Chase - UPDATED 5/22/10

[tonyshuman]

Woo-HOO!

 

[Amy27]

I figured it was time for an update. So much has happened. I took Chase back to the vet the beginning of December. The sludge was still gone. Bad news was in the 2 months she gained 1 lb. She is really overweight. She now weighs 7.5 lbs. I was giving her banana's for potassium, plus craisins twice a day to get her to take the Lasix and tons of water soaked greens. The vet was not happy though. So we agreed to wean Chase off the Lasix since she hadn't had any sludge in a few months and removing the Lasix would allow me to cut out all of the stuff I was feeding her.

I then took Chase back in January. Even with being off the Lasix which was the only thing that kept the calcium sludge under control, she was sludge free. The vet told me she doesn't think Chase is cured and to not get my hopes up. But how can I not. She has been sludge free for the first time in a year. She will go back in a month and if she is still sludge free I won't have to take her every month. We will move the appointments farther apart until she is getting her regular yearly visits.

I really hope this long ordeal is over. I am so happy. I know it was the pellets that made the difference. It was the only thing that has changed.

I will keep this thread updated. I hope it can provide help to other people going through this.

 

[Maureen Las]

I think that it is hopeful that she is sludge free and also it is a good idea to take a break from lasix and see what happens. The weight ..you can do something about that.
I am wondering if there is a potassium supplement that you could have given her..that would be something to investigate if she goes back on lasix later

Thanks for the update Amy

 

[myheart]

Amy, I am so glad to hear that Chase is still sludge-free. So happy that the treatments worked for Chase. It is a step in a the right direction when you are able to take away meds, and the results are still positive.

Yay for Chase!!!! :bunnydance:

myheart

 

[hln917]

Glad to hear Chase is improving! :happyrabbit:

 

[tonyshuman]

So glad she's doing better! I do hope you can take her off the meds, and thus reduce the sugary foods. It's so good to hear that she's doing better. I bet you could use a potassium supplement instead of the banana, though. I have made bunny cookies, based on a recipe I got off the web, with lots of ground flax seeds in them, to try to help with coat condition because of their Omega-3's. I bet you could add ground potassim tablets to the same thing and make super-potassium cookies.

 

[Amy27]

I took Chase in for her check up today and the sludge is back. Chase is now back on the Lasix.

I also took Little Bunny in for her yearly and she has bladder sludge now too and is on Lasix.

I feel like I am doing something wrong. How do both of my rabbits have sludge? What are the odds. I am just so frustrated and sad. I sat in the vets office thinking I can't keep doing this. I am spending so much money. Now they both are going to have to go every month for awhile and it is almost $300 for both of them to have check ups and x-rays. I won't give up because they are both happy and love life. I just don't understand what I am doing wrong. I feel like I should give them up to someone who would care for them better because I obviously am not doing a good job.

 

[billinjax]

It makes me wonder if we have an environmental factor in common. I have experimented with changing water in the past with no luck. I've tried different types of bottled water including distilled water. I wonder what other factors we should be examining?

I also struggle with the fact that I have read some rabbits will always have some amount of sludge but it will not cause any negative affects. Most of my sludge experience with Jack has involved him being symptom free.

 

[Amy27]

Bill, I also tried filter water from my tap and purchased filtered water from the store with no luck. I do wonder about environmental factors because neither of my rabbits had sludge before I moved into my condo. I moved in about 2 years before Chase first got her stone. So, I kind of think may be they are not related.

The only thing that has changed in the last 2 months for Chase is that I started letting her out while I was at work because she is so over weight. Well, she wasn't eating as much of her soaked veggies because she was out and about in the house. So, I am going to have to keep her locked up while I am at work.

Little Bunny actually had a little sludge on her x-rays a year ago. The vet said it wasn't enough to worry about. That most rabbits have a little sludge but the owners never know because it never causes problems. The amount of sludge in the Little Bunny's bladder has about double in a year. Who knows how long she had it before that. The vet did say that usually if rabbits have sludge it will keep accumulating even if it is at a really slow rate. Which is what she thinks is what happened with the Little Bunny.

Both of my rabbits were symptom free when I took them today. Chase has always been symptom free except for when she had the stones.

