Month: May 2018

Rabbit Bladder Problems

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Our Rabbit Diseases section has information on this important disease in rabbits. Here is the link- /rabbit/rabbit-urinary-stones-and-sludge/

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Urinary Stones and Sludge (hypercalciuria)

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Rabbits make wonderful pets, that need special attention from everyone in your family regarding their health 

Rabbits are prone to problems of the urinary tract.  These problems range from irritating sludge in the bladder, to kidney problems,  to the formation of a bladder stone that needs surgical removal. Sludge is urine thickened by calcium salts to the point of being chalky and thick in consistency, sometimes as thick as toothpaste. This causes problems in the urinary bladder usually, although it can occur in the kidneys or ureters. There are many factors why a rabbit might get this problem, so it is important to address all of them.

Rabbits need routine exams to ensure their health

Graphic photos on this page

Underlying Problem

As opposed to most other animals, rabbits absorb almost all the calcium in their food into their bloodstream. This causes a higher than normal blood calcium level relative to other animals. If an individual rabbit is not efficient at utilizing and eliminating any excess calcium through the urinary tract, a sludge or bladder stone problem might present itself.  Some of the factors we know about that might predispose a rabbit to a urinary problem with calcium include:

Genetics- Some rabbits are not as efficient at eliminating any excess calcium

Rabbits that are not good drinkers

Obesity

Sedentary lifestyle- rabbits that stay in a cage all day

A diet with excess calcium

Soiled litter pan area in a fastidious rabbit

Diseases elsewhere in the body can have an effect on a rabbit’s normal physiology, disrupting it to the point that they can stop eating and get dehydrated, leading to decreased kidney function and sludge or stones in the urinary bladder. You can learn more about them in our Rabbit Diseases section. The more common ones are:

GI Stasis

The dark round area in the center is a greatly distended stomach due to GI stasis

E. Cuniculi

The severe head tilt in this rabbit could be a sign of Encephalitozoon Cuniculi

Teeth Conditions

The point on this molar tooth could cause an inability to eat well over a period of time

Pasteurella

This conjunctivitis could be an indication of Pasteurella

Reproductive Disease

This is the radiograph of a rabbit with a uterus that is greatly distended. That large whitish area in the center of this abdomen is the uterus.

This is that fluid filled and greatly enlarged uterus during the surgery to remove this uterus

This male rabbit has a very large tumor in its left testicle. The surgeon is pointing to a normal sized testicle on the other side. The cancer was removed in a neuter surgery.

Urine that contains excess calcium will have the consistency of sludge. This irritates the bladder and urethra, causing significant inflammation and pain. If the problem persists long enough, a bladder stone (urolithiasis) might form.

In order to make a diagnosis of the problem in rabbits, we follow the tenets of the Diagnostic Process. This is a methodical and detailed way to approach diseases that ensures an accurate diagnosis. It includes:

Signalment- age, breed, and gender of an animal

History- what an owner has noticed at home about a pet’s specific behavior

Physical Exam- the findings from an exam by one of our veterinarians

Diagnostic Tests- What tests are used to make a diagnosis

Response to treatment- if the diagnosis is correct the pet should get better

Signalment

Urinary problems in rabbits can occur in all breeds of any age or gender. Young or old, large or small, male or female, it doesn’t matter.

History

Symptoms are variable, depending on the duration and degree of the problem, along with the individual rabbit’s tolerance for pain and discomfort. Some of the symptoms to watch for include the following:

Lethargy

Poor appetite

Diminished droppings

Urinating more than usual (pollakiuria)

Straining to urinate (stranguria)

Unable to urinate

Blood in urine

Chalky deposits on the fur in the perineal area

Moist or damp rear quarters from urine dribbling

Licking at rear quarters

Rubbing rear quarters

Skin rash in inside of rear legs or perineal area

Grinding teeth (a sign of pain)

Odor to urine

These are also the symptoms of other diseases in rabbits, so at the first sign of any of these problem you should bring your rabbit in for an exam with one of our veterinarians.

Physical Exam

Any sick rabbit gets a thorough physical exam by one of our veterinarians. It starts with body weight and temperature, and progresses to checking your rabbit from nose to tail for any physical abnormalities. Typical findings might include:

Low body temperature (hypothermia)

Underweight (low body condition score)

High heart rate (tachycardia)

Dehydration

Irritation to the perineal area

Neurologic deficits

Painful abdomen upon palpation

Small kidneys upon abdominal palpation

Distended bladder upon abdominal palpation

Bladder stone palpable upon abdominal palpation

Excess amounts of chalky or bloody urine when the bladder is expressed

Diagnostic Tests

Over the decades our body of knowledge regarding normal and abnormal values in diagnostic tests of rabbits has increased to the point that they are crucial for a proper diagnosis.

