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To a Long Life: Geriatric Workups
Elizabeth TeSelle In consultation with Cindy McBee, DVM
 
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Needless to say, when we learned that 6-year old Zoe's liver enzymes were elevated, we were worried. I saw enough fatty liver disease in cats when I worked for a veterinarian to know how serious this condition can become, and since, in my experience, rabbits handle most treatments less well than cats, I was wary of trying the more invasive diagnostic tests. Now that the crisis is over and Zoe is healthier than she's ever been, I'm just grateful that we have always been so religious about keeping up with our older animals' geriatric workups.

Prior to her diagnosis, Zoe showed no outward signs of liver disease. Her appetite was good, she seemed healthy and happy, and her occasional litterbox lapses now seem to have been caused by a fat old lady's reluctance to leap over the tall lip I used on her box. So had I not taken her in for routine bloodwork, we might not have discovered her problem until it was too late.

Begin Workups Early

Marc and I began requesting routine bloodwork on our older animals years ago after our cat Lenny died of kidney failure and we learned that many serious diseases do not manifest signs until the organs or systems involved are too far gone for veterinary science to do much good. The safest bet is to begin
routine bloodwork by the time a rabbit is four years old. To ensure that you know what is normal for an individual rabbit (since most veterinarians do not have access to reliable normal values for rabbits) have a "baseline" blood chemistry, complete blood count (CBC), and urinalysis run when the rabbit is young. Then later, if any value in the older rabbit is significantly different from the baseline levels, you and your veterinarian will know that something is wrong and will be able to look into possible causes before clinical signs manifest themselves.

Compared to many of the published rabbit "normals" Dr. McBee and I had researched, Zoe's liver enzyme levels may not seem terribly high. This is due in part to the fact that published normals vary by as much as 100 points on hepatic enzymes, indicating that little agreement exists as to what is indeed "normal" for a rabbit.1 This inexactitude is precisely what the HRS Rabbit Health Database is trying to rectify by accumulating the results of bloodwork on house rabbits (rather than lab rabbits, which have relatively short, abnormal lives) from across the country.

Twice A Year After 7

In our household, rabbits have baseline blood chemistries and CBCs (complete blood count) run by the time they are two or three years old. When they are four, we begin having bloodwork done once a year, and with Zoe, who is now seven, we have gone to twice a year. She receives a complete workup yearly, but at her 6-month checkup we do only a limited chemistry and CBC (which hit the "high points"). This method saves money and reduces the amount of blood that must be drawn. Because of Zoe's history of elevated liver enzymes, we make sure to run those every time.

Urine samples are not always easy to obtain from rabbits, but having a baseline urinalysis done early on is also a good idea. To obtain a urine sample, put the rabbit in a small cage with a wire floor and no litterbox, resting board, or hay. If possible, wrap the cage tray in a plastic bag before sliding it under the cage to ensure that the sample will remain as clean as possible. Leave the rabbit in the cage until she urinates, being sure to check often to prevent the urine from becoming contaminated with feces. Use a syringe to remove the urine cleanly from the tray, and refrigerate the sample until you can take it to the veterinarian (do this as soon as possible).

Of course, all this labwork isn't of much use if you don't know what you're looking for. Keeping an accurate chart that displays bloodwork results from year to year ensures that you and your veterinarian can easily compare results and catch a slight change before it signals a major problem. These records can be kept in a booklet, a computer, or a file folder, but however you choose to organize your records, keep them as accurate and up-to-date as possible. If you must have labwork run at an emergency clinic, your own records will be invaluable to the veterinarian on call, who will be unable to obtain your regular veterinarian's records until morning.

Although an increasing number of veterinarians promote geriatric exams for older cats and dogs, many are not accustomed to doing the same for rabbits. However your veterinarian will be pleased that you want to provide the best in preventative medicine for your rabbit, and will be willing to work with you in obtaining normal values and analyzing the results of your rabbit's tests. Most veterinarians who are really interested in rabbits are excited to have the chance to do bloodwork and urinalyses, because with each result their own knowledge about rabbit medicine increases. Most important, getting onto a schedule of regular labwork may very well save your rabbit's life. There is no doubt that finding out as early as we did about Zoe's problem ensured that we were able to do something significant for her; had we waited, it may well have been too late. It is vital that we take advantage of this relatively painless method to check on their internal health and keep them with us for as long as possible. Thanks to better rabbit medicine and geriatric workups, that gets longer all the time.

References: 1. Lab animal manuals and veterinary texts, containing charts of "normal" blood values for rabbits. Among the most extensive are: The Biology of the Laboratory Rabbit. Ed. Weisbroth, S., R. Flatt, and A. Kraus (NY: Academic Press, 1974, 62-68); Handbook of Laboratory Animal Science, Vol. 11. Ed. Melby, Edward C. Jr. and Norman H. Altman (Cleveland: CRC Press, 1974, 366-402).


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