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Bladder flushing..

Oh dear [emoji38] I’m not sure Fern would welcome her [emoji38] Frosty would probably groom her until she got fed up though[emoji38]

Can you syringe the urine out of the hay end of the tray in case they can test that?

That's fine, I'm sure she'd just sit on your two and assert dominance [emoji38]

So done with this rabbit [emoji38] it's like she knows!


Sadly not, my vet said it had to be a really clean sample hence the special litter :( she peed in her carrier at the vets but because there was hay in it she wouldn't test it... Ahhhh Clementine is driving me nuts... But now ima be worried she's gunna get a blockage for the next few days [emoji849]

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I’m sure those beads will pass through fine, they’re only tiny compared with poops. They might even dissolve on the way through!

Sending lots of vibes. And some hugs xx
 
I’m sure those beads will pass through fine, they’re only tiny compared with poops. They might even dissolve on the way through!

Sending lots of vibes. And some hugs xx
Thanks Zoobec :)

They wanna do another ultrasound and try and get a sample by putting a needle into the bladder... Idk why but my gut feeling is no :/ she's not even recovered from the last time, and they'll have to sedate her again... Idk.. Idk what to do :(

And they tried last time but they couldn't even do it.. They said they'd put the cat litter down.. But I said she eats it.. Idk.. Its not going well!

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Hi Graciee,

Just wanted to see how clementine is doing, and sorry to hear she’s not yet fully recovered.

When we get urine samples, we use the back of a puppy pad which is a smooth surface, out of a new packet which won’t allow the urine to absorb, we then use a brand new syringe out of a sterile packet and use that! If they need a urine sample, can they not try expressing the bladder or is it still too tender?

For the potassium citrate, we have it in powdered form from our vet and mix a small pinch with some water twice daily, and syringe this into bailey. He isn’t very keen at all, but he knows once it’s done he has a treat.. which makes it easier! ��

Our vet also wants us to go in for 6-9 monthly blood tests to check his potassium levels are okay and not causing any issues with any other chemicals/values in his body!

He does still pass sludge, but it’s not huge amounts. At least he seems to remain comfortable which is the main thing! (although we do have a keep an eye out for infections, as he is prone to these now)

Hope you don’t mind me asking, but what’s her urine like? Does she pee normal amounts or more smaller and often? also, can you see any crystals/sediment in there?
 
Hi Graciee,

Just wanted to see how clementine is doing, and sorry to hear she’s not yet fully recovered.

When we get urine samples, we use the back of a puppy pad which is a smooth surface, out of a new packet which won’t allow the urine to absorb, we then use a brand new syringe out of a sterile packet and use that! If they need a urine sample, can they not try expressing the bladder or is it still too tender?

For the potassium citrate, we have it in powdered form from our vet and mix a small pinch with some water twice daily, and syringe this into bailey. He isn’t very keen at all, but he knows once it’s done he has a treat.. which makes it easier! ������

Our vet also wants us to go in for 6-9 monthly blood tests to check his potassium levels are okay and not causing any issues with any other chemicals/values in his body!

He does still pass sludge, but it’s not huge amounts. At least he seems to remain comfortable which is the main thing! (although we do have a keep an eye out for infections, as he is prone to these now)

Hope you don’t mind me asking, but what’s her urine like? Does she pee normal amounts or more smaller and often? also, can you see any crystals/sediment in there?

Hi :)

Yea she refuses to pee if she doesn't have her litter tray with litter, puppy pad wouldn't do it I don't think, she used to rip them up and eat them (used them ages back for her, for different reason) she's a bit of a nightmare.. [emoji38]

I did manage to get this last night though she missed the tray! Idk if it's enough or what but I kept it in the fridge over night and the vets got it first thing.. So here's hoping! I spoke to my vet last night she said if I get the liquid potassium citrate and tell her the strength she'll work out the liquid dose so that should be okay, just need to go buy some and read the label [emoji38]

Her urine looks like the attached picture, it's coming out in drips again, and she often goes then hops back to the tray and goes again... It was more of a stream when she was on fluids.. I should really give her that diuretic but I'm really scared to now, I keep putting it off but it may just really help her.. Worried it'll hurt her instead though :(

What came out when they flushed her bladder was pure sludge.. I saw it, it was just loads of sediment, my vet said under the microscope she could see crystals.

They always try to express her bladder but she won't cooperate... [emoji849]

I'm hoping that sample I dropped off will be okay.. Vet has gotta check with the lab if it's enough liquid, if not she'll have to hang out at the vets next week :(
5db082f539dc8fab4b4ab0db9867baa7.jpg


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Wow, being completely honest I’d be worried there is blood present in there.. especially if it’s coming out in drips, that colour and amount was just like bailey when he was passing blood before we found out he had stones!

