Enlarged Kidney

Question
Hello Dana

I am writing about my Mini Lop "Brownie". He is a rescue, and his age is not certain. My vet estimates his age to be about 4. His previous owners were not good bunny parents and he was not well taken care of. Upon rescue he had abcess teeth that had to be removed and administered antibiotics last year. This was before I adopted him, so Im not sure of what type of antibiotics he was given but he was seen by a rabbit savvy vet, so Im sure they were bunny safe.
Anyway I just wanted to give you some background on Brownie.
yesterday i took Brownie to vet to get his dental exam, and I mentioned a knot on his right side that I had felt before. The vet felt it and did XRays as well as Ultrasound and it appears it is his kidney that is extremely enlarged. The vet performed a biopsy and blood work.
Today I called and his blood work looked okay, no signs of renal failure but the biopsy was inconclusive.
The vet has said that I have two options 1.perform surgery to remove the kidney, and rish loosing him during or after the surgery... or 2.to let whatever this is progress and just try to treat the symptoms.
I have only had 2 bunnies in my life, and the first I had as a baby for a few months when he died during nueter surgery (different vet). And when I received Brownie I noticed he didnt seem to be verty active, I thought maybe it was just his personality or maybe becaseu he was locked up so much during his first years that he wasnt conditioned well. But it seems as though he is even more less active than before. he lays around alot and doesnt run much, when he does he lays and pants like he cannot catch his breath or is hot.
I have been thinking of trying the surgery, but I am wondering about the survival chances on that would be? What are some other reasons his kidney would be enlarged to almost 3x's the size?
I feel like I need to try to do something, I dont want him to suffer, and I dont want him to die of course. Hes had such a sad life and I feel like now he is finally living the life he deserves.

Dawn

Answer
Dear Dawn,

An enlarged kidney is often due to some type of blockage, and that is never a good thing.  Blockage of the ureter is one possibility, as is localized necrosis of tissue (infarction) due to loss of blood supply.  It is nearly impossible to know if this is causing him pain, but it's certainly not a great thing to have.  

Neither option the vet gave you is great.  But they really are the only two options I can think of.  So all I can give you is what I think I would do if I were in this situation.  If I had a rabbit like this, I would try to determine whether he is in pain, and if his quality of life is likely being compromised by this bad kidney.  If so, then the sooner the nephrectomy is done, the better since his health could deteriorate if the condition gets worse or causes complications.

This is a very difficult choice, but you really are between a rock and a hard place.  If you are not sure the vet you're seeing is an expert in rabbit medicine, then please check the list here:

www.rabbit.org/vets

to see if you can find a vet nearby who is very, very experienced with rabbits and who can give you a second opinion.  This surgery is performed so rarely that I really can't give you survival odds.  But as long as the surgeon is competent and able to remove the damaged organ without too much blood loss or handling of other delicate internal structures, it might be the best thing to do.  

If he seems happy and content, then I would consider the other option:  just let him be unless the signs become so obvious that there is no other choice but to remove the kidney.  If he does not make it through the surgery, then you at least have given him a good life full of love.  And--though this might sound awful--there are much worse ways to die than under anesthesia and in no pain.

These are all things to consider, but there are no easy choices here.  All I can give you is a bit more information and some subjective opinions.  I hope they help.

Sending healing thoughts,

Dana