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Lillian unwell - in hospital for an overnight stay

Craig 1965

Warren Veteran
I've had a couple of days off and things had been going well with Lillian. She had been full of life and enjoying lots of garden time.
Then last night - well, it's strange to explain but it's one of those things that happens when we understand and tune into our rabbits. Lillian started to have a long drink from the water bottle in the toilet area. This should be encouraged but I know from experience that this is not a good sign and my reservations came to fruition about 4 hours ago now.
This morning she was bright and waiting for breakfast and her and Leo went outside for the day whilst I was around. Then at about 3:30, Lillian and Leo came out from the garage area dn they sat as they usually do at this time, in the shady area in the garden - or pet cemetary as it's known. I watched her from the kitchen - I can't explain why but I had a strange 6th sense about this and something was telling me to watch her. Everything seemed perfect outside but as I watched her settle, I started counting. I got to 20 and she shuffled, moved and settled. Counted to 25 and she shifted again and looked like she was trying to pee. I could see her back going up and her tail moving. Then she settled. I counted - got to 20 again and she shifted.
So I went to pick her up and I checked her. She had been beautifully dry the last 2 weeks. Everything looking good. I put her down and massaged her tummy and she made motion to pee but didn't. Each time I gently massaged her tummy she went to pee - her entire tummy tightened rock hard and she passed nothing.
This was all very quick so I had to act on it. I rang the vet immediately - 5pm - and at that time of night on a friday it's always a bit of a risk. But I couldnt wait until saturday or even worse monday. The vets were very accomodating and after some shuffling, they said to bring her straight to the hospital which is 15 minutes from us.
I gave the vet a thorough resume and the vet did some investigation. She's lost a bit more weight - she was 3.5k 2 weeks ago, now she is 3.46. Ok, it's not massive but it shows the weight is slowly coming down on her as we try hard to manage her weight issue. The vet also felt the same thing I did with Lillian - the tensing of her tummy and verbalisation from Lillian . The vet said she felt Lillian was certainly in discomfort from her bladder. Everything else seemed ok, but definate pain from the bladder and despite the vets best efforts she could not express any urine.
So, the vet suggested an x-ray then and there. Which I agreed to without hesitation. It is positive that the vets could do that so quickly at short notice.
After what seemed an eternity but was about 15 minutes, the vet returned minus Lillian but covered in Lillian floof!
The x-ray showed, when compared to the x-ray she had 2 weeks ago, that the bladder sludge element had increased and this was a concern. Thankfully there is no evidence of stones - which is such a massive releif, but obviously the sludge is now the primary concern.
The vet suggested immedate intervention to perform a bladder flush to disrupt and hopefully drain/remove as much of the sludge as possible. It means anaesthetic on Lillian but with little other less invasive options, this was the only route to take for a positive outcome. Whilst it won't be pleasant for Lillian and she won't understand why she is going through this, I hope that in a few days time, she will be much more comfortable. The vet couldn't find any other evidence that was restricting Lillians urine so thsi has to be the primary cause.
So Lillian was admitted then and there and I had a few tears and tried to figure out how things spiraled out of control so quickly when things seemed to be going so positively. Lillian will be scared and she was very stressed when I took her to the vet. she kept wanting to jump into my arms but my skills are not enough for her at this level and so the vets need to intervene and make Lillian better by way of the flush procedure.
It is also extremely interesting at home because Leo's behavior is markedly different. He has spent the last 7 months with Lillian and has grown attached to her and now she is not here, Leo is completely lost. He is actively looking for her and has taken to following me round - attached to my legs, whuch he has not done since we first got him in February and he was not bonded. He is visibly lost - and it's interesting observing this pattern of behaviour. People dismiss rabbits and docile and uninteligent but actually it is as far from the reality as you can get. Leo is displaying clear emotional bond with Lillian and is unable to work out why she is not where she should be. And he has reverted to attaching himself to the next safe thing for comfort - us.
I have tears for Lillian and tears for Leo and both are for different reasons. I wish I could help Lillian, comfort her and assure her that she will be ok and although she is going to go through an uncomfortable procedure, she should be much better in a few days. But I wish I could help her understand why this happens for her. And I have tears for Leo because he is new here, and he has got used to life with Lillian and she has suddenly disapeared in his world and he doesn't know why.
We both have long nights ahead for the same reason - love.
I will update the thread as and when I have updates from the hospital - I have not heard from them up until time of posting (8:30pm) and as far as I know the procedure was happening tonight.
CRaig xxx
 
