Category: rabbits

Uterine problems

The female rabbit’s reproductive tract varies greatly compared to dogs and cats. Although there is a difference in the anatomical make-up of rabbits, they can still experience some of the diseases that affect dogs and cats.

Rabbits have two uterine horns which open into the vagina independently, each of them through a separate cervix, therefore there is no uterine body. The urethra (the opening through which the bladder empties the urine out of the body) also opens into the vagina, rather than separately from it.

This anatomical peculiarity is of great importance because it makes some of the clinical symptoms that may be an indication of a disease of the reproductive tract, very difficult for your vet to interpret.

Pseudopregnancy is also called false pregnancy. It is often seen after a non-fertile mating, or may be seen during the spring months in entire female rabbits that are kept on their own. The hormonal changes that occur are responsible for some physical and behavioural changes that are very similar to those occurring in a pregnant doe. The rabbit acts as if she is pregnant but there is no foetus.

Female rabbits can become very aggressive and territorial during pseudopregnancy, exhibiting behavioural tendencies such as growling, lunging and biting, therefore care should be taken when handling her. She may also start plucking fur from her tummy, flanks and dewlap in an attempt to build a nest. Clinical examination may also reveal mammary development and milk production.

This condition normally disappears after a couple of weeks (17 days) without any need for more specific treatment. The condition can be stressful for the doe and it can recur several times.

If your rabbit suffers from pseudopregnancy, once she has made a full recovery, it is strongly recommended to have her spayed to avoid any future episodes.

Endometrial cystic hyperplasia is an abnormal thickening of the lining of the uterus. An overgrowth of cells predisposes the rabbit to abnormal tissue changes in the uterus. This is commonly seen in unspayed female rabbits over the age of 4 or 5 years. At present, it is still not clear if this condition can predispose to the development of uterine cancer.

Clinical signs may mimic those of uterine adenocarcinomas, with the rabbit showing signs of anorexia, haematuria, weight loss and lethargy. Palpation of a firm, irregular mass in the abdomen should prompt immediate investigation to rule out the possibility of a disease affecting the reproductive tract. Cystic mammary glands are also commonly seen in association with this condition.

Diagnosis of uterine disease can be made using x-ray and/or ultrasound, then surgery is usually the only available treatment option. It is normally curative and allows your vet to provide a definitive diagnosis through an histopathological examination of the organ removed.

Hydrometra is considered the third most common problem associated with the uterus in female rabbits, after endometrial hyperplasia and uterine adenocarcinomas. It occurs in older female rabbits (>4 or 5 years of age) and is characterised by the accumulation of watery fluid within the uterus.

The rabbit may have an enlarged abdomen, which, when tapped by your vet, may exhibit a fluid thrill noise. Anorexia, weight loss and a high respiratory rate, due to the pressure that the fluid filled uterus puts onto the abdominal organs, are all possible clinical signs. Diagnosis is usually made by ultrasound.

Spaying will cure hydrometra, but stabilization of the patient, if it is in poor condition prior to surgery, will be necessary; therefore the sooner the problem is diagnosed the higher the chance of a successful outcome.

Pyometra is an accumulation of pus in the uterus. It is a common finding in unspayed dogs but less common in unspayed rabbits.

The rabbit will show signs of anorexia, depression, excessive drinking and urination. Pyometra can be open or closed, meaning that there may be evidence of pus from the vulva, but this is not always the case.

Cases of pyometra are surgical emergencies and the rabbit should be spayed as soon as possible in order to remove the infected uterus. The rabbit will also require medical support and antibiotics. The condition carries a high death rate, as the rabbit is often extremely sick before it gets to surgery.

This is a metabolic disorder, whereby fat builds up in the blood following birth which can poison the rabbit’s system. Obesity is thought to be a common factor in this condition, but stress and too few calories during the final week of pregnancy may also play a part.

The rabbit will show signs of depression and weakness, quickly followed by collapse and sudden death.

If caught early enough, it may be possible to nurse the rabbit with aggressive supportive therapy in the form of nutritional support and intravenous or intraosseous fluids, but often there is little that can be done.

This is the most common type of tumour in rabbits. Uterine adenocarcinomas are estimated to affect between 50-80% of unspayed rabbits by the time they reach 5 years of age. Most breeds of rabbit have had cases reported, and there seems to be no difference in incidences if the rabbit has had previous litters.

Clinical signs of lethargy, decreased appetite, weight loss, blood in the urine and depression are often seen, but sometimes signs may be more subtle, making it very difficult for owners to realise there is a problem.

If caught early enough, it is possible that spaying the rabbit will be curative, but if the disease has progressed before a diagnosis has been made, then spaying is rarely curative as secondary tumours (metastasis) are likely to have developed in the lungs and/or other organs. It is, therefore, very important that your vet takes an x-ray of your rabbit’s chest before deciding to perform surgery, to try to identify if lung changes have already occurred. If this is the case, then it carries a grave prognosis.

If, however, the x-rays are clear, surgery can be performed, and if successful, then screening for metastasis should be performed on a regular basis, as they can develop up to 2 years following surgery.

It is clear that spaying female rabbits when they are young and healthy is the best preventative measure for all of these conditions, ensuring that your rabbit does not contract any of these conditions.

Therefore, early spaying of all female rabbits at around 4-5 months of age is recommended for preventative healthcare reasons.

Urolithiasis

Urolithiasis is the formation of calculi in the urinary tract, also called kidney and bladder calculi or stones, or urinary tract stones. The stones are rock hard crystal aggregations of all shapes and sizes. Sludge is the name given to the thick, almost toothpaste consistency deposit that can build up in the rabbits bladder or kidneys.

Calcium is very important for rabbits; they need it to form strong and healthy bones and teeth (and so to prevent dental problems and osteoporosis). Just as too little can cause problems, so can excess quantities, and although calcium consumption isn’t believed to be the sole factor responsible for the development of calculi (stones), it is thought to play a part, so getting your rabbit’s calcium intake correct may help to prevent future problems.

