I need your help with Jack again

[Karla]

Jack finished his UTI treatment today, but he is still not doing well. He drips and pees everywhere and now he is even beginning to have a wet tail because of urine. He thumps sometimes before dripping. But other than that, he seems fine. He has good appetite (in fact, he is more hungry than ever) and he is active and seeks attention.

I’ve been looking into sludge, but it is my impression is that it would be quite obviousif that was it because the urine will be thick and chalk-like. It is nothing like that, in fact it is very watery. Also, pets with sludge will have problems peeing, which is definitely not the case for Jack. I will phone the vet tomorrow and ask for a prolonged treatment, but what else can I do? He has been on a 10 day treatment.

 

I hate the thought that he might be in pain or feeling unwell and if I cannot get the right treatment for him, then he is better off being put to sleep although I cannot bear the thought.

 

I asked the vet the last time I was there, and he said he could do an x-ray to check for crystals if the meds didn’t work, but that it hadn’t been done before, and that he didn’t know of any treatment for rabbits, because most rabbit owners will not spend that much money on their rabbits.

[Sarita]

Actually leaking and these symptoms definitely could be sludge. Many times to see the actual sludge since it’s blocking the ability for your rabbit to urinate you would have to express their bladder to express the sludge. That’s how it always was with my super sludgy rabbits.

As for treatment since there is really very little known about this – my vet has suggested plenty of fluids and I’ve done sub-q fluids at home and have the vet show you how to properly express the bladder. Also a urinalysis to check for urinary tract infection – baytril is good for urinary tract infections as well as the nasty urine scald that he sounds like he will get due to urinating on himself.

The x-ray will also show if there is sludge in the bladder as well – I think it will have a cloudy type look, but the vet should be able to distinguish this.

Also BinkyBunny encouraged her Jack to drink by putting an apple juice in the water – obviously you want to dilute it, not just give straight apple juice to encourage drinking.

[Karla]

Thanks! Ok, I will read up on sludge even more then. Jack is a heavy drinker (really!) so giving him anything to drink more won’t be necessary though. I’ve been reading about dry butt baths and I will try to find something to do it tomorrow.

But are you saying that there really isn’t treatment, but it is just a matter of keeping it down? I just worry that he is in pain and that it is my responsibility to make the decision to have him put to sleep, if that is the case.

[Sarita]

I would not say he is in pain but he could be uncomfortable. If you discover it’s sludge ask your vet about teaching you to do sub-q fluids and express his bladder to evacuate the sludge. In my experience, sludge is a continuous problem.

My vet also would recommend as well for you to do a blood test to see what the calcium level shows as well.

You may have to make some changes to his diet but to be honest, that won’t help and vets tell you to do that because really that’s all they know to tell you. Eliminating pellets may help since those are the highest in calcium – but then again, there’s not proof it’s due to calcium.

If it’s sludge, part of the problem is that the way rabbits are built, they have a hard time eliminating it because they are standing and urinating on all fours unlike us so the sludge doesn’t actually go down to the uretha to expel from their body since they aren’t upright. Also sludge can expand the bladder and cause the leakage you are seeing.

You could ask about metacam for a pain medication – does it help? I don’t know, but it doesn’t hurt but you certainly would want to do blood work for look term usage of this since it can affect the kidneys.

[KatnipCrzy]

The sludge should show up on an x-ray- as it is mainly calcium- so it should show on an x-ray like bladder stones and even bones for that matter does.

I think if he has sludge and it has not gotten better at all yet- I could see where he could need continued medical treatment like antibiotics and pain meds.

This is a good article that describes some of the steps that mght be necessary for Jack-

http://www.veterinarypartner.com/Co…amp;A=2423

[Sarita]

The article Katnip posted is excellent too – I’ve read this many times and discussed it with my vet.

We did do a bladder flush on Twizzler and it helped for a short time but the sludge always came back.

[Karla]

Thanks..although I am not happy to read your responses, I have to admit. Giving metacam for a prolonged period is not okay here, because it is believed to cause liver damage. So I don’t think the vet would give me any, or that I would want this solution.

