RETROSPECTIVE STUDIES

Thymomas in Rabbits: Clinical Evaluation,

Diagnosis, and Treatment
Frank Künzel, Dr.med.vet., DECZM (Small Mammal), Katharina M. Hittmair, Dr.med.vet., Jasmin Hassan, Dr.med.vet.,
Gilles Dupré, Dr.med.vet., DECVS, Elena Russold, Dr.med.vet., MRCVS, CVA, Abigail Guija de Arespachochaga, Dr.med.vet.,
DECVCP, Andrea Fuchs-Baumgartinger, Dr.med.vet., Andrea Bilek, Dr.med.vet.

ABSTRACT
Thymomas are rarely recorded in rabbits, and the literature includes comparatively few cases. Medical records were reviewed
to identify all pet rabbits in which a mediastinal mass was diagnosed between Feb 2007 and Jan 2010. Signalment, history,
clinical signs, diagnostic work-up (including laboratory data, diagnostic imaging, and ultrasound-guided fine-needle aspiration
of the mediastinal mass), treatment modalities, survival time, and histologic findings were evaluated. Cytologic and/or histo-
pathologic examinations revealed thymomas in all rabbits with mediastinal masses (n¼13). Rabbits with thymomas showed
clinical signs of dyspnea (76.9%), exercise intolerance (53.9%), and bilateral exophthalmos (46.2%). In seven rabbits the
thymoma was removed surgically. Two rabbits were treated conservatively, and four rabbits were euthanized because of their
poor clinical condition. The two rabbits that underwent surgery were euthanized 6 mo and 34 mo later. Mediastinal masses in
rabbits appear to be more common than previously believed and consist primarily of thymomas rather than thymic lympho-
mas. Cytology of samples collected by ultrasound-guided fine-needle aspiration is an accurate diagnostic tool for the
identification of thymomas in rabbits. Due to a high rate of perioperative mortality, intensive perioperative care and the pro-
vision of a low-stress environment are recommended for a successful thoracotomy. (J Am Anim Hosp Assoc 2012; 48:97–104.
DOI 10.5326/JAAHA-MS-5683)

Introduction indications associated with an intrathoracic mass include

A thymoma is a neoplasm in the cranial mediastinum. Thymomas dyspnea, exercise intolerance, and bilateral exophthalmos.4,6,9
are composed of thymic epithelium and normally include various Various treatment options for rabbits diagnosed with thymomas
degrees of benign lymphocytic infiltrations. In domestic animals, have been proposed, including surgery, chemotherapy, and ra-
the masses are largely restricted to the cranial mediastinum but they diation therapy.9
may extend from the neck to the caudal mediastinum. Thymomas The rationale underlying this study is that, according to the
are usually nodular and encapsulated, causing compression of ad- authors’ experiences, mediastinal masses, especially thymomas,
jacent tissues.1 Although the disease is rarely documented, it has often remain unrecognized in rabbits with respiratory distress
been reported in dogs and cats, as well as in cattle, goats, sheep, pigs, and/or exercise intolerance. Furthermore, the authors hypothesize
1–3
horses, ferrets, rats, and humans. that mediastinal masses in this species are predominantly repre-
To date, information about rabbits with thymomas mainly sented by thymomas rather than by thymic lymphomas. The
stems from clinical reports. 4–11
Apart from thymomas, thymic purpose of the study was to evaluate clinical findings, diagnostic
lymphomas and mediastinal abscesses should also be considered work-up, treatment options, and the outcome of rabbits with
12–14
as possible causes of mediastinal masses in rabbits. Main thymomas.

From the Clinical Department for Small Animals and Horses (F.K., K.H., CT computed tomography; FNA fine-needle aspiration; IM intramuscular(ly)
J.H., G.D., E.R., A.B) and Department for Pathobiology (A.GdA., A.F-B.),
University of Veterinary Medicine, Vienna, Austria.

Correspondence: [email protected] (F.K.)

