Need advice for cancer diagnosis 11yo female bunny

Ok, this might be a long one. I'm also new here, I'm not going to skimp on the details.....

So my female bunny is 11 years old (birthday yesterday ), has been spayed, I've had her for her whole life, never had any health problems except for a 'wart' on her back diagnosed by a few different vets, suggested not to remove unless its bothering her (which it didn't)
So a few weeks ago I notice that one of her shoulder blades on her back seems a lot more bony and is a lot bigger than the other. The lump literally feels rock solid like bone, doesn't feel particularly smooth/not completely round (like I would expect a tumour to feel...). She's not bothered by it at all, although my boyfriend things she hops slightly wonky but I can't notice it!

Anyway, took her to the vets the next day. Vet suggested it could be an abscess, tried to take sample of pus even with big needle but nothing coming out so ruled out abscess. She took a few cells (needle aspiration) and sent off for lab analysis. Results come back and say the cells are inflammatory and mesenchymal (something else also but I can't remember). Vet asks if she has had trauma/injury as could be due to trauma, we ruled out this is not the case. So took her in for a biopsy under GA.

Arrive at vets for Lola's biopsy, mention to vet that she also has a wart on her back that she's not bothered by but she says that they can quickly remove that too as she will be under GA anyway. (Reluctantly) let Lola go with nurse. Go home. They checked her blood before GA and I assume all was good (w/r to kidney/liver function etc) as they went ahead. Get a call a few hours later from surgeon who said they had found another lump (like the wart on her back) on her cheek and we agree to remove it as well. They also take X-rays (I don't know the results yet). Get call later saying all went well and she was stable under GA, but she is a bit cold after GA so they are warming her up and also she is v sleepy/seems depressed so they kept her in overnight.

We (me and boyfriend) went to see her that evening, she was looking a lot more worse for wear than I expected, but she seemed v happy to see us as by the time we left she was eating and drinking and even trying to hop around!! She was fine over night and we took her home next morning. She was very sleepy for 2 days, slept lots on 3rd day and by then was mostly herself again she's been in the house since as she can't be with Stanley (bonded bunny) in case he nibbles stitches! Stitches healing really well and she's not really bothered by them at all.

So today (op was on Thursday, today is Wednesday) I get a call from vets with results.
1. The 'wart' on her back was actually a low-grade papilloma. So I know papilloma can be benign, but does "low-grade" mean it was cancer? they said they aren't worried about that because it was well excised.
2. The large mass which felt like bone to me (even the vet who examined it said it did feel very hard!!) is a low-grade soft tissue sarcoma. When I got the results of the needle aspiration I spoke with the vet for a while and she suggested even if it was benign/low-grade we should probably remove because if we waited and it got bigger it would be more difficult, and also don't want it to spread. Vet I spoke to this time said that they wouldn't want to remove it as they would really worry about her under GA as is a more invasive procedure, and because it is low-grade it isn't likely to spread and suggested we just monitor it as it isn't bothering her.
3. The bad news (as if the other is 'good' news :/) - the lump they removed on her face the lab results weren't clear for. The results say "poorly differentiated" - which having almost finished my Cell Biology degree I know isn't good. So its indicative of a higher grade cancer..vet says more likely to spread and be aggressive, but they don't know what it is. She said if we want to know what it is the lab would do further staining of the tissue, but that whatever the result it probably wouldn't change our treatment plan. I ask what they would do to test if it has spread, vet says they would take cell samples from her lymph nodes and send to lab, but says this is a difficult procedure in itself. She says although it is more likely to spread, that he surgeon was confident they removed it all. So the question just remains HAS it spread? And what could be done to make her comfortable?

I felt unsure on the information as vet seemed slightly indecisive about what should be done, but then again I know its my decision. She is going to get the surgeon (who did Lo's biopsy operation and would do any more) to give me a call to see what he suggests should be done.

So the thing is, she's so full of life, she doesn't act old and is brilliant. Options seem to be:
- Monitor big lump and her general health and just make sure she is comfy and not in pain
- Excise big lump and test lymph nodes for metastasis under GA
- Leave big lump alone and just test lymph nodes

But then, if they found that it HAD spread to the lymph nodes, what could be done anyway? So is there any point in testing to see if it has spread?

