Major Incontinence Issues

[pinknstink]

Hello RabbitsOnline! This is my first post, as I am in the hopes of getting some advice for my rabbit's problems. My rabbit Cotton has some birth defects, such as a weird bite and only being able to see out of one eye, but he also has bad incontinence issues. He hasn't always been incontinent, but throughout the past year or so it has gotten very bad. I give him butt baths every few days yet he still ends up soaked with urine and sometimes poop. His feet, inside thighs, and belly are all stained yellow so it is hard for me to tell if he is totally clean or not. His feet and inside thighs get soaked with urine, and he has been losing hair on the inside of his legs and a little on his feet. His skin is also a little red, probably from urine scalding. The vet says that he is pretty underweight and dehydrated, but they also said that Cotton's condition has gotten better since I started giving him baths which is really good news. I guess I am just writing this in the hopes of getting some advice in caring for an incontinent rabbit. The vet thinks that this is just caused by something in his blood that he was born with, but they said that it could also be two other things. One was something that I cannot remember at this time and that it was not treatable, and another option was rabbit syphilis? I thought that was just lesions, but I may be wrong. I would have to do some tests to determine if it is that and maybe it could be cured, but I kind of feel like it is just a part of his birth defects, as I have been researching about syphilis and E. cuniculi and other stuff that could cause incontinence and it seems like no one is having the same problem as my rabbit, but maybe it could be something like that. I sometimes ask myself if I should put my rabbit down but he eats a lot, doesn't seem to be in any pain, and seems to be curious about what is happening around him so I don't think I should. I am hoping that there are other owners of incontinent rabbits out there to give some advice. What are your cage setups like? Cotton lays in his litter box all the time which definitely doesn't help. I was thinking I could get him a comfier area to lay so that he doesn't stay in his litterbox, but I am not sure what kind of material would be good so that he isn't laying in his urine. Would a grate over the litterbox work with that? I use wood pellets for bedding, is there a better bedding that I could use? Also, he seems to pee and poop wherever he wants to, most of it goes in the litterbox only because he constantly sits there but he also pees and poops outside of the litterbox. Since he somewhat struggles to use his litterbox, would it be a good idea to just get rid of it and have basically his whole cage be a litterbox? He sometimes lays outside of his litterbox, but there is also little spots of pee there. The cage has a plastic bottom. In the past, I have tried taping baby socks to his feet so that the urine stays off his feet, but as you can imagine, that didn't last too long, haha! By morning time, the socks would be off. I have heard some people have used diapers, is that a good idea? He kind of has mushy poops, and I feel like maybe he isn't too flexible because I think he eats his cecotropes by pooping them out and then turning around and eating them, not eating them directly from himself. He is a Lionhead Angora mix, so he has a lot of hair! He gets some sanitary trims, but it takes him a long time to dry after his bath. I don't want to rub his hair too much with a towel because of his sensitive skin, and I have a hard time getting him completely dry. Honestly, I just really need some help. If you guys have incontinent rabbits, what are some things that have helped you the most? This is basically his only symptom other than some eye discharge (probably from his weird bite), does this sound like more than just a birth defect? I have attached a photo of my rabbit's stained fur to show how big of a problem this has been (also, my rabbit has white fur, is there any way to remove stains from the fur?) As you can see from the photo, basically his whole underside is yellow. I took this photo right after I bathed him today, so he is clean, his fur is just really stained so it looks like he is still dirty, which makes it hard for me to make sure that he is 100% clean. I apologize for all of this information and all of these questions in one post. I have never had to care for a disabled (?) rabbit so any tips and tricks for his care would be greatly appreciated!! Thank you!

 

[Blue eyes]

Could you please describe a typical daily diet for him (including brands and quantities)?

 

[pinknstink]

Sure! He is somewhat underweight so I have been giving him more pellets than usual for the last 9 months or so (around the time when this whole incontinence thing began) in the hopes of him gaining some weight. In the morning, I give him about 1 cup of pellets every day, but he usually only ends up eating about half of that and then dumping it in his cage, so he only gets about 1/2 cup or so a day. The pellets I use are Select Choice Pro Formula Premium Feed for Rabbits. I put about a handful of hay in his litter box in the morning as well, and I refill it as it starts to get low. I am planning on making some sort of hay holder for him so that he always has access to as much hay as he wants. The hay I use is Kaytee Forti-Diet Natural Timothy Hay. I am trying to get him to use a bowl for water, but he tips his water bowl a lot so he has been using his water bottle. I feel like he can't get as much water that way, so I am trying to find a solution for him tipping both his food and water bowls. In the afternoon, I usually give him a big handful of vegetables, usually something like cilantro or shredded carrots (if I do carrots, I give him less than what I would give him if I did cilantro because I read that too many carrots can cause diarrhea problems) , but every now and then I will switch it up and give him something such as parsley. I get the vegetables from my local grocery store.

