Blood in the Urine in Rabbits

True blood in the urine, or hematuria, can occur when a urogenital disease is present, such as calcium stones or sludge in the urinary system, cystitis, or cancer in the reproductive organs. Sometimes the blood comes from the reproductive system and is excreted when urination occurs. While often simple treatments can solve the problem, in the rare cases where bloody urine is indicative of a more serious condition, treatments can vary from dietary changes to surgery.

Bloody urine, or red colored urine, is a common occurrence in rabbits, and is generally urine that is tinted in shades ranging from dark yellows to dark reds. This results from plant pigments in foods, dehydration, or other environmental factors.

Symptoms of bloody colored urine are:

• Urine tinted in color from darker yellows, to oranges, to shades of reds and browns
• Dark urine accompanied by a strong smell, indicative of heat stress or dehydration

Symptoms of true blood in the urine are:

• A slight tinge of red that is sometimes difficult to see, but can be verified using a urine dipstick

Accompanying symptoms indicative of a more serious condition are:

• Straining to urinate, urinating only drops at a time, or an inability to urinate
• Frequent urination
• White, chalky urine that can dry into solid sludge
• Stones in the urine
• Urine scalding
• Vaginal discharge, sometimes tinged with blood
• Increased aggressiveness
• Lethargy, difficulty breathing, pale gums and a decreased appetite in females
• Weight loss
• Depression
• Increased aggressiveness
• Blood clots in the urine
• Inability to conceive, or smaller litters for females

The causes of bloody colored urine are:

• Ingestion of plant pigments from foods, such as cabbage, dandelions, broccoli, beta-carotene rich foods like carrots and spinach, and fir leaves
• Heat exhaustion
• Dehydration
• Antibiotics
• Environmental change, such as the first cold day of fall

The causes of true blood in the urine could be:

• Uterine cancer in females
• Abortion in females
• Genital cancer or trauma in males
• Calcium stones or sludge, either in kidneys or in other areas of the urinary tract, often due to a diet high in calcium
• Cystitis

To determine if the urine is only tinted in color, or if actual blood is present in the urine, a urine dipstick can be purchased for home use. If there is no blood detected, and there are no other symptoms besides the color of the urine, a veterinary visit is often not necessary. In most cases, the color will clear up on its own, especially if the rabbit is kept hydrated, protected from excessive heat, and eating right.

However, if there are other symptoms present, or there is actual blood in the urine, a veterinarian will start by ordering a urinalysis to be sure. Once verified, X-rays may be used to look for tumors, calcium stones or sludge in the urinary system. Blood tests and urine samples will be used to look at kidney function, bacterial infections, calcium in the blood, and other factors. If the rabbit is female, an ultrasound may be used to look for tumors, and an X-ray of the chest may be ordered. For males, an X-ray of the genital area may be administered. 

Any symptoms should be reported to your veterinarian to help in the diagnosis, however small. Be ready to discuss the rabbit’s habits, environment, diet, and breeding history to better narrow down the true cause of the condition.

For tinted urine without true blood, treatments will vary, depending on the environmental issue.

Diet

Often, a diet high in beta-carotene is to blame. Though harmless, you can lower the amounts of those foods, which include carrots and spinach. Often, the color will go away on its own, from within a few days to weeks.

Environment

Since heat stress can be a factor, especially when the urine is dark in color and smelly, ensure your rabbit is protected from excessive heat and has extra water to drink.

Dehydration

Often seen in conjunction with heat exhaustion, dehydration can also be a cause of dark and smelly urine. Provide extra water, especially during warmer months of the year. In more severe cases, a subcutaneous lactated ringer solution can be administered by your veterinarian.

For true blood in the urine, treatments vary for each condition. 

Uterine cancer 

Your veterinarian should discuss the risk involved, based on the age of your rabbit. In cases of uterine cancer, X-rays are generally taken before any surgery to determine if metastasization has occurred. The afflicted rabbit will require hospitalization. Blood transfusions may be given when there is a significant loss of blood from the uterus. A hysterectomy is required, and any mammary tumors detected may be removed at the same time. Postoperative care will include assisted feeding when necessary to avoid any GI issues, and prescribed pain medications, such as meloxicam, butorphanol, buprenorphine, or carprofen. Chemotherapy is ineffective for uterine cancer, and will not be prescribed.

The treatment of anesthesia before any surgery does carry a small risk, so speak with your veterinarian about your rabbit for details. 

Abortion 

An abortion can be a sign of another serious issue. After determining if any of these issues are present, a veterinarian will prescribe treatment appropriate to the cause. 

Genital Cancer in Males

Testicular cancer can result in the enlargement of the testicles, which are usually firm, but not painful. As with any cancer, there is a chance of tumors spreading to other areas of the body. Treatment is usually castration. Speak with your veterinary caregiver about your rabbit for details about the risks of anesthesia.

Calcium Stones or Sludge

A high amount of calcium in the body creates stones or sludge in the urinary system, causing kidney stones, bladder stones, sludge and sediment filled urine, and blockages that can be fatal.  

Treatments can include fluid therapy, administration of potassium citrate to help bind the calcium present in urine, manual release of the bladder, and antibiotics, such as trimethoprim sulfa and chloramphenicol. Surgery may be performed to remove the stones or blockages. Dietary changes are the most common solution, and involve lowering the levels of calcium in food. The amount of alfalfa in the diet, common in pelleted food, should be lowered, while grass hay, such as timothy and prairie hay, is recommended.

Cystitis

Urinary tract infections can be caused by dietary imbalances, or by viral, parasitic or bacterial infections. It can generally be solved with prescribed antibiotics, and an increased intake of fluids. This can be done with moisture laden foods, or through intravenous or subcutaneous fluid intake. In the rare case of a blockage or life-threatening emergency, hospitalization and surgery may be required.

Uterine Cancer

Follow up appointments are necessary if metastasis is a factor, and X-rays should be taken for the next year or two in 3 month intervals. Ensure your rabbit continues to eat to avoid any GI issues after surgery.

Genital Cancer in Males

As with uterine cancer in females, proceed with regular checkups to monitor possible metastatic spread.

Calcium Stones or Sludge

Maintaining a good healthy diet with a lowered calcium content can usually stop excessive calcium intake at the start, and prevent the condition from reoccurring.

Cystitis

As this can be a continuing problem, you can minimize future occurrences by always having fresh water available, ensuring proper exercise opportunities, continual maintenance of toilet areas, and provide a diet high in moisture rich foods.