urine retention / manually expressing a rabbit ?

We've just joined here - hello all.

We've got a question on manually expressing a rabbit (giving him a helping hand to empty his bladder by applying pressure to it) - but it is probably best to give a bit more background information first.

one of our rabbits - jaro - has been having a bad time of it over the last few months.

(if you didn't see our intro post - this is a piccy of him http://www.midnight-raven.co.uk/buns/washing.jpg

He's got renal failure which has resulted in a build up of urine in his bladder - which in turn has caused his bladder to bloat. He is still peeing, but obviously not enough to empty his bladder.

The vets have done various tests - including for e-cunniculi which he has (although this in itself may meen nothing, as many rabbits can carry this parasite with no ill-affects).

His calcium blood levels were high too - even though he was on a relatively low calcium diet. His calcium intake has been reduced further by changing his diet (change of pellets to timothy hay based - and less of them too) - which has brought his blood calcium down.

His urine is quite 'sandy' - although this does not appear to be 'bladder sludge' as calcium levels are normal in the urine - and may be a factor of urine sitting in his bladder for some time before being peed out.

The vet has checked for stones and none were indicated.

Day to day - Jaro is fine, going through his normal routines and eating / drinking as normal (possible drinking is higher than it used to be - but that would reflect the kidney problem he has).

As his bladder gets more full, the urine is backing up and preventing the kidneys from working correctly (and has probably caused permanent damage in there) - this forces nitrogen levels in his blood up too.

At the moment we are taking him to the vet when we think his bladder is getting too full - for them to manually express him - literally squeezing the bladder empty.

Our question (finally ) is how we can help Jaro to pee more regularly without the dangerous risks of manually expressing him ourselves - which we have tried albeit very tentatively.

Apparently there are herbal diuretics (like parsley) which can help - but we dont want to get him making more urine which will fill his bladder up more quickly - we just want him to pee as much out himself as possible.

Alternatively if anyone knows of a good source of information on how to manually express him ourselves - that would be great.

thanks for reading all that - and for any help advice anyone has got

Martin & Pam

Awww poor bunster , I don't know but wanted to say best of luck with your mission.

I wonder if cranberry juice would help - like with humans - it is supposed to be good with infections causing problems urinitaing but not sure it would be relevant here. I know pure unsweetened apple juice is used to get buns to drink more water. I wonder if cranberry juice is safe or would even help. :?:

Dandilions are diuretic (unfortunately they can also cause loose stools), I don't know if this would encourage him to pee more regularily or make the problem worse.

I can't help with advice about manually expressing rabbits but Jay and Adele have lots of experience with special need rabbits so may be able to help more - I am sure one or both will be along soon!

Caz

I think really the main thing here is to get more practice with your vet or vet nurse showing you what to do so you can have a proper go yourself...it takes a bit of getting used to sometimes!

From a cystitis sufferer here, i don't know if anyone has tried Cranberry juice?...well it works absolute wonders in preventing urinary infections but believe me it makes you want to well errm...... GO!! :lol:

So if bunny isn't passing the urine in the first place it might just be the same affect as the Parsley you mention, Martin!!

Brings tears to my eyes! Oh Dear!

Martin, I don't know if this is any good to you as I have just found it, I haven't registered but it may be of interest : http://groups.yahoo.com/group/cfr-rabbits/

