spay or not spay 10yo with uterine mass?

[potaterbun]

Hi everybun!

This is my first post here on binkybunny so please excuse weird formatting. Long post ahead!

My 10 year old bun Peanut and I have been struggling with some health issues in the past couple months, and I’m looking for some advice as I am terribly conflicted about how to move forward.

In short, my girl is not spayed, and likely has uterine cancer or endometrial hyperplasia or a uterine cyst that caused a lot of bleeding with clots last week. She was perfectly fine for 2-3 days after the event, and the vet said I had to decide whether or not to spay her. I was weighing pros and cons, was in contact with a highly recommended exotics vet, when she stopped eating and I thought it might be time for her. I took her in and we are treating aggressively for GI stasis and possible uterine infection. She’s doing better now, maybe 65% back to her normal sassy self. I am planning on bringing her in for x-rays, ultrasound, etc., when she is eating more normally.

My question is this: considering her age, her recent GI issues, and the fact that her mass has been present for at least a year and a half, should I go through with a spay? I am terrified of losing her on the surgery table and want to keep her stress & pain-free as much as possible. 

In long, I have lived with bun since she was a little baby, but was not primary caretaker until just before COVID. She’s always been very healthy and energetic, loves cuddling and her treats 🙂 In the last year we have gotten very very close. She is unfortunately not spayed.
About a year and some months ago, I brought her in for some lumps around her nipples. The vet did an aspirate and determined that they were filled with milk. He also discovered a mass in her uterus, but I didn’t seriously consider spaying her due to her age. Having done more research, I wonder if they were not actually filled with milk, but if they were some kind of mammary tumor. I am drowning in regret that I didn’t get her spayed at this point, but I was nervous about putting a senior girl under anesthesia.
About two months ago, she had her first ever bout of GI stasis, after going through a false pregnancy. I rushed her in for medical care, and she ended up being hospitalized overnight. Her kidney values were elevated and there was concern for kidney disease. The doctor thought her GI stasis could have been triggered by her possible kidney issues or uterine mass. We did syringe feeding, pain meds, panacur for possible e. cuniculi, and subcutaneous fluids until her recheck blood work came back all clear ❤️ It was a very stressful time for both of us, but I’m so happy and grateful that she made it through. It took her a couple weeks, but she was back to her normal self. We had an amazing 2 months together after that.</p>

Two days ago we were cuddling on the couch when she bent over to check her hind end. I thought she was eating her cecotropes until I saw the pool of blood. There was so so much blood, with a few large clots. She had just jumped off the couch and back on, so I thought she had broken something, but it was coming from her vulva. I absolutely panicked and was about to race her to the ER when I got a hold of her vet, who told me to monitor and bring her in asap next morning since the bleeding stopped fairly quickly. He said she was stable and that I need to decide whether or not to spay her, as he thinks her uterine mass is what caused the bleeding. He didn’t see any evidence of cancer on the x-rays we did during her stasis episode 2 months ago. He said it could be a cancerous mass, or an overgrowth of normal tissue / hyperplasia.
I got into contact with a highly recommended exotics vet to consult on her case and weigh the pros and cons of putting her through surgery (she said she doesn’t do rabbit spays because they are difficult, which made me so nervous!). She was doing perfectly well for 2-3 days after the bleeding, when she stopped eating well. I literally thought she was going to pass at home just three days ago, she was hiding, not moving for hours, didn’t want to be touched, trying to bite. She improved a bit with at home GI stasis care (simethicone, critical care, pain meds), and I took her in to a different vet yesterday. We are treating for stasis with more of the same, plus fluids and an antibiotic for possible infection as I am fairly certain she is having tan discharge from her vulva. The vet and I agreed on focusing on getting her through this episode of stasis first, before moving forward with x-rays to check for spread of cancer & ultrasound to check on the mass. She thought it would be risky, or even very risky, to do surgery the way she is now.

