Older mini lop going off food - probable lymphoma

[Omi]

I'm so sorry to read your update I suspect people will handle this situation differently and I think you will need a little time to process what you have been told in order to come to a decision on what to do.

So this would be my view, but I'm not suggesting that this is what you should do. You need to be happy with any decision you make.

Your vet has admitted that she is not a rabbit specialist. However, she has experience in lymphoma in cats, which will help inform her thoughts. If he were my rabbit I would want to have the diagnosis confirmed, whilst anticipating that it would be. So I would want to have a consultation with the exotics specialist and I would want any further diagnostics to be done by the specialist. Personally I would need a definitive diagnosis to be able to handle the situation. Having a biopsy would not only confirm the diagnosis, but would also give an indication of how aggressive any cancer found was with probable timescales. An exotics specialist would also in worst case scenario be able to advise the best way of managing it in the best way for Archie.

I have no experience of lymphoma, but I imagine the treatment would be chemotherapy. I would consider this if the diagnosis was confirmed, but I imagine that it would be expensive, possibly unpleasant and I would want to be assured regarding success rates. Always taking into consideration Archie's age.

Regarding the immediate situation I would discuss with the vet the possibility of giving fluids at home, if he still needs them tomorrow morning. I would want them home and can completely understand your views on rabbits' expressions. Syringe feeding and meds you could do at home.

Are the blood test results back tomorrow? I think it's a positive that Archie still tried to eat the leaves even with his strong painkiller.

Sending lots of hugs.

 

[InspectorMorse]

I think it’s important to wait for the blood test results before making any decisions at all. There are other reasons for enlarged abdominal lymph nodes and Rabbits are not always febrile if they have an infection. A definitive diagnosis of lymphoma cannot be made based on just feeling two enlarged lymph nodes.

If the blood tests back up a diagnosis of lymphoma then personally I would not pursue further diagnostics such as CT scans or a GA and biopsies etc. A GA for an elderly already very poorly Rabbit would be a significant risk and IMO the risk far outweigh any benefit to the Rabbit. Only to us in that it might add more evidence to a presumed diagnosis.For Lymphoma chemo can be attempted, but it is seldom very beneficial and again it’s not something I would consent to for a Rabbit in my care. Especially a very elderly Rabbit. Active treatment is only likely to buy the Rabbit a few months of time and whilst side effects from chemo might not be as unpleasant as they can be in humans there are still side effects. IMO quality of life has to take priority over quantity

I hope they both have as comfortable a night as possible.

 

[Omi]

I think it’s important to wait for the blood test results before making any decisions at all. There are other reasons for enlarged abdominal lymph nodes and Rabbits are not always febrile if they have an infection. A definitive diagnosis of lymphoma cannot be made based on just feeling two enlarged lymph nodes.

If the blood tests back up a diagnosis of lymphoma then personally I would not pursue further diagnostics such as CT scans etc. For Lymphoma chemo can be attempted, but it is seldom very beneficial and again it’s not something I would consent to for a Rabbit in my care. Especially a very elderly Rabbit. Active treatment is only likely to buy the Rabbit a few months of time and whilst side effects from chemo might not be as unpleasant as they can be in humans there are still side effects. IMO quality of life has to take priority over quantity

I hope they both have as comfortable a night as possible.

Would it be possible to confirm a diagnosis of lymphoma from the blood tests? I had assumed it wouldn't, hence my thinking a biopsy or other diagnostics would be necessary, but perhaps that's wrong.

 

[InspectorMorse]

Would it be possible to confirm a diagnosis of lymphoma from the blood tests? I had assumed it wouldn't, hence my thinking a biopsy or other diagnostics would be necessary, but perhaps that's wrong.

Blood tests can give some indication but a full diagnostic work up would include biopsies. I would need to feel comfortable with putting an elderly Rabbit through chemotherapy which is unlikely to be curative and only likely to buy them a few more months if I was going to risk the GA and biopsies. Especially when the Rabbit is already very unwell.

But that’s just my personal opinion. It isn’t necessarily what someone else might chose to do.

 

[Moonstone]

Thank you both. Yes, waiting for the bloods makes sense. Seeing a rabbit specialist also makes sense.