ª 2012 by American Animal Hospital Association JAAHA.ORG 97

Materials and Methods Results
Case Selection Signalment, History, and Clinical Signs
Medical records from the Small Animal Clinic at the Animal Thirteen pet rabbits met the study’s inclusion criteria. In all rabbits
Hospital of the University of Veterinary Medicine Vienna (Austria) the mediastinal mass was identified as a thymoma. Nine rabbits
were reviewed from Feb 2007 to Jan 2010 to identify all rabbits in were males and four were females. Nine rabbits were mixed-breed
which mediastinal masses had been diagnosed. All pet rabbits with rabbits and four were purebreed rabbits of various breeds, including
a clinically recognized cranial mediastinal mass and subsequent Thüringer (n¼1), tan (n¼1), and Lionhead (n¼2). The ages ranged
cytology and/or histology results were included in the study. from 3 yr to 10 yr (median, 6.1 yr).
The histories of 10 of the pet rabbits were available, relating to
Diagnostic Work-up the duration between the onset of the disease and the time the
Diagnostic work-up of the rabbits with a suspected mediastinal rabbits were first examined by a veterinarian. An acute onset was
mass included case history, clinical examination, and diagnostic observed in three rabbits. Seven owners reported clinical signs
imaging with thoracic radiographs (n¼12) and/or ultrasonogra- lasting for a period of up to 6 mo. The median period of noticeable
phy (n¼12). Thoracic radiographs were taken in left lateral and clinical signs in the rabbits before their presentation was 45 days
dorsoventral views. Ultrasound examinations were performed (Table 1).
with an ultrasound unita, employing a 5–8 MHz small parts Typical clinical signs in pet rabbits with a thymoma were
curved-array transducer in a bilateral intercostal approach with dyspnea (n¼10), exercise intolerance (n¼7), and bilateral transient
the rabbits in either sternal or lateral recumbency. Ultrasound- exophthalmos (n¼6). In only two cases was an exophthalmos
guided fine-needle aspiration (FNA) of the mediastinal mass noticed by the owner before the animal presented to a veterinarian.
(n¼11) or thoracocentesis of pleural effusion (n¼1) was per- Symptoms such as lack of appetite, coughing, and bilateral prolapse
formed and evaluated by cytology. FNA of the mass was per- of the third eyelid were also detected in affected animals. Auscul-
formed under sedation with intramuscular (IM) midazolamb tation of the thorax revealed muffled heart sounds or a heart
c
(1 mg/kg) and medetomidine (0.2 mg/kg). In eight rabbits, a murmur in four rabbits (Table 2).
complete blood cell count was performed and serum biochem-
istry was analyzed using standard laboratory methodsd,e. Diagnostic Work-up
Hematology and serum biochemistry profiles were performed in
Treatment eight rabbits. Red blood cell counts showed a mildly decreased
Depending on the clinical condition of the rabbit and the owners’
wishes, the following treatment modalities were implemented:
surgical removal of the thoracic mass, conservative treatment, TABLE 1
and euthanasia.
Duration of Clinical Signs, Treatment Modalities, and Outcome
(Survival Time) of 13 Rabbits Diagnosed with Thymomas
Histopathology Age Duration of clinical Survival time
A histopathologic examination of the surgical removed mediastinal Case (years) signs (days)* Treatment (days)
mass was performed in seven rabbits. Furthermore, a necropsy 1 6.1 60 Thoracotomy 3
2 5.8 1 Aspiration of cyst 150
including histopathology was carried out in nine rabbits (five of the
3 8.3 — Aspiration of cyst and 270
seven rabbits that underwent surgery and four rabbits that were prednisolone
immediately euthanized). Thymoma with .50% lymphocytes 4 6.6 120 Thoracotomy 955
were classified as lymphocyte predominant and cases with .50% 5 3 60 Thoracotomy 1
epithelial cells were subcategorized as being epithelial predom- 6 8.7 10 Euthanasia
7 5.5 180 Thoracotomy 180
inant. Cases with approximately 50:50 cells were diagnosed as
8 4.5 — Euthanasia
mixed lymphoepithelial. In cases of lymphocyte predominant
9 7.1 45 Thoracotomy 0
thymomas (n¼6) where a differentiation between thymoma and 10 6.5 — Euthanasia
thymic lymphoma was difficult, immunohistochemical analysis 11 10 1 Euthanasia
of cytokeratin expression in paraffin-embedded tissues was 12 4.5 20 Thoracotomy 2.5
f
performed. Mouse anticytokeratin was used as the primary 13 4.9 45 Thoracotomy 1.5

