Possible wrong diagnosis?

Hi,
I'm looking for advice or any opinion really.
To recap - at the start of this year Harlie had this eye bulging problem (both eyes), first vet had no idea, a second vet took x-rays and said it was an enlarged heart. For the past eight months we've been on Fortekor and Frusol. Bulging went away after the first couple of months. Sometime in July I think Harlie starts parking herself infront of a tower fan I have and later I notice her having these heat attacks - mostly after eating, her back, the back of her head and her ears would get incredibly hot and she seems to have difficulty breathing. I have to cool her down with water and ice packs. I think I've mentioned this problem to the vet 4 or 5 times now and the explanation has either been oh it must be the heat or it's her heart condition. I've continued this cooling Harlie process religiously everyday. But last month her breathing deteriorated considerably, not only would her head point up in the air, but sometimes she would stretch out her neck and turn her head to the side, and her nostrils would flare (unfortunately worse was to come). So the last time we saw the vet (a week or so ago) I mention this again. The vet said she might have developed a tumour but would need to take x-rays - no way not in her fragile condition. Having done a lot of searching on these boards (sometimes really late into the night) and found similar breathing problems I mention could it be Pasturella, or some kind of respiratory problem - maybe - so Harlie is now on 0.75ml Baytril. Unfortunately Harlie is so fragile the first time I tried to give the medicine she got so stressed she opened her mouth to breathe - I almost cried (and I'm a bloke!) she's done it 2 or 3 times since. I just back off so sometimes she doesn't get any medicine or get her full dose. Luckily I bought these tins of oxygen which seems to help. Sorry this is getting a bit long

The reason for the title - I am not a vet, is it possible this has been a respiratory problem all this time? I think somebody mentioned the possibility when I first posted in Feb. Does anyone know the consequences being on the wrong medication i.e. Fortekor for 8 months? Or having an untreated respiratory problem for 8 months? Harlie has lost weight she was 2.5kg in Feb, she's now 1.85kg. The Baytril 'seems' to do something but it's only 5 days since I started it. I desperately want my baby to get better. It's just heartbreaking watching her deteriorate like this.

It may be a thymoma

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

Jack's-Jane said:

It may be a thymoma

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

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Thanks Jane I've read this, infact this possibility was first mentioned when I posted back in Feb. But she's had this condition for 9 months now, should she have lasted this long if it was a tumour - I don't know. Would it have shown up in any x-ray? Apparently the same type of symptoms of eye bulging and breathing difficulty can be seen in respiratory problems http://www.medirabbit.com/EN/Respiratory/Bacterial/URI.pdf - the bit on lower respiratory tract disease. But as I said I'm not an expert and was no good at biology. I guess I'm trying to exhaust all possibilities - I don't want to give up hope. If it is respiratory maybe I have more hope than if it was a thymoma.

floptastic said:

Thanks Jane I've read this, infact this possibility was first mentioned when I posted back in Feb. But she's had this condition for 9 months now, should she have lasted this long if it was a tumour - I don't know. Would it have shown up in any x-ray? Apparently the same type of symptoms of eye bulging and breathing difficulty can be seen in respiratory problems http://www.medirabbit.com/EN/Respiratory/Bacterial/URI.pdf - the bit on lower respiratory tract disease. But as I said I'm not an expert and was no good at biology. I guess I'm trying to exhaust all possibilities - I don't want to give up hope. If it is respiratory maybe I have more hope than if it was a thymoma.

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AFAIK Thymoma's can be slow growing so I guess it is possible that a- it was missed at the first Xray and b- it has now grown and is causing more respiratory problems.

I have had numerous Rabbits who have had a chronic lower respiratory tract disease but none had symptoms quite like those you describe :? But I had one Bun (Huckle-Bunny Finn) who developed a Thymoma and his symptoms were very similar to your description :? But I am not saying that I definately think its a Thymoma, I am just making comparisons with what I have seen in my Rabbits.

Has the Vet prescibed an anti-inflammatory to see if that helps ?

This pic shows Huckle Bunny Finn proping himself up on Lara and mouth breathing due to the Thymoma (which had not been diagnosed when this photo was taken)

In addition to everything you and Jane have already discussed. I expect the reason it could be getting worse again just after eating is that in rabbits the chest cavity is relatively small in comparison to the abdominal cavity and when bunny eats and the tummy gets full this pushes the diaphragm up a bit and will temporarily make the chest cavity smaller - therefore harder to breathe. If there is a space occupying lesion in the chest cavity then this is likely to be more pronounced. When my bun gets his bloat his breathing certainly becomes shallower due to compression of the chest cavity.