 

[Blue eyes]

Thanks. Rabbits can have different sensitivities to different foods. Hopefully Jenny (JBun), our health moderator will hop on here as she is well-versed in this. In the meantime, I would totally cut out carrots. They are sugary and can cause digestive issues. Some rabbits are sensitive to certain greens so the messy bottom could very well have to do with diet. I've also heard that some rare rabbits don't do well with pellets either, but Jenny would have more to say on that. It could very well be that any carrots can cause problems for your particular bun. Sometimes a certain green can cause issues for individual rabbits. So it could also be the cilantro and/or parsley too.

For hay, he should be eating his body size in hay every day. Does he eat that much? Rather than a handful, he should be offered his full body size at least once per day.

As for bowls that don't tip, try the ones that twist on to a clamp like these:
https://www.petsmart.com/small-pet/...g-things-plastic-crock-40888.html?cgid=600119

or these:

 

[JBun]

Did the vet ever check for and rule out a UTI as the cause for the urinary incontinence? Did the vet ever try antibiotics to clear it up or any other medications, and if so, which ones specifically?

 

[pinknstink]

Thank you so much for the info about the food bowls, I will have to check those out! I took him to the vet earlier this year about this and she did some blood work and ruled out a UTI. She gave us an antibiotic just to try out. I can't remember the name right now, I will try to find it, but it was a pink liquid. As far as I could tell, it didn't help his condition. That is the only medication we tried. From the blood work, the vet said that it was most likely either something that could not be cured (I don't think she told me the name of it) or that it was rabbit syphilis, and that I would have to do some more tests to be sure. I am thinking about doing those tests since she said that rabbit syphilis could be cured, but I have been doing some research, and I feel like rabbit syphilis doesn't really cause any incontinence problems, but maybe you have some information on that!

 

[zuppa]

Hi, may I ask how old is he and how long is he with you, when this started and if there was something like changes before it started.

What I know for sure that's no more carrots for him, zero carrots, and cut his pellets I think his diet is too rich. I understand that he's underweight but maybe he's losing weight because of this constant diarrhea?

In any case I would start with just keeping him on plain hay diet for a week or so, Timothy hay (make sure he's not getting any alfalfa hay) and fresh water (maybe boiled), no vegs and treats, no pellets. I would recommend adding some dried herbs to his hay but I'll wait for your answers to my questions first.

Also, if you could post some photo of his setup, his litter box, his cage, his toys etc.

 

[pinknstink]

If I remember right, I got him in 2013 and I believe he was under a year then, so I would say he is about 6 or 7 years old. He has always had some problems because of his birth defects, but the problems have changed over time. Up until about 9 months or so ago, the only problems he had was that we believe he can only see out of one eye, he has some eye drainage and sometimes a runny nose, and he has a malocclusion so we have to get his teeth trimmed every 3 or 4 weeks or so. Then, about 9 months ago, we noticed that he was starting to get urine on the fur between his legs and a little on his stomach, and the problem has just progressed. Since his hair is really stained, it is hard for me to tell how bad it is, so I am thinking of shaving his stomach and inner leg area, so hopefully that helps. He used to have diarrhea but I don't think he does anymore, he could definitely eat more hay, however. I am not at home right now but I will attach some photos of his area later. His cage is a little small but that is because he gets a bigger area to exercise in for most of the day, but I am planning on building him a bigger setup in the future.

 

[pinknstink]

I have attached a photo of my rabbit’s current setup. I also just got him a new hay rack and food dish thing, is that enough hay? Or should I attach possibly a second one so that he is getting enough hay? I am hoping to get some sort of fleece bedding to cover the bottom, would the sheep-like fleece or microfiber fleece be better for absorbing urine? Thanks!

 

[Blue eyes]

Yes. More hay. He should have easy access to his body size in hay at all times. If you put the hay directly on top of the wood pellets in the litter box, he'll have easier access to the hay and will be more likely to eat more then. It will also help keep the urine and soiled litter off of his paws as the pee will seep below the hay.

