Rabbits/Hemosiderosis, rabbit of 8
Dear Dr. Krempels,
I am a vet from Spain really worried about her rabbit of 8, she is apparently fine but, during a routine checkout, we found hepatic hyperechogenicity. We performed a fine needle aspiration and sent samples to cytology, result was hemosiderosis.
My rabbit behaves normally, active, hungry (she loves food) and without any sign of pain or discomfort but symptoms could be a matter of time. Problem is we don’t know how to proceed.
Could you give us some advice?
_We have not found normal parameters of serum transferrin saturation in rabbits or serum ferritin levels
_We do not know what kind of therapy we should follow in case of confirmation as phlebotomy in rabbits is new for us and chelating agents seems not recommended unless phlebotomy was contraindicated (human approach). Do you know if there is any protocol for this procedure in rabbits?
Her haematology results were:
RBC 5.26M/µL; HTC 34.2%; HGB 11.3g/dL; MCV 65.0fL; MCH 21.5pg; MCHC 33.0g/dL; RDW 13.9%; RETIC 1.3%; WBC 3.69K/µL; Hetero 29.5%; Lym 48.0%; Mono 11.9%; Eos 1.9%; Baso 8.7%; PLT 427K/µL; MPV 7.4fL; PDW 8.7fL; PCT 0.31%
Na 140mmol/L; K 4.5mmol/L; Cl 103mmol/L
GLU 118mg/dL; BUN 14mg/dL; CREA 0.4mg/dL; BUN/CREA 35; Phos 5.8mg/dL; TP 6.7g/dL; ALB 4.2 g/dL; GLOB 2.5g/dL; ALB/GLOB 1.7; ALT 71U/L; AST 14U/L; ALKP 38U/L; TBIL <0.1mg/dL; CHOL 7mg/dL
Please, I appreciate any advice you could gave me to control the disease of my rabbit. I know she is an elder bunny but I’d do anything in my hand to extend her life and of course, improve her quality of life.
I am deeply thankful for your time and support.
Kind regards, Noelia.
This is a very unusual diagnosis, and I have not heard of it before it a rabbit. You have probably looked up the various causes, as I have, and not found anything that might be a common cause in a rabbit.
If this were a congenital problem, one might expect this to have shown up sooner. I do wonder if the excessive deposition of hemosiderin in the liver might be indicative of a neoplasia causing bleeding there, but that's just a guess. Chronic, toxic insult to the liver should not cause bleeding or deposition of iron-compounds, as far as I know.
I guess that if there are no other obvious pathologies, and she is acting normal, then one approach might be to simply support liver function with B-vitamins, and maybe even try an herbal supplement (supposedly) associated with liver support, such as milk thistle extract. It won't hurt to try.
If there is a neoplasia, there is little one could do, since chemotherapies are not calibrated well for rabbits at this point.
I am sorry I can't offer more information. The only other hopeful thing I wonder is: could this be an artifact of collection? Do you have another bunny you could do a routine exam on, to see if this might be something unusual about rabbits, in general?
I hope all turns out well.