Have you got a good rabbit-savvy vet? I really think you need one for Harley and asap. Whereabouts are you? Perhaps someone on here can suggest someone better to give you a more accurate diagnosis?
I'm sorry that Harlie is so poorly

Jack's-Jane said:

AFAIK Thymoma's can be slow growing so I guess it is possible that a- it was missed at the first Xray and b- it has now grown and is causing more respiratory problems.

I have had numerous Rabbits who have had a chronic lower respiratory tract disease but none had symptoms quite like those you describe :? But I had one Bun (Huckle-Bunny Finn) who developed a Thymoma and his symptoms were very similar to your description :? But I am not saying that I definately think its a Thymoma, I am just making comparisons with what I have seen in my Rabbits.

Has the Vet prescibed an anti-inflammatory to see if that helps ?

This pic shows Huckle Bunny Finn proping himself up on Lara and mouth breathing due to the Thymoma (which had not been diagnosed when this photo was taken)

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<sigh>
Thanks for sharing that Jane I really appreciate it. (BTW your babies are beautiful). Ok I can accept that a thymoma is a real possibility but here's more embarassing revelations that I didn't mention or tell the vet . The rabbits live in my room. I had a wooden pine shelving unit and I put one of their litter trays on the bottom shelf. I change the litter everyday but Harlie when she pees raises her bum and misses and pees on the shelf. I use to put newspaper but I didn't clean it as often as I should've but it's now been removed. Also in March I developed an adenoid problem - spitting puss and blood. In May I had an operation to have it removed. It's only when I look back now and think - what if it's all related? And finally Max my other rabbit also suffers from this overheating problem. It's frustrating I really have no idea what's going on and as I've said we've been to the vets a number of times - but they only see a snapshot of my rabbits at one particular moment in time. :?

It is potentially possible for cross species transmission of respiratory pathogens. If you are suspecting a respiratory infection - then covering antibiotics are going to be sensible for your bun. Nasal swabs and a GA for a proper swab is going to be tricky in a respiratory compromised rabbit like Harlie. I really do think you need a rabbit savvy vet to take this further and it is important to mention your infection as well I think. Good luck

Some nebulised antibiotics for Harlie might be useful alongside any oral or injectable ones if vet suspects a true respiratory infection? :?

prettylupin said:

In addition to everything you and Jane have already discussed. I expect the reason it could be getting worse again just after eating is that in rabbits the chest cavity is relatively small in comparison to the abdominal cavity and when bunny eats and the tummy gets full this pushes the diaphragm up a bit and will temporarily make the chest cavity smaller - therefore harder to breathe. If there is a space occupying lesion in the chest cavity then this is likely to be more pronounced. When my bun gets his bloat his breathing certainly becomes shallower due to compression of the chest cavity.

Have you got a good rabbit-savvy vet? I really think you need one for Harley and asap. Whereabouts are you? Perhaps someone on here can suggest someone better to give you a more accurate diagnosis?
I'm sorry that Harlie is so poorly

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Thanks prettylupin. Can you speculate why so much heat is generated? I go running so in my simple way of understanding things - my heart rate goes up, I'm using up oxygen, burning energy and I produce heat, I sweat. Harlie's heart rate is already high - it's mostly over 80 breaths per minute, she eats something, because of her depleted oxygen level/ her condition her system works overtime and so generates heat? But this doesn't happen while she eats - it happens after she eats, it's more like a reaction. The other confusing thing is my other rabbit Max exhibits this same overheating problem.
So frustrating I have no idea what's going on. I try and tell the vet these things but I think I end up sounding like a complete nutter :shock:

prettylupin said:

It is potentially possible for cross species transmission of respiratory pathogens. If you are suspecting a respiratory infection - then covering antibiotics are going to be sensible for your bun. Nasal swabs and a GA for a proper swab is going to be tricky in a respiratory compromised rabbit like Harlie. I really do think you need a rabbit savvy vet to take this further and it is important to mention your infection as well I think. Good luck

Some nebulised antibiotics for Harlie might be useful alongside any oral or injectable ones if vet suspects a true respiratory infection? :?