antibody. * Between onset of the disease and time of diagnosis

98 JAAHA | 48:2 Mar/Apr 2012

 Characterization of Lapine Thymomas

round, measuring up to 4 cm in diameter (Figure 2), or smaller

TABLE 2
and crescent-shaped (Figure 3).
Clinical Signs Associated with Thymomas in Rabbits
An ultrasound-guided FNA of the mass (n¼11) or a thora-
Clinical signs/ Number cocentesis of pleural effusion (n¼1) was performed. One rabbit was
clinical examination of rabbits Percent
euthanized due to its deteriorating condition before a FNA was
Dyspnea 10 76.9
Exercise intolerance 7 53.9 taken. Cytology of 10 aspirated samples identified the mass as a
Exophthalmos 6 46.2 thymoma (one sample was nondiagnostic). Cytologically, thymomas
Inappetence 4 30.8 were characterized by a mixed population of small and occasional
Coughing 3 23.1 large lymphocytes and various amounts of epithelial cells (Figure 4).
Prolapse of the third eyelid 3 23.1
In one case it was not possible to differentiate between thymoma
Muffled heart sounds 2 15.4
and thymic lymphoma by pleural fluid cytology (Table 4).
Heart murmur 2 15.4
In 11 rabbits in which a histopathologic examination of the
mediastinal mass was performed, the mass was identified as
hematocrit in five cases. Erythrocytes remained within the ref- a thymoma. The thymomas were graded as a lymphocyte pre-
erence range. Total protein was moderately elevated in one rabbit. dominant type (n¼6), a mixed lymphoepithelial type (n¼4), and
A lymphocytosis was observed in four rabbits. In six of the blood an epithelial predominant type (n¼1). Cytokeratin expression was
samples, a hyperglycemia was noted. Ca levels were determined in immunohistochemically detected in all specimens tested (n¼6).
four rabbits and were mildly decreased in one case. Creatinine and In eight cases, cytology and histology were available and histologic
alanine aminotransferase were within the reference range (Table 3). results confirmed the diagnosis of thymoma by cytologic meth-
Diagnostic imaging in 12 rabbits included thoracic radio- ods. Additional postmortem findings in nine rabbits included
graphs and ultrasonography. Thoracic radiographs were almost pleural effusion (n¼6) and pericardial effusion (n¼3) (Table 4).
identical in all cases. The cranial contour of the heart was not visible
and the trachea was elevated (Figure 1A). In the dorsoventral view, Therapy and Outcome
the entire cranial thorax was opacified, and a soft-tissue mass was In seven rabbits the thymomas were removed surgically. Two
suspected (Figure 1B). Ultrasonography of the cranial medias- patients were treated conservatively, and the remaining four were
tinum showed a nonuniform, hypoechoic mass cranial to the euthanized at the owner’s request due to their poor clinical
heart with small to large cystic lesions. The masses were either condition (Table 1).

TABLE 3
Hematology and Serum Biochemistry Results of Eight Rabbits with Thymomas

Case numbers

Parameter 2 3 5 8 10 11 12 13 Reference ranges

Glucose 130 283 221 271 186 217 122 245 75–150 mg/dL
Creatinine 1.1 1.3 1.1 1.4 0.9 1.5 1 1.5 0.8–1.8 mg/dL
Urea — 47 — 26 — — 39.6 48.5 18–37 mg/dL
Total protein 9.4 5.7 5.7 7 6.6 6.8 6.3 5.1 5.3–7.5 g/dL
Alanine aminotransferase 50 39 25 — 23 36 — — 0–61 U/L
Potassium 4.7 — — — — 4.4 4.3 — 3.6–7.5 mmol/L
Ca — 3.5 — 3.1 — 3.8 3.5 — 3.3–3.8 mmol/L
Erythrocytes 5.8 4.6 4.6 5.3 — — 5.5 4.9 4–7.23106/mL
Hematocrit 37.8 28 27.7 31.2 35 30 37 32.8 36–48%
WBCs 36.1 8.9 10.2 17.4 — 20.7 19.1 8.9 3–11.93103/mL
Lymphocytes 28.1 5.2 7 10.7 — 15 13.8 5.5 1.6–7.93103/mL
Monocytes 2.2 0.4 0.2 0.6 — 0.7 0.5 0.3 0–0.83103/mL
Neutrophils 4 3 2.4 5 — 4.1 4.5 2.6 0.8–53103/mL
Eosinophils 0.4 0.1 0.3 0.2 — 0.2 0.1 0.2 0–0.083103/mL
Basophils 0.7 0.3 0.3 0.8 — 0.7 0.2 0.3 0–0.53103/mL

