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Bladder flushing..

I'm really upset tbh :(


She's home and doing okay, very sleepy etc... We are doing SQ fluids at home because they couldn't even get a catheter in her ears apparently there's so many bumps from old ones etc.

I asked the vet nurse what the plan was going forward, and said that it's not great having to flush once a month and she said yea Idk really, then mentioned quality of life :/ so idek anymore. I can't believe it's come to this.. And I think ima need a second opinion for sure... Obviously I understand what she meant and I agree, but there's no suggestions on how to manage it.. And no ideas, and idek if there's any medications we could try.. Seems like they have no answers :/

I'm really really upset and I can't believe it's come to this. It's just like the legs all over again, she's absolutely fine and happy, it's just something important is fundamentally not working :/

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Can you get to Maidstone Gracie ? If so I am 100% certain Mark Rowland would be able to offer some options and also look at the bigger picture- ie Clementine's orthopaedic history and also if there is anything else physiological/systemic going on . It seems that everything is being focused on the bladder problem atm, but maybe not on what could be the primary cause of it. Eg is her immobility related to her orthopedic issues or another problem. Is it 'lethargy' due to poor exercise tolerance and if so what is the reason for that. Obviously I am not in any way qualified, but from what you have posted the current Vet seems to have a bit of 'tunnel vision' re the bladder issue. I may be completely wrong though.

And yes, there are some medications which could be of help and there is no way I'd be thinking along the 'quality of life/PTS' issue at this stage. So please dont get upset about that prospect. IIWY I'd give Trinity Vets a call today, explain your situation and that you would like to obtain a 'Second Opinion' specifically from Mark. Hopefully he's not away on Holiday.

http://trinityvetcentre.com/

Or if you prefer you could call your current Vet today and request that he/she Refers you to Mark

http://trinityvetcentre.com/referrals

I hope that Clementine is recovering from her procedure and that she is eating OK. Sensing lots of vibes for her x
 
I'm sorry you're so upset, Gracie :( I agree with Jane's post. I would be looking for a second opinion.
 
I’m sorry you are in this position :cry: I agree, I would go for a second opinion. Topping up the vibes and hugs xx
 
So sorry that you and poor Clementine are going through this. I really hope you can get a second opinion. Lots of hugs and nose rubs xxx
 
Can you get to Maidstone Gracie ? If so I am 100% certain Mark Rowland would be able to offer some options and also look at the bigger picture- ie Clementine's orthopaedic history and also if there is anything else physiological/systemic going on . It seems that everything is being focused on the bladder problem atm, but maybe not on what could be the primary cause of it. Eg is her immobility related to her orthopedic issues or another problem. Is it 'lethargy' due to poor exercise tolerance and if so what is the reason for that. Obviously I am not in any way qualified, but from what you have posted the current Vet seems to have a bit of 'tunnel vision' re the bladder issue. I may be completely wrong though.

And yes, there are some medications which could be of help and there is no way I'd be thinking along the 'quality of life/PTS' issue at this stage. So please dont get upset about that prospect. IIWY I'd give Trinity Vets a call today, explain your situation and that you would like to obtain a 'Second Opinion' specifically from Mark. Hopefully he's not away on Holiday.

http://trinityvetcentre.com/

Or if you prefer you could call your current Vet today and request that he/she Refers you to Mark

http://trinityvetcentre.com/referrals

I hope that Clementine is recovering from her procedure and that she is eating OK. Sensing lots of vibes for her x

Ohh yess, I'm just seeing how she goes atm (altho there's more poops and she's already eating a little hay so way better than last time already recovery wise) but I think ima be calling this week and try get in next week with him (just don't wanna take her if she's really unwell like last time she was terrible for a week at least wouldn't have wanted to take her that far in that condition you know?) but if she continues like this to get over the flush I wanna get the second opinion ASAP. My only concern is the Dartford crossing (because I live near it I know the hold ups, the traffic it's like constant, but it's gotta be done - I drive over it frequently, but again wouldn't wanna get stuck on the other side with her maybe I'll take supplies incase - the other week my mum didn't get home til 11pm, there was a fuel spillage and they had to resurface the whole section of road [emoji849][emoji849][emoji38]) we really need more tunnels! That's a tangent though! Does trinity vets have parking does anyone know?

I was gunna ask, have you used potassium citrate ever? Doesn't it change the pH of the urine? Or am I getting confused? Coz I saw this

https://rabbit.org/health/urolith.html

Idk how good of a source it is but it says this...

Not useful - Urinary acidifiers - Due to the fact that rabbits are herbivores, and their urine is normally alkaline, using products designed to make the urine more acidic not only will not work, but in some cases could be harmful. This is different than the situation in cats, which are carnivores with naturally acidic urine. In cats with bladder stones it is common practice to administer urinary acidifiers or to feed special diets designed to create a slightly acid urine to prevent further stone formation.

