Broken foot/Possible bone cancer?

Hi everyone,

I'm wondering if anyone might have any advice for me regarding my rabbit Chandler. He's a nearly eight year-old English angora who has been in excellent health up until this past week. While clipping his nails on Sunday, I noticed that his right hind foot was quite swollen when compared to the left one. It also felt like there were lumps in places I took him to the vet yesterday, and an x-ray revealed a small fracture in one of the metatarsal bones. The vet attributed the swelling to internal bleeding (hematoma) at the site of the fracture. However, farther up the leg, near what I guess we'd call the ankle joint, there is another lump-like area with additional swelling. Indeed, based on the x-ray, the whole leg is somewhat swollen. The vet said that it's usually pretty clear to see bone cancer on an x-ray, but Chandler's x-ray befuddled him. He's suspicious that there may be some neoplastic changes going on at the ankle joint, and he wants to see Chandler again next week for another x-ray. In the meantime, I'm confining him to his cage to give the foot time to heal, as well as giving him Metacam for the pain. He's frequently licking the swollen foot, so I think it's bothering him despite the medication.

I really have no idea if the two issues (foot fracture and swelling/lump farther up the leg) are truly separate or if they are just the same injury. I have no idea how he might have injured his foot; perhaps by jumping down from somewhere or getting into some other mischief when I'm either not home or sleeping. Otherwise, he's eating and drinking normally and is showing his typical curiosity and affection. He really wants to get out of the cage; he's not used to being stuck in it because I've always let him be free.

Based on your guys' experience, do you have any idea what might be going on here? It is frustrating that I don't have a clear diagnosis!

Thanks a lot!

Its impossible to say anything without seeing xrays etc and tbh this case sounds as though only one or two of the people on here would have the experience even to look at those in a meaningful way.

However I would suggest that if your vet is unsure you ask them to refer you to a specialist 'exotics' (rabbit ) vet who will have more experience of this sort of thing.

I do not know where in the country you are but there are exotic referrals vets quite widely spread - although the top vets are in Bristol, Edinburgh and Harrogate - there are also referral vets in Cambridge and other locations.

I good vet will always seek to get another opinion if they are unsure and should welcome your suggestion of a referral.

Yes, forwarding the xray to another vet for a second opinion might be a good option. I expect the vet is hoping next weeks xray will make things clearer - hopefully it will show improvement.

It might be worth discussing with your vet taking a body xray at the same time as the second one if they think it could be cancer to see if there are any signs elsewhere - that's a little outside my knowledge though. If does turn out to cancer and just in that leg, it could be amputation is an option - which rabbits generally cope well with.

In the meantime if you give your vet a call about the metacam dose it might be they can up it a little if he's showing signs of pain, most vets will discuss something like that over the phone

Thanks for your replies and for the suggestion of seeking a second opinion. The waiting coupled with not knowing what's going on are the hardest parts!

Nothing to add but best wishes.

Thanks for the sentiment, Anne.

Does anyone know if Metacam can cause constipation? Chandler isn't pooping as much as he normally does. Perhaps part of it has to do with his being confined to his cage and not getting his usual exercise? But I'm also suspicious about the medication.

I don't think that's usually an issue with metacam (it's very commonly given to rabbits) but rabbit's guts can be quite sensitive and just stress or pain can upset the balance. It's quite common for their gut to slow down and that can cause stasis (it stopping completely). If he stops eating/pooping that's an emergency and the vet will give drugs/fluids to help.

Tempting him with his favourite foods might help, and you could try something like fiberplex - basically a paste with some extra fibre/probiotics in.

chandler said:

Thanks for the sentiment, Anne.

Does anyone know if Metacam can cause constipation? Chandler isn't pooping as much as he normally does. Perhaps part of it has to do with his being confined to his cage and not getting his usual exercise? But I'm also suspicious about the medication.

Click to expand...

I have never experienced that happening - and have used it on a LOT of rabbits. However given when there is no food in the stomach it can cause gut ulcers.

Just something to be wary of.

Poor bun. I have no advice but best wishes.


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Appreciate all the feedback on the constipation question; I'll certainly defer to your extensive experience in treating rabbits! Will give another update after the vet visit on Tuesday. The leg looks the same as it did five days ago--no decrease in swelling. I'm not sure how long it typically takes for the swelling to abate in a case where there is just a fracture and no other complicating elements. Thanks again for all the support!