I don't want to put her through some invasive/awful surgery at this age if there is no point, but if there is something (that is feasible i.e. won't put her through necessary stress/surgery) that can be done, and I don't do it which means that she gets worse/ potentially leaves us then I will never forgive myself. I feel like I haven't got all the information I need to decide. I guess staining the sample further to try find out what it is might help, but as the vet said, it probably wouldn't change their treatment plan? I don't know also if this staining would be able to indicate whether it probably would have spread? I thought maybe they could have tested to see if it had spread by testing her blood or something??

I know its a catch-22 either way. It boils own to this:
*****I want her to be happy and comfortable, but I don't want her to get worse/die from something that could have been treated.****


So sorry this is so long, if you've read to the end I applaud you. She means the world to me and I just want her to be healthy, happy and comfortable, and do the best I can for her!
I'm appreciative of any advice you guys might have/experience.

Thanks so much,

Sophie

Hello Sophie and welcome to the Forum :wave:

I'm sorry to hear Lola's tale, but it sounds like you and your vet have been fairly thorough in trying to cover all bases, even though all the results aren't crystal clear at the moment.

She has had a lovely long life with you, and you must be very happy about that. Lucky rabbit

Cancer (excepting uterine cancer) is relatively rare in rabbits, but I have had rabbits with cancerous growths. My personal opinion would be to treat conservatively and not allow her to undergo invasive and debilitating surgery. If she is bright and happy within herself then I would major on that and keep her happy and pain-free for as long as possible.

I tend to go for quality of life, especially in older rabbits, rather than trying to fix something like cancer, as in my experience, cancer spreads and it's unlikely that it's all caught via surgery. Possible, but not always likely.

Good luck whatever you decide

I completely agree with MightyMax.Keeping her comfortable and happy is a priority at this stage in life.Shes very lucky having such a caring owner and has obviously had and is still having, a happy life.

Hope that whatever happens, you continue to have happy times together for as long as possible.x

Sorry that you are having to cope with this. Given Lola's age I think that I too would go for conservative management that will allow her to spend as much time as possible with Stanley and monitor her quality of life. Sending lots of love and healing vibes X

Thank everyone for your quick replies! After letting it sink in for a bit I've realised you are all right, I think is a bit of a shock because she seems so healthy and a couple of weeks ago I was none the wiser! I just want her to be happy and comfortable, as for now she's definitely still a little madam!!

I totally agree. I would not want to put her through any invasive treatment. Remember also, that whilst you are aware of what the problem is, she will not know that she has cancer and will continue to be happy from day to day. Sending lots of vibes for her and hugs for you.

sophiebssn said:

Thank everyone for your quick replies! After letting it sink in for a bit I've realised you are all right, I think is a bit of a shock because she seems so healthy and a couple of weeks ago I was none the wiser! I just want her to be happy and comfortable, as for now she's definitely still a little madam!!

Click to expand...

I'm glad you feel you have a bit of a way forward now :thumb:

With my cancer bunnies, they were quite happy and were blissfully unaware of their tumours! I obviously kept a close eye for growth, and also any other symptoms such as breathing difficulties.

If any other symptoms appear, even though they may seem unrelated, that may be the time to ask the vet about the way forward

I hope she continues to have a good quality of life for a long time and continues being spolit by you! If you wanted you could go to the photo and story section and post some pics....

Ah I will do that! I actually tried to post some here but couldn't do it!

She actually wasn't doing as good last night and this morning, she was grinding her teeth and wasn't happy, gave her some metacam and she seemed better, today she is noticeably not putting weight on her left foot (tumour is ontop of her left shoulder blade) so I'm wondering if she is uncomfortable or hurting a bit. She needs a post op check anyway so another vet trip is in order! X

sophiebssn said:

Ah I will do that! I actually tried to post some here but couldn't do it!

She actually wasn't doing as good last night and this morning, she was grinding her teeth and wasn't happy, gave her some metacam and she seemed better, today she is noticeably not putting weight on her left foot (tumour is ontop of her left shoulder blade) so I'm wondering if she is uncomfortable or hurting a bit. She needs a post op check anyway so another vet trip is in order! X

Click to expand...

Good luck at the vet's Sophie

Here's how to post photos:

http://forums.rabbitrehome.org.uk/showthread.php?136183-Tutorial-How-to-Post-Photos

http://forums.rabbitrehome.org.uk/s...tos-directly-from-facebook-or-another-website


I look forward to seeing some piccies of your lovely one

Thanks MightyMax! I will do it at the earliest opportunity!! My dissertation is due Monday and it definitely needs some of my attention! Eek!