Just basically wondered what your thoughts on it was tbh. I wonder if that's why my vet hasn't bothered with it? Idek.

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I'm sorry you're so upset, Gracie :( I agree with Jane's post. I would be looking for a second opinion.
I’m sorry you are in this position :cry: I agree, I would go for a second opinion. Topping up the vibes and hugs xx

So sorry that you and poor Clementine are going through this. I really hope you can get a second opinion. Lots of hugs and nose rubs xxx

Thanks everyone, will definitely be getting one, Clementine deserves better than this xx

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I'm sorry I've not caught up with Clementine's thread for a while. Really sorry you're still struggling with her. It seems like you've done & considered everything you can. I hope you are able to see a specialist & can get a treatment plan going for her. Hugs & vibes xx
 
I'm sorry I've not caught up with Clementine's thread for a while. Really sorry you're still struggling with her. It seems like you've done & considered everything you can. I hope you are able to see a specialist & can get a treatment plan going for her. Hugs & vibes xx

I really hope so too, she's such a fighter.

The SQ fluids are going okay, it's easier than I thought but I hate how tough her skin is, and the pop feeling when you get it in... It's not pleasant but she doesn't seem to mind [emoji38] also she doesn't have enough loose skin for my liking, I made "tents" on the other three and they'd be way easier to do it on, she's so... Plump? She doesn't seem to have much excess skin [emoji849][emoji38]

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I don't have any advice but I've just caught up with this thread and really feel for you and Clementine. I would definitely consider a second opinion, and I hope you can get to the bottom of it really soon. She's lucky to have you fighting her corner xx
 
I don't have any advice but I've just caught up with this thread and really feel for you and Clementine. I would definitely consider a second opinion, and I hope you can get to the bottom of it really soon. She's lucky to have you fighting her corner xx

Thank you :) yea I'm hoping the new vet will be able to help her x

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Have just caught up with this, I’m so sorry clementine is not well. It’s so stressful when buns get ill as it has an impact on everything.

Thoughts are with you Clementine
 
Have just caught up with this, I’m so sorry clementine is not well. It’s so stressful when buns get ill as it has an impact on everything.

Thoughts are with you Clementine

Thanks Zigzag x

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Just gave Clementine her pain meds and 1/4 of that diuretic human tablet thingy - staying close by I hope it'll be okay D:

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I am sure she'll be fine, she will just wee and probably drink more xx
So far so good! Tbh with you I've not seen her drink or her water bowl level go down at all since she came home :/ I don't think she drinks enough, not sure how I can fix that though :(

She's had a few more treats today [emoji38] just so I can make sure she's herself, she gets all excited for noms so this way I can make sure she's okay [emoji38]

Do you think it's okay to give her the tablet diuretic, and natural ones? Or is that over kill? Because she's now happily taking two of the oxbow urinary support tablet treat thingys per day, and she loves dandelion roots (another treat, but again a natural diuretic [emoji38]) and I'm growing ribwort which I just found out is one too, I was actually growing it for Atticus it doesn't upset him too badly but she could have some too.. I just don't wanna over do it!

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Hi graciee

I’ve been meaning to post on this thread for such a long time (I did once and then it was lost by my phone and I never got chance to start again)! One of current bunnies (Dusty) suffers with sludge and we have been on a very long journey the last 18 months or so! I am by no means a rabbit expert but I hope what I’m going to write might be helpful! (It’s likely to be a long post! Sorry!)

Dusty is a rescue bun and was previously owned by someone else and came to live with us in March 2018 as she had lost her partner and we were looking a new partner for our other bunny Axl after his sister died. She’d had one episode of sludge problems a few months before but had been fine after a bladder flush. Within the first week of us owning her she had a major UTI which gave her urine scald and gut stasis - this was put down to the stress of bonding and moving to a new home. She perked up with antibiotics and usual stasis treatment but a month later had another which required a 2-3 month course of antibiotics to resolve. An ultrasound of her bladder showed significant bladder sludge but our vet was reluctant to flush her bladder as did not want to give her an anaesthetic or sedation due to the stasis so we were giving sub cut fluids for the 2-3 months also (as well as metacam). Once the uti resolved we slowly reduced her fluids and pain relief but 2 months after stopping we noticed that she was starting to leave damp patches on her tiles and when I picked her up the fur at her back end tinged with wet urine. Our vet thought maybe she may have some arthritis causing difficulty living her tail so so We restarted the fluids and pain relief but after a few months didn’t notice any massive improvement .

