Top tips for working with rabbit patients

Rabbits can be challenging veterinary patients.

We all know that rabbits aren’t small dogs and cats, but when it comes to veterinary care they really do need special care. Given their popularity as companions, there’s relatively little we learn about them in veterinary school, but the little things can make all the difference. We asked three exotics veterinarians their top tips for working with rabbits.

Dr David Vella – Director, Sydney Exotics and Rabbits Vets (SERV)

• To examine the oral cavity of rabbit, the use of a hand-held human nasal speculum is far superior to a traditional otoscope. The nasal speculum allows you to move the tongue and cheeks away from the cheek teeth thus facilitating examination
• Patient warmth provision is essential during general anaesthesia. It is vital to monitor body temperature peri-operatively and actively warm rabbits that are below 37C

Dr Narelle Walter – Founder, Melbourne Rabbit Clinic

• Analgesia in rabbits is often underutilised. Stress and anxiety (a common presentation in the rabbit) plays a major role in exacebating painful situations and we should always consider pre-emptive analgesia.
• A towel is an essential rabbit handling tool and should be present in every rabbit consultation.

Dr Michelle Dalli

• Be confident when talking about husbandry and diet in rabbits, so know the facts. I find in consults that when owners know that you know about these things they have more confidence in you as a vet.
• Be confident in handling rabbits during the examination as again owners are more confident when you handle them well. Comes with practice!

The above veterinarians are teaching a workshop on rabbit surgery and dentistry next weekend at Charles Sturt University through Vetprac. For more info check out the program here. 

Vet's pets: Lynette Chave and Chocolate Bunny

Chocolate Bunny leads a charmed life.

This week we introduce the second veterinarian in our Vet’s Pets series. Dr Lynette Chave is a veterinarian with the Animal Welfare Unit in the NSW Department of Primary Industries. It’s a position that enables her to work with animal welfare on a broad scale.

By day she deals with animal welfare legislation, and her main area of work is the regulation of the use of animals in research and teaching.

Like many vets, Lynette met her companion - Chocolate Bunny - at work. Not only is she a brilliant colleague (speaking from previous experience), she is a fantastic writer.

You can read her blog here or follow on facebook here.

How did you meet Chocolate Bunny?

Chocolate Bunny hopped into my life, and straight into my heart, during a time when my office was located in the middle of the Cumberland State Forest. A friend in the information centre rang me to say she had a chocolate bunny. At first I thought it strange she should want to tell me about her afternoon tea, until I realised she meant not a sweet imitation but the real thing. He had apparently been spotted around the forest nursery for about a week before being rescued. I went over to meet him and as soon as I held his soft bunny body in my arms I knew there was no place he was going except home to stay with me.

Working from home.

Does he have any conditions that require treatment? What was involved in treatment?

There’s a long list…so I suggest sitting down and grabbing a cup of coffee…

The first was malocclusion – totally missed by Yours Truly. I thought Choccy just didn’t like eating greens, until a friend, who happened to be a rabbit judge [not the courtroom style judge but one who judges rabbit shows], paid him a visit. The first thing he did (much to my bunny’s chagrin), was to tip him on his back to examine him…the way you apparently do if you have a background in rabbit judging. Gasps from my friend and me followed with the sight of the curling incisors that greeted us. Thus began my association with the wonderful David Vella, Rabbit Veterinarian Extraordinaire. David operated to remove the incisors (better than regular tooth clipping which runs the risk of  fractures and subsequent infections). And lo and behold, Chocolate Bunny began eating greens with a vengeance (albeit chopped up to accommodate his incisor deficiency).

Then there was the gut stasis – new to me but a common rabbity emergency. Again managed by David, and I became familiar with Critical Care formula and force feeding a reluctant bunny into the wee small hours.

A couple of years ago (I’m assuming you want me to go on!) rapid breathing again saw me and Choccy making the trek to Crows Nest for a diagnosis of a condition akin to asthma and the start of long-term treatment with a bronchodilator twice daily. For this, my bunny is very grateful to his rabbit vet, because it means he gets the tablets inside sultanas – which he LOVES.

In recent times this condition has sadly progressed to what appears to be inflammatory airway disease. What I thought was sneezing David advised was coughing (yes I learnt rabbits are obligate nose-breathers). After X-rays and some trial and error treatment, during which my little fellow became very unwell, we have come up with a therapy that seems at least to be keeping him comfortable and somewhat back to his happy, binkying self. 

