Follow-up on Jack's Bladder Sludge

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My vet did express urine from Chase's bladder for urine samples a couple of times but never tried to express the sludge. When she did express the urine Chase never seemed to be in pain during or after. The massages we did never seemed to bother Chase either.

No, Chase has never had to be anesthetized for her x-rays. They have two people hold her. One at her head and one at her bottom and they stretch her out on her side. I couldn't image them having to anesthetize her. That would screw her up for days. The previous vet I took Chase to didn't have digital x-rays and they didn't anesthetize her there either. I would really push the vet to try the x-rays without anesthesia. If they have 2 people holding Jack they should be able to get one good x-ray. I had a vet tell me before they would have to anesthetize her to do the x-rays and I informed them she has had them done before without it and to try and they did and the x-rays came out fine. My other rabbit has had x-rays of her head and stomach without being anesthetized on a regular x-ray machine and digital. I can't image how stressful that must be to have him put out everytime. If he is going to have x-rays often the vet really needs to find a way to do it while he is awake. I would ask them to try.

If your vet stands his ground that Jack has to be anesthetized, I would ask them to use an ultrasound machine and see if they would feel more comfortable doing that without anesthetizing him. I believe you can see the sludge just as well and they use a wand so Jack wouldn't have to be completely still as he does for an x-ray.

That is great Jack is drinking. I tried all types of flavors and it didn't work. Him drinking will really help.

I also wanted to add that I would use Lasix as a last resort. It doesn't really cure the issue that is causing the calcium build up. There could also be long term side effects that are not known. When my vet explained it to me she told me that because this drug is generally used on rabbits with fluid on their heart, there is not a lot of research on the long term side effects because those rabbits don't usually live more then a few months. I chose to take my chances because 2 vets had talked to me about possibly having to put Chase to sleep if the stones/sludges didn't stop. The vet who did her 2nd surgery told me her bladder didn't look good and wouldn't handle much more of this. 10 days post op she had already had sludge in her bladder. Her sludge was turning into stones. So in extreme cases I would use it if nothing else worked, but I would do everything you can first.
 
I wonder if posting what is in the pellets you feed would be helpful. My vet and I believe that what ended up curing Chase was adding good quality pellets to her diet. She wasn't receiving any pellets before that. I started the pellets and at her next monthly appointment the sludge was completely gone. It has been gone for 3 months now and I am weaning her off the lasix. Sometimes it is the things you would never think of. May be someone here could tell you if your pellets have a good source of vitamin D in them.

I feel your frustration on trying everything and nothing working. I actually did switch vets after Chase's second stone was removed. If I didn't, there is no doubt Chase wouldn't be here. The vet was good. But she didn't have enough knowledge to try to think of new things to try when it seemed like you had tried everything. Is there a large university in your area that may be able to lead you in the right direction of a good exotic vet. If they have a vet there that teaches exotics and practices. It wouldn't hurt anything to get a second opinion.

You could try to contact my vet. May be she knows someone in your area. May be she could give you some advice on what she would recommend doing. She really cares about animals and I think she would help you in any way she could.

I also tried the different water and different water filter, bowls, fountains, bottles, everything. Nothing helped.

I would post everything you are feeding him and what is in it. May be someone could look at it to make sure it has all the vitamins/minerals that is needed.

Another thing you can ask about is trying to get a blood test to check the vitamin D levels. I tried this and my vet said it couldn't be done but it wouldn't hurt to ask your vet.
 
You are very welcome Bill. I am going to post what is in those pellets and hopefully someone more knowledge can comment.

Oxbow Bunny Basics T
Ingredients:
Timothy Grass Meal, Soybean Hulls, Wheat Middlings, Soybean Meal, Cane Molasses, Salt, Limestone, Yeast Culture (Saccharomyces cerevisiae), Vitamin A Acetate, Vitamin D3 Supplement, Vitamin E Supplement (tocopherol), Vitamin C Supplement (Ascorbic Acid), Colloidal Silica, Menadione Sodium Bisulfite Complex (Vitamin K), Riboflavin, Niacin Supplement, Vitamin B12 Supplement, Pantothenic Acid, Biotin, Thiamine, Choline Chloride, DL-Methionine, Pyrodoxine Hydrochloride, Folic Acid, Sodium Selenite, Magnesium Sulfate, Ferrous Sulfate, Cobalt Carbonate, Manganese Oxide, Zinc Oxide, Zinc Sulfate, Copper Sulfate, Mineral Oil, Calcium Iodate, Potassium Chloride.

