Thymoma Related Advice please

As some of you may know, Emrys has a thymoma. He was diagnosed last Tuesday but in reality has probably had it much longer. I am at the stage where its 50/50 about keeping him alive and I don't really know what to do. I wll outline why below.

One of the major issues is that he is not eating properly. He has gone right off pellets and eats leafy greens occasionally. He won't eat carrots or even accept a raisin. Most of his eating takes place at night and his poos are small and black, some of them soft. He does eat hay but not as much as he used to. I am considering making him some porridge just to give him something substantial. But since he did not eat mashed up pellets he might do the same with porridge. Its worth a try at least. I am concerned that he might be starving but his weight has not decreased. Unlike my healthy rabbits he shows no enthusiasm for food.

He also has to take tablets for high blood pressure. The tablets have been successful in that his eyes no longer bulge or are bloodshot and he has some vision back. But he hates taking the tablets, I put to put them right at the back of his mouth and he will do his best to get them out. I always succeed eventually but it is stressful for him.

He is resting a lot, lying down stretched out or sitting with feet tucked under. He is not hunched like a stasis bunny and always seems relaxed and at ease but he definitely wants to take it all at a slower pace.

He is not cleaning his back end properly and is slightly urine or poo stained which means I have to clean him and again he finds that stressful.

Because he is not eating as much or moving as much, I surmise that the tablets are not helping to reduce the pressure of the thymoma on his trachea and esophagus. And its only going to get bigger so his time is limited.

On the positive side, some of the pressure has been relived around his eyes and he does have short bursts of activity. He will jump through the playhouse window sometimes which requires a good deal of energy. He also made a new friend of my house rabbit and is getting a lot of grooming and attention. He has also returned this attention and even tried to hump her a bit relentlessly. In that respect he seems like a young rabbit again.
He seems relaxed and happy with us humans too and we are getting a lot of loving licks and he will happily snooze on my lap for ages.
His urine also seems normal and he is drinking as normal.

Emrys still seems to be there mentally, he is more quiet but still very loving. Occasionally he honks or grunts to assert himself but he is otherwise quite passive. He used to be a proper alpha male(despite being neutered), very territorial, very randy and bouncy. But a lot of that vigour and bounce is gone understandably. I think he knows he does not have much time

I am just not sure what to do though. The eating is the biggest issue for me right now. I can deal with the rest but the eating seems so major. Perhaps he is not that hungry though because he is using less energy. But I would say at least 70% of his time is spend sleeping now. He is due back at the vet next week for a review but I am wondering if he should be pts next week. The thymoma will only get worse and I want to spare him further discomfort and indignity. But my Emrys is still in there and I am scared of letting go too soon as well

If anyone has any dietary advice or advice on what might be best for him (perhaps I am too biased to see it clearly just now), I would really appreciate it. I have had to pts rabbits before and I have also nursed extremely ill rabbits until the end and Emrys is not at complete deterioration but I don't want to let it get to that stage. However having nursed really ill rabbits I still have a some sort of hope and a feeling that he is quite happy despite everything. But maybe I am too involved. I love him and I know he must die soon but its deciding to help him get there and when that is so hard.

From his Xray his Thymoma does look to be very large and it is probably affecting how full his stomach feels. Did the Vet mention giving a steroid which can halt further growth of a Thymoma and might actually reduce the size of it.

All my Rabbits who have had a Thymoma diagnosed have been prescribed a Steroid as part of their palliative care regime.

As far as diet goes I would let him eat what he wants when he wants. It is not unusual for Rabbits to go off pellets in the latter stages of a terminal illness. They tend to prefer more 'natural' food such as grass, hay, forage, weeds, leaves etc.

Personally, from what I've read, I'd say it was time to say goodbye to your boy.

I am a firm believer in everyone/everything having the ability to die with dignity. I don't really like the whole 'dying wish' thing, but mine will always be to die with dignity. Even with humans, I would much rather we say a comfortable and lucid goodbye and then they die. Otherwise you end up dragging the whole situation out, all the while knowing they are going to die, until they are a mere shadow of their former selves. At the end of it, what do you gain? You watch them deteriorate before your eyes, all for a few more weeks. Those few weeks are not particularly happy, either. They're tinged with sadness, especially towards the very end, as whenever you see them doing something, you think 'that's the last time I'll see them doing that'. That spark goes out of their lives, and they become tired. Not just sleepy tired, but 'tired' tired. You know it will get to that stage eventually, but do you really want it to? With people, they can choose when they want to die. Unfortunately rabbits can't, they can't talk and tell you when they feel it's time, so you have to make that horrendous decision on their behalf.

If it was me, I'd spend the next few days with him. Take photos, videos, fur if you wish. Let him eat whatever he wants, give him the life of luxury. Make your last memories and enjoy the time you've got. Then, when it is time for your appointment, I'd let your boy slip away knowing that he had a wonderful and relatively pain-free life, even if it was a little shorter than you'd planned.