But I will read this article to learn more. I will get the vet to do the blood test and the x-ray on Wednesday. But if it is sludge, I think right now, that it is not a solution for us to keep him. Things are different here, and I don’t have the same options as you do, and continued antibiotics and pain meds are not allowed or at least given.

Well, that ruined my Sunday. I will get back to you when I have seen the vet.

[Sarita]

I know you’ve been terribly frustrated with the vet care for your buns and I would feel the same way you do knowing that they really limit the options you have for caring for your rabbits. Please keep us updated. I do feel it’s better to know though so you can make a decision.

There are other options for pain meds though like banamine.

[Karla]

Since my post yesterday, I have been terribly heartbroken and couldn’t sleep all night due to the thought of having to put Jack to sleep. But I’ve decided that it won’t be this time.

I have a suspicion that it might be his kidney. I was reading yesterday that if a bunny drinks a lot of water and pees constantly and the pee is watery, it is most likely renal problems. And renal problems might result in sludge. He drinks a lot! All three empty a water bottle of 500 ml every day and sometimes more often, and Karl hardly ever drinks and Molly only a little bit, so Jack is the one mostly drinking the water. And he pees all the time.

So, this is what the vet should check:

His calcium level (should be 45-60%)
His liver
His kidney

I want a urine test for any infections or bacteria.

And then he should do an x-ray looking for bladder stones or sludge.

Last time I asked for a urine test, he said they couldn’t do that, but they would have to send it somewhere else, so I let it go. But this time, I won’t give in. Then we just have to wait for the results.

Anything else I ought to get him tested for?

This morning I noticed that he had an open sore on his foot – urine scald. I will get a hold of some talcum-free baby powder. Anything else I can do? I might put some towels out on the floor, so he has somewhere to sit and dry a bit.

[jerseygirl]

I think with blood tests they look at the BUN levels for renal problems. Blood Urea [ edit ]Nitrogen.  But apparently renal idicators don’t show until they are already something like 50% into renal failure – then it’s just a case of managing it. At least this is what I learnt when reading up on it for Jersey. As you know – she’s a big pee-er and drinks alot, though not nearly as much as Jack! I did read that the increased drinking is the rabbits way of self management.

It can be daunting looking into all these things and I can understand your worry. Sometimes it is good to step back from all the info and just get a feel for how Jack is. If he’s active, got an appetite and seeks companionship – then I’d say he’s not suffering too much. Though constant peeing and having a wet end is no small thing – I’m not meaning to down play it.

[jerseygirl]

On Jacks appetite…what is his main diet now that he’s had the incisors out? I sometimes wonder whether Jersey drinks to fill her stomach – then pees alot because of the pressure on her bladder. She seems complusive about drinking or maybe it’s just something to do. Do you find Jack behaves like this at all?

[Karla]

Well, in regard to Jack’s appetite – he is starving, if you ask him. He is constantly begging for food. He doesn’t eat hay anymore, so he basically only get the veggies I feed in the evening. And he is a slow eater, but the again, the others don’t eat as much as he does, so he should get his share. I have been thinking about giving him more veggies, and perhaps I should. I had been hoping that he would begin eating his hay again.

Jack is actually doing fine, except for the peeing and the urine scald. He is active, has a big appetite and wants to cuddle as always. And you are right, it is easy to get carried away and be worried. I will try not to. I will have the vet run the tests and take it from there.

[jerseygirl]

it is easy to get carried away and be worried. I will try not to.

Well, if you figure out how to do that, can you teach me?!

[Monkeybun]

I think adding more veggies will make him not want to eat hay even more. If anything, I’d cut down on the veggies in order to get him to eat the hay again.

[Karla]

MB: you are right and I have been carrying out strict hay days, but the little guy just don’t want to eat it. Well, sometimes he does, but nothing worth mentioning. I’ve even cut all the hay into tiny pieces, so that his teeth were no excuse for him. There is some really expensive hay at petstore, which he likes, but I don’t buy it that often. My plan is to make him eat grass from the garden once it starts growing again as a substitute for hay.

And now JG made me feel guilty about trying to feed him hay by only serving greens in the evening, if that is the reason why he drinks so much water because he is hungry. *Sigh* how come bunnies bring so many worries :S

Anyways, I got an appointment for tomorrow morning instead of Wednesday. Such a relief. But my animal-hating superior must be really tired of me always having to go to the vet.

