Bladder Sludge

[Bun4Life]

We have a bit of an unusual situation in that we’re 2 hours from a vet. We usually have one come visit us and do all the vaccinations etc in one day. This vet was primarily equine but since knowing us and our rabbits, he’s taken an interest in them and has even done a course to help treat them.

Anyway. Our 7 year old Poppet is a spayed female rescue. She’s been bonded to her husbun for 6 years. Both are house rabbits. When Poppet was around 2, she started passing bladder sludge and crystals. Vet gave her a check over, took her in for X-rays and cultures and put it down to hormones as at the time, her partner had ‘spring fever’. Vet said it would clear up once they settled into the season and surely enough, it did.

This then happened annually, almost like clockwork. We’d head into spring, husbun would get honky and Pop would pass sludge. We give her apple juice in her water and dandelions to help and then it usually clears up after a couple of weeks. Her mood, eating and toilet habits remain unchanged.

This year, we’re in week 6 of it. Husbun still honky, Pop still passing sludge. She’s at the point now where her genital area is soaked every morning so we’re also having to give her bum baths and wash her bedding every day. Vet visited and said it’s likely just prolonged spring fever but prescribed some antibiotics at the week 4 mark whilst he consulted with a colleague. This has made no difference.

We’re reluctant to take her on the 4 hour round trip to have an X-ray/needle inserted into the bladder for cultures. Vet believes the stress of this might just make things worse. Vet’s colleague suggested giving some good gut bacteria and a hormonal treatment (usually used for horses). We’ll start on the bacteria but I haven’t been able to find out much about the hormonal treatment.

We’re also now using a calming spray for the husbun to reduce his honking and this has helped a bit.

Has anyone tried hormonal treatments before?

Or has anyone had a bun suffer with sludge and can offer some tips we haven’t yet tried?

 

[Shimmer]

Has he been neutered? If not, it may help with the behaviour and reduce her stress, which in turn may help with the bladder sludge.

I would suggest that she needs some more / different antibiotics and possibly pain relief. What was she prescribed before?

If she's fed any of the cabbage family (kale, spring greens, etc) or spinach, I would reduce / remove that from her diet at the moment as well. Lots of fluids is always good to help flush out the bladder, and being encouraged to move around. So fresh grass, wetted greens / forage, etc. She will also need her bum to be kept clean and dry, otherwise she will develop urine scald and be a prime candidate for flystrike. If there are no cats around, you can use F10 germicidal wound spray with insecticide against flystrike - and it can be used on broken skin.

https://hyperdrug.co.uk/f10-germicidal-wound-spray-with-insecticide-100ml/

I would ring your vet anyway. You can always do videos of her behaviour and pics of a urine sample to show how cloudy it is as a starting point. I was wondering if you could get a urine sample to your vet via an express postal service? You may have to pack it with an icepack so it doesn't go 'off'.

 

[Shimmer]

Not sure why your vet needs to insert a needle into the bladder for a sample of urine. Usually they express the bladder manually and collect the urine that way. Or if bunny happens to wee on the examination table duringthe appointment.

 

[InspectorMorse]

I would be very concerned about the constant urinary incontinence as it could indicate that there is now some very thick sludge in the bladder that is impossible to pass and will eventually form bladder stones. Personally I would want another X-ray done to establish the extent of the bladder sludge now, catheterisation and bladder flushing might be necessary. Or maybe aggressive fluid therapy (IV or SQ) and a diuretic to try to dilute the sludge and increase urination.

I would also want a full blood profile run, including a hormone panel. I am not convinced that hormone treatment would be of any benefit and I certainly wouldn’t want it started without clinical evidence of the necessity to do so.

Is the Doe a good weight? Is she active or does she spend a lot of time resting? Lack of exercise and/or obesity can contribute to bladder sludge problems.

What does her diet consist of?

Re hormone treatments. I only have experience of the use of a hormone implant (suprelorin) to treat Adrenal Gland hyperplasia.

 

[Bun4Life]

Thank you for your help.

Husbun is neutered, has been for 7 years.

Pop is a good weight, she’s out all day in the field so gets plenty of exercise. She’s very active, loves to dig and “garden” and this has continued.

Her diet consists of veggies served 2 x a day and unlimited hay plus dried and fresh dandelions. She also grazes on the grass all day. Veg includes parsley, coriander, mint, dill, basil and spring greens. She demolishes the herbs and tends to only go for the spring greens as a last resort.

We treat for fly strike after every bath. She can get down there to clean easily, she can also still bend around and do her tail and above.

A urine sample has already been done, it showed no sign of infection. Vet explained that some bacteria don’t show after being exposed to oxygen, hence the general course of antibiotics just in case. I don’t recall the name of the drugs, I definitely remember him combining two different types in one course though.

The needle into the bladder would not be to collect urine. It’s to see if there is bacteria in the tract.

She hasn’t had her bloods done, I imagine that would be the next step if I opted for the hormone treatment. That is something I can ask for.

Vet is of the opinion to wait and see, as it’s happened every year before. The soaked bum is new though so I just don’t know how best to proceed. Plus Husbun’s spring fever has lasted so long this year. One of the horses has been the same.

Another point to mention is that she only seems to pass the sludge when she’s handled/being chased by husbun. Otherwise it’s just fairly normal wee she does but seemingly a lot more of it than normal. (We only handle her for baths/when vet checks her.)

 

[Shimmer]

It sounds like there is a significant amount of sludge depositing in the bladder. I would probably be looking at washing out the bladder under a GA to remove all the sludge, then assessing why it was happening and working at reducing the likelihood of it recurring. While there is sludge there, it will be irritating the urinary tract (hence the leakage) and possibly providing a hiding place for bacterial build up, which could affect the kidneys. It needs sorting out.

This may be useful:
https://www.harcourt-brown.co.uk/ar...-sheet-for-rabbits-with-urinary-tract-disease

 

[Bun4Life]

Thank you, shimmer.

It’s looking like a vet trip is inescapable isn’t it.

I had considered borrowing a friend’s caravan for the trip. Perhaps let her have an explore in it the day before then take her over with husbun. At least then I can put her blanket and bed in it. I also have the calm spray. I don’t want to make the situation worse by stressing her out.

I’ll make an appointment and let you know how we get on.

Thanks again.

 

[SarahP]

Not sure why your vet needs to insert a needle into the bladder for a sample of urine. Usually they express the bladder manually and collect the urine that way. Or if bunny happens to wee on the examination table duringthe appointment.

As far as I know, they do it to try to get a sample to test for bacteria, otherwise you can't be sure where any bacteria that grows has actually come from.