A week ago, I had a very busy weekend. On Saturday, Bunny came in for what was supposed to be an upper respiratory infection. However, on physical exam, the rabbit had a very large urine filled bladder that was difficult to express. I was concerned the rabbit could have a bladder stone or sludge and according to the owner, Bunny had a history of bladder sludge that was previously treated. For those not familiar with bladder sludge, this is a medical condition in which calcium salts build up in the urinary bladder. Rabbits are very efficient about absorbing calcium from the diet and the kidneys filter the excess out for excretion. Some rabbits also have a genetic predisposition to this problem as well (this is suspected in Bunny). The excretedcalcium will combine with other minerals and you end up with a clay like substance that sits in the bladder. This sediment, aka sludge, is so thick and irritating that it can lead to bladder inflammation, difficulty to urinate, infection, and cause the pet to not feel well. Radiographs (x-rays) confirmed a diagnosis and I recommended medical management to help with the symptoms. Often, treatment includes fluid support, massaging and expressing the bladder, antibiotics, and pain medications. I also recommended a medication to help improve bladder tone and make it easier for Bunny to urinate. We had planned on following up on Monday as well. The following day, I received a call that Bunny needed to go to the ER in the evening because she stopped urinating. They were able to give more fluids and express her bladder but by Sunday morning, she was struggling again and the owner wanted to see if we can give more fluids in the morning. So I came in on Sunday and we talked about how Bunny was doing and that morning she really wasn’t eating well. After giving fluids, I attempted to express her bladder but at that time I was unable to express any urine except a few drops. Now it became a concern that she was obstructed. We discussed attempting to catheterize and see if I can empty her bladder with a catheter and the owner consented. We were both concerned since Bunny was debillitated and this will require general anesthesia. But I didn’t know what other choice we had. After preparing everything, my assistant and I sedated Bunny and attempted catheterization but to no avail, it was just not successful. When I called Bunny’s owner/mom, I discussed my concerns and difficulties and we talked about the next step. Although risky, the next option is a cystotomy which means opening up the abdomen, opening the bladder and flushing out all of the material. There were anesthetic risks, risks that she still would not be able urinate after surgery, and risks of infection. Unfortunately, our only other option was to consider euthanasia. Bunny’s mom opted to give surgery a try so we proceeded. The surgery was tricky since I had to flush out sand as well as grit the size of small pebbles. I had to liberally flush the abdomen of any of the sediment that had managed to migrate out of the bladder and I had to make sure we tried to get every little piece out. It wasn’t easy and there was no guarantee that I could get every thing. Finally, I reached a point that I felt I had done all that I could so I closed my incisions and we woke up Bunny. She was amazing through surgery and after. Bunny’s mom was able to transfer her to the overnight emergency facility for further intesenive care. After I left, I continued to fret about this bunny for the next 24 hours–most vets cannot leave their job at the door. But the next day I received a call that Bunny was urinating on her own and starting to eat. The plan was that she would be released from the hospital the following day if she continued to do well. By Tuesday, Bunny was able to go home! Now its a week later and Bunny came in for a recheck visit. Her owner has worked hard with her all week to assist her feedings and give injections as well as oral medications. All of the hard work has paid off. Bunny is doing really well, eating, urinating and active. She still has to finish her recovery and will need long term monitoring for recurring sludgy bladder but she is a fighter and I am so glad to have been a part of her recovery. Not all emergencies end up the way you want, hope, wish–so I never take the good ones for granted. This happy ending will stay with me.
Archive for the 'July 2011' Category
Since I have blogged about rats, I decided to put a blog together about their flying compadres–the Pigeon. Truth be told, I also love pigeons. They are adaptable, non-agressive, wildlife with an amazing history. We all think of these dirty birds that carry disease and poop on you when you are walking in a big city. But there is alot more to them. They have a military history and have received commendations for bravely flying messages out of enemy territories even when injured. The racing pigeon can fly for hundreds of miles to make its way home (I cannot drive across town sometimes without getting lost and having to call my husband for help or refer to my phone’s GPS) and the fancy breed of pigeons can rival any other species in beauty and quirkyness. I have had some doves and pigeons as patients. The pigeons were racing pigeons we diagnosed with bacterial infections. Unfortunately, there can be alot of overuse of antibiotics in the pigeon world and that leads to resistant bacteria. I am lucky to have dealt with some clients that have appreciated this concern and we were able to actually submit cultures and treat infections appropriately. My own personal experience with the pigeon’s close cousin –the morning dove–was during one summer living in an apartment in Fairfax, VA. I had a little balcony that was set up with a table, chairs and I had some pots for flowers out there. I had left the soil filled pots outside during the winter, and by spring it apparently made a great nesting site for a pair of doves. I kept hearing alot of cooing and noise outside and when I looked out the window, I found the pair building the nest…then laying eggs…then feeding the chicks. I was able to watch the progression through the spring and eventually there was a whole family living out there. I did not step out onto the balcony for months due to these squatting tennants, but I enjoyed watching them interact. Once everyone flew the nest, I had a major cleanup project to deal with–not so fun.
One of my best experiences with pigeons was feeding and having them perch on my in St. Mark’s Square, Venice Italy. This was one of the stops on my honeymoon, and for me one of the most memorable.
I am not the only one that has an affinity for these birds. Mr. James Walker has an amazing website that includes drawings and photos of these birds–appreciating the differences of pigeons around the country and also their beauty in flight: www.organicdebris.com Check out the link to snapshots and see the slide show.
Some wonderful books for the pigeon lovers out there include:
This is an easy read and really puts an educational and humerous spin on the natural history of the pigeon.
Another fun book (table book) is:
I thought I would blog a little bit about rats. I really like them and I have some clients that LOVE them. You wouldn’t think that they would be great pets but the are smart, social, and affectionate. Unfortunately, their life span tends to be about 2 years and by that time they may dealing with chronic diseases like cancers, heart disease or the dreaded respiratory infections that are so common. Now, although I would never touch a sewer rat, I find them fascinating as well. I love going to Manhattan and while waiting for the subway trains, look on the tracks to see if any rats are around. Usually I can spot one or two and it makes my day–I don’t know why. I do know I am not the only one though. Robert Sullivan wrote a fascinating book that I purchased during one of my last trips to NYC. It can also be purchased on Amazon. It is a great read if you are like me and curious about the rats in our country:
As I stated earlier, I have an affinity for pet rats, but I have clients that do take it to a bit of an extreme. When talking to these rat aficionados, there does tend to be a high level of anthroporphism. I think part of this is due to the fact that rats use their front paws like hands and will push away medications they do not want and use their paws to eat favorite foods. I also find that rat owners are very protective and I can actually really appreciate this. Many people look at rats as vermin and have instinctual fears. I find I usually have to show my clients that I like rats, I know how to pet them and make them boggle. Once you gain the trust of the patient and the client, then you can help provide medical care. I had one client that would fax me pages of information from a self proclaimed rat expert and I would have to read through the information and then discuss it with him. It was quite challenging at times, especially when I did not understand the medical reasoning behind this person’s suggested therapies or when there was no proof of safety. So we would negotiate on our plan of action with every call. Ah, the age of the internet. Eventually, this client moved out of state and he would still contact me regarding his rats since he could not find a local vet that would see rats. After his last rat passed away, I believe he opted to not adopt any more, it was just too emotionally draining when they became sick or aged.
When the movie Ratatoulle came out a few years back, I was so excited. It shed light and humor on the relationship between people and rats. Depending on the context, a swarm of sewer rats can be scary and disease ridden. But one or two pet rats can bring humor and companionship to a family. To know them is to love them.