A rabbit fed a good balanced diet shouldn’t be calcium deficient and wont need a calcium or mineral supplement. It has been suggested that the average sized, adult, non-breeding, pet rabbit needs around 510 mg of calcium daily.

Rabbits have an unusual calcium metabolism; In most mammals, the amount of calcium absorbed from the diet is regulated at gut level by Parathyroid hormone (PTH), but rabbits predominantly absorb calcium in proportion to what is present in their diet, whether or not they require it. Meaning that whatever amount of calcium a rabbit has in their diet, they will absorb it all. Any excess calcium that is absorbed into the bloodstream from the gut is excreted through the urinary tract, where it may be deposited and form calculi/sludge. Rabbits can form solid calcifications in their kidneys, ureters, bladder or urethra, as well as depositing thick calcium sludge in their kidneys or bladder.

Calculi

One or more stones may develop, with or without sludge being present. Symptoms of calculi include: loss of appetite, loud painful teeth grinding, hunched posture, lethargy, unwillingness to move, pressing abdomen on the ground, loss of litter training, blood in the urine, perineal scalding and straining to urinate. One or more symptoms may appear gradually, or have a sudden onset and be intermittent.

A blood test is useful for determining kidney function and calcium levels in the blood. A urine test should also be taken to see if calcium crystals and/or a urinary infection (cystitis) are present.

Sludge

Rabbits suffering from sludge may display any of the symptoms described above for calculi, as well as passing thick, white, gritty urine that in severe cases will become semi-solid when passed. White or sludgy urine on their own are common in rabbits and often occur after the rabbit has eaten high calcium foods. They aren’t necessarily indicative of sludge within the urinary tract; this must be confirmed. Diagnosis is the same as that of calculi; as the sludge is made of calcium, it too will show up on an x-ray or ultrasound as a mass.

As some rabbits exhibiting no clinical symptoms, can upon investigation, be found to have some degree of sludge in their bladder or kidneys, treatment to flush the sludge from the bladder, is only necessary if the sludge seems to be causing the rabbit problems. Sludge in the kidneys is more difficult to eliminate, although kidneys can be flushed, and flushings may be sufficient to return the kidneys to an acceptable working capacity, it is unlikely to clear all the sludge.

Treatment depends upon the location of the calcification/s. The deposit of calcium salts (calcifications) show up on x-rays and ultrasound scans, as the calcium content makes them radiopaque (light in colour). Calcifications detected in the bladder, ureters or urethra should be surgically removed once the rabbit’s condition has been stabilised.

Rabbits suffering from calculi are often in a lot of pain and as a result will not eat or drink, subsequently being dehydrated and necessitating fluid therapy, gastrointestinal support and pain relief prior to surgery. Currently there is no known method of breaking up rabbit calculi and it is rare for the rabbit to pass them naturally, due to their often-jagged texture and size to which they can grow. Ureteral calculi may cause enlargement of the kidney (hydronephrosis) due to obstructed urine flow from the kidney to the bladder. With such a situation, once the rabbit is stabilised, prompt surgical intervention to remove the calculi is vital to avoid irreparable damage.

Rabbits presenting with calculi in both kidneys, displaying clinical symptoms have a guarded to poor prognosis. Surgically removing calculi from the kidney is extremely hazardous, and for these cases management may be the only treatment option, with their quality of life paramount. If calculi are only located in one kidney, it may be possible to remove the affected kidney, as the remaining kidney should have adequate function to keep the rabbit alive. However, if the remaining kidney becomes unable to work to near full capacity, the rabbit’s prognosis is extremely grave.

Calcium consumption isn’t believed to be the sole factor responsible for calculi/sludge development, which is why solely reducing the calcium intake often doesnt prevent the problem from reoccurring. Other possible reasons, include:

A low water intake

This is suspected to be one of the most important factors leading to the formation of urinary calculi. Less urine is produced with a low water intake and calcium precipitates out when urine is saturated with calcium. To rectify this problem you must increase the rabbits fluid intake, which can be achieved by:

  • Adding apple juice or other sweet flavouring to their water.
  • Giving the rabbit a plain salt lick or sprinkling a small amount of table salt onto their veg.
  • If neither of the above works, syringe-feeding fluids or fluid administration by your vet may be the only way of increasing the fluid intake.

Overweight rabbits

Overweight rabbits may be physically unable to completely empty their bladder, due to weak muscle tone, or adopt the correct position for urination, which will give any calcium in the urine a chance to settle in the bladder.

Kidney damage

The rabbit’s kidneys may be unable to manage the amount of calcium, which they are required to process. Kidney damage only shows up on blood tests when at least 50% of kidney function is lost.

Litter training

Most rabbits will only urinate in a select amount of places. If the rabbit is unable to reach these places, i.e. no litter tray in pen, it may wait until it can urinate in its desired area, so always ensure your rabbit is able to reach its toilet areas.

Oxalate (a poisonous salt of oxalic acid)

Some green foods are high in oxalate (spinach, parsley, spring greens, etc). Oxalates should be metabolised by bacteria in the gut, but if there aren’t enough oxalate-eating bacteria, the oxalate will be absorbed rather than broken down and excreted via the kidneys, with calcium hitching a ride.

Other illnesses

Illness which causes the rabbit to sit around and not urinate regularly, e.g. osteoarthritis, spinal problems or anything causing discomfort/malaise, etc, can cause problems. The underlying factor needs to be corrected, on top of addressing the sludge/calculi problem.

Genetics

Even after a low calcium diet has been implemented and all the above explored, if the rabbit still continues to produce calculi/sludge, then a genetic reason should be considered. Some rabbits may fundamentally be “stone/sludge formers” and whilst a genetic reason cant be ruled out, rabbits affected with urolithiasis problems should never be bred from.

