Bunny liver cancer

[Anna G]

Hi everyone,

I don’t know how to start my story, without getting upset or sad again but I would like to share the story of my first time bunny named Rocky, who passed away one month ago, and he was only 8 months old 

Anyway, first health problems appeared in the late summer, when he was 6 months old. He started losing fur in patches and I noticed he had sore hawks. I took him to the vet (I had a recommendation from a friend who had 2 bunnies) and he prescribed antibacterial baths 2 times a week (we previously took samples of fur and sore hawks skin and blood, and it was positive for Staphylococcus bacteria). Additionally, he recommended applying a cream 2X a day, 7 days, directly on his sore hawks (Triderm cream consists of a mixture of antibiotic- gentamicin, antifungal agent – klotimazol and corticosteroid – betamethasone). Rocky also had some discharge from his eyes that would come and go from time to time. 10 days later we went for a checkup and weeks his fur was well, fluffy and shiny, but his sore hawks didn’t clear out entirely. I noticed at the exam that he lost some weight but the vet didn’t seem to be alarmed, and he recommended putting on Triderm cream again on his sore hawks again until the problem is all gone.

But here comes the sad part, after about a week I noticed that Rocky is losing some more weight even though he did eat regularly, his sore hawks didn’t clear out (he was on Triderm cream for about 3 weeks in total), and his eyes had this constant clear but sticky discharge. So I took him to the vet again and we did the blood work. The results were devastating, his liver was totally damaged, liver enzymes were sky high, and he was anemic. So the vet suspected toxic liver damage, or some strong bacterial infection.

So for 3 days we struggled to keep Rocky with us, the vet gave him infusion of antibiotic gentamicin and some hepato-protective drug, and some electrolytes and glucose too. His appetite was completely lost on the second day of treatment, and on the third day he was gone, 3 hours after receiving his therapy. Since the death was so sudden, and he was such a good looking and happy little buck before, I decided to go for an autopsy. The results were hepatocellular carcinoma (liver cancer).

You may wonder why I am writing all this, because it just seems like we did all we could? Because, after he died I was really confused and started to inquire more about the therapy the vet prescribed in the first place. His initial thoughts were that it could be poisoning before the autopsy results came, and so I started digging for the cause, and I came across the information that corticosteroids (like the one my vet prescribed for the sore hawks) can cause liver damage and death. So, I am trying to figure out if maybe the treatment for his hawks caused all the trouble afterwards? Of course, I confronted my vet about my concerns but he doesn’t think that this cream could cause liver damage & cancer even though I red some articles that point out that corticosteroids are toxic for rabbits! But he didn’t give any further info on how this cancer happened and why…

I also realized that he didn’t recommend to force feed him even though on the last few days he barely ate at all, and I feel that maybe the death could be avoided if we started the more intensive home treatment and if we started it when he first started losing weight. I also fear that in the end he starved to death because of this!

I would appreciate any thoughts on this subject, I know that what is done is done, but I would really like to hear about other treatment for sore hawks and liver problems because I feel that many vets are just sloppy when it comes to rabbits. I also feel fear that I will lose the bunny again if we go for another one in the future..

Thank you in advance for your comments…

All the best to you and your rabbits!

[Bunny House]

I am so sorry for your loss.

Was this vet rabbit savvy or a regular vet? Vets don’t learn about exotics in school very much, most of the knowledge is when they do residency after school. You are right. With my research, any amount of corticosteroid can be deadly in bunnies after a few uses. Bunnies can’t handele it in thier system and so when the bunny is trying to flush out the corticosteroid, the liver traps some of it and becomes damaged. I know this doesn’t make you feel better about it. And a bunny in the iuc should be given lots of subq fluids to help things get washed out. And of course force fed because the body needs nutrients to keep fighting. It seems like the vet wasn’t experienced in rabbit or other care would have taken place and other hock medicine would be given. I know chlorohexadine is a great soaking liquid and SSD cream helps things heal very fast. My New Zealand always has sore hocks so I make sure the litter box and floor has padding on it. My lop had a bad ear infection and we did the tiniest amount of steroid in her ear to help, and did regular blood tests.

