Urinary tract infection

In a rabbit, a urinary tract infection (UTI), also known as bacterial cystitis, is usually a lower urinary tract infection involving the urinary bladder and/or urethra.

Symptoms

 * None in some patients
 * Frequent urinating in small volumes (pollakuria)
 * Urinating in places that are not regular
 * Urine scald
 * Beige to brown, thick urine in rabbits with excessive calcium in the urine (hypercalciuria)
 * Blood in the urine (hematuria)

Secondary UTIs are occasionally seen in rabbits with hypercalciuria, one of the most common problems seen in indoor rabbits. UTIs are most often seen in middle-aged rabbits of 3 to 5 years and obese rabbits with a sedentary lifestyle and poor nutrition.

Causes
Common causes of urinary tract infections in rabbits include the following:
 * Escherichia coli and Pseudomonas spp.
 * Inadequate exercise, cage confinement, or painful conditions (reluctance to move).
 * Inadequate water intake (dirty water bowls, unpalatable water, changing water sources, inadequate water provision)
 * Inadequate cleaning of litter box or cage may cause some rabbits to avoid urinating for abnormally long periods.
 * Urine retention (underlying bladder pathology, neuromuscular disease)
 * Obesity
 * Calcium or vitamin/mineral supplements added to the diet predisposes to hypercalciuria.

Diagnosis
A diagnosis of a UTI in a rabbit should be confirmed with urinalysis, urine culture, radiography, and ultrasonography. A urine culture is necessary for definitive diagnosis.

Female rabbits with a uterine infection (pyometra) or uterine cancer (uterine neoplasia) may expel blood or a thick, often blood-tinged vaginal discharge when urinating that may mix with urine and mimic a lower urinary tract infection.

Other diseases with similar symptoms include the following:
 * Urolithiasis or hypercalciuria without a secondary UTI.
 * Lower urinary tract cancer.

Treatment
For rabbits without symptoms, they may be treated with antibiotics, increased water consumption, dietary modification, weight loss, and an increase in exercise alone.

The base choice of drug should depend on the results of a sensitivity test. Initial choices can include enrofloxacin, marbofloxacin, or trimethoprim-sulfa. For an acute infection, drugs should be used for at least 2 weeks.

To help increase water consumption,
 * provide multiple sources of fresh water.
 * flavor the water with fruit juices (with no added sugars).
 * use a bowl instead of a water bottle.
 * provide a variety of clean, fresh leafy vegetables sprayed or soaked in water.

While special diets have not been reported to help break down bladder stones in rabbits, a reduction in the amount of calcium in the diet may help to prevent or delay a reoccurrence.

Severely affected rabbits with large amounts of bladder sludge may require treatment with fluid therapy and voiding urohydropropulsion, the act of using a liquid to expel something from the urinary tract.

Any areas affected with urine scald should be kept clean and dry. Zinc oxide + menthol powder (Gold Bond, Martin Himmel, Inc) can be applied to clean the skin regularly.