I really wish there was more research so we knew more about bladder sludge and stones. Like what things in the environment can cause it. But then it always comes back to, even if a rabbit gets to much calcium, a normal rabbit should expell it. So why are ours not? Makes me wonder if there is another factor here that isn't being considered. What is required for a rabbit to expell sludge? We know Vitamin D is required and obviously water consumption. But I bet there are more factors then those two.

 

[tonyshuman]

Hi Amy, a while ago Pipp had me pull an article from a scientific journal on feed, calcium metabolism, and tooth issues. I know tooth issues aren't the deal here, but they're certainly related to calcium metabolism. I am also trying to get this article:
http://www.ncbi.nlm.nih.gov.ezproxy.library.wisc.edu/pubmed/18165142

I can email you the article. Same goes for you Bill.

I think there's something going on that you and the vets just can't figure out. Rabbits seem to be very complex creatures in terms of how their bodies deal with calcium. Maybe they need more phosphorus, maybe they need a vitamin D supplement, maybe they need a 30 min sun bath every afternoon, it's hard to tell. I know I'll keep looking for an answer.

There's nobody that could be better bunny parents to these guys than you two though, that's for sure. I just think that veterinary science doesn't understand the rabbit kidney well enough yet.

 

[Amy27]

Bill, you got me thinking now. If you don't mind. Will you list everything you can think of about Jack's environment and what he gets and I will do the same. Lets see if anything is the same.

My rabbits live in the basement on carpet. Currently get tap water. Get Kleenmama's hay. Oxbow Organic pellets. Veggies are dandilion (lots), cilantro (lots), red leaf (a little), and endive (a little). I buy them from Giant Eagle. They get crasins as treats. One is housed in a NIC cage, the other in the laundry room. I live in a new built condo (sludge started after I moved). Both rabbits get a water bowl and bottle. Veggies are soaked. They don't eat anything like the carpet or a lot of cardboard. I am running out of environmental things lol. They both get 4-5 hours out a day and have full run of 1600 sq. They never go outside.

Okay that's all I can think of.

 

[Amy27]

Claire, sorry I was writing while you posted. That is weird you mention teeth though. The Little Bunny does have some spurs but the vet is leaving them alone until they cause a problem. I am off to read that article.

ETA: Just realized I can't read the article. I will PM you my email address and if you could send it to me that would be great. Thank you so much!

 

[myheart]

Amy, I am so sorryI am first seeing this now. I saw you post in the other section and decided to check the Infirmary to see what's up.

I feel so bad for you and your bunnies. I wish there were something I could do for you, especially now that its both bunnies with sludge. I could just cry for you and them.

I am wondering about the dandelion greens. I opted not to use them for Luna because I saw on one table that they were high in calcium. It seems as though there might be conflicting amounts on different calcium tables.

I know you want to do everything you are able to do for them. I will always support any of your decisions in their care and comfort. {{Sending tons of hugs and support to you and your fur-babies}}

myheart

 

[tonyshuman]

Dandelion greens might be a toss-up, because they are also a diuretic which could make the urine less concentrated, but then again they might make the rest of her dehydrated.

I also read a paper today (that I sent to Amy as well) that stated that adding vitamin D to the diet won't help, and calcium primarily comes from the ingested food--totally opposite to what we've been hearing lately. This paper was written in 2008 and seems to be pretty good, although it's a review of other papers that are a bit older, so maybe it's not the most current opinion of the field. I'm all sorts of confused right now.

 

[Amy27]

Thanks Janet. You are so sweet. It means a lot to me and the buns.

I stopped feeding dandilion greens for awhile due to their calcium content. But then I felt that the calcium wasn't related to the diet I started feeding them again. Now that I think about it I started feeding it again in October 2009 about the time I started them on pellets. May be that is why Little Bunny's sludge has increased so much.

I got that paper thanks Claire. I haven't read it yet. I plan to take both papers you sent me to the vets when I go in a month and see what she thinks.

When I had mentioned vitamin D to the vet, she really didn't think it had and impact. She tried to explain why but I really didn't understand. It was something about how humans need vitamin D to process calcium. She stated that rabbits don't. However, we still don't want the rabbits to be lacking in vitamins, she just didn't think it would help.

So lets say calcium comes form ingested food. What causes some rabbits to take that food and calcium and never have stones or sludge and some due. I can see how it would be diet related if it was an excess amount.

I am curious about the papers now and am going to go read them. Not sure if they will make much sense to me. I have learned way more about this subject then I ever wanted to lol.

