December's case of the month is a really unusual case with a very happy ending in a lovely rabbit called Luna. Most of you would look at a lump like this in a mouth and think that it carried a really bad prognosis but read on as Luna is doing brilliantly!
Luna is an indoor rabbit. Rabbits make excellent indoor pets; they are very sociable and easy to toilet train. They enjoy having lots of company and as a result Luna's owners noticed very quickly that she was doing some odd mouth movements and occasionally sucking and dribbling. You may not know but rabbits have very specialised teeth that grow throughout their lives. These open rooted teeth are designed to cope with high levels of wear living on a high fibre grass diet.
Immediately on noticing Luna's funny sucking behaviour we were all concerned that Luna may be developing a sharp tooth from abnormal wear. She came to the Barn for a physical examination and to have her teeth examined. Conscious examination of a rabbit's mouth is not always easy but Luna was incredibly well behaved. With some concern an abnormal soft tissue mass could easily be seen in her mouth, her teeth on the left hand side were completely hidden by this lump that was ulcerated and angry.
Fearing the worst we admitted Luna straight away and prepared her for an anaesthetic to assess this mass and see what our options were. Luna had normal kidney and liver parameters on her blood sample and despite having lost some weight (300g) there was no sign of anaemia and only a slightly raised white cell count.
Luna was anaesthetised, as you can see there was an enormous mass extending from the upper left molar arcade. With concern that this was possibly cancerous, chest x-rays thankfully revealed no sign of any secondary spread (metastasis). After discussion with the owners it was decided to try and remove the mass or at least get a decent chunk removed for biopsy and further analysis.
Using diathermy (there are lots of blood vessels in the mouth) and careful dissection, this big lump actually only had a tiny stalk of tissue attaching it to the gum between the back two molars. We were very pleased to be able to remove the entire mass as you can see from the pictures with a great before and after!
Luna made a fantastic recovery from her anaesthetic and was eating straight away. A courier kindly collected the mass for analysis and Luna went home the same day on antibiotics and anti-inflammatories whilst we had a worrying wait for the results.
Given this all occured on Monday 20th December we were all expecting a nervous Christmas before getting the results but Cytopath our lab did an amazing job and Christmas Eve we had the best news.
Amazingly this big angry looking lump was not cancerous. Luna's growth was something called Proliferative Stomatitis - essentially a big lump of infected benign tissue that has become hyperplastic. There is a very small chance it might grow back over time but can be easily trimmed as necessary and carries an excellent prognosis giving everyone the best Christmas present!