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Abscesses
Emergency Kit Have questions or comments? |
Taken from newsletter of spring 2003 Stones and sludge: Is too much calcium the only cause? Calcium is usually the main focus when discussing the
causes of bladder stones and As Dr. Susan Brown writes in her "Bladder Stones
in Rabbits" article, rabbits have a different way of processing calcium
than other mammals. The amount of calcium that humans absorb depends upon
what our body needs at the time. Excess calcium is then passed into the
gastrointestinal tract and excreted as waste. However, in rabbits the
calcium from their diet is absorbed whether they need it or not. The excess
calcium (in the form of calcium carbonate) is mainly excreted via the
kidneys. When excreted, excess calcium carbonate gives the rabbit's urine a white or cloudy appearance. You may notice a white chalky residue on the bottom of your rabbit's cage after the urine has dried. This thin white chalky residue is not necessarily cause for alarm. However, it does indicate that your rabbit has more calcium in his diet than he needs, and you may need to make some dietary adjustments. In some rabbits, the calcium carbonate in the urine binds together to form stones in the kidneys, bladder or ureters. What causes this mineral to bind together in some rabbits but not others is still unknown. Sludge, on the other hand, refers to a large number of small 'crystals' in the urine, which make the urine thick, gritty, sandy, or creamy and difficult or painful to pass. Calcium is necessary for strong bones and teeth, so it
should not be completely eliminated from your rabbit's diet. Alfalfa hay
has more than twice as much calcium Calcium metabolism in rabbits is not fully understood.
As Laura Atkins and Susan Smith Ph.D. point out on their web site, www.carrotcafe.com,
there are many complex elements to consider when discussing calcium levels
in vegetables. For example, if the calcium measurement was based on 'dry
weight', the vegetable's water content may not have been taken into consideration.
Also, most vegetables contain oxalates, which bind Other factors for developing
stones Unfortunately some of these factors, such as genetics, will be unknown to most owners and other factors cannot be prevented. Therefore it's important to watch your rabbit closely to see if there are possible behaviours or dietary concerns that put him at higher risk. Possible Signs of Urinary Problems
Jack's story: Jack's diet at the shelter had consisted of unlimited high fat, high calcium, low fibre pellets and alfalfa hay. I switched him to rationed high fibre pellets, and added numerous vegetables and timothy hay to his diet. He enjoyed the veggies, but wasn't interested in the hay. I suspected painful molar spurs might have been causing his gastrointestinal slowdown. However a vet checkup ruled that out: his teeth were fine. The vet palpated his abdomen to check for a possible blockage, but that was fine as well. I noticed Jack didn't drink much water, so I continued to offer wet greens and tempt him with hay. Another trip to the vet brought subcutaneous fluids (under the skin) and an injection of Reglan (a motility drug), hoping that would jump-start his GI tract. But it didn't help, so I requested an x-ray. This provided the answer: Jack had a very large bladder stone. It's size indicated it had been a long-term problem. Although I knew little of Jack's medical history, I had
witnessed a few factors that could have put him at a higher risk for stones.
I knew his previous diet was high in calcium, he drank little water and
had limited exercise. I also realized during the short time since Jack
lived with me that he wasn't the 'unclean' bunny I first thought. Actually
he was too clean, he refused to urinate in his cage. Apparently the close
proximity of bathroom and Perhaps this odd behaviour, combined with a high calcium diet, little exercise and low water intake lead to this bladder stone. Whatever the cause, the only solution now was to have the stone surgically removed. But my vet wanted Jack to be eating and pooping a bit more before the surgery so the appointment was scheduled for early the following week. That Sunday night Jack seemed uncomfortable. He sat in his litter box for long periods of time, often shifting and arching. I was very worried about him. I called the emergency clinic but the vet on call had little experience with rabbits. The next day I took him to my vet before the clinic even opened. Jack sat in his carrier looking alert and washing his face. He really didn't 'look' like there was anything wrong with him. But seeing how stressed I was, and when I explained his behaviour from the night before, my vet decided to operate early that morning. I soon got a call with bad news. The stone had left the bladder and lodged in the urethra behind the pubic bone. Not only was it inaccessible, it had torn his urethra and urine was leaking into his abdomen. My vet couldn't help Jack further. I really felt like I had let Jack down, he must have been in a lot of pain. I have two rabbits now that often have thick urine and
are at a higher risk of developing sludge or stones. Many of their siblings
have had problems with stones, so genetics may be a factor in their case.
