Post-Op Cystotomy/Urethrotomy

Question
I have a 3 year old hermaphrodite Rex Rabbit (took it in for spay, no ovaries; no testes, but has a penis).  Bun must have developed strictures due to spay/neuter surgery.  October 2006, bun had a stricture around its colon; surgery performed; everything fine for 14 months.  Last week, rabbit not able to urinate and in hunched position.  After several tests, including a dye ex-ray, rabbit underwent cystotomy/urethrotomy.  Removed a jaw-breaker sized calcium deposit (almost the size of a quarter) from inside his penis, causing vet to remove partial penis.  Catheter placed for 4 days; rabbit in cone to prevent licking genitals.  Question:  Catheter removed; bun is getting his under belly, legs and tail wet with urine.  There is still some blood (watery looking) in urine.  For this vet, it was the first time performing this operation.  Besides looking out for utine scald, what else can I do for this bun?  Is this a temporary urination problem due to the size of the hole in his bladder, or does something else need to be done?  I've had rabbits 14 years now; this is the first time I've ever had a problem bun (besides old age problems).  Rumor has it more adhesions and strictures can occur and bun will possibly need another surgery in the future.  Appreciate your help.

Answer
Hi Jackie....We also have a hermaphrodite Silver Martin....mostly female with some male parts.  The urine problem is hard to call.  It all depends on what damage has been done to the bladder and possibly the kidneys.  I am not a vet....but in this situation, I would probably be administering an antibiotic and an aggressive narcotic to manage pain.  Most likely would offer a NSAID...but only for a few days and with caution since most of them will damage the liver and kidneys if there is any dehydration.  I would also be supporting the renal system by sub-q fluids using Lactated Ringers Solution.  We have dealt with urinary issues for weeks.  So time is probably what this rabbit needs right now.  The best treatment overall we have seen in situations like this is supporting the renal system and helping those kidneys and bladder by flushing with the sub-q fluids.

I would also modify housing to make every effort to keep the belly off any flooring.  We generally use the plastic sitting mats that are available at most farm supply stores.  We bathe them using an oatmeal based shampoo daily.  Virbac makes Epi-Soothe (shampoo and skin conditioner is available) and we use that here.  It is available thru some vet clinics and numerous supply companies on the internet.  We also use human diaper rash salves/powders to help protect the skin and allow it to heal from urine scald.  We have recently been using a product called Bag Balm and we are very pleased with it....again, it's available at most farm supply stores.  You might also want to examine the diet to see if you can limit the calcium intake.  There have been some studies that have linked high calcium levels in food to urinary stones/sludge in rabbits.  This tends to make sense since rabbits metabolize calcium differently than other animals.  And here in our rescue, we had one rabbit that developed stones and sludge from the mineral content in our well water....so don't rule water out either.  We switched him to a bottled water with known mineral content.  We did not use distilled water because they do need some of the minerals.

As far as future surgeries, I would suspect that to be likely.  There isn't a lot known about the hormonal effects of being a hermaphrodite.  We are still debating on getting Scoots spayed/neutered....we just don't have a lot of info to make a good decision.  And with any surgery, there will always be scar tissue, lesions or other issues that might come into play down the road.  And a note to your vet...I am very impressed that he/she could perform this surgery.  A true testament to this doctor's skills.  Based just on getting this rabbit thru this, I get the feeling that your rabbit is in good hands.

Randy