Santa
Wise Old Thumper
Hello! I'm sure it won't have escaped your attention by now that we've had RHD2 here at the invisabuns. I think we are now all safe - vaccinations were nearly 2 weeks ago and Jeremy the sick boy seems to be doing well. So I thought I'd write out a little bit more about the sort of signs, symptoms and treatments we've used, in case it's useful to anyone else along the way. I hope it won't be because I hope no-one else experiences this. I've probably already said this in various places, but here I want to put it all into one place and one post without a lot of the other stuff around it. If you want to read the other stuff around it you can follow my original post here:http://forums.rabbitrehome.org.uk/showthread.php?456989-Sad-news-from-the-invisabuns or for even more detail, my blog here:https://rhd2diary.wordpress.com
Ok so I'll start off with things that I've read and heard vets say in relation to RHD2, before moving on to describe what I've experienced here.
-RHD2 has a much more variable range of symptoms than classic RHD, and that vets are often working them up as stasis cases as they tend to present as fairly non-specific initially
- Going off food/inappetance
- Bleeding under the skin, potentially at injection sites if bunny has had antibiotics etc
- Weight loss
- Signs of liver disease - in some cases jaundice
- At post mortem, the signs associated with RHD1 (fragile bloody liver/blood free in cavity/thorax) are not so well developed or are absent completely
- Lower & variable mortality - 5-70% (average 20%)
- Can also affect young rabbits
And here's my experience, which sort of chimes with that but I think I can be a bit more specific about changes, timescales and behaviour changes. I should stress though that these are my experiences, and indeed each of these instances is different, which confirms the veterinary info that cases are much more non-specific and present slightly differently.
*Someone I know (RHD2 was confirmed) lost all 4 of her rabbits in the space of a few days. The first two died a day apart without any warning or indications of ill health. When the second one died, the third and fourth were inappetent and listless. The following day, the third one developed a very heavy thirst and died several hours later. The fourth was given metacam by the vet which perked her up somewhat, but she then became inappetant again the following day and developed the same heavy thirst. She was euthanised to prevent further suffering. None of these rabbits were vaccinated against myxo-rhd.
*Lily, the 6 week old baby here who was affected, fell ill very suddenly. She had breakfast as normal at about 7.30am, but when I went to do a quick head count at 11.30am I found her hiding in a corner, hunched and clearly in significant discomfort. I picked her up to put her in a carrier to take her to the vets and could feel that she felt extremely hard underneath, where normally there would be squidgy abdomen. She screamed when I picked her up, so she must have been in a lot of pain When the vet saw her, he thought that it felt like she had a stomach blockage and said we either had to pts or open her up to remove the stomach contents, but that the prognosis was not good. Given that there wasn't really any choice, I said open her up. He removed all her stomach contents which he said were hard and impacted but that there was no obvious reason - no blockage stopping the stomach contents from moving. He said however that her liver was covered in small haemorrhages and he took a biopsy which was sent to the lab and which subsequently confirmed RHD2. Lily survived the surgery but passed away on coming round from the anaesthetic.
*Lily lived with her six siblings and mother. Jeremy was the only other to fall ill from this point (I started to notice the signs that same afternoon but didn't take him to the vet until 2 days later as I convinced myself I was imagining things through paranoia). The other five siblings have all been absolutely fine and had no symptoms at all.
*Jeremy's symptoms were a lot slower at coming on. First off, I noticed that his eyes were just not quite as open as his siblings, but he was still bright and bounding around and eating. See what I mean? Just not quite as wide and alert.
*Next, he started to get a little bit 'vacant'. He was still eating and moving around, but just didn't seem as aware of his surroundings. When my cat came past and all his siblings stamped and scattered to hide, he just stayed where he was, munching on his food. It was also about this time that he started being on his own. I don't know if he isolated himself from them, or if they isolated him from themselves, but either way it was noticeable that wherever he was, they weren't.
*This is when I took him to the vet, who felt his undersides and said that his liver and spleen felt enlarged. He was just under 7 weeks old at this point and we were still waiting for the final results from Lily. He was given lactulose to support his liver and septrin in case it was a hepatitis/coccidiosis. We discussed pain relief but he didn't seem to be in pain and metacam would not be a good idea at this point if his liver was affected. We also discussed milk thistle which could be given from 8 weeks old.