Hiya, I have read through your post with interest, as we too had a bunny with a similar problem for a year.
Melissa had excess calcium in her diet, being fed predominantly pellets before she came to us.
She was in a dreadful pickle and it took a whole lifestyle change to get her back on track.
Basically the bladder sludge/ excess calcium in the kidneys took a year to get rid of properly, and I added a quarter teaspoon of fresh lemon juice to a syringe of water twice weekly to help dissolve the sludge, but only in tiny doses!.
I gave unsweetened Cranberrry juice diluted in a syringe three times a day (for a year), and took Melissa off pellets/ dried food completely. She never has any dried food now, only hay and a handful of parsley for her bladder (every other day in moderation as parlsey is classed as a green)
No vegetables as carrots , cabbage, brocolli and even celery make things worse.
Purely hay only, and plenty of water to keep flushing the kidneys out, even if you have to syringe it yourself.
I kept Melissa on baytril for a year as each time she came off it, infection reoccured, and being in a weakened state the infection could have killed her if allowed to take hold.
I expressed her bladder three times a day, holding her over a bowl or in the garden and very gently with teh flat of my hand pressing across the lower abdomen. The vet may have a specific technique but I used my own..as long as you are gentle and not pressing on an organ you should be fine.
Or Ask your Vet to show you first.

After a year of this routine, Melissa came off baytril and has a course every two months just as a preventative, and nothing except hay and a handful of parsely in her diet for LIFE.
Dried food , even the low calcium one is too much for bunnies in kidney failure(hope I am not clashing with your Vets advise here, but adult bunnies really do not need dried food) ), all the nutrients they require are in the hay.
If your bunny has actual kidney failure then it is better to keep them on Baytril for the rest of their life, not to wait for infections to redevelop.


Hope this helps a little :wink:

Thanks for the feedback there - some good advice

do we need to get Baytril from the vet on prescription only ? he's on it at the moment, and I must say it does seem to make a difference, although we only have about 3 days supply in total.

He had a bad turn last week when his blood urea(?) levels went sky high and put him off food and water (very unusual - he normally eats anything) - he had to go in the vets overnight on a drip - and was much better afterwards.

So we are obviously keen to avoid all that again - and keep his bladder as empty as possible.

His calcium intake was already pretty low as he was on a pretty good hay intensive diet - with only limited (low calcium) pellets, so the high blood calium levels are more likely due to kidney problems - although we have further reduced it to reduce the overall levels.

We'll definitely try the cranberry (still not sure on the parsley - we really dont want to increase his urine production without solving the peeing / expressing first) and will try to get the vet to show us how to do it ourselves.

The vets are a bit hesitant about showing us how to express him ourselves - i think because of the risks involved - but we are keen to keep his vet visits to a minimum to avoid stressing him unduly.

Sounds like keeping him on Baytril would help too.

Thanks for the link to the renal failure group too - we had joined there -although it's pretty quiet - not like here

thanks again

Martin & Pam

Baytril is perscription only but your vet should be able to give you a repeat without seeing the bun everytime. You should get more then a 3 days course too, usually 7-10days is normal though in your case it might be longer anyway.

What sort of hay are you feeding? Some brands have higher calcium levels than others, Alfalfa being one of the highest.

Did the vet treat the EC? Although it doesn't reverse damage it can stop further progression. Its usually a months course of pancur.

There are some references on reneal failure here: http://homepage.mac.com/mattocks/morfz/rabrefs.html#kidneyfail

Best wishes,
tamsin

hi martin and pam

to be honest i have no advise for you, i have not yet had to deal with anything like this before and hope not to, but with 12 bunnys i wont hold my breathe :lol: :lol: .

i just feel a great urge to commend you on all your hard work and efforts to try to keep this bunny in good shape, it is heart warming to see as i feel so many people would come acrossed a problem like this and do the dreeded pts.

so from me and probably everyone here i wish you and your bunns the best wishes

Eve x

thanks again for the advice...

Tamsin...

we're feeding him a mix of timothy hay and 'standard' meadow grass hay (local supplier here - not sure on exact type but should be grass rather than legume (?) based like alfalfa).

on the Baytril -I meant we had 3 days left - we had about 7 days in total, which by the sound of it isn't enough - I'll definitely try and get some more.

The vet was hesitant to overdo the Baytril - citing concerns over GI balance - although we think his bladder is probable more of an immediate concern at the moment.

Yep he underwent about 5 weeks worth of fenbendazole (parafend) for EC - we are still waiting the bloodtest results on how successful that has been.