JAAHA.ORG 99
 FIGURE 2 Ultrasonographic image of the mediastinal mass in
a sagittal view. A large, hypoechoic, irregularly contoured mass (Th)
is seen displacing the heart (H) caudally.

was maintained with a combination of IV propofol (11 mg/kg/hr)

and remifentanili (10–20 mg/kg/hr). Once the thoracic cavity was
opened, the lungs were manually ventilated with a tidal volume of
10–15 mL and a peak pressure of 10 cm H2O. Additionally, the
rabbits received 5 mg/kg carprofenj IV and 0.03 mg/kg bupre-
norphinek IV during anesthesia and the postoperative period. A
combination of lactated Ringer’s solution, hydroxylethyl starchl, and
5% glucose (i.e., 60% lactated Ringer`s solution, 30% hydroxylethyl

FIGURE 1 Thoracic radiographs of a rabbit in a lateral (A) and

a dorsoventral (B) plane. There is a soft-tissue mass in the cranial
mediastinum causing elevation of the trachea.

Anesthesia and Thoracotomy

All rabbits undergoing surgery were premedicated with 0.2 mg/kg
medetomidine and 5–6 mg/kg ketamineg IM. Anesthesia was in- FIGURE 3 Ultrasonographic image of the cranial mediastinum
h
duced with IV propofol . The trachea was intubated with a cuffed in a sagittal view. A crescent-shaped, hypoechoic mass (Th) is seen
endotracheal tube (internal diameter was 2–2.5 mm), and anesthesia cranial to the heart (H).

100 JAAHA | 48:2 Mar/Apr 2012

 Characterization of Lapine Thymomas

Thymoma excision was performed by subtotal to total median

sternotomy. In cases where the mass adhered to the pericardium,
a partial pericardectomy was performed. The thymoma was re-
moved either in its entirety or in fragments when the tissue was
friable. An 8 French chest drain was placed and connected to
a three-way tap. The chest drain was removed once air or fluid
production was minimal. All rabbits received 10 mg/kg enro-
floxacinm either subcutaneously or orally q 24 hr for 7–14 days.
Five rabbits died within 3 days of surgery. One rabbit im-
proved after surgery but had a recurrence of thymoma 6 mo later
and was euthanized. One rabbit recovered completely after surgery
but was euthanized 955 days following surgery because of a re-
currence of the mediastinal mass (Table 1).

FIGURE 4 Cytology of a thymoma. Note the cluster of thymic

Conservative Treatment
epithelium (large white arrow) surrounded by a mixed population
Larger cystic lesions within the thymoma were aspirated in two
of large (thin white arrow) and small (black arrow) lymphocytes.
rabbits under sedation with 1 mg/kg midazolam and 0.2 mg/kg
The presence of a heterogeneous lymphocytic population differ-
medetomidine administered IM. One rabbit was also treated with
entiates thymomas from thymic lymphomas. Diff-Quick staining,
oral prednisolonen at a dose of 0.5 mg/kg q 48 hr for 90 days.
original magnification 3400.
Rabbits that received conservative treatment survived for 5 mo
starch, and 10% glucose) was administered IV at 10 mL/kg/hr. and 9 mo (Table 1).
Anesthetic depth and physiologic parameters, such as heart rate
and rhythm (via an electrocardiogram), blood pressure (noninva- Discussion
sive oscillometric cuff), partial oxygen saturation, end-tidal carbon According to the literature, mediastinal masses in rabbits are
dioxide, and anesthetic gas concentrations (mainstream spirometry) composed of thymic lymphomas and thymomas.15 Some authors
were monitored closely throughout the procedure. have reported that thymomas are uncommon in rabbits; however,