[jerseygirl]

And now JG made me feel guilty about trying to feed him hay by only serving greens in the evening, if that is the reason why he drinks so much water because he is hungry

Oh no! Don’t feel guilty! It’s just a theory. I know Jersey gets enough food – and she can darn well eat hay if she’s hungry. She also acts hungry all the time. It’s just one of my thoughts for her and her water drinking.

[Karla]

Haha, you see how easy it is to make me worry I’m actually glad you say that Jersey is acting hungry all the time as well. It’s nice to know and does make me feel better about it.

[LittlePuffyTail]

Sorry to hear about all the problems you are having with Jack. I know how hard it is to worry about the little guys.

Just sending some {{{{Get Well Soon Jack}}} vibes your way.

Good luck with your appointment.

[Sarita]

Blood test will show about any and all the things you mentioned.

It’s not unusual that they may have to send the urine test out for analysis either.

As for renal failure – I’ve only had experience with this with one of my rabbits who was also a sludge rabbit as well and he was pretty far gone once we determined what the problem was – wouldn’t eat, slept all day – the vet said the only thing that kept him going was the sub-q fluids I gave him. Obviously he was so far into renal failure we let him cross the bridge.

I do think you must demand they do these tests – after all you are going to be paying for them. Some vets hold back on suggesting things because they are afraid the owner may not want to do them due to costs or other things, but my vet always suggests and gives me alternatives.

[Karla]

I was a the vet this morning with Jack. I was really hopeful, but the vet wasn’t. Anyways, he told me to expect all this to cost around $2,000. It is unusual to do blood tests on rabbits here, so it is quite expensive and costs just half of it. The vet of course wanted to put Jack to sleep. I have to admit, it is difficult to put a price on your pet…how can I? Unless the blood tests reveals something really bad, we are going all the way with whatever it takes for him to get well, I guess.

I am going back to the vet in a few hours…

I had completely forgotten you have to deal with issues, such as euthanasia and saying goodbye, when you get a pet. Are we being selfish for wanting to keep Jack alive? Would you let him go? I’ve been crying all morning. If you think we should have him put to sleep, do you think we should have it done today, while he is there, or wait to the end of the week and then bring Karl and Molly with him so they are there when it is done?

[Monkeybun]

Not selfish at all! If he is a happy bunny, and enjoys life, I’d say see what happens.

[Karla]

Well, back from the vet. Vet couldn’t find anything on the x-rays, so we are waiting for the blood test results which will be here on Thursday. I tried explaining what you guys do to treat sludge, but he just said that he didn’t agree with the way things are done in USA and compared it to declawing and debarking. But it is no way comparable in my eyes!! But I couldn’t argue with him as I was completely teared up. So right now we are waiting for the results and hoping for a miracle that it is in fact an infection that the Baytril could not kill.

if not, then I have to make an appointment and say goodby to little Jack.

[Karla]

Oh, and by the way, he said that sludge was not visible on x-rays, which is rubbish. Because I have seen such x-rays on the web. I guess I just live in the wrong country if I want to keep rabbits as pets…

[Sarita]

I’ve had to deal with euthanizing 3 of my rabbits in the past 6 months so I know how you are feeling. For myself and for the vet, it was extremely obvious it was time to say good-bye and I agonized over them and cried as you are. I know now that the obvious right decision was to let them cross the bridge – they were not getting better and their quality of life was suffering and they were too.

It always helps to have a very supportive vet too who is honest with you when you are unsure. They look at it from a more clinical view. I have to say though based on what you say about your vet, I’m not sure your rabbit is getting the quality of care you expect from a vet and your choices are limited so you need to take that into account. There is only so much that you can do as well with the support you get.

I do have a question – does Jack appear to have any urine scald or is he wet around his backend? That has always been something my sludge rabbits have had as well.

