Rabbit stopped grooming/urine scald

My 6 year old lop (spayed female) has incontinence problems. I recently had her to two regular rabbit vets and also to an exotic animal specialist. They did U/A, bloodwork, X-Rays and ultrasound. She is 100% healthy but they say that she doesnt have the correct amount of hormones because of her spay. We tried proin but it didnt help so there is nothing I can do. The MAIN problem is that she stopped cleaning herself. She is not overweight and according to the vet/XRays she does have any arthritis or physical problems that would cause this. Her hind end is DISGUSTING! I brought her to the vet several times so she can get that area groomed. I have also been giving her butt baths at home about once a week but she is losing a lot of hair and its really looking bad. The rest of her body is happy, good appetite, playful, etc. I am not sure what else I can do. I tried clipping and shaving the area but sometimes it sometimes makes her bleed because her skin is matted to the fur in some areas. Would it make a difference if I buy a rabbit shampoo? (im using natural dog shampoo now)... should I get her a cage with a grid bottoms so the pee/poop falls through the holes and she cant be sitting in it? I am not sure what else to do :-(

You could use a bedding such are CareFresh Ultra...it not only holds a lot of liquid, but it will prevent that liquid from transferring to other surfaces. It is expensive but effective...the low dust and lack of irritants may help some. To date, I've not used any bedding or litter I think is better so I use it as the main litter in the litterboxes, along with a small amount of zeolite to absorb the strong ammonia scent.

The high ammonia content in rabbit urine is a skin and lung irritant. Because of that, I think that buildup should be removed even if it does cause more irritation. If the standard shampoo does not cut it, you may need a compromise between a solvent that is gentle and a solvent that can remove caked up gunk. One possibility could be trying one of the two-step processes used to remove caked up debris on animals during certain human-created disasters such as petrol spills. In one protocol (after strapping on some nitrile gloves), the first step is covering the affected area in a cooking oil that can benefit skin (like olive oil), and allow it to soak in, massage it into the skin/fur, and it will soften the buildup. Then, using a diluted solution of Dawn dishsoap, you can remove the softened buildup along with most of the olive oil. The olive oil not only loosens the gunk, but it protects the skin to some extent and allows you to use less cleaning solvent to accomplish the same task. It is not a traditional method, I am not sure how much Vets use it, but it I have personally used this method and seen it used first-hand and it is very effective. Leaving some of the olive oil behind can be of benefit...especially when cleaning may remove a lot of the natural oils that skin and hair need.

If the rabbit is losing fur, skin irritation is almost unavoidable due to such sensitive skin. Eventually, this irritation can turn into a chronic wound and be very, very difficult to control. If it were me, my second highest priority would be preventing the exposed area from becoming a wound. A thicker weight cream without potentially harmful ingredients could reduce some of the irritation to try to prevent infection, but its effectiveness may depend on how willing a rabbit is to leave it be. If it does develop into a wound, I find that a product called MediHoney is damned near miracle strength and it is one of the few products on the market that can treat chronic wounds or ulcers (for example, it is unreal what it can do for an infected hock that hasn't responded to other methods.)

Have any of the specialists you talked to done a poop analysis? The diagnosis may be correct, but certain parasitic infections can cause incontinence issues. I mention that because it happened to me once, but unfortunately the incontinence reached a point where a free-roaming rabbit couldn't free roam anymore, and as the disease progressed the quality of life decreased.

Oh please do not oil up your rabbit.
You dont want to add anything to the rabbits skin that will soften it and make it easier to damage.
Nothing should be put on skin unless their are physical wounds. Bunny skin is easy to damage.

Using other shampoos is also not a good idea. Stick with what is safe. It is generally regarded to use nothing but a warm damp cloth unless cases are severe.

Can you post some photos of your rabbit? As well as of the affected area?

What is the housing like? What is the rabbit living on? What is the litter box like?

Hopefully ine of our long time experts can pop by and offer advice.

