Weight loss. Causes/tests?

[Azerane]

Hello all.

Luna is about 6 and 1/2 years old now. About 3 weeks ago she suddenly developed a cataract in her left eye. That all checked out and doesn’t need treatment but she is of course now blind on her left side. At our first appointment for the cataract (the day after it appeared) she was weighed at 1.95kg. She normally weighs 2.4-2.5kg so she lost 1/5 of her body weight. I was so focused on her eye at the time that I didn’t think properly about it until a day or two after. I knew she had lost a little bit of weight but I still had expected her to weight about 2.2kg.

Needless to say it’s a lot of weight to lose. My first thought was I’m not feeding enough, Apollo (her husbun) who is overweight has not lost any weight (he doesn’t steal her food or stop her from eating).

Even so I increased pellets to daily (they’d been twice a week treats). She dropped down to 1.90kg, I increased pellets to twice daily and added some lucerne hay in with their oaten hay. She dropped down to 1.85kg.

I’ve got a vet appointment for early next week and in addition I’ve just started to supplement with critical care to see if I can impact on her weight at all. I’m weighing her daily so if she drops below 1.8kg I will bring the vet appointment forward ASAP.

So my reason for posting is to ask for any insight as to what we should be asking the vet for. In terms of her appetite, she eats normal amounts, drinks normal amounts, and pees and poops. Acts normal.

I’m thinking a full blood work up to check organ function and whatever else they can check with that. Maybe an x-ray to check for masses that may be pressing on her stomach or something? Is there anything that causes drastic weight loss without change to appetite? Obviously a major cause of weight loss in rabbits in dental issues but she eats soft and hard food with ease. Would it be worth getting a shot of metamide (appetite stimulant) to try and icrease her intake?

Would appreciate any insights.

[LBJ10]

Hi Azerane! The sudden cataract in one eye is suspicious. Have you considered EC? Weight loss is a symptom, it just isn’t something normally think about. Drastic weight loss can be caused by other things, of course. Since there is no loss in appetite, you think of more sinister things like cancer.

[Azerane]

We saw an opthamologist for her cataract after our regular vet, he mentioned EC but didn’t think it looked like an EC cataract, which of course doesn’t mean it definitely isn’t one. He said that one eye was unusual as well (age related are usually both eyes or shower onset) but in terms of overall eye health otherwise there was nothing to be concerned about.  And yes, cancer or other big looming problems have definitely crossed my mind.

[Bam]

Hi Az! I’m very sorry to hear Luna isnt well.

As LBJ says, weightloss without a marked decrease in food intake does make one think of really bad things. I think its very wise to supplement her with CC. How is her water intake? (Diabetes would cause weight loss but also a vast increase in thirst and urinary output). ETA: Sorry, I now see you said water intake is normal. That would pretty much rule out diabetes, then.

EC is a possibility, but when it is affecting the kidneys, it often manifests in incontinence.

A full blood panel can show many things, so I think that’d be an excellent start, together with a manual exam.

[Azerane]

Thank you. Unfortunately after closer supervision today I realised her water intake has increased. I watched them all afternoon from the time I got home from work and she drank 5 times in the time Apollo drank twice, and she drank for longer times than he did.

I know it’s not diabetes because with her weight loss at her first vet visit I collected a urine sample after to test for diabetes. So at least that has already been ruled out. The more I think about it the more I worry about EC. The timing with the weight loss, cataract and increased water is very concerning. I’m more frustrated that I didn’t pick up on the weight loss or water intake sooner. She seems to be urinating normally but that’s a bit trickier to tell.

The more reading I do the more stressed I get, if it’s EC or anything that has damaged her kidneys, has it potentially been going on too long to be able to reverse the damage?

I’ve been trying the critical care a few times a day, the trouble is she doesn’t want to swallow it. She’ll eat a tiny bit but most of it ends up just oozing out of her mouth. I think she’s just not hungry enough to want to eat it when she’s stressed at being force fed? She won’t eat it out of a bowl, doesn’t like the smell, and it’s the flavoured kind.

