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Veterinarian Articles on Rabbit Care RABBIT
HEALTH Spay & Neuter Eating, Drinking, Pooping
and Peeing BEHAVIOR Rabbits do much better in pairs and with the proper introduction they will bond for life. Rabbits are very territorial and bonding rabbits must be done very carefully in a neutral territory for about 10 minutes a day, you can call us for our information sheet on Bunny Bonding for more details. Make sure your rabbits are spayed or neutered before starting the bonding process. Chewing is necessary for rabbits as their teeth grow continuously so they need to be provided with bunny safe wooden chews at all times. Your rabbit will chew on other items such as furniture, electrical cords and just about anything left in it’s path, so be sure to bunny proof and not to leave anything on the floor you do not want chewed. To stop your bunny from chewing on your furniture clap your hands and move your bunny away. Spaying and neutering also helps with behavioral problems. Your bunny should never be punished or put in his cage for bad behavior. GROOMING Trimming the Nails Scent Glands PLEASE
SPAY AND NEUTER! HOLDING
YOUR RABBIT LIVING
QUARTERS A rabbit's diet should be made
up of unlimited grass type hay, fresh veggies and limited pellets. Only
healthy treats should be fed. It is a good idea to split the veggies and
pellet rations into two feedings, morning and evening. Hay must be available
at all times. Water A rabbit’s diet is very important; many people tend to feed the wrong pellets, not enough hay and store-bought treats that can be very harmful to rabbits. Unfortunately, there are alot of unhealthy items out there that are made for rabbits and marketed towards their humans, making the treats and pellets look like candy. The bad thing is that these items are often full of sugar, which can cause health problems in rabbits and can even be deadly. At The Bunny Bunch we have had rabbits for twenty years and have come to find the best diet for optimal health. Hay plays a very important part in a rabbit’s diet and should be provided at all times. It is very important that you have a good reliable source for getting hay for your rabbits. Hay should be fed unlimited (meaning as much as your rabbit wants) on a daily basis. We pile the litter boxes full, every morning and evening, so our buns will get as much hay as they want. Hay can also be put into hay baskets in your rabbit's pen, or around the house for extra munching. Hay is one of the most important parts of a rabbit’s diet. Make sure your rabbit is eating lots of hay! If you are overfeeding pellets, your rabbit will not eat as much hay, so make sure you are limiting pellets and giving the right amount based on your rabbit’s weight. We do not suggest putting hay in hay racks. While rabbits will pull at the hay and eat it, the hay consumption tends to be much less. Why Hay? Rabbits need lots of fiber to keep their GI tract healthy. Hay plays an important part in keeping the intestinal tract moving. Rabbits (unlike cats) cannot vomit, so everything must pass through their GI tract. One of the most common rabbit illnesses is “GI Stasis”, which occurs when the GI tract slows down or stops. You will often hear that a rabbit has a hairball, which slowed down the GI tract. The fact is, the GI tract slowed down before the hairball. Because the GI tract slowed down, the hair and other food particles did not move through the intestines or stomach, causing the rabbit pain. Rabbits in GI stasis can die within twelve hours. (Click here to read our article on GI Stasis for more important information). Eating unlimited hay and a healthy diet can help to prevent this illness. If you notice that your rabbit has small poops, large poops, misshapen poops, soft poops or poops that have a bad smell, go to a rabbit vet right away. Often, these are signs of not enough hay or a poor diet. Your veterinarian should be seen right away as these signs could also be the result of an underlying illness or parasites. Types of Hay Timothy -This is a great hay to be fed unlimited on a daily basis. Lots of nice stems with great color and smell. Bunny Bunch Blend ™ -This is a blend of delicious Oat, Wheat and Barley. Our buns go crazy over it! Oat -Another one the buns love. Lots of seed heads for munching on. Orchard -A softer, fine hay that rabbits enjoy. We often give a handful as a treat. Alfalfa -This hay is for the young ones only. Good for growing buns that need calcium for strong bones and teeth. We do not recommend giving this to adults, though. How to store hay Hay should be stored in a cool, dry, dark location. It is very important to make sure your hay does not get damp or wet, as this could cause mold to grow, which is life threatening to rabbits and other small animals. Hay should not be stored in an airtight container, as it needs air to circulate. If you go through your hay pretty quickly, (which most of us do) you can store it in a hay bin with a loose lid. Or, you may want to store it in a large cardboard box. If your hay is in a plastic bag, do not seal the bag; leave the top open. If you have cats, make sure they do not have access to the stored hay, as they often like to use it as a litter box.
Our Bunny Bunch Boutique ships hay all over the United States. Rabbits just love it. Our supplies are also available for will call in Southern California at our location in Chino and at our many adoption and education events. Please make sure that your rabbit is getting unlimited amounts of good quality hay at all times. Back to other Veterinarian Articles on Rabbit Care 10 Way
to Get Your Rabbit to Cooperate Does your rabbit come to you when called? Can you pick up and hold your rabbit? Does your rabbit sit still to be groomed? Can you get your rabbit into a carrier for a trip to the vet? The answer I often hear is "No". It seems to me that most rabbits have their humans under a spell. Almost everyday people tell me they cannot pick up their rabbit, that their rabbit just won't cooperate. At our weekend adoption and education events we have a line of people with their rabbits in carriers waiting to get a nail trim, because their rabbit won't let them do it at home. The stories I hear about how long it took to get the rabbit into the carrier or how traumatic it is for the rabbit to be picked up are endless. To tell you the truth, half the time I think it is the people who are having the hard time and the rabbits just have them fooled. Rabbits are built to be low to the ground; even though they jump up onto the couch or onto a bed, they are not climbers like cats are. Therefore, they prefer to have all four feet on the ground and that is part of the reason they may resist being picked up. It is important to spend time with your rabbit at their level, meaning lying on your tummy on the ground. Your rabbit will come up to you after a while and settle down by you hoping for head and ear strokes. This will start a growing trust between you. It is also important to know how to pick up and hold your rabbit, how to groom your rabbit and how to put your rabbit into a carrier. If your rabbit is sick or injured and needs a trip to the vet, or if there is an emergency such as an earthquake, fire or flood, you need to be able to do this quickly and safely. 10 ways to get your rabbit to cooperate Get your rabbit
to trust you A rabbit must feel safe and secure when being approached, picked up or held. So here are a few tips to show you how to accomplish this. Getting to know your rabbit When you first bring a rabbit
home, it is important to give the rabbit a safe place to call its own.