Has she had an x-ray after the sludge was removed? And are you sure she doesn’t have any stones? If you have and no stones, then I’m guessing her bladder lining is seriously very sore. That also explains why it'll be super painful for her to have her bladder expressed. So I wouldn't want them trying that again.

if she hasn't had an x-ray, I think this is the first call to check and make sure? our vets are adamant Bailey's stones formed after his flush.. but I always thought he probably had them beforehand and the flush made him worse!

Sorry if I’ve already asked, but is she on anti-biotics too?
 
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Thinking of you and Clementine. I've no experience of this sort of thing, so can offer no advice, but I am really sorry that it is all so stressful.

I think that your vet would have contacted you by now if the urine sample contained blood.
 
Wow, being completely honest I’d be worried there is blood present in there.. especially if it’s coming out in drips, that colour and amount was just like bailey when he was passing blood before we found out he had stones!

Has she had an x-ray after the sludge was removed? And are you sure she doesn’t have any stones? If you have and no stones, then I’m guessing her bladder lining is seriously very sore. That also explains why it'll be super painful for her to have her bladder expressed. So I wouldn't want them trying that again.

if she hasn't had an x-ray, I think this is the first call to check and make sure? our vets are adamant Bailey's stones formed after his flush.. but I always thought he probably had them beforehand and the flush made him worse!

Sorry if I’ve already asked, but is she on anti-biotics too?

See I always thought their urine could be that colour? Depending on what they've been eating? I'm no expert though!

So she's had 4 xrays in total to date, is going to have another next week, and another ultrasound to try get a sample(if the sample I got isn't enough liquid, still waiting to hear about that) the xray before the flush showed sludge, the xray after the flush showed none. And the pan that collected it all showed lots [emoji38][emoji38] no stones have been found.. But the sludge had crystals and sediment in it.

She isn't actually showing any signs of discomfort she just hates being handled, she's her normal self except she's not eating enough hay, she has output though and they are getting more golden again, but she's been eating a lot of veg, herbs, forage (fresh and dried) because I didn't wanna force feed unless absolutely necessary and I've stopped the Emeprid and she's ticking over, I will say though they aren't as huge and golden as normal.

She had a course of antibiotics, baytril which we finished sometime last week.

I hope there's no blood in that sample! I guess we'll see, she's only on tramadol now. I need to get the potassium citrate and I'm taking a day off next week to do the diuretic I think.

I appreciate your advice because I'm really lost with this!

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This sounds so stressful. Nose bumps for lovely Clem & some hugs for you xx



Thinking of you and Clementine. I've no experience of this sort of thing, so can offer no advice, but I am really sorry that it is all so stressful.

I think that your vet would have contacted you by now if the urine sample contained blood.



Thanks both :) you'd hope wouldn't you! [emoji38][emoji38]

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How long was the course of Baytril ? Was it prescribed based on the lab results of a previous urine sample ?

With bladder infections the course of abx often needs to be very long, sometimes up to 4 weeks. This is because the infection can be located deep within the bladder wall. So if the abx are stopped too soon some latent bacteria may remain and infection will kick off again.

When she wees does she strain and/or wee on herself (on her feet/inner hind legs)

One more Q (Sorry!) Has she had a recent blood test to check her renal function ?
 
How long was the course of Baytril ? Was it prescribed based on the lab results of a previous urine sample ?

With bladder infections the course of abx often needs to be very long, sometimes up to 4 weeks. This is because the infection can be located deep within the bladder wall. So if the abx are stopped too soon some latent bacteria may remain and infection will kick off again.

When she wees does she strain and/or wee on herself (on her feet/inner hind legs)

One more Q (Sorry!) Has she had a recent blood test to check her renal function ?

I wanna say it was a week... On the baytril, the pee sample I got last night was the first one we've ever been able to get.. So it was just on the off chance I think.

No straining and no pee on her

She did... I forgot to ask about the results actually...! I need to do that. I assume my vet has looked at them or the results aren't back yet? Idek.

Good to know about length of time needed for antibiotics, I'm hoping this sample will give some ideas what's up.

And I'm fine answering a million questions if anyone has any thoughts or suggestions [emoji38] this is all a bit overwhelming and I'm just so worried we won't be able to fix this.. And that'll be it :/

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See I always thought their urine could be that colour? Depending on what they've been eating? I'm no expert though!

So she's had 4 xrays in total to date, is going to have another next week, and another ultrasound to try get a sample(if the sample I got isn't enough liquid, still waiting to hear about that) the xray before the flush showed sludge, the xray after the flush showed none. And the pan that collected it all showed lots [emoji38][emoji38] no stones have been found.. But the sludge had crystals and sediment in it.

