Nipping Common Health Problems in the Bud


In This Chapter
  • Finding the right vet
  • Spaying and neutering
  • Recognizing signs of pain
  • Spotting symptoms of illness
You may not be surprised to discover that your rabbit, like all creatures, can easily become sick or injured if he’s mishandled or improperly cared for. In fact, rabbits can get sick even if you take really good care of them. Of course, a rabbit who’s well cared for is less likely to become ill, but it can happen. The key to keeping your rabbit healthy is to watch him closely for signs of illness because rabbits are good at hiding their illness — a trait that’s frustrating for rabbit owners but valuable in the wild. Rabbits instinctively hide their illness so that predators are unable to detect their vulnerability.

Most illnesses are more successfully treated if they’re caught early. Familiarize yourself with your rabbit’s normal behavior so that you’ll notice when something is wrong — before it’s too late. While this chapter covers more of the common ailments that bug bunnies, Chapter Coping with Other Health Woes and Aging Issues outlines many of the chronic health problems of rabbits, as well as those health problems that arise later in life. Chapter Ten Signs That Require Emergency Action covers ten signs that you need to take emergency action.
Remember
If your rabbit gets sick, taking him to a veterinarian who specializes in treating rabbits is vital. After you locate a good veterinarian, bring your rabbit in for annual checkups.

Finding Dr. Doolittle


No matter what kind of pet you own, finding a good veterinarian is imperative. Unfortunately, finding a vet who treats rabbits may be harder than you think, so please find a vet before you have an emergency situation.

A small animal vet who treats only cats and dogs isn’t a good bet when it comes to treating a rabbit because rabbits have a unique physiology that’s very different from more common pets (see Chapter Jumping into Rabbit Ownership). In the world of veterinarian medicine, rabbits are considered exotics, and they’re grouped together with rodents, reptiles, birds, and other less common pets. Most veterinarians who have a special interest in treating these kinds of animals advertise themselves as exotics practitioners. They not only have special training in this area, but also a certain level of experience.

Not only must your vet know rabbits inside and out, but she must also be good at what she does. Just as with any profession, the skills and attitudes of veterinarians differ from individual to individual. You need to find a vet who is good at handling rabbits, excellent at diagnosing them, and an ace at treatment. Finding someone who has a good bedside manner with human clients isn’t a bad idea, either.
Remember
In most areas of the country very few veterinarians have specific training or extensive experience with exotic pets. For example, people who live in rural areas won’t have the selection that city dwellers have. Therefore, you may have to deal with a small animal vet who’s willing to work with you and learn about your pet.
So how do you find a veterinarian to treat your rabbit? You can use a number of different options:
- Personal referrals. Talk to other rabbit owners and find out which vets they use. Ask them what they like about each one and get details of the situations where they’ve used them. By listening to these stories, you can get a good sense of who each doctor is.
- Rescue groups or shelters. Talk to the knowledgeable folks at rescue groups and shelters or check the House Rabbit Society’s online referral list (www.rabbit.org/vets/vets.html) for a state-by-state listing of veterinarians who practice veterinary medicine on rabbits.
- Veterinarians. Even if they don’t treat rabbits themselves, vets often know of exotic vets that do. Talk to local vets (you can find them in the phone book or through a state association of veterinarians) to get recommendations.
- Veterinary organizations. Contact the Association of Exotic Mammal Veterinarians (AEMV), an organization dedicated to improving medicine and surgery of the exotic companion mammals (www.aemv.org). In 2009, veterinarians will be able to apply for exotic companion mammal specialist status through the American Board of Veterinary Practitioners (www.abvp.com). Several other organizations are considering adding exotic companion mammals as a specialty, so in the nottoo-distant future, rabbit owners will truly be able to look for boarded specialists for their pets.
- Club referrals. Contact a local rabbit breed club or 4-H club to get a referral to a local exotics veterinarian. Please note that many people who participate in clubs or breeding do not subscribe to a house rabbit philosophy, so their veterinary needs may differ from yours.

Evaluating a vet


Once you find a vet or two that you think you might like to use, contact the office by telephone and ask the following questions:
- How long have you been treating rabbits? The answer should be at least two years, preferably longer.
- How many rabbits are treated at the office each week? Ask, too, about the number of rabbits that are spayed or neutered each week. This answer gives you a good idea whether a vet really has a sufficient amount of experience with rabbits.
- What kind of special education or experience do you have treating rabbits? You want a vet who has training in this area, or at least has a significant amount of experience to make up for lack of formal training. Continuing education courses and programs are a good sign that this vet is serious about treating rabbits.
- Which antibiotics do you prescribe to rabbits? Some antibiotics commonly given to cats and dogs can be fatal for rabbits. An experienced veterinarian will know not to use amoxicillin and most of the other “... cillin” drugs. Chapter Coping with Other Health Woes and Aging Issues covers more on antibiotics.
- Do you take after-hour emergencies? If not, where are they sent? If your vet closes at 6 p.m. and can’t be reached for emergencies that take place after hours, she most likely refers patients to a 24-hour emergency clinic. Ask questions about the clinic’s experience with rabbits and visit it to make sure that it meets your requirements.
- May I visit your clinic to look at your facilities? The answer should be a resounding “Yes.” Please respect the fact that an appointment may be necessary so as not to interfere with the services given to clients during the day.
Remember
Once you’ve narrowed your search, pay a visit to the clinic. While you’re there, look for the following:
- Clean environment: A clinic should look and smell clean. The exam rooms and reception areas should be neat and tidy, and the personnel should be well groomed.
- Friendly, knowledgeable staff: The receptionist and technicians you meet should be nice, friendly, and willing and able to answer questions.
- Skilled vet: You probably won’t get to see the vet in action until you make your first appointment. When you’re there, observe how she handles your rabbit. The vet should be gentle but firm and patient. She should also be willing to answer your questions, admit when she doesn’t know the answer to something, and be friendly and a good listener.
- Affordable fees: With veterinary care, you often get what you pay for. Don’t expect to get great care for dirt-cheap prices. On the other hand, make sure that you can afford the services offered. Ask for a fee schedule, which should show what the clinic charges for examinations, lab fees, and spays and neuters.
Tip