Even if your rabbit is going to have full run of the house or a room,
for the first week or so it is a good idea to provide an exercise pen
for your rabbit to live in. This does a couple of things. First of all,
your rabbit has its own space to call home. Second of all, rabbits coming
to a new home will litter train much better in an enclosed pen at first,
rather than in a large room. Once you have had your rabbit for a few days,
open the pen and let it come out for exploring and run-about time. Be
sure to rabbit proof any room your rabbit will have access to by removing
any dangers such as poisonous plants and cover all electric cords so they
cannot be chewed. Picking up your rabbit Some rabbits are more shy than others and may take longer to come around to you. If this is the case, try spending time on the floor in the rabbit's living quarters. Just sit and read and spend time in there. The rabbit will be curious and start coming to you and with time will want fuss and to spend time with you. First, go up to your rabbit crouching down and give it a stoke on the head talking calmly. Some rabbits will run when you approach them as they are used to the routine of you trying to pick them up and them running away from you. If this is the case, you first need to gain your rabbit's trust. Sit on the ground and wait for the rabbit to come up to you. Once that happens, hold your hand out with a treat in it, such as a couple of sprigs of parsley or cilantro. Eventually, your rabbit will come up and eat the treat. Do this a couple of times a day, without trying to pick the rabbit up. This will establish trust between you. Then firmly (but not squeezing) put one hand under the rabbit's chest with your thumb around the rabbit's side or back, and your forefinger in between the rabbit's front legs. With your other hand, scoop up the rabbit's bottom. Do this all in one motion, putting the rabbit against your chest. If the rabbit starts to struggle, that means it does not feel safe and you may need to hold him a little tighter, keeping in mind not to squeeze too hard. It may take a few trys for you and your rabbit to feel comfortable. It is a good idea to practice doing this from a kneeling position on the floor so you don't have to lift the rabbit up too high. Clicking will have your rabbit running to you If you have a hard time getting your rabbit to come to you, start making a clicking sound with your tongue, or click every time you feed your rabbit, also calling your rabbit's name. This is a super way to get your rabbit to recognize a noise and associate it with food. All my rabbits know that if they hear the clicking sound or I am calling their name that means to come to me, and that all started by training them with a small healthy treat. Now they just come even without getting a treat. Be careful though to give only healthy treats such as veggies, untreated rose petals or rabbit-safe flowers and herbs such as rosemary or bay leaves. Too many pellets or fruit can be fattening, and store-bought treats are often full of sugar, which is not a good idea. Never give crackers, cereal or junk food to your rabbit. The good thing about hand feeding a treat to your rabbit is that it will not just associate your hands with being picked up, but will know your hands as offering a treat, too. Getting your rabbit to sit still for a nail trim and grooming First of all, get everything you need to groom your rabbit: nail clippers, quick stop, q-tips for cleaning the scent glands and a brush for removing the loose hair. Decide where you will be grooming your rabbit. If you are using a counter or table, make sure your rabbit is not going to be able to run and jump off. Holding your rabbit on a towel on your lap often works very well. Pick up your rabbit and place him on your lap. Let your rabbit settle by talking to him calmly and stroking his head or ears. If he wants to get off, just hold him firmly. Sometimes covering his eyes for a little bit will settle him down. Once he gets used to the routine and knows he cannot do want he wants, but has to do want you want, you should have no trouble. Getting your rabbit into a travel carrier Your rabbit's carrier does not need to be a place your rabbit does not like to go. It can be made into a good experience for your rabbit. Look at it from a rabbit's point of view. First they are chased, and then after a while caught and stuffed into a carrier they only see once in a while. Often the carrier is not appropriate for transporting a rabbit, which makes it all the more a bad experience for the rabbit, and the owner, too. The kind of carrier you transport your rabbit in can make a huge difference in making your rabbit feel safe and secure. Get a hard plastic carrier. You need to be able to easily get your rabbit in and out of the carrier, either through a top opening, or a large front door. Many carriers in the stores are made for cats, who will often just walk out of the carrier whether the opening is small or large. Rabbits, however, need to be taken out so make sure there is enough room to put your hands in and take the rabbit out without catching its legs on the door. Never use cloth or cardboard carriers. The cardboard carriers do not hold up and the cloth carriers are just not safe. For one thing, your rabbit may chew out of a cardboard or cloth carrier, plus they are just not protective. In the bottom of the carrier, fold up a nice soft towel so your rabbit has something to lie on and to prevent him from sliding around in the carrier. If you leave your rabbit's carrier out in his area with the door open, he will often use it as hidey place to go and nap. If you don't have room to leave it out all the time, try to put it out from time to time, putting the towel in and a few veggies in the back. Before long, your rabbit will go in by itself, munch on the veggies and not feel scared of it. If you still have trouble getting your rabbit in the carrier, don't forget the clicking sound. By having the carrier out on a regular basis, putting a few veggies in it and then clicking so your rabbit knows it is food time will get him in a routine and running into the carrier and munching on the veggies. Then you can close the door and be on your way. Make sure you secure the carrier in your car by putting the seat belt around it. What not to do Don't scare
your rabbit by chasing it around the room, yelling and screaming its name How to avoid being scratched or bitten A rabbit's nails are continually growing, which can make them very long and sharp. When a rabbit is being picked up and does not feel safe, it will struggle to be put down, often resulting in the person being scratched, sometimes quite badly. This does not mean that the rabbit was trying to hurt you; it just means it did not feel safe and struggled to be put down, resulting in scratching you. So always keep your rabbit's nails trimmed. Rabbits rarely bite. Some rabbits can become aggressive if not spayed or neutered, or if they are kept in a cage. Often the combination of both can result in the rabbit protecting its living area by lunging, boxing and sometimes biting. If this is the case, a few simple changes can prevent this. First of all, the rabbit should be spayed or neutered. Once that is done and the hormones die down, they don't feel the need to be so protective of their area. Then the rabbit should be provided with adequate space for living. We suggest an exercise pen instead of a cage. The minimum space a rabbit should live in is 4 ft wide x 4 ft deep. Make sure you provide lots of toys and chews so your rabbit does not become bored. Last of all, rabbits should not live alone and need to be bonded to at least one other rabbit. Rabbits naturally live in groups, so having them by themselves can cause a rabbit to become lonely and destructive.
It is natural for rabbits to use a certain spot to go to the bathroom. They are very clean animals and do not like a dirty area. Get a large litter box, big enough for your rabbit to lie in. Put rabbit-safe litter (like Carefresh) in the bottom of the box and pile a good-quality grass hay on top of the litter. Rabbits like to graze on hay and poop at the same time, so by putting hay in the litter box not only will your rabbit start using the litter box, he will also start eating more hay. The hay should be piled up in the morning and again in the evening. Depending on how many rabbits use the litter box it should be changed every day or every other day. If you find your rabbit is pooping outside the litter box, just pick up the poops and put them in the litter box and that should solve the problem. Make sure you clean your litter box out with white vinegar once a week to keep it free of built-up urine. For good litter box habits, it is important that your rabbit is spayed or neutered. Litter Box Do's Do have a large
litter box Litter Box Don'ts Do not use cat
litter
The answer is a big NO. Rabbits do well with kindness and rewards, not harsh words or punishment. If you use some form of discipline with your rabbit, your rabbit will not want to be around you, will become scared and frightened of you and could become depressed and withdrawn. Rewarding your rabbit for coming to you with strokes, praise and sometimes treats will benefit your relationship and grow into a strong trust between you. Tips for keeping a single rabbit happy Have your rabbit
spayed or neutered Tips for getting rabbits to cooperate with each other Rabbits need
to go through the bonding process before they can be together Caroline
Charland is founder and president of The Bunny Bunch Rabbit Rescue &
S.P.C.R. (Society for the Proper Care of Rabbits), and Bunny Bunch Boutique.
She has been caring for rabbits for over twenty years. For free rabbit
care information or advice, you may contact her at (909) 591-7200 or at
www.bunnybunch.org or www.bunnybunchboutique.com Alert
on Topical Flea Products Medical Alert: Problems Reported with New Topical Flea Products Our hospital has become aware of problems with one of the new topical flea products, Frontline, marketed through veterinarians by Rhone Merieux Inc. To date, we have consulted with veterinarians who have prescribed Frontline resulting in the death of three rabbits; another rabbit has been successfully treated for severe seizures it developed after Frontline was applied. The active ingredient in Frontline is not supposed to cross into the central nervous system of mammals, and has proven to be safe for dogs and cats. It kills both fleas and ticks, and is difficult to wash off. However, it is important to note that use of this product on rabbits is an "off label use" and has never been recommended or approved by the manufacturer. (This is the case with most pharmaceuticals used in rabbits.) Representatives of Rhone Merieux Inc. admit they have received other reports of "adverse reactions" to Frontline when used on rabbits, but would not go so far as to say that they knew if other rabbits had died. They went on to say that they strongly recommend Frontline NOT be used on rabbits or other exotic species. In addition we have heard an anecdotal report (someone had a friend whose neighbor told them of a rabbit that developed gastrointestinal upset after licking a large volume of Advantage off another rabbit just after it was applied. Before recommending Advantage for our clients' rabbits, our hospital did an in-depth literature search, consulted with the manufacturer (Bayer) and tested the product on many unowned rabbits to make certain that the product was safe. Gastrointestinal upset has been reported in cats who lick a large volume of the product off another animal. We recommend that multiple pet households separate rabbits or rabbits and cats for 12 hours after Advantage has been applied so the product can disperse on the animal's coat before another animal has the opportunity to groom the treated rabbit. The reason that these products are sold by prescription only is that there is some risk involved with their use. It is important for the veterinarian prescribing the product to understand those risks-and in this case, those risks specific to rabbits-and be able to explain those risks. Should you have questions about the