Fruit and vegetable can be grouped into good, moderate and poor calcium providers. The approximate calcium mg content per 100 g is shown alongside:

Good calcium providers

  • Kale (130)
  • Spinach (170)
  • Parsley (200)
  • Watercress (170)
  • Mint (210)
  • Spring Greens (210)

Moderate calcium providers

  • Cabbage (49)
  • Broccoli (56)
  • Celery (41)
  • Parsnip (41)
  • Swede (53)
  • Turnip (48)
  • Oranges (47)

Poor calcium providers

  • Brussel Sprouts (26)
  • Carrots (25)
  • Cauliflower (21)
  • Cucumber (18)
  • Peppers: Red/Green (8)
  • Tomatoes (7)
  • Apple (4)
  • Apricot (15)
  • Banana (6)
  • Grapes (13)
  • Kiwi Fruit (25)
  • Nectarines/Peaches (7)
  • Pears (11)
  • Pineapple (18)
  • Strawberries (16)
  • Baby sweetcorns (2)

Alfalfa hay contains approximately 1.5% calcium, compared with 0.4-0.8% calcium in grass hays. Nutritional values for hay and fresh foods vary depending upon the soil the product was grown in, the time of year it was harvested and other conditions that affect nutritional values.

Once the initial condition has been treated, attention must focus on trying to prevent reoccurrence of the condition, but even then there is a possibility of further calculi or sludge forming, particularly if the rabbit still has sludge within their kidneys or bladder.

The most successful approach to preventing reoccurrence of calculi or sludge seems to be by adopting a multi-tiered approach and tackling several possible factors concurrently:

  • Dried rabbit mixes should be excluded from the diet or fed in tiny proportions as an occasional treat. Any alfalfa-based foods and calcium/mineral supplements should be permanently removed from the diet.
  • Feed limited amounts of foods classed as moderate calcium providers, with their main intake from the poor group, avoiding those in the good group. This not only lowers the calcium intake but also increases water consumption, which seems to be critical for rabbits with urolithiasis.
  • Offer grass hays (timothy, fescues, ryegrass, bromegrass or orchard grass) ad lib.
  • Ensure the rabbit isnt overweight and gets plenty of exercise.
  • Always ensure the rabbit can reach its toilet areas.
  • Implement careful monitoring, usually consisting of blood and urine tests, as well as periodic x-rays/ultrasounds to monitor the condition and detect any reformation of calculi/sludge early on.

Changes in diet should be done over at least a couple of weeks to prevent digestive upsets. Introduce one new food at a time and if it seems to upset the rabbit in the next 24-48 h exclude it from the diet. Try to feed smaller quantities of numerous different foods, rather than larger quantities of a few foods. This gives the rabbit a variety, and also helps to achieve a balance of other minerals.

The vast majority of rabbits on a hay and veggie diet manage fine, and get through a mound of fresh food their own body size daily. Hay and water must always be available.

Finally, it is vital to ensure the phosphorus intake doesn’t exceed the calcium. Discuss your rabbit’s diet with your vet, and expertise is also available from nutritionists employed by feed companies in the UK and US.

Red urine

Bloody urine is rare in rabbits and rodents. Cases of bloody urine in rabbits often turn out to be normal rabbit urine which is simply a deep red colour due to the extretion of plant pigments within the diet. True cases of blood in the urine (haematuria) are often due to stones/sludge within the urinary tract, cystitis, uterine adencarcinoma, polyps or abortion.

Bloody urine in rabbits may be rare, but red urine is not. Owners who pay close attention to what is in their rabbits litter tray will be familiar with the variation of colour that normal rabbit urine can be.

Red urine is observed in rabbits, and is almost always caused by plant pigments and does not affect the animals health. Vegetables such as cabbage, broccoli and dandelions will often result in the excretion of red urine. Normal rabbit urine will vary from a pale yellow or clear colour, through various orange and brown colours, right up to a deep red colour. Rabbit urine may also look cloudy due to the presence of calcium carbonate being excreted within the urine. Red urine is not a medical problem and usually returns to normal within one to three days, although it has been seen to take as long as three to four weeks before the urine returns to the pale yellow colour.

Dark and/or very strong smelling urine can result from heat stress or dehydration, so always ensure that your rabbit has plenty of fluids, especially in the warmer months of the year when they may appreciate a water bowl to drink from as well as a water bottle. If your rabbit frequently has dark or very strong smelling urine then it may be worth discussing this with your veterinary surgeon.

For obscure reasons red urine may occur due to any of the following:

  • While on antibiotics
  • At the first cold snap in autumn
  • After eating fir leaves
  • After eating carrots, spinach or other veggies containing beta carotene
  • Eating cabbage, broccoli and dandelions, especially if the rabbit isn’t used to eating these

If your rabbit appears well in themselves; is eating and drinking normally, active and bright, producing lots of normal droppings then do not panic when you observe a change in colour of your rabbit’s urine. Monitor the situation and if it doesn’t resolve then speak to your vet for advice. If your rabbit seems unwell in anyway then always consult your veterinary surgeon as soon as possible.

Blood in the urine is also known as haematuria.

True haematuria can occur due to disease anywhere within the urogenital system. An unspayed female rabbit might show a bloody discharge from her vulva, or drops of blood after urination, which could be confused with urine; either of these occurrences could be a sign of uterine cancer. An un-neutered male rabbit could have genital cancer or trauma which could cause blood to appear in his urine in either case you should take your rabbit to see your vet immediately.

Other causes or haematuria may result from calcium stones or sludge anywhere within the urinary tract system (kidneys, ureters, bladder or urethra), cystitis, polyps or even abortion. All of these conditions need urgent veterinary attention as most are painful to the rabbit and life-threatening if not given immediate veterinary care.

When we see red urine, most of us worry about a bladder or urinary tract infection. However, actual blood in the urine is usually difficult to see with the naked eye. When due to kidney disease, straining to urinate may not occur, but straining is the most common sign of urinary bladder disease.

A rabbit straining to urinate assumes an unusual stance, that is, he sits for an unusually long period of time on the tip toes of the back feet, with the tail very high in the air. If you notice your rabbit is straining, you should immediately change the litter box so you can determine if he is producing urine or not.

Cloudy/white urine

Rabbits metabolise calcium very differently from other mammals such as dogs and cats. Whereas dogs and cats will only absorb the amount of calcium their body needs from their diet, rabbits absorb all of the calcium within their diet and excrete the excess through the urinary system. This is why rabbit urine is often observed as being cloudy or white in colour.

