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bladder sludge and urethreitis

22 10:19:51

Question
QUESTION: I have a 7 year old rabbit who in the last 2-3 years hads developed an
increasing tendancy to bladder sludge and irritation. He has had t be
cathetered twice in the last 2 years, as well as manually expressed of the
sludge on a monthly basis. We have been told to have a totally low calcium
diet,  and are currently also on a course of frusol (to make him wee a lot) and
antobiotics in case of infection (there is no blood present),
I see from answers in the year 2004 you suggested that these may be
endocrinal problems rather than actually calcium or oxalates problems.
Do you have any updates on that and also how could we know if that was the
case? Is there any test for endocrinal problems?
The vet want him on a very low calcium and low oxalate diet - we normally
feed grass, dandelions, thistles, raspberry leaves, and a small amount of (non
alfalfa) pellets.




ANSWER: Dear Twigs,

The real expert in this area is Dr. Frances Harcourt-Brown:

http://www.any-uk-vet.co.uk/harcourt-brown/

She is convinced (and I agree with her), that bladder sludge and other renal calcification problems are not due to (nor changed by alteration of) dietary calcium, but of metabolic bone disease.  I know from my own experience and that of many other rabbit rescuers that a low-calcium diet does NOT change the degree of bladder sludge or stones, and may even make the situation worse, since the affected rabbit cannot keep calcium in his bones in the first place.  Reducing calcium may speed osteoporosis without improving the renal problem.

Dr. Brown has written many articles and an excellent textbook in which she covers this subject.  A good start is here, from Exotic DVM magazine

Calcium Metabolism in Rabbits. Frances Harcourt-Brown, BVSc, MRCVS. 15 ... Frances Harcourt-Brown, BVSc, MRCVS. 33. Approach to Selected Orthopedic Disorders ...

I would recommend your vets try to get a copy of this article and of Dr. Brown's textbook, which is arguably the best on the market.

http://books.google.com/books?id=xT9MWYDBIwEC&dq=frances+harcourt+brown+rabbit+m

I hope this will help get your bunny on the right track.

Dana

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

QUESTION: Thank you for this. The 'sludge' issue does appear to be one that divides
vets!.  
I (and I presume my vet) do have Harcourt Brown's textbook - and it does
seem to say that in fact although there are 'other factors' in sludge, a
restricted calcium diet will help reduce sludge, although with the warning to
not over-restrict (It is possible therefore that she has changed her overall
opinion since writing the book). I do not have the article you mentioned
though and will get that (I have one with a similer title by Leah Postman).
I shall try and call Harcourt-Brown (as I am in England) and see what her
most recemt views and advice are I think. So a huge thanks for alerting me
that she has a particular interest in this specific area. It is so very confusing
when one source says to reduce calcium and then others say that it will not
make any difference and that we should be looking for and treating another
problem that is causing the symptom. And of course all we want to do is help
our rabbit! With your advice in mind I shall call Harcourt-Brown.
Thank you  

Answer
Dear Twigs,

I hope that Dr. Harcourt-Brown will be able to advise you about this.  If she can't, then I'm not sure who can.  As you say, this is a very controversial area, and there have not yet been any controlled studies to really establish what the causes of bladder sludge and other renal calcium problems are.

But I can say that we have not noticed any improvement in sludge when we alter the diet, unless the diet was *extremely* high in calcium to begin with.

Good luck!

Dana