Blood panel

This test should be performed on all sick rabbits irregardless of the symptoms. It should also be performed yearly as part of the Wellness Exam on rabbits. These animals age rapidly, and oftentimes hide their symptoms, so it is important to have baseline normals on an individual rabbit, and to catch problems before they become entrenched and untreatable.

The blood panel in rabbits checks for a wide array of problems. It starts with a check of the red blood cells for anemia or infection. There are tests of the kidneys and liver, important organs to assess when we suspect a urinary or kidney problem in rabbits. We also check the electrolytes, and especially the calcium level.

This rabbit has blood abnormalities that can happen with a sludge problem, and also many other problems

Urinalysis

This will check for white blood cells, red blood cells, and crystals in the urine. We also assess the specific gravity and the protein and glucose levels, in addition to looking for signs of bacterial infection.

Urine Culture and Sensitivity

If we suspect a urinary tract infection (cystitis) we will take a sterile sample of urine directly from the bladder and attempt to grow out any pathogenic bacteria. If they do group out, we will check many different antibiotics to find out what antibiotic that particular bacteria is sensitive to and will kill it. This report takes 2-3 days.

This pet has a Staph. infection, that is sensitive to several different antiboitics

Radiography (X-rays)

It is important to radiograph any sick rabbit. There are a multitude of problems that can occur on the inside that are not apparent externally during our physical exam.

This is what a radiograph of a rabbit looks like. The important abdominal structures are labeled:

K- kidney

B- urinary bladder

Cecum- our appendix

Did you notice the spinal fracture? Without this radiograph, we would not have known this.

This rabbit is laying on its back for a radiograph. The arrow points to the left kidney because this rabbit has significant sludge in its bladder, and we wanted to assess the kidneys. Do you notice anything else?

The two lower arrows point to the different appearance of the wings of the ileum of the pelvis, which could indicate bone cancer. We would never had known this if we had not taken a radiograph. 

The sludge that occurs in the bladder, and the stones that also might occur, have a large amount of calcium carbonate in them. This means that they are radiopaque, and show up vividly on an abdominal radiograph.

The small whitish area in the center of this radiograph is some sludge in the urinary bladder of this rabbit. This small amount is of no significance in a rabbit with no symptoms of disease.

This rabbit has more sludge in its urinary bladder. This amount may or may not be of significance, depending on how this rabbit is doing, other diagnostic tests, and follow up radiographs.

S- stomach

K- kidneys

This rabbit is not eating well, is lethargic, and has an odor to its urine with urine scalding on the perineum. It needs to be treated for sludge in its bladder. Can you identify other organs besides the sludge in the urinary bladder? The radiograph below labels the organs. 

H- heart

L-liver

S-stomach

The cecum and sludge are obvious. In the radiograph above, did you notice the calcifications in the kidneys, circled in red?

Same rabbit as above, this time laying on its back. The large amount of sludge in the urinary bladder is even more apparent in this view.

You can see the calcification of the kidneys in this view also

This is what a distended bladder looks like at necropsy

In addition to sludge, rabbits with urinary problems can get bladder stones. Other names for bladder stones are urolithiasis and cystic calculi. These stones also occur in dogs and cats. They are handled differently in the rabbit though.

Click here to see how we take care of bladder stones in dogs and cats.

Click here to learn more about how we do surgery at the Long Beach Animal Hospital in a wide variety of animals.

These are bladder stones in the urinary bladder

Bladder stones in rabbits are removed surgically. We take special precautions in all rabbits when anesthetizing them. Our Anesthesia page has more details on anesthesia.

We have a team of people present when we anesthetize a rabbit

They are closely monitored while under anesthesia 

We approach rabbit surgery like any other surgery using aseptic surgical techniques.

Everyone in the surgical suite practices aseptic surgical techniques

We use the laser to make an incision into the bladder and remove the stone. Note the lack of bleeding on this highly vascular urinary bladder when using the laser. 

After any anesthetic procedure we closely monitor our patients until full recovery

Ultrasound

This is a precise and highly accurate way to assess the kidneys and urinary bladder, and it complements radiography. We also check the other organs in the abdomen carefully with ultrasound.

This is an ultrasound of the urinary bladder with a bladder stone

In this ultrasound the kidney it is being measured

Treatment

In the acute phase sludge is removed with gentle manual expression. If your pet has a chronic problem with sludge in the bladder we can teach you how to do this at home. Flushing the bladder, after manually expressing most of the sludge, helps complete the process. We might sedate your rabbit if we need to pass a urinary catheter to flush out of the sludge.

