Help regenerative anemia

Hello,

I am new to the site and need some help with my lionhead bunny Amelia. 3 weeks ago both of my rabbits (Winston and Amelia) got GI stasis I believe from the stress of my cousin moving in with us and turning out to have a major alcohol problem and us having to kick him out. Winston was 7 years old and ended up passing away. Amelia didnt have GI stasis as severe as him but things got really bad for her when he died 2.5 weeks ago. Amelia hasn't eaten or drank since he passed away. The vet has been treating her for GI stasis and we just got bloodwork and x rays done 4 days ago as the vet is concerned there could be something more as Amelia isn't showing any improvement. The x rays showed a large amount of gas which she prescribed dyoctol for besides the gas she said the x rays were fine. The blood work however showed a low number of red blood cells. The vet did 6 blood smears but couldn't find the source of the problem so she sent the blood away to a pathologist. The results came back today saying Amelia has regenerative anemia. The vet had her assist call me to tell me this and said that Amelia has internal bleeding. My question is - how does the vet know its internal bleeding ? I haven't had a chance to ask her yet as she is out of town. The vet said she has to open Amelia's abdomen to find the source of the internal bleeding and that she only has a 50% chance of making it. I just feel like she has jumped the gun a but and wondering if anyone has any thoughts? Are there any other treatments for anemia and or internal bleeding. The bloodwork was done 4 days ago so I would have thought if it was sever internal bleeding she wouldn't have made it until now. How would the vet know its internal bleeding and has anyone ever tried any other treatment methods before syrgery? The surgery will cost a minimum of 1000 and only a 50% chance of living so its a tough decision if I should get the surgery. Is it possible for internal bleeding to heal itself like in humans?

What medication is your Rabbit on, apart from the Dyoctol ?

GI ulcers can form rapidly in Rabbits who are in gut stasis/anorexic so a histamine H2-receptor antagonist- eg Ranitidine- that inhibits stomach acid production may help. A bleeding ulcer is a possibility.

Is Amelia spayed ?

I would be very, very reluctant to agree to a laparotomy . Has the Vet not suggested an abdominal ultrasound ?

Where her Liver enzymes OK ?

Renal function ?

Has the Vet done a urinalysis/fecal analysis ?

Hello and thanks for your reply.

Yes Amelia is spayed.

These are her meds:
Critical care
Subcutaneous fluids
Dicotyl
Lactulose
Tramadol
Metaclopremide
Cisapride

She was on baytril but the vet stopped this.
She hasn't done urine or fecal tests.

Kidney, liver and white blood cells were all fine.

She hasn't suggested an ultrasound. This is why I am so confused about wanting to do the surgery so suddenly.
Thanks,

Britt

Britt said:

Hello and thanks for your reply.

Yes Amelia is spayed.

These are her meds:
Critical care
Subcutaneous fluids
Dicotyl
Lactulose
Tramadol
Metaclopremide
Cisapride

She was on baytril but the vet stopped this.
She hasn't done urine or fecal tests.

Kidney, liver and white blood cells were all fine.

She hasn't suggested an ultrasound. This is why I am so confused about wanting to do the surgery so suddenly.
Thanks,

Britt

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There is not any possibility that both Rabbits ingested some sort of toxin is there ? Unlikely, but just a thought given the presence of an unstable person and the subsequent illness of both Rabbits.

I am very sorry that Winston passed away

Perhaps you could have a more detailed discussion with your Vet and express your reluctance to agree to surgery but ask what other non invasive diagnostics he/she could run.

I would definitely ask about the 'anti-gi ulcer' drug- either Ranitidine or Omeprazole.

I am sorry you lost Winston and now have Amelia so unwell.

Regenerative anaemia is a condition whereby the bone marrow needs to produces extra red blood cells to replace those which have been lost. It is normally an ongoing process as red cells have a life span of about 120 days in humans but probably a bit less in rabbits. An over representation of young cells (reticulocyte) suggests a loss of normal red cells before their life span completes. If there are no outward signs of bleeding then the most likely cause is internal haemorrhaging.

I fully agree with Jack's-Jane regarding an ultrasound before a laparotomy is performed, unless Amelia's condition becomes life threatening.

I sorry to ask but is it anyway possible your unwanted guest could have caused any physical abuse, no matter how mild, towards these bunnies?

Hello,

I do not think that my cousin would have harmed the rabbits, he actually has a rabbit of his own that he is flying here from another province as he loves it so much. He is very much an animal lover and I don't think that he would have poisoned them or hurt them in anyway. It is strange that both Amelia and Winston got the GI stasis at the same time. To me that says that their was a common denominator (possibly the stress of having my cousin here) and then I truly believe that Amelia isnt recoving as she is so depressed that her BFF is gone.

She actually started to show some improvement for a couple of days but it didn't last unfortunately now she is back to being lathargeic and not eating or drinking.

I am taking her back to the vet today and I am going to have the CBC blood test done again. I found out more info from the vet when I finally spoke to her. She said that it is "mild" regenerative anemia and that she had a score of 26/32 . 32 being the norm. I am going to see if the number went up or down today and then discuss other options. I suggested the ultrasound and the vet said she could do a "mini" untraound but that she isnt very good at ultrarsounds so she would have to send me some place else if I wanted a "full" one. Whatever that means....

I am also going to ask about ulcers and the two drugs Ranitidine and Omeprazole.
Does anyone know if these drugs would do harm to her if she doesn't have an ulcer?

It has been 3.5 weeks of force feeding every 4 hours and subcutaneous fluids and she just doesn't seem to be getting better, She is "stable" not declining but also not getting better.

Has anyone ever made their own type of critical care with ground up pellets? Is this essentially the same thing? I found a recipie on the internet. I am trying to save money some where between both rabbits I have spent 2000 at this point and todays appointment will likely be another 500 with refills on all the meds.

Any other advice before I see the Vet?