use of a prescription product or should you experience a problem during the time
your rabbit is taking a prescription medication, it is important for you to contact
your veterinarian immediately. Antibiotic-induced Enteritis and Enterotoxemia By Jeffrey R. Jenkins, DVM Why must your veterinarian take care when choosing antibiotics for use in the rabbit, and which antibiotics are not recommended for use in the rabbit? Many antibiotics suppress the healthy population of intestinal bacteria (flora) resulting in "dysbiosis" (meaning upset bacterial flora) which leads to "enteritis" or "enterotoxemia," and/or diarrhea and can potentially take the life of the rabbit. Disease is caused when an overgrowth of disease-causing bacteria produce toxins and damage the cecum and colon, as well as affecting other body systems. Clostridium spiroforme, a bacterium normally present in the rabbit's lower intestinal tract in very small numbers, is the most common cause, and produces a toxin similar to the toxin that causes botulism food poisoning. E. Coli and other pathogenic bacteria may also proliferate and be the cause of disease. Not all antibiotics are a problem; rather, only those that affect the "normal" bacteria that populate the rabbit's lower intestinal tract. These antibiotics typically kill the normal, healthy bacteria in the rabbit's cecum and colon. Most of these "healthy" bacteria are classified as "Gram positive bacteria" and/or the bacteria that grow in the absence of oxygen (anaerobic bacteria). The chance of the antibiotic causing enteritis or enterotoxemia is greater if it is administered orally, rather than by injection. A diet rich in simple carbohydrates (sugars, starches such as grain and refined flour, as well as high-sugar-containing fruits such as grapes or bananas) will increase a rabbit's chance of developing enteritis when taking antibiotics. This is because of the destabilizing effect simple carbohydrates have on the normal bacteria and because Clostridium spiroforme needs simple carbohydrates to produce its toxin. A diet high in fiber, such as grass hay, will decrease the chance of antibiotics upsetting the rabbit's flora because the fiber increases the motility (motion) of the cecum and colon. Antibiotics in the macrolide family, such as clindamycin, erythromycin and lincomycin; the penicillin family, such as ampicillin and amoxicillin, as well as several other antibiotics have been reported to cause enteritis in rabbits. Less likely, but capable of causing problems is the cephalosporin family of antibiotics. Antibiotics that rarely if ever cause problems include the quinalone family, such as enrofloxacin (Baytril); the potentiated sulfa drugs, such as trimethoprim-sulfamethoxazole; sulfa drugs such as sulfadimethoxine; and the aminoglycoside antibiotics such as amikacin. Signs that a rabbit has enteritis include one or more of the following symptoms: anorexia (not eating or drinking), depression or lethargy, abdomen distended with gas, abdominal pain and diarrhea with or without blood, or even no stool production. Treatment of enteritis and enterotoxemia consists of aggressive supportive care and efforts to increase cecal and colonic motility, and to discourage the growth of pathogenic bacteria and the production of toxins while supporting the growth of normal flora. Correction of dehydration and maintenance of normal hydration are of paramount importance. Intravenous or intraosseous fluids are often indicated. Motility stimulating drugs such as metaclopramide HCl (Reglan) and a diet high in fiber, force fed if necessary, give the most favorable results in the author's experience. Cholestyrine, an ion-exchange resin capable of binding bacterial toxins, has been used with very good results. Antibiotics have limited value in treating the disease and are used primarily as "supportive" therapy. Prevention of enterotoxemia depends on maintaining optimal husbandry and minimizing stress. Feed a diet with no less than 18% to 20% fiber from a good quality grass hay. Sudden changes in the diet should be avoided. Weaning rabbits should have feed, including hay, available from three weeks of age, and early or forced weaning should be avoided. Back to other Veterinarian Articles on Rabbit Care By Jeffrey R. Jenkins, DVM Pet rabbits are commonly affected with urinary stones or more properly "calculi." These calculi present themselves in two common forms: as large stones (at times reaching sizes more than an inch in diameter) and as very small sand or crystals (smaller than a grain of sand). The small calculi are typically present in large numbers and are collectively referred to as "calciuria," "sand" or "sludge." Urinary calculi are a disappointing problem in the pet rabbit as they are difficult to treat effectively and the problem commonly recurs. The exact cause of calculi formation is poorly defined. Both urinary tract infection and the contribution of a high calcium diet are strongly suggested. Other contributing factors include any change in the rabbit that makes it difficult to completely empty his bladder. These include neurological problems such as disc disease or back trauma, abdominal adhesions related to the castration or spaying of the rabbit, inguinal hernias and congenital abnormalities of the bladder. Some cases may be related to a behavior of not urinating frequently (such as a rabbit who will not urinate in his cage and thus goes all night without urinating). Signs of calciuria in the rabbit are poor appetite or anorexia, frequent and sometimes painful, straining urination and, in some cases, the passing of sand-like stones. The bunny may be reluctant to move, have a hard or painful abdomen and "hunched-up" posture caused by a painful, overly distended bladder. A sandy urine precipitate may be found on the fur between the legs, on the tail or seen where the rabbit has urinated. The diagnosis of calciuria in rabbits is made by the veterinarian using a combination of urinalysis, abdominal radiographs, stone analysis, urine cultures and blood tests. Urine for urinalysis should be collected just before it is examined and is best collected into a sterile syringe using a urinary catheter or by "cystocentesis" where a syringe needle is passed through the abdominal wall into the bladder. In this way the urine is not contaminated by bacteria in the urethra or from the substrate, if the rabbit urinates normally. Cultures taken from the urine should be performed before any antibiotics are given to maximize the chance of finding the bacteria responsible for the infection. Radiographs (X-rays) will tell the veterinarian if the stones are limited to the bladder or if the patient has stones in the kidney(s) or ureter(s) as well. Stones in the kidneys or ureters present a much worse situation. Stone analysis helps the veterinarian determine the underlying cause of the stone formation. In most cases there is an underlying bladder infection that must be completely corrected to prevent the stones from returning. In other cases, the stones may be related to very high levels of calcium in the rabbit's diet or to other metabolic abnormalities. The most important aspect of treatment for a rabbit with urinary calculi is to remember that calculi are a symptom of an underlying problem, much like a cough is a sign of an underlying respiratory tract disease. Stones or sludge calculi must be removed surgically or flushed from the bladder and the rabbit started on appropriate antibiotics. Correction of the underlying problem may also involve changing the diet to remove sources of excess calcium and management changes that facilitate frequent and complete urination. Treatment may also involve supportive care, such as hospitalization for fluid therapy. Prevention of urinary tract calculi is best accomplished by assuring good urinary tract health through proper hygiene. Equally important is replacing or diluting high-calcium foodstuffs in the diet. This includes alfalfa hay and alfalfa-based pellets. Rabbits absorb calcium efficiently from their gut in proportion to the calcium concentration in the diet. Therefore, high blood calcium concentrations (12-16 mg/dL) are commonly found in rabbits on a calcium-rich diet, such as alfalfa. The primary way for the rabbit to control calcium concentrations is through excretion of calcium into their urine. It is therefore important to assure adequate water intake so that urine is not concentrated. A safe, private location for the rabbit's litter box as well as frequent periods and adequate space for exercise all help to increase the frequency of urination. Back to other
Veterinarian Articles on Rabbit Care by Leah Postman, DVM Calcium is a common mineral element which is fundamental to many normal bodily functions. Of the 15 known essential mineral nutrients, calcium is the one found in largest amounts in animals, and therefore is required in the largest amounts. Almost all (99%) of the total body calcium is found within the bones and teeth. While most mammals make one or two sets of teeth to last a lifetime, rabbits and horses continually form and wear down their teeth throughout their life span. For rabbits, continual tooth eruption is a factor in long-term calcium requirements. The other 1% of body calcium supports critical metabolic functions, including nerve impulse conduction, muscle contraction, heart rate and contraction, and blood clotting. Most mammalian species follow a similar pattern of calcium metabolism. While rabbits do not follow the typical mammalian prototype, I will describe it for comparison purposes. After calcium is eaten, it is absorbed by the small blood vessels supplying the intestines, into the bloodstream. The level of calcium in the blood is closely controlled by two hormones: parathyroid hormone and calcitonin. These two hormones act in tandem to keep calcium levels within the blood optimally balanced. Parathyroid hormone (parathormone, PTH) is produced by the parathyroid glands: tiny glands located adjacent to the thyroid glands. When the parathyroid detects that the level of calcium in the blood is getting too low, it secretes extra PTH. This increased level of PTH in the blood acts on cells in the kidney to stimulate formation of an active form of Vitamin D. This activated Vitamin D in turn acts on cells in the intestine to increase calcium binding capacity. In this way, more of the ingested calcium is picked up by the intestines, and the low blood calcium is corrected by increased intestinal absorption. This intricate loop acts to protect animals from the potentially deadly consequences of low blood calcium -- heart attacks, seizures, and muscular tetany. Just as too little calcium in the blood can be dangerous, so can too much. To protect against elevations in the blood calcium level, the thyroid glands produce calcitonin. The thyroid produces more calcitonin when it senses an increase in circulating calcium. This increased level of calcitonin acts on cells