Passing cloudy urine can be normal for rabbits which are fed a high calcium diet or those rabbits which are slightly dehydrated. However, rabbits who are fed a high calcium diet are much more likely to develop stones or sludge deposits within their urinary system, which often require corrective surgery and can be impossible to rectify.

Therefore it is recommended that rabbits are not given calcium supplements unless specifically stated by a veterinary surgeon and are not fed excessive amounts of alfalfa hay or vegetables high in calcium; carrot tops, spinach, water cress, kale or dark cabbages, etc.

It is not necessary to take your rabbit to the vet for the condition of red (pigmented) urine, unless your rabbit is showing any other symptoms.

If you notice urine that is red or pink (orange is OK) and there are no other symptoms, you could wait until the next available appointment at your vets to ask them to test the urine for blood.

If your rabbit is straining to urinate, he may only produce a drop or two of urine at a time because of the frequency with which he is attempting to urinate, if this is the case you should make an appointment for your rabbit to see your vet on the next available appointment. However, if your rabbit is straining and isn’t producing any urine at all, there could be a blockage, which is an emergency and you should take your rabbit to see your vet immediately to determine if there is a blockage. If there isn’t a blockage your vet may want to perform further tests to find out what the problem is.

Yes, your vet can test a urine sample (urinalysis) to determine if there is blood within the urine.

If haematuria is diagnosed then your vet will want to determine exactly what is causing the blood in the urine.

This may involve taking x-rays of the abdomen to look at the bladder and associated ureters and urethra to look for stones or sludge, which show up very well on x-rays.

A urine sample may be taken and tested for bacterial growth and to determine what antibiotics would be most effective.

If your rabbit is an entire female then the vet may do an ultrasound examination to look at the reproductive tract for any sign of tumours. If any growths are located then it is advisable to take chest x-rays to look for any spread of the disease before embarking upon any surgery.

Blood tests may also be used to assess kidney function and to look at the blood cells.

Rearing orphan rabbit kittens

Handrearing a rabbit kitten or kittens can be an extremely rewarding experience but is not a job to be taken on lightly. The task ahead is difficult, exhausting and there is no guarantee of success. However hard you try, you are a poor substitute for a kitten’s natural mother and despite the best efforts of human volunteers the death rate among orphaned kittens is often high.

Rabbit kittens can require hand-rearing if they are true orphans due to maternal death, or because the mother is unable to feed her kittens. Kittens only suckle once every 24 hours, at night and only for 5 minutes or so – they are left in the nest for the rest of the time and ignored by their mother. This avoids drawing attention to the nest (a survival strategy).

Mothers with a new litter can take 24 hours to start producing milk. If the kits have not been fed for 48 hours then mis-mothering can be diagnosed. Unfed kits will have thin tummies and wrinkled skin. Check also that the kits have pink rather than blue skin colour. They will also cry if they are not being fed.

Occasionally a mother will abandon one or more kittens in the litter. The kitten may look perfectly normal but the chances are that it has some serious defect which would prevent it from living a full and active life. Letting it die may seem cruel but it is nature’s way and in these situations it may be kinder to ask your vet to put the kitten to sleep. If a litter of wild baby rabbits is found, it is wrong to assume that they have been abandoned – the mother is probably out hunting or watching from a hiding place. Leave the kittens where they are. If you disturb them or move them from the nest, you will reduce their chances of survival.

The most common causes of failure and death are pneumonia due to inhalation of milk into the lungs and diarrhoea due to failure to establish a normal gut flora (the mother’s milk is not only the best source of nourishment but also provides the gut bacteria essential for their digestion).

Kits under 7 days will need to be kept at 27-30°C (an airing cupboard will do). Their fur will grow when they are about 7 days old. Baby rabbit’s eyes open between 10 and 12 days and they can hear by the fifth day. Place kits in a box, e.g. a shoe-box, lined with hay, maternal fur (rabbits will pull their fur before giving birth to make a nest), soft cloths or fleece veterinary bedding. Temperature can be lowered after 7 days if the kits are thriving.

Rabbit milk is highly concentrated and commercial substitues available are Esbilac, Climicat and Lactol (although full cream goats milk and evaporated milk (e.g. Carnation) diluted 50:50 with water have also been used). Ask at your Veterinary practice for supplies. The commercial preparations are recommended and should be prepared according to the manufacturer’s instructions. A probiotic, e.g. Protexin, Avipro, and multivitamins, e.g. BSP drops, should be added to the milk, following the manufacturer’s instructions.

Made-up milk can be stored for 24 hours in a refrigerator but the milk should always be given at body temperature and can be tested on the back of the hand before it is given. Use Milton’s fluid to clean teats, bottles and syringes, rinsing in water before use.

Nursing bottles with teats available for kittens, or syringes can be used. Teat feeding is best as it carries less risk of aspiration pneumonia. If fed by syringe you cannot generally revert to teat feeding as the suckling reflex is lost after about two days. If using a syringe, administer the milk very slowly to minimise the possiblity of aspiration.

Hold the kit on your lap with its head gently restrained between the thumb and second finger, and the first finger placed on the top of the head. If using a sryinge, this should be gently inserted through the side of the mouth behind the incisor teeth. Stop between mouthfuls to allow swallowing. Once accustomed to being fed, the rabbit will refuse milk when it is full.

Feed the baby rabbit between 3-6 times a day. 4 times a day is usually adequate with a break of 6-8 hours overnight. Weigh the kit regularly and increase the volume and/or frequency of feeds if they are failing to gain weight. As a rough guide, new born kits consume about 2 ml/day, increasing to:

  • Day 4: 10 ml/day
  • Day 7: 13 ml/day
  • Day 10: 15 ml/day
  • Day 14: 22 ml/day
  • Day 21: 27 ml/day – starting to nibble hay and use water bottle
  • Day 27: 30 ml/day – eating hay
  • Day 30: 20 ml/day – well established on hay
  • Day 35: weaned! Eating mainly hay, and a small amount of solids (concentrates) and wild plants/vegetables.

A water bottle should be introduced when the kits are about 3 weeks old. Probiotics should be added to the water.