Being a good client


You want a veterinarian who’s skilled and compassionate and will take excellent care of your rabbit. You can do a lot to make sure that you’re a good client, too, by following these guidelines:
- If you’re happy with your vet, be sure to stick with her. Don’t jump around from clinic to clinic trying to save money.
- Pay your bills on time. If you’re having trouble paying, be honest with your vet and try to work out a payment arrangement.
- Follow your vet’s instructions thoroughly regarding your rabbit’s health.
- Be honest with your vet about your rabbit’s care and condition.
- Ask questions if you don’t understand explanations, diagnosis, or treatment plans.
- If you have a complaint with the veterinary staff, bring it to the vet’s attention first so that there’s an opportunity to get it cleared up to your satisfaction.
- Never be afraid to get a second or even third opinion. A responsible veterinarian won’t feel threatened if you seek other ideas.
- Be a proactive pet owner and do research as needed to help your pet. Bring any information to your veterinarian and discuss your findings.

Going for an exam


Unlike dogs and cats, rabbits don’t get annual inoculations (except in the U.K. with myxomatosis and hemorrhagic viral diseases; see Chapter Coping with Other Health Woes and Aging Issues). However,’ taking your rabbit to the vet for an initial exam is an excellent idea, even if he appears healthy. The vet can check him to make sure that he’s in good health and can discuss your rabbit’s diet, plans for neutering, and other health-related issues.

The initial exam also gives you the opportunity to get to know your veterinarian, and gives the doctor a sense of who your rabbit is. If your pet gets sick and needs immediate care, the vet will already have information on file and have a good sense of how you’re caring for your bunny.
Remember
Following that initial exam, annual exams are a good idea. These annual exams are invaluable in keeping ahead of disease problems and in communicating any changes in care. As they become geriatric (7 years of age and older), get an exam every 6 months.

Spay It, Don’t Spray It


Plenty of good reasons exist to spay your female rabbit (having her uterus and ovaries removed) or neuter your male rabbit (having his testicles removed), including improved behavior (see Chapters Putting Boxing Gloves on Your Rabbit: Training and 13) and the elimination of the potential for more unwanted rabbits in the world (see Chapter Choosing the “Right” Rabbit). But one of the best reasons is for the health of your rabbit.
Warning!
Spayed and neutered rabbits are less prone to a variety of diseases and tend to live considerably longer than rabbits who haven’t been spayed or neutered. Male rabbits who haven’t been neutered are also inclined to spray strong smelling urine around the house and get into other kinds of trouble. You’ll be much happier with your male rabbit if you have him neutered.
Rabbits can be spayed or neutered as soon as they reach reproductive maturity: about 4 months of age or later. Females should be spayed before 2 years of age to lessen the chance of developing uterine cancer. (See this chapter’s “Fighting female troubles” for more on that topic.) Both procedures are fairly routine in the hands of a veterinarian experienced with rabbits.
Technical Stuff

Counting backwards from ten


If your bunny needs surgery or a certain diagnostic procedure requiring that he be anesthetized, you may be worried. Is it safe to put bunnies under anesthesia? Can their sensitive systems handle the chemicals required for surgery or diagnosis?

The answer to these questions is yes. In fact, other than the obvious need for anesthesia during surgery, it’s often better to sedate the rabbit for stressful diagnostic procedures. Doing so eliminates your pet’s fear or discomfort. A safe anesthetic gas (usually in combination with other injectable drugs to reduce anxiety and pain) is used for general anesthesia, which produces complete unconsciousness. If lighter sedation is needed, the vet can use a variety of injectable drugs. Sometimes a local anesthetic alone is all that’s needed (for example, in eye exams or small skin biopsies).

If your bunny needs surgery for spaying or neutering or some other medical procedure, take your pet to a veterinarian with rabbit experience. The vet can determine the safest method of anesthesia to minimize discomfort and stress for your pet.

The cost for these procedures varies depending on many factors, including the area of the country in which you live and the age and health of your pet. The spay procedure takes considerably longer than a castration to perform and requires abdominal surgery; therefore, the cost for spaying a female may be two or more times the cost of neutering a male. Many veterinarians require presurgical laboratory work to make sure that your pet is in good health prior to the procedure. Please discuss with your vet any questions you may have. This onetime cost is well worth it, however, because a spayed or neutered rabbit lives a longer, healthier life.

Playing Doctor


An annual trip to the vet is a good idea, but you can do a great deal for your rabbit’s health on your own. Your rabbit is likely to live a much healthier life if you monitor her health every day and prepare yourself for any first aid emergencies that may arise.

