Bunny with consolidated area of the chest.

Question
QUESTION: my 8.5 y/o female dutch rabbit has been fine until a few days ago when i noticed some changes.  i noticed that she didn't seem to be eating her pellets or drinking water----although she would eat veggies.  Her litter was dry.  She was acting FINE except for little grunting noises that I thought were "cute".  I found a vet who is knowledgeable regarding rabbits and took her there this morning.  Cleo (the rabbit) is hospitalized.  BUN and Cr are elevated but per Dr, not horribly so.  Electrolytes are OK!!  Chest Xray shows a large (50%) area of consolidation.  Her GI tract is full of gas.  They have her on O2 and pain meds and IV hydration.  Do you think she should be put to sleep?  The cost is already at least 600 dollars and I can't afford to take another day off work (tomorrow).  If we end up bringing her home tonight she may need force feeding and I can't stay home to do this, nor is anyone else avail to do this.  what do i do?  help.

ANSWER: Dear Amy,

Do the vets think this is a lung infection?  Or is it a cancerous mass, such as a thymoma?  I would need more details on the specifics of the lung mass before I can advise you.

If it's pneumonia, this is treatable, and if cost is a problem, then ask about injectable long-acting Penicillin G Procaine.  It is very inexpensive, and could save her life if this is an infection caused by bacteria (e.g., Pasteurella) susceptible to this antibiotic.

Nebulization can also help, as can warm steam, if this is lung congestion from infection.

If the mass is cancer, then there is not much you can do but keep her comfortable and pain-free, as per the vets' instructions.

I hope some of this will help.

Dana

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

QUESTION: Thanks Dana:  I brought Cleo home last night.  She has had a VERY small amount of urine output and a few BM's (very small but fairly firm).  She is on Reglan and Abx.  Only problem is, I'm having trouble with the syringe/force feedings. It is so traumatizing for her, even though I am very confident (I'm a nurse) and calm when I'm doing this and we are in a quiet spot etc...she gets so worked up that she is completely out of breath and it takes her a long time to recover.  As far as her chest xray is concerned, the Dr is not sure if this is due to a pneumonia or to a mass, but she said she "thinks" it is likely due to a mass.  I guess there's no way to know for sure?  Ultrasound?  In any event, I can't really even get the food/water/meds into her.  I feel like if she dies it will be my fault.

Answer
Dear Amy,

Bringing Cleo home was probably the very best thing you could do, since there's not much the vets could do than you can do at home.  And now she's with you, where she needs to be.

Is the mass anterior, just above her heart?  If so, she may have a thymoma, a cancer of the thymus gland.  We're seeing this more and more in rabbits, and I have lost two to this awful condition.  It can be treatable, but it will be expensive, as it involves radiation therapy.  And if she's already having trouble breathing, then it will have to be done soon, if this is a thymoma.

For more information, please see:

http://www.rabbit.org/health/thymoma.html

and

http://www.rabbit.org/health/thymomastory.html

One very important thing for you to know is that it is NOT your fault if something awful happens.  This is her journey, and though you are doing everything you can for her, there is only so much you can do.  

What antibiotic is she on?  If the vet suspects pneumonia, then a common culprit is Pasteurella, which are generally susceptible to injectable Penicillin-G (long-acting).  We start with an IM injection to get it into the system quickly, then back off to subQ for the duration (every 48 hours).  It won't hurt, and might help, to try.  And injections will be less stressful for her than oral meds, from the sound of it.  (Reglan also comes in injectable form, and you might be able to get this from a human pharmacy if you have hospital connections.)

If she is not producing much poop, then the stress of this illness may be eliciting GI slowdown, and this will make her not want to eat.  (I can tell you from personal experience that ileus, even if not at the painful stage, will make you want to barf from just LOOKING at food.)  So until her guts are moving, don't force food on her too much.  It might do more harm than good, stressing her and putting more strain on her heart than she can handle with all the physical pressure already there.

Gentle, vibrational tummy massage can really help the intestines get moving, and help break up gas.

The description of her being so out of breath with even slight exertion is really distressing and so familiar.  :(  I hope some of this helps, but if it's a thymoma at this stage, she needs treatment quickly or it may be too late.  The terrible thing is that this can sit there growing and the bunny shows *no* sign of trouble until the mass is life-threateningly large.

Know that you are doing everything possible, and that sometimes things are just out of our hands.  I'm sending lots of healing thoughts.  

Dana