Also the vets went as well as could be hoped, will fill you all in later

I had a female bunny who developed a lump between her leg and her body when she was about 10 years old. Since the lump was growing and starting to cause her to hop lopsided, I had it removed. It was cancer. Due to the location being so close to her intestines, the specialists my vet contacted did not recommend any radiation or other treatment. About a year later when the lump started to return, I had it removed again and this time it seemed to be gone for good. When she was 13 years old she developed an unrelated problem and passed away at age 13.5.

The reason I mention this is because your vet may not be able to remove every cancer cell, so it could grow back. However, surgery may be worth the risk in the future if your bunny's tumor starts to grow and causes her discomfort or other issues.

sophiebssn said:

Also the vets went as well as could be hoped, will fill you all in later

Click to expand...

:thumb:

(after you've attacked your dissertation!)

Hi sorry I haven't written on here sooner and sorry I haven't got round to uploading those photos! Been a hectic few weeks at uni!

Update on lola! Since her biopsy and removal of the two smaller lumps, all stitches have been taken out and she has been on metacam since I posted last: 0.75ml once per day. Was doing well for a while, never got back to 100% though, but still had her amazing appetite, pooing and weeing, hopping round less than usual though and reluctant to be picked up ( I think she got bored of having her stitches checked).

But the last few days she's not been herself and has been more reclusive, hiding in the corner, looking depressed looking at the floor. Tuesday I took her to the vets because she has another round small pea sized (although growing noticeably)lump growing onto of her tumour that is onto of her shoulder blade (low-grade soft tissue sarcoma). I also think the sarcoma has grown too, maybe making her more uncomfortable. Vet thinks the tumour is budding off, and thats what the little lump is.

Today I called the vets about upping her metacam and we decided to increase to 1ml once per day (NB: she is 2.66kg, she was about 2.85kg but on tues they said she has lost weight (in the space of 1.5-2 weeks:/ )). 2 hours after she had had it she was looking really worse for wear, couldn't get comfortable, grinding her teeth occasionally (definitely unhappy grinding), didnt want to be putting weight on her foot at all, kept trying to tuck her feet or her sore foot under her! looking so depressed and sad called vets and we talked about not increasing metacam more but possibly trying tramadol. She will hop around when prompted but when sitting she will try to not put pressure on her foot.

I was all ready to go to the vets to pick up some stronger painkillers, and to spare her the stressful car journey moved her into the kitchen with Stan (other bonded bunny) for company and she's perked right up. Eating, hopping about more....seems ok again, not acting like she's in pain at all. I can't keep up!! I told the vet and she says that it might be that it will come in waves and she will be ok then not ok, and I said I wouldn't know when to give painkillers (as we need to try the tramadol and see if its a good option for her or not and what dose etc). She's fine now so decided to leave it for tonight and she has an appointment tomorrow afternoon.

She's going downhill quicker than I expected but also one minute she's not ok, next she's fine??? I don't know how to interpret that with regards to pain relief, etc.

What do you guys think?? Would keeping her on metacam and then giving tramadol when it seems she needs it (if its a good option for her of course) be a good idea? A few people have recommended tramadol over other opioids. Keen to hear anyone else experiences or just what you think generally. I am just finding how she's feeling difficult to judge, I just want her to be happy, comfortable, warm, and pain-free for as long as possible.

Thanks again everyone. I will post some photos

sophiebssn said:

Hi sorry I haven't written on here sooner and sorry I haven't got round to uploading those photos! Been a hectic few weeks at uni!

Update on lola! Since her biopsy and removal of the two smaller lumps, all stitches have been taken out and she has been on metacam since I posted last: 0.75ml once per day. Was doing well for a while, never got back to 100% though, but still had her amazing appetite, pooing and weeing, hopping round less than usual though and reluctant to be picked up ( I think she got bored of having her stitches checked).

But the last few days she's not been herself and has been more reclusive, hiding in the corner, looking depressed looking at the floor. Tuesday I took her to the vets because she has another round small pea sized (although growing noticeably)lump growing onto of her tumour that is onto of her shoulder blade (low-grade soft tissue sarcoma). I also think the sarcoma has grown too, maybe making her more uncomfortable. Vet thinks the tumour is budding off, and thats what the little lump is.