I did bring her vet visit forward to tomorrow. The more I watch her the more things I notice and the more serious I realise it is and there’s no point waiting.

[Bam]

I’d be more inclined to think its EC, tbh. Diabetes is very rare in rabbits. There are some drugs that could help kidney function, but the info I have on that is sth like 5 years old. I will try to find my notes from the EC webinar.

Asriel and Bombur’s Bombur has chronic EC that affects his kidneys. She has been managing it though, with repeat courses of Panacur.

ETA: I found my webinar notes, silly of me but I didn’t write down which vet it was. The vets that held those webinars were Molly Varga, Livia Benato and Richard Saunders. I have some vague idea that this particular webinar was held by Molly Varga though. So, these are the clinical sign, and the next pic is about EC affecting the kidneys. Will email you the whole document, if you don’t mind:

About EC affecting the kidneys:

[Azerane]

Yes when the vet mentioned testing for diabetes she said it was unlikely but worth double checking since test is easy and non invasive etc.  Said she could count on one hand the number of rabbits she’s seen with diabetes.

Thank you so much, would appreciate any extra info. I find it always helps to go into a visit well armed with knowledge, that way I know better which questions to ask etc.

[DanaNM]

Hi Azerane,

I think blood work is a good first step. And maybe even treating for EC so you can rule it out, since the tests are so unreliable? Is she showing any lethargy or other signs of pain?

Do you think she would eat critical care cookies? I’ve seen some recipes for them where you bake the CC at a low temp to make little biscuits. I also had a lot of success using tiny 1 mL syringes to feed my girls when we were moving recently (otherwise they just spit nearly all of it all out). I had always used the larger ones but now I use the large syringe to load up the small syringes and it goes pretty fast.

I wonder if your vet would be open to supplementing with oat groats? You could feed them to her separately so Apollo doesn’t eat them.

Excess drinking could also be a symptom of dental pain. She’s around that age where they can get some molar spurs due to changes in bone density, so maybe she has some spurs that are just enough to reduce her food intake to cause weight loss, but not be that noticeable otherwise?

. . . 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.  

[Azerane]

Thank you, yes I definitely want blood work. I think you’re right about treating for EC as a precaution too, if it is that and we don’t treat it’s only going to damage her kidneys more. As far as I can tell she’s not lethargic, at least not any more than Apollo, I think they’re both just less active than they used to be due to their age.

However she has been doing this funny stretch for a while, but it was so infrequent (I’d see it maybe once a week) that I didn’t think much of it, and there were no other symptoms to go with it, she did it a few times yesterday. She’ll kind of reach forward and to the side with her front paws so that it twists right at the back of her tummy. It’s hard to explain. It’s not like any stasis type stretch or movement I’ve ever seen. Like I said it was so infrequent I just thought it was a stretch.

She’d probably eat CC cookies, I bought some oxbow treats recently and have been sneaking her some when Apollo isn’t looking, lol.

With how much weight she’s lost I can’t see them having a problem with oats to try to get some weight back on.

It certainly could be dental, but I just don’t get any impression of dental issues at all.

I’m so pleased I brought her vet visit forward, I’m so stressed about her now.

[Bam]

Weird stretching could mean gas even if its in a way you’ve never seen before. You could give some simethicone baby gas drops -if they help, they help, but wont do any harm.  Is she molting at the moment?

Dental problems can cause weight loss, so its of course wise to have the vet look at the teeth.

Both my Bam and Vildevhad full blood panels when they were poorly, and that really gave a very good picture of what was going on. In Bam’s case there was an infection which showed up in the immunoglobulines and white blood cells. In Vilde’s case it was “just,” elevated liver enzymes, which can mean liver damage or be a result of stasis. The liver enzymes went back to normal after a few days of CC by syringe, so it was all about stasis.

Worrying is awful  but know this: whatever shows up at the vet tomorrow, Luna has had the best bun life since she came to you. She is an extremely lucky girl.

 

 

[Ellie from The Netherlands]

Sorry to hear that she’s poorly 🙁 I’m worried as well, and I hope that they’ll be able to treat the problem.

