Excessive drinking/peeing and wet chin

Question
Hello, and thank you for entertaining all of our questions! We just adopted a
rabbit from a rescue organization, and it seems that every day a new worry
crops up. He is currently seeing a vet, but I wondered what your take on the
situation might be. Three days after we got him, he started chewing "nothing"
and sticking his tongue out repeatedly. We took him to the vet immediately,
and she found that he had broken his front teeth! We have no idea how. She
prescribed him sulfatrim just in case, and metacam for pain. He eats critical
care out of a bowl twice a day, as well as hay and fresh vegetables (nothing
too hard). He is a voracious eater and doesn't seem to mind any of this. Two
days after that, I noticed that he was drinking what seemed like a lot of water
and peeing a lot. I called the vet and told her, mentioning he was on this
medication, and she told me to stop giving both to him until we could do a
urinalysis. So, I stopped the meds, but nothing changed. He is 3lbs and
drinks 2-2 1/2 cups of water (out of a bowl) a day. Recently, the water
drinking has become so vigorous, that he sticks his whole face in the bowl
and comes up shaking the water off. Consequently, his chin is now always
wet. In addition, I noticed yesterday that his droppings, while appearing
normal, squish easily. Just today, I noticed he makes a little grunting noise
while peeing. I have never heard him making any other noise. Sigh. He is a
sweet and lovely rabbit, and I just want him to be ok. He went for the
urinalysis yesterday, and has an appointment to check his teeth on Thursday,
but I was wondering if you had any thoughts on the situation? Oh, in case it
matters, they think he is a Holland lop, maybe two years or less. No one
knows since he was abandoned. Thanks so much, Sami

Answer
Dear Sami,

Hoo boy.  It sounds as if you've adopted a bunny with multiple problems.

The incisor problem could be self-inflicted.  He may have been tugging on his cage and broken them off, which I've heard can happen.  But it also could mean that he has a molar malocclusion that is causing him a lot of pain.  This alone can cause excessive drinking, as he drinks to soothe the pain of a cut up tongue and inside of his mouth.   Please read:

www.bio.miami.edu/hare/dental.html

Holland lops are *very* prone to dental problems, and he may need to be put under general anesthesia for the vet to have a really good look deep into the mouth to check for spurs that need to be clipped or filed.

I do *hope* it's molar spurs causing his drinking, because the other possible cause of excessive urination and excessive drinking (polyuria/polydypsia, or PU/PD) is renal failure.  If his kidneys are giving out, there is no treatment except palliative care.  \

I would avoid giving subQ fluid therapy unless he starts to act sick. We've found that rabbits with renal disease are very good at managing exactly how much water they need, and when we intervene, we often make the problem worse.

Unfortunately, urinalysis alone will not always tell you if the bunny has renal disease.  If he's been drinking excessively, he'll likely have very dilute urine even if his kidneys are normal.  Bloodwork to check his B.U.N. and creatinine (and a few other associated values) along with the urine specific gravity test will tell you (1) if his kidneys are removing toxins from his bloodstream and (2) if his urine is a normal concentration.  Both really should be done to get the full picture.

If you're not sure your present vet has the experience to deal with rabbit dental work, then please find another vet here for a second opinion:

www.rabbit.org/vets

I hope this helps, and that the only problem is his molars.

Take care,
Dana