Whether it’s daily (during a petting session) or weekly (while you’re brushing your bun), get in the habit of doing the following eight-point check, starting at the top:
- Ears: Look inside and out to see whether they’re clean and smooth, without sores, bumps, flaking, or excessive wax build up.
- Eyes: Be certain eyes are clear, clean, and free of discharge.
- Nose: Look for a dry clean nose and listen for clear, regular breathing.
- Mouth: Check that your rabbit’s teeth are aligned (growing straight) and not overgrown or broken. Make sure that she’s not drooling.
- Fur/skin: Feel her body for unusual lumps, bruises, cuts, or sores.
- Tootsies: Make sure that her toes are all straight, with no signs of lumps or inflamed tissue. Bottoms of paws should be covered with fur; any visible skin should not look bright red or infected.
- Nails: Check that nails aren’t too long. Those that are may tear off, bleed, and even become infected.
- Genital area: Take a peek at her privates to be sure that the area is clean and dry. (See Chapter Making Fitness and Fresh Air Fun for Your Bunny to find out how to spot clean if it isn’t.)

Fighting female troubles


Unspayed female rabbits can develop a variety of problems. The ailments listed here can happen before, during, or after a pregnancy and some occur even if you never breed your rabbit. Knowing how to recognize these problems increases your doe’s chances of survival.

Keep in mind that spaying your doe eliminates the possibility of all these conditions developing in your rabbit.
- False pregnancies: Female rabbits are so geared toward pregnancy that those who aren’t bred can act as if they’re pregnant anyway. Even though she isn’t carrying any new baby bunnies, milk production and other characteristics associated with pregnancy appear. The female may become aggressive as part of this condition.
- Mammary gland disorders: Nursing mother rabbits are prone to a number of problems that affect the mammary glands, or breast tissue. Each requires help from a veterinarian.
- Pregnancy toxemia: This condition occurs in the last few days of pregnancy or the first days after giving birth. Does with pregnancy toxemia can develop depression, weakness, seizures, and coma.
- Endometritis and pyometra: Endometritis is an inflammatory disease of the lining of the uterus, and pyometra is an accumulation of pus in the uterus accompanying the inflammation. With mild disease, there may be few signs; however, as the disease progresses, she may develop a distended abdomen, loss of appetite, and weakness.
- Uterine adenocarcinoma: Uterine adenocarcinoma is a form of cancer of the uterus and is the most common cancer seen in intact female rabbits. Although it’s a slow-growing tumor, if left untreated, it can metastasize, or spread, through the body, attacking the lungs, liver, bones, skin, and other organs. Eventually, it can result in death.
- Uterine aneurysm: Uterine aneurysm is a noninfectious disease that results from the rupture of one or more large veins in the uterus. These veins can rupture and heal several times. The blood loss may be gradual or sudden. If the blood loss is excessive, the results can be fatal.

If you notice anything out of the ordinary, including any odd behavior, contact your veterinarian right away.
Tip
Though it may not be much fun, you should also keep track of what’s coming out of your rabbit. Changes in urine and feces can signal serious health problems, so do the following each day:
- Check your bunny’s urine for unusual color, odor, or consistency. Changesin urine or urination habits may be a sign of dietary changes or disease. (For more on this topic, see this chapter’s “Urinary tract concerns.”)
- Check your rabbit’s droppings and get an idea of what’s normal. Any changes in size and consistency can indicate a gastrointestinal problem. (See “Gastrointestinal problems,” later in this chapter.)

Assembling a first-aid kit


Although many ailments described here require a vet’s attention, it’s a great idea to have some basic medical supplies on hand in the event that your rabbit needs some minor medical attention. Store these items in a tool or tackle box, with your vet’s phone number and address taped to the inside:
- Antibiotic ointment (be sure it’s safe for animals; your vet may recommend Neosporin, the formula without pain relief)
- Thermometer (animal or pediatric rectal; normal is about 103 to 106°F) and lubricant, such as K-Y jelly.
- Stethoscope (for listening to intestinal sounds and the heart and lungs)
- Hydrogen peroxide for cleansing (use diluted)
- Cotton swabs and cotton balls
- Heating pad or hot water bottle for shock or hypothermia
- Styptic powder or cornstarch for bleeding nails
- Saline eye wash (to flush out foreign matter)
- Gauze bandages and sterile cotton pads for wounds
- Plastic medicine dropper
- Tweezers
- Scissors
- Towel for wrapping or securing your rabbit

2 Identifying signs of pain


Chapter Thinking Like a Rabbit talks in depth about your pet’s body language and what he does when he’s in the world of hurt. If you’re unsure about whether your bunny needs vet care, use the following signs as a cue that you need to call a vet:
- Abnormal hunched appearance when sitting
- Alert but reluctant to move
- Moves slowly or with effort
- Depression/lethargy
- Limping
- Unusual or sudden aggression
- Loss or decrease in appetite or water consumption
- Tooth grinding
- Hiding when it’s not usual behavior, facing the corner
- Shows no interest in the surroundings (loss of curiosity)
- Crying or grunting when moving/defecating/urinating or being handled/examined
- Coat is unkempt due to loss of interest in grooming
- Taking a long time to eat
- Dropping food out of the mouth

Dealing with Bunny Ailments


Rabbits can develop a whole slew of diseases and conditions; some of the more common health problems are covered here. Chapter Coping with Other Health Woes and Aging Issues addresses other health problems, such as infectious diseases and conditions related to aging.