About the CC feeding: could it be mashed with banana to make a porridge? It’s how we gave Breintje his medication.

We froze banana slices separately and thawed one in the microwave for a couple of seconds every day. We mashed it with a fork and mixed in the meds. Breintje dug in and nearly licked the glaze off the saucer. We were surprised that it worked so well because the meds smelled strongly of anise, and he hated that. Apparently banana is the bunny equivalent of chocolate 🙂

Wishing you and her all the best! Good luck at the vet tomorrow!

[LBJ10]

Hopefully you can get some answers from the vet! I agree that sometimes it’s best to just treat for EC since the tests are not very reliable.

[Azerane]

We’re at the vet right now, they’re just taking bloods. No dental problems, definitely concern about the kidneys. She’s happy to try a course of panacur but after the blood results come back tomorrow to check her liver function first. They’re also going to give her some sub q fluids now to help give her a bit of a boost.

She also recommended mixing in something really yummy with the critical care like banana. I don’t normally give any fruit though so don’t even know what she likes, lol.

Pretty sure half of Luna is still on the exam table though, she shed most of her fur, lol. Also she bit me, which is the very first time in 5 years. So she’s obviously stressed.

[Ellie from The Netherlands]

Good that she got some fluids. Poor girl, she sounds really stressed to be biting you. Fingers crossed for good results.

I can tell you: bananas are bunny crack 😉 One problem though: once they’ve had a taste, you’ll never eat one again without having to share. Or you’ll get THE STARE! Those round big eyes staring up at you: feeeed meeeee! Feeeeed meeee….

 

 

[Azerane]

I stopped at the shops and picked up a couple of options, blackberries, strawberries and banana. Will see what she likes best. First and last time I’m paying $7 for a tiny punnet of blackberries, lol.

[Bam]

Blackberries! 😋

Fingers crossed her liver tests come back fine so you can start her on the Panacur.

You could mix some baby fruit puree/smoothie in her CC, but sugar content in those products is still rather high even though it’s natural fruit sugars (commonly banana or mango or pear). Berries sounds ideal, but 7 dollars is quite steep 😳

I give Vilde grated carrot. I think grating it releases irresistible fragrance -he only eats it freshly served, if its left to dry he won’t touch it. (Rabbits do keep us on our toes! 😂)

(For readers of this thread: Vilde is a special needs bun who has trouble keeping weight on. It’s not recommended to give grated carrot to rabbits in general).

 

[DanaNM]

Some bunnies like canned pumpkin in their CC too. You might also try some other brands of recovery food. 2 of my bunnies like the CC apple banana, the other two like the Sherwood recovery food better. They all have their preferences!

Also, there was a timely article in the newsletter from our rescue about training buns to take their meds willingly. Maybe Luna could learn to like her CC? I’m having trouble accessing it online, but here’s the text from it:

“Cooperative Care

By Jean Silva

“Give her 1.5 cc’s by mouth twice a day.” the Vet Tech said handing me a bottle of medicine, a syringe and Fang’s carrier.

“How am I supposed to do that?” I thought as I smiled and nodded.

Once home, I checked the internet and found all sorts of helpful suggestions:

Wrap your pet in a towel like a burrito. No good. It took both hands to keep Fang wrapped in a towel.

Have someone hold the bunny for you. My husband held Fang. Fang tried had to bite my hand whenever it came close to her mouth.  The burrito had been a big mistake.

Finally, I squeezed drops of medicine onto a mini shredded wheat until it soaked in.  Fang, ate it right up. Problem solved – sort of.

In those days I gave medicine to the sick animals at BUNS.  I tried many things.  Pry the mouth open and shove the pill down the rabbit’s throat with a finger. Ouch. It worked for the vet.  Use a Pet Pillar instead of your finger to place the pill in the back of the mouth. The pet spit the pill out.  I held the mouth closed until the pet swallowed. If looks could kill.  Mash the pill with banana and serve it on a tiny china plate. If the pet refused to eat it, draw the mixture up in a syringe. Hold the bunny and squirt it into the mouth.  Small wonder the everyone began to back away whenever I came near.

