayed, once she is in reasonable enough shape to be a good candidate for surgery.

Unspayed females have an incredibly high risk of uterine cancer, and the longer you wait (if she has a neoplasia or full-blown adenocarcinoma), the greater the risk of metastasis.  Caught relatively early, this cancer is usually fully controlled/stopped by the spay surgery.  Most common site of metastasis is the lungs, so if she's already had radiographs and her lungs are clean, then I would opt for the spay if she were my bunny.

Even if the uterus isn't the problem now, there is a very high chance that it will be later.

No surgery is 100% risk free.  But when the signs point to cancer the way Daisy's do, I would rather err on the side of caution.

I hope this helps.

Dana