When we saw Dr. Mayer on Saturday, he presented us with several options. If we are going to proceed with any course of treatment, we first have to determine what the mass is. If it is a thymoma it would be treated differently than a thymic lymphoma, which can mean the cancer is more places in her body. So that was new information, we hadn't even known it could be anything other than a thymoma.

The first step, then, is to do a fine needle biopsy, guided by ultrasound, and determine which of the two it is. He said he's pretty sure it is a thymoma, but wants to know for sure.

If it is a thymoma, there are several different treatments for it, not just "surgery or nothing."

Surgery is one option, but it is invasive and traumatic - they'd have to crack her chest open. We were already shying away from even considering that, considering Miss Hoppy's age. Then Dr. Mayer said that doing the surgery isn't necessarily a cure. He had one bunny that had the surgery done, and in a matter of weeks, the tumor was back, and just as big. So there's no way we'd go that route - we want to make her MORE comfortable, not less. As my Dad said "She's just a widdle bunny!"

There are two kinds of radiation treatments to consider. There's the "curative" kind, which is more intensive, every day for up to a month. It uncomfortable, and can result in burns on the bunny's skin. It's supposed to "cure" the cancer, but there's no guarantee. There are other side effects. And it is several times more expensive than the next option.

The "palliative" radiation is more focussed, and Miss Hoppy would likely not feel a thing. Its goal is to shrink the size of the tumor considerably, so it isn't pressing on her heart, and so she can breathe better and more freely, her eyes won't be bulgy, and she won't be sniffly/sneezy. He has had good results with other rabbits with this treatment, had one that lived for three years afterwards - it just died recently, he doesn't yet know what from, maybe old age. While there are no guarantees with this either, he thinks she could live a couple more years. And one good thing is, if in a year or so she begins to have breathing trouble again, confirming the tumor has regrown, it could be done again, if we chose to. It would be maybe three or four treatments, a week or so apart.

The last option is just treating the tumor with steroids. This is the least expensive option, but, while it may temporarily shrink the tumor, it will get to a point, maybe in six months, maybe in two months, where it no longer works. Then the cancer becomes resistant, and more virulent, and is not treatable. The bunny doesn't last long after the prednisone stops being effective.

The good thing is that Dr. Mayer answered all our questions thoroughly and carefully. We asked "Is it even okay to give a ten-year-old bunny anesthesia?" And he said, "Some people would say "No, you cannot anesthetize a rabbit, they die." But that attitude is outdated by 15 years, and the science of anesthesia has changed a lot in the intervening time." He described what they would do, both for the biopsy/ultrasound, and for the radiation, is put a little bitty "oxygen mask" on her, and give her an inhaled anesthetic, so she'd just breathe it in, and remain still for the procedure. As soon as they stop the gas and remove the mask, she'd be right back to normal. Paul asked if, because the tumor is pressing on the heart, the radiation would damage the heart. Dr. Mayer explained very carefully what how the radiation effects the cells, and why there would be very little damage to her heart at all, small parts of her heart would be damaged, but that her heart would still function.

There are no guarantees with any of the procedures, but he has had very good results with the palliative radiation treatment, and said that's what he'd do if it were his bunny. (By the way, he has a little boy bunny that looks very much like Miss Hoppy!)

I have called, and we will schedule the biopsy, and will keep you all updated as to how that goes, and what's next.

I am trying to be as thorough as possible, because I know we have many bunnies and bunny owners on Pet Talk. Remember, this all started because she had a case of the sniffles that wouldn't go away.

Dr. Mayer did listen to her heart, (after telling her "now, stop grunting so I can hear this!") and said it wasn't just a simple murmur, her heart is working so hard it sounds like a machine more than a heart. My poor bunny.

The Foster Veterinary Hospital at Tufts' Cummings School for Veterinary Medicine does seem like a world-class facility, and we are fortune that it is less than an hour's drive away.