within the bones to increase absorption of calcium into the bones. The calcium within bones not only provides structural integrity, but serves as a reserve supply for the body, should nutritional sources of calcium become scarce. Just as PTH protects animals from the consequences of LOW circulating levels of calcium, calcitonin protects animals from the consequences of HIGH circulating levels of calcium-- seizures, mineralization of tissues and blood vessels. Rabbits metabolize calcium very differently from other animals. Unlike other mammals, rabbits' blood calcium levels fluctuate widely, dependent upon the level of calcium in their diet. Rabbits also have very complete intestinal absorption, and thereby end up with blood calcium levels that are generally higher than other mammals. Although Vitamin D mediates intestinal absorption of calcium in most mammals, intestinal calcium absorption in rabbits is apparently independent of Vitamin D. Only rarely, in conjunction with the changes in calcium metabolism associated with birth and the high calcium requirements of lactation, do their calcium levels drop to a dangerous level, resulting in tetany. On a practical level, for the spayed house bunny, this is not a concern. What is a concern however, is the upper end of the blood calcium range. In other mammals, the thyroid-produced hormone calcitonin acts to lower blood calcium levels, to keep them below a ceiling value. This type of control does not seem to exist in rabbits. Their blood calcium levels become elevated in direct proportion to the calcium consumed in their diet. To make the bunny calcium situation even more of a conundrum, rabbits are even more unusual because they, being inherently prone to elevations in blood calcium, filter excess calcium through their kidneys, and excrete it through their urine. Whereas most mammals can rid their bodies of excess calcium efficiently and without adverse effects through bile and intestinal secretion, bunnies apparently cannot. Studies on pika, jackrabbits and mountain hare have demonstrated that the wild lagomorph relatives of domestic rabbits share this pattern of urinary excretion of calcium. The kidney's serve as the body's filtration system -- to discard waste products, to conserve normal levels of electrolytes within the body, and to regulate water balance. To accomplish this, incoming blood is juxtaposed with a network of fine tubules, across which filtration occurs. The delicate tissues within the kidneys are ideally suited to filtering soluble substances --ions, glucose, proteins. But once the kidneys have reached their (limited) capacity for reabsorption, calcium precipitates within the urine, and is excreted as insoluble crystalline salts. This is what is in that cloudy white urine ("sludge"), or gritty puddles that you may have cleaned. It has been theorized -- not proven yet -- that the red pigment often seen in rabbit urine, although not blood, is a blood pigment indicating damage to the kidneys' tubules, most likely by calcium salts. Some feel that "red urine" is caused by harmless plant pigments, and is in no way a problem. We do know that calcium stones are a significant problem for pet rabbits. These stones can be found anywhere within the urinary tract -- kidneys, ureters, bladder, urethra. Depending on their location, they can be painful and often require surgical removal. And they can be very difficult to remove. We also know that urinary excretion of calcium correlates directly with the level of calcium in the diet. In other words, the more calcium that the bunnies eat, the more their kidneys process and eliminate. Given the potentially serious, and all-too-common problems associated with calcium excess, it makes sense to provide no more calcium than what is needed for maintenance of skeletal and neuromuscular needs. There are two standard sources for determining rabbits' nutritional requirements: the National Research Council (NRC, 1977) and Francois Lebas (Lebas, 1980), both referenced in Cheeke's _Rabbit Feeding and Nutrition_, 1987. The NRC did not determine the maintenance requirement for calcium, but sets 0.4% as the growth requirement; maintenance should be considerably less. Lebas determined the maintenance requirement to be 0.6%. Based on this data, current recommendations are for a calcium content of 0.4% to 0.6% (dry matter basis). Almost all of the commercial pellets currently available exceed this, some by almost double. All of these pellets share a common trait -- they are formulated primarily from alfalfa meal. And alfalfa meal, like the alfalfa hay from which it is made, has a very high calcium content -- 1.5%. So it is a challenge to make a pellet that starts with alfalfa -- inherently high in calcium, and dilute the calcium content by 60%. There is really only one pellet that avoids this formulation dilemma. Oxbow Hay Company's Bunny Basics/T starts out with Timothy meal, not alfalfa meal, and thereby produces a pellet with 0.4-0.8% calcium. The other potentially significant source of calcium in rabbits' diets is fresh greens. Although many people worry about the greens noted for high calcium content -- kale, spinach, collards -- I do not. All fresh greens are about 70% to 85% water, which greatly dilutes all nutrients. To eliminate the potential to misrepresent nutrient content due to variability in water content, it is essential to compare calcium content on a dry matter basis, which is how the nutrient requirements are expressed on labels and in tables. For example, kale, which many recommend avoiding by virtue of its calcium content, has 1.6% calcium on a dry weight basis. In other words, dehydrated kale has roughly three times the NRC recommended calcium content. However, the fresh bunch of kale is mostly water, so the calcium content drops dramatically, to 0.24% when fed fresh. If you were to feed a medium-sized (5 pound) bunny 1/4 cup (about 60 grams) of a pellet meeting NRC recommendations, he would consume about 0.30 grams of calcium. To obtain a similar quantity of calcium from kale, the bun would have to eat over 4 ounces (130 grams) of kale. That is a sizable pile of kale -- about as much as you could stuff in a half gallon milk carton. Similarly, dandelion greens, have a calcium level of 1.6% on a dry matter basis. But since our bunnies eat them fresh, they are only getting 0.20% calcium. Again, we see that even for greens with a relatively high calcium content, the calcium level of the leaves the bun is munching is actually quite low. So, what does all this mean in real life? It mean's that to protect a rabbit's kidneys from calcium overload, we must minimize the calcium we feed them. Alfalfa -- both hay and alfalfa meal derived pellets -- is the biggest source of calcium overload for domestic bunnies. Minimizing the alfalfa in rabbits' diets will automatically reduce their calcium levels. While some veterinarians (notably, Dr. Susan Brown) may recommend eliminating pellets entirely from the house rabbit's diet, I do not. I think a balanced pellet, fed in limited quantities, can help even out the fluctuations inherent to hay -- soil content, day length, first cutting vs. second cutting, etc. From my point of view, there is one preferred pellet -- Oxbow Bunny Basics/T. Oxbow has been the only manufacturer to date to realize that basing a pellet on Timothy hay just fundamentally makes more sense. Although there are a few alfalfa meal based pellets with a reasonably low calcium content, they do not have the fiber content of Bunny Basics/T (29%), so on the fiber count they don't stack up. I think Bunny Basics/T is the best thing to happen to bunnies since Farmer McGregor retired. Of course, good quality grass hay should be the bulk of your rabbit's diet, with fresh greens for variety, added fluids and vitamins. I believe that this combination of feeds offers the best available complete nutritional profile, as well as taking into account a rabbit's idiosyncratic calcium metabolism, and minimizing the risk of associated urinary tract disease. Back to other
Veterinarian Articles on Rabbit Care By Jeffrey R. Jenkins, DVM
Contrary to common wisdom, many well kept rabbits live long and happy lives. With better owner education, improved diets and husbandry, and better medical care, more rabbits are living into their senior years. In this article we will review some of the special care and problems we see in the senior house rabbit. Rabbits often live into their second decade. Early House Rabbit Society literature reported rabbis living only 4 to 5 years. This misconception was likely because of rabbis dying at an early age due to poor management, rich diets and lack of ovariohysterectomy (spaying). In our experience, 10- to 12-year-old rabbits are not uncommon, and rabbits as old as 14 years have been presented to our practice. We have not as yet determined the record-breaking age for a rabbit, but there are anecdotal reports of rabbits living 16 to 18 years. Breed may have a significant effect on the aging process. Breeds with specific conformational traits (long or floppy ears, small size, long backs, etc.) appear to live shorter lives. These are many of the breeds kept as house rabbits, including dwarf and lop breeds. Signs of aging may be noticed in rabbits as young as 5 or 6 years of age. Decreased activity, weight gain or loss, problems with mobility (especially problems with back legs), dental problems, problems with eyesight and hearing, growths on skin or mucous membranes, and changes in behavior may all herald old age in your pet. Aging is inevitable but there are things you can do to slow the process and make your friend more comfortable in his senior years. Problems of older rabbits The first change you may notice in the older rabbit is a decrease in activity. This may start with moving at a slower pace and progress to a reluctance to venture far from favorite places. Changes in activity may be due to weight gain, weakness, and aches and pains from back problems and/or arthritis. Keeping your rabbit active will help keep him fit and slow this aging process. Several new medications help rabbits with painful joints and backs. Don’t put off caring for mobility problems. Properly diagnosed, your veterinarian can make a significant difference for these rabbits. Precursor of joint material and joint fluid can be given to help slow arthritis and decrease arthritis pain, thereby greatly improving the quality of life for rabbits with arthritis. Keeping your rabbit on a diet high in fiber (grass hay) and low in simple carbohydrates (grains, refined carbohydrates and sugars) will help him stay slim. Rabbits must spend time out of their cage to get regular exercise. A confined rabbit will live a shorter life and have a poorer quality of life. Back and neck problems are common in rabbits, especially breeds with long backs, including large lop breeds. Ruptured intervertebral disks and arthritic spinal problems both result in partial to total paralysis. The onset of paralysis may be acute or chronically progressive. Early intervention in these cases similarly improves their long-term prognosis. Radiographs (X-rays) are needed to diagnose these problems. Again, keeping your pet slim with a good high fiber, low calorie diet and regular exercise will aid in preventing back and neck problems. Also, try to prevent large, long-backed rabbits from leaping off high perches such as couches, beds and chairs. Treatment for spinal diseases includes those medications mentioned for arthritis above as well as judicious use of steroidal anti-inflammatory therapy.
