enlarged heart, kidney problems, weight loss, increased appetite

[buggles001]

Buns is a 9 year old lop-eared miniature rabbit. I have had him to the vet 3x in the past 2 weeks. He is not moving around much and has lost .3 kg in about a month. I can feel his backbone and ribs whereas he was quite solid before this. The vet carried out blood tests (borderline anemia, kidney function reduced, borderline low protein, lowered red blood cell count but evidence that new red blood cells are being produced in the bone marrow). He did xrays and ultrasound and found an enlarged heart and some mineralisation of the kidneys.

Buns has been eating constantly and when he got home from the 2 hour vet visit today, he was ravenous and went straight to his Timothy Hay pellet dish. I tried him on some carrot slices and kale and he gulped these down. He doesn't usually gulp food like this. Some of his droppings have been 1/3 normal size although he has plentiful droppings as usual.

The vet said when rabbits have kidney problems they lose sugar and protein in the urine instead of instead of it cycling back into their body. So they also lose weight in losing some of these essential nutrients.

The weight loss is scary. I want to help him as much as I can with nutrition before it gets any worse. In addition to the pellets, I give him fresh veg every day (romaine, kale, 2-3 baby carrot slices, broccoli) in tiny amounts or he gets painful gas.

Buns is now on an ace inhibitor to help his heart and kidneys. The vet has concluded that Buns is most likely having weight loss from kidney problems. His anemia is only slight so I am puzzled at the significant drop in activity level.I am not sure how the enlarged heart fits into all of this

What can I feed him to get his weight back up? The vet carries a syringe-delivered liquid food replacement but Buns doesn't like syringe feeding and I don't want to put him off eating.

Does anyone have any ideas for an alternate explanation for the weight loss and inactivity? Just a month ago, Buns was quite active and his normal weight.

Thank you,
Elizabeth

 

[LakeCondo]

I'm sorry Buns is going through a hard times right now, & you are too.

Rabbit Health in the 21st Century suggests, besides the usual [Critical Care, pellet slurry, pumpkin puree], Ensure Lite [especially strawberry flavor] or Deliver 2.0 [which has more calories & less sugar than Ensure "available through pharmacies"]. It also suggests asking the vet about taking milk thistle [health food store] or lactulose [vet prescription], which remove ammonia from the blood & help the liver.

 

[tonyshuman]

The syringe food is probably Critical Care. It is a good diet for bunnies that aren't eating enough and some will eat it out of a plate so you don't have to syringe feed.

Our Netherland Dwarf Benjamin had a thymoma--a cancer of the thymus, which is an organ located very close to the heart. It caused a cough, which led us to get it investigated, and it ended up looking like an enlarged heart on x-ray. I don't know what it looked like on sonogram, although we had the vet do a ultrasound-guided needle aspiration of the tumor to try to figure out what it was, so I assume on sonogram it was possible to differentiate from the heart. I know his heart did end up being enlarged because it was under pressure from the tumor later on. He also had a hard time keeping weight on, somewhat because he wasn't eating as quickly, somewhat from the out of control growth of his tumor relative to the rest of his body. I would ask the vet if this is a possibility for your guy. Many of the clinical reports of this kind of cancer are in Netherland Dwarves, and many are older (like your Buns). Our Ben was only 3-4 when this occurred. We wouldn't have known about it until the disease had progressed very far if he hadn't been coughing. Many bunnies will have no signs of this until the very end. For the last few days of his life, Ben was a bit lethargic.

I am not sure what to say because usually we recommend older bunnies having a hard time keeping weight on to have alfalfa pellets in addition to their normal timothy because of the higher protein content. However, the reduced kidney function + the increased calcium in an alfalfa pellet might be bad. I know one of our contributors, PamNock, recommends NutriCal for older bunnies, but I am not sure how I feel about it because it is formulated for dogs/cats and the diet of a carnivore is much different from our bunnies. It does have a lot of B vitamins, which can stimulate appetite. B vitamins can also be given in other ways, most often by vets by injection. Black oil sunflower seeds and oatmeal are also sometimes given. Unless he needs the fresh veggies to help with gut motility, you might want to just go to pellets and hay (and banana, if he likes that and tolerates it well).

So, my recommendations aren't all that good, sorry. Definitely ask the vet about the possibility of thymoma, and maybe read up on it a little. Unfortunately, there's not a lot that can be done. Some bunnies have had success with radiation and chemotherapy treatments, but I wouldn't put a bunny through that. Our Ben may not have had as long a life as he possibly could have if we had done everything medically possible, but the life he did have was much happier than if we had subjected him to a lot of uncomfortable treatments, in my opinion, and he was still a young bunny. If he starts having bulging eyes or difficulty breathing, it's an emergency and you may want to get him to the vet so he doesn't suffer. If it's just age-related, try some of the diet supplements.

 

[Nancy McClelland]

ray:

 

[buggles001]

Thank you so much for taking the time to give me all this information. Bun's vet did suggest the possibility of cancer but could not find anything on the xray or ultrasound. I will definitely ask about thymoma.

This is a bunny who up to a few weeks ago was lively and a good, solid weight. I monitor his physical status daily as he has a chronic infection of the little tube that runs from both sides of his head and I clean it daily up on a table so I can see and feel his muscle mass etc. He is very bony right now.

