rabbit urinary tract infection treatment
Health and Wellness

How to Treat Urinary Tract Infections in Rabbits

Urinary tract infections may seem trivial, but they are a medical emergency. If your rabbit is leaking urine or struggling to pee, you must act fast.

The most common UTI is bacterial cystitis, which can be treated with antibiotics. However, UTIs tend to return if you don’t take steps to prevent them in the future. You should increase your rabbit’s water intake, change her diet, and make sure her litter pan is always clean.

Rabbits with UTIs tend to have other urinary diseases such as sludgy urine, kidney stones, or kidney disease. We’ll be looking at the full range of urinary tract problems in rabbits.

Your Rabbit’s Urinary System Explained

Your rabbit’s urinary system is made up of the kidneys, ureters, bladder, and urethra. The role of the urinary system is to remove water, urea, and other waste products.  Here is how the process works:

  • Kidneys – When your rabbit eats a meal, the amino acids are converted into a substance called urea. Urea is a waste product that must be removed from the body. Urea enters the kidneys via the bloodstream and is then filtered into the ureters.
  • Ureters – Your rabbit has two tubes called the ureters; these connect her kidneys to her bladder. Urea, water, and other waste products exit the kidneys and then travel down the ureters towards the bladder.
  • Bladder – Your rabbit’s urine is stored in her bladder until it is ready to be expelled.
  • Urethra – When your rabbit is ready to pee, her pee exits her body through the urethra.

Urinary tract infections can affect any part of the urinary system, but they are most common in the bladder and urethra. If an infection takes hold, urination will be very painful.

Related Urinary Tract Diseases in Rabbits

Although our focus is on UTIs, other urinary diseases occur alongside UTIs, so it’s vital to be aware of them. In addition to UTIs, rabbits may experience the following urinary tract diseases:

  • Hypercalciuria – Sludgy Urine in the Urethra
  • Urolithiasis – Bladder and Kidney Stones
  • Kidney Disease and Kidney Failure

These diseases can cause (and be caused by) UTIs. For example, UTIs can cause sludgy urine, kidney stones, and kidney failure. Also, sludgy urine and kidney stones can cause secondary UTIs.

It’s easier to treat and prevent UTIs if you understand the full spectrum of urinary tract diseases.

Bacterial cystitis is the most common UTI in rabbits.

What Causes Bacterial Cystitis in Rabbits?

Bacterial cystitis is an infection of the bladder. It is usually caused by Escherichia coli or Pseudomonas spp. bacteria. The risk factors for bacterial cystitis are as follows:

  • Abnormal Urinary Tract – Some rabbits are born with an abnormal urinary tract. Others develop an abnormality after injury or trauma. Your vet will be able to tell you if your rabbit has an abnormal urinary tract.
  • Dehydration – If rabbits don’t drink enough water, this can lead to sludgy urine and urinary tract inflammation. In turn, this makes rabbits more vulnerable to UTIs.
  • Dirty Hutch or Litter Pan – A dirty environment will encourage bacteria to multiply. Also, rabbits will avoid using a filthy litter pan. Holding in their urine increases the risk of a UTI.
  • Dirty Water Bowl or Bottle – Again, this exposes the rabbit to more bacteria. Rabbits are also less inclined to drink from a dirty bowl or bottle, and dehydration can lead to UTIs.
  • A Tumor – Uterine cancer is common in unspayed female rabbits. This cancer can cause tumors which press against the urinary tract and interfere with urination.
  • Obesity and Inactivity – Overweight rabbits are more prone to UTIs (and other urinary diseases). This may be because obese rabbits sit in their own filth for longer, and they find it harder to fully empty their bladder. Added to which, obese rabbits may have a hormone imbalance with makes them more susceptible to UTIs.
  • Hyperplasia – This is an overgrowth of tissue in the rabbit’s urinary tract system. It is a rare condition.

Bacterial cystitis is quite common in rabbits, but that doesn’t mean it should be ignored. Cystitis needs to be treated by a vet to avoid further complications.

rabbit urine milky yellow

Symptoms of Cystitis in Rabbits

When rabbits have a UTI, they tend to become very lethargic and stop eating. Most rabbits will also avoid physical contact. In addition, symptoms of cystitis include:

  • Urinating much more often than usual
  • Urinating much less frequently than usual
  • Leaking urine
  • Milky or sludgy urine
  • Brown or red urine (although if your rabbit has eaten beetroot, red cabbage or another red vegetable, this may be normal)
  • Crying or grunting when urinating
  • Straining when peeing
  • Hunching over when peeing
  • Urine scalding (wet tail) – Yellow fur and reddened skin on the rabbit’s undercarriage

What Causes Urethritis in Rabbits?

