Q: I took my rabbit to the veterinarian as she has been having blood in her urine; I see it in her litter box. My rabbit is female and almost 5 years old. The veterinarian said she thought she felt lumps in my rabbit, and it was most likely urinal cancer. She said that X-rays could confirm the diagnosis, but they are really expensive. She also said that she could spay her and then they could remove the cancer if it hasn’t spread. Because she believes my rabbit has cancer, the cost of the surgery is higher. I live in Canada and it normally costs $300 to spay a rabbit; the veterinarian wants to charge $700 for this surgery. I decided to book a spay appointment with another veterinarian, and I didn’t tell them that my rabbit has blood in her urine, so they are just charging $300. They are rabbit experts like the other veterinarian was. My rabbit is so happy and very friendly, and I’m not sure if I should even spay her. Today, I noticed she has even larger amounts of blood in her litter, so I don’t know if that means that her cancer spread. I don’t know if I should spay her or if it’s too risky for her at this point.
A: It can be a very big, even fatal, mistake not to let the other veterinarian know about the blood in your rabbit’s urine. The first veterinarian you saw gave you great advice. It is likely uterine (not urinal) cancer. This is very common in rabbits that are not spayed. It is thought that over 50 percent of female rabbits will get this cancer if they are not spayed.
The good thing about uterine cancer in rabbits is that it takes a very long time to spread; even though you may be seeing more blood, there is no way to know if this means the disease has spread. If the disease has not spread, then spaying your rabbit is a 100 percent cure. It is one of the few cancers we can actually cure. If your rabbit has this disease and you don’t spay her, then this disease has a 100 percent death rate. This disease will kill your rabbit.
Other diseases can cause similar amounts of blood in the urine. These would be diseases such as uterine infection and uterine aneurysm. And it may even be possible the blood is coming from the bladder, which would be a sign of bladder disease.
The increased cost for spaying a rabbit with uterine disease versus a normal rabbit is for a number of reasons. The rabbit with uterine disease is sick and will need extra monitors, possibly a different anesthesia protocol because of an abnormal metabolic profile. The rabbit with disease may also need extra fluid support, because the rabbit is losing a large amount of fluid in the blood. It may take more than one surgeon or another anesthetist to properly care for this rabbit during surgery because it is so sick. Also, it is always recommended to biopsy any diseased tissue, so the extra cost might represent a biopsy cost.
Another important factor is that if the tumor has spread, it is not recommended that surgery be performed; once the cancer has spread, there is no cure. Taking a debilitated patient to surgery when there is no hope for a cure is considered unethical.
If you do not let the veterinarian know about the blood and prior diagnosis, you could be putting your rabbit through an unnecessary surgery with associated discomfort and pain. And even if you don’t tell the newer veterinarian about the diagnosis and signs, it will be obvious once your rabbit goes to surgery and you may be getting a call during surgery telling you what they found and that there will be additional costs involved with a diseased patient. So you may not be escaping the extra charges at all.
These are not easy decisions and your rabbit’s best chance of surviving is to have the surgery performed as soon as possible and give full disclosure to your veterinarians about the health history of your rabbit.