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My old boy Sumi - abnormal liver results

Fionabun

Mama Doe
Hello there,

I'm looking for some advice from you good people at RU.

My 8 year old bunny Sumi ('Soomi') developed GI stasis on Saturday and started to show some improvement on Tuesday. He was fully syringe fed and offered all fluids va syringe until Tuesday evening. He's a fantastic little syringe feeder and he maintained his weight throughout all of this. He got all of his meds and pain relief and the vet took bloods on Monday afternoon. Those of you who know or remember me might recall that Sumi was one of my recurrent GI stasis bunnies many years ago, thought to be linked to mild EC and the (relatively unknown) effect it can have on bunny guts.

He has picked up well and back to his usual cheeky self now, though continues to have spells where he lies oddly pushing his tummy into the ground. He remains on pain relief via Metacam twice daily.

His blood test results came back today and I got the sorry news that all of his liver function results are abnormal. The vet is suspicious, given his age, that he may have a liver tumour. He was also very tender in that area during examination on Monday. We are pressing ahead to treat with antibiotics at the moment to see if there is a chance of an infection of some kind, given that he has perked up greatly. We'll also be trying lots of milk thistle and tender loving care to see if he keeps improving. The plan is to repeat his blood tests next week to see if there is any improvement, and failing that, will xray and ultrasound his liver to check in more detail. He has lost 0.35kg in the last four months, though stable at the moment (will be checking weekly).

My questions are:

1) Does this sound like an okay plan? Should I rush to xray/ultrasound this right now or wait a week or so to see if the antibiotics make a difference? Please bear in mind he's getting old now so I need to bear in mind his quality of life in all decisions about investigations and treatments.

2) What are other people's experiences of dealing with liver problems in their beloved bunnies?

3) What dosage of milk thistle do I offer him? He's a little super star when it comes to syringe feeding so I can make up a solution to give him via an oral syringe. I can't find an ideal dosage anywhere though.

4) Does anyone know if EC has a known impact on the liver? We're certain Sumi has battled EC throughout his life, without any of the major and more well known symptoms.

4) Any other advice people may have?

Many thanks to you all,

Fiona
 
I have posted my replies in red font :)

Sending vibes for Sumi xx


Hello there,

I'm looking for some advice from you good people at RU.

My 8 year old bunny Sumi ('Soomi') developed GI stasis on Saturday and started to show some improvement on Tuesday. He was fully syringe fed and offered all fluids va syringe until Tuesday evening. He's a fantastic little syringe feeder and he maintained his weight throughout all of this. He got all of his meds and pain relief and the vet took bloods on Monday afternoon. Those of you who know or remember me might recall that Sumi was one of my recurrent GI stasis bunnies many years ago, thought to be linked to mild EC and the (relatively unknown) effect it can have on bunny guts.

He has picked up well and back to his usual cheeky self now, though continues to have spells where he lies oddly pushing his tummy into the ground. He remains on pain relief via Metacam twice daily.

His blood test results came back today and I got the sorry news that all of his liver function results are abnormal. The vet is suspicious, given his age, that he may have a liver tumour. He was also very tender in that area during examination on Monday. We are pressing ahead to treat with antibiotics at the moment to see if there is a chance of an infection of some kind, given that he has perked up greatly. We'll also be trying lots of milk thistle and tender loving care to see if he keeps improving. The plan is to repeat his blood tests next week to see if there is any improvement, and failing that, will xray and ultrasound his liver to check in more detail. He has lost 0.35kg in the last four months, though stable at the moment (will be checking weekly).

My questions are:

1) Does this sound like an okay plan? Should I rush to xray/ultrasound this right now or wait a week or so to see if the antibiotics make a difference? Please bear in mind he's getting old now so I need to bear in mind his quality of life in all decisions about investigations and treatments.

I think so

2) What are other people's experiences of dealing with liver problems in their beloved bunnies?

Depends on the exact nature of the problem really. There are many possible causes.

http://wildlife1.wildlifeinformation.org/S/00dis/Parasitic/Encephalitozoonosis.htm

http://wildlife1.wildlifeinformation.org/S/00dis/Parasitic/Hepatic_coccidiosis_rabbits.htm

http://wildlife1.wildlifeinformation.org/S/00dis/Miscellaneous/HepaticLipidosisRabbit.html

http://wildlife1.wildlifeinformation.org/S/00dis/Parasitic/Tapeworm_cyst_infection_lagomorphs.html

3) What dosage of milk thistle do I offer him? He's a little super star when it comes to syringe feeding so I can make up a solution to give him via an oral syringe. I can't find an ideal dosage anywhere though.

I have not used it for a long time (no need, thankfully) but I would chat with your Vet re the dose. You can buy dried milk thistle


http://www.shelledwarriorsshop.co.uk/dried-milk-thistle-20g-tortoise-rabbit--free-post-1589-p.asp

4) Does anyone know if EC has a known impact on the liver? We're certain Sumi has battled EC throughout his life, without any of the major and more well known symptoms.

See links above. According to Richard Saunders (Bristol Rabbit Clinic) EC is not thought to be a significant cause of Liver Disease.

4) Any other advice people may have?

I think you are doing everything possible. Maintaining optimum nutrition will be important. Richard Saunders suggests supplementing the diet with water soluble vitamins which may be lacking due to the compromised hepatic metabolism.


Many thanks to you all,

Fiona
 
Many thanks for your comprehensive response Jane. I'll have a good look at all of the references.

Fiona
 
These are very interesting references Jane, thank you. I have bought some of the milk thistle leaves on the website you linked and will syringe him a small solution in the meantime. My vet was not sure of the solution to make up, but I appreciate his honesty.

Hopefully my wee boy will be okay :(

Fiona
 
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