A urine sample showing bloody urine (haematuria)
©Prof Derek Knottenbelt
A urine sample showing bloody urine (haematuria)
Bloody urine (haematuria) is rare in rabbits. Cases of bloody urine in rabbits often turn out to be normal rabbit urine which is simply a deep red colour due to the excretion of plant pigments within the diet. True cases of blood in the urine are often due to stones/sludge within the urinary tract, cystitis, uterine adenocarcinoma (tumours), polyps or abortion.
Why is my rabbit's urine red?
Bloody urine in rabbits may be rare, but red urine is not. Owners who pay close attention to what is in their rabbit's litter tray will be familiar with the variation of colour that normal rabbit urine can be.
Red urine is observed in rabbits and is almost always caused by plant pigments and does not affect the animals health. Vegetables such as cabbage, broccoli and dandelions will often result in the excretion of red urine. Normal rabbit urine will vary from a pale yellow or clear colour, through various orange and brown colours, right up to a deep red colour. Rabbit urine may also look cloudy due to the presence of calcium carbonate being excreted within the urine. Red urine is not a medical problem and usually returns to normal within one to three days, although it has been seen to take as long as three to four weeks before the urine returns to the pale-yellow colour. You can always speak to your veterinary practice for advice if you are concerned.
Dark and/or very strong-smelling urine can result from heat stress or dehydration, so always ensure that your rabbit has plenty of fluids, especially in the warmer months of the year when they may appreciate a water bowl to drink from as well as a water bottle. Most rabbits, given the choice, prefer a water bowl over a bottle. It enables a natural drinking method, doesn't block, like can happen if the ball bearing jams in the bottle, and enables them to 'quench' their thirst easier than a water bottle. If your rabbit frequently has dark or very strong-smelling urine then it may be worth discussing this with your vet.
What causes red urine?
For obscure reasons red urine may occur due to any of the following:
- While on certain antibiotics.
- At the first cold snap in autumn.
- After eating fir leaves.
- After eating carrots, spinach or other veggies containing beta carotene.
- Eating cabbage, broccoli and dandelions, especially if the rabbit isn't used to eating these.
- Sometimes there isn't an obvious cause.
If your rabbit appears well in themselves; is eating and drinking normally, active and bright, producing lots of normal droppings then do not panic when you observe a change in colour of your rabbit's urine. Monitor the situation and if it doesn't resolve then speak to your vet for advice. If your rabbit seems unwell in anyway then always consult your veterinary surgeon as soon as possible.
What about blood in the urine?
Blood in the urine is also known as haematuria.
True haematuria can occur due to disease anywhere within the urogenital system. An unspayed female rabbit might show a bloody discharge from her vulva, or drops of blood after urination, which could be confused with urine; either of these occurrences could be a sign of uterine cancer. An un-neutered male rabbit could have genital cancer or trauma which could cause blood to appear in his urine in either case you should take your rabbit to see your vet immediately.
Other causes or haematuria may result from calcium stones or sludge anywhere within the urinary tract system (kidneys, ureters, bladder or urethra), cystitis, polyps or even abortion. All of these conditions need urgent veterinary attention as most are painful to the rabbit and life-threatening if not given immediate veterinary care.
When we see red urine, most of us worry about a bladder or urinary tract infection. However, actual blood in the urine is usually difficult to see with the naked eye. Blood in the urine usually appears as distinct areas of red (blood) within normal urine, whereas red urine appears as the whole amount of the urine being red in colour. When due to kidney disease, straining to urinate may not occur, but straining is the most common sign of urinary bladder disease.
A rabbit straining to urinate assumes an unusual stance, that is, he sits for an unusually long period of time on the tip toes of the back feet, with the tail very high in the air. If you notice your rabbit is straining, you should immediately change the litter box so you can determine if he is producing urine or not. If no urine is being produced this is an emergency and you must take your rabbit to your vet immediately.
Rabbits metabolise calcium very differently from other mammals such as dogs and cats. Whereas dogs and cats will only absorb the amount of calcium their body needs from their diet, rabbits absorb all of the calcium within their diet and excrete the excess through the urinary system. This is why rabbit urine is often observed as being cloudy or white in colour.
Passing cloudy urine can be normal for rabbits which are fed a high calcium diet or those rabbits which are slightly dehydrated. However, rabbits who are fed a high calcium diet are much more likely to develop stones or sludge deposits within their urinary system, which often require corrective surgery and can be impossible to rectify. There are many other precursors to developing urinary stones and sludge which go hand in hand with having a high calcium diet. Examples include obesity, inactivity, lack of opportunity to urinate and a dry diet lacking in grass and greens. The amount of calcium in the diet isn't the most important or sole reason for these to develop.
It is recommended that rabbits are not given calcium supplements unless specifically stated by a veterinary surgeon and are not fed excessive amounts of alfalfa hay or vegetables high in calcium, eg carrot tops, spinach, water cress, kale or dark cabbages, etc.
How do I know if I should take my rabbit to see the vet or not?
It is not necessary to take your rabbit to the vet for the condition of red (pigmented) urine, unless your rabbit is showing any other symptoms.
If you notice urine that is red or pink (orange is OK) and there are no other symptoms, you could wait until the next available appointment at your vets to ask them to test the urine for blood.
If your rabbit is straining to urinate, he may only produce a drop or two of urine at a time because of the frequency with which he is attempting to urinate, if this is the case you should make an appointment for your rabbit to see your vet on the next available appointment. However, if your rabbit is straining and isn't producing any urine at all, there could be a blockage, which is an emergency, and you should take your rabbit to see your vet immediately to determine if there is a blockage. If there isn't a blockage your vet may want to perform further tests to find out what the problem is.
Can my vet do tests to find out what the problem is?
Yes, your vet can test a urine sample (urinalysis) to determine if there is blood within the urine.
If haematuria is diagnosed your vet will want to determine exactly what is causing the blood in the urine.
This may involve taking x-rays of the abdomen to look at the bladder and associated ureters and urethra to look for stones or sludge, which show up very well on x-rays.
A urine sample may be taken and tested for bacterial growth and to determine what antibiotics would be most effective.
If your rabbit is an entire female your vet may do an ultrasound examination to look at the reproductive tract for any sign of tumours. If any growths are located it is advisable to take chest x-rays to look for any spread of the disease before embarking upon any surgery.
Blood tests may also be used to assess kidney function and to look at the blood cells.