Thank you for your replies! The pics attached are pre-bath yesterday so now she is much cleaner but it doesn't last. As you can see she has a large bald spot above her tail that is growing. None of the vets or specialist did a fecal sample from what I recall. It's also to the point that she is in a cage for the first time in her life instead of free roaming (bc of the frequent urination). Could this be what is causing her to not groom herself? Being confined? She's in the largest cage I was able to find and once a day I express her bladder and let her roam the house for a bit. I use the Kaytee soft bedding. And her litter box is full of hay. Reading the replies makes me nervous that her raw exposed skin will get cut/infected. I do not know what else to do.

Picture of her hind end

Why are you expressing her bladder? Is she paralyzed? Squeezing the bladder of an awake alert functioning animal can cause severe damage to the kidneys and other issues.

Is there a grate on her litterbox? Towels in the rest of her cage? What keeps her from coming into contact with soiled bedding until its been changed?

Being able to groom herself is 1 thing, but there is something else going on causing her to get to that point in the first place. Something the vets could have missed.

Do you have a photo of (all of) her? Her setup?

Just a few questions. Is your rabbit overweight at all or does your rabbit have sore hocks? Did the vet try her on any medications such as an antibiotic in case of infection, or meloxicam(pain reliever/anti inflammatory) to see if the urine scald was happening due to pain? Was e. cuniculi ruled out? Do you know what caused the bald spot? Was it shaved, did the fur fall out due to urine scalding, or did your rabbit pull the fur out or chew it off? Do you know if she is getting the urine scalding from laying in her urine, or is it happening when she is in the process of urinating?

http://wildpro.twycrosszoo.org/S/00dis/Miscellaneous/UrineScaldingRabbit.htm

Her cage and litter box. Her cage is 45", 24" if that helps.

Pic of cage

Bald spot

Rabbit cage

I disagree.

I am not advocating using olive oil or a 1% Dawn soap dilution in normal cases. According to the OP, this is an extreme case; consequently, this buildup may be fusing to the skin. The most urgent priority is IMO removing the buildup. The second most urgent priority is protecting the exposed skin to avoid it from becoming a chronic wound. The longer this buildup stays on skin, the worse things are going to get. If I did not believe this method would be successful in safely removing the buildup while minimizing additional skin irritation or stress, I would not have recommended it.

Watermelons said:

Oh please do not oil up your rabbit.

Click to expand...

Why use oil to help remove severe dried buildup?
Oil can soften this type of severe buildup and can reduce the amount of scrubbing as well as the quantity of solvent needed to remove the buildup. In this specific case, IMO the benefits greatly outweigh the risks.

Ammonia burns skin and buildup can begin to fuse to the skin. The process of butt bathing a rabbit can further irritate this because the natural body oils are being removed. This can trigger an inflammatory response. The antioxidants and vitamins in olive oil are beneficial to skin health, and it does not clog pores. It can supplement some of the natural skin oils that can be lost from bathing, and protect skin from further damage.

You dont want to add anything to the rabbits skin that will soften it and make it easier to damage.

Click to expand...

Actually, that is exactly what I would want in this instance. The oil softens the buildup better than water alone can, and helps gently separate it away from the skin, helping to avoid unintentionally ripping out fur or ripping off skin that is stuck or fused to this gunk.

Nothing should be put on skin unless their are physical wounds. Bunny skin is easy to damage.

Click to expand...

Why use a topical designed to reduce and prevent further irritation?
I agree that rabbit skin is very sensitive and easily damaged, hence the need to prevent exposed skin from going from bad to worse.

In this case, the exposed skin is presumably very vulnerable. It is in an area that will make contact with surfaces, have contact with waste products (including ammonia), and is vulnerable to friction burns. The loss of natural skin oils can make this worse. We have products designed to help protect extremely sensitive skin from damage and replenish healthy skin oils (for example, CeraVe.)

With no hair to protect it, why leave such sensitive skin vulnerable to these elements?

Using other shampoos is also not a good idea. Stick with what is safe. It is generally regarded to use nothing but a warm damp cloth unless cases are severe.