After each feed, wipe the kit’s bottom with a damp cloth or cotton wool to stimulate urination and defecation (the mother’s tongue usually does this). This will need to be done until the rabbit is about 10-14 days old.

Weaning is a critical period and it is important that only hay is introduced first. The rabbits should be well-established on hay before small amounts of solid food (concentrates) and vegetables are introduced.

Kidney problems

Like other mammals, rabbits possess two kidneys. The kidneys are essential for filtering out toxins from the body and excreting them via the urinary system. There are many potential problems which can affect the kidneys, with varying degrees of severity.

Rabbits produce alkaline urine and rely heavily on renal excretion as the major route of getting rid of any excess calcium within the diet. A rabbit’s calcium metabolism is completely different when compared to that of other mammals because blood calcium levels reflect their dietary intake. This means that if the diet consists of too much calcium, this alone can cause problems. Furthermore, the rabbit depends greatly on kidney function to regulate the metabolism of calcium in the body. The calcium that is eliminated via the kidney can precipitate the urine forming crystals that give the rabbit’s urine its typical creamy appearance.

There are numerous reasons why a rabbit’s kidneys may fail or the efficiency of them may lessen. Unlike the liver, kidneys do not possess any regenerative powers, so once the kidneys have been damaged or disease has become apparent, the damage cannot be reversed.

Renal failure is when the kidneys fail to filter the toxins and waste products from the blood properly. Acute renal failure happens over a short period of time, but clinical symptoms may involve reduced appetite and reduced urine production, which may go on to a cessation of appetite and urine production altogether. The rabbit may become depressed, dehydrated and grind its teeth in a painful manner (bruxism). Secondary gastrointestinal problems may also arise.

Clinical examination may reveal enlarged kidneys and uraemic odour from the rabbit’s mouth.

Acute renal failure is often due to the ingestion of a harmful substance; these commonly include lead batteries, anti-freeze and nephrotoxic drugs.

Treatment involves aggressive fluid therapy to correct the dehydration and in the hope that the toxins can be flushed from the body in time before any long-term damage is done. However, the longer the problem has gone untreated, the poorer the prognosis. All potentially toxic drugs should be discontinued immediately.

Unlike acute renal failure, chronic renal failure may develop over many days or weeks, and the clinical signs may go unnoticed for some time.

Clinical signs can include weight loss, gradual reduction in appetite, increased urine production and increased water consumption. The rabbit may lose body condition and generally look ‘unwell and scruffy’.

A clinical examination will detect small ‘shrivelled’ kidneys which may feel irregular in shape. A blood sample is invaluable in these cases as it may show an increase in some parameters which may be indicative of a kidney problem. In particular, examination of the blood may show elevated creatinine, although urea is unlikely to be raised until over 50-70% of kidney function has been lost.

Potential causes of chronic renal failure include E. cuniculi infection, bacterial infections, sludge/stones within the kidneys and renal tumours.

Treatment is aimed at treating the underlying cause of the renal failure, whilst supporting the rabbit’s kidneys and ensuring they remain hydrated and their gastrointestinal tract doesn’t go into stasis.

Pain relief is also recommended, but all non-steroidal anti-inflammatory drugs (NSAIDs), such as Metacam® (meloxicam; Boehringer Ingelheim) or Rimadyl® (carprofen; Zoetis) must not be given due to their harsh nature on the kidneys.

A prognosis will depend on the severity of the kidney damage and the underlying cause of it. If this cannot be corrected/managed, then the prognosis is extremely grave.

This has been reported in rabbits whereby small, multiple cysts have been located in the kidneys. Most rabbits with the condition show symptoms of chronic renal failure by the age of 2-3 years, which is often inherited. It has many similarities to polycystic kidney disease seen in humans and cats.

These seem to be an incidental finding in rabbits and have often been diagnosed on ultrasound examination whilst looking for other problems.

Cysts don’t seem to cause any impairment to the function of the kidneys, and treatment is not required.

Some rabbits may be born with only one kidney, which can affect both bucks and does. The rabbit may show no symptoms and lead a perfectly normal life, however, if their one kidney becomes disease in any way, and its function is compromised, then the rabbit’s prognosis is grave.

This is the term given for the surgical removal of one kidney.

If one of a rabbit’s kidneys is diseased to the point where it is causing the rabbit pain or problems, then it is possible to remove the diseased kidney. The surgery is a major undertaking and serious consideration should be given to the rabbit’s welfare and long-term prognosis before proceeding.

If the rabbit’s other kidney is diseased or not working properly, then the prognosis is extremely grave.

Pododermatitis in rabbits – sore hocks

Disruption of the normal stance or locomotion in rabbits may lead to pressure sores on the base of the feet, known as pododermatitis. Starting as a skin problem, this condition progresses over time to affect deeper tissues and can be extremely debilitating.

Pododermatitis is basically a pressure sore, with inflammation occurring where the feet are in contact with the ground. Damage to the blood supply leads to deeper inflammation and infection. Once the skin is damaged, bacterial infection can easily occur. Left untreated, the skin problem progresses to affect other tissues, including tendons and bones in the foot.

The back feet are usually affected, since they support the majority of the rabbit’s weight, though the front feet may also be affected; the rabbit’s stance may be abnormal. This condition is painful and other clinical signs you may also see include reluctance to move, anorexia/reduced appetite, depression and/or aggression and bruxism. Obesity may be present as a predisposing factor, although weight loss may occur due to anorexia. This condition may be fatal if pain leads to anorexia or if infection spreads to the rest of the body.

An increase in pressure on tissues in the base of the feet may occur for several reasons:

  • Giant breeds are more at risk as the incidence increases with weight.
  • Overweight or pregnant inactive rabbits put excessive pressure on the base of their feet.
  • Poor conformation or a leg/spinal injury may lead to increased weight-bearing on a specific foot.
  • Pain may cause the rabbit to move around less.
  • Arthritis may lead to the rabbit adopting a different gait and weightbearing abnormally.
  • Elderly rabbits that become inactive may bear weight abnormally.
  • Rabbits whose claws are allowed to become overgrown regularly will lead to the rabbit placing more weight on the back of the feet.

