1030. Blood in the rabbit's urine

1.5-year old rabbit, obese, female.
"The rabbit is greedy for treats and ate a lot daily," the sister said.
"She also ate a lot of pellets. For the past 1 week, she has frequent urination. The sister and her friend took the rabbit to Toa PayohVets for a check up as the rabbit had become lethargic. The owner was busy at work and the sister and her aunt were very worried.

"Collect her urine without any stools," I advised over the phone. "Wash and clean the pee tray first."  This was the most practical way to collect urine. Urine must be analysed as part of the practice of evidence-based medicine rather than just giving antibioitcs.

URINE TEST on Jul 8, 2013
pH 9, SG 1.005, Protein 3+, Blood 4+, WBC 0, RBC 999, Bacteria 3+, Amorphous phosphate 3+.

What to do?

Dr Daniel had the scalded genital area washed. He prescribed medication and the owner came later to take the rabbit home. "No more treats," I said.

FOLLOW UP
It is important to follow up as many Singapore pet owners don't review the case. Perhaps it is due to lack of time or financial constraints.

On Jul 17, 2013, 9 days after treatment, I phoned the non-owner sister. Since she did not reply, I sms her: "Is the rabbit still passing blood in urine? Pl update. Dr Sing. Toa Payoh Vets."

Her reply: "The first 2 days of medication no blood. But past few days, the urine seems to have blood.  Not sure whether it is orangey or blood. The medication does not seem to have finished yet though. Is the medication supposed to be finished? But I have tried feeding her fresh veg (water cress) which she quite enjoyed. She seems to be a bit more hyper now."

My reply: "Do you still feed treats n pellets? U need to reduce at least 50% of dry food n treats."

In summary, I advised feeding as much fresh vegetables as possible without causing diarrhoea and monitor amount of water drunk. X-rays for bladder stones if there is still blood in the urine.

There is not much the vet can help the rabbit but to educate the owner by following up. Often, vets have no time to follow up. It is just not practical to follow up every case. In this case, there may be bladder stones but will the owner want to pay for X-rays of the bladder?  As in people, the over-consumption of certain food or treats can lead to ill health. I suspect the kidneys may be involved too.

Since X-rays were not consented, it is hard to tell whether there are bladder stones. Tablets to acidify the urine is being given as well as antibiotics.