We might need to hospitalize to provide intravenous (IV) fluids in a dehydrated rabbit and to help support the internal organs like the kidneys. Pain medication is commonly used, along with assist feeding for those rabbits not eating.

If a bladder stone is present we will remove it surgically.

Once your rabbit is stabilized our goal is to help prevent recurrence of  the stone. This is done by you at home in many ways:

Adding water to the food if your rabbit is not a good drinker

Giving supplemental (SQ) fluids under the scruff of the skin to increase urine output

Showing you how to express the bladder

Show you how to assist feed

Keeping the litter box clean

Decrease the weight if obese by feeding less, and increase activity

Using medications as prescribed by us if one of our doctors think it is indicated. This could include:

Pain medication

Antibiotics

Cranberry juice

Vitamin C (ascorbic acid)

Using food that does not have an excess of calcium might be helpful. This means no pellets or alfalfa hay.

Feed only Timothy, Oat, or Orchard Grass hay. A small amount of fruits, and grass hay based pellets can be fed

Also feed fresh leafy green vegetables like kale, mustard greens, dandelion parsley, broccoli leaves and romaine lettuce.

If your water is hard (lots of minerals in it like calcium) you might want to get a water softener.

Follow Up

Any rabbit that has a sludge or bladder stone problem is susceptible to recurrence. Routine monitoring by physical exam, blood panels, and radiographs every 3-6 months is needed to catch the problem early.

Our Rabbit Diseases section has  more information on rabbits, including how we surgically repaired the fractured femur in the radiograph below. This is put here as a reminder that rabbits have powerful back legs in relation to their spine and long bones. If not restrained or held properly they can easily fracture these bones. A femur can be repaired, a fractured spine cannot.

This is called a mid shaft transverse fracture of the femur

Don’t forget to give your bunny lots of TLC, like Dr. Kennedy is doing here on one of her patients

 









 

 

 

 

 

 

 

 

 

 

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Birthday Girl’s

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Clients and Their Pets

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Check out some of the new people that came in with their pets this week. You will find them in the Clients & Pets menu heading at the top of the page.

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Welcome to the Falkland Islands

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Dr. P took Dr. K and two assistant photographers to tour the Falkland Islands (they should be renamed the Breezy Islands) on a three-week personal tour in January of 2018. Our tour guide was Georgina Strange, a Falklands native. She was trained by her father Ian, the man who wrote the book (actually ten books) on the Falkland Islands 40 years ago. She knows her stuff, and was our personal tour guide par excellence!

Georgina has a company called Design in Nature that takes small groups on specialized tours around the island, teaching photography and the natural history of the area. We interviewed her in front of the house where she grew up (in between being chased by baby penguins).

It was such a good trip Dr.P is going back in late October of 2020 (not 2019 like Georgina says in this video, the date had to be changed to accommodate the number of people that are interested in going) with a group to watch the ginormous male elephant seals up close. You will see why he is going back when you go through this page. It was penguin and marine mammal heaven!

Pace yourself, this set of pages on the Falkland Islands has many links to a large number of photos and videos. A few of the thousands of photos we took are on this page. They are downsized and in low resolution for easy downloading. They represent only a small fraction of the photos and videos we have of this trip.

Our welcome to the island at Stanley harbor

Our group, after several days of traveling to get there. We look pretty good after all that traveling! We have two Michiganders, two Californians, and one Falklander in our group of peeps


The Falkland Islands lie 3oo miles east of the tip of Argentina. We went in late January, which is their summer since they are south of the equator. Temperatures ranged from the high 40’s to the low 70’s.

Here are the four locations we visited:
1. Stanley– the main town, and staging area for flights to the other locations
2. Sea Lion Island– for one week to see an extensive amount of penguins and marine mammals
3. Volunteer Point– for two nights to see the King penguins
4. New Island– for one week to see a wide variety of marine and bird life up close and personal

1. Stanley

Stanley is a quaint little town that contains most of the 3,200 that live in the Falkland Islands. We stayed at a wonderful bed and breakfast called the Pale Maiden.

We started the day with full tummys after eating  the gourmet and fresh food Teresa made for us every morning. It was a great way to start the day. Dr. P told Teresa that she was the Martha Stewart of the Falklands. She wasn’t sure what that meant, and had to call her daughter to find out that it was a compliment (we never told her Martha went to jail!).

There is a large monument to the people that died in the war with Argentina in 1982. Even though the British won that war, and don’t plan on leaving any time soon, there is still some animosity between the two countries. 