Click to expand...

Getting the buildup off ASAP is of the greatest importance. A damp cloth is inadequate in this specific circumstance.

No it is still not okay to do that. Plain and simple.

Watermelons said:

No it is still not okay to do that. Plain and simple.

Click to expand...

I assume you have extensive experience using the described 2-step method and cleaning wildlife? I mean, how else could someone speak in such definitive terms? (esp?)

Not too long ago, the general consensus was that skin should be kept dry and wounds should be kept dry. And even with evidence that shows moist wounds heal faster with fewer complications, still there is little interest in further discusssion.

Watermelons said:

Oh please do not oil up your rabbit.
You dont want to add anything to the rabbits skin that will soften it and make it easier to damage.
Nothing should be put on skin unless their are physical wounds. Bunny skin is easy to damage.

Click to expand...

Watermelons said:

No it is still not okay to do that. Plain and simple.

Click to expand...

I had a rabbit that occasionally lost small chunks of fur towards her side in an area that would make contact with the crapper, carpet, sidewalk, etc, without having hair to protect it. For a long time, I did the whole keep it dry and don't put anything on it. After all, virtually everyone in the rabbit community echoed the exact same thing.

This is an image from the test to determine the value of trying to protect the exposed area. Hair loss in these two areas occurred at roughly the same time. One of these areas were treated with a periodic film of medical-grade Leptospermum honey. The other was kept dry. Why is one area infected and the other not? Because, even though the loss of hair and exposure to the elements still resulted in some irritation, the pathogens that cause opportunistic secondary infection are rapidly killed. The ability for Leptospermum honey to rapidly turn wounds sterile has been well documented in medical literature, as has its anti-inflammatory properties. At this point, there was no question regarding efficacy so I applied the product to the infected side and it cleared up in a few days.

So frankly, I do not understand why everyone is so hellbent on a single solution when there are clearly other effective options. When you tell me nothing should be put on vulnerable skin, for the life of me I cannot wrap my head around that.

Ts you just went against what you are trying to prove me wrong with....

If there is an open wound or infection yes, you put something on. Not if it is just plain skin. It's simple.
If everyone put something on every sore hock with no wounds or bare chested nesting rabbit, we would have a bunch of goopey rabbits resistany to antibiotics

FLequestrian
I would be looking at changing that housing setup. Your bun really shouldn't be able to be sitting in their own urine. Look into building a grate for that litterbox out of eggcrate (Light diffuser) to keep that bunny bum off the litter and pee. As well I would be switching the rest of the cage to nice plush towels if your rabbit is safe with them, you have a plastic bag for the litter box and while that is concerning, if your rabbit doesn't chew that I have a feeling she is okay with towels. And keeping them clean even if that means changing soiled linens twice a day.
It's hard to tell if she is overweight in those photos. Has Metacam been tried as Jenny asked? I would still think there is another reason she is not grooming herself, and getting urine all over her. Lets try and keep her away from the urine in her cage first, then work on her.
Jenny (Jbun) asked a few questions it would be helpful to get the answer too.

I agree with Watermelons. I would try to put cover the bottom of the cage with newspaper at the very least. You can still put the bedding on top, or you can leave it out. That cage looks similar to two of our rabbit cages. The plastic can cause them to slip and slide, and the bedding might be making that slipping worse. I would start there. I would also not put plastic bags in the litter box. I would put in newspaper and then hay on top. I would try to change it out at least twice a week and make sure the surface of the hay is dry in between (if not, then add a bit more hay if it's not the time to change it). The key here is to keep her bottom from being in the urine. My next concern is why she is frequently urinating? What does the vet say about that? Does she have any sludge in her bladder? Then my next concern would be whether she was in pain. Our rabbit had some sludge in his bladder, and was having similar problems, but after getting treated for a urinary infection, and now getting daily pain meds, Metacam, (for arthritis), that resolved the issue and he is no longer peeing outside his box.