Today I called the vets about upping her metacam and we decided to increase to 1ml once per day (NB: she is 2.66kg, she was about 2.85kg but on tues they said she has lost weight (in the space of 1.5-2 weeks:/ )). 2 hours after she had had it she was looking really worse for wear, couldn't get comfortable, grinding her teeth occasionally (definitely unhappy grinding), didnt want to be putting weight on her foot at all, kept trying to tuck her feet or her sore foot under her! looking so depressed and sad called vets and we talked about not increasing metacam more but possibly trying tramadol. She will hop around when prompted but when sitting she will try to not put pressure on her foot.

I was all ready to go to the vets to pick up some stronger painkillers, and to spare her the stressful car journey moved her into the kitchen with Stan (other bonded bunny) for company and she's perked right up. Eating, hopping about more....seems ok again, not acting like she's in pain at all. I can't keep up!! I told the vet and she says that it might be that it will come in waves and she will be ok then not ok, and I said I wouldn't know when to give painkillers (as we need to try the tramadol and see if its a good option for her or not and what dose etc). She's fine now so decided to leave it for tonight and she has an appointment tomorrow afternoon.

She's going downhill quicker than I expected but also one minute she's not ok, next she's fine??? I don't know how to interpret that with regards to pain relief, etc.

What do you guys think?? Would keeping her on metacam and then giving tramadol when it seems she needs it (if its a good option for her of course) be a good idea? A few people have recommended tramadol over other opioids. Keen to hear anyone else experiences or just what you think generally. I am just finding how she's feeling difficult to judge, I just want her to be happy, comfortable, warm, and pain-free for as long as possible.

Thanks again everyone. I will post some photos

Click to expand...

It may be that Lola is not actually in pain as such, but is having periods where-by she is just feeling rotten. Do you know if she has any liver function issues now due to her cancer ? I know from current first hand experience for myself how liver function problems can make you feel terrible at times.

If the Vet thinks that another analgesic is now needed then personally I would opt to try Tamadol first as it tends not to cause the sedation that opiates often cause.

If Lola's 'not so good' times are less to do with pain and more to do with her biochemical state then some fluid therapy may help. Your Vet could show you how to administer subcutaneous fluids so you could give them at home rather than having to keep taking Lola to the Vet.

sophiebssn said:

Hi sorry I haven't written on here sooner and sorry I haven't got round to uploading those photos! Been a hectic few weeks at uni!

Update on lola! Since her biopsy and removal of the two smaller lumps, all stitches have been taken out and she has been on metacam since I posted last: 0.75ml once per day. Was doing well for a while, never got back to 100% though, but still had her amazing appetite, pooing and weeing, hopping round less than usual though and reluctant to be picked up ( I think she got bored of having her stitches checked).

But the last few days she's not been herself and has been more reclusive, hiding in the corner, looking depressed looking at the floor. Tuesday I took her to the vets because she has another round small pea sized (although growing noticeably)lump growing onto of her tumour that is onto of her shoulder blade (low-grade soft tissue sarcoma). I also think the sarcoma has grown too, maybe making her more uncomfortable. Vet thinks the tumour is budding off, and thats what the little lump is.

Today I called the vets about upping her metacam and we decided to increase to 1ml once per day (NB: she is 2.66kg, she was about 2.85kg but on tues they said she has lost weight (in the space of 1.5-2 weeks:/ )). 2 hours after she had had it she was looking really worse for wear, couldn't get comfortable, grinding her teeth occasionally (definitely unhappy grinding), didnt want to be putting weight on her foot at all, kept trying to tuck her feet or her sore foot under her! looking so depressed and sad called vets and we talked about not increasing metacam more but possibly trying tramadol. She will hop around when prompted but when sitting she will try to not put pressure on her foot.

I was all ready to go to the vets to pick up some stronger painkillers, and to spare her the stressful car journey moved her into the kitchen with Stan (other bonded bunny) for company and she's perked right up. Eating, hopping about more....seems ok again, not acting like she's in pain at all. I can't keep up!! I told the vet and she says that it might be that it will come in waves and she will be ok then not ok, and I said I wouldn't know when to give painkillers (as we need to try the tramadol and see if its a good option for her or not and what dose etc). She's fine now so decided to leave it for tonight and she has an appointment tomorrow afternoon.

She's going downhill quicker than I expected but also one minute she's not ok, next she's fine??? I don't know how to interpret that with regards to pain relief, etc.

