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Harley's thread - Confusing update #56

~ILoveMyBunny~ said:
Just a quick update in case anyone wants to know..
Last week saw some improvement with Harley after a week on the new meds, he's able to stand up now outside of his pen generally without rolling and righting himself easier. However he's still got a very severe head tilt and no significant progress was made this week. At the vet today he seemed a little worse than the last visit in terms of rolling on the floor (although it's obviously very slippery).
He'd had another blood test which the vet sent to a different lab this time, the results came back negative for EC again so it looks like it probably rules that out (probably). The anemia is still there and roughly the same but she said it did seem as though it was regenerative so there must have been a very slightly improvement.
The lymphocytes were at 68% which is a drop as they were up around 97% apparently so she's still considering lymphoma to be unlikely, even more so now. I think she strongly believes it to be the ear infection.
He's scheduled for a CT scan on Thursday, though the vet suggested it would be around £680 at Swindon (plus another £70 for contrast) and on the phone today they told me an estimate of £950-£980 :shock:
We don't have a choice as she really wants to confirm the diagnosis and it's going on too long - something needs to be done, he can't keep going on like this. I am tempted though to phone Cardiff's one tomorrow as it's half the distance and the only reason we chose Swindon is she said Cardiff's vet would be around £900. So I may phone in the morning and see what they say, if it's around the same price I may ask her if she can change the referral or not as it's a long distance to travel. If it's confirmed she may try another antibiotic like metronidazole or may go for surgery.
What does worry me though, she said if both ears are infected his prognosis is very poor. Aside from the increased cost for surgery it will come at a far greater risk to him and the possibility of scar tissue that causes a permanent problem will be high.
I feel awful as this is using most of the money my Mum was going to use to put up a shed for our work but we all agree this little fighter needs it and deserves it. He's so strong willed and he's got such a character. He's fought through this for months now and he's still an unstoppable force. He deserves every chance. I just hope he can pull through it as he's got such a will to live.

Edit: changed thread name as lymphoma seems unlikely now
Click to expand...

Well obviously I am very glad that Lymphoma has almost certainly been ruled out .

Have you discussed in full exactly what surgery involves,how major it is, risks, success rates etc ?

*WARNING GRAPHIC SURGICAL IMAGES*
http://www.ivis.org/proceedings/navc/2006/SAE/617.pdf?LA=1


If so do you think you would definitely go ahead with it if middle ear infection is confirmed ? Unless you are certain about proceeding to surgery then personally I cant see the point of doing a CT scan that is going to cost almost £1000. Does the Vet realise Bunny is not insured ? There is the option of managing chronic ear disease with long term antibiotics and pain relief. Personally I would not dismiss this option out of hand. I had a Rabbit with chronic ear disease that was managed without surgery ...............for 5 years. His passing, aged 8 was 100% unrelated to ear problems. He had an inoperable tumour in his abdomen and heart failure.

Given that his latest blood test is showing improvements maybe keeping him on the abx for another month and then run another blood test is an option ? If that showed more improvement then I would seriously consider just keeping on with the treatment and not having the CT scan. Unless of course, you are 100% certain you would opt to go down the surgical route if what the Vet is almost sure the problem is (middle ear infection) is confirmed.

The other realistic thing you need to bear in mind is the cost of Surgery. I doubt it would be less than another £1500 +

Whatever you decide I wish you well and I am sending lots of vibes xx
 
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Thank you all, and thank you Jane for your reply.
You have got me wondering now :? Although the vet did leave the option up to us I could tell she really wanted the CT scan as she wants to confirm it is an ear infection we're dealing with and not something else.
I was under the assumption that without surgery he wouldn't have much hope of recovery. Though I must admit glancing at the link you sent, it is indeed a bit more involved than I thought (I did look myself for photos etc of the surgery but came up with nothing!)
The problem is that despite his willingness to fight, he needs to have some improvement in his ability to move around. If he were to be like this for the rest of his life.. I don't think it would be fair to let him go on that way. And I can't imagine that as a possibility.
Now I'm wondering what to do for the best :? She told me the surgery was somewhere around the £900 mark if I recall correctly (definitely wasn't over £1000), but she also told me the CT scan was around £680, and it's quickly jumped up by nearly £300 :? We agreed yesterday as it had gone on so long and I thought it was the best decision for Harley.
That was obviously for one ear, now she's mentioning possibly both being affected which I never considered. Obviously if it's both I know we'll be looking at £1000+.. Which is a scary thought..