The skin will become damaged more easily in certain instances:

  • Removal of the thick fur, by shaving or clipping, from the base of the feet removes this protection. Rex rabbits have less skin protection than other breeds due to their lack of guard hairs and thinner coat.
  • In rabbits housed on surfaces which are hard, such as grid flooring, or abrasive, such as carpeting, the feet can be damaged and become infected.
  • The skin is also easily damaged in rabbit kept on wet or soiled bedding/litter.

The most common infection involved is Staphylococcus aureus, but other bacteria can also infect the inflamed tissues.

Pain due to tissue damage and infection in turn leads to less mobility and a vicious cycle in which the condition worsens.

After examining your rabbit, the vet may suggest some other tests to assess the extent of the condition before advising on the best treatment:

  • Blood tests can show the overall health of your rabbit, in particular identifying signs of infection.
  • Xrays and ultrasound are primarily used to assess whether deep involvement of tissues is present in the foot. They can also be useful to check for other conditions that may predispose pododermatitis, e.g. arthritis.
  • Sampling from lesions for testing of bacteria helps your vet choose the best antibiotic to use, while other laboratory tests like histopathology can rule out tumours.

Your vet will probably use the results from these tests to grade the pododermatitis:

  • Grade I: early disease with no symptoms.
  • Grade II: mild disease with intact skin.
  • Grade III: moderate with ulcers/scabs present.
  • Grade IV: severe with abscess formation and deeper tissues affected.
  • Grace V: severe and often irreversible, as bone infection occurs and tendon damage results in a permanently altered stance.

Addressing any underlying causes is paramount, including providing an appropriate substrate for the rabbit. Often medical therapy will merely alleviate the condition.

General treatments include:

  • Provide soft, dry bedding for your rabbit (vetbed is very useful).
  • Provide an appropriate diet, supportive feeding if anorexia is present; correct obesity by increasing fibre/decreasing carbohydrate intake. Weight loss must be done slowly to avoid hepatic lipidosis.
  • Trim overgrown toenails.
  • Clean the feet.
  • Topical ointments may be used to help protect the feet from further trauma or infection.
  • Some cases benefit from dressings (though some rabbits won’t tolerate them). Most importantly, ensure the dressing is kept clean and dry.
  • Anti-inflammatories/pain relief.
  • Restrict activity if tissues are severely damaged, but encourage activity in the long-term.

More specific treatments may be appropriate for certain diseases, e.g. antibiotics for infections or surgery to address deeper disease. General anaesthesia is required if surgery is performed.

The prognosis depends on the grade of pododermatitis at the time of diagnosis. Early detection and treatment greatly improves the prognosis.

Grade I-III lesions can be treated, though your rabbit may have recurrence of disease.

If deeper tissues are affected, tendons can become permanently and irreversibly damaged; for Grade IV-V lesions, the prognosis is guarded to poor.

Good care of your rabbit will reduce the risk of many diseases. Clean any soiled/wet litter daily and encourage exercise.

Provide your rabbit with a balanced diet and an appropriate environment in which to live.

Avoid the following to reduce the risks of pododermatitis:

  • Hard or abrasive surfaces in your rabbit’s environment.
  • Wet, urine- or faeces-soaked surfaces.
  • Clipping the fur from the hocks, especially in Angora rabbits.
  • Stressing your rabbit, nervous rabbits traumatise their back feet when they stamp!
  • Excessively warm/humid environments.
  • Obesity.

Lice infestation

Rabbits can host a variety of parasites on their fur and skin. These are termed as ectoparasites, since they live on the outside of the rabbit. Lice fall into this classification and can be a problem for pet rabbits.

Clinical signs of a lice infestation may include pruritus (intense scratching), bald patches within the fur or thinning of the fur.

With advanced infestations, the rabbit may appear very agitated, restless and may also lose weight and eat less because they spend so much time scratching. Anaemia may also be present, especially in very young rabbits, as lice feed by sucking the rabbit’s blood. This is especially noticeable in albino rabbits which will appear very pale. Severe anaemia can cause weakness and even death.

The rabbit louse is Haemodipsus ventricosus, and is a sucking louse, but is thought to be rare in pet rabbits. They are normally found along the back and on the sides of the rabbit as well as around the rump area. Adult lice are visible with the naked eye and can be seen moving. The eggs (nits) are oval in shape and are laid and firmly attach to the shafts of the hair, these can also be seen with the naked eye. The entire lifecycle from egg to louse takes 2-5 weeks where environmental conditions are at an optimum.

Ivermectin injections at 7-10 days apart for 3-4 treatments are normally effective. Treatment needs to last long enough to eradicate the eggs as they hatch.

Imidacloprid (Advantage®) is effective in dogs and could also be used in rabbits.

Do not use fipronil (Frontline®) in rabbits as it has been associated with toxicity.

There has been some discussion as to whether or not the rabbit louse can act as a vector for myxomatosis. In theory, if a louse from a myxomatosis infected rabbit found its way onto a domestic rabbit this is potentially possible, although in reality an extremely unlikely possibility.

However, it is recommended that all rabbits are vaccinated against myxomatosis, which now, with the new combined myxomatosis and viral haemorrhagic disease vaccine (Nobivac Myxo-RHD), only requires an annual booster.

This has not been documented, since the lice are species specific, but it is wise to get your rabbit treated as soon as you notice any symptoms, and to clean the environment after every treatment.

Flystrike in rabbits

Vets know that with the arrival of the warmer months, comes the common problem of rabbits affected by flystrike being presented to them. This is a deeply distressing condition for owners, the veterinary team and especially the rabbit, which is literally being eaten alive. However, with some simple preventative measures, hopefully your bunny will never have to endure this condition, or if they are unlucky enough to be affected, you will be able to act quickly enough so they are one of the lucky ones who can be saved.

Certain species of flies (e.g. bluebottles), use other animals as a host to lay their eggs on, which hatch into maggots, and then proceed to eat into the flesh of the animal, causing immense suffering to the animal, which in essence is eaten alive.