Then I began to see zoo animals that voluntarily came forward and stood still for an injection. I bet they never even tried to wrap the hippopotamus in a blanket like a burrito. Hmmm.  My friend Peggy Hogan trained her horses to voluntarily participate in dental exams, eye treatments and wound care.  People were calling it Cooperative Care. Wow! Did I really need to pick up, immobilize and pry open an animals mouth to give it medicine.  What if I just offered the meds to the bunnies?

I started with a honey flavored liquid anti-inflammatory (Meloxicam, also known as Metacam) that most bunnies seemed to like.  I’d draw up the medication in an oral syringe and make a small “bead” of the stuff on the tip of the syringe.  Then I would put the tip of the syringe right under the bunny’s nose near the mouth and gently move it back and forth until I felt the bunny take the syringe into its mouth. As I felt the bunny lightly chew or move its lips on the syringe I would slowly depress the plunger.  If the bunny stopped so would I.  When they began again, so would I.  Some of the bunnies began run toward me as I approached with the syringe.  That’s a good sign.

When Clyde was prescribed SMZ-TMP I picked him up, held him still, lifted his lip and gave him the medicine.  He hated it.  He would run away when I approached.  That’s a bad sign.  Well, I thought why not?  I loaded the oral syringe and tapped it on the enclosure wire to make noise.  Clyde came over, sniffed the syringe and drank the whole thing. The medicine was fine. Clyde just hated being caught and immobilized.

I offered the syringe when Bindi was prescribed SMZ-TMP.  She was happy to drink the medication from an oral syringe.  Bindi lives with her mom, Ponta.  When Ponta saw Bindi happily drinking her medication, Ponta wanted some too.  I started giving Ponta a rabbit pellet for each dose of medication Binda drank.  One night as we sat on the couch, my husband asked, “Why are Ponta and Bindi standing there?”  I looked at the bunnies who were liked up at the edge of their enclosure.

“They are waiting for their medicine.” I said, all cool.  WOW! Not only were they voluntarily taking medicine, they asked for it.

Next I tried Juniper the guinea pig.  She was new to the shelter. But she took treats from my hand. So why not medicine. Juniper swallowed the SMZ-TMP and tried to pull the syringe out of my hand.

When the Vet Tech hands you an oral medication, consider just offering it to your pet. You might be as surprised as I was.  If your patient has a companion, please bring something for that bunny as well.  Bunnies and guinea pigs are more comfortable in groups and no one wants to miss out on treats.  Engaging both animals gets good momentum going.

It helps if your bunny or guinea pig is used to taking food from your hand.  So long before your bunny or guinea pig gets sick, offer some parsley, cilantro or food pellets from your hand.  Do that regularly.

If they don’t take medicine voluntarily, try changing the delivery method.  I have had good success squirting SMZ-TMP onto spoon sized shredded wheat for example.  Rabbits will eat the SMZ-TMP laced biscuit even if they declined straight SMZ-TMP.  Mixing a medication with banana can work too. Tossing it as dressing on a salad is another possibility.

If none of those things work, then it may be time to get out the towel and try a bunny burrito.  But try something else first.  Your bunnies would appreciate your thoughtfulness.”

. . . 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.  

[Azerane]

Thanks for sharing Dana, I love that article, unfortunately she’s going to take a bit more work. I’ve offered the CC in a bowl, and I did also try offering it straight from the syringe without touching her at all. Will just need practice with something really tasty.

Results are in.

The short of it is her bloodwork is pretty much fine,  there are some very small anomlies but nothing that screams anything or leads to any diagnosis. Which is a huge relief that her kidney values are good. As a result we have started her on a 28 day course of panacur today for E. cuniculi to see what happens and hope she improves. That’s really the short best scenario version.