Now I don't know :?
We haven't discussed the surgery in depth, I know it's risky and that he will lose the hearing in the ear operated on, but beyond that I can't say I know much more. She said the prognosis for both ears is very poor, I assume he would have only a small chance of surviving in that case. But I assumed it was his only option as the antibiotics aren't helping with his head tilt and balance? Should we just wait longer? I know the blood results look better this time but I feel like the past few days have seen him deteriorate slightly symptom wise.
I just want to do what's right for Harley :cry:
 
Okay... I've cancelled tomorrow for multiple reasons, one being it's a long way for my Mum to drive and she's been quite ill today. I did phone my vet (receptionist) to arrange to go to Cardiff instead for the CT as it's much closer and a similar price. I've waited all day for them to return my call and they never did. This is the third time they've done this. The receptionist never passes on my messages as I'm starting to get annoyed with it.
I'm also now in a lot of doubt about it, the surgery is similar but much worse than I thought. If I knew it was his only hope of recovery I would absolutely give it a try, but.. I feel like I need to speak to the vet again. I have a feeling she'll be upset with me, in a way I don't blame her but this is a major decision for us, even the scan isn't without risk to Harley and whilst it's by no means the priority - the priority is Harley - it is a lot more money than she initially told us it would be.
I want to ask her about the possibility of trying metronidazole now, repeating bloods as Jane said in a few weeks or something and then maybe reconsider the CT scan again. I feel awful that I'm messing the vets around, but I don't know what's best. If she strongly feels we definitely need the CT scan we'll reschedule and go ahead, but I think I've rushed into it when maybe I shouldn't.
I don't know. I just don't know.
I wish I knew what was right for Harley above all else, if I knew for certain then that is what I would do.
The positives seem to be that he's gained weight again, the lymphocytes have gone down, he may have had very minor improvement with the anemia and he was showing remarkable improvement considering. I say was as I feel he has backtracked a little and is rolling more again the last few days :?
In his pen he remians fairly mobile, however when you take him out - especially somewhere unfamiliar - he has severe trouble staying upright and navigating his way around.
I have tried to film him but it's hard as when he rolls you have to go and stop him as he gets scared, meaning dropping the camera :? I got this just now in the bathroom (he's never been in there before so completely unfamiliar territory) and had to stop as it stressed him badly. Not sure if it shows very much of benefit but I'll put it up anyway :?
He is nothing like this in his pen, he stumbles a bit but is generally okay. He was even trying to binky the other morning. But he's getting absolutely not exercise outside the pen at the moment as he simply can't do it and he gets so stressed.
If he has a hope of recovery that's one thing but he has to improve from this or it's not fair on him. I don't mind if it takes a while, I'll support him for however long is necessary, but I need to know what I guess it's impossible to know - that he has a hope of living a somewhat normal life eventually :cry:
I'm sorry, I feel quite hopeless again. I love this cheeky little boy so much and I just want him to get better by whatever means are necessary - I just don't know what that is :cry:

[video]https://streamable.com/m3bae[/video]

Edit: Not sure if that link worked? I don't know how to add videos :?
 
~ILoveMyBunny~ said:
Okay... I've cancelled tomorrow for multiple reasons, one being it's a long way for my Mum to drive and she's been quite ill today. I did phone my vet (receptionist) to arrange to go to Cardiff instead for the CT as it's much closer and a similar price. I've waited all day for them to return my call and they never did. This is the third time they've done this. The receptionist never passes on my messages as I'm starting to get annoyed with it.
I'm also now in a lot of doubt about it, the surgery is similar but much worse than I thought. If I knew it was his only hope of recovery I would absolutely give it a try, but.. I feel like I need to speak to the vet again. I have a feeling she'll be upset with me, in a way I don't blame her but this is a major decision for us, even the scan isn't without risk to Harley and whilst it's by no means the priority - the priority is Harley - it is a lot more money than she initially told us it would be.
I want to ask her about the possibility of trying metronidazole now, repeating bloods as Jane said in a few weeks or something and then maybe reconsider the CT scan again. I feel awful that I'm messing the vets around, but I don't know what's best. If she strongly feels we definitely need the CT scan we'll reschedule and go ahead, but I think I've rushed into it when maybe I shouldn't.
I don't know. I just don't know.
I wish I knew what was right for Harley above all else, if I knew for certain then that is what I would do.
The positives seem to be that he's gained weight again, the lymphocytes have gone down, he may have had very minor improvement with the anemia and he was showing remarkable improvement considering. I say was as I feel he has backtracked a little and is rolling more again the last few days :?
In his pen he remians fairly mobile, however when you take him out - especially somewhere unfamiliar - he has severe trouble staying upright and navigating his way around.
I have tried to film him but it's hard as when he rolls you have to go and stop him as he gets scared, meaning dropping the camera :? I got this just now in the bathroom (he's never been in there before so completely unfamiliar territory) and had to stop as it stressed him badly. Not sure if it shows very much of benefit but I'll put it up anyway :?
He is nothing like this in his pen, he stumbles a bit but is generally okay. He was even trying to binky the other morning. But he's getting absolutely not exercise outside the pen at the moment as he simply can't do it and he gets so stressed.
If he has a hope of recovery that's one thing but he has to improve from this or it's not fair on him. I don't mind if it takes a while, I'll support him for however long is necessary, but I need to know what I guess it's impossible to know - that he has a hope of living a somewhat normal life eventually :cry:
I'm sorry, I feel quite hopeless again. I love this cheeky little boy so much and I just want him to get better by whatever means are necessary - I just don't know what that is :cry:

[video]https://streamable.com/m3bae[/video]

Edit: Not sure if that link worked? I don't know how to add videos :?
Click to expand...

