Rabbit - Fluids for Bladder Stones

Question
Hi Dana.

My rabbit Pepper had 3 bladder stones removed at the end of October and another removed at the beginning of January.  After being advised on a forum, I approached my vet with the idea of prescribing fluids for Pepper to try and avoid another.  My vet has prescribed 20ml of fluids every day (Pepper is around 2kg), he originally started on saline, but the new bag of fluids is saline and glucose.  People on the forums who have used this method with their rabbits give alot more fluids less frequently (50mlto 100ml's / 2 or 3 times per week) and use lactating ringers instead of the saline that I have been using.  

My worry is that the little and often approach is not the right one, and I should be giving him more - less often and using lactating ringers.

Could you advise?  Whilst I think the principal is making the rabbit pee more often - I just want to be doing it right one way or another.

Thanks in advance for any clarification you can provide.

Andrea

Answer
Dear Andrea,

I'm not a big fan of preventive fluids, to tell you the truth.  They are uncomfortable and can make things worse in terms of messing with a bunny's homeostatic ability to control his own electrolytes.  Twenty ml per day isn't a huge amount.  But it might be better to simply give that to him orally, rather than subQ.  This way, the intestine can regulate the intake of fluids into his tissues.

You might find that a stone will recur despite the fluids.  

Another way to deliver fluids is via enema, as the colon is a major site for re-uptake of liquid from the feces.  It's less painful than daily needles, and can also help hydrate his GI contents while letting just the amount of water he needs into his tissues for his kidneys to handle.

Bunnies who make stones have metabolic problems that may not be curable.  And since they are already having trouble mobilizing their electrolytes, you can't really be sure what you're doing by giving extra fluids every single day.  

Just my opinion.  But in human medicine it's generally now *not* considered wise to give extensive extra fluids to flush the kidneys unless the patient is unable to drink enough water on his own to manage the job.

If this were my bun, and I were using the fluid therapy, I'd opt for a larger bolus of fluids less frequently than a small bolus daily.  But with this imprecise method, there's really no way to know which is better, if either.

I hope your bunny doesn't make any more stones, in any case.

Good luck,

Dana