If you know how to recognize rabbit ailments, you’ll respond quickly, calling the vet and getting appropriate treatment. The more quickly that you respond, the better your chances of effectively eliminating any disease or discomfort that’s afflicting your rabbit.
2 Gastrointestinal problems

Rabbits are prone to a number of gastrointestinal (GI) tract problems. The most common underlying cause of these disorders is an inappropriate diet. However, various microorganisms like bacteria, protozoa, and viruses can play a role, too. In rare cases, some rabbits are born with a GI tract that doesn’t function normally.
Remember
Since proper diet is so important for GI health, the best thing you can do to prevent disease of the GI tract is feed a healthy diet high in fiber and low in carbohydrates. By following the dietary suggestions in Chapter Stocking Up on Carrots, you reduce the likelihood that your rabbit will develop digestive problems. In the event that your rabbit does feel under the weather as a result of digestive tract disease, you and your vet can hopefully step in and get her back to normal.
Warning!
Diarrhea in rabbits is characterized by the excretion of large amounts of dark brown to blood-tinged stool in the absence of any normal stool. Diarrhea is a different condition than soft stools, which is a mixture of soft pudding-like stools mixed with normal stools. Diarrhea can be the result of several different diseases, but it’s always an emergency signal and is a life-threatening situation. Seek veterinary attention immediately if you observe diarrhea in your rabbit.

Soft stool


Soft pudding-like stools present along with normal round, dry stools are a sign of a disruption of the delicate balance in the rabbit’s intestinal flora. This condition is not life-threatening, but needs to be treated before it progresses to a more severe disease.
Technical Stuff
Rabbits normally produce two types of droppings. One is the round hard stool you find in great profusion in your rabbit’s cage, and the other is the nutrientrich cecotrope produced from the cecum and is eaten directly by the rabbit to be digested. (See Chapter Jumping into Rabbit Ownership for more information on rabbit GI physiology.)
Normally you never see the cecotropes and if, on occasion, you do, they should be soft but formed in small, oblong pellets. When there’s a mild disruption to the normal flora of the cecum, the cecotropes come out unformed in mucous-coated blobs or pools of thick pudding-like stool. (Sounds appetizing, doesn’t it?) This isn’t true diarrhea because the rabbit can still produce the normal round droppings. These soft cecotropes get stuck to the rabbit’s fur and are deposited to dry into an almost concrete-like substance in the cage and exercise areas. The rabbit can’t eat the cecotropes because they have no form and these sticky clumps can eventually cause not only a cleaning headache, but an impaction of stool on the bunny’s rear end.

The most common cause of soft cecotropes is a high-carbohydrate, lowfiber diet. Other, less common causes are cancer, internal abscesses, partial intestinal obstruction, and other systemic diseases, such as liver or kidney disease. It’s best to have your rabbit examined by a veterinarian to make sure that there is no underlying disease. Because the majority of cases are caused by an inappropriate diet, all that’s usually necessary for treatment is a switch to a high-fiber diet low in concentrated carbohydrates. See Chapter Stocking Up on Carrots for details on feeding your rabbit a healthy diet.
Warning!
If a rabbit doesn’t produce any stool for 24 hours, he’s in need of immediate medical attention. The most common cause is a complete or partial obstruction to the GI tract or a complete shutdown of the GI tract caused by a chronic GI motility problem. These conditions are fatal within 48 hours if left untreated. Chapter Ten Signs That Require Emergency Action has more information on this topic, including symptoms that may accompany this lack of stools.

Enteritis


The rabbit GI tract, particularly the cecum, contains a complex population of bacteria, protozoa, yeast, and other organisms that make it possible to digest high-fiber foods. Any change in this population can lead to a disruption of normal digestive ability and, in some cases, to life-threatening disease.

Enteritis is an infection or inflammation of the intestines and has a number of causes. Rabbits suffering from enteritis may have
- Stools ranging from occasional soft stools to outright diarrhea
- Bloated abdomen
- Teeth crunching
- Restlessness
-Lack of appetite
- Weight loss
By far, the most common cause of enteritis is feeding your pet the wrong diet, particularly one that is low in fiber and high in carbohydrates. (See Chapter Stocking Up on Carrots for what bunnies should eat.) Other causes include the use of antibiotics that are inappropriate for the rabbit, exposure to high levels of stress, and exposure to certain bacteria. (See Chapter Coping with Other Health Woes and Aging Issues for more information.) Really, anything that causes a serious change in the normal population of healthy microorganisms in the rabbit’s gut will allow “bad” bacteria to overgrow leading to disease. If your rabbit is showing any abnormalities in his stools, you should contact your veterinarian as soon as possible.
Remember
The most important thing you can do to safeguard your rabbit from enteritis is to feed a healthy high-fiber diet, as well as provide a clean, stress-free environment (see Chapters Shacking Up with an Indoor Rabbit and Stocking Up on Carrots).

Enterotoxemia


The most dangerous complication that happens because of disruption of the
GI tract’s normal bacteria is enterotoxemia. This condition occurs when bacteria
that are normally present — and cause no trouble (such as Clostridium
species or E. coli) — start to overgrow.

When these bacteria proliferate, they produce dangerous toxins absorbed
into the blood stream, and they poison the rabbit. Enterotoxemia is seen most
often in young weaning rabbits, but can be seen in any rabbit that has had a
severe disruption of the normal GI tract flora due to the conditions covered in
the “Enteritis” section, earlier in this chapter.

Medicating your rabbit


If your bunny is diagnosed with an illness, chances are she’ll need medication. (Be wary of antibiotics, as some are toxic to rabbits; see Chapter Coping with Other Health Woes and Aging Issues for more on using antibiotics.) Medication may be in the form of a pill, liquid, or eye or eardrops. Ask your vet to show you how to administer the medication before you take your bunny home. Before you begin, take a deep breath and resolve to be patient. Rabbits can be uncooperative when being medicated, so be prepared.