 

[Amy27]

Okay so reading the article it said that most dietary calcium is absorbed in the intestine, and the excess is excreted in the urine.

So does that mean a rabbit who has bladder stones or sludge, the calcium has to be excess? Otherwise it would never make it to the bladder?

Reading about the vitamin D. I could be reading it or misunderstanding it but it looks like a rabbit that is deficient in vitamin D had no change in intestinal absorption of calcium but urinary excretion of calcium and phosphoris was decreased. So may be vitamin D is only beneficial for urinary excertion? Am I reading that right? (I read that on page 143 last paragraph)

I just want to post this for other people lol I was excited about this sentence. When rabbits are fed a high-calcium diet, urinary calcium excertion increases but urine volume remains constant, increasing the liklihood of crystal aggregation and stone formation.
That would be why the Lasix works for my rabbits. Because it is increasing their urine volume. I have just never heard it put like that and it makes so much sense.

Another part I wanted to share for people who don't have the article.
The unusual calcium metabolism of rabbits makes it essential to maintain a diet that is well balanced, with appropriate calcium concentration, calcium-to-phosphorus ratio, and vitamin D content.

For those that can figure out how much calcium you are giving your rabbit, it states a dietary calcium level of 0.22% supports normal growth, but 0.35% to 0.4% calcium is required for optimal bone calcification and growth rates in young rabbits. Okay then farther down in the article it states 0.6%-1.0% of calcium is the ideal diet for rabbits and should have a calcium-to-phosphorus ratio of 1:1 to 2:1.

Okay so my Organic Oxbow contains 0.60%-0.90% of calcium and 0.30% of phosphorus. However that doesn't really tell me how much to feed them lol. What serving size is that based on. I think I must not be understanding what the percentages mean.

It also said that many vegetables are high in calcium, they often contain calcium oxalate which is not metabolized by rabbits, and thus, cannot contribute to urine sludge.
So I wonder if dandilion contains both??

Okay my head is spinning. This is great information Claire. Thanks again for sending it to me.

 

[Amy27]

Raw Vegetable Oxalate content milligrams per 100 gram serving
Spinach 750
Beet greens 610
Okra 146
Parsley 100
Leeks 89
Collard greens 74

These are somethings that contain the calcium oxalate. None of them are things I feed except carrots occasinally. So I am figuring the veggies I feed, cilantro, dandelion, red leaf, and endive contain calcium which would all be absorbed. May be I am over feeding calcium. I am going to stop feeding the dandelion. All the other greens I feed are low in calcium and plus they get these pellets. I am going to have some unhappy buns!

ETA: Just found an article that said dandedlions do contain oxalate calcium. Now I am really confused.

Oxalate-rich foods include rhubarb, spinach, strawberries, chocolate, nuts, beets, wheat bran, blackberries, blueberries, wheat germ, whole wheat products, tangerines, beet greens, dandelion greens, olives, leeks, kale, concord grapes, figs, carrots, celery, soy sauce, marmalade, grits and pretzels.


ETA-Again-You guys are going to kill me.

Okay so the percentages above are daily value percentages right? What if you don't feed it daily lol. I don't get this. Anyway 55g of dandelion contains 10% DV. 1 ounce contains 5% DV and 52.4 mg. 100 grams which equals 0.435 cups is 19% and 187mg. OMG I was feeding like several cups a day. That is a lot on top of the other veggies and pellets.
While I am at it I will do some other veggies.

Cilantro 1/4 cup 4g has 2.7 mg 0% DV.

Read leaf 1 outer leaf 17g 5.6 mg 1% DV

Endive 1/2 cup chopped 25g 13 mg 1% DV

Parsley 1 cup 60g 82.8 mg 8%Dv

Those are all for raw veggies and the figures are just for calcium.

 

[tazzychan]

Hi Everyone

I was looking for help on this forum a while ago when my bunny Tazzy was having Bladder Sludge and bladder stone issues and you were all such a great help I wanted to update you all on her condition. Tazzy is currently bladder stone and sludge free for the past six months so I thought I might let you guys know what worked for us so far.