Guaranteed Analysis:

Crude Protein (min) 14.0%
Crude Fat (min) 1.5%
Crude Fiber (min) 25.0%
Crude Fiber (max) 29.0%
Moisture (max) 10.0%
Calcium (min) 0.35%; (max) 0.85%
Phosphorus (min) 0.25%
Salt (min) 0.5%; (max) 1.0%
Vitamin A - 20,000 IU/kg
Vitamin D - 880 IU/kg
Vitamin E - 140 IU/kg
Copper - 20 mg/kg

I couldn't find American Pet Diner Timmy Rabbit Pellets nutritional information. It wasn't on their website.

I feed Oxbow Organic Rabbit and love it. I compared it to what you were feeding. Some of the vitamin content seemed higher but not a lot higher so I don't know if it would even help anything. Bad thing is the calcium content is also higher. This is Organic Rabbits nutritional info:

Ingredients
Organic Grass Hay, Organic Canola Meal, Organic Wheat Straw, Organic Sunflower Meal, Organic Barley, Organic Flax Seed, Sodium Bentonite, Limestone, Sea Salt, L-Ascorbyl-2-Polyphosphate (Source of Vitamin C), Organic Dandelion Leaf, Organic Ground Rosemary, Inulin, Organic Cranberry, Organic Blueberry, Dried Yucca Schidigera, Yeast Culture (dehydrated), Vitamin E Supplement, Choline Chloride, Zinc Proteinate, Zinc Sulfate, Ferrous Sulfate, Niacin, Copper Sulfate, Selenium Yeast, Vitamin A Supplement, Folic Acid, d-Calcium Pantothenate, Copper Proteinate, Riboflavin Supplement, Manganese Proteinate, Biotin, Manganous Oxide, Thiamine Mononitrate, Magnesium Sulfate, Vitamin B12 Supplement, Sodium Selenite, Pyridoxine Hydrochloride, Cobalt Carbonate, Vitamin D3 Supplement, Calcium Iodate, Ethylenediamine Dihydriodide

Guaranteed Analysis
Crude Protein min 12.00%
Crude Fat min 2.00%
Crude Fiber min 23.00%
Crude Fiber max 25.00%
Moisture max 12.00%
Calcium min 0.60%
Calcium max 0.90%
Phosphorus min 0.30%
Vitamin A IU/kg 19,000
Vitamin D IU/kg 900
Vitamin E IU/kg 190
Copper ppm 25

I don't know if it would benefit you try and find a pellet with more vitamins. Hopefully someone more knowledge can comment on that.
 
I am by no means an expert, but from what I've read, the calcium:phosphorus ratio is very important in preventing the metabolism of the bones that can lead to sludge. Now I know that there's supposed to be more calcium than phosphorus, but I don't know how much that should be. Vitamin D is also important, and you may look into a food with more vit D. I have also thought about vitamin D supplements, as I take them myself. Mine are gel capsules, so it wouldn't be too difficult to cut them open and give the stuff inside. Grinding up vitamin D pills and giving those might work too.
 
I will cross my fingers for you bill, that the change in pellets help. It is a long shot but I think when you have tried everything you are suppose to, you have to start looking at other options. I don't know if you have a Pet People or Pet Supplies Plus, but both petstores carry the Organic Rabbit in my area. Pet Supplies Plus is about $2.00 a bag cheaper then Pet People.

I hope you do post the link to your records of what you are trying. It will help other members who may have this issue.

How is Jack doing? I hope things are going well.
 
I am glad you posted an update Bill, I have been wondering how Jack was doing. I wish it was better news though. Keep trying things. I know it is frustrating but hopefully one of the things you try will work. Don't give up hope. It took me about a year to find a resolution.
 
The reason may be that calcium citrate is soluble and other compounds with calcium are insoluble and will form solids. Adding acid to the urine can also help keep the calcium dissolved. Best of luck to you guys, I hope you find something that works.
 
That's what happens in sludge. But, the calcium citrate is soluble in water, so it won't be a solid. It will stay in the liquid. Calcium carbonate is what most bladder stones and sludge are made of, and it's not very soluble in water. If you replace the carbonate with citrate, the calcium will be in the liquid, as dissolved ions (like salt in water).
 

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