She isn't actually showing any signs of discomfort she just hates being handled, she's her normal self except she's not eating enough hay, she has output though and they are getting more golden again, but she's been eating a lot of veg, herbs, forage (fresh and dried) because I didn't wanna force feed unless absolutely necessary and I've stopped the Emeprid and she's ticking over, I will say though they aren't as huge and golden as normal.

She had a course of antibiotics, baytril which we finished sometime last week.

I hope there's no blood in that sample! I guess we'll see, she's only on tramadol now. I need to get the potassium citrate and I'm taking a day off next week to do the diuretic I think.

I appreciate your advice because I'm really lost with this!

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Yes, urine can differ in colour but when you look at that tube, there is clearly sediment in there as you can see it caught on the sides of the tube, and I wouldn't be surprised if their are blood particles present - (you can see some of the drops are light and dark, and our vets have always said blood is very common when they have anything wrong with bunny bladders - our vet never told us and just said it's expected) we only realised how much when we started testing ourselves and then discussed it with the vet! Hey I may be completely wrong but I'm sure the vet will clarify this for you. It was only a suggestion as I know how bailey's was...

Anyway it's amazing news there's no stones in there, but I've also just seen your comment to Jane about the anti-biotics. Our culture came back negative but he was given septin anyway (I think) for at least 2 weeks and we only really saw an improvement after day 10 as even we we're shocked it hadn't kicked in sooner, so it may well be worth asking to have some more?

Potassium citrate will really help her, but if she's got a really sore bladder, it may be best to try and get her bladder better first as the potassium will help make the urine more acidic, and this can also cause more pain. Bailey had a re-occurring infection about a month ago and we had to stop the potassium for 2 weeks whilst he recovered!

wishing you good luck and hope they can find out the problem
 
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I wanna say it was a week... On the baytril, the pee sample I got last night was the first one we've ever been able to get.. So it was just on the off chance I think.

No straining and no pee on her

She did... I forgot to ask about the results actually...! I need to do that. I assume my vet has looked at them or the results aren't back yet? Idek.

Good to know about length of time needed for antibiotics, I'm hoping this sample will give some ideas what's up.

And I'm fine answering a million questions if anyone has any thoughts or suggestions [emoji38] this is all a bit overwhelming and I'm just so worried we won't be able to fix this.. And that'll be it :/

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IME a week of abx to treat a bladder infection is never long enough. IME it's been 14 days minimum. Baytril is usually an effective abx for UTIs BUT it needs to be given at the correct dose (usually higher range) and for a long course.

If she had sludge then that will have caused a lot of inflammation in her bladder and an ideal environment for a deep seated infection. So I really would not be thinking the worst case scenarios, it could just be that she needs a longer course of abx, maybe a different one and perhaps a few days of SQ fluids too to get all the nasties flushing through. The fact that she is OK within herself is a positive. There are other meds that the Vet may consider trying if the condition is identified as cystitis.
 
IME a week of abx to treat a bladder infection is never long enough. IME it's been 14 days minimum. Baytril is usually an effective abx for UTIs BUT it needs to be given at the correct dose (usually higher range) and for a long course.

If she had sludge then that will have caused a lot of inflammation in her bladder and an ideal environment for a deep seated infection. So I really would not be thinking the worst case scenarios, it could just be that she needs a longer course of abx, maybe a different one and perhaps a few days of SQ fluids too to get all the nasties flushing through. The fact that she is OK within herself is a positive. There are other meds that the Vet may consider trying if the condition is identified as cystitis.

Thanks Jane that's made me feel a little better :)

So the sample I got wasn't enough, so they're gunna have her next week and try get some more to test :( was really trying to avoid that, because I just don't think it's good for her tbh. SQ fluids... Is that like the catheter in the ear? Or something else?

Asked about bloods, receptionist had no idea.. So yea.. I guess I'll be talking to my vet next Tuesday about it all :( I'm hoping we can get her on the potassium citrate over the weekend I asked them to give me the dose for that. Idk whether to insist on a catheter back in her ear.. She was peeing in streams with 10ml of fluids every 4 hours.. But she hates that thing on her ear :( wish there was another way I could get fluids into her :(

Maybe I should ask for more baytril too, probably wouldn't hurt to have it for longer? Would I have to effectively start again though? So 14 days from now? Obviously I'd get my vet to sign off on it [emoji38]
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Thanks Jane that's made me feel a little better :)

So the sample I got wasn't enough, so they're gunna have her next week and try get some more to test :( was really trying to avoid that, because I just don't think it's good for her tbh. SQ fluids... Is that like the catheter in the ear? Or something else?