TABLE 4
Cytologic and Histologic Results of 13 Rabbits with a Cranial Mediastinal Mass and Findings of the Postmortem Examination Associated
with a Thymoma

Case Cytologic diagnosis Histologic diagnosis Histologic subtype Associated findings on postmortem
1 Thymoma* Thymomay Lymphocyte predominantx Pleural effusion, chronic epi- and pericarditis
2 Thymoma* — — —
3 Thymoma* — — —
4 Thymoma* Thymomay Lymphocyte predominantx —
5 Thymoma* Thymomay Mixed lymphoepithelial Vasculitis, peribronchitis
6 Thymoma* Thymoma** Mixed lymphoepithelial Hydropericard
7 Thymoma* Thymoma/lymphomay Lymphocyte predominantx Recurrent thymoma
8 Thymoma* Thymoma** Mixed lymphoepithelial Pleural effusion, hydropericard
9 Nondiagnostic Thymomay Mixed lymphoepithelial —
10 Thymoma/lymphomayy Thymoma** Lymphocyte predominantx Pleural effusion
11 — Thymoma** Epithelial predominant Pleural effusion
12 Thymoma* Thymomay Lymphocyte predominantx Pleural effusion
y
13 Thymoma* Thymoma Lymphocyte predominantx Pleural effusion, hemopericard

* Cytology from ultrasound-guided fine-needle aspiration of the mass

y
Histology from surgically removed mass
x
Immunohistochemical analysis of cytokeratin expression was performed.
** Histology from postmortem examination
yy
Cytology from pleural effusion

