Stomach impaction, possible blood in urine?

[Natusha]

My little boy Radagast, who is a 5 month old mini lop, became quite skinny, and so he went to the vet.
She said his stomach is impacted, and when you press it feels as though there's a stress ball in there... She described it as a fibrous lump causing him gut motility issues and probably some discomfort and lack of nutrition etc etc.
So since Wednesday he has been having duphalac (lactulose) 2.0ml 3 times a day, and Zantac, 0.1 ml 2 times a day, she suggested his diet be adjusted also, so he is eating a lot of kale, spinach and silver beet. He is also having the ox bow young rabbit pellets as recommended.

His weight has gone up slightly, but just under 100 grams. (He weighed 860g when he went to the vet, his weight was down 20%)
He is eating his food, he isn't so playful but she said he'd more than likely be a little uncomfortable, however he does seem a bit better and he's not so bony either.

This morning when I was cleaning his littler and hutch(which is located outside, though he comes inside to play freely anywhere from 4 hours a day) and I noted what looked like a stain on the matting, that had dribbled down where it slopes a little, and it was a very very deep red, almost like it was consisting only of blood.
But his litter after that appeared normal with all of his new widdles being of normal colour that I could see.
Then tonight I went to give him his last little bit of medication for the day and I noticed a pee next to his litter tray that was orange in colour, to me it looks as though it's urine with a little blood in it, though my partner and friend disagree and they think it doesn't look as though it's blood and that I am paranoid because I know he is under the weather.
I know I need to phone the vet, but in the meantime I need advice. I fear for my little boy.
My vet has just gone on holidays today, she is a rabbit specialist and the only one in the state.
I don't feel comfortable taking him to another vet after previous experience with the other veterinarians, who seemed to have very limited rabbit specific knowledge.....
I can't afford to take him back to the vet, though I will if I need to, but I'm just so worried I cannot sleep.
I have been getting up through the night to check him, so he is very closely monitored.

Is this a possible side effect of the stomach impaction?
Could it be due to the medication?
Is it possible that the orange urine does not have blood in it?
Should I be alarmed?

 

[JBun]

The kale, spinach, silverbeet, may be adding more pigment to his urine. Urine color will vary depending on what a rabbit eats, and certain foods can really change the color. I know dandelion can really pigment the urine. I would imagine the kale, spinach, and silverbeet would also have an affect on the urine color. Orange urine is usually going to be plant pigmentation. All pictures that I have seen of fresh urine with blood in it, has been a brighter red color, or with threads of red in it. Blood in the urine will primarily be due to bladder or kidney issues, not due to a digestive issue. Though a digestive issue could tie in to urine color. If a rabbit were dehydrated due to a GI issue, then that could make the urine darker in color. But it can be the other way around. A kidney/bladder issue can be a root cause for a rabbit developing a digestive issue.
http://www.medirabbit.com/EN/Uro_gen_diseases/generalities/Sludge.htm

If you are concerned about the urine color, with your vet out maybe you could phone the office and ask if you could bring in a urine sample to be tested for blood?

 

[Natusha]

Thanks for the information, and I think I will phone the vet and do just that.

This is a photo of the first One I found, I don't know what it is... But it was half dried when I found it, but part of it was still wet and it was a deep red.

View attachment ImageUploadedByRabbit Forum1426278906.324302.jpg

 

[Natusha]

The second wee I found that was more orangey was nothing like that, and I guess I assumed it to be blood because id seen the first one, and I thought maybe it just had less blood in it.
I'm glad that it could be due to other causes, but I'm still very confused about about what the first one is.

 

[Natusha]

One more thing, over night his poops have been so tiny, almost a third of the normal size and they are almost black......

 

[squidpop]

First, I would not feed kale, spinach, and silverbeat every day especially in large amounts. They are all three high in oxalates which somehow messes with the bodies ability to absorb calcium properly and can lead to kidney stones etc... in all animals including people they are warning not to overload on veggies high in oxalates. Those three veggies are often on rabbit lists as "feed in moderation" for that reason. So, it would be better to choose a low oxalate fresh green like green curly lettuce. I think, its would be ok to feed the spinach, kale, and silver beat too, as long as you alternate with greens that are lower in oxalates. You can look up oxalate lists to find veggies that are lower in oxalates.