Your rabbit may drink the liquid medicine out of a bowl. Today, most medications are offered in liquid form, eliminating the hassle of trying to disguise a pill:

The best way to restrain your rabbit is to
1. Have the medication all measured out and ready to go.
2. Wrap her in a towel.
3. Stabilize the bunny against your body.
Keep your rabbit from struggling so much that she hurts herself.
4. Talk to her in a soothing voice and try to help her calm down while you administer the medications.
Your method of administering medicine to your rabbit will depend on the form of the medication.

Here are tips on how to give a variety of medications:
- Liquid medication: You can put liquids in a syringe (without the needle) and place it in the space between the incisors and the molars on the side of the mouth. Slowly inject the liquid, letting your bunny swallow it. Don’t put the rabbit on her back because she may inhale the medication into her lungs if you do that.
- Eyedrops or ointment: You can pull down the lower lid of the eye and place the drops or ointment in the pocket between the eyeball and the lid. When the rabbit closes her eye, the medication spreads around the surface of the eyeball. Be careful not to touch the eye with the applicator.
- Eardrops: Simply place the medication into the rabbit’s ears and then gently massage the base of the ear to get it worked down into the ear canal. Expect plenty of earshaking and scratching. (Having something cold and wet running down your ear canal feels weird!) Be sympathetic toward your bunny and be sure to help her wipe her face clean if the ear medication musses her fur.

Signs of enterotoxemia include
Warning!
- Profuse diarrhea that’s brown or bloody
- Loss of appetite
- Weakness
- Sudden death
If you suspect that your rabbit is suffering from enterotoxemia, contact your veterinarian right away because this condition is rapidly fatal if left untreated with medicine. It’s better to prevent this serious disease altogether with a high-fiber diet.

Urinary tract concerns


Rabbits are prone to a number of ailments that affect the bladder and kidneys. Each of these maladies is serious and requires immediate veterinary treatment. If you’re doing a good job of monitoring what comes out of your rabbit, you may notice changes in your rabbit’s urine that can signal problems in your rabbit’s urinary tract or elsewhere.

Seeing red: Colorful urine


Normal rabbit urine can be quite colorful and range from light yellow to a deep orange-red (a rusty color). This rainbow of colors could be scary if you didn’t know it was normal. The colors are produced either by pigments that pass through the system from some food or from normal pigments called porphyrins, which are excreted by the bladder.
Warning!
Be alert, however, when the urine is bright red. Bright red color or red streaks is usually an indication of blood coming either from the urinary tract or, in the case of an unspayed female, from the reproductive tract (see the earlier sidebar “Fighting female troubles”), and is definitely something to pay attention to. Sometimes it can be hard to differentiate red from the rusty (which is more orange) color of plant pigments. It is easy to tell the difference by having your veterinarian test a fresh urine sample. If you see red in your rabbit’s urine, particularly if she strains to urinate or acts abnormal in any other way, seek veterinary attention as soon as possible.

Cystitis


An infection of the urinary tract or bladder, cystitis is somewhat common in rabbits. Signs of the condition are the same as urolithiasis. (See the list in the upcoming “Urolithiasis” section.)

Because these symptoms are similar to that of urolithiasis, taking your rabbit to a veterinarian immediately for diagnosis is critical. Cystitis may be cured with long-term antibiotic treatment.
Tip
Rabbits who develop cystitis often have recurring bouts of the condition, so watch them closely for recurrences.

Kidney disease


Kidney disease (also called renal disease) can occur, particularly in older rabbits. Kidney disease can be caused by bacterial infection, parasites, toxins, or cancer. See whether your rabbit has any of the following signs of kidney disease:
- Anemia (may be indicated by pale gum color)
- Depression
- Poor appetite
- Weight loss
- Excessive water consumption
- Excessive amounts of urine
Warning!
Kidney disease is a serious condition. The sooner treatment takes place, the better your pet’s chances for survival. If you see any of these signs, take her to a veterinarian right away.

Urolithiasis

Technical Stuff
Urolithiasis is seen in rabbits. Rabbits, unlike dogs, cats, and humans, normally excrete any extra calcium from their diet through their urine, which can give normal rabbit urine a cloudy look. (Humans, dogs, and cats excrete extra calcium through the stool.)
Occasionally, rabbits can develop stones or bladder sludge (thick material not yet formed into stones). The causes can be many, including long-term inadequate water intake (leading to more concentrated urine), underlying bladder infection, and genetic predisposition. The high calcium level of some foods has often been blamed entirely for this disease, but this alone won’t cause stones. Inadequate water intake can occur when the water isn’t changed frequently, is frozen, or isn’t easily accessible.

Rabbits suffering from urolithiasis show the following signs:
- Straining to urinate
- Frequent small amounts of urine produced, often outside of the normal toilet areas
- Small stones or blood present in the urine
- Depression
- Abdominal pain (hunched posture)
Warning!
If your rabbit shows any of these signs, take her to your veterinarian immediately for diagnosis and treatment. Surgery may be necessary in the case of large stones. Sludge and small stones can often be flushed out of the bladder under anesthesia.
The best prevention for bladder stones is making sure that your rabbit
- Takes in sufficient amounts of water daily. Chapter Stocking Up on Carrots discusses suggested water quantities for rabbits.
- Eats a healthy diet including high-moisture fresh foods, which adds water to his system. Read Chapter Stocking Up on Carrots for recommendations for fresh foods.
- Has available water changed daily and that the bottle is working properly. That way, your pet doesn’t have to work too hard to get a drink.
- Exercises. You can get ideas on exercising in Chapters Making Fitness and Fresh Air Fun for Your Bunny and Playing Around Isn’t Just for Dogs.
- Has a clean toilet area. Cleanliness encourages urination, which keeps the bladder contents flushed. Rabbits that aren’t exercised or have unclean toilet areas may tend to hold their urine for much longer periods of time.

