(RIP) UPDATE: Luna has stones in both kidneys

[myheart]

I never thought I would be posting in this section about any of the bunners...

This past week/weekend have been horrible for Luna. She slowly went into stasis, so I did all of the usual stuff including pedialyte, pumpkin, wet veggies, and bene-bac. She just was not snapping out of it as easily this time, so I started adding Critical Care and juices (cranberry and pineapple) to keep her hydrated and fed. Her poor little tummy was gurgling something aweful from being gassy and hungry.

Saturday was the worst night. I had a terrible fear I was going to lose my little girl, but she was a trooper and took her Critical Care and juices, and started snapping out of it later that evening.

Sunday night she ate finally ate most of her veggies, and last night she ate everything I gave her!!! Luna was much perkier this morning and actually looking for her morning berries.

I had a vet appointment set for her for today since last week, and although I knew it would be a bit dangerous traveling in such bitter temps, I figured it would be best to make sure there was nothing else going on with her to trigger this longer-than-usual stasis. I also knew that if Randy were to read this, he would still say that evenif Luna were eating normally, she still wouldn't be "gut ready" and out of the woods completely.

I told the vet every thing that happened during her stasis, and agreed toan x-ray of her abdomin. He came back saying that Luna has kidney stones in both kidneys that have a calcium composition, according to the crystals in her urine. He said that if the stones were in the bladder, there would not be a problem with doing a surgery to remove them. The kidneys are a different story.... Surgery is not an option because there is too much that could go wrong.

Luna now has to be on a calcium restricted diet in the hopes that they will dissolve or pass on their ownwith the hopes that none of them cause blockage to the bladder. The vet said that was probably the reason for her stasis lasting so long... she was in pain from trying to pass a stone. So, Luna will not be allowed to have pellets or alfalfa hay. I will be able to give her lots of wet leafy greens,haynot containing any alfalfa,and some cranberry juice to help curb any UTI that could develop from the stones. The only green he really blacklisted was spinach. I asked about kale, but he said that should be fine. I also managed to get my hands on a bale of blue-grass hay (I hope that will be okay for her(?)).

Just wondering if anyone else has delt with kidney stones in their bunner, what diet changes they made, and whether or not the stones resolved themselves.

myheart

 

[TreasuredFriend]

dear J, I am so sad to hear about Luna's stones. I would preventably eliminate any high calcium greens, veggies, fruits - and stick with all low-calcium items. I shall look in the books by Kathy R. Smith (and the Special Needs' book) for more info in case a PM on additional pampering or mealtime items helps.
Oh little Luna girl, your mom is doing everything she can :kiss:...

Greens at the top of Sylvia's list were romaine, green and red leaf, endive, chard, sweet yellow and green peppers, cilantro. Perhaps some of this will help. No parsley. (No carb items like cereal. Definitely no alfalfa). I'd be wondering on Kale, as that is a higher calcium green. * Beautiful blue Luna, and her snugglemates. *

 

[TreasuredFriend]

Here's another viewpoint (where kale is not considered a watch-list item):

http://www.mahouserabbit.org/newsletter/calcium.asp

another article:

http://www.rabbitwelfare.co.uk/resources/content/info-sheets/calcium.htm

 

[Maureen Las]

I think that we should try to get get Randy invovled inthis....

I"m going to change the title of your thread if you don't mind.

I am presently trying to find something re. kidney stones but I'm coming up with bladder stones.

I did have experience with a guinea pig who had one large bladder stone removed and made a rapid and excellent recovery.

According to the first article it is difficult to get rid of them with out surgery and if they are in the kidney and not the bladder that definitely is difficult,

http://www.rabbit.org/journal/3-5/bladder-disease.html
http://www.rabbit.org/journal/3-5/calcium.html
http://homepage.mac.com/mattocks/morfz/calcium.html
I'll keep on adding info asI come across it. I'm so sorry about Luna

 

[naturestee]

My poor girl.

I thought I remembered dandelion being recommended for kidney issues. A quick Google search turned up more stuff on it detoxifying the liver but it is thought to be a diuretic- increases urine flow. I know Piggly Wiggly often has good fresh stuff, so if you can find some it would be a good addition to Luna's veggie salad. Maybe next time you talk to the vet, you could ask if he recommends anything like that in pill form? You could could crush a pill and sprinkle it on her wet veggies.

And just for some more basic info on kidney stones, there's a lot of stuff here:

http://www.kidney.org/

There's some info in the Urinary Problems library article too:

http://www.rabbitsonline.net/view_topic.php?id=12052&forum_id=10

Unfortunately the herbal remedy article linkfrom Friends of Rabbits isn't working. I just emailed them to see if they can send me a copy.

:hug:

 

[Maureen Las]

here is a good article in medi-rabbit


http://www.medirabbit.com/EN/Uro_gen_diseases/Mech_diseases/Urolithiasis.pdf

 

[tonyshuman]

Poor Princess Luna. Naturestee's recommendation of dandelion greens sounds right on spot, as do the lists of low-calcium veggies already posted. Many "natural" grocery stores sell dandelion greens--here the Whole Foods and Sentry Metcalfe do (Copps/Roundy's and Cub Foods do not). I'll be thinking of you both...

