Sludge removal under sediation, aftercare, and expectoration

[Mori]

Hi – Our buns is going into the vet on Friday for a sedation/catheter/sludge removal. We had him examined earlier last year for a big lump in his abdomen. Xrays, ultrasound were done and the vets had no idea.

We’ve recently moved to an area with a rabbit expert and they immediately figured out the lump was sludge that has solidified in his bladder.

Now, since it’s been a good 9 months since we found it, I’m wondering how likely is it the sludge lump is solid and won’t be removed by a saline flush? I’d hate for him to be sedated only to be told it didn’t work and the lump would have to be removed by surgery (which I think is too difficult in bunnies to cut into the bladder/stitch it back up?).

Can anyone tell me their experience with this procedure? Or aftercare?

We’ll be cutting down calcium ladden greens after this, though we think he’s just prone to sludgey backups.

Is there a way to expectorate sludge and can anyone recommend a method they use?

Thanks so much! We’re hoping it’s a simple procedure and he’ll be more comfortable.

[Bam]

I’m sorry we are late to this!

I asked Forum Leader Jerseygirl, who has some experience with bladder sludge and bladder stones. She says it’s good if your bun goes under on Friday in either case. The new vets can do a new set of x-rays to determine any changes that have occured since the last x-rays were taken, and they might be able to express some of the sludge manually so it can be tested for possible bacteria and your bun be put on antibiotics pending surgery – IF your bun will need surgery.

Rabbit savvy vets will be able to determine if the sludge can be expressed or if surgery is required. Surgery to remove kidney stones in rabbits is not unheard of, but rabbits have been known to pass urinary stones as big as a pea through the urethra.

Here is a link that Jerseygirl sent me, it has some graphic content so only look if you feel you are up to it:

http://www.lbah.com/rabbit/rabbit-urinary-stones-and-sludge/

Real sludge is often due to other factors than an improper diet, but cutting out really calcium-rich greens like kale won’t hurt. Dark green vegs as a rule have more calcium than lighter colored greens like romaine lettuce. Fennel is another green that’s very low in calcium and often appreciated by buns. 

ETA: The vets will be able to teach you how to express your boy’s bladder yourself if that is needed on a more regular basis. You could perhaps also ask if you can give sub q fluids at home to keep him hydrated, and they can show you how to do that. We have members that have given their rabbits daily sub Q fluids at home, for example Forum Leader Little Puffy Tail with her rabbit Bindi. 

[jerseygirl]

Hi Mori

Best of luck for the procedure today. I hope it helps your bunny. Please do give an update if you can.

I wasn’t able to post last night, so thank you Bam for tending this post!

I’ve not expressed the bladder myself before. I just have been reading up in bladder sludge and stones due to 2 of my rabbits having some issues. One has now passed away. My rabbits are all seniors.

With the initial x-rays, the sludge should have been visible. Did the new vet spot this or take just palpitate the bladder? I’m told with sludge, the bladder would feel much like a water balloon filled with wet sand. Perhaps that is why the vet was confident about what the lump was?

As mentioned, I believe your rabbit being sedated today wouldn’t be pointless if flushing the bladder turns out to be unsuccessful. It’s and opportunity to get another set of X-rays or do ultrasound if necessary.

Avoiding calcium rich foods is advisible but you don’t want to avoid calcium altogether. They need it for their teeth & bones.
Low oxate greens is wise also.

There are some diet sheets here put together by Dr Harcourt-Brown. http://www.harcourt-brown.co.uk/articles/free-food-for-rabbits/diet-sheets

[Mori]

Hello, Thank you both for the information. The boy has had his procedure and is doing okay. He’s on antibiotics and pain meds as he had 5 catheters(!). The sludge was too thick and crumbly – the catheters kept getting blocked and not all has been flushed according to the xrays. We’re a bit worried as there’s no sludge coming out when he pees. Because they didn’t get all the sludge out, he’s going in for another round in a few weeks if he heals properly.

We’re going to also wait until he feels better then modify the diet so there’s less calcium (dandelions are high on his love list). Thank you for the links.

I’d really like to learn to expectorate his bladder so we can attempt to do it if it starts to get sludgy again after the next flush. Over the two years we’ve had him, he’s only ever had sludge pees once every few months. And he completely stopped sludge-y pees last year, so we think it may have just been building up until and since then.

Initially, we found the lump last year when we were living in a different town. Had xrays, ultrasounds, and consultations with 3 vets. No one knew what it could be, dismissed sludge, found a cancerous growth and we ended up concentrating on that since the lump didn’t seem to be causing issues. After moving we found a vet with good recommendations from rabbit owners in the area, and the vet immediately felt the lump and after a few questions suggested sludge.

Thanks for the suggestion about sub q fluids. He barely drinks water but we were told this was okay because his diet is almost 100% greens. And we’ve been putting water out around the rooms he roams in, as we found he drinks more if he finds one of the many, rather than one. But the sub q – I’ll ask our vet about, because I’m never sure if he’s dehydrated. It would be good to get more into him if it dilutes the chance of the sludge sticking and building up.

 

[Bam]

Thanks for the update, I’m glad he’s back home! It seems you have really good rabbit vets where you live now. 5 catheters, poor little guy! But he must be starting to feel better now with all that sludge out, even if you didn’t get all of it.

We’d be very happy for continued updates. Many safe healing-vibes for your (((((boy bun)))))

[jerseygirl]

Wow, 5 catheters! Have you noticed any change in him since? 

 
I was reading on Medirabbit about sludge.

The presence of sediment in the bladder may be accompanied by urine retention. If the amount of sediment is large, urination and complete voiding of the bladder is difficult. The bladder gradually gets distended et its size becomes larger and larger. http://www.medirabbit.com/EN/Uro_gen_diseases/generalities/Sludge.htm (Again, contains graphic images).

So it’s possible the lump initially felt was enlarged bladder due to sludge AND retained urine?
I suspect retained urine compounds the problem. Once a flushing is done and urine is passing better, hopefully that would mean less likely chance of sludge build up again. Or slower if it does start to collect.

Since you have now moved, it might be worth checking the water in the area for the mineral content. Maybe the water where you used to live could have been a contributing factor??

[Bunny House]

I have to add, having excess phosphate in the diet can cause bladder stones as the calcium can’t be absorbed in the intestines,as the high amount of phosphate in the diet prohibits it. Of course having too much calcium in the diet can cause it too. I’m in animal nutrition right now and we just learned that. Glad he made it though surgery!

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