Whilst no-one can give you any cast iron guarantees there most definitely is a chance that Harley can recover to the point where he has a good quality of life, even if that is with a permanent tilt. Are you on FB ? If so I'd really encourage you to join this group

https://www.facebook.com/groups/HelpforHeadTiltHoppers/

There are many many stories like Harley's. The road to recovery can be months and months, sometimes with a few setbacks along the way. Surgery was NOT part of the treatment in all of the 'good outcome' cases.
 
Thank you Jane :) I've always been extremely reluctant to join facebook for personal reasons as there is someone who will stalk me if they find out I'm on there and the worst possible thing for them to find out is that I have not only another rabbit but a sick one (previously said person reported me to the RSPCA for my 'underweight' 34kg German Shepherd - the same dog that had been to the vet a couple of weeks before, weighed and checked and declared to be in good condition minus the condition that had landed him there in the first place - which he was treated for immediately, on new years eve no less)
For that reason I've signed up using my middle name and a pretend last name, purely because I cannot risk my real name on there. I was accepted into the group yesterday and they have been wonderful, there's so much information and so many helpful ideas! It's good to see some successful stories, it gives a bit of hope that he can fight through.
Thank you so much for recommending it to me again, I should have joined it the last time you suggested it to me.

Regarding Harley himself he's a bit better today, very bright and strong. He seems to be gaining strength each day so I'm hoping this is positive!
After weighing everything up and the vet being wonderful and chasing up the hospital about the pricing of the CT (turns out they'd priced him as a referral, not an outpatient.. or the other way around, not sure how it worked out now!) she's got it back to the original price (+ contrast but it's not that much more considering the benefit of having it) we've decided to go with it after all. It is certainly a lot of money for us but we've weighed everything up and decided he needs to have it done at this point. We need to know how severe this is and have a confirmation. Money is money, it can't come before a life.
He'll be going for it on Tuesday so I'll update with results when we get them.
Thank you all again so much for your continued support xx
 
Pleased that Harley is a little bit better, he certainly is a little fighter. Good luck with the scan, hope you get some answers xx
 
Just caught up with this. What a roller coaster you and Harley are on. Sending loads and loads of vibes for your brave boy xxx
 
Thanks all :)
Really nervous about tomorrow. Can't help worrying about the what if's.. What if the CT shows something irreperable? A tumour, lesions etc...
So nervous :(
 
~ILoveMyBunny~ said:
Thanks all :)
Really nervous about tomorrow. Can't help worrying about the what if's.. What if the CT shows something irreperable? A tumour, lesions etc...
So nervous :(
Click to expand...

It is understandable that you are anxious, but try not to let your mind run ahead to all the what ifs. Easier said than done, I know. At least Harley is blissfully unaware of all the worries. I really hope that things go well for him today and the results enable the Vet to decide on a plan of treatment going forward.


Sending lots of vibes for him xx
 
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Thanks all. Little Harley got through the CT okay, stayed in on fluids for a bit and was released at 7pm. We didn't get home until nearly 10 tonight but he's been eating (becuase of course he has :lol:) so recovering well from the sedative. We've been told 24-72hrs for the results, but I think our vet is quite likely to come back to me sometime tomorrow with them. Just hoping it's 'good' news - as far as can be anyway.
Just sitting and waiting now :|
 
So pleased to hear he coped well with the procedure and the journey. I hope that you dont have to wait too long for the results xx
 
Glad the scan went well, and that Harley made a good recovery. Really hope the results come in quickly, so that you are not waiting too long xx
 
Just had a phone call from the vet. In a sense great news but also..????
So the CT came back clear. No sign of ear disease. No lesions, no sign of lymphoma. The only significant finding was that the right eye is bulging (which we sort of already knew) but this could be from the tear duct not draining properly and is more of a result of the tilt than a cause from my understanding.
In a way we're now back to square one. She mentioned possibilites such as stroke but he's only 6 months old, toxic exposure but I can't think what he could possibly have eaten etc. Or possibly larvae that have gone presumably to the brain, but again she said it's very uncommon and she's only ever seen it once in a rabbit. That said the plan is to treat him for that and see if it helps, but yeah.. Now we're at a bit of a loss :?
So great in a way but also very confusing.
He's seeing her next tuesday so I guess we'll see from there. But yeah... Very confused right now!!
 