Update at 8:40pm!
As is typical with things in my life, no sooner do I post the thread and say I'll update you all, and then the minute I clicked submit, the vet nurse rings.
This is where we are. They anaestetised Lillian - the vet's first thought was that giving Lillian an anaesthetic would forcibly relax her tummy muscles and allow them to express urine. Lillian was still fighting this and then once the anaesthetic kicked in, the vet was able to express a load of urine. This was obviously a huge positive as it has avoided the need at this time, for a flush. The vet said the urine was a bit thicker than usual but there weas nothing at that stage to cause her concern.
Lilllian was just coming round from the anaesthetic.
The progonsis at this exact time is therefore positive but there are caviats. Lillian is on pain meds to assist her with any discomfort and she will be monitored thoroughly during the night. I have found the care from our vets to be excpetional, although it is not cheap. If Lillian does not pee during the night then the vets will have to intervene and will need to do so more aggressively and either do a catheter flush or worse case scenario is to open her up and flush the bladder that way to clear out the remaning sludge. That is worse case scenario and I am keeping everything crossed that this does not happen.
So far Lillian has remained a strong willed rabbit with a zest for life and despite her bladder issues, she is a happy if independant rabbit with a free spirit and a second chance of a better life with us. So I hope that she responds to the intervention tonight and having had aload of pee expressed, feels a whole lot better and more able to then pee on her own.
I will next update in the morning when the vets hopefully next ring. If I'm updating this before then, then it means things have not gone well.
I'm relieved I don't drink because right now I would probably get completely smashed off my face the way I feel.
Craig xx
 
Oh so glad that the vets could help her empty her bladder, sending vibes for Lillian and gentle nose rubs for Leo. I hope he settles tonight
 
Sorry to hear Lillian isn't well, Craig. Thinking of you all and fingers crossed she is home where she belongs asap xx
 
Just seeing this, sending pee vibes for Lillian and comforting vibes for you and Leo. I hope everything turns up right for you all by morning. xx
 
I'm so sorry to read that Lillian is having bladder problems again and that she is having to spend the night at hospital. I'm glad however the vet managed to express some urine so hopefully she will be feeling more comfortable now. You acted incredibly quickly so you have done everything humanly possible to help her and it will give the vet a fighting chance in getting on top of this.

When you have a bunny with a chronic health issue, I think you do tend to be more "tuned in" that it's about to flare up again. More often than not I've often found that it manifests itself as a feeling of dread in your own stomach!

Sending lots of vibes for Lillian and nose rubs for Leo xx
 
Lillian is lucky she has you to identify her issue and get her prompt care. It is good vet was able to express urine once he sedated her and her ab muscles relaxed. Sending you , lillian and leo positive vibes for a quick recovery.
 
Sending Lillian lots of vibes. I hope that she has improved during the night at the hospital and also that they can give you some idea why this is happening together with some advice on how to manage it in the future. I think you have the Frances Harcourt-Brown article on helpful dietary advice, not to lose weight but to manage the calcium issue.
 
Sending Lillian lots of vibes. I hope that she has improved during the night at the hospital and also that they can give you some idea why this is happening together with some advice on how to manage it in the future. I think you have the Frances Harcourt-Brown article on helpful dietary advice, not to lose weight but to manage the calcium issue.

Yes, I think management is going to be the key. Incase you do not have FHB's diet sheet here it is :

https://www.harcourt-brown.co.uk/ar...t-for-rabbits-with-urinary-tract-disease/view
 
10am- now at vets. Will update later once we’ve got Madame - she’s fine but you’ll all be surprised at what the problem is with her.
 