 

[naturestee]

Oh, FYI: Luna had bloodwork done when I first got her (early November 07) and when she was spayed (February? Month before you adopted her). All levels were normal then. I don't know if the vet would want to do bloodwork again to see if there is kidney damage, or do stones not do enough to see in the bloodwork?

 

[Amy27]

I have one rabbit that had a huge bladder stone removed in October and my other bun has sludge. I am working to get the sludge moving through on it's own. Here are some websites I used that tell what the calcium content is of hay and veggies.

http://www.rabbit.org/journal/3-5/calcium.html

http://www.shady-acres.com/susan/Calcium-Phosphorus.shtml

Ok several of the websites I used the webpage is no longer available. I just searched calcium content of veggies and hay. A lot of members gave me good advice if you want to search my threads. Somethings I have done is offer a water bowl in addition to 2 water bottles. When I get there veggies ready I soak them for 30 mintues so they soak up all the water and the buns get some extra water. I also installed a water filter so they are not getting as much calcium from the water. They get plenty of exercise but I have tried giving them more time going up and down the stairs to move that calcium around and hopefully out. I have tried to feed better treats. I have done a lot. If you have any questions let me know. I am not sure if this will help you if the problem is in your buns kidneys. Good luck.


ETA: When my vet diagnosed my buns she took x-rays which clearly showed the calcium. It was really white. On the bun with sludge she did an ultrasound to see how bad it was. Chase with the stone you could see via the x-rays it was to big to ever pass.

 

[Maureen Las]

stones in the kidney could damge the kidney ; I think labwork would benecessary ..I just pmd Randy

 

[myheart]

Thanks all for the links. I will have to check them out tomorrow as I am almost done here at work (yes, I get to be online and on RO for four hours). Time to go clean cages and get the kids ready for bed.

Naturestee, I had blood work done for their dentals either this last time (December) or the time before, and nothing was said about the results being out of whack for Luna. Maybe I will ask if they still have the results and if there are any indicators now that we know what the problem is. Dr. Tavis said that stones develop rather quickly in rabbits, so there may be no way of knowing when it started.

Patch and Luna go for their next dental on the fourth of February. I have already asked him to do another x-ray of her tummy as long as she will be out for her teeth. That will also be a concern then also.... the anesthesia for the dentals. Won't that be even more hard on her system if her kidneys are wonky already?

So much to ask the vet about...

myheart

 

[naturestee]

LOL, I suppose I should have posted that I had already pm'd Randy. He's probably in the process of writing a huge response right now...

 

[naturestee]

Another thought- when you talk to him about pain meds see if he can give you something that's easier on the kidneys than Metacam is. She's been on Tramadol before, prescribed by the same vet so I know they keep some on hand.

For the record, I don't believe that calcium in veggies is a problem because of the water that comes with it. And even rabbits prone to stones need some dietary calcium or they risk reabsorbing it from their bones.

 

[tonyshuman]

But what about oxalates? That article from medi-rabbit that angieluv posted said that limiting greens high in calcium is a mistake, but it also mentioned that oxalates can cause stones too. Unfortunately a lot of the high Ca veggies are also high in oxalates (I'm looking at you, broccoli family!)--maybe dietary intake of oxalates should be limited to reduce the risk of stones? You would think though that if it were strictly dietary the other two cuties would have it too... I hope her years of neglect have not made her kidney function wonky.

 

[ra7751]

Umm....been here before. Some of you might remember Yoda....he was our special little fighter that fought so hard for so long against EC. He also had bladder sludge and stones. Learned a lot from him. We pulled all the calcium rich foods from him. We had him on lowest calcium content pellets, all grass hays and watched his greens carefully. Nothing seemed to help. The sludge just kept coming. You know how sometimes certain things that have no relationship to whatever it is you are doing will turn on a light. I looked over at one of my very large aquariums. It had this sludge looking stuff all around the top. Looked just like the "calcium" in Yoda's urine. Since we are on a community well, there are tests done (mainly for contamination) but also it breaks down components and we have a very high mineral content water. I modified his medical treatment...and changed to a low mineral content water. There is no real evidence, just hear say, that excessive calcium causes sludge or stones. While it's true that rabbits do metabolize calcium differently, certain individuals might be more prone to this issue.....and like in our local area, this is known a the kidney stone belt due to mineral content in the water....and I know all about that from personal experience. Even without clinical proof, I would still watch the calcium intake. Collards, spinach and kale are all high in calcium...and I use these greens in squirrels in the initial attack on Metabolic Bone Disease. And the calcium like deposits might not be calcium at all....could be spores.

Having said that....hereare my suggestions on how to proceed. Discuss this with your doctor.

>Perform a urinalysis to see exactly what is in the urine and look for signs of infections. Stones will many times cause infections. UTIs have become very difficult to treat in recent years.