I don’t know what to do. I keep going from one decision to the other, back and forth. I want to give her the best chances at a good life, but she is already 10 years old, and surgery, even if successful, may not give her much more time. If it is cancer, it may have spread to places that are undetectable on diagnostics. She may not make it through anesthesia, or have a painful and difficult recovery or not recover. But maybe it will be successful and we can have more time together. Or should I keep her on pain meds, maybe steroids if that is a option, keep her happy and comfortable until it is time? I keep checking to see if she is breathing / eating / pooping; I have been an emotional wreck. Any advice, experience, thoughts are welcome and appreciated. Thank you!

 

edited by DanaNM to remove weird formatting

[DanaNM]

I’m sorry you are going through this! 🙁

I think it will be important to work closely with a vet who is very rabbit savvy and see what they say once they have more info.  I agree that stabilizing her first is important.

It will be important to find a vet that does a lot of rabbit spays and rabbit surgeries in general. I do know of a couple case of emergency spays (for cancer) in a 7 year old rabbits. It wasn’t as advanced as this, but both rabbits did recover well and are doing great.

I can imagine a lot of different scenarios, but they will all depend on how advanced the cancer is. You may end up deciding to try the surgery, with the knowledge that once the vet starts, they may see that the cancer is very advanced and opt (with your pre-approval) not to wake the rabbit up. You also may decide to just focus on symptom management, but it will be important to consider quality of life and to be sure she isn’t suffering.

I’m sorry I can’t be of too much help, I think once you get more info it will help you decide.

. . . 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.  

[potaterbun]

Thank you for your kind words <3

She is doing a lot better today, I finally feel comfortable leaving her for a bit to go out and run errands. She is eating all her greens, eating some hay, although not quite as much as I want her to. Her poops are a bit dark but I will take what I can get!

I think you’re right about needing more information to make the best decision. I have scheduled x-rays and an ultrasound on Monday, but it’s really only to see how far her illness has gone, if other organs are affected, if she is in more pain than I thought. I hope it will give us more info on what to expect in the next weeks or days. Had the big hard cry yesterday, and I think I have known in my heart all along that she would hate being put through a major surgery. Its hard and stressful enough trying to pick her up for critical care and fluids – no way she would have a good quality of life constantly being handled for recovery from a surgery that just has too many risks. She has just been so fragile lately.

Fingers crossed for good news on Monday!

 

[BZOO]

Well, only you can decide.  Reminder quality of life is the most important factor.

Personally, at this stage, I would focus on that and keeping her happy and comfortable.

Keep us posted!  Hugs to y’all.

[potaterbun]

Thank you so much 🙂 I will pass your hug to her!

I think I was in a battle between heart and mind – selfishly wanting to get her through surgery and recover to have more time with her. But if I really think about how much stress, fear, and pain she would be in… She wouldn’t want that. Cried long and hard yesterday, but I have finally admitted that I will lose her at some point, and I want to focus on making the time we have left together amazing. ❤️

 

[DanaNM]

You’re welcome, glad she seems to be feeling better! Keep us posted!

. . . 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.  

[potaterbun]

Hi all! Just wanted to update on the situation with Peanut 🙂

She’s doing great at home – we’re currently trying to figure out the best combination / timing of pain medications for her. She’s currently on Meloxicam in the AM and gabapentin in the PM, and she gets so excited for medication time because she gets it in a bit of banana baby food! Her appetite, energy, and poops are improving every day.

As for the surgery… I’ve decided not to go ahead with it. I just don’t think she would do well with the anesthesia and the recovery. Luckily the doctor didn’t find anything else during the ultrasound and x-rays : her uterine mass looks more defined and is quite sizeable, and there’s definitely some sort of fluid (could be blood or something else) in her uterus, but there’s no signs of other spots of cancer and the lungs are all clear. There hasn’t been any sort of discharge from her vulva either.

The radiologist did see some age-related changes in her spine, so I’m sure she must be feeling more comfortable with her pain medication on board. We’ve made lots of changes to her living space to accommodate – she’s officially a senior gal!

I’m just focusing on keeping her pain free and happy, and reminding myself to treasure each moment I have with her 🙂

 

[DanaNM]

I’m happy to hear she is doing better!

. . . 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.  

[Author]

Messages