Unusual Lump Under Tongue - Seen Vet

Question
Hi Dana,

I have just taken my rabbit Leila to the vet today and will have to make some decisions soon on what the next step will be or just to moniter this carefully and would really appreciate your advice as you've helped me before.

Basically I noticed a week or so ago that Leila was making a much louder noise when licking and washing but I didnt think anything much of it at first. It went on quite a while and was unusual so I decided to look in her mouth. As she flickered her tongue out I noticed a small perhaps pea-sized lump on the underside of her tongue. It's pink and white.. firm but soft, not hard or crusty. No puss, no blood, looks clean.

It seemed to coincide with her not liking the latest bag of her usual feed. I bought this bag and when I opened it I thought it was slightly different, maybe bigger pellets and smelt diff but I fed it anyway. She didn't touch it so I put in some mixed feed I happened to have as backup. She ate that fine, though selectively. I then gave her the last bit of pellets from the old bag which she also ate eagerly. I bought a new bag of the same pellets from a different shop and she didn't touch those. So she's back on mixed feed at the moment and only eating the bits she likes. However she's eagerly eating several types of hay and dried herb treats and fresh veggies.

Other than the sound and the lump she is totally normal. I wouldnt have even noticed if I didnt spend so much time very close to her. She's hopping, binkying, drinking, pooing (though they are always smaller when she's not eating the pellets) weeing, playing, giving bunny kisses, washing, humping her squishy ball toy even and generally getting up to mischief...

The vet was very uncertain and couldnt even get a good look at it. She said she didnt think it looked infected, like an abcess would. She said it could be inflammatory or it could be a lump, benign or malignent. She suggested biopsy and sending to the lab. But that if it was benign it prob wouldn't grow any bigger and she could prob live with it and if it was malignant there might not be much they can do apart from remove and hope it hadnt spread. So for now we've settled on antibiotics as a long shot to see if these make a difference. She had two injections today and is going back for more on monday.

After that I need to make a decision whether to risk anaesthesia to get this lump off her tongue and get it tested or to carefully moniter it and leave it on there as long as she's happy, healthy and it's not getting bigger. It would probably be april before I could afford this anyway. Obviously if it suddenly got worse I'd find the funds somewhere though. What I'm wondering, is if it's exactly the same/smaller/gone down by april would that be indicative of it being totally benign? Would surgery then pose more of a risk than leaving it? Afterall rabbits need to eat straight away after surgery and a tongue op would make eating v painful im guessing.

The vet said she'd never seen anything nasty/malignant in that area but also that most people just wouldn't notice it.

Another option is to see another vet, a more rabbit savvy one, to get a second opinion.

Have you ever in your experience seen or heard of anything on or under the tongue of a rabbit? It's right in the middle. The vet did look at her molars briefly but said she could only see the first set and they looked ok. She also said her tongue mobility was fine, which I know because she's still licking away at any given opportunity!

This image actually comes close to what it looks like particularly in size and colour - http://www.lbah.com/rabbits/malocclusion.htm
Although I can't tell if the lesion (which is an ulcer in this picture) is as raised as leila's which I could probably hold between my fingers. Its not like a round ball, more like half a ball, half a pea to be precise.

This image says that the ucler was cassed by pasturella, I asked the vet about that and she said it's a common problem but they usually have snuffles and other syptoms leila isn't showing at all.

Strangely enough it reminds me of wart or veruca in that the skin on it looks sort of frayed, a little jagged, with slight layers perhaps.. it's hard to describe. So when I typed rabbit wart into google it came up with papillomitis and rabbit oral papilloma. I couldnt find any pictures except of the warts on dogs. They look smaller and more grey than leila's though. I could try to ask someone to take a pic whilst I held her mouth open but I've never been able to look at it for longer than a few seconds.

It's definately not got any bigger over the 5 or so days I've known it was there. It's really baffling and worrying me!

Thanks so much in advance, and sorry for the essay!

Dawn

Answer
Dear Dawn,

Without seeing the lesion, it's nearly impossible for me to make a really good guess as to what this might be.  It could be a papilloma or an ulceration.  But if it's white, there could be pus inside.  Rabbit pus is very hard and caseous (cheeselike), and does not generally come out when an abscess is expressed.

If this were my rabbit, I would get her to a rabbit savvy vet:

www.rabbit.org/vets

and not just have a biopsy done, but see whether this is something that needs to be entirely removed, as if it were a tumor.  If it is something bad, then at least it will be gone, and she won't have to go under anesthesia a second time.  If this is a cancerous growth, then it's best to remove it while it's still possible, lest it grow to inoperable size, or invade surrounding tissues.

I hope it's nothing serious.  But I would *definitely* get her to a rabbit expert to see what this is, and how much needs to be done about it.  It certainly must be uncomfortable.   :(

Hope this helps.

Dana