Many vet are very negligent, the ones I showdowns now prove that to me and it’s so sad. You can always report him to AVMA I think that’s the right association, and tell them what happened. I know it’s angering knowing that you should have done the home care and because someone didn’t know how to treat your baby caused them to now be gone. I had a bun a few months ago that had a dry compacted cecum, she’s a great vet so it isn’t her, it’s the technology we used that it didn’t show us what was wrong, it showed the cecum empty and we did all intemsive care to 2 weeks but if I had known that maybe adding oral fluids force fed might have softened his cecum and not went in for surgery, he might still be here.
I know it’s scary thinking about getting another bun after this. I still have 3 and that event made some so worried my others would have the same fate, but the thought goes away after a while. If you do get another bun, find a rabbit savvy vet and ask them how they would treat specific cases on a bun, so you know you have someone reliable to go to if your bun is sick. Just know your baby was probably so out of it from everything that he didn’t really feel anything in the last couple of days. Again, I am so sorry, it’s heartbreaking and angering loosing an animal to poor medical treatment. Just know that if you run across a bun to adopt, it might be him in the bun

[jerseygirl]

Im sorry to hear about your rabbit. So young..

There are some cautions around using corticosteroids in rabbits, mainly because they can suppress the immune system. But sometimes they are used short term because they are so fast acting. And, they are also used in topical applications. There are varying strengths of corticosteroids. Betamethasone and Triamcinolone are more potent then something like hydrocortisone.

However, given that the autopsy found liver cancer, I highly doubt the meds could have caused that. I would guess at some of the other things Rocky suffered were due to secondary infections, with cancer being the primary disease.

In people, that type of cancer often doesn’t present symptoms until it is quite advanced.  It also occurs when there is already existing  liver damage. I do not know if that is the same for rabbits. There are some conditions caused by parasites that can cause liver damage.  

Again, Im very sorry for you loss. It is normal to question things. You could always ask another vet to go over the autopsy report and discuss it with you if that helps bring some closure.

***Binky Free, RockY***

[Wick & Fable]

I am sorry for your loss, and I hope writing about it has helped you get through this difficult time. Regardless of blame or cause, the loss of a rabbit family member is hard to deal with, but I hope you find comfort in realizing just how much you did for Rocky out of love, as I’m sure he realized it as well. A short life, but one that happened along side a very caring owner, and that’s really something value for any living creature.

I do not have experience with corticosteroids, but I have done some research just now. Yes, there is a lot of information online with experiments done on rabbits which show effects to major organs and immune suppression with usage. What is a low dose vs. a high dose, I’m unsure. I will mention that many of the studies I came across, I have a hard time generalizing them to your situation exactly. It seems 95% of the time, the corticosteroid is administered through the eye, sub-q, or another method that is, at face value, a lot more direct than a topical treatment. I am no expert in corticosteroids, but I’m reminded of rabbits and penicillin — penicillin is absolutely harmful to rabbits if ingested orally or injected into a blood vessel/muscle (from what I’ve been told/read), but you can give sub-q shots of penicillin to rabbits with no issues. The mode of administration can make a big difference, so without more formal pharmacological education and a better understanding of the rabbit biologically, I hesitate to assume that topical application will have the same effects as the eye/injection route. Again, additional information on how triderm is absorbs would be more informative, but to that extent I cannot readily access that information (in a way I’m comfortable in reading and informing others).

I did find a study that compared tolnaftate, hydrocortisone, clotrimazole, gen-tamicin, and betamethasone (the one you mention used on Rocky) and there was no significant different on intact skin after 21-25 days of consecutive use. Unfortunately, I cannot access the full study so I do not know if they took measures of other organ function. That being said, this is one study and also does not apply to you exactly as you may not have been applying to intact skin, and I cannot access it to see the methods for a more critical eye.