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Thanks again prettylupin unless anyone knows any good rabbit vets in Northumberland we'll have to do the 100mile round trip to Newcastle (depending of course on Harlie's condition.)

floptastic said:

Thanks prettylupin. Can you speculate why so much heat is generated? I go running so in my simple way of understanding things - my heart rate goes up, I'm using up oxygen, burning energy and I produce heat, I sweat. Harlie's heart rate is already high - it's mostly over 80 breaths per minute, she eats something, because of her depleted oxygen level/ her condition her system works overtime and so generates heat? But this doesn't happen while she eats - it happens after she eats, it's more like a reaction. The other confusing thing is my other rabbit Max exhibits this same overheating problem.
So frustrating I have no idea what's going on. I try and tell the vet these things but I think I end up sounding like a complete nutter :shock:

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Are you meaning that his respiratory rate is raised :?
If so is this all the time or does it return to normal ?

Jack's-Jane said:

Are you meaning that his respiratory rate is raised :?
If so is this all the time or does it return to normal ?

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Sorry I'm getting the two confused - I can't measure the heart rate it's too fast I'm counting the number of breaths she takes and that use to be 80 per minute. I've just spent the past hour counting breaths Harlie is now between 90 and 100 and my other rabbit Max is fairly consistent around 60. It doesn't look too good does it

floptastic said:

Sorry I'm getting the two confused - I can't measure the heart rate it's too fast I'm counting the number of breaths she takes and that use to be 80 per minute. I've just spent the past hour counting breaths Harlie is now between 90 and 100 and my other rabbit Max is fairly consistent around 60. It doesn't look too good does it

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Ok, well I have had Rabbits with a LRTI whose resps have been way up.
But they did not mouth breathe or extend their necks to get a better airflow.

Some responded well to Baytril. Their resps returning to normal after about 7-10 days and treatment was continued for another 2 weeks ie they were on Baytril for 3-4 weeks.

Others did not respond to Baytril but they did to Depocillin INJECTIONS given on alternate days. One Bun needed 3 months of treatment before symptoms completely resolved.

It might be infection, secondary to the heart problem.

Jack's-Jane said:

Ok, well I have had Rabbits with a LRTI whose resps have been way up.
But they did not mouth breathe or extend their necks to get a better airflow.

Some responded well to Baytril. Their resps returning to normal after about 7-10 days and treatment was continued for another 2 weeks ie they were on Baytril for 3-4 weeks.

Others did not respond to Baytril but they did to Depocillin INJECTIONS given on alternate days. One Bun needed 3 months of treatment before symptoms completely resolved.

It might be infection, secondary to the heart problem.

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Thanks Jane, ok yes I completely accept that last possibilty too.
I took a video of Harlie at 6.10 pm tonight.
http://pets.webshots.com/video/3026814980048640457kcKGBj

Hopefully that link works otherwise it's http://community.webshots.com/user/floptastic and go to October 2009

I suppose this is normal - it's difficult to take a video when shes really struggling.

But if it was only a heart condition would she still exhibit this behaviour - this breathing difficulty? Since the beginning of the year or in 9 months she's gone from 2.5kg to 1.85kg. She's still eating well, pooping ok, peeing like a trooper. I asked the vet if we could categorically rule out the possibilty of infection the answer was no - hence 0.75ml baytril a day. As prettylupin mentioned should we try the nebulizer option?
BTW I'm still giving the heart meds (fortekor + frusol).

Oh dear

Well I am not in any way qualified but personally I'd be very surprised if it is 'just' infection.

Given the weightloss despite a healthy appetite and the dyspnoea I fear it may well be a Thymoma. The flaring nostrils and extended neck is exactly how Finn was. He was eating like a horse but the weight was dropping off him.

Could the Vet do an Ultrasound. That could be done without sedation.

How long have his resps been that bad ?

Oh dear, all the symptoms put together do not sound too good do they. I agree with Jane that you need something diagnostic to take a look in her chest cavity, and with a respiratory problem like that a GA seems to be out of the question unless suggested by an exotic expert. I have no idea if an ultrasound can be performed consciously but I suppose if bunny could sit still enough and the fur didn't interfere with the signal too much I don't see why not? :?

Back to your earlier question re. heat.... I expect if there is infection she could be running a little fever, or it could be the extra effort in breathing and shorter shallower breaths or a combination of the two. If it were purely a heart condition then this could potentially have some impact on her respiratory rate as well, congestive heart failure does have a back pressure effect on the lungs, if the heart is enlarged it could be occupying more space in the chest cavity, insufficient cardiac output will mean bunny needs to acquire more oxygen and therefore resp. rate could again go up. But to be honest, the significant loss of weight despite her appetite does not bode too well does it poor little girl
Has she had some bloods done recently? This might give an indication of a mass? But i'm not familiar with Thymomas. :?

