Pet Factsheets

A urine sample
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Cystitis is an inflammation of the bladder. It is often caused by infection and is usually accompanied by frequent, painful urination. There are several reasons why rabbits may suffer with primary or secondary cystitis.

What signs may my rabbit show?

Cystitis is painful and often the rabbit may attempt to pass urine, only passing a few drops or none at all. There may be blood in the urine. They may hop in and out of the litter tray a lot more than normal and urination may be painful (they may squeak and vocalise with pain). They may also urinate in inappropriate places and have urine scalding around their back legs, tail and feet.

If the rabbit is in a lot of pain they may stop eating or eat less, become lethargic, pass fewer and smaller/dehydrated droppings, press their abdomen on the ground in pain, grind their teeth in pain and have an increased body temperature. A variety of these signs, which will vary dependant on the severity of the condition, may be seen.

What causes cystitis?

Cystitis is defined as inflammation of the urinary bladder. Cystitis may be the primary cause of the rabbit’s symptom due to an infection, or it might have a secondary problem caused by another underlying condition.

Secondary causes of cystitis include:

  • Infection (can be combined with a primary infection).
  • Bladder stones/sludge (urolithiasis).
  • A tumour in the bladder (neoplasia).
  • Incomplete emptying of the bladder when urinating (due to spinal pain/disease, behavioural disorders, obesity, etc).

What about red/orange urine?

This is very different to blood in the urine (haematuria). Rabbit urine is naturally a variety of colours and shades from clear, white, yellow, brown, orange and red and is usually attributed to diet, environmental temperature or some antibiotics. The colour of the urine changing is not usually of any concern and doesn’t cause any health problems. It will resolve within a week or so and no treatment is required.

Blood in the urine often appears in clots or defined areas within normal urine whereas with red and orange urine the whole of the urine is the same colour.

How will my vet diagnose cystitis?

Your vet will want to perform some diagnostic tests to help rule out possible causes and get a diagnosis. These may include:

  • Samples to look for any bacteria in the urine. Often a cystocentesis sample, which is obtained by placing a needle into the urinary bladder, is required, so the sample is sterile and not contaminated. This may require the rabbit to be sedated.
  • X-rays and ultrasonography of the bladder may be required to look for abnormalities, bladder stones/sludge and tumours. This will need to be performed under sedation or general anaesthetic.

What treatment will my rabbit need?

If an infection is diagnosed, then antibiotics will be required. Pain relief is likely to be required for all rabbits with cystitis, regardless of the cause.

Urine scalding will require careful clipping and cleaning of the area (under sedation), pain relief and often antibiotics (topical or systemic). Often rabbits with cystitis are also overweight, if this is the case, they will need to be placed on a weight loss programme.

Bladder stones will require surgical removal and bladder sludge may require flushing from the bladder. The diet, environment and overall health of these rabbits will need investigating to prevent further occurrences of the problem in the future.

If a tumour in the bladder is diagnosed further diagnostics, such as CT scanning, may be required to ascertain if it may be operable. If not, sadly euthanasia is the only option.

Rabbits with spinal pain will require investigations into the cause of pain and long-term pain relief in an attempt to get their pain under control so they’re able to adopt the correct position for urination.

Can it be prevented?

Some of the potential causes of cystitis can be targeted to reduce the likelihood of developing the condition. These include ensuring the rabbit is kept in a suitably sized environment, allowing them to exercise and exhibit normal behaviour, they are fed a diet high in fibre and are not allowed to become overweight.

Water consumption is important, and bowls should be offered to allow the rabbit to drink adequate amounts. Rabbits fed vegetables high in calcium, who are overweight and unable to empty their bladder completely may be more predisposed to developing bladder stones and sludge, another reason why it is important to ensure they do not become overweight.

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