Tazzy started out with bladder sludge first and she spent two days in the hospital being given Sub-Q fluids and antibiotics. We reduced her pellets (timothy hay based) to one small scoop full in the day and one in the evening. I feed her unlimited amounts of hay consisting of Orchard Grass, timothy hay,Oat hay and botantical hay. I also gave her more greens such as parsley which she loves and I heard that Dandelion greens had a diuretic effect which I read was good at flushing out the sludge. She was doing great on this diet for the next 3 months and I thought our nasty bladder sludge days were over. Then one day I found her passing blood in her urine and off to the vet we went to check it out. Sure enough all of her bladder sludge was gone but now she had developed a large bladder stone. After having the bladder stone removed I decided to give Tazzy's diet another make-over.

Whenever Tazzy urinated it use to always leave a white chalky residue after it dried which led me to believe that she was having too much calcium in her diet. I later learned that parsely and Dandelion greens both have high calcium contents so I decided to elminate both of those from her diet. I did research on what vegetables had lower calcium contents and started to feed her a mixture of those greens which included cilantro, bok choy, green leaf lettuce, romaine lettuce and sometimes peppers. She also gets unlimited hay which basically includes a variety of three to four different types of hay excluding Alfalfa hay which is high in calcium. I also stopped feeding her any pellets because my vet says that rabbits can do very well on just greens and hay and Tazzy has actually gained weight since being on this new diet. I always soak her greens in a nice big bowl of water before giving them to her to increase their water content and eatting so much hay really makes her thirsty because she drinks a lot after she eats her hay. One additional thing my vet recommended was giving her potassium citrate 0.45cc twice a day which helps reduce the adsorption of calcium, the vet said that this approach is a little controversial but it seems to work. I usually give it to her with a little bit of banana and she loves it. Tazzy just had an X-ray done six months after her bladder stone was removed and the vet saw no signs of bladder sludge or stones which is great news.

If anyone has any new diet suggestions I would love to hear them.

Take Care
Gloria

 

[tonyshuman]

Whew give me some time to catch up! LOL

Gloria, I have heard of other buns with potassium added to their diet to combat sludge--the member's name is billnjax I think...

 

[tonyshuman]

Amy27 wrote: Okay so reading the article it said that most dietary calcium is absorbed in the intestine, and the excess is excreted in the urine.

So does that mean a rabbit who has bladder stones or sludge, the calcium has to be excess? Otherwise it would never make it to the bladder?

[line]I don't think so. Some bunnies whose diets are low in calcium still have sludge because they take calcium away from the bones. That is Metabolic Bone Disease. I think. However the article doesn't talk a lot about MBD.
[line]
Reading about the vitamin D. I could be reading it or misunderstanding it but it looks like a rabbit that is deficient in vitamin D had no change in intestinal absorption of calcium but urinary excretion of calcium and phosphoris was decreased. So may be vitamin D is only beneficial for urinary excertion? Am I reading that right? (I read that on page 143 last paragraph)

[line]I think it means that vitamin D is important for telling a rabbit's body how much calcium to have in the blood. On pg 143, it says "The hormone is also necessary for osteoclastic bone resorption and mobilization of calcium from bone, and increases renal tubular reabsorption of calcium and phosphorus." So, vitamin D tells the body whether to break down bones or build them up in order to get more calcium for what it needs. It also decreases the amount of calcium and phosphorus in the urine. That's why with low vitamin D, a lot of calcium and phosphorus was excreted. Calcium comes from two sources: food and bone, and is eliminated by making bone and being eliminated via the urine. Vitamin D increases plasma Ca by reabsorbing bones and causing the kidneys to not excrete as much calcium. I think eventually the body has all this plasma Ca and it needs to put it somewhere, though, so it goes into the bones. That's a guess though.

This page has a good picture and some explanations:
http://www.mfi.ku.dk/ppaulev/chapter30/kap30.htm
[line]
For those that can figure out how much calcium you are giving your rabbit, it states a dietary calcium level of 0.22% supports normal growth, but 0.35% to 0.4% calcium is required for optimal bone calcification and growth rates in young rabbits. Okay then farther down in the article it states 0.6%-1.0% of calcium is the ideal diet for rabbits and should have a calcium-to-phosphorus ratio of 1:1 to 2:1.

[line]I'm confused to why they change their recommendations: why not give only 0.22% calcium, since that's about all they need? Maybe it has to do with how much calcium from the feed is absorbed? Like only 13 to 1/5 of calcium in the food is absorbed?
[line]