Second, my boy had GI stasis and I did research on lactulose. It is a stool softener and works by pulling water from the body and hydrating the intestines. Hydrating the intestines is good to get the blockage moving out, but the problem with lactulose is it can be dehydrating to the rest of the body. So the rabbit is supposed to have extra fluids and electrolytes or it can get dehydrated. They say to even give sub Q injections with the lactulose but I didn't do that with my rabbit. I gave the lactulose and put some low sugar electrolyte solution in his water and pureed some apples to make juice and put that in his water to get him to drink lots or water while taking the lactulose. Lactulose is also extremely sweet, it is a type of sugar, so if you flavour the water with anything sugary be aware its not good to make it too sugary, just flavour it enough to get the rabbit to drink more. So, hydration is very important if you want the lactulose to work its magic. My rabbit did get better so hopefully yours will too.

 

[squidpop]

I just read the part about the poos being small, I would really work on getting him as hydrated as possible. The intestines can't work properly if he isn't really hydrated and there has also been a lot written about dehydration as being the real cause of blockages and gut slowdowns in the first place. So, if he isn't drinking lots of water I would even syringe fluids/electolytes into him.
Here is an article that backs up what I am saying about dehydration and its relationship to gut slowdowns.

http://www.veterinarypartner.com/Content.plx?A=484

(Excerpt) "......As the movement of material through the GI tract slows, the ingesta sits longer then normal at any point, particularly in the stomach and in the cecum. Fluid continues to be extracted from this ingesta while it is delayed and eventually the ingesta can become thick and dry as it dehydrates. The dehydrated ingesta causes further slowdown of GI motility causing a vicious cycle. The result is dry, impacted material in the stomach as well as the cecum, which ceases to move altogether. The rabbit stops eating and drinking because nothing is moving and further aggravates the condition. Now we have a "ball" of material in the stomach that can be felt on a physical examination and seen on an x-ray. Dehydrated stomach contents viewed on an x-ray exhibit a halo of air demonstrating that there is little liquid present.

So where does the hair come from? Rabbits always have some hair in their stomach contents. They groom themselves constantly and swallow the hair. A true "hairball" is comprised of nearly 100% hair as in cats or ferrets. In rabbits, hair is mixed with stomach contents in a loose mass. As the stomach contents dehydrate as described above, the largest particles are left behind, which includes the hair. The liquid stomach contents gradually turn into a solid tightly adhered mass. If you look closely at a “hairball” you can see that it is made up of both hair and dried stomach contents. In a few rare instances, the longhaired breeds of rabbits, such as Angoras and Jersey Wooly’s, can develop excessive amounts of hair in the stomach because the hair is abnormally long. Humans have created this situation through the alteration of our pet’s genetics. In these species it is beneficial to brush the pet frequently to reduce the amount of hair eaten.

To sum it up, the cause of this condition is not hair in the stomach, but rather a GI tract motility disorder that results in dehydrated ingesta in the stomach and the cecum. If the underlying problem is not corrected, the condition is destined to reoccur....."

 

[Natusha]

Thanks for all the tips, I have noticed his water has not seemed to go down, so I believe he is dehydrated, his poops have gotten larger, though.
But his urine went from being an orange colour to now being milky.
I really am new to the rabbit thing, I've only had him since Christmas so I honestly have no idea what I'm doing.
The vet recommended the spinach, kale and silver beet, about 2 cups packed full daily of those + broccoli and a few others. So I have just followed her instruction because I guess I felt I should just trust her being that she is a vet... I guess they're not always right.
I'm so grateful for his site though, thanks for the information, I'll do some reading and alternate with other veggies.
What can I be adding to his water to help? I'll try the apple, that's a fantastic idea.

The vet gave him a sub q injection and said that if it was necessary she would show me how to do it myself so I could at home to keep him hydrated. She hasn't as yet though because he hasn't gone back for a check up.
She did to bring him back in 3 weeks to see how he is doing, and his weight has increased by nearly 200g in 4-5 days so I hope that means he is improving.
So if you can give me some more advice of the best ways to keep him hydrated I would appreciate that!

 

[Natusha]

The other thing I forgot to mention was she suggested I feed him a bit of mashed pumpkin too.

 

[Natusha]

And just now I was stroking him and he was laybg on my lap on his back and he has a lump I didn't notice before. It's almost hard and it's just under his ribs and to the side.

 

[squidpop]

Does the lump seem like it is deep inside? You might have palpated an organ like a kidney or gal bladder maybe, or could it be a blockage, I'm not sure. If its on more on the surface cyst or abscess maybe. Would need a vet I think to feel it.

