Regen anaemia in 9mo rabbit - my own!

Re: Regen anaemia in 9mo rabbit - my own!

Ashley Sykes — Mon, 20 Apr 2015 16:27:06 GMT

Quick a reply just to say that Sprie has fully recovered now and back in with his companion! Thanks for everyone's input.

Re: Regen anaemia in 9mo rabbit - my own!

Suzanne Kelly — Tue, 31 Mar 2015 00:15:26 GMT

Yay, thanks for the update

Re: Regen anaemia in 9mo rabbit - my own!

mariette asselbergs — Mon, 30 Mar 2015 21:37:25 GMT

Thanks very much for this interesting case and very best wishes for a good outcome!

Mariette

Re: Regen anaemia in 9mo rabbit - my own!

Marie Kubiak — Mon, 30 Mar 2015 18:59:18 GMT

Good stuff! Glad all has gone smoothly and fingers crossed for a smooth recovery.

Marie

Re: Regen anaemia in 9mo rabbit - my own!

Ashley Sykes — Mon, 30 Mar 2015 18:47:31 GMT

A little update for you all: guess what? It was right liver lobe torsion! Thanks for both for suggesting. My colleague and I scrubbed in together (me with a dodgy arm and my colleague doing most of it), and we resected it without complications! He is back home with me for post-op care now. Here are some pics if you're interested:

Left side of image (R side of animal) the torsed liver lobe can be seen with omentum:

After removal, no bleeding!

Liver lobe in question:

Prepping for o-tube placement (he's a bugger to syringe feed)

Jumping about at home with O-tube and IV-line in place:

I'm hoping for a speedy recovery! Thanks again

Re: Regen anaemia in 9mo rabbit - my own!

Marie Kubiak — Mon, 30 Mar 2015 14:46:26 GMT

It's odd if torsed for such slow progression but it does sound suspicious from the latest scan. Hope all has gone well today and you're both on the mend,

Marie

Re: Regen anaemia in 9mo rabbit - my own!

Clare Tapsfield-Wright — Mon, 30 Mar 2015 13:46:14 GMT

How is he today Ashley ? hope all becomes clear.

Re: Regen anaemia in 9mo rabbit - my own!

Ashley Sykes — Sun, 29 Mar 2015 20:17:05 GMT

Marie thanks for your reply. His PCV has gone 22% > 18% > 18-19% ish over 3 days since diagnosis. He is fairly bright, but today has been worse in general, not eating at all, not swalllowing food syringed, passing barely any faeces.

I re-scanned today at our sister practice, with my other boss and (crucially) our better ultrasound scanner. There is a lobe which seem much more hypoechoic than others, and an area of very dense hyperechoic lateral to it (not sure if this part is liver or not). When you poke your finger right into the hypoechoic area it feels firmer. Perhaps I've convinced myself there is a lobe torsion, but he's declining now and there is enough evidence to go for ex-lap, so it is planned for tomorrow with my colleague (I'm on IV antibiotics with a cannula in my arm so cannot scrub/operate!!), and if it is not torsion than a liver biopsy will tell us more information regardless.

Thanks again for your help, will update tomorrow evening!

Re: Regen anaemia in 9mo rabbit - my own!

Marie Kubiak — Sun, 29 Mar 2015 19:48:17 GMT

Liver lobe torsion is definitely top concern on initial presentation but if he is improving 24hrs later and no palpable firm enlarged liver lobe then it becomes less likely but I would repeat the scan if your initial findings showed hepatic changes but no clear cause. What's his PCV doing now?

If no evidence of perihepatic haemorrhage and no other blood loss then consider marrow suppression (idiosyncratic reaction to fenbendazole is well recognised and can cause marrow suppression and , even more rarely, hepatopathy but obviously if started after bloods then that can't be the culprit!), gastric ulceration or any chronic disease as anaemia is common in pretty much all sick bunnies. Be aware that faecal occult blood may be negative with upper GI bleeding due to bacterial breakdown of blood in the lower GIT in rabbits so I would start this rabbit on anti-ulcer therapy as a precaution unless you are confident enough in your scanning to rule out mucosal defects.

Marie

Re: Regen anaemia in 9mo rabbit - my own!

Ashley Sykes — Sun, 29 Mar 2015 09:40:18 GMT

I am aware of the fenbendazole considerations, but started it to rule out other parasitic causes just in case. They've never had fenbendazole prior to this.

I must admit I hadn't thought about lobe torsion: mainly as he doesn't seem that painful and there was no haemoabdomen, no free fluid at all. I will re-palpate today, but he seems to be clinically improving and brighter. Our ultrasound is not that great which worries me that I/we may have missed it!

Re: Regen anaemia in 9mo rabbit - my own!

Suzanne Kelly — Sun, 29 Mar 2015 00:33:57 GMT

Fenbendazole can reportedly cause anaemia in rabbits, not sure if this is a veterinary myth though. Scan again and check for a liver torsion - would be worried about this with anaemia and high liver enzymes.