Rabbit drooling and regurgitating after eating.

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rabbit215

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Hello new to the forums... looking for opinions as we have been to multiple vets who are having a hard time finding a diagnosis and the condition seems to be worsening... sorry for the long post but I want to provide as much background information as possible:

Our 8-9 year old Dutch has had several health problems over the years since we adopted her from a rescue shelter.
Back in December while being treated for a sore hock using your wrapping method and metacam for pain relief, she started drooling on several occasions.
This started escalating from just drooling to choking, regurgitating and aspirating, with the fluid and whatever she was eating last coming out of her nose and mouth with a horrible retching noise.
Coincidence or not, it seemed like these episodes were happening around the time of her metacam dosage.
We brought her in for examination at the end of December, asking for head and throat x-rays.
We also switched her pain relief for the hocks from metacam (nsaid) to tramadol (opoid).
The episodes seemed to have stopped. By March the hocks were looking much better and she was hopping about normally.
We started stepping her down from tramadol very slowly (to reduce the potential of any withdrawal effects).
By the time April came she was down to less than half the dosage of medication then when she started.
We noticed during this time some shaking of the head and some sneezing a few times.
We were not sure if this was some of the withdraw effects of tramadol (dizziness and sneezing are listed as side-effects from what i have read) or something more sinister (she had a case of head tilt in 2009 which cleared up with baytril) then soon after that the drooling returned and more choking and regurgitation.
In the middle of April she regurgitated shortly after eating a cecotrope, then later that day she had a similar issue but it did not follow eating and the discharge was fluid only (a slimy, clear saliva-like discharge). We brought her to emergency care facility (as this happened late night on the weekend and our regular vet was closed.
They put her in oxygen therapy. We asked for head and chest x-rays and a culture and sensitivity test while on the isoflurane. After an overnight stay, she was fine and had 99% pulse ox. The vet saw her tongue was swollen and had four point marks on her tongue in the back. He clipped the points. He looked down her throat and did not see any problems. He also cauterized a polyp from her anus which had been there from since we brought her home from the shelter.(Her poops were always smaller than that of our other bunnies because of it).
He prescribed baytril for what he believed was aspiration pneumonia. I expressed concern that baytril would not be strong enough to treat pneumonia and
he said that this was a good starting point. 2 weeks of baytril. It turned out they never performed the culture and sensitivity test and did not take a head x-ray either.
However, she did not seem to have another episode until the following week. This time just the sticky saliva fluid. Then another week of no problems and then another episode.
We thought maybe while she was recovering from pneumonia this was to be expected. Then we ran out of baytril. We could not get a hold of the prescribing vet and our regular vet would not prescribe the medicine without consulting with the prescribing vet first. There was a two day gap before we would get more baytril.
But two days after resuming the baytril she started drooling again, this time once a day every morning 4 days in a row which culminated yesterday in another choking regurgitation event shortly after eating a cecotrope.
We took her over to our normal vet asking for culture and sensitivity test and head and chest xrays.
They only did the chest xrays. They stated that while on the baytril the culture and sensitivity test would be compromised. (Which is why we had asked the emergency clinic to do this before anything).
And they were not in a position to do the head x-ray (under isoflourine) during that visit as there were too many emergency patients and limited staff at the time on the weekend - We would have to schedule it.
Later that night she ate all her food no problem and there was no drool this morning but tonight shortly after charging over to her salad, she choked and regurgitated again this time on some of her leafy greens
(She brought up chlorophyll green from her mouth and nose). After the event and recovery time of about an hour she casually went over to her food and has been eating on and off normally throughout the night.
She does seem to make a chewing motion when she is finished and just laying there almost as if there is something still in her mouth (almost like a cow chewing her cud).
She is a voracious eater, she sits and waits for her large salad every night and barely lets me get it on the plate before she has her head in it.
Even though several vets say she does not have a dental problem, we don't believe it. I don't know how to interpret x-rays but I don’t think the images are clear enough to prove or disprove anything.
Based on all of our research of her symptoms but no clear evidence from the diagnostics, we are really only guessing at this point.

Dental abscess or dysphasia seem likely possibilities.

I want to put her on Durapen(Bicillin)as it can help with both pneumonia and abscesses and our vet will give us a prescription for it, although she is not too familiar with it and will have to consult to determine a proper dosage amount.
Also, two of three vets thought her heart might be slightly enlarged but the third vet thought it looked in spec. This could possibly explain fluid up.
I have uploaded all x-rays from these events to have another set of eyes on them. I was even able to capture some shaky video of part of one of her episodes. The links are here:
x-rays: http://tinyurl.com/6939r8s
video: [ame]http://www.youtube.com/watch?v=4aI48zZE_rc[/ame]
I also want to mention that during this entire length of time she has been pooping out "strings-of-pearls" almost exclusively but they have been going through a long shedding period.
And she sometimes will shake her head and scratch at her left ear. We did give her a course of selamectin and cleaned her ears with nolvasan otic (prescribed by the vet before because of a yeast build up from antibiotics).
We are really looking for some advice here as this is a very stressful possibly life-threatening problem and we have spent a considerable amount of time and money and have not made much progress on figuring this mystery out.
We fear that with our busy schedules, she will have an episode when we are away and we will come back to find a bunny that has drowned in her own fluid.
Even though she is getting up there in age, there is still a lot of life in her, very active in eating and playing and seeking out pets from her human servants and grooming from her mate.
Thanks for reading this and if there is any other data I should obtain please let me know.
Regards,
Michael
 
I think you may want to get another opinion. You're vets don't seem willing to do what you're asking for, despite their lack of options for a diagnosis. In my personal opinion and ruling everything you've mentioned, I would think it has something to do with her throat, if not with her teeth. But the fact of her not being able to swallow and pushing up food makesme lean more towards something her throat.