With mine to hydrate I wizzed up 3 slices of apple and some frozen blueberries into about a cup of water. I'd say ratio was 1 part fruit to 3 parts water. I also had some electrolyte tablets for sick people. With the electrolyte tablets I put half the amount of tablet than it said on the label because I was worried about too much sweetness. My rabbit seemed to love the fruit in the water and I was lucky because he would drink lots when I did that.

If you are really worried he is dehydrated and he doesn't drink extra water on his own after putting some fruit in it, I really would get a 3ml syringe and syringe feed 10ml to 15ml of electrolytes in him to get him going. Syringing fluids can't hurt him and it might help.

I'm a bit worried that you think he might be dehydrated and he is also having lactulose which can dehydrate the rest of the body.

 

[Natusha]

I'm worried too, can't tell you how much I appreciate the advice. I'll do just what you've suggest and see how it works for him.

He'll have to go to the vet I think, the lump is firm and feels fairly close to the skin.
It's just under his rib an it's probably the size of a 20 cent peice, an Aussie one that is, but it's an odd shape.

 

[Azerane]

How confident are you with your vet that you see? I always thought that a rabbit's tummy was supposed to feel spongy like a stress ball, or doughy as its often called.

The other lump that you found could be a concern. The urine and feeding issue has already been addressed in regards to pigmentation etc. Are you feeding any hay? What kind and how much?

 

[Natusha]

I felt confident but it's pretty hard to know... She has been recommended by many other rabbit owners and is the only rabbit specialist where I live.

She seemed like she knew exactly what she was talking about, but I guess any body could come across that way.

Im very worried about that lump, I'll have to ring the vet tomorrow. But she isn't actually there so it'll be a different one, which concerns me. Because I took my other rabbit to the vet and the one he saw didn't seem to have any rabbit specific knowledge and diagnosed him with coccidiosis and I now know there are things I should have known that I wasn't told and as a result he died.
So I really don't feel confident in the other veterinarians at that clinic.

 

[Natusha]

Oh and he has grass hay, that's all I know about it, and he has that unlimited

 

[squidpop]

I think its good your vet said to feed lots of leafy greens, its just that those three types together would be high in oxalates. I would swap the silver beat or the spinach out for romaine lettuce or curly leaf lettuce. I read this house rabbit society article and it talks about oxalates and the kale is on the low oxalate list but I have always thought it was high in oxalates. I know spinach and silver beet (also called swiss chard) is very high in oxalates. Here's the rabbit society article and they talk all about it.

http://rabbit.org/suggested-vegetables-and-fruits-for-a-rabbit-diet/
Many plants contain a naturally occurring chemicals called an alkaloids, which are mild toxins that protect plant in the wild. The one most talked about with rabbits is oxalic acid and it is completely harmless to animals or humans when consumed in small amounts. The amount of oxalic acid within each plant can vary significantly due to several factors including the composition of the soil the plant grew in, the time of year and the age of the plant. Most of the fresh vegetables we feed rabbits have a low to zero level of oxalic acid, but a few, most notably parsley, mustard greens and spinach have relatively high levels. (Note that kale, which is often implicated as a high oxalate food is actually very low in oxalates). The toxicity of oxalic acid comes with feeding large quantities of foods high in this chemical and can result in tingling of the skin, the mouth and damage to the kidneys over time. These foods are nutritious and do not need to be excluded from the diet if you feed them appropriately. I recommend feeding a minimum of at least 3 types of leafy greens a day (and only one of them should be from the group listed above) Don’t feed the same greens all the time from week to week if possible, mix it up. For instance if you feed parsley this week, then leave it out of the diet for next week and use something else. Rotating the greens will also give your bunny variety in taste, texture and general nutrition!

 

[Natusha]

Thank you!
I won't give him the silver very anymore.

In terms of this firm lump, when you press gently it doesn't appear to hurt him and it seems to actually move as well.... He's more active today than he has been and his weight is up, he seems so much better, but this lump is scarIng me.
Is what I'm feeling the impaction perhaps?

 

[Natusha]

The article of food was very helpful, thank you!

 

[squidpop]

I'm not really sure what the lump could be. Sometimes with my rabbits I am surprised I can easily feel the actual poo pellets inside them, they feel like hard little peas. What ever it is its is probably a good sign that it moves easily, so not connected to other tissue. But really I'm not sure what it could be.

 

[Natusha]

Good point!
Well i can't feel it anymore, and due to the size it was I imagine that means it's probably gone, his tribe is back to normal, he is eating and drinking and his weight has increased, he no longer feels bony, still has a little more weight to go but he is significantly more plump.
He seems to be ok, I appreciate all the advice I've been given, it's been a great help.
Thank you all.