Just got home from the vet hospital - it was a quick handover but there's a story behind that. The exotic specialist rang us at 8am - thankfully we'd had no calls during the night. The exotic specialist was called in to oversee Lillian as she has keenly followed her journey. She had come in last night and contacted her good friend at Newmarket who happens to be one of the top exotic specialists in the UK. That's a stroke of luck. Now, it's been felt that Lillians issues arise from her weight and that has always been something that the vets have pulled us up for. However, and this is where it gets interesting, this top specialist in Newmarket told our exotic specialist that he has 2 buns there who suffer similar issues - so it's not isolated.
It was determined last night (and I'll come back to the newmarket specialist in a mo), that when they administered the anaestheric (keratin?) last night, Lillian relaxed sufficiently to allow them to express wee and Lillian peed a further 3 times during the night. It has been determined that Lillians issues yesterday were not as a result of sludge or blockage. She was suffering a spasm attack from the muscles round the bladder - a sort of cramp if you will. I had leg cramps last week and they are incredibly painful so I can imagine how Lillian must have felt. The spasm was inhibiting the bladder from allowing urine to pass.
I'm sue JJ will be quite fascinated by this. I certainly was.
Now, back to the newmarket chap - he said that they have found huge success with treating this condition with some muscle relaxant medicine called bulsomthing or other. It has to be injected (and we'll have to be shown how to do this and I freak out at the sight of needles so not looking forward to that) whenever Lillian has one of these episodes. But it is felt and agreed by this specialist that this will ease the spasm and Lillian will then be able to relax and pee.
This is an interesting diagnosis and just shows how complex at times these matters can be.
A management plan is being prepared but here's what we have so far. Lillian hasn't eaten during the night or pooped and the vets arent happy about that. Hold that thought.
The exotic vet said Lillian has been incredibly stressed all night - which is perhaps why she hasn't eaten. Coincidently, Leo has not eaten all night and was still in a very lost state this morning. This demonstrates just how poweful and connected a bond is with animals.
The vets have administered metaclopromide via an injection to help start Lillians gut. We are to give her metacam twice a day for the next week to help reduce spasm episodes and make her more comfortable. When an episode occurs, we are to administer 2ml of metacam in an attempt to ward off the effects of any spasm and then use this new drug which we don't yet have (and it's rather pricey).
So the vets were concerned at how Lillian was regarding eating and pooping but have managed the urine problem which was the primary concern.
Lillian came home 20 mins ago, and I wish I'd had a camera handy. She belted out of the carrier, sploofed and Leo immediately ran up and gave her a full facial wash and ear clean.
Then, she started chomping into some fresh greens and herbs as if nothing had happened, and also had a good drink of water. Her demeanour is completely different - a complete polar opposite to how she was yesterday evening.
And it starts to make sense if I think about it. She had been fine the last 2 weeks. Then very quickly yesterday her whole manorism changed - and I can't explain why I had a sensation to watch her when this all happened. I was going to go to work but something inside me told me to stay off that day and I'm glad I did. She changed so rapidly and I am pleased that I got her to the vets as swiftly as I did - and I thank you all for your encouraging and warm words of support on this. For me, Lillians health and wellbeing is first and foremost and whilst there's so much I don't know and get wrong, I am learning all the time and doing everything I can to get treatment fast.
Lillian is settled and much more relaxed and comfortable and now she is showing an appetite, this is all positive. Leo is also much different.
So it would appear that initially, sludge is not the major issue - but yes we would like to establish what causes the spasm (cramps). It may be that this is just a condition she has, perhaps insitigated from the deliberate starvation she was subject to in her former care?
Thank you each and everybun for following her, and this thread and your words of support and comfort and vibes.
I'll try to take some photos of her later - I have to go and paint ceilings at the moment but my wife is on nursing duties.
Thank you all so much again
Craig xx
 
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