~ILoveMyBunny~ said:
Just had a phone call from the vet. In a sense great news but also..????
So the CT came back clear. No sign of ear disease. No lesions, no sign of lymphoma. The only significant finding was that the right eye is bulging (which we sort of already knew) but this could be from the tear duct not draining properly and is more of a result of the tilt than a cause from my understanding.
In a way we're now back to square one. She mentioned possibilites such as stroke but he's only 6 months old, toxic exposure but I can't think what he could possibly have eaten etc. Or possibly larvae that have gone presumably to the brain, but again she said it's very uncommon and she's only ever seen it once in a rabbit. That said the plan is to treat him for that and see if it helps, but yeah.. Now we're at a bit of a loss :?
So great in a way but also very confusing.
He's seeing her next tuesday so I guess we'll see from there. But yeah... Very confused right now!!
Click to expand...

Crikey- confused.com !!

Well it is good news that there are no signs of middle ear disease and Lymphoma has 99.9% been excluded. But that said it can be just as stressful for you not to know what is going on.. What treatment has the Specialist prescribed for the possibility of 'larvae having gone to the brain' ?

I guess the Vet is thinking of something like this ?

http://wildpro.twycrosszoo.org/S/00dis/Parasitic/Cerebrospinal_nematodiasis_lagomorphs.htm

I hope that Harley remains in good spirits despite his problems xx
 
Jack's-Jane said:
Crikey- confused.com !!

Well it is good news that there are no signs of middle ear disease and Lymphoma has 99.9% been excluded. But that said it can be just as stressful for you not to know what is going on.. What treatment has the Specialist prescribed for the possibility of 'larvae having gone to the brain' ?

I guess the Vet is thinking of something like this ?

http://wildpro.twycrosszoo.org/S/00dis/Parasitic/Cerebrospinal_nematodiasis_lagomorphs.htm

I hope that Harley remains in good spirits despite his problems xx
Click to expand...

She hasn't said at the moment, we're seeing her on Tuesday so hopefully I'll know a little more then.
But yeah, really confused now! As I say in a way I'm really glad as it doesn't appear to be any of the nasty possibilites like lymphoma etc (hopefully) but still - ! I don't know how to feel about it at the moment!
Now you're left with this question of why on earth his head is tilted if he's negative for all the likely possibilities. As I say, 6 months old.. Surely a stroke is extremely unlikely?! Toxic exposure.. Unless it's something he's somehow eaten (and I admit he will indeed eat anything), surely the others would have been exposed if it was something environmental? Food wise... I know ivy poisoning can take a while to show (no way he's been near ivy btw) but surely most other toxins would show and either get better by now or have done further damage? And surely he wouldn't get better then worse again as he did nearer the start of it all?
I'm just so confused. Surely by now, app 3 months later, parasites like larvae would have done serious damage if left untreated? Surely he'd get massively worse? Again, why did he get better for a while if it was parasites?
He went down again after being off of the metacam.. So I assume something to do with inflammation?
So many questions and I'm not sure there are answers :?
I was linked this on the Head Tilt for Hoppers facebook thing: https://rabbit.org/sarcocystis/?fbclid=IwAR3VSSN00QmvSXO8zpEZyRW_Qx5GRmkVIthVCiNGzDED8hfUGMiq32N5g0s
I briefly mentioned it to the vet but I'd forgotten the name. I told her I'd bring it along on Tuesday as she didn't think she'd heard of it.
So confused!!!
 
Oh, should have said, Harley seems to be doing well considering. He's slightly better tilt/balance wise today and over the last few days. He seems to have ups and downs to a minor degree in that some days he's slightly better, some days slightly worse. But sadly not significantly better.
Of course, his rex gene as you say is still working overtime. Can't stop this little one eating :roll:
 
So the facebook group mentioned a disease similar to EC that seems to be emerging in the US, as I linked earlier.
I can't find any documented cases in rabbits in the UK, but have found several other animals such as sheep that are known to have been infected:
http://wildpro.twycrosszoo.org/S/00dis/Parasitic/Sarcocystosis.htm
https://veterinaryrecord.bmj.com/content/170/22/571.1
Seems extremely unlikely, but at the same time we've pretty much ruled out likely causes-?
I don't know :?

There are many different species of Sarcocystsis that affect different animals. S. neurona causes neurological symptoms in horses and sea mammals, while S. falcatula causes neurological symptoms in birds of prey. House Rabbit Society is doing DNA sequencing to try to determine which species of Sarcocystis is being found in rabbits. At this point, we know the species affecting rabbits is not S. neurona or S. falcatula, but there are many species of Sarcocystis, and it’s possible this could even be a closely related Apicomplex this was taken from the House Rabbit Society's page on it. So at this point it's not even known which type infects rabbits :?
 
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