He’s now on a daily inhalation of corticosteroids…initially started with some trepidation, as apparently the rabbit immune system and corticosteroids are not a good combination, but so far so good.  Chocolate Bunny is less impressed with his rabbit vet for this treatment, which requires restraint and is thus a serious challenge to his ego.  He’s also a little put out by the rampant Oryctolagus cuniculus discrimination which sees the ready availability of Aero-Dawg and Aero-Kat inhalers, but nary an Aero-Bun inhaler to be found.

Chocolate Bunny is a house bunny so makes himself at home.

How would you describe their relationship?

I am totally in love with this tiny creature with a personality the size of a small planet, and he appears completely bonded to me, for which I am very grateful (rabbits can be quite fussy about the company they keep).

What do you do to spend time together?

Choccy is a house rabbit. He lives inside with me and has free run of the house (yes he uses a litter tray). So he tends to be wherever I am. When I greet him in the morning, he is in the habit of running around and around my feet in a display of rabbit love – and it melts my heart every time.

Has caring for Choccy taught you anything you didn’t already know?

Yes…see all of his conditions above – it appears I knew almost zero about rabbits….this includes:

• That their incisor tooth roots are extremely long – which makes removal quite difficult.
• Rabbits go bananas for banana (carrots are a long way down the list of favourite foods).
• Rabbits have no idea that they are roughly the size of a sawn-off ugg boot. Their attitude indicates they think they are somewhere around the dimensions of a polar bear.
• Rabbits are officially the cutest creatures in the world, be it leaping in the air for the sheer joy of it (binkying), flopping on their sides in bunny bliss, or just cleaning their ears. It is doubtless annoying for them when their housemates oooh and aaaah over their every move, but a source of constant joy for the housemates.

There is an entire online community of people equally as obsessed with their rabbits, for whom behaviours such as posting endless cute bunny pictures and talking in “bunny speak” (think “buntastic”, “bunderful” and “OMB” ) is perfectly normal and acceptable.

Chocolate Bunny shares a secret.

How has Choccy changed your approach to veterinary work?

I don’t work in practice, but it has reinforced how active rabbits are and that confining them to small cages or hutches cannot possibly meet their physical and behavioural needs.

Any parting words of wisdom?

I have learnt that my home would not be complete without a house rabbit.

I also share my life with two horses (one a 30 year old retired paddock ornament the other a somewhat reluctant dressage partner), 4 chickens, 2 budgies and plethora of wild visitors to my home at Joyfallee. They feature in The Chicken Diaries, which began on Facebook and has continued more recently in my blog – The Joyfallee Chronicles. 

For those with an arty bent, The Chicken Diaries is to be the subject of an exhibition by Fresh Arts in Dubbo, with opening night on 7 August 2015 – in a sort of art-meets-social-media-meets–the residents of Joyfallee - http://www.dubbo.com.au/events-calendar/the-chicken-diaries-goes-arty ...All are welcome…and it’s free!

OMB, Lynette! Thanks for sharing your story and hopefully a lot of people will make it to the exhibition.

A few things I learned about rabbit desexing

Animal cakes at the AVA conference. I made sure I had my blood glucose checked at the wellness stand before sampling these carb-tastic beauties.

Have you ever desexed a rabbit? In some States in this country where rabbits are illegal to keep as pets (such as Queensland), it’s unlikely. But interestingly, between 150 and 200 vets rocked up to a session on rabbit desexing. It felt like everyone in the conference flocked to one room (which is a semi-accurate estimate, it was about 20 per cent). Some had over forty years’ experience. Which gives you an indication of how challenging it can be.

Exotics veterinarian Dr Brendan Carmel shared his techniques with the eager crowd. For males he recommends an open technique via a pre-scrotal incision. He doesn’t worry about subcutaneous sutures as there is barely any subcutaneous tissue, and uses tissue glue to close the wound.

He does advocate speying female rabbits because of the high incidence of uterine neoplasia. Depending on the study you read it’s between 40 and 80 per cent in rabbits over 3 years. Ovariectomy can be considered in rabbits at 2-3 months old.

Reassuringly, Dr Carmel advised that the mesometrium is a major fat storage area in rabbits. Thus speying an adult female rabbit who is a bit on the plus-size side is the lagomorph equivalent of desexing a bit fat Labrador. He advocates sending off any uterus that looks hyperaemic, lumpy or bumpy in case there is uterine neoplasia. Often in females with uterine adenocarcinoma, the fat has atrophied somewhat. If he palpates a very large uterus in an adult rabbit, run some bloods and do chest radiographs before you do surgery.