[Karla]

He is wet around his backend and I have noticed a little sore on his foot. Also, yesterday he was sitting on the toilet straining himself to pee but just couldn’t. He tried and tried for a long time, and then like in complete frantic he went for the water bottle and drank while still trying to pee. And then afterwards he jumped out of the toilet box and dripped. So obviously he has trouble peeing, and he might think the drinking water helps him. That’s why we are sort of hoping that it could be a UTI, which Baytril couldn’t take care off. Vet said he didn’t think so, but that is what I’m hoping for.

It would be an easy decision if I felt that he wasn’t doing well. But we have just spend the past hour in the garden and he was jumping around, eating dandelions and looking fine. He has actually lost a bit of weight, and the vet thought it could be his kidney since he is hungry and eats all the time, but still loses weight.

[Karla]

Sarita, I’m sorry to hear about your three bunnies. I guess it is never easy regardless of the reason.

[Deleted User]

Karla, no matter what happens with Jack, it is obvious that he is a blessed little bunny to have been taken in by you. I would say he is the luckiest rabbit in all of Denmark.
Vibes for Jack! Vibes for you, you must be frustrated with the vet.

[mocha200]

((((((((((((((healing vibes for jack)))))))))))))))))))))))

[Elrohwen]

I am so sorry to hear about Jack!! ((healing vibes)) I’m also sorry your vet doesn’t seem to be on the same page as you. I hope you’re able to figure out a course of treatment that will work for him. It sounds like it should be treatable at this point if your vet can figure out what’s wrong.

[mrmac]

I am sorry to hear about Jack, I hope everything works itself out and it is treatable. Jack is lucky to have found you and enjoyed time with Karl and Molly too. Don’t be too hard on yourself! (((Hugs & Healing vibes!!!)))

[MimzMum]

Poor Jack! Karla, I’m sorry I’m so late to this thread but your last post made me think…why the little guy is smarter than the doctor! He knows what he needs…going to the yard and eating dandelions. Dandelion tea is always used for bladder issues. I think we should call him Dr. Jack now! ^_^

I know it is so hard to think of losing him. I just gave my best dog of 14 year back to God last month and I still ask myself, even though I know the answer, ‘Did I do the right thing?” But for him it was time. He was not eating, sleeping mostly, and couldn’t get up to go potty. It really didn’t take long at all once we took him in and I know he was blessedly relieved to be free again.

However, if Jack is still showing signs of being active, albeit you can see his frustration in the litter box, and eating and performing other bunny functions well, then I think he should be given the chance. I, too, think you are somewhat trapped by a doctor who isn’t invested enough in your case because he doesn’t have the knowledge. Doctors don’t like looking dumb.

In the meantime, I would do what you can to help keep Jack’s bum clean and comfortable, there’s lots of different ways, from shallow sitz baths to cornstarch. The more clean he is, the more comfortable he will be. This should make it easier to judge if he is either in pain or has that spunk you are looking for.
Many vibes and prayers that the tests will come up with the correct and treatable conclusion! (((((((((((((((((((((((Karla & Jack)))))))))))))))))))))

[Monkeybun]

Poor little man…. (((((((((((vibes for Jack))))))))))

*shakes finger at vet* Bad vet for making our girl here cry!

I hope the results come back as a UTI that can be treated. Jack is such a trooper, and sounds like he is determined to be a happy boy regardless.

[Sarita]

Here is my experience with sludge – they were always wet around the butt area. My sludge rabbits always ate and seemed fine, they really did but I had to know that they truly couldn’t be comfortable and I am lucky to have a vet who knew stuff and we treated and treated and treated. Twizzler not only ended up with bladder sludge which we lived with for probably 2 years but in the end she had some neurological problems so the combination and the fact that the last vet visit my vet could see her frustrations with her neurological problems helped us decide it was time to euthanize.

I have to say that just based on what you say, it sounds like it could possibly be sludge too. My Toffee has had an ongoing urinary infection but she does not have bladder sludge and she does not strain or get wet around the bottom and we’ve been doing baytril for going on 3 weeks.

He is extremely lucky to have such a caring owner like you – too bad that the vet care for rabbits is not as good as we have here in the US and I think that being the case I would feel the same as you. You have to look at the whole picture in this case – he may not be able to get proper and decent vet care and that’s so important with an ongoing condition that you need to get vet support.