*Next came the inappetance. It never got really bad, it was more like he forgot than he was inappetant. If I moved food to him, he'd be like 'hey, here's some food, I'll eat this' but he wouldn't go looking for it. He spent about 2 days being a bit moribund and lifeless but still didn't seem in pain, he was more just 'the lights are on but no-one is home'. He lost weight.
*Then he started to perk up again. He was being very picky with food, he wouldn't eat pellets and would only pick out certain bits of the food (most notably wild geranium/herb robert (both of which are supposedly astringents/good for 'internal bleeding') and cleavers.
*Over the following week he got progressively less away with the fairies and started to get back to normal. His weight took about 2 weeks to get back to his pre-illness weight, and about another 10 days before he started to gain with any great gusto. It took about 3 weeks before his appetite completely returned to normal and he started eating pellets again. At about 9 weeks we added in the milk thistle, which was crushed and mixed with the lactulose. This seems to make it much more palatable and Jeremy runs up and begs for his meds! I don't know when I'm going to stop giving this, suppose I should ask my vet! We continued it for a little longer than I may otherwise have done as Jeremy hurt his leg last week (think his bigger siblings started bullying him a bit so I separated him) and we thought it was helpful to continue the liver support so that he could have some metacam a little more safely.
*With hindsight, I wonder if mum had the illness a couple of weeks prior but it hadn't really developed into anything. I must stress that I don't have evidence for this, but given what transpired after, I think it's highly likely. I took her to the vet because she kept on lying stretched out (like they do when they're relaxed) except I could see that she wasn't relaxed. She was panting heavily and was extremely hot, if I put my hands on her ears I could feel them throbbing. The vet examined her and couldn't find anything obviously wrong except an elevated temperature (39.8). We thought she was being a stressy mum and removed her from her children for a while to give her a bit of a rest. Her temperature continued to have spikes and she would go through phases of getting very hot and panting for maybe a couple of weeks. Like I say, it might be unrelated but personally I would clock any such symptoms.
I feel as if we have been pretty lucky here to have only lost one. Everybun here was vaccinated with nobivac myxo-rhd (the babies were done the week before Lily/Jeremy fell ill) so I don't know if this has had anything to do with the lower mortality than experienced by the other lady that I know?
Enough waffle I think...I sincerely hope that none of you need to know this, but I also think this is exactly why it's likely to be extremely under-diagnosed!
Ok so I'll start off with things that I've read and heard vets say in relation to RHD2, before moving on to describe what I've experienced here.
-RHD2 has a much more variable range of symptoms than classic RHD, and that vets are often working them up as stasis cases as they tend to present as fairly non-specific initially
- Going off food/inappetance
- Bleeding under the skin, potentially at injection sites if bunny has had antibiotics etc
- Weight loss
- Signs of liver disease - in some cases jaundice
- At post mortem, the signs associated with RHD1 (fragile bloody liver/blood free in cavity/thorax) are not so well developed or are absent completely
- Lower & variable mortality - 5-70% (average 20%)
- Can also affect young rabbits
And here's my experience, which sort of chimes with that but I think I can be a bit more specific about changes, timescales and behaviour changes. I should stress though that these are my experiences, and indeed each of these instances is different, which confirms the veterinary info that cases are much more non-specific and present slightly differently.
*Someone I know (RHD2 was confirmed) lost all 4 of her rabbits in the space of a few days. The first two died a day apart without any warning or indications of ill health. When the second one died, the third and fourth were inappetent and listless. The following day, the third one developed a very heavy thirst and died several hours later. The fourth was given metacam by the vet which perked her up somewhat, but she then became inappetant again the following day and developed the same heavy thirst. She was euthanised to prevent further suffering. None of these rabbits were vaccinated against myxo-rhd.