Abscesses


An abscess is a collection of pus surrounded by inflamed tissue, the whole mess is typically the result of a bacterial infection. Abscesses, which can occur almost anywhere on a rabbit, are common and, unfortunately, difficult to treat. Common causes include
- Bite or puncture wounds
- Systemic infections
- Dental infections
The pus found in rabbit abscesses is very thick, which makes drainage and treatment particularly difficult. Treatment will vary according to the location of the abscess. In many cases, complete surgical removal of the abscess is recommended; however, you must address the underlying cause of the abscess, or the abscess will return.

Although some rabbits can live with abscesses on their body for years, any unusual lump found on your rabbit should be checked by your vet. As with other health conditions, early treatment can increase the chance of a cure; in addition, lumps can also be tumors or cysts that require immediate removal.

Dental disease


Dental disease is fairly common in pet rabbits. Nature designed your bunny to eat a variety of plant materials that includes some tough, abrasive material. In order to keep your rabbit’s teeth from wearing down to the point where he can’t eat, nature arranged it so that rabbit teeth are always growing.
Technical Stuff
If a rabbit’s teeth are improperly aligned, the teeth won’t wear down properly. The result is teeth that grow too long, making it difficult for the rabbit to chew (a condition known as malocclusion, which is shown in Figure 9-1). Either the crown (the top) of the tooth can overgrow or the root (bottom of the tooth under the gum line).
If the crown overgrows, sharp edges form, which can cause sores on the tongue and the inside of the mouth. If the root overgrows, it can cause deformities of the jaw bone, leading eventually to abscesses (read more on abscesses in this chapter). If the upper incisor roots grow too long, they can pinch off the tear duct so that tears can’t flow. This situation leads to spilling of tears on the face and a chronically wet and matted facial fur.
Figure 9-1: The rabbit on the left suffers from malocclusion. The choppers on the right are okay.

The exact causes of dental disease are still being debated. As in life, multiple causes are probably working together. The most commonly mentioned cause is inadequate wearing of the teeth due to a diet low in abrasive material (fiber), but other experts suspect early metabolic bone disease (a nutritional imbalance involving calcium) or bad genetics as well. Trauma to the mouth can be another cause of dental disease. Check your rabbit for the following signs of dental disease:
- Being picky about foods (particularly unable to eat pellets or hard vegetables)
- Bulging eye(s)
- Dropping food from the mouth
- Excessive salivation
- Loss of appetite
- Nasal discharge
- Tearing eyes
- Excessive teeth-grinding
- Lumps along the jaw or under the eye
Warning!
If your rabbit has any of these signs, take him to a veterinarian immediately. Dental disease that’s just starting may show no outward signs, so it’s important that your veterinarian perform a thorough mouth exam at least once a year on even outwardly healthy pets; in fact, most dental disease is related to teeth other than the incisors. Early detection is key to treating dental disease in rabbits.
2 Ear infections

Your rabbit’s great big ears are prone to problems that include mites and infections. (For more on mites, see this chapter’s upcoming “Banning pesky parasites.”) Signs of infection include
- Head shaking
- Ear scratching and sensitivity
- Runny eyes
If you suspect a problem with your bunny’s ears, have her examined by your vet; untreated ear infections can lead to head tilt, a more serious condition described later in this chapter. Lop ears, which create a warm, moist setting for bacterial growth, are particularly at risk for infection.

Heatstroke

Warning!
Your bunny is capable of tolerating cold much better than heat. Rabbits who become overheated are susceptible to heatstroke, which can be fatal. Temperatures of 80°Fahrenheit are dangerous to rabbits.
Rabbits on the verge of heatstroke lay in a stretched-out posture and pant, breathing rapidly and sometimes foaming at the mouth.

How many teeth does my bunny have?


Take a guess. Most people will say rabbits have 4 incisors, but actually they have 6! Assuming all is well with your rabbit’s dental health, her mouth should contain 12 upper cheek teeth and 10 lower cheek teeth, for a grand total of 28 teeth.

Heatstroke is an emergency situation. Before you transport your rabbit to the veterinarian, take measures to bring his body temperature down.
1. Get him out of the sun and into a cool place.
2. Put a cool, wet towel around his ears.
The wet towel around his ears cools the blood that’s flowing through his ears. Then that blood circulates throughout the rest of his body, thus helping to lower overall body temperature.
3. If he’s conscious, offer him fresh water.
4. Rush him to the veterinarian for immediate treatment.
The vet will give the rabbit fluids intravenously and other medications.

Head tilt


Head tilt (also called wry neck or torticollis) is a sign of any one of a number of problems, including inner ear disease or disease of the vestibular (balance) area of the brain, such as cancer, trauma, stroke, or parasitic infection.
Warning!
If your rabbit is tilting his head to one side, take him to your veterinarian right away for a diagnosis. Your vet may be able to treat the problem, depending on the cause. The earlier head tilt is treated, the greater the chances for a cure, so address this condition as soon as you notice it.
If the condition is irreversible despite treatment and your pet is still active and eating well, you can opt to let your rabbit live with this condition. Many rabbit owners have found that their “tilted” rabbits are able to live relatively normal lives.

