10 ways to help the critical rabbit

Recognising a sick rabbit can be difficult as they often mask the signs of illness until disease is quite advanced. This is common in a prey species where they have evolved to hide illness to avoid being identified as weak and vulnerable. Consequently, we regularly only get to see them in advanced stages of illness and disease, for which they then need to be treated as an emergency or critical case. In this article we take a look at 10 areas of nursing where you can help them in hospital when they are already seriously ill.

Posted: 22 September 2020

10 ways to help the critical rabbit

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Nursing the critical rabbit

1. Hospitalisation

Rabbits are easily stressed in a hospital environment and need special attention. They must be kept apart from predator species (e.g. cats, dogs, ferrets and birds of prey), and the environment needs to be quiet and away from the busy activities of the waiting and prep rooms. Within the rabbit cage itself you should provide security in the form of a hiding place. A cardboard box or a small towel is sometimes all that you need.

Other things to consider are;

  • Bring a friend - rabbits are social creatures, so encourage your clients to bring along a companion for their pet.
  • Safe bedding and litter – you need to avoid substrates which may be toxic or cause harm if eaten. Shredded newspaper is ideal as it’s safe, cheap and readily available.

2. Feeding the critical patient

Nutritional support is vital to ensure that the patient is able to recover from illness and surgery, however this can only be done safely once the animal is warm and hydrated. Assisted feeding for the mild to moderately ill patient, is one of those nursing skills that requires patience and time. At Burgess Pet Care we produce the ideal product, Excel Dualcare Recovery, which can be given to all fibrevores to help them recover.

If you are unable to help by syringe feeding your patient, then an oesophagostomy tube or nasogastric tube may be necessary.

When the patient is able to eat and swallow of its own accord, it should be offered appropriate food and water. Try to encourage owners to bring in the animal’s normal diet from home.

Only offer quality food – never compromise on food. Use plenty of good, fresh, dust free hay and herbs. At Burgess Pet Care we have an extensive range of the finest fibrevore foods. See our range of fibrevore rabbit food >

All rabbit critical care wards should have;

  • Fresh dust free feeding hay
  • A supply of fresh greens (herbs, parsley, carrot tops etc)

3. Monitor appetite and urine/faecal output

It goes without saying that any critical patient being closely monitored needs to have its appetite, urine output and faecal production recorded. With rabbits, gut activity is essential, and ensuring any abnormalities are detected quickly is important. This can be done in a number of ways, including counting faecal pellets, every hour if necessary. You would normally expect to find hundreds of the hard and dry faecal pellets per day. If you’re not looking, you’ll miss any early signs of a problem, which could indicate gastrointestinal hypomotility and ileus.

Appetite monitoring must consist of how much is offered and how much is consumed, together with seeing normal foraging and frequent chewing.

4. Monitor for signs of pain

Rabbits are particularly good at hiding pain, so when they are hospitalised, we should all be aware of how to read their body language. Look for;

A reduction in;

  • Activity or interest in exploring
  • Appetite and weight
  • Faecal pellets

Or an increase in;

  • Heart rate
  • Respiratory rate

As well as;

  • Flinching or licking wounds
  • Hunched posture
  • Abdominal straining
  • Teeth grinding
  • Bruxism
  • Keeping the eyes half-closed
  • A dull and distant gaze
  • A greasy appearance or ungroomed coat
  • Facial indicators used in the Grimace scale such as;
  • Orbital tightening
  • Cheek flattening
  • Nose and nostril shape
  • Whisker position
  • Ear position

5. The TPR

We’re all used to checking the temperature, pulse and respiration (TPR) of our patients, but with rabbits, it’s often more relevant if you do this from a distance. The respiratory rate is often the easiest and least stressful one to measure. Body temperature can be taken using a rectal thermometer. Ideally use a small, soft, flexible rectal thermometer, with plenty of lubrication.

6. Oral medications

When using oral suspensions or paediatric syrups, choose one with a fruit or sweet taste. Rabbits are more likely to accept them which makes drug administration easier and more reliable. Avoid adding medications to drinking water as you can’t be sure of how much is taken.

7. Antibiotics

Rabbit are particularly sensitive to oral antibiotics with the potential of developing a fatal enterotoxaemia secondary to the overgrowth of Clostridial bacteria. The antibiotics most likely to disrupt the gastrointestinal flora are;

  • First-generation beta-lactams (e.g. amoxicillin, ampicillin)
  • Lincosamides (e.g. clindamycin, lincomycin)
  • First-generation macrolides (e.g. erythromycin)

Low-risk antibiotics – antibiotics that rarely cause problems include the quinolone family, potentiated sulphonamides and the aminoglycoside antibiotics.

8. Injections

Medicating a critically ill patient is always a challenge, and with small rabbits it can be particularly difficult. They will frequently need injections of antibiotics, painkillers, intravenous fluids and prokinetics. Knowing where and how to give them is really important. Some simple rules to adhere to are;

  • Size matters - use the smallest gauge needle, preferably a 23G or smaller.
  • Alternate sites – if injections are given several times a day, try to vary where you give them to reduce over traumatising the tissues.
  • Epaxial musculature – these are frequently used as the muscle mass tends to be large and minimal manual restraint is required.

9. Fluid therapy

Intravenous or intraosseous fluid therapy is often required with critically ill patients. It offers a safe and accurate means of delivering fluids. As with all small animals, it’s important to monitor them very closely as profound changes can occur rapidly. One problem we can encounter with rabbits is that they are often inquisitive and likely to chew through the giving sets. Elizabethan collars and extensive bandaging may be required, but this can bring its own challenges, since when they are used for more than a few hours they can prevent the normal ingestion of nutrient rich caecotrophs.

10. Oxygen support

If your patient is showing signs of respiratory distress, it should be placed in an oxygen cage prior to handling. Remember that rabbits are obligate nasal breathers and their breathing can significantly improve if the nares are clear. If a nasal discharge is present, gently clear this away to open the airways. If your practice lacks an oxygen cage, alternative arrangements can be made by improvising. For example, a plastic bag placed around the pet carrier or over the front of the hospital cage, with oxygen tubing then being directed into the cage, will help retain a higher oxygen environment.

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