Walking around Stanley we got a kick out of some of the signs, like this interesting speed limit sign limiting speed to 9.5 mph. Leave it to the Brits!

We ate at a wonderful restaurant in town called the Waterfront. This is the bean burger. Dr. P  forbade anyone from taking pictures of him trying to eat it. 

We love the British sense of humor. This is a sign at the entrance to the ladie’s room at the Waterfront.

And now the men’s room

These signs have historical significance. They were used during World War II to help the British people withstand the bombing of London from the Germans

2. Sea Lion Island

After a night in Stanley we flew on the Falkland Islands Government Air Service (FIGAS) airplane to Sea Lion Island. You find out what time your flight is leaving the night before when they announce it on the radio. They do this after the weather report, and after they tell you the ultraviolet radiation index for the sheep for the next day! It’s all part of the quaint Falklands experience.

Here is the announcement

The FIGAS pilots are very experienced, and flew low over the water on the way to Sea Lion Island to help spot whales. If they see one they will circle over it to get a good look.

Landing on Sea Lion Island in a BN2B Islander airplane

 

We made it to Sea Lion Island!

At Sea Lion Island we were literally in the middle of Gentoo, Magellanic, and Rockhopper penguins, along with Elephant Seals, Southern Sea Lions, and Imperial (King) shags (cormorants).  This is the place we are returning to in the late fall of 2020 to see the large elephant seals do their thing.

We stayed at a very nice lodge on the island that was located in the middle of the wildlife. In the video you get to meet cardboard Rocky for the first time. 

The staff was great, and accommodated us with all of our dietary and personal needs

Our lunches even included personalized Snickers bars

On one unusually calm day we went hiking to see the huge Southern Sea Lions. We decided to make a video with Georgina explaining their behavior while sitting on a cliff above them. It was a great opportunity to do a field interview without the wind interfering.

Gentoo Penguins

The lodge is a 5 minute walk from a gentoo penguin rookery. Click on the photo to see some of the way-too-many photos we took of them (we couldn’t resist) as they went fishing, fed their chicks, and waddled right up to us. There is nothing more entertaining than a penguin!

Elephant Seals

The juvenile elephant seals are molting and resting after months of feeding. Click on that cutie’s face above and watch them as they spar with each other in preparation for when they go from their current 2,000 pounds, to 8,000 pound beachmasters in a few years. This is when the males fight for control of a harem, and will be on the focus for the October 2020 trip

Magellanic Penguins

There is a reason they are also called “jackass” penguins. Click on the photo and see a some of their antics. 

Rockhopper Penguins

They are nothing short of amazing as they climb high cliffs by jumping on the rocks with their stubby legs. This Rockhopper offered Dr. P a rock-how appropriate for a bird with “rock” in its name! This section shows how amazing they are. 

King (Imperial) Cormorants

They posed for us whenever the camera was pointed at them. In this section you can see them as they come in for what is best called “an uncontrolled landing”.

After Sea Lion Island we went to Volunteer Point to see the King penguins. But first, we had to get off Sea Lion Island. The expertise of the FIGAS pilots with their BN2B Islander airplanes was apparent, as they came to get us right on time, and off we went to our next destination.

3. King Penguins at Volunteer Point

They look like they are little people wearing tuxedos as they stand at attention. Learn more about them in this section

4. New Island

After Volunteer Point two members of our photography team flew home, after a final toast to the Falkland Islands, of course.

After they left,  Dr. P, Dr. K, and Georgina flew to the island where Georgina was raised. It was here that her father taught her the extensive knowledge she has of the area. It was a special part of the trip, since tourists routinely do not go on this island.

To get to New Island in the far west of the Falklands we needed to take a plane and a boat. The boat was captained by Jerome Poncet, a 72 year old French gentleman with an extensive knowledge of sailing these waters. Any professional film crew, like the BBC or National Geographic, hires Jerome to take them around.

We spent a week on New Island and stayed at a small house that Georgina grew up in. Not only is she an outstanding guide, she is also a mean chef, and cooked up quite the spread!

Her homemade bread was delicious

In the links below you will learn what it was like to sail with Jerome, see the Rockhoppers that risked their fins every day in the rough surf finding food, watch the graceful Black-Browed Albatross as they soared overhead, and a get a front row seat to watch a special sea lion that has a taste for penguins. We end with the quaint museum at New Island, and then some photos of us in action.

Sailing to New Island with Jerome

New Island Black-browed Albatross

The rogue Sea Lion at New Island

The museum at New Island

How we got the photo

Return to the Wildlife Photography page.

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