Urinary diseases in rabbits

Urinary disease in rabbits, including renal failure, is common. As a species they are sensitive to pain, stress, dehydration and anorexia, all of which can lead to a variety of secondary problems including reduced glomerular filtration and increased calcium secretion into the urine. Below we look at 4 of the more common urinary diseases that result.

Posted: 07 March 2018

Urinary diseases in rabbits


1. Renal disease

This is relatively common in rabbits and is most likely to be seen in older animals. They tend to present with signs similar to those you’d expect in dogs and cats, including;

  • Polyuria
  • Polydipsia
  • Anorexia
  • Diarrhoea
  • Weight loss
  • Abnormal urine – low SG and mineral sediments
  • Kidney abnormalities – they can sometimes be palpated, but are more frequently identified using ultrasound or radiography
  • Raised BUN, creatinine and white blood cell count
  • Anaemia – look for a low PCV

There are a number of common causes of renal disease, including infections, toxins, age related degeneration and neoplasia.

2. Red urine

Normal porphyrins

This is probably the most common complaint associated with the urinary system in rabbits. Rabbit urine tends to be cloudy, opaque and occasionally thick in nature. The colour varies from yellow-orange to red-brown, with the colour being caused by porphyrin pigments. This catches many owners out thinking their pet has suddenly started bleeding, when in fact the urine is completely normal. To rule out the presence of blood, a simple urine dipstick test can be performed.


True haematuria is caused by disease affecting the urogenital system. It can arise from renal calculi, renal tumours, cystitis, bladder wall damage or a uterine adenocarcinoma.

The approach to a diagnosis is similar to other mammals and will include all the diagnostic tools available in your practice.

  • Urine dipstick
  • Urine cytology
  • Culture
  • Radiography
  • Ultrasonography

Treatment may include;

  • Antibiotics – many antibiotics are suitable to use against urinary pathogens. Ideally base your antibiotic choice on culture and sensitivity results. Always check the dose rates using a good resource such as the Exotics Animal Formulary by Carpenter  and the BSAVA Manual of Rabbit Medicine. It goes without saying that we must all follow the rules of the Cascade. If you need a quick refresher, check the VMD Guidance notes on the use of the Cascade.
  • Catheterisation – this usually needs to be done under sedation or anaesthesia
  • Fluid therapy – intravenous fluids to stabilise an acute patient is essential
  • Surgery – be prepared for emergency procedures if there is partial or complete obstruction
  • Modifying the diet – in many cases, the diet will need to be addressed

3. Urolithiasis and sludge

Unlike other mammals, calcium absorption and blood calcium concentration are directly related to dietary calcium in rabbits. An excess of calcium in the diet will result in excretion of large amounts of calcium in the urine, resulting in precipitation and uroliths formation.

‘Sludge’, where calcium sediment accumulates in a thick paste in the bladder, is a frustrating urinary problem affecting rabbits of all breeds, ages, and both sexes. It can be difficult to treat, and despite intervention, frequently recurs.

The signs of ‘sludge’ can be variable, but usually include some or all of the following.

  • Thick urine – rabbit urine is high in calcium carbonate, and in rabbits suffering from sludge, the sediment is thick and ‘sludgy’. The urine can take on the appearance and texture of thick smooth toothpaste.
  • Frequent urination – affected rabbits will often attempt to urinate more often, and not always in the same place.
  • Straining to urinate – the obstruction of the urine outflow from the bladder by the thick creamy deposit can make for difficulty in expression. Constant attempts akin to an animal with constipation will be observed.
  • Pain – grinding of teeth and crying may be noticed by the owner.
  • Haematuria – blood can sometimes be present, but not always. Don’t confuse this with normal rabbit urine pigmentation or blood from a uterine adenocarcinoma.
  • Chalk - visible signs of chalky sediment on the fur as the sludge voided dries.
  • Urine scalding – many rabbits with sludge will get reddened skin around the hindquarters and down the inside of the back legs. When examining them always turn them over to have a good look.
  • Loss of appetite – the constant discomfort and stress caused by sludge will result in depression and anorexia.

To help prevent calcium sediment in the bladder, it’s important to feed a diet that doesn’t contain an excess of calcium. Offer plenty of fresh leafy greens such as dandelion, parsley, beetroot tips and raspberry leaves. You can also point your clients to our fibrevore feeding guidelines

4. Urinary incontinence

Urinary incontinence in rabbits can be caused by a number of conditions;

  • Lumbosacral vertebral fractures
  • Vertebral dislocations
  • CNS lesions arising from E. cuniculi infection
  • Urinary calculi
  • Urinary sludge

Sometimes the first signs are the owner complaining of a rabbit with a smelly wet back end. Check under the tail and you may notice;

  • Urine-soiled perineum
  • Ulceration of the skin under the tail and vaginal mucosa
  • Strong urine smell
  • Flies (beware of myiasis in the summer months)

Read our article on Flystrike >

Incontinence needs to be managed urgently, initially with daily cleaning of the perineum and treatment for any secondary pyoderma or ulcers. The primary cause of incontinence ultimately needs to be identified to solve the problem.