Well I brought Chandler to his vet appointment today, and a CT scan was done on his leg. The vet called and said it definitely looks like there is some cancerous process going on, coupled with extensive osteolysis to the point where the bones in the leg are "melting down". I'm living in Sweden, and I asked about amputation of the leg and was told that amputating a rabbit's hind leg is unethical, as they need both back legs to have a good life. Yet I've read a lot of stories of vets in other countries who say that rabbits adjust well to having a back leg amputated. Here I've been advised to euthanize him ASAP, as the condition is undoubtedly painful and they won't prescribe pain medication because he says they don't know how to give proper doses to rabbits. I'm still giving him the Metacam. They're not even positive that he has cancer because no biopsy was done, and they haven't looked for metastases because to them it doesn't matter. I'm really frustrated and want to find a vet who would consider amputation if everything else is clear. I feel like the veterinary care here is subpar in that they would euthanize without investigating all other possible options.

Hi

I'm really sorry to hear about your bun; we had a bunny who had one of his hind legs amputated when he was about 6 years old and had a good 2 years of life afterwards. I am not sure what the vets are like in Sweden but our vet in the UK was adamant that amputating would be the best solution rather than euthanising him (as were we!)

I hope you manage to find a vet who can help with this.

Gem

Yes, as you have seen many forum member have tripod bunnies that cope fine. Backlegs take more weight than front legs but bunnies still seem very agile.

If your vet isn't sure about pain med doses etc. they should be able to use their contacts to find a vet that can tell them.

We don't have many swedish bunny owners here but there are a few about on facebook etc. so you might be able to find someone that can recommend a vet. The organisation that accredits vets in sweden might also keep track of vets that specialise in particular animals. Is there a house rabbit society in Sweden - they might have a vet list. Rabbit 'show jumping' (Kaninhoppning) is popular there I would guess they might have a network of rabbit owners and they might be able to help you find a more helpful vet.

'oompa-loompa' is in Sweden, you could PM her to see if she knows of any Rabbit Savvy Vets

http://forums.rabbitrehome.org.uk/member.php?10810-Oompa-Loompa

Then there are these links that you could print out to show the Vet *WARNING, SOME LINKS SHOW GRAPHIC IMAGES OF SURGICAL PROCEDURES*

http://wildpro.twycrosszoo.org/S/00...iv_TechniquesRabbit/LimbAmputationRabbits.htm

http://books.google.co.uk/books?id=...onepage&q=rabbit hind limb amputation&f=false

http://www.vetstream.com/lapis/Content/Technique/teq00024

http://books.google.co.uk/books?id=...onepage&q=rabbit hind limb amputation&f=false

http://www.cabi.org/isc/FullTextPDF/2011/20113161615.pdf

I don't know if this helps, but I found a recommendation from a rabbit owner, for a Bo Runsten, an exotics vet at this clinic:

http://www.blastjarnan.se/om-oss/medarbetare/veterinarer/bo-runsten/

Thank you all for your tips and advice. I will definitely print out those links. I made an appointment with another vet for tomorrow; I have no idea if they'll be any better, but I'm going to do my best for this rabbit so that if I'm forced to put him down because he can't get quality care then at least I'll know I did everything to help him. When Chandler's been in pain in the past (e.g. from GI stasis), he'd just lie in the corner of the cage and not eat, drink, or show interest in anything. I would have to give him pineapple juice with a syringe. Yet now, he's eating, drinking, grooming, and really wants to come out of the cage. He'll even stand on his back feet if he thinks I have a treat. This is the rabbit the vet wants to euthanize because of "severe pain". I assume they didn't want to give me pain medication so that I would feel compelled to kill him. It's an animal hospital, yet they say they don't know how to manage a rabbit's pain. Totally outrageous.

I sincerely appreciate all your support. It's nice to know that there are some people who actually CARE.

And I've PMed oompa-loompa

A follow-up question:

Would a rabbit lie on his side with legs outstretched if he were in severe pain? Chandler just ate, and now he's assumed his normally relaxed position.

It tricky to judge with rabbits as they do hide pain, but you'll be best placed to guess as you know his normal behaviour. If you think he's as relaxed as normal - eating, lively and wanting to interact then I would say the metacam seems to be doing the job

An update--

I took Chandler to another vet who also refuses to amputate due to ethical reasons. I managed to find a vet in Stockholm who would do it, but it's not practical to make the five hour car ride there. It would be too stressful for him; if he were younger I would consider it, but he's nearly eight and I don't want to put him through all that. I still haven't received a clear diagnosis, but I got some antibiotics from the vet yesterday. I might as well try and see if it helps. I also got Fibreplex and more Metacam. He's still acting normal even though his leg is swollen along with the fracture.

I know I'm going to have to put him down but the question is when? He has a huge appetite, drinks plenty, gets excited for treats, is still curious, etc. I let him out of the cage for a little bit yesterday because I don't want him entirely locked up for his last days. Does anyone have any advice as to the best time to euthanize a rabbit? It is hard to consider doing it when he's still acting normal.

Thanks again.

If the bun isn't in pain and isn't showing you signs of suffering then let the bun tell you when it's time they usually do or you'll just know when it's time to help them to the bridge

I am so sorry *hugs*