Does anyone on here know a good bunny vet in Northumberland? :wave:

I've just watched your video....poor little girl She looks very uncomfortable breathing and when she settled down I could see she looks a little thin across her haunches. I personally feel she needs some medical support with that breathing asap - perhaps even some Oxygen when it is bad, she doesn't look comfortable at all to me. (I've not had a respiratory compromised bunny before though so I don't know how much they can tolerate without intervention but to me she looks to be in quite a bit of trouble with her breathing). I hope you can find someone good to help her soon.

I'd have thought if it was purely heart related then she would be controlled on the meds you have been giving her.

First of all thank you very much both Jane and prettylupin for your thoughts and experiences I really, really appreciate it, thank you.
You know how you sense a sort of ending and you cling to any possibilty of hope however remote - that's where I am
Harlie turned 6 years old this month. I've had her since she was just 3 months old from what was I think the bracknell rabbit rescue - somebody called Sue? I think ran it, if anybody knows how to contact her I'd be grateful (I never did give her an update )
Jane - Harlie started having these really bad breathing problems beginning of August and just deteriorated since then.
prettylupin - yes I do have tins of oxygen which I use when she's really finding it hard to breathe.
Oddly enough about 3/4 weeks ago I asked my nearest vets about doing an ultrasound and they said they could but they wouldn't be able to interpret the results. The nearest would be Edinburgh which is 65 miles from me. Our other vets are in Newcastle which is about 50 miles away. If Harlie's up to it we'll try and see them early next week.
We'll just have to take it a day at the time. I'll keep you posted.
Thanks again both of you!

floptastic said:

First of all thank you very much both Jane and prettylupin for your thoughts and experiences I really, really appreciate it, thank you.
You know how you sense a sort of ending and you cling to any possibilty of hope however remote - that's where I am
Harlie turned 6 years old this month. I've had her since she was just 3 months old from what was I think the bracknell rabbit rescue - somebody called Sue? I think ran it, if anybody knows how to contact her I'd be grateful (I never did give her an update )
Jane - Harlie started having these really bad breathing problems beginning of August and just deteriorated since then.
prettylupin - yes I do have tins of oxygen which I use when she's really finding it hard to breathe.
Oddly enough about 3/4 weeks ago I asked my nearest vets about doing an ultrasound and they said they could but they wouldn't be able to interpret the results. The nearest would be Edinburgh which is 65 miles from me. Our other vets are in Newcastle which is about 50 miles away. If Harlie's up to it we'll try and see them early next week.
We'll just have to take it a day at the time. I'll keep you posted.
Thanks again both of you!

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Could your Vet do the U/S then get a printout of it and fax it to Edinburgh for them to interpret :?

ETA She is spayed isnt she......... ??

Jack's-Jane said:

Could your Vet do the U/S then get a printout of it and fax it to Edinburgh for them to interpret :?

ETA She is spayed isnt she......... ??

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We're in the middle of rural northumberland our nearest vet is half a mile from us - nice people but definitely not rabbit savvy hence the 100 mile round trip to Newcastle. So last time we saw our local vet as well as enquiring about doing an ultrasound I asked about doing a blood test - after the third attempt I told them to stop - it was just embarassing

Hopefully tomorrow morning we can make the trip to Newcastle (we were scheduled for more meds anyway). I'm a little worried because of her condition .

Yes she is spayed. Jane you mentioned an anti-inflammatory - would that be metacam? Is there anything else you might think I could suggest to the vet that would be helpful? Thanks.

floptastic said:

We're in the middle of rural northumberland our nearest vet is half a mile from us - nice people but definitely not rabbit savvy hence the 100 mile round trip to Newcastle. So last time we saw our local vet as well as enquiring about doing an ultrasound I asked about doing a blood test - after the third attempt I told them to stop - it was just embarassing

Hopefully tomorrow morning we can make the trip to Newcastle (we were scheduled for more meds anyway). I'm a little worried because of her condition .

Yes she is spayed. Jane you mentioned an anti-inflammatory - would that be metacam? Is there anything else you might think I could suggest to the vet that would be helpful? Thanks.

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Yes, Metacam is an anti-inflammatory but tbh I wonder if at this stage risking a steroid might be something the Vet would consider :?

Will you have someone with you on the journey ? I'd certainly advise calling the Vet you intend to see in Newcastle (Judith Brown ?) and let them know just how poorly Harlie is. Perhaps you could email them the video of her struggling with her breathing. They *might* advise against transporting her on such a long journey given just how bad she is.

Do please keep us updated