I would have another vet take x-rays of that area and go from there.
 
Poor girl. I wonder if the vets ever mentioned something like a mass in her neck or throat area. Our Benjamin has a thymoma, which is a cancer of the thymus, an organ of the immune system located near the heart. Thymoma is one of the more common cancers in rabbits. It often leads to difficulty breathing due to pressure on the windpipe, heart problems due to pressure on the heart, and, depending on the extent of the tumor, issues with the eyes bulging due to increased pressure in the head. I am not a vet, but I think there might be a mass near the heart on your x-rays. I can take a look at our copies of Benjamin's x-rays and see if there are any similarities. This cancer is usually diagnosed post-mortem because the signs are often very slight.

Try a search of "rabbit thymoma". There are treatment options, and I think in her case they are a good idea, depending on your budget. We decided not to do them because Ben has no outward symptoms, except occasional sneezing, and the treatments are very stressful on the bunny's body (radiation, chemo), and do not cure thymoma but just extend the life of the rabbit. We were concerned that the treatments would just make him sick and reduce the tumor size, then he'd go into remission and be ok for a few months, but it would grow back, leading to another round of treatments, and the cycle repeating itself. Since she is very much bothered by this, treatment would make more sense in her case. Now she is a bit old, but it is not unheard of for Dutches to live more than 10 years.

Is there a vet school you can go to nearby?
 
I am very curious how it all turned out for you. My rabbit steve, six years old, has been doing exactly what I see in your video after eating hay. It has happened about five times in the last month and a half. He is now on baytril but still sneezes occasionally and last night had a short choking episode that resolved quickly. X-rays and bloodwork from a month ago were all normal. I am so stressed when I give him fresh hay because he gets so excited and I'm afraid he'll choke again. He vets diagnosed an upper respiratory infection but like I said on baytril he still sneezes and chokes. Please let me know what happened with your poor bun.
 
I am very curious how it all turned out for you. My rabbit steve, six years old, has been doing exactly what I see in your video after eating hay. It has happened about five times in the last month and a half. He is now on baytril but still sneezes occasionally and last night had a short choking episode that resolved quickly. X-rays and bloodwork from a month ago were all normal. I am so stressed when I give him fresh hay because he gets so excited and I'm afraid he'll choke again. He vets diagnosed an upper respiratory infection but like I said on baytril he still sneezes and chokes. Please let me know what happened with your poor bun.

Was a thorough dental exam also done, and what where the xrays of(head, chest, belly)? Is it only with his hay this happens and not with pellets or veggies? Have allergies been looked into, maybe one to the particular hay you are feeding? Have you tried feeding a different type of hay?
 
Yes he had three dental X-rays and an abdominal one. The teeth look fine with no Spurs. I have been feeding the same hay for the three years since I adopted him. I have another rabbit with none of these issues. The choking episode last night was brought on by eating an apple branch that comes from my brother in laws yard with no pesticides. The other times it was always with hay, but I can't remember if he had had an apple branch earlier. My husband thinks we should cut out the apple sticks for a while. Although the vets think upper respiratory infection that was because his nose had green wetness on it following his choking spell. But to me it doesn't look like green mucous but clear saliva that is tainted green due to the fact he was eating green stuff! After the apple branch last night the spit up was clear. I didn't do the nasal cultures or repeat X-rays yet because he needs to be sedated and I don't think that's safe while he has bouts of breathing issues. I have another vet follow up on Saturday but to be honest I feel like I'm throwing money away. Sigh. What delicate little creatures. Also I am giving him half an oxbow immune support tablet per day and half a digestive support one. He was on the digestive support ones for a while just as a precaution.
 
Dental problems would have been my first guess, but looks like that has most likely been ruled out. I have a few thoughts that I'll just throw out there. There could be a lump or polyp of some sort in the esophagus causing these choking episodes, or it could be some sort of inflammatory condition in the throat causing constriction which could lead to easier obstruction. I also know of another bun that had some odd throat issues with air chewing, odd throat sounds, and throat rubbing, along with some GI problems. I think it took the owner about a year of multiple tests and lots of worry, before she found a rabbit specialist that figured out what was going on. If I remember right, the vet scoped the rabbits throat and discovered an old sore with a fungal infection involved.

You could ask your vet about trying daily metacam to see if it helps, which it may if it's an inflammatory condition causing this to happen. But otherwise you may be to the point where the throat may need to be scoped to see if there is a problem inside the throat.

Another option may be to try altering the diet. It could also just be that your bun isn't chewing rough foods like hay and branches, well enough, resulting in the choking. You would need to cut out rough things like branches, and may need to feed a plain hay pellet instead of long stem hay. Not ideal, but better than your bun choking on his hay.

I agree that the green mucous from that one choking occurrence, was likely just the food, but a course of antibiotics was probably still a good idea in case anything was aspirated into the lungs, which is a great concern with choking episodes.
 
The vet did mention doing a swallowing study or something to that effect, but unfortunately the only place to do it is three and a half hours away and that's a long car ride for my babies. I will mention the metacam, thanks for the suggestion, and I'll look into different forms of hay.
 
Well after our follow up visit with the vet last weekend we are not much further along. She talked to some colleagues and thymoma was suggested based on his choking and a suddenly discovered opacity on his X-ray which no one saw previously. The vet suggested ultrasound and possible aspiration if there is a tumor there. I told her I'd think about it. It's about $700, and it he does have this cancer, she said rabbits do not do well with surgery or radiation. Besides that he has no other symptoms of it! I've decided to monitor for now, steve has been doing really well, he hardly sneezes at all and he has not had another choking episode, knock wood. the bunnies don't get Apple sticks anymore which I know they wonder about but oh well!
 

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