Based on what I’ve read and addressing the idea of the cream usage and cancer. I agree with jerseygirl that the medication usage, although higher concentration in steroids than other alternatives, most likely did not cause the creation of cancer from nothing. Immune suppression can set off a lot, and this could have accelerated what already existed. While reading your story, I was heavily reminded of another user (https://binkybunny.com/FORUM/tabid/54/aft/165835/Default.aspx), whose rabbit was taken over by a skin condition and observed weight loss. It was later discovered a tumor was growing on the liver, suppressing the immune system, and this was causing the obvious symptoms.

I am sorry for your loss, and I wish you the best.

Binky free Rocky~

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[Bam]

I’m very sorry you lost your rabbit. I too think the sore hocks and bald spot was secondary to the liver cancer or separate issues due to Rocky’s immune defense already being heavily challenged. Corticosteroids should be avoided in rabbits, but they are still used for some conditions. Corticosteroids given by the oral route would affect the liver more or less directly, and prolonged use of oral steroids is known to sometimes cause liver damage in children, but it’s a rare side effect. Your Rocky didn’t get oral steroids, and the period of time during which he had topical corticosteroids was too short to qualify as prolonged use.

As for the refusal to eat, I’m pretty certain that syringe feeding him would not have saved him. It could have prolonged his life with a week or two, perhaps. My father passed from liver cancer that had metastatized from the stomach. He wasted away, cancer does that.

[Anna G]

Thank you all for your answers!

It means a lot to me, and you are right, it is not easy to find a study that relates completely to the situation I had but the corticosteroids certainly didn’t help the sore hawks or his immune system after all. Thank you for sharing the link for this articles, will read them for sure. The more info the better…

I know there is a change that the cancer was there first, before the fur loss started, but one always wonders if something could have been done differently.
This was my first bunny pet, and my daughter (6 years old) was also so happy with him which makes it even worse now, because it is her first contact with death… Rocky was a Holland lop, they are so sweet and cuddly…

How long did you wait before you got another bunny pet?

Wish you all a nice weekend!

[Anna G]

Thank you for your reply, it means a lot to me!

As for the vet, my good friends recommend him to me, since he treated her bunny with some heart failure, and she spoke highly of him. But now I see that he isn’t as competent as he should be to treat rabbit emergency situations. If we do get another bunny, I will have to interview a few vets in advance for sure.

Anyway, I did give him my trust, and didn’t expect that this could happen so quickly in such a young rabbit, he was so smart, good looking and sweet from the start. But I know it’s hard to tell now for sure what were first, the cancer or sore hawks/ fur problems.

In the future I certainly wouldn’t go for treatment with corticosteroids as I see it is highly controversial.

And you are right; the end was probably inevitable, as the disease progressed…

All the best! 

[Anna G]

Thank you for your thoughts on this subject.

Cancer is always hard, in humans and animals too… I could say without hesitation, one of the toughest situations in life.

My father had gastric cancer 10 years ago, and from a strong, tall and a sold built man he was gone in 11 months

So, these things are very hard to detect in time to be curable 

[LittlePuffyTail]

I’m so very sorry for your loss. I wish I had answers for you but I don’t have anything helpful to add. However, I know how you are feeling. Years ago, when I was a pretty new bun owner I lost a bunny who had stasis after a vet who “sees bunnies” treated her. The treatment, if you could even call it that, was all wrong and I lost her 2 days later. It still saddens and upsets me, many years later. She was only 2 years old. So, I know how hard this is for you, but you are not alone in feeling this way. Your bunny was lucky to have you, though, for all your care and love.

And also sad to hear about the loss of your Dad. My Dad also suddenly got cancer, 14 years ago, and he was only around for 3 months after that. What a horrible disease.

[Author]

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