This is another common condition in rabbits. Urethritis is infection or inflammation of the rabbit’s urethra. As mentioned, the urethra is the tube that transfers pee from the bladder.

Rabbits can develop urethritis from sitting too long in their litter pan. Also, sludgy urine (hypercalciuria) can cause the bladder and urethra to become inflamed.

Once the urethra is inflamed, peeing will cause a burning sensation. According to Science Direct, inflammation then leaves the rabbit vulnerable to secondary UTIs.

Why Is My Rabbit’s Pee Sludgy?

If your rabbit’s pee is cloudy, sandy, or sludgy, she probably has a condition called hypercalciuria. This means that there is a buildup of calcium (sludge) in your rabbit’s bladder.

So, why does calcium build up in the bladder? According to Rabbit Welfare, most animals control the amount of calcium they absorb from their diet, but rabbits cannot. Rabbits absorb all the calcium that their diet provides, and then expel the excess via their kidneys.

The kidneys filter the calcium, and this passes through into the bladder. If the bladder is not fully emptied each time the rabbit pees, calcium can build up and form a sludge.

This sludge will then make its way into the urethra and cause inflammation – leaving the rabbit vulnerable to UTIs (as mentioned above). So, to prevent sludgy urine, rabbits need to:

  • Drink plenty of water.
  • Fully empty their bladder each time they urinate.

Reasons Rabbits Don’t Empty their Bladder

There are reasons why rabbits do not fully empty their bladder when peeing. These include:

  • Arthritis (or Another Pain Disorder)Rabbits with stiff joints find it painful to go to the toilet. They can’t perch in the usual way, so they aren’t able to fully empty their bladder.
  • A Dirty Litter Pan – Rabbits will be reluctant to use a dirty litter pan. Even if they do use it, they’ll be in such a rush that they may not fully empty their bladder.
  • Fear – Although rabbits tend to get on well in pairs, there can sometimes be issues. At times, one rabbit will be more dominant and aggressive than the other. The weaker rabbit feels too scared to use the litter pan. The submissive rabbit may not fully empty their bladder.

These issues need to be fixed to promote good urinary health.

rabbit UTI medication

Bladder and Kidney Stones in Rabbits

If the sludgy calcium deposits are not flushed out of the rabbit’s system, they may grow into kidney stones (urolithiasis).

Bladder/kidney stones are severe because they can block the urethra and make urinating even more painful. In some cases, the blockage will cause a secondary bacterial infection in the urinary tract.

Risk factors for developing kidney stones are very similar to the risk factors for developing cystitis. These include dehydration, a dirty toilet pan, being inactive and overweight, and eating a poor diet.

Kidney Disease and Renal Failure in Rabbits

Kidney disease affects around 25% of rabbits during their lifetime. It is more common in older rabbits, but it can affect younger rabbits, too.

As mentioned, the kidneys filter waste products and expel these through urine.  If a rabbit’s kidneys aren’t working correctly, they’ll become sick very quickly.

So, what causes kidney disease in rabbits? There are many different causes, but UTIs are certainly one of them. Bacterial cystitis (especially when chronic) can cause kidney disease.

According to Tufts, Pseudomonas sp, E. coli, P. multocida, Staph. sp, and Encephalitozoon cuniculi infections are known to cause chronic kidney failure in rabbits.

At the same time, kidney disease caused by other factors (such as diabetes, cancer, and trauma) can cause secondary UTIs to develop.

So, if you want to prevent UTIs, you should monitor your rabbit’s kidney health closely.

Symptoms of Kidney Disease in Rabbits

Kidney disease symptoms differ somewhat from UTI symptoms. They include:

Treatment for Urinary Tract Infections in Rabbits

If you suspect your rabbit has a UTI (or any other urinary disease), you should take her to the vet for a diagnosis. Your vet will take a sample of your rabbit’s urine to look for signs of bacteria.

The vet can look at the urine under a microscope to detect signs of blood or protein. If there are signs of a UTI, they may prescribe a broad-spectrum antibiotic such as chloramphenicol.

Your vet may also send the urine sample off for culture testing. Some bacteria die as soon as they are extracted, so culture testing does not always provide answers. However, in some cases, the culture test will reveal a specific strain of bacteria, and then targeted antibiotics can be prescribed.

How Long Do Rabbit UTIs Last?

This depends on how severe the infection is, and whether there are sludgy urine and kidney stones (see below).

At the very least, a course of broad-spectrum antibiotics will last for 7-10 days. If the culture test reveals something more specific, another course of antibiotics may be prescribed.

