Non-drinking rabbit: neuro blood tests

Question
Hi Dana, it's me with the other non-drinking bunny again (I see you just got a question from another one the other day).  This Sunday it will be 6 weeks since she quit drinking fluids.  We did cancel the dental work that I wrote you about(too aggressive anesthesia), and have since gotten some blood results back on the e.c. and pasteurella.  The e.c. report said "reactivity in both test and control wells. The serum exhibited a non-specific reactivity on the elisa plate. This reactivity could not be differentiated as being positive or negative...Reasons could include presence of reactive proteins within the serum or red blood cell hemolysis."  The hemolysis was listed as 3+. The vet did have a lot of trouble drawing the sample and had to try both legs before getting some bits and squirts. I would use a different vet for a redo just in case. I know you're not a fan of e.c. titers though, so would it be a waste of time and money to redo this (at $100+ a pop)?  

The pasteurella test was more interesting, reporting a 1:128 antibody titer (said <1:16 was considered negative).  Since this was done 3-1/2 weeks ago, it could be redone now (another $100) to see if the values are rising or falling, or should we just start her on some antibiotics "in case" (though I'm not a fan of them)?  I haven't ever heard of Pasteurella causing non-drinking as the only symptom, but maybe it's just the tip of the iceberg. Also, if the e.c. test was due to a bad sample, could the pasteurella test have also been affected by this?

I took her to a new vet for a 2nd opinion two weeks ago, and he is also stumped. Said she looked like a healthy, happy rabbit and suggested what you did -- to quit investigating and go home and let her be a rabbit, specifically not to give her subQ fluids for 4-5 days so that she could settle down and have some motivation and need to drink. I did so, and the only result was her poops just got smaller and smaller, and then quit, so we're back to 100 cc's every 2-3 days which seems to keep her eating and pooping happily.
There is one small note of improvement -- whereas she
was waiting to eat greens till they'd dried before, she is now willing to eat them with the water drops still on them. She is not freaking out as badly around wetness, which makes me think maybe it's a psychological trauma/behavioral issue? Or that whatever is affecting her may be slowly subsiding or healing.

The new vet does not like injectable anesthesia (yay) and can do the dental xrays and molar filing with just the isofluorane mask (double yay).  But he doesn't think that's necessary and is actually more inclined to do some abdominal xrays (he said he may be able to do some dental xrays as well without anesthesia).

So what do you think might be the next most cost-effective and likely beneficial thing to do:
--redo Pasteurella test to see if that might be causing some neuro problems ($100)?  
--do the abdominal xrays ($?)
--do the dental xrays and filing of the slight ledges the other vet saw (about $200 and anesthesia required)?
--just continue as we have and see if she becomes more willing to drink. She has stuck her nose right over the bowl a few times as if to drink, then stopped and eaten pellets instead.
--something else?  I'm wondering about sinus problems, or maybe some kind of bloating reaction when liquids hit the stomach, making her unwilling to drink.

I also notice some posts on rabbit lists that mention rabbits staying away from water if they have kidney stones. Is that something that the abdominal xrays would show, since the urine specific gravity (done twice since) hasn't shown any kidney abnormalities?

Thanks again for help with this mystery,
Petra  

Answer
Dear Petra,

Well, this is just the weirdest thing.  It really does sound dental to me, though.  It just does.  But to answer your questions:

--redo Pasteurella test to see if that might be causing some neuro problems ($100)?

As you said, I'm not a big fan of titers.  All they do is tell you if there's been exposure. And even a paired titer is not always easy to interpret.  Is the titer falling because the bunny is getting better, or because his immune system is not working?  No good way to know.  And will it really change the way you treat?

--do the abdominal xrays ($?)

Yes, I'd do this.  But it is good news that the urine SG is normal, since that means she's concentrating urine.  And that means that maybe her water intake is normal for her.  The small poop thing is odd, but maybe related to something other than the water intake.  (You could try lactulose--an osmotic laxative--without subQ fluids and see if that keeps her poops normal, but causes some mild dehydration?)

--do the dental xrays and filing of the slight ledges the other vet saw (about $200 and anesthesia required)?

Personally, I would do this.  Some rabbits are just incredibly sensitive to the slightest spurs.  But there is risk involved any time there's anesthesia, so that's something to consider, too.  :(

--just continue as we have and see if she becomes more willing to drink. She has stuck her nose right over the bowl a few times as if to drink, then stopped and eaten pellets instead.

See?  That just sounds so DENTAL (and mental) to me!

--something else?  I'm wondering about sinus problems, or maybe some kind of bloating reaction when liquids hit the stomach, making her unwilling to drink.

How's her respiration?  If she has lung congestion, she might be unwilling to drink, if it makes her feel as if she can't breathe.

**I also notice some posts on rabbit lists that mention rabbits staying away from water if they have kidney stones. Is that something that the abdominal xrays would show, since the urine specific gravity (done twice since) hasn't shown any kidney abnormalities?**

Hmm.  I haven't heard of that, but it would be interesting to know.  Abdominal rads would show this. So I'm with the vet:  abdominal rads and as little subQ fluid as possible.

Man.  What a strange mystery!

Dana