🐰 The Vet’s Guide to Rabbit Hematuria in 2025

Authored by Dr Duncan Houston BVSc – experienced veterinarian & Ask A Vet founder. This comprehensive guide explains hematuria—blood in the urine—in pet rabbits. Learn the causes, diagnostic steps, treatment options (medical or surgical), home-care strategies, and long-term prevention to safeguard your rabbit’s urinary health in 2025.

🔍 What Is Hematuria?

Hematuria refers to the presence of red or pink blood in a rabbit’s urine. Causes range from mild irritation to serious health conditions. Unlike “red urine” caused by plant pigments (e.g., beets or berries), true hematuria is confirmed via veterinary testing.

⚠️ Why It Matters

• Visible blood may indicate infection, stones, sludge, bladder irritation, trauma, or renal disease.
• Untreated hematuria can lead to urinary obstruction, significant anemia, or systemic illness.
• Prompt veterinary assessment is essential in any case of suspected hematuria.

🔬 Common Causes of Rabbit Hematuria

• Urinary tract infection (UTI): Common cause; leads to inflamed bladder lining and bleeding. Confirm with urinalysis/culture.
• Bladder sludge or stones: Calcium sediments or uroliths scratch and irritate the bladder or urethra.
• Trauma: Injury from improper handling or cage trauma can damage urinary structures.
• Tumors or bladder polyps: Rare but possible, especially in older rabbits.
• Kidney disease: Causes microscopic hematuria due to renal damage.
• Reproductive issues in unspayed does: Uterine or vaginal bleeding may mix with urine—always rule this out.
• Vaginitis or vulvar infections: Can lead to blood-tinged urine.

🩺 Recognizing Clinical Signs

• Red, pink, or brown discoloration of urine.
• Hang-time: frequent urination, straining, accidents, or urine dribbling.
• Cloudiness, sandiness, or sludge in litter.
• Possible blood clots or urine staining on fur.
• Signs of pain: teeth grinding, hunched posture, reduced appetite.
• Change in water intake—polydipsia or decreased thirst.

🔬 Veterinary Diagnostic Process

1. History & Physical Exam: Ask about diet, water intake, litter habits, and reproduction; palpate bladder.
2. Urinalysis & Culture: Detect blood, bacteria, crystals, sludge; confirm infection and antibiotic sensitivity.
3. Bloodwork: Evaluate kidney/liver function and infection markers.
4. Imaging: X-ray or ultrasound to identify stones, sludge, bladder wall changes, trauma or reproductive sources.
5. Reproductive Exam: Unspayed females should be examined for uterine bleeding.
6. Biopsy or cystoscopy: If masses are suspected within the bladder or urethra.

💊 Treatment & Management

1. Treat the Underlying Cause

• UTIs: Culture-guided antibiotics for 10–14 days plus anti-inflammatories.
• Sludge / Stones: Increase hydration, flush bladder under sedation, dietary adjustments; surgery if stones are large or lodged.
• Trauma: Pain control, rest, and fluids to facilitate healing.
• Tumors / Polyps: Surgical removal or biopsy followed by histopathology-guided treatment.
• Kidney disease: Manage with fluids, renal support diet, and monitoring.
• Reproductive bleeding: Recommend spaying in unspayed females.

2. Supportive Care

• Ensure clean, accessible hydration—bowl + bottle.
• Provide soft bedding for bladder comfort.
• Urinary tract supplements (cranberry-free) to support bladder health.
• Pain relief as prescribed—NSAIDs like meloxicam or opioids.

3. Urine Scald & Hygiene

• Check for urine burns—gently clean with warm water, pat dry.
• Apply barrier creams as directed (e.g., zinc oxide).
• Change bedding frequently to keep the area dry.

🏡 Home Monitoring & Prevention

• Check litter daily—record urine color, frequency, and volume.
• Monitor water intake and appetite.
• Feed unlimited grass hay and low-calcium greens; reduce pellets if needed.
• Encourage mobility and exercise to support urinary flow.
• Schedule recheck urinalysis after completion of treatment.
• Spay intact females before age 6 months to prevent reproductive bleeding.

🤝 Ask A Vet, Woopf & Purrz Support

• Ask A Vet: Tele-consults for triage, treatment guidance, and follow-up care.
• Woopf: Hydration-focused blends, support for urinary health, and clean bedding products.
• Purrz: Supplements promoting bladder comfort, mineral balance, and systemic well-being.

📚 Case Studies

Case 1: UTI with Hematuria

“Bella,” a 5-year-old spayed doe, presented with pink urine and frequent urination. Urinalysis showed E. coli infection. Treated with culture-specific antibiotics and hydration—bleeding cleared within 48 hours, and follow-up urinalysis was normal.

Case 2: Bladder Stone Injury

“Thumper,” a 4-year-old buck, had blood-tinged urine and lethargy. Ultrasound identified a 3 mm stone. After sedation and surgical removal via cystotomy, post-op care and diet change kept him hematuria-free 6+ months later.

⚠️ When to Contact Your Vet Immediately

• Visible or persistent blood in urine
• Straining to urinate, incontinence, or urinary blockage
• Lethargy, fever, weight loss, or pain signs
• Female rabbits with reproductive bleeding

These signs may indicate serious urinary or reproductive conditions—urgent vet care can be lifesaving.

✅ Key Take‑Home Points

• Hematuria is a symptom, not a diagnosis—requires veterinary evaluation.
• Urine testing and imaging help identify whether it's infection, stones, trauma, or disease.
• Treatment may include antibiotics, surgery, pain relief, and dietary change.
• Home monitoring and clean bedding support recovery and reduce recurrence.
• Spaying, proper hydration, hygiene, and bladder care are essential preventive steps.
• Use Ask A Vet, Woopf, and Purrz to support treatment, hydration, and urinary tract protection.

With quick action and well-rounded care in 2025, most rabbits recover fully from hematuria causes. For personalized support and live vet guidance, download the Ask A Vet app now. 🐇❤️