I have spent the last twenty minutes or so writing and re-writing this post, so I hope you can understand what I'm trying to say and I haven't come across too strong. Obviously this is completely up to you and I will fully understand what you do either way, but this is just my opinion. x

The first thing I thought of was the BP meds. I know from hearing my OH and his dad talk about them that they can make humans feel rather poo and inappetant. I wonder if it is the same way for bunnies? That might also explain some of the fatigue at least.
Over the years I have had to struggle with the pts decision quite a few times and I've gotten there too late in some cases, so I really don't feel qualified to speak to it. He really does seem 50/50 at the moment. I'd say when that tips to a point you can't say that anymore it may be time. But really, you know your bun best. When Mimzy got tilt and was rolling so very badly in those first few weeks I was struck hard with the thought that I should let him go. Obviously it is a different circumstance because tilt can be recovered from, but I can empathize with the thought that bunny may be too uncomfy for enjoying life. It is hard to know how to do.
Whatever you decide, you have my support. I really hope Emrys can enjoy more time with you and his bunny friend. xxxx

Sorry I haven't kept up to date with all that you have been doing for Emrys, but have you tried raising his food so he doesn't need to put his head down so far for it? This has helped Fluff eat better.

I also found Fluff does better on metacam (the vet is aware he is on it). Could you ask your vet if it might benefit Emrys?

Thanks for all the replies, they are really helpful. Emrys shows signs of life and seems happiest with his friend and when outdoors. I thought tonight that his mucus membranes had a grey tinge and when he rests its like he is shutdown mode. His nose barely twitches and his breathing is very infrequent and the breaths look small or shallow. He is not mouth breathing however and he has tried to mount and also groomed his friend. He has also been pulling carpet. I will raise his food a bit more to see if that helps, I will do the same with his water. And I will also talk to the vet about the steroid and metacam. I did wonder if due to the size of the tumour, it was so far advanced that it is too late for steroid treatment. We touched on it briefly last week but said we would talk more next week. Maybe I just panicked. Its really warm today outdoors and in so maybe that has made Emrys seem a bit quieter. Its just very hard to see him like this and to know what is best for him. I wish I could ask him what he wants to do. I want to do right by him and keep him as happy as possible until the end. I am going to forage in the garden now for some weeds and grass. There are some thistles out there as well, would he be fine to have those?

I'm sorry you're having to think about this, it's so difficult to know what to do for the best if he still seems contented enough and enjoying being with you and his bunny friend, I say leave him be for now. I think he will let you know when he's had enough x
I am panicking now though as his eating and behaviour sounds identical to my Daisy at the moment, and she hasn't been diagnosed with anything she doesn't have bulging eyes though. I think I'll have to take her to get checked out at a specialist
Sending vibes for Emrys xxx

Thanks everyone. It is very windy just now but he has hopped out of the back door and onto to the patio (its predator proofed) and he is thankfully eating some of the grass and dandelions I have plucked. I put more in a tray indoors on top of a brick in case he gets hungry tonight. He has been hoisting himself up on his rolled up towel a fair bit so it does look like he is trying to alleviate the pressure somewhat.

Ripminnie, poor Daisy, I hope she does not have a thymoma. An x ray is the best way to find out and all the better if it is diagnosed early.I will keep my fingers crossed that it is not something serious though xx

Thank you. I hope Emrys starts munching a bit more and that he remains happy for a good while yet xxx

Fifibutton said:

Thanks everyone. It is very windy just now but he has hopped out of the back door and onto to the patio (its predator proofed) and he is thankfully eating some of the grass and dandelions I have plucked. I put more in a tray indoors on top of a brick in case he gets hungry tonight. He has been hoisting himself up on his rolled up towel a fair bit so it does look like he is trying to alleviate the pressure somewhat.

Ripminnie, poor Daisy, I hope she does not have a thymoma. An x ray is the best way to find out and all the better if it is diagnosed early.I will keep my fingers crossed that it is not something serious though xx

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How is Emrys today?

He has actually been a more active today and ate more. It was very warm yesterday which must have affected him considerably. It is still warm today but I popped a fan in and it seems to have helped.

We will take him back to the vet next week and get him started on steroids and see if they make a difference. If they don't then that is probably when to let him go. Thank you so much for all the advice, its been really helpful

Here are some pictures from today.

Oh he's just gorgeous!!! and his friend too i'm glad he's had a better day xxx

He and his friend are gorgeous. I hope the steroids work and he can spend more time with you xxx

ETA - one of my buns was quite lethargic yesterday and today but was eating when the box was shaken. Tonight he is bounding everywhere as normal :roll: I can only put it down to being warm the last couple of days as the air is fresher tonight.