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Rabbits/Hemosiderosis, rabbit of 8

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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 dont 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/L; 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/L; Hetero 29.5%; Lym 48.0%; Mono 11.9%; Eos 1.9%; Baso 8.7%; PLT 427K/L; 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 Id 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.

Answer
Dear 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.

Dana

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Dana Krempels, Ph.D.

Expertise

I've lived with companion rabbits for more than 35 years, and consider them members of my family. I can answer any questions about the biology and health of rabbits, from the commonplace to the unusual. But please note:

RULE #1:
THE INTERNET IS NOT THE PLACE TO SEEK HELP IN AN EMERGENCY.

...it is an EMERGENCY.

Find a rabbit vet at www.rabbit.org/vet for immediate help, and don't risk your bunny's life by spending time asking questions online! If you can't get in touch with your vet, read these Emergency Sick Bunny Instructions.

If you have found a wild baby rabbit, please read these EMERGENCY INSTRUCTIONS FOR WILD BABY RABBITS and then use this link to FIND A LOCAL WILDLIFE REHABILITATOR who can give you the right advice.


RULE #2:
Help me help you! Please make your subject line informative if you have an urgent question. then LET ME KNOW IN THE SUBJECT LINE so I can give your question highest priority over non-urgent questions. If you don't do this, then I can't guarantee timely assistance!

For all the best, most accurate rabbit health, care and behavior information, visit The House Rabbit Society.

Experience

I have been rescuing and rehabilitating domestic and wild rabbits for about 30 years. I have written articles for many rabbit rescue publications, as well as for the veterinary journal, Exotic DVM. I own EtherBun, the internet's largest listserve dedicated to health, care, and behavior of domestic rabbits.

Organizations
Houserabbit Adoption, Rescue, and Education, Inc. (H.A.R.E., Inc.) president National House Rabbit Society (Board member)

Publications
Exotic DVM
Warren Peace (Journal of the House Rabbit Society of Miami)
Various newsletters of the House Rabbit Society, nationwide

Education/Credentials
Ph.D - Biology
B.S. - Biology
B.A. - English

Awards and Honors
Lightspan Academic Excellence Award for web site on rabbit health and biology
(http://www.bio.miami.edu/hare)

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