A complication of arthritis and spinal disease is urine scald caused by urine dripping or spraying on the skin between the rabbit’s back legs causing a diaper rash-like irritation. The best treatment for this problem is to correct the underlying cause, however this may not be possible in all cases. Shaving the hair from the affected area, bathing with mild soap and the use of topical products (A&D Ointment) offer temporary relief. Many rabbits benefit from surgery that moves the skin or urinary opening so that urine does not collect on the skin of the perineum and inner thighs. Dental problems may plague the older rabbit. This is most often due to the gradual tipping of the cheek teeth leading to sharp edges forming that can irritate the tongue or cheek. Signs of this problem include the gradual rejection of hard foods (hay, pellets, and hard vegetables such as carrots), salivation and a foul or sweet odor to the rabbit. As the problem progresses the rabbit may lose weight or stop eating altogether. An oral examination under isoflurane anesthesia may be required to diagnose the problem. Sharp edges are trimmed from the teeth to correct the problem. Many rabbits ultimately die of renal (kidney) failure. Early signs of kidney problems include breaking litter box training, increased frequency of urination or urine volume, or increased thirst. Urinary tract infections, bladder stones or sludge and kidney stones may make a rabbit more prone to kidney failure. Early treatment and good follow up of these problems are highly recommended to keep your rabbit healthy. Feeding a diet low in calcium, good litter box hygiene and lots of fresh water will help prevent urinary tract disease as well.. Preventative medicine Rabbits should be examined by a veterinarian familiar with rabbits annually. Starting at 5 years of age, blood tests and urinalysis should be performed at least every other year to 9 years. Rabbits with decreased mobility should have survey radiographs taken to rule out early arthritis or spinal disease. Care must be taken to provide a healthy diet to the older rabbit and not allow him to become obese. As with all rabbits, we recommend a diet of grass hay, dark leafy greens and limited, if any, high fiber pellets. This diet will promote a healthy gastrointestinal tract and prevent obesity. Euthanasia Eventually the time comes when the aging process causes our friends to have aches and pains. Many new analgesics (pain killers) are on the market that hold promise of helping in these times. Never forget that the quality of our pets lives is more important than the quantity. All too soon the times comes to say good-bye and offer euthanasia to an old friend no longer happy with his daily existence. Signs that this may be the case include refusal of food, and ceasing of grooming behavior. Your veterinarian will be able to help you with this decision when the time comes. Euthanasia is typically accomplished with an overdose of an injectable anesthetic. A gas anesthetic may be administered initially to minimize any restraint or perception of the injection. The best way to have your rabbit live a long and healthy life is to offer him a happy healthy environment, a healthy diet and regular medical care. Not surprisingly, avoiding fattening foods, getting exercise and a happy social environment all contribute. Early attention to health problems and a good preventative health program will keep little problems from turning into life threatening ones. Back to other
Veterinarian Articles on Rabbit Care Causes and Treatment of Common Dental Problems in Rabbits By Jeffrey R. Jenkins, DVM Two major problems occur with the cheek teeth of rabbits: malocclusion, or overgrowth of the cheek teeth, and dental abscesses of the cheek teeth. Of the two, malocclusion is the more common and can often be dealt with easily by trimming the sharp points from the offending tooth or teeth. Cheek tooth abscesses are much more difficult to treat and, in the past, have required a lifetime of antibiotics to prevent their return. Recent research, published in March 1995, may offer new hope to rabbits with this condition. To better understand the diseases of the rabbit's cheek teeth we need to discuss the workings of their teeth and the nature of the abnormalities that cause problems. Rabbits have open rooted molars that
grow throughout life. The upper and lower incisors (front teeth) of rabbits grow
4 and 5 inches a year, respectively. Similar statistics for cheek tooth growth
are not available; however, the rate is significant. In the normal rabbit mouth,
biting and chewing of food continually grinds down the teeth, keeping this growth
in check and the teeth at stable lengths. Any interference to normal wear results in malocclusion of these constantly growing teeth. Malocclusion leads to difficulty in biting, chewing and swallowing of food. As the growth of cheek teeth is altered, the lower cheek teeth overgrow toward the tongue, whereas the upper teeth overgrow toward the cheek. Sharp points develop on the longer sides of the teeth causing lacerations of the adjacent cheek and tongue. A common sign of this problem is the rabbit trying to pick up or eat food, only to drop it without chewing. As the condition advances, the rabbit will drool excessively, causing wet, matted fur around the mouth, chin, chest and forelegs. Here, secondary bacterial infections may develop, leading to hair loss in those locations. Malocclusion has been blamed on a number of things. A genetic defect (mandibular prognathism, or MP) that leads to malocclusion of incisors is well documented in rabbits. In this recessive disorder, both the doe and buck (mother and father) rabbit must carry and pass the trait to their offspring and, then, only 81% of those who get the trait will have a problem with their teeth. Rabbits with this trait typically show signs by 8-10 weeks of age- at or just after the time of weaning-starting with incisors that just meet. Rabbits with early signs of MP often also have problems with malocclusion of their cheek teeth. In this instance, the cheek-tooth malocclusion is likely caused by the overgrown incisors, preventing normal wear of the cheek teeth, and resulting in overgrowth. Rabbits whose abnormal incisors are cut regularly do not appear to develop problems with their cheek teeth. Similar to the animals with incisor malocclusion, rabbits who show cheek-tooth malocclusion at a young age may be victims of genetics affecting the angle of cheek-tooth growth. Diet and nutrition may also be involved. Excessively high levels of fluoride (chronic fluorosis) and a diet deficient in folic acid have been shown to cause similar problems.
However, the group we see most often afflicted with malocclusion is older rabbits, where the changes in the cheek teeth are usually the result of aging. As with the horse, older rabbits develop elongated tooth-enamel points even though the length and angle of tooth growth may be normal. Lastly, loss or damage of a tooth may lead to the overgrowth of the opposing tooth. Because of the depth of the oral cavity caused by the long diastema, the space between the incisors and the cheek teeth, and the limited amount that the mouth will open, it is difficult to treat tooth problems. Treatment of malocclusion requires
the rabbit go under general anesthesia, either with isoflurane, a safe gas anesthesia
agent or a short-acting injectable agent. Instruments are used to prop open and
light the rabbit's mouth. This makes it easier to see the teeth and gives sufficient
space to work. The teeth are cut with specialized bone-cutting instruments designed
not to splinter or shatter the tooth. Animals typically return to normal eating
behavior within a day or two after their teeth have been trimmed. If the sharp
tooth points have caused significant damage to the oral cavity, an antibiotic
is administered for several days. Abscesses of cheek teeth are not uncommon in rabbits. Most often, food impacted alongside the tooth or in longitudinal tooth fractures causes mixed infection. Occasionally pure cultures of Pasteurella multocida or Staphylococcus aureus are found. Because a cheek abscess cannot be completely cut out, it has heretofore been typical that the rabbit would need lengthy, perhaps lifelong, treatment. Treatment begins with extraction of the tooth or teeth involved and a surgical scraping of the abscess sac. The resulting lesion is left open following surgery and treated with a cream (Kymar ointment) or spray (Granulex) containing digestive enzymes, long-term systemic antibiotics and daily irrigation with a disinfectant solution using a Water-Pic. Cleansing and irrigation with the Water-Pic and antibiotics continue until the lesion has begun to grow healthy skin. Now, at last, comes good news. Recent research shows that packing the abscess with a dental preparation, calcium hydroxide, may greatly increase the chances of total elimination of dental abscesses. In a study published in the Journal of Veterinary Dentistry (vol. 12, no. 1, March, 1995) 10 rabbits treated in this manner healed without recurrence of the abscess. At the Avian & Exotic Animal Hospital we have begun using this treatment for cheek tooth abscesses. We hope our success rate will equal that of the researchers. Back to other Veterinarian Articles on Rabbit Care
