Early Signs An observant person can often detectbladder disease in their rabbit before he becomes lethargic, anorectic,or is in a life-threatening situation. Signs of early trouble will varywith each rabbit, but you should seek veterinary help when any of thefollowing occur: Loss of litterbox habits, straining to urinate,hopping in and out of the litter pan, wetness around the genital areaor chronic skin irritation in that area from urine scalding, semi-solid(like toothpaste) urine, or blood in the urine. Blood in the urine mustbe confirmed with a veterinary urinalysis or microscopic exam, or by aurine "dipstick" which can be purchased over-the counter from apharmacy. Many people mistake porphyrinuria (the presence oforange-to-red colored by-products in rabbit urine that result fromchlorophyll and other vegetable component break-down) for blood in theurine.
Diagnosis Any animal with clinical signs such asthose mentioned should have a veterinary visit. An experienced rabbitveterinarian uses a urinalysis and radiographs (x-rays) as the initialsteps in diagnosing a bladder problem. Because rabbits' bladder stonesand bladder "sludge" are primarily composed of calcium, they are ableto be detected on plain radiographs (x-rays). Your veterinarian shouldbe familiar with normal rabbit urinalysis values and the radiographicappearance of a rabbit bladder. Many normal rabbits may have someradio-opaque material present in their bladders but will not have theabnormal urinalysis or clinical signs to support a diagnosis of bladderdisease. Once bladder disease is confirmed, a urine culture, serum(blood) chemistries, and a complete blood count will help theveterinarian determine the extent of the disease and how to treat theproblem in that individual rabbit.
When Stones Are Detected Treatment in a patient with actual bladderstones will necessitate having the stones removed, as they frequentlydo not pass on their own and there is no known way to dissolve them. Ifthese calculi are left unattended, they will continue to enlarge andwill irritate and damage the bladder wall, allowing chronic infectionand inflammation of the bladder (cystitis) to make the rabbit seriouslyill. Depending on the rabbit's condition at the time of diagnosis, theveterinarian may first need to stabilize the patient with fluidtherapy, nasogastric feeding, or antibiotic administration prior tosurgery. Post-operatively, most rabbits require at least one to twodays of hospitalization for continued fluid therapy and pain managementbefore they are discharged.
[size="-1"][Photo Caption: Bladder stone passed (very painfully) bya 6-pound female rabbit. Fecal droppings from the same rabbit are shownfor comparison . In most cases, this size stone would have to beremoved surgically.][/size]
"Sand" in the Bladder If a rabbit does not have bladder stones, but hasan accumulation of thick "sludge" or "sand" in the bladder causingdisease and discomfort, treatment can usually be medical rather thansurgical. It is again recommended that the rabbit's overall health belooked into, not only with the urinalysis and radiographs mentionedearlier, but also with a urine culture, serum chemistries, and acomplete blood count. This will allow the veterinarian to determine thedegree of infection and disease, and whether other organs, such as thekidneys are affected. Rabbits with "sludgy bladder" disease may requireseveral days of hospitalization for fluid and antibiotic therapy beforebeing discharged. They may need manual help from the veterinarian inexpressing the thick "sludge" from their bladders, and sometimes willrequire pain medication for bladder and urethral pain control andspasms.
At-home care for rabbits (after hospital treatment is complete) willinvolve a minimum of ten days of continued antibiotic therapy.Sometimes several weeks of antibiotics may be indicated if the urineculture indicates a severe infection. Dietary changes are also criticalif the rabbit is not to have a recurrence of bladder disease.
Rabbits (over six months of age) with a history of bladder problemsshould have pellets removed or severely restricted. They should receivea variety of fresh vegetables (at least a cup or more daily),
excluding thosehigh in calcium such as kale. No alfalfa hay should be fed, buttimothy or grass hay should be available at all times. Animals that areoverweight should be encouraged to exercise a minimum of one hour atleast twice daily. This can be accomplished by letting them chase youand then you chasing them, up and down stairs and around the house.Some rabbits will spend a considerable time tossing a wire ball back toyou. There are numerous ways to both enjoy and exercise your rabbit atthe same time.
All rabbits that initially presented with bacterial growth on a urineculture should have a urinalysis and urine culture repeated after thecompletion of antibiotic therapy to be sure all infection is resolved.Also, even with all the treatments described and diet changes, thebladder stones may still reoccur in some rabbits and frequent (at leastevery six months) visits to the veterinarian for regular radiographs tocheck for recurrence is important. If caught early by an observantperson bladder disease should be controllable and should not cause anypermanent damage to the rabbit's health or life-span.