[BinkyBunny]

I am so sorry Karla. What a rough spot to be in. There is no doubt that you love Jack and whatever happens you will make the a decision based out of love and care for him, and we will be here for you. I don’t have much more to add at this point except positive thoughts and vibes.

Keep us updated.

[RabbitPam]

Karla,
I can’t add anything more helpful than the others medically, but i just caught up with this post and want to add my support to you and Jack.
I wish you had better vet care available, or at least an alternative for the other two, but we’ve looked into that for you in the past I seem to remember and you’re in a tough spot. Please understand that you are far more caring than the owners they routinely see, and are doing your absolute best for Jack.
Your concern about his quality of life is in the forefront, and whatever happens, you will do what you can for him to keep him from suffering, and do it out of love. That comes through loud and clear. But your heart breaking is something we all feel at times in similar circumstances. You will do what is best for your little guy. Never doubt that. We all face this at some time, and it is always too soon, whether it’s ten years or one.
And we support you whatever you learn and whatever you try for him.

[Beka27]

I haven’t been on in a couple days except for a quick peek so I missed this. I’m so sorry you’re dealing with this. Big hugs for you and healing vibes for Jack.

[Lintini]

Karla….I just caught up with your posts here…and I read about how you said he was jumping into the box and straining…then drinking and straining to pee some more. This is identical to when my cat had bladder crystals, which dissolved, and then 10 years later he actually had stones in his bladder that would go into his urethra and block him from being able to pee. I am sorry if I missed this anywhere but has he had Xrays or has anyone thought of kidney or bladder stones? Socrates cost us 4,000$ after the bladder stones incident but from what you said…it triggered my memory of this. He would sit in the sink and drink water from the tap and also strain to pee ….this sounds so similar…

Okay so I read up, you have had xrays..but do those rule out crystals? I don’t know if crystals show up on xrays.

[Monkeybun]

Now that you mention it Lin, my mom’s old cat Jack had the same thing. There was a couple time we thought we’d lose him, but we managed to get him fixed up. old boy lived to be quite the old happy man

[BinkyBunny]

Ironically today, I had taken my OWN Jack in to the vet and we had to have xrays done on his bladder. So I discovered something about bladder sludge and xrays that may be helpful. We originally had the xrays done to double check for small bladder stones. There were no bladder stones, thank goodness. However, he did pee out some thick sludgy stuff after the vet  tried to express his bladder. My rabbit-savvy vet said that sludge can show up on the x-ray (the bladder showed up whitish) but there is a catch— A bladder filled with normal urine can show up like this too. She said that the xray is helpful if other symptoms (like actually sludge expressed or peed out) show up.)  So the xray becomes a tool that can be used in conjunction with other symptoms, but if no other symptoms are present then it may be difficult to no for sure. I found some info about this

http://www.rabbit.org/journal/3-5/bladder-disease.html

(Diagnosis Section)

For your convenience I posted the portion that relays to the xray: 
“Any animal with clinical signs such as those mentioned should have a veterinary visit. An experienced rabbit veterinarian uses a urinalysis and radiographs (x-rays) as the initial steps in diagnosing a bladder problem. Because rabbits’ bladder stones and bladder “sludge” are primarily composed of calcium, they are able to be detected on plain radiographs (x-rays). Your veterinarian should be familiar with normal rabbit urinalysis values and the radiographic appearance of a rabbit bladder. Many normal rabbits may have some radio-opaque material present in their bladders but will not have the abnormal urinalysis or clinical signs to support a diagnosis of bladder disease. Once bladder disease is confirmed, a urine culture, serum (blood) chemistries, and a complete blood count will help the veterinarian determine the extent of the disease and how to treat the problem in that individual rabbit.”

Jack never had major thick sludge and as long as he drank plenty of water, his urine remained clear, however, these last two months, he’s become bored of his water again (even the flavored stuff) and for my Jack, this was key to keeping this under control, but as he slowed down, I noticed his urine became a bit more opaque at times (not all the time) and this last week, he would sit kind of funny and urinate outside of the litterbox much more, and these last two days, his urine definitely had more white in it, but not thick thick. So off to the vet we went.