At this point our vets opinion was that we should just live with it, her fur was only tinged and she was generally happy in between her utis and stasis episodes caused by other things (she had two dentals last year also so was pretty much in stasis every 2 months for some reason or another!). I wasn’t happy with this as I felt we were just firefighting rather than providing a good maintenance strategy. in February this year we got a second opinion from a specialist (CJ Hall). They agreed with me that we were fire fighting and did a full review. Full body xrays showed no evidence of arthritis and her bladder did not show any sludge. They diagnosed her as having a cystitis/bladder wall irritation likely due to previous sludge and utis which was causing her to urinate very small amounts. We left them on additional pain relief (tramadol) and cystaid and potassium citrate and to be honest it’s been a massive game changer for us. She is now off the tramadol and continues with the sub cut fluids daily to help her keep flushed as well as the potassium citrate and cystaid

(I have just arrived at work so cant carry on with my message but I’ll finish up later and answer any questions of you have any!)
 
I can finish now!

Since we started the cystaid and potassium citrate she has only one episode of what we think was uti. A urine sample tested positive for ecoli but it needed a specific antibiotic that proved hard to get hold of. And by the time we did, her symptoms had resolved and a further urine sample was negative for ecoli. When she has uti’s or sludge problems she will sit in the same spot, urinate on herself, or urinate in small amounts in multiple places, and will sit and squeak while she strains to push it out. Sometimes you can see sludge too coming out too - like toothpaste


As I said above we are now off the tramadol (I didn’t think it helped much anyway to be honest except in the very initial instance when she is unwell) but we keep a bottle at home incase she is unwell as it’s helpful to have additional pain relief if the metacam isn’t touching it. She continues with the cystaid and potassium citrate every day and we vary her fluids depending on how she’s doing - routinely she has 60mls per day but can go up to 100mls depending on how she is. We give the fluids once a day as she’s not massively keen on all the handling so this gets it out of the way in once go, but sometimes when unwell I give over two sessions for more of a spread.

In addition to medication we avoid all high calcium veg and she eats mostly cucumber and celery which we personal in water before giving. We have switched to bottled water (Tesco ashbeck) and if we can get grass we do and presoak also. We also cut pellets right down (she used to have half an egg cup now she only gets a teaspoon which is only about 4 sticks!). She also has long term ranitidine to protect her gut

It’s always a difficult balance as dusty is also prone to dental spurs - so spurs stop her from eating, drinking and moving so that can increase the affect of sludge because she’s not urinating it out or moving around to break it up. And sludge can cause reduce eating and cause pain so she doesn’t eat and then I worry about spurs!

We seem to be in a good place at the moment and when she had a dental recently we managed to keep her clean and she suffered no bladder affects as a consequence. We feed her on a fairly strict schedule and as a consequence we are able to notice any changes in behaviour/eating within a matter of hours and that has helped us to be very responsive to medication adjustment etc.

Sorry! I know that’s very long - I hope it’s helpful and I’m sorry for wasting your time if it doesn’t help!!
 
I can finish now!

Since we started the cystaid and potassium citrate she has only one episode of what we think was uti. A urine sample tested positive for ecoli but it needed a specific antibiotic that proved hard to get hold of. And by the time we did, her symptoms had resolved and a further urine sample was negative for ecoli. When she has uti’s or sludge problems she will sit in the same spot, urinate on herself, or urinate in small amounts in multiple places, and will sit and squeak while she strains to push it out. Sometimes you can see sludge too coming out too - like toothpaste


As I said above we are now off the tramadol (I didn’t think it helped much anyway to be honest except in the very initial instance when she is unwell) but we keep a bottle at home incase she is unwell as it’s helpful to have additional pain relief if the metacam isn’t touching it. She continues with the cystaid and potassium citrate every day and we vary her fluids depending on how she’s doing - routinely she has 60mls per day but can go up to 100mls depending on how she is. We give the fluids once a day as she’s not massively keen on all the handling so this gets it out of the way in once go, but sometimes when unwell I give over two sessions for more of a spread.

In addition to medication we avoid all high calcium veg and she eats mostly cucumber and celery which we personal in water before giving. We have switched to bottled water (Tesco ashbeck) and if we can get grass we do and presoak also. We also cut pellets right down (she used to have half an egg cup now she only gets a teaspoon which is only about 4 sticks!). She also has long term ranitidine to protect her gut

It’s always a difficult balance as dusty is also prone to dental spurs - so spurs stop her from eating, drinking and moving so that can increase the affect of sludge because she’s not urinating it out or moving around to break it up. And sludge can cause reduce eating and cause pain so she doesn’t eat and then I worry about spurs!

We seem to be in a good place at the moment and when she had a dental recently we managed to keep her clean and she suffered no bladder affects as a consequence. We feed her on a fairly strict schedule and as a consequence we are able to notice any changes in behaviour/eating within a matter of hours and that has helped us to be very responsive to medication adjustment etc.

Sorry! I know that’s very long - I hope it’s helpful and I’m sorry for wasting your time if it doesn’t help!!
This is all very informative and helpful, I have a lot of questions if that's okay, but I need to sit down and list them all out etc which I'll do later if that's okay :) thank you though I really, really appreciate you posting, it's so good to hear how other people have dealt with it and what things they've tried etc :) x

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