>Perform a full CBC so you can have a reference point for charting kidney function. Send out a blood sample for EC titer.

>Get fluids going---stat. I would most likely use Sodium Chloride SQ. The idea here would be to "flush" the renal system. Wet leafy greens...romaine lettuce would be good....can help with hydration.

>Modify diet to restrict calcium just in case.

>I would switch to a low mineral content water (not distilled...they need some minerals). I think there is something called Rocchetta Water that can be purchased online. I think Oxbow offered a low mineral content water at one time but I don't remember seeing it recently.

>If this is stones, it would be painful. I would want some pain management. If you can maintain hydration, I would use a NSAID....most likely Metacam. I have often been tempted to use Toradol but there is a high risk of gastric ulcers (I use this drug personally). I would have no problem adding a narcotic like aspect to the treatment if needed. Buprenex is my first choice but Tramadol would be an acceptable alternative. The idea in using a NSAID is to possible reduce any inflammation inside the kidneys and allow the very small passages to open just enough to move the stone.

>I would use cranberry extract (not the processed juice). I think Oxbow offered something called Critter Berries at one time....don't know it they still do. Cranberry extract can also be found at health food stores.

>I also use ascorbic acid to acidify the system. This has to be used with extreme caution in order to not upset the gut...especially considering recent history. I do this by using small pieces of oranges. Citrus is an excellent source of this acid....it's Vitamin C....and thereis a lot of water in oranges. Some rabbits will even eat the orange flavored human vitamins....and guinea pigs have a tasty Vit C tab since they usually need C supplements. This would be the last thing I do if the others don't work. If this becomes necessary....start small and proceed slowly.

>I would suspect the prognosis of surgery would not be good. As your vet said, bladder stones are one thing, inside the kidneys are a totally different world.

>Heat can reduce the pain associated with stones/sludge. A covered heating pad on lowest setting might be beneficial. Monitor the pad closely to insure it doens't get too hot (and it can even on low).

>Let her move around as much as possible. Movement will sometimes cause these things to move.

Hope this helps. I really think you need a little more detailed diagnosis to determine exactly what is going on and exactly how to attack it.

Randy

 

[Bo B Bunny]

http://www.rabbit.org/journal/3-5/calcium.html

:hug: ray:

 

[naturestee]

Janet, a thought: call the clinic tomorrow and get the email address. I was told Dr. Travis is the regular person to check those anyway, and ask if he'll be willing to look over Randy's suggestions. Include his contact info and what he does (wildlife rehab).

 

[Maureen Las]

it would be great if Randy would help out with this ; I think that he would like to help

 

[Haley]

Great info here guys and awesome post, Randy! We have to bookmark this for our Library.

I dont really have anything else to offer other than what has been suggested. Yes, bluegrass hay is great. I would just give bluegrass and timothy hays. Definitely avoid alfalfa. www.kmshayloft.com has some great timothy/bluegrass mixes. If it were my bun I would avoid those higher calcium veggies (kale, parsley,spinach, collard greens etc) even though theres some debate about how much calcium is actually absorbed.

I would also ask about potassium citrate which is often used to dissolve bladder stones and sludge, which might work in the kidneys? I also know people who give cranberry chewable vitamins (like cranactin except with less sugar) and swear that helps as well.

I'll be praying for Luna. Let us know if theres anything we can do to help.

 

[myheart]

naturestee wrote:

Janet, a thought: call the clinic tomorrow and get the email address. I was told Dr. Travis is the regular person to check those anyway, and ask if he'll be willing to look over Randy's suggestions. Include his contact info and what he does (wildlife rehab).

I was thinking about checking for an e-mail address for Dr. Travis because I did have other questions anyhow and thought an e-mail might help me get my thoughts organized instead of getting him on the phone and totally forgetting everything.

Like I said, Luna goes back to the vet on the fourth of February. Does anyone think that is too long of a time in between before getting the blood work done? I did not get a chance to look at the x-ray or inquired about number of stone (one of my questions to vet) so I do not know how extreme the stones are. My concern is that vet's schedule may not fit my schedule and I do not know if I want to take another venture with this bitter cold for the rest of this week. It is one thing to put myself in harms way, but another thing to involve any of the kids unless it is an emergency. I also do not want to cause Luna anymore stress than necessary. Aside from diet, I am trying to send positive, healing thoughts her way of having healthy kidneys again. Honestly, with the way she has been acting yesterday and today, you would not think anything is wrong with her (she is busy cuddling with Zappa).

btw... I think the pain reliever that he wants to perscribe is the Tramadol because it does have a muscle relaxant feature to it. I really should either try to get the perscription and/or have all of the information faxed to Manitowoc vet for weekend emergencies andso they are on the same page.

Thanks Randy for all of the information. Once again you pull through and offer most excellent advice. I will be sure to re-read everything a couple of times to make sure I know what I am talking about when I do get a hold of Dr. Travis. We all learn from these types of experiences, and unfortunately we lose some in the process. Hopefully, your experience with little Yoda will help Luna pull though this to live a happy, healthy life.

myheart