Rabbit thymoma?

Dr. Marie replied:

Hi there...I just want to let you know that I am working on your reply to your question. It's likely going to take me a few more minutes because I am attaching your xrays to show you a few things. Just wanted to reply now so you didn't think that I had forgotten you!


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Dr. Marie replied:

Aw, sorry to hear that your Bunny is having problems. I really get concerned when any animal is having problems with breathing. If her mouth is open when she is trying to breathe then this is a sign that she is really struggling.

Thanks for sending the videos and photos. You can tell by the video that she is having a hard time breathing.

I'm really concerned about the xray that shows the chest and abdomen:



I have outlined the chest with red:



What I am seeing on this xray is that there is almost no lung visible. Lungs should be black. Here is a picture of a more normal rabbit chest:



Can you see how there is much more black area on this xray?

What this means for your bunny is that there is something very serious going on. The white in her chest can only be one of a few things. The most common is if it is because of cancer. The most common cancer affecting the chest of rabbits is either thymoma or thymic lymphoma. Another possibility is if there is fluid. The fluid could be because of cancer, or because of heart disease. But, if this was heart disease then the vet should really have been able to hear a heart murmur or other abnormalities with their stethoscope. And the final possibilities for too much white in the lungs is pneumonia which is a severe bacterial infection, or an abscess. However the xrays look to me to be more like cancer than infection. (Keep in mind that I can't give you a diagnosis over the internet...I can just give you my thoughts on this case.)

It is hard to tell exactly what is going on just from the xrays. A CT scan could tell more, but would be very expensive. Sometimes doing an aspirate (i.e. taking fluid) from the chest can help but this can be difficult to do and also adds expense.

Regarding the back legs, there is something very strange on the xray. I've drawn a circle around it:



There are all sorts of white things present on this side that I have circled as compared to the right. It's possible that these are arthritis changes...or they could be some type of bone cancer. I honestly don't know what this is.

To summarize, I'm really concerned about your girl. It sounds like the first vet gave antibiotics in the hopes that the breathing problems were related to an infection. The point of the steroids were to help reduce inflammation around a tumor. But they will not cure what is going on.

If this is cancer in the chest there are some chemotherapies that sometimes work but we don't have great success using them. It might buy you some time, but again, will be expensive.

I wish I had better news for you. But, unfortunately if your girl is not improving we may have to consider euthanasia.

So sorry.

Dr. Marie.

Dr. Marie replied:

This all depends on how she is doing. If the problems with her breathing are not improving then I don't think it is fair to let her keep on struggling.

If you are thinking that you would like to do more tests to determine what the cause is and whether this is fixable then this is possible. If your vet doesn't feel comfortable doing more tests then they can likely refer you to someone who can. However, it's possible that you could spend a lot of money doing more tests and the chances of this being something fixable are small.

I think it's not a bad idea to call your vet back and let them know how Bunny is doing. If she is not improving you can ask them what they think the next step is.

Dr. Marie replied:

An ultrasound may be able to help us determine what is going on. I think it's worthwhile to try. Oxygen is a good idea too. I really hope everything goes ok!

Dr. Marie.

Dr. Marie replied:

Sandostatin is a chemotherapy agent. I did some research and I see that it can be used as part of a treatment for thymoma. (I'll be honest that I have no personal experience with this). The cases that I read had surgery to remove the tumor and then followed up with this chemotherapy. I'm not sure what the success rate is.

Reglan is an anti-nausea medication which is likely given to help fight the negative effects of chemotherapy.

Metacam is a commonly used anti-inflammatory drug.

The Reglan and Metacam are commonly used by most vets, but these drugs alone are not going to treat the tumor. If you were interested in using Sandostatin then you would need to get a referral to a veterinary oncologist. They can give you the best advice on how much help it is likely to be.

Dr. Marie replied:

Most veterinary teaching hospitals will have an oncologist on staff. But you can likely do a google search for "veterinary oncologist near..." and put your city in there.