Hematuria in Rabbits
Hematuria is defined as the presence of blood in the urine. Although dietary pigments (i.e., components of ingested food or drink) or blood from the female reproductive tract can sometimes lend a red tinge to the urine, this should not be confused with true hematuria, which is indicated by blood that has originated with the stream of urine.
Symptoms and Types
- Red-tinged urine (due to the discharge of blood clots)
- Painful abdomen on palpation
- Development of tumor/lump
- Enlarged bladder, leading to distended abdomen
- Frequent bruising (due to excessive clotting)
- Urocystoliths (bladder stones) may be detected by abdominal palpation; often, one single, large calculus can be felt
Sedentary rabbits, female rabbits, and middle-aged rabbits are all at risk of developing hematuria. This may be due to kidney stones, bacterial bladder infections, and/or an increase of calcium in the blood. The most common cause of hematuria in intact females, however, is the dysfunction of the reproductive tract. Coagulation, clotting disorders, or an injury to the genitals, urinary tract or bladder may also cause blood to develop in the urine.
Your veterinarian will first need to rule out typical causes for red-colored urine, such as a dietary trigger. Also, discolored or brown urine will need to be differentiated from true hematuria. Blood and urine component analysis will be completed and tests will be done to check for the presence of calcium or cancer cells in the blood.
If your doctor suspects the origin of the blood to be from within the bladder, such as from a tumor, or from bladder stones, an endoscopy can be used to visually examine the bladder space. This method uses a small camera that is attached to a flexible tube, and which can be inserted into the actual space to be examined. The endoscope may be inserted into the bladder cavity by way of the urinary tract, using a cystoscope, or it may be inserted through a small incision that is made in the abdomen. In this way, your veterinarian can get a more precise image of any blockages, or injuries, and if indicated, take a tissue sample for biopsy if a tumor is detected.
True hematuria may indicate a serious underlying disease, which will require immediate treatment. It is possible that your rabbit has lost a lot of blood through the urine; if it is severely anemic, a blood transfusion may be necessary. Hypercalciuria, meanwhile, requires a modified diet as well as changes to the environment. If your rabbit's is showing discomfort, pain medications may be used to decrease inflammation. Fluids will be given to treat dehydration, and kidney and urinary stones require surgical removal.
Living and Management
After the initial treatment has resolved the cause of the hematuria, your veterinarian will schedule a follow-up visit to monitor your rabbit's response to treatment. Physical examinations, laboratory testing, and radiographic and ultrasonic evaluations will be required, as your doctor looks for any complications or recurrences of anemia, urinary tract obstruction, or kidney failure.