Flies are attracted by soiled or wet fur, usually around the tail area of the rabbit, but any area can be affected, or any open wound, cut or scratch. Once laid, the eggs will hatch into maggots within 12-36 hours, burrowing into the rabbit’s flesh, causing vast tissue damage and pain, which can prove to be fatal even with prompt veterinary treatment.

The months of April to October are quoted as being the months when animals are more susceptible to flystrike, but it has been reported to have occurred in rabbits as early as January or as late as November, so owners need to be vigilant throughout the whole year, but extra vigilant during the flystrike season of April to October.

Any rabbit, even those kept as house rabbits who keep themselves beautifully clean, can be affected by flystrike; it only takes one area of soiled fur/skin or scratch, and one fly. However, not surprisingly those most at risk are rabbits who have frequent dirty bottoms, so ensuring that your rabbit is clean and dry is the best prevention against this awful condition. If your rabbit is often affected by a dirty bottom then, along with your vet, you need to ascertain the cause of the problem in order to treat the underlying condition, whilst also being extra vigilant in spotting the first signs of flystrike.

Possible causes of dirty bottoms include:

  • Dental disease making cleaning too painful.
  • Spinal problems making cleaning difficult or painful or causing difficulty in adopting the correct position to eat the caecotrophs (normal soft droppings produced by rabbits which are eaten direct from the anus as they are produced).
  • Balance problems unable to adopt the correct position to clean themselves.
  • Obesity too fat to reach their bottoms to keep clean or retrieve the caecotrophs.
  • Incorrect diet leading to too many caecotrophs being produced.
  • Too much dried food filling up on this and so not hungry enough to eat the caecotrophs, which then get left and stuck to the tail area.
  • Old age not able to keep themselves clean.
  • Urinary tract diseases, causing incontinence or abnormally smelly urine.
  • Disease of the uterus of female rabbits, because of the abnormal odour associated with discharges, and also because disease of the uterus is painful and can stop the rabbit grooming itself.

Longhaired rabbits are also more susceptible to flystrike, because of the amount of fur they have and faeces are more likely to get caught up in the fur, and, as aforementioned, any bloodied area (cuts or wounds etc) will also attract flies.

As far as flystrike goes, prevention really is better than cure and cannot be stressed enough, and even if your rabbit isn’t classed as being at high risk of developing flystrike, it is still imperative you still do as much as you can in preventing them from contracting it low risk, doesn’t mean no risk.

Ways on trying to prevent flystrike include:

If possible, treat any condition which places the rabbit in a high risk category.
Consider spaying does which are not used for breeding (there are many other benefits to this procedure too).
Ensure that your rabbit isn’t overweight and is fed a correct diet.
Check the whole rabbit, paying special attention to the back end and tail area, at least twice a day, going through the fur to check for soiled/wet fur or maggots.
If the rabbit has a dirty bottom, clean it for them immediately.
High risk rabbits may be safer inside the house, but must still have their bottom checked twice daily.
Clean litter trays daily and remove all soiled bedding from hutches daily.
Staple net curtains over the hutch/run to insect proof them.
Consider using Rearguard (Novartis Animal Health). Rearguard is a liquid which is applied to the tail area of the rabbit by sponge, and should any eggs be laid on the area it will prevent them from hatching into damage causing maggots. Rearguard is available from veterinary surgeons, but if using this you must still check your rabbits bottom area.

You may not be able to see any actual maggots as they may be concealed under matted or soiled fur (especially in long-haired rabbits), so if your rabbit is displaying symptoms such as restlessness, irritation, ‘wetness’ or abnormal odour around a certain area (usually the tail area), lack of appetite, sudden aggression etc, you should take it to your vet immediately. If you suspect flystrike and your veterinary surgery is closed, then you must phone an emergency on-call vet.

If you can see any obvious maggots remove them with tweezers as quickly as possible, but do not put the rabbit into water in an attempt to wash off some of the maggots. Clippers don’t work very well on wet fur and your vet may be delayed in treating your rabbit if they have to dry the fur first. The longer a rabbit is left the more damage the maggots will cause, which may be impossible to treat, with the only option of putting the rabbit to sleep, to stop it suffering any longer, so time really is of the essence.

Cases of flystrike can be successfully treated if caught early, but this is dependent upon the amount of damage caused by the maggots and if your vet feels that the rabbit has a reasonable chance of recovery. It is also necessary to take account of any underlying diseases such as dental disease which may also affect the likely outcome.

If your vet feels that the rabbit has a reasonable chance of recovery then treatment usually consists of:

Clipping the fur from the affected area to assess the damage.
Washing and removing all visible maggots.
Surgery to remove any concealed maggots, necrotic (dead/infected) tissue and repair tissue damage.
Antibiotics to prevent a secondary infection or treat infection if one is already present, fluid therapy and other treatments to counteract the effects of toxins that may have entered your rabbit’s bloodstream, and painkillers to make your rabbit more comfortable.
Identifying the cause as to why the rabbit was affected with flystrike and treatment to correct any underlying problem.
Rabbits will need to be anaesthetised for surgery and often rabbits affected with flystrike are suffering to some degree with shock, and so will carry a higher anaesthetic risk.

If the rabbit does survive, the wounds can take weeks to heal and during this time the rabbit will be at an increased risk of further bouts of flystrike and also infections, so careful nursing by the owner will be required and preventative treatment measures must be stepped-up.

Claire King, The Rabbit Welfare Association.

Ear canker in rabbits

Ear canker can be a painful and irritating condition for your rabbit. Signs of this condition tend to appear 2-3 weeks after the animal is first infested with mites, therefore early detection of the mites that cause ear canker is important when trying to prevent this condition from taking hold.

Ear canker is a condition of the rabbit’s ears caused by the ear mite Psoroptes cuniculi. Psoroptes cuniculi is a common parasite of rabbits and occurs worldwide. The mites irritate the lining of the ear which causes oozing serum and thick crusts to accumulate within the ear canal. Lesions can spread to the face and neck and perforate through the eardrum leading to middle ear disease (otitis media).