They drink very little water, but I've found that adding unsweetened pear
or apple juice helps to make it more appealing. This trick increases their
water consumption and helps to dilute their urine. Plus they eat a lot
of vegetables. It's my hope that I can help prevent the painful bladder
problems for them that I couldn't for Jack. Carrie Long Cocoa's story: When Cocoa was a yearling, I began noticing a frequent
chalky residue in his litter box. But it wasn't until I discovered the
online resources concerning proper house rabbit care that I learned sludgy
sediment and stones could scrape the bladder wall, making it vulnerable
to infection. With this knowledge, I reduced Cocoa's alfalfa based pellets:
geared to quickly grow show rabbits, and rich in the calcium that can
contribute to sludge. During his fifth year, Cocoa began leaving puddles outside
his litter box, digging with frustration in his litter, and constantly
squatting without results - all classic signs of bladder infection. My
vet, the only exotics specialist in my northern Ontario city of 130,000
people, diagnosed a bladder infection, along with sludge and a couple
of small While treating the infection, we decided to administer
daily subcutaneous fluids to flush the bladder and possibly pass the stones.
This option best accommodated my small budget. I began further reducing
calcium from Cocoa's diet by gradually switching him For two years following, Cocoa remained healthy and active,
but then once again began showing signs of a bladder infection with blood
in his urine and increasing incontinence. A medical exam revealed a single,
large bladder stone had formed and would have to be removed. Since I was
sure I would never be able to afford the costly procedure and the medications
required, I was heart-broken. But miraculously, a number of people from
the Internet rabbit group I frequent offered generously (around $1300)
to pay for the surgery. Cocoa's life was spared! With only one exotics veterinarian to perform this operation, Cocoa's surgery could not be set into her full schedule for two more weeks. With trying to keep his appetite up (fresh grass saved his life) and having to lay towels everywhere to absorb the constant peeing, I knew he couldn't wait that long. After explaining our situation, the receptionist was kindly able to swap Cocoa's time slot with a cat spay patient. After a week of Baytril for his bladder infection, my
almost eight-year-old boy, equipped with a bag lunch of veggies and his
favourite fresh grass, went in early for bladder stone surgery. By afternoon,
the vet informed me that he had come through the operation with My vet said Cocoa's bladder had been swollen due to the
abrasive stone, so she had to sew together both the inside and outside
layers of the bladder. The doctor had done an excellent job. His inverted
abdominal stitches were seamless; he never once bothered to Since Cocoa's operation in May of 2002, I have again reduced his pellet intake to only a teaspoon per day. It was explained to me by a knowledgeable source1 that calcium content per dry weight in a pellet is more concentrated than the same amount in vegetables, which contain water. It is better, in my opinion, to give more juicy veggies than dry pellets. Soaking wet romaine, cilantro, (very limited) parsley, endive, celery, brussel sprouts, and fresh grass (in summer) are on Cocoa's daily low calcium menu, along with his unlimited timothy hay. Nearing the first anniversary of his operation, Cocoa is still healthy and happy without any reoccurrence of his stone. In retrospect, I believe the sludge and stone could have
been prevented if he had been fed the timothy-based pellet at an earlier
age. This type of U.S. made pellet is still difficult and costly to obtain
in Canada; I mail order mine, though my vet is now importing them. Exercise
also seems to be a crucial prevention factor: helping utilize the calcium
within the body, and increasing bladder function. Cocoa is a fully freeroaming My advice is to think about your rabbit's diet early in life for prevention later. For not yet clearly understood reasons, individual rabbits metabolize calcium differently.2 Most adult house rabbits don't need the amounts of calcium in alfalfa-based pellets. Many rabbits have no problems with it, but it is something to consider. Arlette Hunnakko Introduction by Carrie Long Footnotes: References and suggested reading: |
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Almost
an inch in diameter, the 'rock' is what I call the single stone surgically
removed from my boy's bladder. Not surprisingly, it gets 'oohs' and 'ahs'
from incredulous visitors, who like me, can't believe it could have been
inside a six and a half pound bunny. 