Inflammation of the feet


Pododermatitis (also known as sore hocks) occurs when the area below the hocks (the joint closest to the paw on the hind leg) becomes inflamed and develops ulcers, often in conjunction with hair loss. A bacterial infection is usually present.
Tip
Obesity, a dirty, wet environment, or a lack of space within which to move around can set the stage for this condition. Your veterinarian can treat sore hocks with a wound cleanser and an antibiotic. You can also
- Keep the cage floor dry and clean. If your pet has an all-wire cage floor, provide an area off the wire to sit, like a box with shredded or flat newspaper in it (in addition to the litter box).
- Put your rabbit on a diet. Take a look at the nutritional guidelines offered in Chapter Stocking Up on Carrots; in particular, read the section that coaches owners on how to cope with chubby bunnies.
- Provide more room and more exercise time for your rabbit. Cages that are too small can aggravate the problem. Chapter Making Fitness and Fresh Air Fun for Your Bunny talks about ways of bringing fresh air and exercise into your rabbit’s life.
Tip
To avoid having to deal with this problem in the first place, keep your rabbit fit and healthy and provide him with a clean, good-size cage. (Chapter Shacking Up with an Indoor Rabbit offers more information on smart housing options.)

Obesity


An obese rabbit is at increased risk to develop other health problems. It’s vital to prevent this common condition.
Tip
You can keep a handle on your rabbit’s weight by feeding him properly and weighing him regularly to make sure he’s not gaining too much weight. (See Chapter Stocking Up on Carrots for information on proper diet and how to weigh your rabbit.) He’ll be weighed at his annual veterinarian visit and your vet can tell you whether he’s tipping the scales too far.
Some of the health problems that obesity can contribute to include
- Difficulty grooming
- Foot inflammation
- Inability to ingest cecotropes, rabbit-produced pellets that contain essential nutrients (see Chapter Jumping into Rabbit Ownership)
- Sluggish, unhealthy digestive tract
- Shortened life span
- Stress on the heart and vertebrae
Rabbits become obese the same way that people do — too many calories and not enough exercise. Among rabbits, excess calories often come from eating excessive amounts of alfalfa-based commercial rabbit pellets.

Rabbits who eat fresh foods and hay as a primary diet and get regular exercise are less likely to develop obesity. If your rabbit needs slimming down, talk to your vet about creating a new diet for your pet. (For more on diet and exercise, see Chapters Stocking Up on Carrots and Making Fitness and Fresh Air Fun for Your Bunny, respectively.)

Paralysis and hind limb weakness


Rabbits are prone to several conditions that can result in weakness or paralysis of the hind legs, including arthritis and fusing of the spinal vertebra, intervertebral disc disease, trauma, parasites, toxins, stroke, bacterial infections, cancer, and systemic disease.

Because the conditions that cause hind limb weakness or complete paralysis are so variable, you may see a variety of other abnormalities, such as loss of appetite, pain, or lethargy. However, any noticeable weakness of the hind quarters is abnormal even in the absence of other signs, and your pet should get veterinary attention as soon as possible. Some conditions are reversible if treated immediately.
Tip
If your rabbit has any of the aforementioned abnormalities, take him to the vet for an evaluation and treatment. Many diligent rabbit owners have been able to make life livable for paralyzed bunnies with special care and support. (If you’re living with a paralyzed rabbit and need help, contact your local House Rabbit Society for information. See the Appendix for contact information.)

Banning Pesky Parasites


Just like dogs and cats, rabbits can be bothered by parasites — organisms that feed off your rabbit’s body — that can make them pretty darn miserable. Keeping those nasty parasites at bay is your job as a rabbit mom or dad.

Intestinal parasites


Intestinal parasites include roundworms, pinworms, protozoa, and tapeworms. Signs of a heavy parasite infestation include
- Distended abdomen
- Poor coat condition (dry, unhealthy looking hair)
- Worms in the litter box or near the anus
- Loss of weight even though the pet is eating well
Your rabbit may have a light worm infestation without showing any obvious outward signs. Your veterinarian can diagnose intestinal worms in your pet by examining a stool sample. (You can get a sample by putting a few pieces of your rabbit’s stool in a plastic bag.) Treatment consists of a deworming agent, administered orally or by injection to your rabbit.
Tip
To prevent your rabbit from becoming infested with intestinal parasites:
- Avoid letting your rabbit graze in areas where wild rabbits may have been, particularly where you see their droppings.
- Keep your bunny away from outdoor areas where dogs and stray cats may have defecated.

Ear mites


Settling in the rabbit’s ear canal, ear mites cause itching and a dark, crusty discharge. Frequent head-shaking and ear-scratching are common signs.

A veterinarian, examining the discharge from your rabbit’s ears under a microscope, can diagnose ear mites. An injection or topical application of an antiparasitic drug can successfully treat ear mites. Infected rabbits need to be separated from other rabbits until the mites have been cleared up because ear mites are highly contagious between rabbits. Also, even though the mites that affect cats are different from rabbit ear mites, cats can carry the parasite that affects rabbits and pass it along to them. Left untreated, ear mites can lead to severe infections that can cause hearing loss.