Ear mites cause the rabbit intense irritation, so you will notice your rabbit headshaking, ear flapping and scratching at the ears more often than usual. More severe signs may include twisting of the head (torticollis) and spasms of the eye muscles.

If you look down the rabbits ears you may notice crustings and scabs down the ear canal. The rabbit may resent you touching the ears as the condition is also very painful.

Long-term suffering can lead to further problems where the rabbit may lose skin from the ears and succumb to secondary infections which can damage the inner ear and may reach the central nervous system (CNS).

If you suspect your rabbit has ear canker, you should take it to see your vet as soon as possible, since the longer you leave it before treatment the more serious it will get and the longer the rabbit will suffer.

The recommended treatment is Ivermectin injections once every 10-14 days for three treatments or Moxidectin injection once every 10 days for two treatments. All in-contact animals should be treated even if they are showing no symptoms. Mild infections may be treated with eardrops.

The systemic treatment should be sufficient to resolve the crusty lesions down the ears, but if necessary they can be removed by being softened in mineral oil before being very carefully removed. Care must be taken not to damage the lining of the ear canal and your vet may need to sedate your rabbit to carry this procedure out safely.

Painkillers (analgesia) in the form of a non-steroidal anti-inflammatory drug (NSAID) may also be prescribed to help with the pain and irritation the condition causes.

All bedding within the cage/hutch should be disposed of (preferably burnt) after each of the rabbit injections. Hutches should be carefully cleaned and disinfected to ensure there are no mites present which may cause further infections.

Biting and nuisance flies

The most common flies that affect rabbits include green bottles, house flies, face flies, stable flies, horn flies, horse flies and blow fly species. Some species, like blow flies, are attracted to moist decaying environments in which to lay their eggs. Other fly species such as face flies, flesh flies, screw worm flies and bot flies target living animal flesh, including drinking the tears of live animals, biting the animal for a blood meal, or reproducing by laying eggs under the animal’s skin.

Flies are insects that are characterised by a pair of wings. Their ability to fly gives them the ability to travel large distances in search for food or a suitable environment to reproduce.

Their keen sense of smell draws them to foodstuffs, decay, excrement and moisture, and these are frequently found around animals, this makes animals a prime target.

The fly’s extraordinary mobility makes infestation and disease transmission between animals a real concern.

One of the most common conditions resulting from fly infestation in rabbits is flystrike (a type of myiasis).

This condition begins when female flies are attracted to moist soiled fur where they lay eggs that hatch into voracious larvae (maggots). The larvae crawl and eat their way through the decaying excrement and broken down skin causing a rapidly expanding open wound that can be life-threatening.

Signs of flystrike include:

  • moist matted fur
  • hair loss
  • reddened skin
  • foul odour
  • visible wounds
  • the presence of eggs and larvae/maggots in the fur

The rabbit may act weak, depressed, lay on its side or have an abnormally hunched posture. It may have a reduced appetite, or be reluctant to move. In severe cases, it may even lose consciousness or experience seizures.

Treatment for fly strike involves physical removal of the larvae and soiled fur followed by careful wound care and attention to secondary infection and pain control. Treatment is not always successful in advanced cases where the wounds are large or deep.

To prevent flystrike it is essential that the rabbit has clean dry fur, especially during the warm summer months when flies are most active. It is imperative that the housing environment is free from excess moisture and that the area is regularly cleaned of faecal matter and soiled bedding. Screened enclosures can help prevent flies from entering the habitat. In addition, all rabbits should be checked each evening to ensure that the body, and especially the undercarriage and hind end is free from excess moisture and debris and that no eggs have been laid. Failure to do this can result in significant damage in just a few short hours as eggs hatch and larvae migrate over the body.

Rabbits most at risk of flystrike are those that are obese and unable to reach their hind end. It is important that the rabbit is able to reach its hind end to groom itself and to consume soft faecal pellets (caecotrophs) which are essential for digestive health. Lack of grooming can lead to fur becoming matted with debris and faecal matter. Additionally, failure to ingest caecotrophs can lead to poor health and diarrhoea, another leading cause for flystrike.

Good bodyweight and intestinal health in rabbits requires a high fibre diet. Rabbits should eat at least 80% quality grass or meadow hay (not alfalfa hay) supplemented with fresh dark green leafy vegetables and herbs and only about 5% high quality fresh rabbit pellets. Sweet vegetables and fruits should only be fed occasionally as a special treat as the high carbohydrates can negatively affect digestion.

Another type of myiasis is caused by parasitic flies that have larvae that burrow into the skin or tissue of the rabbit. The majority of these species belong to the Cuterebra family which are primarily found in North America.

Bot flies lay eggs in a variety of places including near open wounds or orifices. They can even lay in moist soil in an animal enclosure or on other insects to transmit the larvae to the host.

Once a larva is on a host, it can burrow under the skin where it will sit and develop using host tissue as a source of energy. Some of these larvae can travel to the respiratory or gastrointestinal tract, or into the eyes and nose.

Clinical signs of infestation can include swelling, pain, ulceration and discharge around the larval cyst with secondary bacterial and fungal infections being common. The wound can cause distress to the rabbit and in severe cases can cause depression, weakness and serious infection.

Treatment includes careful physical removal, followed by cleaning and treatment of the wound.

Prevention is difficult as the flies are attracted to the host, even in clean conditions, but screens can deter some. Regular daily inspections of the rabbit’s skin and fur can help detect problems before they become severe.

Flies can also transmit dangerous diseases; both viral haemorrhagic disease and myxomatosis are viruses that are spread by biting flies, and both diseases can prove fatal.

Clinical signs include swelling of the eyes, face and genital as well as blindness, difficulty eating, drinking and breathing.

Treatment for these diseases in not guaranteed with the majority of cases proving fatal, although early detection and intensive care can improve outcomes.

Prevention of fly transmitted viruses is relatively easy via vaccination.

Biting flies can still be a real nuisance to rabbits causing painful bites and wounds on the ears and face; screened enclosures can do wonders to help provide a safe and comfortable habitat.

It is also essential to provide a clean, dry enclosure for your rabbit which can decrease the incidence of attracting flies in the first place.