The long not best scenario version is an assortment of scary things, mainly cancers. The plan of attack is of course to start the panacur. This weekend I have to separate her from Apollo for 24 hours so that I can measure her water intake, I’ll measure Apollo’s as well for comparison. Something about 100ml of water but I can’t remember if that’s how much she should be drinking or if that’s a lot or if I’m getting that confused with another number. If she loses another 100g I need to take her back, and if she crashes obviously she needs to be seen ASAP. The goal is that with the panacur her weight loss will slow and eventually start to climb again in which case given ongoing monitoring and she stabilises we can probably leave it at that. If she continues to drastically lose weight then we’ll do imaging, chest x-ray and an ultrasound to look for masses. The trouble is she said that anything below 0.7cm can’t really be seen. This is where it gets tricky, there are some small variances in her blood work that could indicate something, the white blood cells have occasional atypical nuclear cells and her globulin is 35 where the cut off is 32. Both of those could be triggered simply from inflammation, or perhaps low readings from an early stage mass or cancer that may not be big enough to see on a scan yet.

Long story short, we have no idea what’s wrong yet and it’s just process of elimination. She is going to follow up with the other rabbit vet tomorrow morning to review the blood results and she’ll call me if she thinks there’s anything else that needs consideration. At this stage I’m happy with a tentative E.c. diagnosis because it fits her cataract as well.

I’m happy to post the full bloodwork results if people want to see them, that will just be tomorrow once I have more energy 😛

[LBJ10]

I’m sorry the blood results weren’t more conclusive. At least you know things are functioning well enough for her to have Panacur though. Hopefully that is all this is and you will see improvement.

[Azerane]

Thank you, yes it is a little frustrating but hopefully we’re currently doing the right thing. I separated them just over an hour and a half ago so I could measure each of their 24 hour water intake. Of course because I moved one of the litter trays out Apollo has already done a big wee outside of the litter tray. This is why I put Luna outside the condo, and left Apollo in it, lol.

No change from Luna otherwise, she is still eating well, moving around etc which is all promising. I’m torn between giving extra pellets, treats and oats to try and promote weight gain, but also trying to minimise how much I change for her at once not wanting to bring on stasis. Though in the 5 years I’ve had her she’s never once had stasis.

[Azerane]

The results are in. Luna weighs 1.839kg and drank 150ml in 24 hours (the vet said 90ml is normal for her size).

For comparison I measured Apollo’s intake as well,  he weighs roughly 3.3kg and drank 125ml in 24 hours. Which I’m guessing would be normal for his size.

I’ve e-mailed the vet the results, she won’t be in until Monday now (currently Saturday afternoon) but without much change in Luna there’s nothing we should be changing anyway, but at least we know for sure her water intake is well above what it should be, which makes it strange that her kidney values are fine.

In good news, I managed to syringe her panacur to her while she was in her litter tray yesterday, just had to hold one hand gently on her head. I had to restrain her again for the critical care today but she was better about eating it and I got 20ml in her without too much fuss. I don’t want to do too much at once because she is eating normally.

[Ellie from The Netherlands]

Yes, good girl, keep eating! Glad to hear that it went better with her meds and her food. Sending you lots of love!

[Bam]

Increased water consumption can have causes stemming from other organ systems than the kidneys. For example, I had a dog who who started to drink and pee a lot more than normal, and it turned out to be pyometra. (Luna obviously doesnt have pyometra, so this is just an example of how infection and inflammation can cause excessive water consumption). My dog had no kidney problems and the problem was  resolved with castration.

If her kidneys are fine, maybe she could have meloxicam? Meloxicam could help bring down the inflammation that is a secondary effect of e cuniculi.

[Azerane]

Thanks Ellie 😀

The meloxicam is a really good idea, thank you. Will ask the vet about that on Monday.

[Azerane]

Brief Luna update, I spoke to the vet today and got her some pain medication so she’s just had her first dose of meloxicam. The vet suggested getting a second opinion from a more experienced rabbit savvy vet might not go astray. I tend to see my local rabbit savvy vet who is very good and then proceed to the specialist or other rabbit savvy vets where needed. Will see how she progresses this week before deciding on that, because if the panacur is going to do anything I should see that soon.

Luna’s weigh-in today was pretty special, she actually gained weight. It could mean nothing because it’s literally only 5g up on yesterday, so maybe she just hadn’t peed or pooped recently, lol, but the fact that she didn’t lose any weight is a big deal.

