Urinary Incontinence in Rabbits
Urinary incontinence is clinically described as a condition in which there is loss of voluntary control of urination, usually observed as accidental urine leakage. This is often caused by a loss of bladder tone (normal tension and sensitivity) or an obstruction of the bladder. For example, a partial obstruction may cause the urine to backflow into the bladder and lead to muscle tension and weakness due to bladder distension.
Urinary incontinence is most common in middle-aged rabbits (3-5 years old). And although it mainly affects the urinary and kidneys systems, the rabbit may also have skin burns and irritation around the genital areas due to urine leakage.
Symptoms and Types
In addition to urine scalding on the skin, rabbits with incontinence may dribble small amounts of urine when picked up or in atypical areas (carpet, upholestry, your lap). The urine is typically cloudy or thick, and beige to brown in color. The bladder may also markedly increase in size if the underlying disease is not treated promptly, and may even fill most of the abdominal area, giving the rabbit a bloated appearance.
Causes
Neurologic
- Damage to the local nerves that control the bladder and valve function
- Spinal cord injuries
- Injuries of the cerebellum and areas of the brain that control voluntary urination
Urethral Disorders
- High calcium levels in the blood
Anatomic
- Development or structural disorders in the urinary tract that may cause backflow of urine
- Risk factors include inadequate water intake — which may be due to dirty water bowls, unpalatable water, changing water sources, or inadequate water provision
- Inadequate cleaning of the litter box or cage may cause some rabbits to avoid urinating for abnormally long periods
- Obesity, lack of exercise, and feeding of only alfalfa-based pellet diets
- Adding calcium or vitamin/mineral supplements to the diet
- For neurologic causes — improper restraint, which can lead to injuries
- Injury, paralysis of rear limbs, spinal disease
Diagnosis
Because there are several possible causes for this condition, a differential diagnosis is the best method for identifying the underlying cause of the incontinence. This process is guided by deeper inspection of the apparent outward symptoms, ruling out each of the more common causes until the correct disorder is settled upon and can be treated appropriately. Initial tests may differentiate between other causes of improper urine output and discolored urine, which can attributed to something as mundane as the diet.
If blood and urine analysis are taken, it will typically demonstrate abnormal levels of calcium and enzyme content. The urine sample will also be examined for bacterial infections. X-rays, meanwhile, may demonstrate calcium deposits in the urinary tract and/or kidney stones. A complete neurologic examination may be necessary -- with an examination of anal tone, tail tone, and perineal sensation -- to check if the nervous system's mechanisms are functioning properly.
Treatment
Treatment is usually given on an outpatient basis; in fact, the need for hospitalization is rare. If a urinary tract infection is present, that will be addressed first. If high calcium levels are present in the urine, fluid therapy can be beneficial for keeping the urinary tract clear. And if possible, your veterinarian will treat the underlying neurologic disorders.
Antibiotics and bladder tone modifying drugs may be prescribed. However, surgical removal of gall and/or kidney stones may be necessary. If other less invasive methods are available, your veterinarian will discuss them with you.
Living and Management
Your veterinarian will schedule a follow-up visit to check the levels of calcium in your rabbit's urine, and to check for the presence of blood and enzymes in the urine contents. If stones had been found in the kidneys of bladder, follow-up exams may be necessary to analyze your rabbit's response to treatment.
It is important areas affected by urine scald (e.g., legs, genitals, etc.) are kept clean and dry. Possible complication related to urinary incontinence, include permanent urinary incontinence, urine burns and urinary infection that spreads into the bladder. Rabbits with incontinence caused by neurologic disease have limited recovery potential.