Elderly Rabbit with Bladder Stones dribbling urine, already on Doxycycline

Question
Hello Dana,

Thank you for taking the time to answer my question.

I have a Female Netherland Dwarf mix who just turned eight. I'm sorry to say that she is not spayed.

Sophie has three major health issues. The first is an external abscess on her dewlap that has been around for two years. Whenever we take her off of antibiotics, it comes back. So we are leaving her on antibiotics permanently.
The second is uterine cancer, which she has had for about a year and a half.
The third is bladder stones, which she was diagnosed with two months ago.

For the bladder stones, she has been put on Metacam once a day. This has made a HUGE difference in her happiness level.
In fact, if you met Sophie, you would probably think she was perfectly healthy. She's a perky, active, bright-eyed bunny without a care on the world.

My question is: The only symptom of her bladder stones has been that she would pee twice in a row.
But today, she left little dribbles outside of her box, like she didn't quite make it in time.
So, is this another sign of the bladder stones, or could it be a bladder infection?
I'm wondering because for the last year Sophie has been on Bactrim for her abscess. But it recently stopped working, so she was switched to Doxycycline. I know that Bactrim was a good antibiotic for bladder infections too, but I don't know about Doxycycline. I don't know if it's a broad-spectrum antibiotic that would work for a bladder infection or not. If it's not, then perhaps I should add Bactrim or Baytril in case of infection?

Or does her slight incontinence sound more like the effect of bladder stones and old age?

Also, if she becomes more incontinent, what's the best thing to use to protect her from urine scald?

Thank you so much!

Answer
Dear Bethany,

Bladder stones move around and are very uncomfortable, even if the bunny doesn't show obvious signs of distress.  Shifting stones could cause the dribbling.  But stones and bacterial infection often come together (though no one knows which is the chicken and which is the egg).  Antibiotics are a good idea, though it's often very difficult to culture urine:  obligate anaerobes may be the cause, and they are very hard to culture.  So if she has an infection that's not sensitive to the doxycycline (or any of the other antibiotics you mention), you might not know it.  It's an unfortunate guessing game.  :(

At the age of eight, she's not really an elderbun these days.  She's more on the outer cusp of middle age.  If this were my bunny, I would ask the vet to do bloodwork and tests to see if she is a reasonable candidate for surgery, and then have those painful stones removed if she is.  We just had this done on our Fuzz (who is at least eight), and he is a NEW rabbit!

I'm not saying that the surgery is 100% risk-free.  No surgery is.  But given her age and the fact that she might still have half her lifespan ahead of her, it might be time to consider getting rid of the problem instead of just treating the symptoms.  Whether she's a good risk will be up to the vet and you to decide.

Urine scald can be prevented by keeping her clean.  There are really no salves that will help as much as just keeping up with the pee.  For instructions on wet and dry butt baths, please see:

http://www.bio.miami.edu/hare/buttbath.html

I hope this helps.

Dana