JAAHA.ORG 101
the current study revealed a thymoma in 13 rabbits over a period of six rabbits, but assumed this to be stress-induced. Lymphocytosis
3 yr, indicating that mediastinal masses in rabbits consist primarily associated with a thymoma that was detected in four rabbits and
8,9
of thymomas rather than thymic lymphomas. This study indi- was previously reported in one dog.19
cates that thymomas appear to be more common than previously Methods for the diagnostic imaging of mediastinal masses in
reported. rabbits include radiographs, ultrasonography, and computed to-
The rabbits in the current study were of comparable age mography (CT). Thoracic radiographs were helpful for visualizing
(median age was 6.1 yr; range, 3–10 yr) to those reported in several a soft-tissue mass in the cranial mediastinum in conjunction with
other investigations, in which thymomas were found in rabbits the characteristic elevation of the trachea. The dorsoventral plane
5–10 yr old. 8,10,11
Only one rabbit in the current study was ,4.5 yr. was chosen instead of a ventrodorsal view as most rabbits were
The current study did not show any breed predilection for suffering from respiratory problems as a result of the thymoma.
thymomas. To the authors’ knowledge there have been no in- Ultrasonography of the cranial mediastinal mass determined
vestigations of breed predisposition for thymomas in rabbits. its echogenicity and extent. A small, high-frequency transducer
In the current study, dyspnea was observed in approximately should be used when attempting the intercostal approach. Because
75% of the rabbits with thymomas. There are numerous causes of the masses occupied most of the cranial mediastinum, lung
dyspnea in rabbits, including upper respiratory disease (e.g., artifacts did not pose a problem and it was possible to place the
pasteurellosis, oronasal fistula following periapical abscess, foreign rabbit in lateral recumbency. In accordance with one previous
bodies, myxomatosis), lower respiratory disease (e.g., broncho- report, larger cystic lesions in the thymoma were detected in two
pneumonia, pulmonary hemorrhage, pulmonary metastases from rabbits, which were subsequently aspirated under ultrasound-
uterine or mammary carcinomas, pulmonary edema) as well as cases guidance.10 Aspiration of these cysts is useful when the animal will
that relate to nonrespiratory reasons (e.g., pleural effusion, pneu- not undergo surgery, as it alleviates the dyspnea.
mothorax, diaphragmatic hernia, abdominal distension, metabolic CTs were not performed on any of the patients in this study as
disease).15,16However thymomas are often neglected. the diagnosis was confirmed by ultrasound-guided FNA. One
Bilateral exophthalmos and bilateral prolapse of the third eyelid author recommends CT of the thorax and the head to evaluate the
were observed in almost 50% and 25% of the rabbits, respectively. extent of the mass and to eliminate the possibility of retrobulbar
These results are consistent with other reports in which bilateral masses.10 Thoracic CT (including the application of IV contrast
4,6,10,11,15
exophthalmos is commonly mentioned. Occasionally, bi- medium) may provide more information regarding the invasive-
lateral exophthalmos in rabbits was transient and stress-induced and ness of a cranial mediastinal mass and the presence of pulmonary
the condition was therefore either often undetected or misinter- metastasis. Although the application of a preoperative CT scan is
preted by the referring veterinarians. According to previous pub- useful, it can sometimes be difficult to determine the true extent
lications, exophthalmos in rabbits is consistent with cranial vena of pleural and pericardial invasion.9 A greater number of patients
cava syndrome due to a space-occupying mass that compresses the will be required to evaluate whether a CT of the thorax is of di-
vessels of the thorax and restricts vascular return to the heart.7 agnostic benefit in rabbits with thymomas.
Therefore, measurements of intraocular pressures to rule out Ultrasound-guided FNA of the cranial mediastinal mass led to
buphthalmia were not performed in the six rabbits with bilateral the diagnosis in all cases but one, in which there were too few cells for
exophthalmos as the condition was solely attributed to a cranial vena an evaluation. In eight cases, cytology and histology were available
cava syndrome. Differential diagnoses for unilateral exophthalmos and histologic results confirmed the diagnosis of thymoma by cy-
in rabbits mainly include retrobulbar abscesses due to dental disease tologic methods, giving a positive predictive value of 100%. Nev-
and retrobulbar lymphoma of the Harderian gland.17,18 ertheless, thymomas may be difficult to diagnose by cytology when
Similarly to other reports, the authors of this study did not a large number of lymphocytes are on the slide. In such cases,
notice anything remarkable or specific in the blood (hematology, histology with staining for cytokeratin to detect epithelial cells is
serum biochemistry) of affected rabbits.10,11 Hypercalcemia, found indicated to obtain a definitive diagnosis.1
as a paraneoplastic syndrome in dogs, was not detected in any of Depending on the lymphocyte component, the thymomas
the four rabbits in which Ca levels were measured. Some authors could be classified as lymphocyte predominant (n¼6), mixed
discuss a connection between hypercalcemia and thymoma in lymphoepithelial (n¼4) or epithelial predominant (n¼1). In the
rabbits; however, they fail to consider a possible influence of diet six rabbits with a lymphocyte predominant type, immunohisto-
and Ca metabolism on the serum concentration of calcium in chemical analysis of cytokeratin expression was used to confirm the
rabbits.5,6,15 In this study, the authors observed hyperglycemia in diagnosis of thymoma because histologic differentiation between

