Urine Scald?

Question
QUESTION: I've had my bunny for about five years now. She has had a LOT of problems, and frankly, my mom is getting pissed off about it. She has always been a bit on the heavy side, and I know it's unhealthy, but I figured that she's a rabbit and doesn't have that much long of a life anyway, so she should be happy.
I'd say that about a year and a half ago is when she started getting...well, what the vets called "balls of feces" that would be stuck to her bottom. By the time I noticed that they were there, they were already stuck. The vet cleaned her off, shaved her, and put her on antibiotics. For a while, she was fine. But then another one slowly began to form, and I wasn't comfortable giving her a bath myself, so back to the vets she went about two months ago. The vet again gave her antibiotics. Then, while still on antibiotics, she started "dribbling" all over her papers. She would move from one area to another and leave a puddle. To the vet we went again. They did all sorts of tests and told us that she'd lost weight! At first I was happy, but then I realized that she'd lost about four pounds in only a month and a half! Before, she was about twelve pounds, so she'd lost a third of her body weight. The vet said this wasn't healthy, and I knew that, so we did more tests to no avail. She recommended us to a specialist, but my mom, having spent about three hundred dollars in only a few days on this mystery illness, said no.
So I've been watching her closely for further signs, and the "dribbling" has continued. But I've also been noticing MORE "dribbling" and she drinks more as well. I don't know much about rabbit illnesses or anything, but could this be diabetes? Her urine scald is terrible and seems to bother her, but I just don't know how to properly bathe her! Is there anything I can do?

ANSWER: Hi Tori,

I see a lot of red flags here.  First, a heavy rabbit is a very sick rabbit.  Rabbits metabolize fat much differently than most other animals and are very prone to a condition known as Hapatic Lipidosis....aka as fatty liver disease.  An overweight rabbit is usually being fed too many pellets or too much junk (treats).  Not only does that make a fat rabbit, it disturbs a delicate balance of beneficial bacteria that is required to digest food.  Being overweight also prevents them from ingesting cecals...aka as night poops which further compromises the gut.  The end result of this is a poopy butt.  I am having a very difficult time justifying why the vet would put your rabbit on system antibiotics.  I would really like to know exactly what the drug is, the concentration of the drug, the amount and frequency given and the weight of your rabbit at that time.  Many antibiotics that are given by mouth can cause severe GI upset (and a poopy butt) or even death.    I would also like to know what "tests" the vet performed and exactly what the results were.

My gut feeling here is your rabbit might have bladder sludge or a urinary tract infection.  There is also a possibility of a protozoan infection known as E Cuniculi.  It is a very misunderstood issue.  There are very few vets that actually can effectively treat rabbits....and E Cuniculi is one that only a precious few have actually seen.

This rabbit really needs to be seen by a highly skilled rabbit vet.  This should not be a really difficult issue to diagnose.  I would like to see an x-ray of the bladder as sludge is easily seen in rads.  I would also like to see a blood panel paying particular attention to the liver and kidney values....and in that same lab have a titer for EC performed.  That would be the proper way to treat this.

Here are some suggestions that might help.
>Review her diet.  An adult house rabbit's diet should be low protein/high fiber.  That means they should have unlimited amounts of grass hay available at all times.  Pellets should be very limited and be of high quality.  Greens should be made available in moderation.  No treats.  No carrots.  Pellets should be high quality pelleted food...no pretty little treats.  I use pellets only to maintain weight and body conditioning.  I have a pair of 30 pound Flemish that get less than a quarter cup pellets per day.  I would start reducing the amount of pellets you are feeding and start providing unlimited hay.  Make any changes in the diet slowly over a period of several days.  Bring her weight down slowly to protect her very delicate liver.  We have had to completely remove pellets from some rabbits...but we did so over a period of about a month starting with what they had been getting and reducing it to none over that time.
>Make sure she is properly hydrated....give her all the water she can drink.  Romaine lettuce and dandelion greens (in moderation) are also good hydaration.  The only thing that can clear sludge is hydration.  And if she has an infection, it will require correct antibiotics for treatment.
>Urine scald is very painful and can lead to additional infections.  Bathing rabbits is sometimes chanllenging but we usually put about an inch or two of luke warm water in a dish pan and gently bathe them.  You can use corn starch or most any human diaper rash treatment to help cool the burn.  We also use prescription pain meds.

Again, this rabbit really needs to be seen by a rabbit savvy vet.  The symptoms you mentioned can easily be life threatening in a rabbit.  If you can't afford a vet, is there a vet school near you that would exchange or discount treatment just for the training experience?  You might also want to consider surrending her to a rescue in your area.  This issue is almost impossible to treat without the help of a vet.  Good luck.

---------- FOLLOW-UP ----------

QUESTION: Thank you for answering so quickly!
I think that they gave her Amoxicillin, and I think it was because she'd developed an infection from the feces and urine. I really don't know the concentration, but we gave it to her in the morning and again at night for about ten days or so. And they did a lot of tests....An x-ray and a urine test and a few other things I can't remember, but everything came back "normal" with no bladder sludge apparently. My vet really isn't that qualified in rabbits though...I don't think she'd even check for E Cuniculi and she certainly didn't propose it as a possibility.
As for her diet, she has an umlimited amount of hay currently. She gets Romaine lettuce in the morning and Kale at night, and she gets...probably more than a quarter of a cup of pellets. I'll try to reduce that over the next week. She always has water available.
I'm going to try bathing her as well.
As for getting her to an expert, it's harder than that. Being that I don't have my liscence yet, my mom is my only way of transportation and driving to a rabbit vet isn't exactly what she wants to do. I'll push her on the issue and make sure I get my bunny to a good vet as soon as possible.
Thanks for all of your help.

Answer
Hi Tori,

Amoxicillin is usually fatal if given to rabbit by mouth.  It can be used as an injectable but only in extreme circumstances and under the watch of a highly skilled rabbit vet.  Please let me know when this was give, how it was given and how much.  If she has been given oral amoxicillin, we need to act quickly and aggressively to attempt to repair the damage.  This drug causes a die off of the bacteria needed to digest food and allows a toxic bacteria, clostridium, to grow unchecked...the condition is known as cecal dysbiosis and is life threatening.  And if you can confirm the vet gave oral amoxicillin...some education is in order for the doctor. In their defense, they get precious little training on exotics...but the VIN is readily available to them. If she has had oral amoxicillin, it would be easier and quicker to discuss her treatment off the forum either by direct e-mail or even by phone.... if necessary I will provide you with either my direct e-mail or phone number.  Please confirm the antibiotic she was given and how it was given and get back to me as soon as possible.