Fur mites


Fur mites are tiny spiderlike parasites (Chelyletiella parasitovorax) that can be seen with mild magnification. Also known as walking dandruff, fur mites can cause
- Clumps of hair to fall out
- Dry, flaky skin
- Red, crusty, and itchy patches of skin particularly along the spine and Rump
Your veterinarian will examine a sample of the skin debris under the microscope. The treatment for this parasite can include topical or injectible antiparasitic medications as well as a thorough cleaning of the environment.
Tip
If the population of mites is low, signs of their presence may be nonexistent for a long period of time. (It can be for many months.) However, rabbits can still transmit the mites to other rabbits during this time. These mites can be transmitted to dogs and cats in the household as well (and back again). Treating all the mammal pets in the household as well as the environment is important because the mites can live off the pets in bedding, carpeting, and around cages for several days.

Fleas


Yes, rabbits get fleas — the exact same fleas that drive your cat and dog crazy, too. In fact, if your indoor rabbit becomes infested with fleas, your dog or cat are most likely to have spread these parasites to your bunny.
Tip
To see whether your rabbit has fleas, observe your pet to see whether she’s scratching herself a great deal. (Chapter Cleaning Behind Those Great Big Ears and More gives the lowdown on finding and getting fleas out of her hair.)
The best way to treat fleas is with a topical application (no flea dips, shampoos, or powders, please!) available from your veterinarian. Products applied once a month to your rabbit’s skin are most effective, making flea reproduction impossible. All your other mammal pets need to be treated as well, including cats, dogs, and other rabbits.
Remember
Frontline, which is commonly used for dogs, should never be used on rabbits. Advantage, Program, and Revolution are considered safe flea treatments for rabbits if applied in conjunction with the advice of a veterinarian.

Flies


Flies just annoy people, but they can be dangerous for your rabbit, especially an outdoor rabbit (another great reason to cohabitate with yours indoors). Some species of flies like to lay their eggs on the rectal area of a rabbit, especially if the area is moist and dirty. (See Chapter Cleaning Behind Those Great Big Ears and More for information on keeping your rabbit clean and well groomed.) Flies also like to plant their eggs on open sores anywhere on a rabbit’s body. The resulting maggots burrow into the rabbit and feed on her flesh — disgusting (and painful), for sure.

You can keep flies from doing their dirty business on your rabbit by
Tip
- Making sure that both your rabbit and her outdoor digs (pen, run, and so on) are clean.
- Checking around your rabbit’s rectal area and keeping it clean and dry. Keeping the rectal area clean is especially important if you have a longhair rabbit because feces, trapped in the long wool, attract flies.
Warning!
Contact your veterinarian immediately if you notice
- Fly eggs and/or maggots on your rabbit
- Matted fur
- Wet, irritated skin
To kill the fly larvae, your vet needs to treat your rabbit by removing the larvae and dead tissue from your rabbit. Your veterinarian then prescribes supportive treatments to help with healing.
Technical Stuff
One species of fly known as Cuterebra lays a single egg, often in the neck area where the skin is thinner. The egg hatches, and the single larva takes up residence under the skin in a snug little pocket where it continues to grow. Eventually, an oblong lump with a small hole becomes visible on the rabbit’s skin; this is the larva’s breathing hole. When the larva is mature, it enlarges the breathing hole, emerges, and drops to the ground. There it forms a pupa and hatches into an adult fly. Do not try to remove this larva by yourself because if it ruptures inside the sac, it can release dangerous toxins into the rabbit’s system. Your vet can easily remove it with a minor surgical procedure.

Encephalitozoonosis


Encephalitozoon cuniculi is a nasty protozoan parasite that can disable your bunny. Encephalitozoonosis is shed through the urine and can be passed along to other rabbits who come into contact with infected urine. This transmission most likely happens between a doe and her babies around the time of weaning. Mother rabbits can also pass the parasite along to their babies through the placenta.

This disease affects the brain, spinal cord, kidneys, heart, and possibly other organs of the rabbit. Its effects on the brain and spinal cord can cause the rabbit to develop
- Head tilt and clumsiness
- Inability to use the hind legs
- Wobbling when walking
Encephalitozoonosis is difficult to diagnose, and there is currently no cure. Usually, by the time the signs are present, the parasite has done its damage. Keeping infected rabbits away from healthy bunnies is important. The good news is that many rabbits exposed to this disease never develop any problems. Rabbits who are best able to keep disease at bay are those that are well cared for and stress-free.

Baylisascaris

Technical Stuff
Baylisascaris, a roundworm transmitted through raccoon feces, is more likely to affect bunnies who spend time in outdoor areas frequented by raccoons. When the raccoon leaves its droppings, usually on logs, decks, and the like, they contain roundworm eggs. If your bunny is exposed to raccoon feces in the backyard or in contaminated hay, she can ingest the eggs, which then hatch into larva (baby roundworms). The larvae migrate to various areas of the rabbit’s body, including the brain, where they cause inflammation and tissue damage.
The signs of infection with this parasite include
- Abdominal pain
- Blindness
- Head tilt
- Loss of muscle coordination
- Paralysis of one or both sides of the body
- Sudden lethargy
- Coma
- Sudden death
Warning!
This disease is difficult to diagnose because it can mimic other diseases. Your vet can perform a variety of tests to try to pinpoint the problem. Some rabbits recover from mild cases, while others may have permanent neurological damage. Antiparasitic drugs are ineffective against this parasite. The best way to avoid this disease is to avoid areas that are visited by raccoons.
Connie Isbell and Audrey Pavia

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