*Lily, the 6 week old baby here who was affected, fell ill very suddenly. She had breakfast as normal at about 7.30am, but when I went to do a quick head count at 11.30am I found her hiding in a corner, hunched and clearly in significant discomfort. I picked her up to put her in a carrier to take her to the vets and could feel that she felt extremely hard underneath, where normally there would be squidgy abdomen. She screamed when I picked her up, so she must have been in a lot of pain When the vet saw her, he thought that it felt like she had a stomach blockage and said we either had to pts or open her up to remove the stomach contents, but that the prognosis was not good. Given that there wasn't really any choice, I said open her up. He removed all her stomach contents which he said were hard and impacted but that there was no obvious reason - no blockage stopping the stomach contents from moving. He said however that her liver was covered in small haemorrhages and he took a biopsy which was sent to the lab and which subsequently confirmed RHD2. Lily survived the surgery but passed away on coming round from the anaesthetic.
*Lily lived with her six siblings and mother. Jeremy was the only other to fall ill from this point (I started to notice the signs that same afternoon but didn't take him to the vet until 2 days later as I convinced myself I was imagining things through paranoia). The other five siblings have all been absolutely fine and had no symptoms at all.
*Jeremy's symptoms were a lot slower at coming on. First off, I noticed that his eyes were just not quite as open as his siblings, but he was still bright and bounding around and eating. See what I mean? Just not quite as wide and alert.
*Next, he started to get a little bit 'vacant'. He was still eating and moving around, but just didn't seem as aware of his surroundings. When my cat came past and all his siblings stamped and scattered to hide, he just stayed where he was, munching on his food. It was also about this time that he started being on his own. I don't know if he isolated himself from them, or if they isolated him from themselves, but either way it was noticeable that wherever he was, they weren't.
*This is when I took him to the vet, who felt his undersides and said that his liver and spleen felt enlarged. He was just under 7 weeks old at this point and we were still waiting for the final results from Lily. He was given lactulose to support his liver and septrin in case it was a hepatitis/coccidiosis. We discussed pain relief but he didn't seem to be in pain and metacam would not be a good idea at this point if his liver was affected. We also discussed milk thistle which could be given from 8 weeks old.
*Next came the inappetance. It never got really bad, it was more like he forgot than he was inappetant. If I moved food to him, he'd be like 'hey, here's some food, I'll eat this' but he wouldn't go looking for it. He spent about 2 days being a bit moribund and lifeless but still didn't seem in pain, he was more just 'the lights are on but no-one is home'. He lost weight.
*Then he started to perk up again. He was being very picky with food, he wouldn't eat pellets and would only pick out certain bits of the food (most notably wild geranium/herb robert (both of which are supposedly astringents/good for 'internal bleeding') and cleavers.
*Over the following week he got progressively less away with the fairies and started to get back to normal. His weight took about 2 weeks to get back to his pre-illness weight, and about another 10 days before he started to gain with any great gusto. It took about 3 weeks before his appetite completely returned to normal and he started eating pellets again. At about 9 weeks we added in the milk thistle, which was crushed and mixed with the lactulose. This seems to make it much more palatable and Jeremy runs up and begs for his meds! I don't know when I'm going to stop giving this, suppose I should ask my vet! We continued it for a little longer than I may otherwise have done as Jeremy hurt his leg last week (think his bigger siblings started bullying him a bit so I separated him) and we thought it was helpful to continue the liver support so that he could have some metacam a little more safely.
*With hindsight, I wonder if mum had the illness a couple of weeks prior but it hadn't really developed into anything. I must stress that I don't have evidence for this, but given what transpired after, I think it's highly likely. I took her to the vet because she kept on lying stretched out (like they do when they're relaxed) except I could see that she wasn't relaxed. She was panting heavily and was extremely hot, if I put my hands on her ears I could feel them throbbing. The vet examined her and couldn't find anything obviously wrong except an elevated temperature (39.8). We thought she was being a stressy mum and removed her from her children for a while to give her a bit of a rest. Her temperature continued to have spikes and she would go through phases of getting very hot and panting for maybe a couple of weeks. Like I say, it might be unrelated but personally I would clock any such symptoms.
I feel as if we have been pretty lucky here to have only lost one. Everybun here was vaccinated with nobivac myxo-rhd (the babies were done the week before Lily/Jeremy fell ill) so I don't know if this has had anything to do with the lower mortality than experienced by the other lady that I know?
Enough waffle I think...I sincerely hope that none of you need to know this, but I also think this is exactly why it's likely to be extremely under-diagnosed!