Of course you will need to add fresh hay on top about twice per day so that he always has fresh hay available.

If the "pink stuff" given by the vet was amoxycillin then that is a big problem. That is penicillin-based and rabbits should not get oral penicillin. It can kill them. So be sure to check the name of that medicine.

 

[pinknstink]

I moved some of his stuff around because I felt that his litter box was a little full. I thought that that wasn’t enough hay, thanks for letting me know! I used to put a bunch on the side of his litter box but I felt that he liked to pee and poop on it rather than eat it so I thought that a hay rack would be a better option. Do you guys know what kind of hay rack would be able to hold enough hay? I really hope he wasn’t given amoxycillin! I will have to check that. And have you tried fleece bedding? I have heard that it is very absorbent so I was hoping to try that out soon.

 

[zuppa]

Very nice and clean! And he uses his litterbox I see.

I would just spread some wood pellets on his floor too, they absorb urine better than fleece or anything else. I would also trim his hair, especially around his eyes so he could see, maybe around his private area so he could reach his cecals and clean himself, I would probably review his diet and make it 80% hay, a handful of fresh leafy greens (cilantro, celery stick, basil, mint) daily and very little amount of pellets, not alfalfa based. Maybe keep him a few days just on hay and greens, then add pellets. No carrots or fruits, no corn etc. Add some dried herbs to his hay, camomile, mint.

 

[Blue eyes]

Wasted hay should be expected. They like to pick through it. I don't think you'll find a large enough hay rack that can fit in that cage. (There are large ones that could work in an exercise pen since the pen walls are taller.)

The amount of hay in your current rack makes the hay difficult to get out. Bunny has to work for it which will make him eat less. Unless you have to fill that rack 4 times per day, he isn't eating enough hay.

Having hay inside the litterbox makes it easy for him to eat it. Yes, he'll pee on some but that is why you add more on top every day (twice per day). That way he'll always have fresh hay. They wont eat soiled hay so don't worry about that.

 

[Blue eyes]

Is he peeing outside the box on the solid floor of the cage?

 

[pinknstink]

I had the vet take care of Cotton while I was out of town and had them trim his hair around his nose and eyes, and they trimmed around his tail and inner legs as well. While he was there, they noticed that he had sores on his feet and that they had to get some pus out of them. I am not sure why they never told me about these before, because maybe I could have prevented them. What kind of treatment should I do for this? I was thinking of getting him a wire bottom floor so that he isn't standing in his urine, but I feel that that would aggravate his sores more. What do you guys think would be the best setup for an incontinent rabbit with sores on his feet? I was thinking about possibly getting rid of his litterbox and just covering the whole bottom of his cage with fleece or something like that since I feel like it would be softer on his feet than wood pellets. About the litterbox, he uses his box but I think he only uses it because he sits in it all day. He just seems to pee and poop wherever he happens to be, so he does sometimes pee and poop outside of his box, which I try to clean up and scoop into his box every night before bed. Thank you for those diet tips, zupper! Cotton seems to be losing more weight. He was already pretty skinny, so I am somewhat worried. He eats all his pellets and any fresh veggies or fruit that I give him, but I cannot seem to get him to eat hay. I give him a big pile every morning and he barely touches it all day. What do you think I should do about that? He never really ate a whole lot of hay but now he is barely eating any, and that can’t be good since hay is such an important part of the diet. Even if I sprinkle in some of his favorite treats, he picks the treats out of the hay. To make up for this, I end up giving him quite a bit of pellets because I don’t want him to lose more weight. Maybe he just doesn’t like the type of hay anymore? I am not sure what to do about that. Any advice would be appreciated!

 

[pinknstink]

I do not remember if I have said this yet, but Cotton also has teeth problems (malocclusion I believe it is called) so we have to get his teeth trimmed every month or so. This may be why he doesn’t eat as much hay, but he can definitely still eat because he loves to eat cilantro, pellets, etc. so how can I get him to eat more hay?