I've been reading steriods could buy him more time and increase quality of life? Perhaps it depends how advanced the cancer is, I think partly why a CT scan was put forward is that it could show how much it has spread. But I'm not feeling happy with stressing him more or doing anything risky as I would really like him to die at home where he feels safe, and I think that would feel better to me and Millie too.

The only saving grace I can find in all this is that lymphoma is pretty random. He's had a really healthy diet (wouldn't touch anything less heathy, not even fruit, bless him), lots of space to run around in and he's been loved. I don't think I could have done anything differently and if it is lymphoma, he's just come to the end of his time, that's all.

Millie is also helping me, I won't be rabbit-less at least.

 

[Moonstone]

Would it be possible to confirm a diagnosis of lymphoma from the blood tests? I had assumed it wouldn't, hence my thinking a biopsy or other diagnostics would be necessary, but perhaps that's wrong.

I'm guessing the blood tests could tell us if he has an infection, if he had a blood count it would show that. Which could indicate another cause of the enlarged lymph but I'm sure if they would saying anything about cancer.

 

[InspectorMorse]

Lymphadenopathy in Rabbits (Lapis) | Vetlexicon

View Lymphadenopathy & more Lapis resources at Vetlexicon. Over 28,000 peer-reviewed resources: Canis, Bovis, Equis, Felis & Exotis.

www.vetlexicon.com

Clinical and pathological findings of rabbits with lymphoma: 16 cases (1996-2019) - PubMed

Rabbits develop a range of lymphoma subtypes and, similar to humans and dogs, diffuse large B-cell lymphoma appears to be the most common. Chemotherapy treatments followed multiple protocols, which were mostly well tolerated and had a highly variable response. Further research into chemotherapy...

pubmed.ncbi.nlm.nih.gov

Chemo for Lymphoma/Inflammatory Bowel Syndrome in Rabbits

Just to say that Peach Blossom is being totally amazing today - she is running round like a lunatic - (like her old self in fact), eating everything she can get, pooing big (for her) round (for her) poos and generally being like a very well rabbit!!!! It incredible. Just hope it lasts . ...

forums.rabbitrehome.org.uk

Lymphoma, steroids and end of life care

Tomorrow it will be three months since Peaches had a CT scan that showed a large tumour in her chest. A week later the biopsy result confirmed lymphoma. Our vet estimated she had weeks rather than months due to the size of the tumour. She's been on steroid meds for around 8 weeks now and shes...

forums.rabbitrehome.org.uk

Advice please! Has anyone had experience with chemotherapy for cancer in rabbits???

Hi all, I'm new to the forum but in desperate need of advice! About a week and a half ago we took our indoor bunny, Blueberry, to the vet as he was sneezing and it looked like he was having some trouble with breathing. He was checked over and given antibiotics as he had a respiratory tract...

forums.rabbitrehome.org.uk

 

[joey&boo]

I'm late to your thread. So sorry archie is poorly with suspected Lymphoma. In your situation I think my priority would be to get him home tomorrow & spoil him for as long as he enjoys a good Q of L. I'm heartbroken for you. So many vibes for your little man & for you, its so hard making these decisions xx

 

[bunny momma]

I am sorry that Archie may have lymphoma. I agree that a second opinion from a specialist is a good option.

IV fluids work quicker and may be required for patients with circulation issues, low blood pressure/volume, or severe illness where immediate hydration or medication is necessary. However, sub Q fluids are fine for a patient with. chronic illness who is able to absorb them in an appropriate amount of time.

My Heidi has cancer in her right arm, and while it metastasized so surgery is not an option, she continues to have a good quality of life with sufficient pain meds. I know this because I have been with her for 9.5 of her 11 years.

Sending lots of positive vibes to your bunnies and you. Do not let anyone bully you into pts unless/until you are comfortable it is the best option for your bunny. You know your bunny best and I know you will make sure he has appropriate care at home.

