Ductulo Vesicular Urolithiasis – Rabbit
Introduction
Ureterolith is a stone in the ureter (study radiographs very carefully). This can be very painful and the use of Buscopan is useful (spasmolytic and analgesic - relieves spasm and kills pain).
Vesicular urolith (stone in the bladder)
The appearance of crystals in the urine. Microscopic examination of the centrifuged sediment helps with the subsequent management of the case. Usually calcium carbonate but often calcium oxalate. Struvite may be seen too.
Urine sludge is flushed out per catheter and found to contain large amounts of crystals (as described above). Treatment always involves dietary alteration and the use of diuretics to flush out the bladder. I use bendrofluazide (PO q24h in the mornings) and another clinician (William Lewis personal communication 2006) flushes the bladder with saline per urethral catheterisation until the organ is flushed clear of calcium sludge – he tells me that this results in a more rapid improvement than the use of bendrofluazide alone. Catheterisation always involves general anaesthesia and, in does, the use of an endoscope to visualise the urethral orifice. Dietary alteration involves offering Timothy hay and fresh greens and plenty of fresh water. Antibiotics are seldom indicated, except in the presence of infection (Treponema or Pasteurella – the former may be directly associate with anuresis but the latter may be involved in other anatomical systems) and used in conjunction with the anaesthetic.
Jenkins (2006) differentiates between normal calciuria and micro-urinary calculi (MUC). MUC form in response to cystitis and can cause construction.
Urine scald occurs as a result of some urine adhering to the fur near the vent (usually due to excessive calcium in the urine (cf. the effect of hard water on your hands). It is a particular problem in obese animals. Management requires pain killers (Buscopan®; Boehringer Ingelheim), neutralising/astringent powders (Cutisan®; Boots Healthcare – available only in pharmacies in France), Rear Guard® (Novartis) to prevent fly strike, and the calcium-sparing diuretic, bendrofluazide, PO q 24 h, every morning. (Note that I use quite a high dose of bendrofluazide in rabbits and rodents).
Supportive Therapy following medical and surgical treatment of urolithiasis:
- Dietary Fibre
- Prokinetics.
- Fluids (oral, Intraperitoneal)
- Acid environment peat moss as a litter to neutralise ammonia in voided urine.
Prevention of Urolithiasis
- Reduce the content of calcium in the diet
Calcium in New Hay:
- Alfalfa 1.8%
- Clovers approx 1.5%
- Fescue 1.5%
- Timothy 0.66%
- Ryegrass 0.65%
- Orchard Grass 0.27%
- Wheat straw/Oat Hulls 0.15%.
Ref: Nutrient Requirements of Dairy Cattle VI (1989) NRC Washington DC
Content of calcium in selected vegetables (in mg per 100g):
- Coriander (16)
- Lettuce (20-102)
- Cauliflower (28)
- Carrots (30)
- Turnips (39)
- Peas (36-42)
- Watercress (40)
- Broccoli (42)
- Spinach (56)
- Parsley (78)
- Kale (94)
Source = www. magpage.com 1997
For an up-to-date review of urogenital diseases of rabbits see Reusch B (2006)
References
- Redrobe S (2000): Urogenital system and disorders In Manual of Rabbit Medicine and Surgery ed Paul Flecknell pub BSAVA Cheltenham
- Reusch B (2006) Urogenital System and Disorders in BSAVA Manual of Rabbit Medicine and Surgery eds Meredith A and Flecknell P, 2nd Edition 2006, published by BSAVA Quedgley Glocs
- Jenkins J R (2006) Clinical Pathology in BSAVA Manual of Rabbit Medicine and Surgery eds Meredith A and Flecknell P, 2nd Edition 2006, published by BSAVA Quedgley Glocs