The vet suggests the symptoms are kidney disfunction and age-related but I think it is a bit odd that a) he is eating ravenously but still losing weight and b) was so bouncy a few weeks ago. His lab shows that he is a bit hypoglycemic. I asked about diabetes as I have a friend with similar symptoms but the vet said his blood sugar was actually a bit low (this was a random test of blood sugar).

Could this still be diabetes as an underlying cause of heart enlargement and decrease in kidney function?

Thank you very sincerely

 

[LakeCondo]

Diabetes usually causes excess water consumption. Any chance of an internal parasite? That causes increased eating but weight loss.

 

[tonyshuman]

LakeCondo is right that a parasite could also be the cause. One that also sometimes causes kidney problems is E cuniculi.

I made a Library thread about our experience with Ben's thymoma including x-rays, and I encourage you to take a look.
http://www.rabbitsonline.net/view_topic.php?id=71285&forum_id=10&jump_to=924806#p924806

There's also a very good recent article on it with x-rays.
http://www.jaaha.org/content/48/2/97.long

I have read one article where a bunny had thymoma and hypercalcemia, presumed to be due to the cancer spreading to the kidneys. It is my understanding that kidney mineralization occurs after long-term dietary problems and in old age.

 

[buggles001]

Thank you, I will also ask the vet about parasites. Buns never goes outside and he has just completed a month long course of Baetril as the vet treated him for a possible intestinal blockage. I will look cuniculi up as I am not sure how he would get a parasite. We do have two dogs in the house but they never come upstairs.

I have begun measuring Buns' food and water intake.This is a bit complicated as his best buddy Pidge (a pigeon-they are devoted pals)likes to eat a little of Bun's pellet food. In the last 24 hours, Bun has had 2 cups of water and almost 2 cups of Timothy pellets with hay cur up in the pellets. I read somewhere that half a cup of pellets per day is adequate. Are Buns' numbers high? He has never been obese.

Thank you, Elizabeth

 

[ZRabbits]

So sorry to hear Buns is having a rough time. Know how it is when one is sick.

Sounds like a lot of food in 24 hours. And what I just read from others it could be an internal parasite, but if he's not outside, and I don't think the dogs brought it in. Is his best friend Pidgie OK?

Hoping you find out what it is for your guy. Ask the Vet again to really look into it. I would bring all this information you just receive with you and talk it through together. I did it with my Rabbit Vet when Neville got the spins and we found out it was Wry Neck. The medication prescribed has gotten him back on track.

Wishing you all the Best. Please keep us updated.

K

 

[jamesedwardwaller]

buggles001 wrote:

Thank you, I will also ask the vet about parasites. Buns never goes outside and he has just completed a month long course of Baetril as the vet treated him for a possible intestinal blockage. I will look cuniculi up as I am not sure how he would get a parasite. We do have two dogs in the house but they never come upstairs.

I have begun measuring Buns' food and water intake.This is a bit complicated as his best buddy Pidge (a pigeon-they are devoted pals)likes to eat a little of Bun's pellet food. In the last 24 hours, Bun has had 2 cups of water and almost 2 cups of Timothy pellets with hay cur up in the pellets. I read somewhere that half a cup of pellets per day is adequate. Are Buns' numbers high? He has never been obese.

Thank you, Elizabeth

when i encounter a rabbit with a behavioral problem/symptoms,-i pull out the digital scale and start weighing them,--sometimes every 6 hours,--with a complete examination,daily,--it won,t do any good to weigh the food--weigh the rabbit before and after eating--or feeding critical care with probotics,--and observe/change the poop box regular--being an older bun it could open a pandoras box --a horse with an enlarged heart won the kentucky derby--,but disease takes many forms-which i am sure the blood tests could rule out---offer--powdered probotics-with water/juice-a few times a day,,i hope something here helps as i have to depend on a proceedure for longevity and my sanity,--sincerely james waller:big wink:

 

[buggles001]

Thank you all for the very helpful advice. I have now supplemented Buns diet with Critical Care, some parsley for iron for his anemia and small slices of carrot. Is it OK to give him a bit of banana? The CC is apple banana flavour and I want him to replace the lost weight. I was so pleased today to see him hop into the kitchen looking for a treat. He looks better than I have seen him in 2-3 weeks. /until today he wasnt moving much except to the food dish and back to his bed.

What other natural foods can I give him for weight gain and energy? He can't process too many veg at a time these days but he is all over any sweet stuff including carrots and his meds that are strawberry flavoured. I wonder if he could be hypoglycemic as his blood sugar was just below normal?

Thank you, Elizabeth

 

[tonyshuman]

Banana is a good treat for bunnies, but it has a lot of sugar so you will have to make sure he doesn't get too much. It's fine for him to have some of these treats that we think are fattening since he needs to put on weight, but too much sugar can be hard on his GI tract microbes. Most bunnies tolerate banana well and LOVE it. The low blood sugar could have been due to not getting enough nutrition. Metabolic diseases like diabetes and hypoglycemia can occur in rabbit but are extremely rare.

 

[buggles001]

This makes a great deal of sense. The vet told me that Buns would be losing protein and sugar via urine because of kidney function decrease.His ravenous appetite is probably in response. Thank you, Elizabeth