She tried to express his bladder and he just would not easily relent, but the act of trying to express his bladder irritated it, and he then kept trying to go and go and he finally peed out a small amount of sludge – that’s when she decided to do xrays.  (for the reason stated above but also to double check that there weren’t any small undetected stones) 

She sent us home with a few days of pain meds (as his bladder is rritated now) and we will be giving subq fluids every day for the next two weeks. It was actually really easy this time -  took only a few minutes.  It didn’t bother Jack much at all, and Jack is resting now from his day at the vets. (Vivian is grooming him and taking good care of him by cleaning his eyes and licking the area where the subq fluids went in.)

I meet with the vet again in a week to figure out what to do next (he’ll have another urine test then.)

I’m not sure if this experience with My Jack helps you at all with Your Jack – but I’d thought I’d share since there are some similarities (except that my Jack doesn’t like to drink water)

[RabbitPam]

Karla,
I just read in your other post that Jack turns out to have leukemia, and I want to add that here so the others will know when they check back to this post. My heart goes out to you and Jack. This has been very, very hard for you, but I am glad he has a definitive diagnosis finally so you know for sure what is happening. You have done all you can for the sweet guy, and we are here for you.
I will watch for your post in the Support section as you mentioned, and ask everyone else to do the same.
{{{{{{{{{Hugs}}}}}}}

[Karla]

RabbitPam, you are right. And thank you for your kind words!

The reason why I wanted to wait to update these threads was the fact that I am at work and this whole thing just makes me really teared up and I rather not people see me. But nevermind. Who cares, right?

I have actúally read all your inputs and thoughts these past days, but I have not wanted to reply, as I have tried to push all my sad thoughts aside. This time has been so difficult, because I have found it so unfair that I have had to make the decision to have him put to sleep because of sludge, which is treatable if I just lived somewhere else. And I kept thinking that perhaps I could buy tons of herbal stuff online and a miracle could happen if I just read enough about sludge and figured out what to do myself. And worst of all, I felt that I was letting Jack down as he has in fact been active and cuddly as usual.

But the blood results came this morning, and it didn’t look too good. He has leukemia, and perhaps some cancer in the uterinary area as well. I was looking at the results and although being no vet, his kidney isn’t looking too good either, so I guess that explains the hunger and the extreme water intake. Bless him. And now it is so much easier for me to accept the appointment at the vet, which I made yesterday morning. Also, his urine with the strange stuff in it (some of you saw those pics in my other thread) clearly shows that it is time now.

Thank you guys for just being on this forum. Words cannot explain how much your presence in here mean to me.

Anyways, Jack is scheduled for his final sleep tomorrow, Friday, at 10.30 am GMT – please help him cross over the bridge in the support thread, I will make once I get home.

 

[RabbitPam]

karla, I am tearing up as I read this. I understand the difficulty of losing a pet while putting a face on it at work. In fact, a volunteer showed up this week at my place, I took one look at her face and asked “is it the kitty?” It wasn’t, but it is easier when you have some pet lovers around you who understand.
Hang in there, don’t think about it any more today, and just cuddle Jack tonight. You are doing the right thing for him.

My vet once told me that when their little systems start to shut down, it actually is easier for them and they are probably in less pain or discomfort and lose consciousness. So if he starts to go before tomorrow, don’t worry that you’ve prolonged anything for him. He will be comforted being with you if he goes naturally, or if you put him to sleep as he is with you tomorrow. You are a great Bunny Mom.

[kralspace]

Dear Karla,

Dittos to everything RabbitPam has said. I am so sorry it’s coming to this, but Jack’s been so lucky to have such a loving mom. It’s so hard to reach that decision even when you know it’s inevitable. I went through that with my little Hershey too. I was determined that I would find a way to get her to eat, etc but it wasn’t to be and she let us know that it was time.

Prayers, hugs and much love, Kathy and the furballs

[wendyzski]

I’m sorry that it came to this, but from everything I read here you are doing the right thing for him.  Thank you for being strong enough to let him go while he is still comfortable and not in too much pain.

[BinkyBunny]

Ohhhh,…I’m just so sorry! I have added more comments about this in your post in the Support Section.

HUGS.

[Denise12]

I’m so sorry

[Author]

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