repeated urinary tract problems in rabbits

Question
I have an 8-year-old spayed female rabbit that has repeated problems with urinary infections caused by bladder sludge.  My husband is a paramedic and we give her sub-Q fluids frequently (3x a week) and we have removed calcium from her diet (no pellets, only veggies low in calcium).  Even with fluids, she drinks plenty of water. She'll have her bladder flushed out by our vet (and be on antibiotic).  She'll be better for 2 months after the flush and then her trouble starts all over again.  Do you have any suggestions on what else we can try?  She's getting old enough that I worry about putting her under anesthesia every two months to have her bladder sludge flushed out.

Answer
Dear Debbie,

I don't blame you for not wanting to have her put under constantly for bladder flushes.  But there may be an alternative.

We have a couple of sludge bunnies, too.  And we've found that giving subQ fluids and then waiting about a half hour to jiggle and gently express the bladder can work *wonders* to remove much of the sludge.  

Our Hamish, who had serious *toothpaste* coming out now has almost no crystals at all.  He's unable to walk, and so we express him daily.  But the sludge problem has completely cleared up with constant, gentle *agitation* of the full bladder (to suspend the sludge crystals) and then gentle, careful expression.  

Many bunnies will eventually even learn to cooperate and void with gentle pressure.  It's a big relief when that sludge is out!

Unfortunately, removing calcium from the diet will not help this problem, which is metabolic, and some very experienced rabbit vets believe that a low calcium diet will actually do more harm than good.  We've found that reducing calcium in the diet has absolutely no effect on the amount of sludge produced.  In fact, because the bunny has a calcium metabolism disorder, withholding calcium from the diet could actually be harmful, not allowing the bunny to get *enough* calcium to replace that constantly being lost from her skeleton.

Sadly, treatment for this chronic problem is pretty much palliative:  there is no cure.  But the jiggle-and-squeeze protocol we use has been *very* effective at helping us avoid the need for *any* bladder flushes.  It's just a constant maintenance thing that becomes part of the routine.

Hope that will help!

Dana