The risk of anaesthetic mortality remains high in rabbits (0.7-7.4% compared with 0.1-1.4% in cats and 0.05-1.3% in dogs). Owners need to be informed about this.

Airway control is challenging to achieve in rabbits but Dr Carmel uses a supraglottid device or V-gel, or uses a rigid endoscope to intubate. These are very nifty, I popped along to the V-gel stand to check them out and they’re really easy to place.

A V-gel used to maintain airway in a rabbit (nb this is a model).

A close up of the V-gel. You can autoclave and reuse these 40 times.

Dr Carmel advocates plenty of analgesia and higher than standard doses of non-steroidals in rabbits, up to twice per day. He does not discharge rabbits until they are eating. If they don’t eat, he assist-feeds them Critical Care formula. The details of course are in the proceedings, but it was an excellent talk.

Do we look after rabbits well?

Are we giving bunnies what they really need?

Do we care for pet rabbits appropriately? It was a question asked by UK researchers who set out to examine the way companion rabbits in England are looked after – and they found some major welfare issues.

Just to put this into context, rabbits are the third most popular mammalian pet in the UK, behind dogs and cats. There are an estimated 1.7 million pet rabbits, kept in 4 per cent of UK households.  I can’t locate any official figures on rabbit ownership in Australia, but the keeping of pet rabbits is illegal in some states (for example, Queensland). Unfortunately, large numbers of rabbits experience stress on a daily basis thanks to their housing, husbandry and handling.

Boris the bunny loves his hay. Every single day.

In Australia at least there seems to be a widespread perception that rabbits are easy to look after, great kid’s pets, not as much trouble as a dog or cat, requiring less time and so on. In fact, this is not the case. Rabbits are complex creatures with similar needs to dogs and cats – companionship, enrichment, exercise, stimulation, and security. As prey animals they mask signs of stress or illness as their survival depends on it.

Unlike dogs and cats, rabbits are usually (but not always) kept in hutches, which gives them little freedom to move, little control over their environment and not a lot of space to express normal behaviours.

There are plenty of guidelines for housing laboratory rabbits in scientific institutions, but when it comes to companion rabbits we tend to assume that as they’re being kept as pets they will be well looked after. But that doesn’t necessarily follow. For example, laboratory guidelines detail the minimum hutch-size for rabbits. But one study from the UK found that one fifth of rabbit hutches for companion rabbits were smaller than the minimum size recommended in laboratories.

A diverse population of 1254 rabbit owners from three different geographical regions in England were surveyed about the husbandry and care of their rabbits. Some people reported that they kept rabbits very well, which is great. But there were a number of issues identified in this study.

While most rabbits had access to exercise areas outside of their hutch, this access was often unpredictable or ill-timed for the rabbits.

Only 41.9% of people kept rabbits with together. Single-housing of rabbits does mean they can’t express social behaviour. One reason for single-housing in rabbits is, of course, aggression. Indeed, in those who kept rabbits with conspecifics, around one quarter fought occasionally, 22 per cent guarded resources like food and 27 per cent outright avoided one another. The authors argue that “it is essential that compatible pairings are selected and introduced appropriately, and adequately-sized and structured living space is provided to allow rabbits to avoid one another if they so choose,” (p11).

Concerningly, the majority of rabbits (61 per cent) did not behave calmly when picked up by owners or other adults (75 per cent). Moreover, 27 per cent of owners weren’t confident holding their own rabbit. This lack of confidence may be something rabbits are aware of, and may exacerbate the stress of handling.

The good news was that the majority of owners fed hay daily, but 10 per cent of rabbit owners did not.

This study proves that there is a need for evidence-based guidelines on basic rabbit husbandry to ensure minimal stress. In addition, some education around the proper care and particularly handling of rabbits could ease stress on the part of rabbits and owners alike.

Reference

Rooney NJ, Blackwell EJ,Mullan SM, Saunders R, Baker PE, Hill JM, Sealey CE, Turner MJ & Held SDE(2014) The current state of welfare, housing and husbandry of the English petrabbit population. BMC Research Notes 7:942

Warning for pet rabbit owners

Boris the bunny needs some additional protection from a novel variant strain of Rabbit Haemorrhagic Disease Virus.

Do you own a pet rabbit and live in NSW? Do you treat rabbits in your practice? If so you should be aware of a new strain of Rabbit Haemorrhagic Disease Virus (RHDV), also known as calicivirus, which has been detected over the last 12 months.