102 JAAHA | 48:2 Mar/Apr 2012

 Characterization of Lapine Thymomas

thymoma and thymic lymphoma is difficult. To the authors’ of five rabbits, which may have contributed to the animals’ post-
knowledge, this is the first time that thymomas in rabbits have been operative death. In general, the survival time of rabbits that undergo
classified into subtypes, as described in dogs and cats. Whereas sternotomy is strongly biased by the fact that patients with a poor
the lymphocyte predominant type of thymoma seems to occur clinical condition are excluded from invasive surgery because of
more often in rabbits, the epithelial predominant type predominates a poor prognosis.
in dogs and cats.2,20 Based on the results of the current study it is not Radiation therapy is recommended after incomplete surgical
possible to conclude whether the percentage of lymphocytes within resection of a thymoma or if a patient is not considered a good
thymomas has an influence on the survival time in rabbits, as has candidate for surgery. It is important to take possible side ef-
been documented in cats and dogs. Pathologic periocular findings
2
fects into account, such as pneumonitis, pulmonary fibrosis, and
(such as orbital abscesses, cysts, or neoplasms) were not found in thrombosis of the thoracic vessels.9 The survival time in the cases
the rabbits that underwent a postmortem examination, and no reported ranged from 7 wk to 98 wk after the start of treatment,
thoracic or abdominal metastases were detected on necropsy. There and one rabbit died during treatment.9,11,15 However, complica-
is only one report of renal metastases in a rabbit with thymoma.10 tions associated with irradiation of the lungs in rabbits have not
The authors of this work emphasize the risk of classifying a thy- yet been well documented.
moma as benign following histology without considering thymic One rabbit treated with aspiration of large cysts in the thy-
carcinoma and possible metastases. Several authors report that moma improved clinically, but died suddenly for unknown reasons
thymomas rarely give rise to metastases in any species.1,9,10,20 Fur- 5 mo later. To date, the survival time after aspiration of thymic cysts
thermore, findings of the postmortem examination included pleural has not been reported in rabbits, and there has been only one
and pericardial effusion, which may have contributed to the dys- report of survival time of a rabbit with a thymoma that did not
pnea or cardiovascular problems in some rabbits. receive any treatment. That rabbit was euthanized 4 mo following
To date there are only a few published reports on the treat- diagnosis because of severe respiratory distress.4 In the current
ment of thymomas in rabbits. The most common treatment study, prednisolone was administered to one rabbit for a period of
options in rabbits are surgery and, with increasing frequency, 90 days. The clinical signs disappeared for 270 days, after which
radiation therapy.6,7,9,11,15 Recommendations for surgery or radi- time the animal was euthanized due to acute dyspnea. A necropsy
ation therapy in rabbits depend on several factors such as con- was not performed. In one report, prednisolone (0.5–2 mg/kg
current diseases (e.g., cardiopulmonary disorders), the condition orally q 12 hr) was successfully used as an adjuvant treatment
of the animal, the availability of a radiation treatment facility, and in rabbits undergoing radiation therapy.9 However, radiation
9
the owners’ wishes. Only 2/7 rabbits that underwent surgery were or steroid therapy (i.e., prednisolone) in rabbits may cause
still alive 6 mo postsurgically. One rabbit had a recurrence of the immunosuppression followed by the clinical manifestation of
thymoma 180 days after surgery and was euthanized. The other encephalitozoonosis.15
rabbit was euthanized .2.5 yr following surgery. In this case, There is limited information regarding the efficacy of che-
thoracic radiographs revealed a mass in the cranial mediastinum. motherapy in rabbits as a treatment for metastatic or invasive
Therefore, a recurrence of thymoma was suspected, but could not thymomas or as supportive therapy in conjunction with surgery.9
be confirmed as cytology or histopathology was not available. One rabbit in the documented study collapsed after receiving
According to one report, perioperative death is the most chemotherapy.
common surgical complication.9 In the current study, five rabbits
died within 3 days of surgery, largely as a result of acute respi- Conclusion
ratory distress. Some authors assume that perioperative death may Mediastinal masses often remain unrecognized in rabbits for a long
be related to pain, stress, anesthesia complications, or the inability period and should be considered as an important differential
to remove the tumor.9 Thus, they strongly recommend intensive diagnosis in rabbits with respiratory distress and/or bilateral ex-
perioperative care (including placement of a chest tube and ap- ophthalmos. This study found that mediastinal masses in rabbits
propriate analgesia) and monitoring, as well as providing a low- consist primarily of thymomas rather than thymic lymphomas,
stress environment for the rabbits. It has not been assessed and that they appear to be more common than previously reported.
whether placement of a chest tube in rabbits causes discomfort Cytology of samples collected by ultrasound-guided FNA give
and consequently affects their clinical condition. Nevertheless, a good indication of the mass origin. Therefore, cytology is an
pleural and pericardial effusion and chronic inflammation of the accurate diagnostic tool to identify thymomas in rabbits. As
epi- and pericardium were detected in the postmortem examination surgical excision carries significant perioperative risk, intensive

JAAHA.ORG 103
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thoracotomy. a geriatric rabbit with hypercalcemia and periodic exophthalmos.
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for the submission of case materials included in this report. appendicular neurofibrosarcoma. J Am Vet Med Assoc 1998;213(8):
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8. Florizoone K. Thymoma-associated exfoliative dermatitis in
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