To diagnosis renal disease, your rabbit-savvy veterinarian will first take a medical history of your bunny and her problems and perform a general physical exam. A urinalysis and blood work are tests that your vet will likely wish to perform on your bunny, and X-rays are always indicated. The urinalysis will reveal increased water content of the urine (an early sign of a problem). X-rays may reveal kidney stones, and blood work can reveal increased levels of creatinine and blood urea nitrogen (BUN) – toxins that healthy kidneys filter out. Blood work may also reveal higher than normal levels of phosphorus (contributes to nausea) and calcium – both of these contribute to mineralization (sludge and stones) within the urinary system. Your veterinarian will want to rule out other causes for the rabbit’s symptoms such as abscesses, other infections of the urinary system, cystitis, etc.
It will be very helpful to both your bunny and your veterinarian if you are able to bring a clean urine sample to your veterinarian if bunny is having troubles with increased thirst and urination. Try scrubbing out a litter box with a little soap and water, rinse it well, and see if your bunny will urinate in it without the litter
A bunny with renal disease is usually treated on an outpatient basis; however, if the bunny is in acute renal failure (crisis) he will need immediate intervention at the veterinary clinic in order to prevent additional insult to the kidneys. The bunny will likely be treated with fluid therapy (to help the kidneys flush out toxins), nutritional support, pain medication if needed (if bunny has kidney stones, cystitis, etc) and possibly supplemental heat to keep bunny comfortable during the procedures. The underlying cause of the renal disease needs to be treated as well, of course. Surgery may be necessary to remove any urinary stones. Antibiotics will be prescribed if any infections are present. If your rabbit has severe anemia, your veterinarian may also suggest giving your bunny erythropoietin injections to stimulate red blood cell production. These are usually somewhat costly and not always effective (sometimes they are effective, however). Your veterinarian can also prescribe medications to combat some of the gastrointestinal symptoms that accompany renal disease.
Your veterinarian will likely wish to do period re-testing in order to assess your bunny’s response to treatment, although the only real test as to whether treatment is working is whether or not your bunny is feeling well and enjoying life. Fluid therapy may need to be continued for the life of the pet – these fluids are given subcutaneously (under the skin) and your veterinarian can teach you how to do this at home.
Rabbits at risk of renal problems should avoid substances that may be harmful to the kidneys including non-steroidal anti-inflammatory drugs (NSAIDs) such as metacam (there are other pain-relieving drugs that can be prescribed instead).
It is very important to get a proper diagnosis and begin to manage the kidney disease is before the bunny becomes very ill. The goal, of course, is to increase the quality of the pet’s life for as long as possible. Plenty of rest and a good diet which includes fresh greens are important for a positive long-term outlook.
With early intervention and proper management, these bunnies can be kept comfortable and have a good quality of life.
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