Coccidia in the Intestines, Liver By Jeffrey R. Jenkins, DVM We seem to spend a lot of time in the clinic talking to rabbit owners and referring veterinarians about coccidia. Coccidia are commonly found in rabbits, but only rarely cause disease. As a result they are poorly understood by the rabbit owner, breeder and veterinarian alike. So much so that a local Humane Society shelter once euthanized all rabbits that were found to have the parasite, not knowing that a majority of normal, healthy rabbits are carriers. [The shelter has since changed its policy.-Ed.] Finding coccidia in a fecal parasite examination may not even indicate a need for therapy. The aim of this article is to give you a better understanding of coccidia. I have included some scientific names for those who are interested in the more technical end of things. Don't let them throw you, however, because the underlying message is pretty simple: Prevention depends on keeping rabbits in hygienic conditions and avoiding infected feces, or food and water contaminated with feces. New rabbits, especially those with an unknown past, should be quarantined for at least 30 days before they are introduced to other rabbits. Coccidia are microscopic, one-celled protozoal parasites that affect the intestinal tract and liver of rabbits as well as other animals. Coccidia are the most common parasites of the rabbit's gastrointestinal tract and a common cause of illness in young rabbits. All rabbit coccidia are members of a single family, Eimeria. There are 12 species of rabbit coccidia reported to infect rabbits, but only a very few of these are important from a disease standpoint and, then, the rabbit's immune system may have to be compromised, or two or more species of coccidia present to create a disease situation. Therefore, the precise roles of the different species of coccidia in causing disease are not clearly understood. While, the presence of only a few coccidia oocyst (the stage shed in the feces of the rabbit) in a fecal parasite examination does not rule out a diagnosis of coccidiosis, neither does it confirm the diagnosis, since many healthy rabbits are infected to some degree. Only one species, E. stiedae which parasitizes the liver, is found outside the intestinal tract. E. stiedae may be found in any large groups of rabbits, from rabbitry to foster home. In mild infections there may be no symptoms or there may be only mild to moderate retardation of growth, but the disease may be fatal, especially in young rabbits. Heavily infected rabbits show signs related to the interference of liver function and blockage of bile ducts. These rabbits stop eating and become debilitated; either diarrhea or constipation may be noted late in the disease. Occasionally a rabbit's abdomen may be enlarged and the skin may appear to have a yellow coloration. X-rays may show that the liver is enlarged and fluid may have accumulated in the abdomen. Blood tests will confirm that the liver is damaged and suggest the diagnosis of hepatic (liver) coccidiosis. Confirmation of the disease is based on finding oocysts in a fecal or bile samples. Numerous drugs have been used to prevent and treat E. stiedae. The sulfa drugs appear to be the most effective. We recommend sulfamethazine and trimethoprim potentiated sulfa drugs. All the rabbits in an infected rabbitry or household must be treated until the disease has run its course. The major role of these drugs is to control the organism until the rabbits' immunity develops, and immunity resulting from mild infections may be lifelong. The most important species of intestinal coccidia are E. perforans, E. magna, E. media and E. irresidua, although the exact species involved may not be as important as the health status of the rabbit. Rabbits become infected by ingesting feces containing the coccidia oocyst. This can happen when the rabbit cleans its feet or fur that has been contaminated with the feces of another, infected rabbit. Although rabbits are cecotrophic (eaters of their cecotropes or soft feces), it is generally accepted that cecotropes do not contain infectious oocyst. Clinical signs of intestinal coccidiosis vary widely depending on the age of the rabbit, the organism involved, the degree of infection and the relative susceptibility of the animal (affected by age, stress, diet, etc.). Signs are more often seen in young rabbits with their immature immune systems. Weight loss, mild intermittent to severe diarrhea which may contain mucous or blood, and resulting dehydration may be seen. Animals with severe diarrhea may develop intussusception, a blockage of the intestines caused by a telescoping of the bowel on itself. Deaths caused by coccidiosis are most often attributed to dehydration and secondary bacterial infections. Treatment and prevention of intestinal coccidiosis are as for hepatic disease. Currently there are no vaccines available against coccidiosis. However, for the rabbit owner there is this good news: Many rabbits diagnosed with coccidiosis don't have coccidia at all! A common mistake made by veterinarians not familiar with rabbits is to confuse Cyniclomyces guttulatulus, a rabbit-specific Ascosporogenous yeast in the Saccharomyces family and part of the normal cecal flora of rabbits, with coccidia on fecal examinations. Back to other Veterinarian Articles on Rabbit Care
Frightened as a Rabbit: Anatomy and Physiology of Fear and Stress in the Rabbit By Jeffrey R. Jenkins, DVM We know rabbit's reputation with respect to fear. It is not at all surprising considering that the rabbit is positioned just above vegetation on the "food-chain." You cannot watch a nature show, it seems, without having the opportunity to see a helpless little bunny satisfy the nutritional needs of a much larger predator that is a click or two up "the ladder." It may be of some interest to you to know what is happening to your long-eared friend during periods of fear and stress and how that affects the way he reacts. The perception of a dangerous or frightening situation causes the release of chemicals called neurotransmitters from the pituitary gland at the base of the brain. These neurotransmitters affect many tissues in the rabbit's body, but most notably the adrenal glands that release epinephrin (adrenaline) and, with protracted periods of stress, glucocorticosteroids. Epinephrine causes the rabbit's heart rate and blood pressure to increase. Blood flow is directed to vital muscles and organs and away from those that are nonessential in this dangerous situation. The rabbit's respiratory rate increases, his eyes dilate, and his blood sugar (the fuel for the bodies tissues) soars. Other neurotransmitter and hormonal effects of fear not as easily understood are that they cause an ileus of the gastrointestinal (GI) tract-that is, they cause the GI tract to stop moving. The effects of these hormones for the short term are obvious. The rabbit is placed in a heightened level of awareness and in a physical state where he can better sense the danger, and can run faster to get away from that danger. He can bolt from the danger in an instant. However, when these physiological conditions exist for a long period, they affect the rabbit negatively. Restriction of blood supply to "nonessential tissues" leads to their dysfunction. Ileus results in changes in GI tract bacterial balance and potentially can lead to gut stasis, diarrhea, enteritis or even enterotoxemia. Exhaustion of liver energy stores leads to a starvation of body tissues that may be lethal. A not uncommon example of this is a syndrome named "Shock Disease," originally described in snowshoe hares in the 1930s. Researchers saw the disease when they trapped the snowshoe hares for study. We have seen this "disease" in obese pet rabbits or pet rabbits who have been on a rich (pellet) diet and have undergone a stressful event. In our practice we have seen shock disease in two rabbits dipped in lyme-sulfur dip, several rabbits infested with fly larvae (maggots), in a rabbit locked on a balcony for the night, and other similarly stressful situations. These rabbits, because of fatty changes in their liver caused by their poor diet, became hypoglycemic (developed low blood sugar levels) once they had exhausted their glycogen stores following stress and adrenaline stimulation. We can't always protect our rabbit pets from stress, but we can work to protect them from some physiological effects. A diet high in fiber (that means mostly good quality grass hay) helps to protect the GI tract from enteritis, and helps prevent gastric stasis and the development of fatty liver. Familiar smells reduce stress as does a favorite companion. If your rabbit experiences a stressful situation, you should return him to a "normal" environment as soon as possible and ensure that it eats and drinks. Should he become depressed, quiet or weak, you must undertake medical intervention immediately. When choosing a veterinarian look for one who has a "rabbit only" ward and takes special precautions to protect the rabbit from the sounds and odors of hospitalized dogs and cats. Back to other Veterinarian Articles on Rabbit Care