What do you guys think?? Would keeping her on metacam and then giving tramadol when it seems she needs it (if its a good option for her of course) be a good idea? A few people have recommended tramadol over other opioids. Keen to hear anyone else experiences or just what you think generally. I am just finding how she's feeling difficult to judge, I just want her to be happy, comfortable, warm, and pain-free for as long as possible.

Thanks again everyone. I will post some photos

Click to expand...

Hi Sophie :wave:

I'm sorry to hear about Lola, it's very worrying for you

I have first hand experience of this sort of thing in rabbits, and what you describe sounds familiar. It's quite understandable that she would feel 'up' one day and then 'down' the next.

I think your idea of keeping her on the Metacam and giving Tramadol as and when she needs it is a good idea. What tends to happen in these cases is that the liver is one of the first organs to be affected. You could have a blood test to show what the liver enzymes would be, but it's expensive so I wouldn't normally say this is imperative. I have used a natural alternative to cleanse and regenerate the liver and please PM me if you'd like details, as it won't interfere with anything given by your vet.

Usually it's a nauseous feeling that makes rabbits feel off colour in Lola's situation.

Sending you loads of vibes and hoping Lola's quality of life means she has more good days than not so good xxx

In my own experience with my bunnies, sometimes the timing of the episodes of discomfort and/or pain can give some clues-expecially if it happens after eating or when your bunny pees or poos.

I too have had bunnies go from looking very sad to being perky within an hour or less.

Jane is right about sub-Q fluids helping some bunnies. Elderly bunnies sometimes need extra fluid when their organs are not as efficient as clearing out the by-products of metabolism which can make your bunny feel ill, even when the bunny is not technically dehydrated.

Fluids can also help to keep fecal matter softer so your bunny can pass it easier.

Sending you and Lola some positive vibes.

Thank you everyone for your lovely comments, it's so good having other bunny parent's experience and opinions!

I feel like the tramadol has been helping lola, she is still uncomfortable and not great but slighty better.

But ...

When I went to the vets last I briefly mentioned her eyes had been more gungy than usual...you know like that yellow/green eye gunge, sometimes White. also said that Id noticed In the past couple of months or so (since her op) that she is licking her urine up straight after she has weed, or emerging newspaper that is wet with urine (old or new) all the time. (NB: newspaper is at the bottom of the litter tray under hay/straw and usually she would never eat it, it just helps me when I clean our!). Any ideas about wee licking?? Vet said potential sign if urine infection but her wees have been normal as much as ive seen and not going more than normal that I've noticed...

Anyway so today, the first day I felt I could leave her, I went out and I got home and she wS sleeping I her side again, she's beendoing this more recently so it's not unusual recently. But I always check on her anyway...so I open the hitch door and notice the floor of the hutch (the plastic floor where hay/straw had parted) was all wet, and when I looked at her face after propping her up I saw she had been leaking yellow-green fluid from her mouth. May have been from her nose too...but difficukt to tell as she was panting and very hot (as in ears etc, not internal temp). She was lying half in sun half in shade, she usually sleeps in shade but when in sun she is usually fine. If she was hit i dong know why she didn't move anyway I don't know if the wet under her nose was because she was hot, but I think she was leaking a but from her nose too.

I was obviously really worried as there was quite a bit of fluid and brought her inside the house, offered her water from a bowl (sometimes she takes more readily than bottle) and she drank a little bit. She could sit up but really didn't want to and was lying down lethargic on the floor still panting. Must before I left for bets she was sitting up and slightly more alert/perky.

Vet thinks fluid Is from her mouth maybe only and fhibks she might have an abcess in her mouth. She is going in tomorrow for a sedation and they are going to have a look, mah explain why I think her pain has increased recently. She's slao been chattering her teeth ( like when we shiver cold but with her mouth closed) and occasionally (not as often) some grinding noises. Also mentioned to vet recently she did more cecotropes(sp?) and didn't eat them which she's usually good at doing. But all her poos today have been fine.

Any ideas? She's still eating fine and everything. I said to vet she is possibly drinking less water but that might just be me overthinking lol. Vet said she's not dehydrated or anything.

Thanks everyone
Sophie

Even slight dehydration can cause disorientation and dizziness.
Older animals can have difficulty regulating their body temp so she may not be able to tolerate being even a little hot. Jane would know more, but I think this is somehow related to the functioning of the kidneys.
Could it be that she got too hot while she was napping and she felt too ill to move on her own into the shade?