She’s still herself, moving around, eating, pooping etc, her poops are still small.

[Ellie from The Netherlands]

Yay, that’s some good news ^_^ At least she hasn’t lost more weight, I really hope that she’ll stabilise!

[LBJ10]

That’s good news! Hopefully she keeps going down this path.

[Azerane]

I’m not sure if it’s the panacur or the metacam, but Luna’s poops are bigger today. Not full sized but bigger than they were.

I booked the appointment for next week with the other vet as recommended. Will give me time to see how she progresses this week, and I’m considering separating them again for 24 hours this weekend to measure water intake again for comparison.

[Bam]

Yay for no weight loss and bigger poops!

Measuring water consumption again sounds wise!

[jerseygirl]

I was hoping the weight loss would at least plateau. So to read that there was a gain already is great! I hope it continues. (((Luna)))

When Maple fell really ill with head-tilt, the weight loss was rapid but regain was slow. It took a couple months for her to look healthy again.

Re foods, I suppose the safe bet it to moderately increase portions of her regular food that her body is used to. Just for the extras calories. For newer things like oats, start small & see how she goes. 2-3 times/week then small amounts daily if not causing any problems.

It sounds like (?) there wasn’t any indicators in her liver values that showed the loss was really detrimental, thankfully.

[Azerane]

I forgot to mention that her weight did drop a little again after the tiny gain, the numbers are so small though it’s hard to tell what’s really happening. It took 3 weeks for her to lose 100g so that could still be happening, she’s lost about 25g from memory in the past week.

She’s loving all her extra treats and oats, she comes over to me a lot always expecting more because I’m giving her stuff so often, lol.

No there aren’t any issues with her organ values at all, which is wonderful but wasn’t what I expected.

[Azerane]

She’s up 17g today! Will be thrilled if I see more gain tomorrow.

[Ellie from The Netherlands]

I’m so happy to hear that! More appetite and better poop ^_^ It’s cute that she comes to you more often now, and it makes me less worried. A rabbit in severe pain or discomfort would avoid others. It also shows that she loves to eat, which is another good sign 🙂

[DanaNM]

that’s great!

. . . 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]

17 lovely grams 🥰🥰🥰

[LBJ10]

That’s great Azerane! Tell her to keep it up!

[Azerane]

We have Luna’s second opinion vet appointment shortly so I should probably update after that but here we are 😛

I think her weight may have stabilised, it’s been yo-yo-ing up and down the last few days but if you look at today vs almost 2 weeks ago it’s about the same. With winter approaching and worrying about her weight I ordered a Snugglesafe on the weekend and some oxbow multi vitamins with express shipping so that’s just arrived. Apollo doesn’t like the multi vitamins but fortunately Luna does.

I will probably just give them the snuggle safe for her at night time then she at least has the option to use it.

[Azerane]

Ok getting this down while it’s fresh. Vet visit went well, her weight seems to have levelled out which is good.

Took an x-ray as a precaution, vet said at quick glance there’s nothing alarming, kidneys etc look normal. Some shadowing over heart and lungs, she said it could be nothing but wants to take the time to study it properly and get back to me on thursday. So of course I have to not imagine the worst until then somehow, lol. So either it really is nothing or she was playing it down until she can give me proper info. Hooray 😛

[Bam]

Well, the Panacur seems to be doing what it should! Fingers crossed her heart and lungs are ok. You’re really doing all you can do, and since her weight has stabilized, it seems you have gotten her the appropriate  treatment.

A SnuggleSafe sounds like a good idea! Vilde likes snuggling up to the radiator during his day resting time.

[Ellie from The Netherlands]

It was good to get a second opinion, this vet sounds very thorough 🙂

I’m really happy that her weight is stable, and that she likes her food. I hope the snugglesafe works well for her! Older buns love warmth because in old age your fat percentage drops. Breintje has become a heat seeking fluff over the last 2 years, he loves sunshine and to snuggle up with me underneath a blanket.

Onwards to Thursday now, I know it’s going to be 2 long days. You’ve done everything you could, and now it’s the vet’s turn.