Thanks for the comments Eve - atm his quality of life is no different from normal - apart from the discomfort when his bladder is full - which we are desperately trying to 'manage' out of the equation - so the efforts we are putting in are just what feels natural to us. Just this morning he was back on the top of the sofa back against the wall - which he knows he's not supposed to do and bouncing back on to the cushions, its moments like that that convince us to keep going.

thanks again all

Martin & Pam

Thanks for the comments Eve - atm his quality of life is no different from normal - apart from the discomfort when his bladder is full - which we are desperately trying to 'manage' out of the equation - so the efforts we are putting in are just what feels natural to us. Just this morning he was back on the top of the sofa back against the wall - which he knows he's not supposed to do and bouncing back on to the cushions, its moments like that that convince us to keep going.

thanks again all

Martin & Pam[/quote]

oh martin i am pleased his quality of life is not altered, and that his condition is manageable, great stuff!!!!
keep up the good work!!!!

Your vet might be able to give you a probiotic (friendly bacteria) or you can buy it without perscription. That helps prevent any problems the ab's could cause. If you do find he develops a poop problem, then you could always switch to injections (the vet can show you how to do this and prepare the syringes for you). With his diet being mostly hay already though I imagine you shouldn't have too much trouble.

He sounds like a lovely chap

Tam

Ah bless him, sounds like you are going through the mill with him!! As far as gut problems go, I'd def recommend a probiotic, you can buy tubs of them on the internet or sachets from the vet (although this will work out more expensive long term so buying off internet would be better). I think it is called AviPro or something similar, I know some people on here have brought it. My bun is on a 2 week course of Baytril (making it in total 3 weeks) and she has been on probiotics all along and no probs gut wise at all. As he is on mostly hay you shoulldn't have too many problems anyway, as Tamsin said.

Good luck with him, sounds like you are doing all you can for him

Nicola

Martin, Baytril is fairly safe long term as it is the antibiotic that least affects the friendly Gut bacteria.
As Tamsin said you can ask your Vet for a probiotic for the drinking water, or buy some yourself online (which works out cheaper ) and use it for a few months.
Vetark sell a probiotic online, which we always have in our rabbit medicine box :wink:
www.noahs-cupboard.co.uk
Best wishes

Zeus has been on long courses of Baytril (2-3 months) and the vet has sold us a full 100ml bottle straight from their cabinet (without decanting) before. We were lucky and never sufferend any GI problems at all.

He is now on injectable penicillin, which has a high GI risk so we are using AviPro Plus in his water and so far have had no problems.

Caz

Thanks again for all the info.

We tried again to express him at home tonight - but nothing came out - although he doesn't feel at all bloated at the moment, so hopefully he is peeing what he needs to.

I'll definitely talk to our vet about getting a longer course of Baytril. He was put on a 10 day course in early December which in retrospect seemed to sort him out for around 5 weeks. Since mid January we have had 2 episodes of bloated bladder with the last being more serious, so it seems Baytril is the key.

We'll order some of the Probiotic too - sounds good to have around for our other bun too.

thanks

Martin & Pam

Not sure whether this will help, but here it goes anyway:

My bunny Sunny had calcium sludge in his bladder and had cystitis regularly meaning that it was too painful to wee. Vet gave him antibiotics and anti-inflamatories, which worked to start with, but then after a few months didn't anymore. The bouts of cystitis got more and more frequent until he got it almost every week. The bladder had to be expressed and he was on pain killers.

When nothing worked anymore, my vet suggested to try a vitamin C supplement to acidify his urine a bit. And bingo - no more cystitis since then, and that was 3 years ago! I once stopped giving him the vitamin C to see whether he would be ok and the cystitis returned promptly. So he is on it for life. I get the tablets from Oxbow (http://www.vetbed.co.uk/smallanimals/gtn50c.html).

Not sure whether it might help in your case, but worth a try I guess!

Vera