 

[JBun]

A thick layer of soft hay is actually the best substrate for any rabbit, particularly one with sore hocks. Temporarily while your rabbits feet are healing, instead of using wood pellets I might be inclined to use kiln dried pine shavings covered with a thick layer of soft hay, cleaning out wet spots daily. The wood shavings would be a softer surface than the wood pellets. Wood pellets could still work though, if you had a thick enough layer of hay over them that your rabbits feet never came in contact with the pellets. Another option(though more expensive) would be to use vet bed fleece over towels or disposable puppy pee pads. The vet bed fleece allows the urine to drain through it to the absorbent layer below. Which ever of these options you decide on, because of your rabbits incontinence issues, I would take out the litter box and fill that whole cage with the litter and hay, or vet bed fleece with the absorbent layer beneath.

With how bad your rabbits feet are, I'm surprised the vet isn't having you wrap them. It's what I would want to do, with some neosporin on the open sores. Maybe ask your vet about it. It's important to be properly instructed on the bandaging by your vet, as if it's done incorrectly you risk serious injury to your rabbits feet if the blood supply is restricted by bandaging too tightly.
http://www.medirabbit.com/EN/Skin_diseases/Mechanical/Pod/Podo.htm
http://www.medirabbit.com/EN/Surgery/Bandaging/band_foot.htm

Incontinence can sometimes be caused by rabbit syphilis, but if he had that I would think you would be seeing other signs of it, particularly around the genitals. Another cause for incontinence but I think often overlooked, is e. cuniculi. I would suggest discussing this possibility with your vet and starting treatment for it with fenbendazole 20mg/kg, which is the usual med used to treat EC.
http://wildpro.twycrosszoo.org/S/00dis/Parasitic/Encephalitozoonosis.htm
"In acute cases that present with urinary incontinence

• This may resolve with Fenbendazole treatment. (B601.11.w11)"

Eating hay requires a different chewing action, so a rabbit with dental problems from molar spurs, can often still eat pellets and soft foods but find it difficult to eat hay because of the figure 8 motion that is done with their molars to grind hay up. It can cause sharp back molars to dig into the cheeks and tongue causing pain and sores to develop. With your rabbit having a history of dental problems, and now not eating hay well, I would suggest having your vet check his teeth right away. But you definitely do need to feed him more of his other foods until you can get the hay eating sorted out. You don't want him to lose too much weight as well as risk him going into GI stasis.

 

[pinknstink]

In the photo of his cage, I made a little grid thing for his litterbox out of some plastic eggcrate stuff I found at Home Depot. If this doesn’t improve his condition, I will probably move to the vetbed idea! I also put some towels in the area where his litterbox isn’t located and then I covered those with fleece, I also attached a photo of the fleece. Is this the right kind of fleece that will be absorbent? I think this is the kind that some other people use for fleece bedding, but I am not sure. I have also been looking around and some people use sherpa material instead of fleece, so if the fleece doesn’t work out, I may try that. I will get in contact with my doctor and see what they say about some sort of treatment for his sores, and I will also ask about those other causes of incontinence. I hope that his condition would be able to be cured, especially since I have been told that it may be his birth defects causing it. But if it is not treatable, I will do my best to keep him comfortable. I am trying to convince my mother to let me build him a bigger cage out of NIC cubes, and I think I am getting close to her saying yes! Thanks again for all the great info and advice!!

 

[JBun]

You actually don't want to use fleece that is absorbent for an incontinent rabbit. Reason is they will then be stepping on the wet fleece and getting their feet and fur wet. You want a non absorbent fleece that allows the urine to quickly drain to an absorbent layer under it, like puppy pee pads or towels, and keeping the top fleece layer relatively dry so the rabbits feet and fur stay dry. That's what vet bed fleece does. Some sherpa fleece is also like this but not as good as the vet bed fleece.

This is what I did for an old rabbit of mine that had lost her mobility, and it worked really well at keeping her dry. I used a type of sherpa fleece with towels and disposable puppy pee pads underneath. So you want a pile fleece like sherpa or vet bed, that has minimal absorption, with an absorbent layer like towels and/or puppy pee pads underneath. Then these need to be changed out at least daily, depending on how soiled they get. The disposable puppy pee pads are nice because you can just throw them out. I got mine from costco. But I also had to use towels in the main area as I found the puppy pad got wet too quickly, so a more absorbent layer was needed.

 

[pinknstink]

Shoot, I thought I got the fleece that would wick the moisture away from the surface like how you described. Did I get the wrong type? I saw that some people “prepare” the fleece by washing it or something like that, should I have done that? I could try the sherpa stuff or I could maybe save up and purchase some vetbed! Thanks for the tip about the disposable puppy pee pads! I use those for my rabbit when I am cleaning his cage, now I can use those in his regular cage as well!