by Dana M. Krempels, Ph.D., Department of Biology, University of Miami, Coral Gables, FL 33124 It's an all too familiar story. "My bunny stopped eating, and then she just died." When we ask for details, we often learn that not only did the bunny stop eating, but she had been producing extremely small or even no fecal droppings, or showed symptoms of "runny stool." True diarrhea (unformed, liquid fecal matter) is uncommon in rabbits. The runny stool sometimes misdiagnosed as "diarrhea" in rabbits is often simply unformed, almost-liquid cecotropes. Rabbits produce two types of pellets: fecal pellets (left in the litterbox) and cecotropes (soft, pungent, normally shaped like a cluster of grapes and reingested by the rabbit to obtain essential nutrients). Liquid or mushy cecotropes are usually caused by an imbalance of the normal bacterial and fungal flora of the cecum (the bunny's intestinal "fermentation vat"). The floral imbalance can be caused by a number of factors, such as the wrong antibiotic (oral penicillins can be deadly to rabbits for this reason!) or a diet too rich in digestible carbohydrates and too low in crude fiber. Often, however, it is caused by a slowing of the normal peristaltic muscular contractions which push food and liquids through the intestines. The slowdown or cessation of peristalsis of the intestine is known as gastrointestinal (GI) stasis or ileus. What Causes GI Stasis? A rabbit's intestine can become static for a variety of reasons, including (1) stress, (2) dehydration, (3) pain from another underlying disorder or illness (such as gas, molar spurs, bladder problems or infection) (4) an intestinal blockage or, most commonly, (5) insufficient dietary crude fiber (which is why unlimited grass hay is so essential in the rabbit diet). Left untreated, the slowdown or complete cessation of normal intestinal movement (peristalsis) can result in a painful death, in a relatively short period of time. If your rabbit stops eating or producing feces for 12 hours or more, you should consider the condition an EMERGENCY. GET YOUR BUNNY TO A RABBIT-SAVVY VETERINARIAN IMMEDIATELY. An intestinal slowdown can cause ingested hair and food to lodge anywhere along the GI tract, creating a blockage. Also, because the cecum is not emptying quickly enough, harmful bacteria such as Clostridium spp. (related to the ones that cause botulism and tetanus) can proliferate, their numbers overwhelming those of the normal, beneficial bacteria and fungi in the cecum. Once this overgrowth occurs, gas emitted by the bacteria can cause extreme pain. Some Clostridium species produce deadly exotoxins. It is the liver's job to detoxify these harmful poisons, at a terrible cost to that all-important organ. Often, the ultimate cause of death from GI stasis is damage to the liver. How Can GI Stasis be detected? Symptoms of GI stasis include very small (or no) fecal pellets, sometimes clinging to the bunny's bottom. In some cases, very small fecal pellets will be encased in clear or yellowish mucus. This indicates a potentially serious problem (enteritis, an inflammation of the intestinal lining) which must be treated as an emergency. With GI stasis, the normal, quiet gurgling of the healthy intestine is replaced either by very loud, violent gurgles (gas blorping around painfully!) or a desolate silence. The bunny may become lethargic, have no appetite and may hunch in a ball, loudly crunching his teeth in pain. GI Stasis and the "Hairball" Myth Too often, a rabbit suffering from GI stasis is diagnosed as having a "hairball." In reality, an apparent hairball usually is a result of GI stasis--not the cause. A vet who has not palpated many rabbit abdomens may be unfamiliar with the normal, sometimes doughy feel of the healthy rabbit stomach. A doughy stomach is cause for concern only when accompanied by an empty lower GI and symptoms of abdominal discomfort. Like those of most herbivores, the stomach and intestines of a healthy rabbit are never empty. A rabbit may eat relatively normal amounts of food, almost up to the time the GI shuts down. Because of this, the stomach may retain a large bolus of food when stasis occurs. Unlike the typical cat hairball, which usually consists completely of hair, the mass misdiagnosed as a "hairball" in a rabbit is usually composed mostly of food held together by hair and mucus. Unless it is allowed to dehydrate into an impassable mass, this bolus of ingested material can be slowly broken down with enzyme supplements and plenty of oral fluids. However, treating a mass this way without addressing the problem of GI stasis will generally be unproductive. If you suspect that your bunny is experiencing GI stasis, you must take him/her to your rabbit-experienced veterinarian without delay. Tell the vet your suspicions. S/he will probably listen for normal intestinal sounds and palpate the bunny's abdomen. The vet also may wish to take radiographs (x-rays) to see whether the various parts of the digestive tract contain normal ingested matter, feces or foreign objects--or are empty and gassy. The appearance of the digestive tract will help the vet determine whether there is an obstruction and, if so, where it is located. If a true intestinal obstruction (almost always accompanied by severe bloating and acute pain) is present, the use of intestinal motility drugs (described later) could make the situation worse by pushing it into a narrow area where it completely obstructs the intestine, resulting in intestinal rupture. However, if the mass is not causing a complete blockage, it is best to consider medical alternatives to surgery. A gastrotomy--surgical opening of the stomach--may be performed to remove an obstruction, but rabbits who undergo this procedure have an abysmally low survival rate. It is very difficult to get a rabbit's intestines moving normally again post-operatively. Those who survive the surgery itself often succumb a few days later to peritonitis or other complications, even when under the care of the most practiced, skillful rabbit surgeon. Surgery on the rabbit GI tract should be considered only as a last resort. Can GI Stasis Be Successfully Treated? If your vet has determined that there is no intestinal obstruction, there are several treatments s/he may wish to use to help your bunny in distress. As always, do not perform any of these procedures or try to administer any of these medicines without the supervision of a veterinarian experienced with rabbit disorders and treatments. I. Mechanical Treatments A. Abdominal massage. One of the single most effective ways to stimulate a lazy gut into action is with gentle massage. Place the bunny on a secure countertop on a towel (or in your lap, if the bunny feels secure there), making sure he can't jump down and hurt himself. With your hands and fingertips, gently massage the abdomen. Knead as deeply as the bunny will allow, but back off immediately if he expresses pain. We have found that gently lifting the rabbit's hindquarters a few inches (with the bunny's head safely tucked into the massager's elbow) helps gas to pass more easily, and seems to be comforting to the bunny. Once s/he gets over the initial surprise of being held this way, a rabbit will often allow his/her legs to droop in comfort and relief as the massage helps gas pockets move towards the exit. A rabbit's internal organs are very delicate; care must be taken to avoid bruising them and making the situation worse. After a bit of manual massage, try an electric vibrating massager. This seems to be even more effective than manual massage, and it's worthwhile to invest in some type of massager with a large, flat surface that can be held against the bunny's tummy for relatively long periods. Press the massager firmly against the abdomen, start on low and work your way up. The bunny may be a bit taken aback at first, but almost every bunny on whom we've tried massage has settled down and enjoyed the soothing vibrations. In addition to stimulating the muscles, the massage seems to help break up gas bubbles and ease colic. Massage as long and as often as the bunny will allow and enjoy. B. Simethicone (liquid, pediatric suspension or tablets) is essential for the relief of gas pain which usually accompanies ileus. For relief of acute gas pain, 1-2 cc (20mg/ml suspension) can be given as often as every hour for three doses, then 1 cc every three to eight hours. This substance has no known drug interactions, is not absorbed through the intestinal lining and acts only on a mechanical principle: it changes the surface tension of the frothy gas bubbles in the gut, joining them into larger, easier-to-pass bubbles. Simethicone is practically inert, and is safe to give, even as a precaution. (Note: liquid suspensions of simethicone are relatively expensive. Less expensive versions, such as 125mg gel capsules are equally effective. A bunny can safely receive the contents of half a capsule at the rate described above.) A flatulent bunny is a happy bunny! C. Petroleum-based laxatives: use with caution. (laxative-grade mineral oil or commercial products Products such as Laxatone or Petromalt) do not affect intestinal motility. Some veterinarians prescribe them in the hope that they might help to slide dry, impacted matter through the intestine more easily. Note, however, that if the intestinal contents are severely dehydrated and brick-hard (yes, we have seen this!), a coating of vaseline-like substance over them will merely impede their re-hydration and make it more difficult for the mass to break up and begin passing. For this reason, it is probably wise to concentrate on re-hydrating the intestinal contents *before* using petroleum-based laxatives, if they are to be used at all. Note also that whereas malt-flavored remedies in a tube are often preferred by the bunny, some vets believe that their higher viscosity may actually contribute to holding a mass of impacted food together, especially if the intestinal contents are dehydrated. Unscented, laxative grade mineral oil is less viscous, and may be more effective. Petroleum-based laxatives should not be given daily or long term, as they can impede the absorption of important, fat-soluble vitamins. D. Enema. It may be helpful to administer an enema of warm, clean water and a very small bit of unscented, laxative grade mineral oil. The addition of epsom salts to the enema liquid (at a rate of about 1 tablespoon per 30-40 cc's of water) may help draw fluid from surrounding tissues into the intestine, helping hydrate impacted matter. If you use epsom salts, however, you must be certain that the bunny is generally well hydrated with subcutaneous fluids so the reservoir of fluids in the bunny's body will not be depleted.
