Anorexic & Lethargic rabbit with hepatic changes

RE: Anorexic & Lethargic rabbit with hepatic changes

Anthony Dennison — Tue, 22 May 2018 14:49:11 GMT

Update on this one - owner didn't want to go for invasive surgery so we just went for medical supportive therapy and he's turned a corner in the last 24hrs, back into his pellets with gusto and was even binking around yesterday.

RE: Anorexic & Lethargic rabbit with hepatic changes

Christina Smith — Wed, 16 May 2018 19:05:20 GMT

Recently removed a tapeworm cyst from a rabbit. Does it have access to grass ?

RE: Anorexic & Lethargic rabbit with hepatic changes

Anthony Dennison — Wed, 16 May 2018 17:27:13 GMT

HAEMATOLOGY

Test Result Alert Units Reference Range

*Red cells 5.11 10^12/L 4.90 - 7.50

Full Blood Count
*Haemoglobin 11.2 g/dL 10.5 - 15.8
*Hct 0.372 l/L 0.320 - 0.470
*MCV 72.8 High fL 52.0 - 72.0
*MCH 21.9 pg 19.0 - 24.0
*MCHC 30.1 Low g/dL 30.5 - 36.3
*White Cells 3.5 10^9/L 3.4 - 12.3

*Neutrophils (Absolute) 1.89 10^9/L 1.50 - 4.00
*Neutrophils 54 %
*Lymphocytes (Absolute) 1.26 10^9/L 0.80 - 7.60
*Lymphocytes 36 %
*Monocytes (Absolute) 0.32 10^9/L 0.00 - 0.80
*Monocytes 9 %

*Eosinophils (Absolute) 0.04 10^9/L 0.00 - 0.30
*Eosinophils 1 %
*Platelet count 459 10^9/L 200 - 1060
*Analyser ID Results generated by SYSMEX XT2000
(14202)

*Morphological No abnormal white cells seen.
Assessment : No morphological abnormalities detected
in red blood cells.

BIOCHEMISTRY

Test Result Alert Units Reference Range

*Total Protein 69.0 g/L 46.0 - 78.0
*Albumin 33.3 g/L 30.0 - 57.0
*Globulin 35.7 g/L 7.0 - 40.0
*AG Ratio 0.93

*Urea 8.0 mmol/L 6.1 - 8.6
*Creatinine 104.0 umol/L 70.7 - 159.0
*ALT (SGPT) 37 C 333.9 High U/L 15.0 - 74.0
*Alk. Phosphatase 37 C 109.0 U/L 20.0 - 205.0
*Gamma GT 37 C 7.2 U/L 1.0 - 13.0
*AST (SGOT) 37 C 161.0 High U/L 8.0 - 77.0

*Total Bilirubin 3.4 umol/L 0.0 - 3.4
*CK (CPK) 37 C 2981.0 U/L
*Bile Acids (fasting) 34.9 High umol/L 2.0 - 18.0
*Cholesterol 1.82 mmol/L 0.30 - 4.30
*Amylase. 37 C 298.2 U/L 100.0 - 500.0
*Sodium 136.0 mmol/L 136.0 - 152.0

*Potassium 5.22 mmol/L 2.90 - 7.00
*Inorganic phosphorus 1.33 mmol/L 0.50 - 2.50
*Calcium 3.48 mmol/L 2.70 - 4.00
*Glucose 7.1 mmol/L 6.0 - 8.9

The anaemia has now resolved and no significant haematological
abnormalities identified.

Elevated ALT may be associated with hepatocellular damage and
necrosis, eg associated with hepatic coccidiosis or hepatic
lipidosis, or may be secondary eg to GI disease. Abdominal
imaging may be informative if not already performed. High AST
could reflect hepatocellular damage but there is also likely
to be muscle damage given the high CK result. There is little
published information on bile acids in rabbits but it is
assumed to be a sensitive indicate of hepatic function as in
other species.

RE: Anorexic & Lethargic rabbit with hepatic changes

Marie Kubiak — Wed, 16 May 2018 16:16:50 GMT

French lops appear predisposed to torsion so keep an eye in case this is a partial rotation without occlusion that will progress. If this has been going on for weeks it is unlikely but if a recent change then I would still be suspicious based on signalment and ultrasound changes described. Worth repeating U/S to see if anything has changed and also taking a tap of abdominal fluid under u/s guidance as bloody fluid would support this as a possibility. Ex-lap to investigate further and biopsy would also be high on my list of things to do, especially if fluid is bloody.

Pancreatitis I have seen in some larger (often obese) rabbits and can cause vague malaise and discomfort but wouldn't explain hepatic changes.

No bloods attached. what was PCV?

Marie