 

[Moonstone]

I'm leaving shortly to fetch them home. Bloods not back yet. Spoke to a different vet who said he'd had two episodes of going flat, breathing heavily with his eyes flickering. They have put him on panacur and tho she hasn't ruled out lymphoma, she's saying enlarged lymph could be EC plus gut inflammation. His eyes have flickered on and off since he had EC two years ago, but mainly only when he's stressed. Same with circling but mostly he is okay. She thinks his prognosis is poor but panacur could give him more days, maybe a few weeks. I questioned this though as he absolutely hates it and I don't want to spend his last hours/days forcing something disgusting into his mouth. If he isn't going to pull through I don't see the point.

She was supprised I wanted him back, she was keen that he wasn't left to die from a heart attack or a seizure so I told her I would call cloud nine when he seemed ready. I feel like I'd know when he's had enough but have actually not had to pts an animal before. Came close once with a hamster but I meditated with him, giving him permission to leave me and he just slowly stopped breathing.

He is so much worse from being in hospital though, maybe he'll rally slightly when home, I don't know.

 

[Moonstone]

I was thinking in the night that he's too ill to transport to the exotic vets but one in Swindon which is supposed to be a centre of excellence for rabbits runs a free emergany advice line for other vets. So when we have the bloods I can ask them to call them about diagnosis and management.

 

[Moonstone]

When he was going downhill with stasis, there wasn't any increase in EC symptoms. You'd have thought if EC was the cause there would have been? Maybe the ECs just getting a stronger hold because he's weak and stressed?

 

[bunny momma]

Sending your boy lots more positive vibes . I hope he improves once he is in familiar territory at home and not feeling stressed.
My vet here in USA does not even give Panacur for suspected ec.

 

[InspectorMorse]

I think getting him home and in a familiar environment alongside insuring he is on good analgesia, is kept warm and hydrated is what I would want to do now. My personal thoughts about Panacur are that I would not prioritise it if administering it causes him a great deal of stress. If he is eating a bit for himself and has some poo output then I would not force lots of syringe feeds on him. I think trying to minimise his stress and making sure that he’s not in pain would be my priorities. It might be that you will not have long with him. If he were to start breathing very fast, grimace, go very cold, shiver or grind his teeth then I would discuss a home visit from a Vet. Unfortunately it isn’t always a case that a Rabbit will ‘slip away’. Sometimes it is necessary for the care giver to request the help of a Vet in order to prevent prolonged distress to the rabbit. I am certain you will do the right thing at the right time.

This is a helpful bit of information

 

[Omi]

Thinking of you both a lot and hoping he feels more settled when at home.

 

[Moonstone]

Thank you all. That's interesting about Panacur in the US.

They are home now. Both came pretty fast out of the basket and ran around their pen. After I'd sorted everything out I went to touch Archie and he bolted away from me. His legs are definitely still working but it's very sad to see him so fearful of touch, he's always been so tame. I left them alone after that, Millie was standing on the heated mat inside their little room, rearranging their fresh straw and Archie fell asleep in the litter tray. I put the heating on and peaked in later to find them both in the litter tray.

I called Cloud Nine and they said they need 24 hours notice, and aren't very likely to come any sooner which isn't fast enough if he's suffering. I have found a local service though so will ask them about timing. I think it will be easier to make an assessment tonight when he's wakeful and I need to medicate him, hopefully he'll be a more over the shock of hospital by then.

I still don't have the blood test results. Today's vet wants to know if there are signs of infection she said she'd chase them up but they may not come until tomorrow. She also said they'd tell us nothing about cancer. She said she could call the exotic vet but she doesn't think they'd say any different and they'd want to see him and do the CT scan and biopsy, she thinks he isn't well enough for either. I will ask again tomorrow, I was trying to wind the conversation up because although she said Millie was happy, bright and lively I could see her in the carrier shaking with fear and I just wanted to get them home.

 

[Omi]

It's good to have them home.

 

[InspectorMorse]

I hope that they will both start to feel more settled now they are home. I don’t know if Archie is still having an opiate analgesic, but if he is or if he had an injection of one just before being discharged that would make him very drowsy.

Sending lots more vibes x

 

[joey&boo]

happy to hear you have Archie & Millie home.

Will he eat a malted shreddie? they are my go to for administering meds & really easy to smear panacur on.

 

[bunny momma]

They must have been glad to be home with the way they bolted out of the basket, and I know you must be very happy to have them back with you.
Sending vibes for your lovely bunnies.