[Azerane]

Thank you so much, you guys always know what to say to make a worried bun parent feel better 😁

On the plus side I had the day off today and the weather is absolutely perfect so I took the opportunity to head out to a park and do some birding. Managed to pass half the day away without thinking about it and I got to photograph a Peregrine Falcon which is not a common occurrence.

She was a very thorough vet though, will definitely see her again for bunnies. When we arrived there was a gorgeous Dutch bunny just leaving.

My only concern is she may have tranced Luna to get her xray rather than mild sedation, but that’s on me for not asking when she said she could do the xray real quick and she wouldn’t need to be put under. That being said, if she really does have problems with her heart, sedation may not have been ideal anyway. To the best of my knowledge trancing causes increased heart rate from stress, but she was already stressed being at the vet anyway, so very quick trance vs mild sedation is tough to weigh up risk vs benefit. And clearly Luna’s come home fine so I can’t fault her there.

[LBJ10]

Glad to hear things are looking better! Even if her weight has only stabilized, that’s still progress! It sounds like this vet was helpful and hopefully the x-rays turn out to be “nothing”.

[Azerane]

The snuggle safe was a hit, I found Luna curled around it this morning. Very pleased that it works as long as it states. I heated it up at 8pm, it says it stays warm for 10 hours, I checked it at 6:15pm and could still feel some heat from it. Amazing product.

[DanaNM]

That’s wonderful! Lovely snuggly Luna 🙂 <3

I might have to get one of those for my buns next winter (and maybe myself LOL). They all liked the cold in California, but they’ve never experienced a New England winter!

. . . 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.  

[Azerane]

I just heard back from the vet about her xray. No masses, which is good. Kidneys etc are definitely fine going by xray. Her lungs are good too, there is some concern with her heart. She said in terms of size, her heart should be an 8.5, but it’s a 9. Meaning she has mild increased heart size which could possibly be due to heart disease/failure which could explain increased thirst.

Since I haven’t seen much change in Luna’s behaviour since starting the meloxicam she recommended I take her off of that over the weekend and phone her on Monday to let her know of any changes. From there she recommended we do an echocardiagram (ultrasound of the heart) to see how well it’s working. They have to get another vet in for that (I forgot to ask who but presume either a heart or ultrasound specialist) so she recommends taking a proper look at Luna’s kidneys at the same time.

So now we have another symptom that doesn’t really fit E.c. We will still be completing the course of Panacur.

[LBJ10]

EC can affect other organs. I believe there are a few known cases of it causing heart damage, but they are rare.

[Bam]

EC can affect the heart.

https://www.dovepress.com/encephalitozoon-cuniculi-in-pet-rabbits-diagnosis-and-optimal-manageme-peer-reviewed-fulltext-article-VMRR

 

The Rabbit Vet webinar also mentioned heart involvement and suggested some meds:

I think it sounds wise to complete the course of Panacur.

 

 

[Azerane]

Thank you for that extra information. I didn’t know it affected the heart, but it does make sense. I have decided to go ahead with the echocardiogram anyway as a precaution. At the very least I’ll find out if there’s any serious damage to worry about and allow us to treat accordingly. That’s on Friday.

On the plus side, I do think Luna is improving. We’re almost at 3 weeks on Panacur and there’s some very subtle changes this week which is great. Today’s weigh in was 1.89kg, which is more than she weighed 3 weeks ago. Her poops have continued to increase in size though there are still some small ones. I’ve also just realised today that she doesn’t seem to be doing the unusual stretch/posturing as much if at all.

Additionally I’m thinking there were other symptoms that I didn’t realise were symptoms until now because they’ve reduced in frequency. When getting up from laying down with her feet stretched out, her back feet would slide back a number of times before she would get them under her. Now I’ve seen this happen a bunch before with rabbits, especially on the fleece and Apollo does it as well, but now that it’s decreased I’m realising how frequent it was with Luna and how it was probably a sign of hind leg weakness. I think it’s just one of those things that crept up so slowly I just didn’t notice. It makes me feel awful that I didn’t catch it earlier,  but also relieved like we just caught it in time before she really took a serious turn with it.