According to a memo from Chief Veterinary Officer Ian Roth, reported cases occur in an area from South Sydney to Kyogle and as far west as Lithgow. In all locations, sudden deaths have occurred. The most commonly affected are young rabbits (4-6 weeks old) and those not recently vaccinated.

This strain, first identified in China, is rapidly replacing endemic strains in a number of countries. Poor vaccination rates in rabbits are allowing it to take hold.

(The endemic strain of RHDV here is the Czech strain, for which the Cyclap vaccine provides protection. Limited studies have shown this vaccine provides "some" protection from the novel variant strain, although protection isn't guaranteed).

Vets should be aware that the manufacturers have made some “off-label” suggestions for use of vaccine to provide additional protection to bunnies.

Here is some info direct from the memo:

The incubation period for the RHDV is between 1 to 3 days, with death following 1 to 2 days after this period. Most rabbits will show no signs of external symptoms of RHD but may have signs of haemorrhage on post mortem. Transmission of RHDV occurs by direct contact with an infected animal or fomites. Rabbits acquire RHDV through oral, nasal or conjunctival pathways. Virus may be present in urine, faeces and respiratory secretions. The virus may also be carried by the wind, flies, rabbit fleas and mosquitoes. [Ed: another good reason to provide rabbits with indoor housing]. Any veterinarian who suspects a domestic rabbit may have RHDV, should submit a fresh frozen (not formalin-fixed) 1 g liver sample to the State Diagnostic Veterinary Laboratory (SVDL) at the Elizabeth Macarthur Institute (EMAI) .See http://www.dpi.nsw.gov.au/agriculture/vetmanual If you live in or near the affected areas, the recommendations are for increased vaccination and health care protocols. These include: Early vaccination (at 3-4 weeks) and repeat at monthly intervals with the final kitten vaccination at 2.5 to 3 months of age More frequent boosters (eg every 6 months) if required Maintaining excellent biosecurity including: preventing contact between domestic and wild rabbits, avoid cutting grass and feeding it to rabbits if there is the risk of  contamination from wild rabbits, washing hands between handling rabbits, good insect control is also important and will help reduce the risks of introduction of both RHDV and myxomatosis, infected rabbits should be isolated and disposed of in a manner that will minimise environmental contamination, all cages and equipment should be thoroughly cleaned and disinfected.

What you need to know about feeding hay to pocket pets

Orchard grass. Good to hide in and also delicious.

If you own rabbits, guinea pigs or other fibrevores then you probably know that the majority of their diet should consist of a good quality hay. 

But did you know that all hays are not equal? Varying the diet of fibrevores doesn't just mean throwing in some veg and pellets and the odd bit of fruit. It means making careful choices about hay. Because your pets surely do.

It looks the same to us, but rabbits and guinea pigs will look at a bunch of hay, pick out their favourite bits and leave the rest. 

Hay houses are also a good snack.

I was able to interview Dr Marcus Clauss, arguably the world expert on hay feeding of pocket pets and guinea pigs, and he revealed that studies have shown that rabbits can differentiate between hay cut from the same pasture in the morning and the evening, maybe because of the sugar content changes through the day.

In one sense this information isn't all that mind blowing. After all, if we spent all day eating hay we'd probably expect that we'd develop a taste for some cuts or types over others. On the other hand though, as a species we are notoriously rubbish at paying attention to our senses and we may not be in tune with the sensory world or umwelt of companion animals and subsequently overlook factors that are important to them.

In his book How to Connect with Nature, natural navigator Tristan Gooley cites William James: "What is called our experience is almost entirely determined by our habits of attention". Too true.

John Burroughs has a slightly more alarming take on that: "There is nothing people differ in more than in their powers of observation. Some are only half alive."

Nobody wakes up in the morning and decides to shut down their senses and stumble through each day in an oblivious bubble, and yet some people end up having much richer experiences than others. If two people go on an identical walk, one of them might have a profounder, more fascinating experience than the other. One reason will be each person's life experiences to date (p48).

Spending a bit more time thoughfully selecting, touching and sniffing hay is then probably just as good for you as it is for the animals you want to feed it to.

So what does it all mean? It means that we should be a) providing excellent quality hay that has been stored appropriately so that it is free of potentially toxic moulds; b) topping up hay daily so rabbits and guinea pigs can choose the bits they want; c) varying the hay that we purchase, including the source, to provide some variety in the diet.

You can read the full article in the latest issue of Rabbits USA here. The article I wrote is geared towards rabbit owners, but if you fancy something a bit more technical check out this brilliant article by Dr Marcus Clauss.