Before you attempt to perform an enema on your rabbit, please ask your veterinarian to instruct you in this process during a regular office visit. Don't wait for an emergency to learn how to do this. If you cannot reach your vet when your bunny is in stasis, you are out of luck! We administer the enema with a pediatric rubber ear bulb/syringe. A 5 lb rabbit can safely be given 10-15 cc's of liquid enema. Mix the water and oil well. Place the bunny on her back, well supported so she doesn't kick. Gently insert the lubricated tip of the syringe into the anus, no deeper than 1/2 - 3/4 inch. (Note: if you're not sure which orifice is the right one, the anus is the one that winks back at you when touched.) Be gentle. NEVER FORCE ANYTHING! Slowly empty the bulb and let the bunny remain on her back for at least 30 seconds, to allow the liquid to travel up the tract a bit. You may need to gently hold the anus closed to avoid a fountain. WE DO NOT RECOMMEND THAT A CATHETER BE USED TO DELIVER AN ENEMA. The rabbit's lower GI tract is extremely delicate and fragile, and it is distressingly easy to perforate the rectum or small intestine. The ear syringe works very well, and is far safer than inserting a catheter deep into the lower GI tract. An enema delivers liquid to the source. It can help hydrate hardened, dehydrated fecal matter in the lower GI, even when subcutaneously administered fluids don't seem to help. II. Non-prescription supportive measures A. Oral fluids (administered at a rate of 100cc per kg of body weight per day--or about an ounce per pound of body weight per day) are essential for hydrating intestinal contents which may have formed a hard mass and be nearly impossible to pass. Water is fine, but unsweetened Pedialyte, an electrolyte drink designed for human infants (and available in the infant section of the grocery store), is even better. Avoid any fluids containing large amounts of sugar (even Gatorade), as these can exacerbate the overgrowth of harmful bacteria in the cecum. B. Force feeding. Anorexia can rapidly cause gastric ulcers and hepatic lipidosis (fatty liver disease) in rabbits. Even 12 hours without eating is cause for concern. As long as your vet has determined that there is no actual blockage, and that there is enough slow movement of the GI to keep the stomach from becoming overly full, keep the bunny eating! An excellent, ready-to-mix emergency food for compromised rabbits is Critical Care, available from Oxbow Hay Company (www.oxbowhay.com). However, if you do not have ready access to Critical Care, one quick and easy recipe is to soak about 2 - 3 tablespoons of pellets in about 1/2 cup of Pedialyte or chamomile tea until soft and fluffy. The pellets will fluff more quickly in slightly warmed solution, but overheating may destroy some of the nutrient content of the pellets. Mix the pellet fluff with vegetable baby food or canned pumpkin until it forms a somewhat liquid paste (you may need to add more liquid). Allow to cool before using a large-bore feeding syringe (available at most pharmacies) to deliver the goods. Insert the tip of the syringe into the space behind the incisors and squeeze gently sideways to avoid squirting food down the trachea (windpipe). Give only 1-2 cc at a time, allowing the bunny a chance to chew and swallow. Aspiration of food can be life threatening, so do this with great care! C. Unlimited grass hay. Even if the rabbit won't eat timothy, oat, brome or other grass hays, it is probably best to avoid giving more than a few strands of alfalfa hay, especially if the rabbit is unused to eating it. A sudden change in the diet can exacerbate Clostridium overgrowth (and alfalfa is an excellent food for certain species of Clostridium) and cause severe, potentially fatal bloat. For this reason and others, grass hay is always better than alfalfa. D. Fresh, wet, leafy herbs. The fiber and moisture in fresh vegetables will also help stimulate the intestine. Kale is a good choice. If the rabbit refuses to eat, try fragrant, fresh herbs such as mint, basil, dill, cilantro, tarragon, sage, fennel, parsley and others. Sometimes it helps to nip off the ends of the stems with your fingernails and wave the fresh, juicy stems under the bunny's nose or even gently insert the stem into the corner of the bunny's mouth. You can even lightly pat the herbs against the bunny's face until she gets annoyed with you and grabs the offending sprig. Sometimes all it takes is a little taste to get the bunny nibbling. Try a variety until one of them gets the bunny to eat. You never know which herb will stimulate the appetite, so it's best to have a variety on hand. E. Lactobacillus acidophilus is not normally a member of the rabbit's intestinal ecosystem, but we have noticed that a good dose of dried Lactobacillus powder (available at health food stores in powder or capsules) seems to help the rabbit survive the crisis until the intestine starts moving again. No one knows why, but it seems to help. Use nondairy powder--NOT yogurt. The milk sugars and carbohydrates in yogurt may promote harmful bacterial overgrowth. Probiotic pastes such as Benebac are available at feed stores, and might also be helpful. Products designed for horses are generally safe and possibly effective for rabbits. F. Cecotropes Some veterinarians believe that cecotropes from a healthy rabbit, although difficult to obtain, can be used to re-establish normal cecal flora in a compromised rabbit. However, other veterinarians and experienced rabbit caretakers are of the opinion that administering cecotropes to a sick rabbit may do more harm than good for two reasons: (1) force feeding cecotropes is very stressful to a sick rabbit, since no one likes being force-fed someone else's poop and (2) even a known, healthy donor rabbit could harbor microorganisms in the cecotropes that could become pathogenic in an already compromised rabbit. Also, because the normal cecotropes is coated with mucus that protects the bacteria while they travel through the stomach, mashing the cecotropes into a pellet mush or baby food might well render them useless. Given time and the proper supportive care, your rabbit will be able to reestablish a healthy cecal flora on his own, without the stress of being force fed foreign cecotropes. However, if you and your vet absolutely insist on trying this, you can obtain cecotropes from a donor rabbit by diapering the donor, or briefly placing an E-collar on him/her during the late afternoon when cecotrophy usually occurs. Don't use the E-collar if the donor rabbit seems very stressed or upset by it! You don't need *two* rabbits suffering from GI stasis! III. Prescription/veterinary treatments A. An intestinal motility agent, such as cisapride (Propulsid) or metaclopramide (Reglan) will help get a static intestine moving again. Both of the aforementioned drugs are safe and effective for rabbits. Cisapride, a more recently developed drug, has fewer potential nervous system side effects with long term use than Reglan. We have used it long term (for several weeks at a time) without apparent adverse side effects. However, as with any drug, your veterinarian should be aware of any potential drug interactions between cisapride/metaclopramide and any other medications your rabbit may be taking. For example, narcotic painkillers should never be given with Reglan due to the potential for dangerous interaction between the two.
It may take as long as two weeks on metaclopramide and/or cisapride before the intestine is fully motile again, and patience and careful nursing for the duration are essential. In severe cases of GI stasis, both drugs can be used simultaneously. Because they work on different areas of the digestive tract (Reglan on the upper GI and cisapride primarily on the lower GI), they may have a synergistic effect. Conventional wisdom holds that if there is a possibility of an intestinal obstruction, these drugs should not be used. However, more and more rabbit-savvy veterinarians are noting that unless there is a problem with the pyloric valve, motility drugs will not necessarily make the problem worse. So far, there is no consensus on this aspect of the problem, and it will be up to your veterinarian and you to determine the course that seems right for your bunny. Once again, it is imperative that you not take matters into your own hands. Have an experienced rabbit vet diagnose the problem and prescribe proper treatment! B. Subcutaneous Fluid Therapy. Note that examining a rabbit's skin turgor (via "tenting" the skin) will often not give an accurate indication of the animal's hydration status. A more useful diagnostic procedure for rabbits is palpation of the intestinal tract, which will feel *very* "doughy" throughout if the rabbit is dehydrated. Because rabbits absorb large amounts of water from the intestine to fuel other bodily functions, a rabbit whose skin feels well-hydrated may still have an intestine packed with a dehydrated mass. Keeping the tissues well-hydrated via administration of subcutaneous Lactated Ringers Solution (LRS) will not only keep the bunny well hydrated, but will also assure that the electrolytes are balanced and make the bunny feel better in general. A dehydrated rabbit will feel tired and ill, and may not have as much will to live as one who is well-hydrated. Rabbits in GI stasis tend to be unwilling to eat or drink, so it is a good idea to administer subcutaneous fluids as a precaution, unless the rabbit has known kidney or heart malfunctions. As with the enema described previously, you should be able to do this procedure at home. But do not wait for an emergency to learn how to do it! Have your vet teach you how to administer fluids during a regular office visit. It could save your bunny's life. C. Cholestyramine (Questran) is a granular resin with a high affinity for negatively charged, hydrophobic compounds, of which Clostridium spiroformes toxins are one type. This product is used primarily to reduce serum cholesterol in humans, and is available at most pharmacies. If the rabbit has mucous stool, there is a good possibility that Clostridium bacteria are proliferating and producing dangerous exotoxins. Questran will absorb these and be passed out harmlessly in the feces. Questran should be suspended in a generous amount of liquid (1/2 teaspoon of powder in at least 20 cc of water) and administered orally: because of its hydrophilic properties, it can dehydrate intestinal contents if given with insufficient water. Questran does not affect the action of the intestine; it is not absorbed by the body. Rather, it works directly upon the contents of the gut. We believe this substance has helped save the lives of many rabbits suffering from a severely inflamed intestine simply by sequestering toxins and buying time while gut motility medications and other treatments get the intestine moving again. It is very safe, used as directed. D. Enzymatic digestive aids can be helpful in loosening and softening an impacted mass of food and hair (which, we remind you, is usually a symptom, not the cause of the problem!). Proteolytic (protein-dissolving) enzymes may be of either plant or animal origin. Papain (found in papaya) and bromelain (found in pineapple) may help to break down mucus binding an obstruction, thus allowing it to slowly break up and pass. However, there is no evidence to suggest that these enzymes break down keratin, which is the main protein component of hair. Both papain and bromelain are available in powdered form at most health food stores, and should be reconstituted in water or Pedialyte shortly before use to ensure maximum potency. Papaya tablets are little more than a sugary treat: they contain very little active enzyme. Canned pineapple juice is useless, as it has been cooked, and its enzymes denatured and inactivated. Even fresh pineapple juice is not as desirable as powdered bromelain, since it is high in sugar, which is just about the last thing you want to add to a compromised rabbit's intestine! Your vet may wish t |
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