Thank you everyone for all your advice and kind words. I’ll update again after her ultrasound or sooner if there’s any significant changes.

[Bam]

It’s of course very wise to go ahead with the echocardiogram! If there is tissue damage to the heart, it could be medically addressed regardless of the  cause.

It’s wonderful that you’re seeing improvement! And yes, rabbits are just horrible with their subtle, barely noticeable compromized-health-induced behavioral changes. But that’s an adaptation that has been fine-tuned for as long as rabbits have existed on earth, just so predators won’t be able to pick up on any signs of weakness. We, mere hoomins, are kind of up against nature itself when we try to suss out what’s going on with our buns.

 

[Azerane]

I just brought Luna home from the vet after she was there today for her ultrasound. Things get more interesting every time we do another test, lol. The vet is still waiting for the full write-up from the ultrasonographer and also needs to do some more reading about progression and treatments etc so I’ll hear from her again early next week.

The short of it is that Luna has mild mitral valve regurgitation, and moderate to severe pyelonephritis.

The first means that when her blood is being pumped out of her heart into her body, the valve is weak and is allowing some blood to flow back in to the heart. For now it’s mild and may or may not be causing the increased thirst. Time progression is unknown so far, so I have to keep an eye on potential symptoms, mostly her rate of breathing when she’s sleeping, as long term it can cause assorted side-effects and of course ultimately heart failure. The walls of her heart are not thickened.

Pyelonephritis is simply inflammation of the kidneys. The amount of which actually surprised the vet because her blood work was so clean, she said with the amount of inflammation showing that she would have expected to see distinct changes in the kidney values. Again this may or may not be causing the increased thirst, it’s most likely damage from the E.cuniculi.

So as of right now we don’t have any medications. To be honest I was in a bit of a fog at the appointment because I’m exhausted from a huge week at work, but I’m assuming that when I speak to her again on Monday that we will discuss potential treatment/medication.

[Azerane]

Received more info from the vet today. So apparently the location of the kidney damage is not consistent with E. cuniculi. I don’t know enough about that but the damage is bilateral (both sides) in the same location. To rule out possible underlying infection we’re doing a short course of antibiotics, following that she’s going on a long-term medication for her kidneys.

The heart problem is very mild and not a concern at this stage so she wasn’t worried about treating that but said the medication for the kidneys will actually benefit her heart anyway.

Luna is doing pretty well though, she’s definitely improved on the Panacur although she still isn’t really gaining much weight. Hopefully that will come with time, but as I said before there’s other subtle things that have improved such as no more strange posturing and less stretching out her hind legs.

[Bam]

It does sound like you are in excellent hands with this vet!

[Azerane]

Yes, she has been wonderful.

Brief Luna update. Her weight seems to be hovering around 1.9kg. We finished the course of antibiotics today and have now started on the kidney medication Semintra (Telmisartan) for long term management. We need to redo her ultrasound in 6 months time to check the progression of both kidneys and her heart.

[SweetPotato]

Wow! This sounds like such an experience! Sending love and prayers to your Luna ❤️. Glad she seems to be doing better!!!!!

[Bam]

I’m glad you have a good treatment plan! Fingers crossed she’ll respond well to the telmisartan!

[LBJ10]

That’s wonderful! Glad to hear she has a treatment plan and things are looking up!

[Azerane]

I just wanted to provide an update on Luna. Today was her 6 month ultrasound review. As usual she handled her stay at the vet like a champ (Apollo stayed home because he stresses). The vet said that there were no signs of progression of either her heart or kidney problem, which is fantastic. We just keep going with the current medication and do a wellness check in another 6 months time.

Happy days, I’m so pleased with the result. It means that most likely the damage (at least in the kidneys) was caused by the E.c. and stopped progressing once the E.c. was treated.

[DanaNM]

That’s really great news!

. . . 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]

Oh, lovely news! Yaay!!

[LBJ10]

This is great! Glad to hear things are looking up!

[Ellie from The Netherlands]

Oh that is great! Really happy to hear this 🙂

[Author]

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