calcium build up

Question
i have a 3 year old lop rabbit. He keeps getting calcium build up and his urine becomes thick and white. this causes him to get sore as he cant clean it properly. He's had his bladder flushed out 3 times already, but it keeps coming back. He is on a low calcium diet and he is also on metacam. I try to make sure his water intake is high & he runs around on the grass to stimulate his stomach. I also give him fresh and dried dandilions and nettle. I dont know why it keeps happening. Can you help?

Answer
Dear Julia,

Unfortunately, in a "sludge bunny," the problem is usually metabolic bone disease that causes the bunny to remove calcium from the bones at an unusually high rate. Because excess calcium in rabbits is excreted via the kidneys, this can cause painful urinary tract problems such as stones and the sludge you are seeing.

There is no treatment to permanently cure this problem, which probably has a genetic component.  Some rabbit expert vets suggest that providing plenty of daylight to help with Vitamin D metabolism can help reduce the problem.  Others warn that reducing dietary calcium intake can actually make things worse, since the rabbit has trouble keeping calcium in the bones to begin with.  It's an area of ongoing study and trial-and-error treatment in the rabbit vet community.

We've found that our own sludge bunnies (Hamish and Kali) stay relatively comfortable if we give them regular bladder expressions at home.  Please ask your vet to show you how to do this, as you don't want to inadvertently cause damage.

It helps if the bladder is very full of liquid.  Pick up bun, invert bun so you're holding her like a baby, and gently *jiggle* the bladder to suspend the sludge in the urine.  We've found that holding the bunny upright (hind legs on the towel, back upright and slightly tilted forward), rather than in normal standing position makes this procedure less painful.  And it can be painful the first few times, when most of the sludge comes out.  :(

We do this for Kali about once a week, and for Hamish (who can't walk) every day.  Hamish is now absolutely sludge free,  probably because we do this every day.  But his bladder is also no longer capable of fully emptying itself.  It's sort of a delicate balance.

Please ask your vet about this.  It can help to administer subQ fluids about an hour before expressing the bladder, since this will provide lots of urine to help carry the nasty sludge OUT.

I hope this helps!

Dana