Then, it may be a further few weeks until your rabbit is back to normal. During this time, you can support your rabbit’s recovery and prevent the UTI from returning.

How to Prevent Urinary Tract Infections in Rabbits

UTIs can be caused and aggravated by many factors. To prevent recurrent UTIs, you may need to make some changes to your rabbit’s diet and lifestyle. Consider the following tips:

1) Increase Water Intake

The most effective way to prevent UTIs is to increase your rabbit’s water intake. Water helps to flush the bladder of calcium deposits. Water also helps to keep the ureters and urethra healthy.

So, how can you persuade your bunny to drink more water? Your rabbit won’t drink stale or dirty water, so make sure it’s changed every couple of days.

Try to offer a water bowl as well as a water bottle. Bottles can easily become jammed, and some rabbits aren’t that keen on them.

Eating moisture-rich green vegetables will also help to hydrate your rabbit.

bacterial cystitis

2) Improve the Diet

A poor diet can contribute to UTIs and urinary problems. Most vets would recommend a diet rich in grass hay (timothy, oat or orchard grass hay).

Supplement the hay with moderate amounts of fresh, leafy greens and other vegetables. Fruits can be given as an occasional treat.

According to the RSPCA, muesli pellets should be avoided. Alfalfa hay should also be avoided because it contains a lot of calcium (which could aggravate sludge and kidney stones).

Although green veg contains calcium, it contains around 90% water, so it’s considered a good choice for rabbits

3) Keep things Clean

Rabbits that spend time in dirty environments are more likely to get UTIs. If you clean the rabbit’s hutch regularly, this will help to reduce the risks.

Pay attention to your rabbit’s litter pan and clean this several times a day (as and when required). Rabbits that have a clean toilet pan are more inclined to fully empty their bladder.

4) Exercise

In rabbits, obesity is a risk factor for UTIs, sludgy urine, kidney stones, and kidney disease. So, keeping your rabbit’s weight under control is one of the kindest things you can do for her.

If your bunny lives inside, take her out of her hutch regularly and encourage her to run around the house. If your rabbit lives outdoors, attach a run to the hutch so your rabbit can exercise daily.

5) Muscle Relaxants

Arthritis and other pain conditions can stop a rabbit from fully emptying their bladder. If your rabbit has arthritis, your vet may prescribe a muscle relaxant medication. This will not only reduce your rabbit’s pain but also prevent UTIs.

Treatment for Sludge and Kidney Stones

Sludgy urine and kidney stones can occur alongside UTIs. If you suspect your rabbit has a UTI, the vet will check for signs of other urinary diseases. Using radiography, they’ll check your rabbit’s bladder and urethra to see if there’s any sludge or stones.

If there is a blockage in the urinary tract, the vet will remove this. In mild cases, the vet can provide pain medication and intravenous fluids to help flush the sludge away.

However, if the sludge is very thick, or crystals have started to form in the urethra, further action is needed. The vet will sedate the rabbit and place a catheter inside the urethra to unblock the sludge/stones. If this does not solve the problem, surgery may be required.

Treatment for Kidney Disease and Kidney Failure

Kidney disease is a severe condition that warrants immediate treatment. If the kidney disease was brought on by repetitive bouts of bacterial cystitis, a new antibiotic might be trialed.

Kidney disease in older rabbits cannot usually be cured. However, the vet can prescribe medication to help you manage the condition. Increasing the rabbit’s water intake and improving their diet may also help to slow down the progression of kidney disease.

What Color Should Rabbit Urine Be?

Rabbit urine can be different colors and still be considered healthy. So, don’t jump to conclusions if your rabbit’s only UTI symptom is strange-colored urine.

So, what color should rabbit urine be? Rabbit urine can be yellow, beige, orange, brown, and red. The color of rabbit urine is affected by the food they eat, so eating beetroot will turn the urine red.

If the urine is sludgy, sandy, or milky, this suggests your rabbit is struggling to metabolize calcium, and that kidney stones may be forming. If there are any flecks of blood in the urine, this suggests something is amiss. In both cases, you should see a vet immediately.

Urinary tract infections might not sound serious, but they can be life-threatening for rabbits.

The most common UTI is bacterial cystitis. If left untreated, this can cause other urinary diseases such as hypercalciuria, urolithiasis, and kidney disease.

Although antibiotics can kill the bacteria, the UTI may return if the causes are not addressed.

To prevent recurrent UTIs, take care of your rabbit’s health. This means increasing her water intake, improving her diet, modifying her activity levels, and keeping her hutch clean.