Asked about bloods, receptionist had no idea.. So yea.. I guess I'll be talking to my vet next Tuesday about it all :( I'm hoping we can get her on the potassium citrate over the weekend I asked them to give me the dose for that. Idk whether to insist on a catheter back in her ear.. She was peeing in streams with 10ml of fluids every 4 hours.. But she hates that thing on her ear :( wish there was another way I could get fluids into her :(

Maybe I should ask for more baytril too, probably wouldn't hurt to have it for longer? Would I have to effectively start again though? So 14 days from now? Obviously I'd get my vet to sign off on it [emoji38]
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SQ fluids = 'subcutaneous fluids'- ie given under the skin like an injection. So no catheter in the ear needed.

Yes, another course of Baytril would need to be started as a 'new course', not a continuation of the previous one.

Why is she on Tramadol ?
 
SQ fluids = 'subcutaneous fluids'- ie given under the skin like an injection. So no catheter in the ear needed.

Yes, another course of Baytril would need to be started as a 'new course', not a continuation of the previous one.

Why is she on Tramadol ?

Ooo Idk if I can be trusted to do that... Is it difficult? Could I mess it up? I'll ask about it

Yea maybe I say shall we just do a two week course or something.

For pain I guess? Idek she was on tramadol and loxicom (so loxicom she was on for a week before the flush and a week after, maybe a week and a half I have to admit I've kinda lost track of time) but vet said she didn't want her to be on loxicom any longer, can be bad for them? Idk? But said to stay on the tramadol.. I picked a new bottle up this morning. I guess maybe because she wasn't eating much they thought she could be in pain? Idk. Either way she's meant to be having it 3 times a day now she's not on the loxicom, I've only been managing 2 x a day though, and tbh one morning I forgot.. And she was no different.. Honestly she deserves better I've been so busy I'm all over the place it's so hard to do all the meds when I'm not at home enough. But it makes me wonder if she's even in pain.. Without it she was fine. Its all such a headache [emoji849]

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Ooo Idk if I can be trusted to do that... Is it difficult? Could I mess it up? I'll ask about it

Yea maybe I say shall we just do a two week course or something.

For pain I guess? Idek she was on tramadol and loxicom (so loxicom she was on for a week before the flush and a week after, maybe a week and a half I have to admit I've kinda lost track of time) but vet said she didn't want her to be on loxicom any longer, can be bad for them? Idk? But said to stay on the tramadol.. I picked a new bottle up this morning. I guess maybe because she wasn't eating much they thought she could be in pain? Idk. Either way she's meant to be having it 3 times a day now she's not on the loxicom, I've only been managing 2 x a day though, and tbh one morning I forgot.. And she was no different.. Honestly she deserves better I've been so busy I'm all over the place it's so hard to do all the meds when I'm not at home enough. But it makes me wonder if she's even in pain.. Without it she was fine. Its all such a headache [emoji849]

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Well IME both for myself (Tramadol makes me feel awfully sick) and in Rabbits Tramadol can cause loss of appetite. I can understand the Vet wanting to be careful re Metacam if any Kidney issues may be involved. But equally I would want to ask the Vet specifically why Tramadol is being prescribed as it is not without it's own side effects.

SQ fluids are easy to give, the Vet or a VN can give you a few lessons. Clementine may only need them for a couple of days, just till the abx kick in.
 
Well IME both for myself (Tramadol makes me feel awfully sick) and in Rabbits Tramadol can cause loss of appetite. I can understand the Vet wanting to be careful re Metacam if any Kidney issues may be involved. But equally I would want to ask the Vet specifically why Tramadol is being prescribed as it is not without it's own side effects.

SQ fluids are easy to give, the Vet or a VN can give you a few lessons. Clementine may only need them for a couple of days, just till the abx kick in.

There's no kidney issues that I'm aware of atm obviously no blood results yet..

It's just for if she was in pain I think, it was introduced after the flush so makes sense, I didn't know it can reduce their appetite though! Although Clementine seems to be getting her appetite back actually, it's just not as much hay as I'd like tbh.

What a mess :( I'm hoping they'll email me back regarding doses for the potassium citrate.. I found a Lloyd's pharmacy kinda near by in a large Sainsburys so I can go get that one you linked, I've sent a pdf of the label to my vet. Just hoping they'll work it out [emoji38]

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So that liquid potassium citrate is out, my vet and William said no because it has ethanol in it. They wouldn't want to give it to a rabbit. So no potassium citrate for now.

Bloods look okay, one parameter is normal the other the urea? Is 3.5.. Bottom parameter is 3.6 so its just slightly below, Idk if that's a problem Idk even know what urea is or if I'm spelling that right.. [emoji38] Anyway ima discuss is more detail next week when I drop her off for them to try get a sample etc.

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