CHAPTER 1

Rabbit Basic Science

and it is believed that they not only introduced rab-
1.1 Biological characteristics of the
bits but also kept them in cages, thereby starting the
domestic rabbit (Oryctolagus cuniculus) process of domestication. The modern pet rabbit still
retains many of the characteristics of its wild counter-
1.1.1 Origins of the domestic rabbit parts despite changes in size, colour, coat texture and
Domestic rabbits are descended from the European temperament.
rabbit, Oryctolagus cuniculus. The ancestral form prob- Rabbits belong to the order Lagomorpha, which
ably evolved in the Iberian Peninsula and spread to are characterized by the presence of a second small
other parts of the Mediterranean (Fox, 1974). Fossil pair of upper incisors or peg teeth situated behind
records show that the European rabbit was confined the central incisors. Lagomorphs were once consid-
to the Iberian peninsula and southern France follow- ered to be a suborder of the Rodentia, which is
ing the Pleistocene era. While rabbits have been asso- divided into Sciuromorpha (squirrel-like rodents),
ciated with man since Roman times, they have only Myomorpha (mouse-like rodents) and Hystricomor-
been truly domesticated for around 200 years. The pha (porcupine-like rodents) that includes guinea
geographical range of the rabbit has been altered sig- pigs and chinchillas. Current opinion suggests that
nificantly by man, who from Roman times onwards Rodentia and Lagomorpha have no fundamental
placed rabbits on islands on various shipping routes, similarities and on the basis of structural features
to allow them to breed and form a ready source of and serological data, Lagomorpha show more affin-
food. Thus their European range significantly altered, ity to Artiodactyla (hoofed mammals) (Nowak,
and rabbits proved very successful where the climate 1999). Other lagomorphs include hares and pikas.
and geographical conditions were suitable. More All members of the Lagomorpha order are terrestrial
recently rabbits were introduced in Victoria, Australia, and eat only vegetation.
where their success, due to rapid breeding and a lack
of suitable predators, rapidly became a plague that
cost the Australian Government millions of dollars
1.1.2 Wild rabbits
and led to the implementation of myxomatosis virus
for biological control. Although European rabbits The behavioural characteristics of lagomorphs differ
have been released in North America, the presence between species. For example, cottontails (Sylvilagus
of suitable predators, an unsuitable climate and other spp.) do not dig burrows, although they may use bur-
species filling their ecological niche proved insur- rows made by other animals. Females dig holes to
mountable. In North America the native wild rabbit make nests and sit over the hole to suckle the young.
is either Sylvilagus floridanus (cottontail) or Sylvilagus Vegetation is used to cover the fur-lined nest between
bachmani (brush rabbit). The North American jack- feeds. Cottontails are solitary animals, in contrast
rabbit, Lepus californicus, is from the hare genus. with Oryctolagus cuniculus, which live in groups with
It is not clear when the European rabbit was intro- a defined social hierarchy (Nowak, 1999).
duced into Great Britain. The Romans brought many The European rabbit, Oryctolagus cuniculus, prefers
food animals with them, such as pheasant and quail, a sandy, hilly terrain with shrubs and woody plants
 Textbook of Rabbit Medicine

and is not found at altitudes above 600 m. It often behaviour above ground (Lockley, 1978). The only
digs complex burrows or warrens that can be 3 m vocal sounds that are made are a loud high-pitched
deep and 45 m long. The tunnels are about 15 cm scream of terror or a range of growls and hums that
in diameter and the living chambers 30–60 cm high. denote pleasure or defence. Apprehensive or fright-
The main surface entrances are usually indicated ened rabbits will thump the ground with their hind
by mounds of earth but there are numerous other feet. The loud thumping sounds acts as an alarm sig-
small openings that lack these mounds. Oryctolagus nal to other rabbits in the vicinity.
cuniculus is essentially nocturnal, leaving the burrow Many of the behavioural characteristics of their
in the early evening and returning in the morning, wild ancestors are still present in the modern-day
although it can be seen grazing or basking during pet rabbit. Domestication has resulted in rabbits
the day. The home range is rarely larger than 20 that are far tamer than their wild counterparts and
hectares (Nowak, 1999). easy to handle. Although some domestic rabbits still
Wild rabbits live in groups of two to eight retain the tendency to dig holes and live under-
adults plus juveniles with a defined social hierarchy ground, many do not, with the result that domestic
(McBride, 1988). The group’s territory is defended rabbits that escape or are released do not survive
by the males, while the females dig out deep burrows for long in the wild. Conversely, wild rabbits seldom
to nest in. Male rabbits within the group will establish become tame in captivity, although the occasional
a dominance hierarchy, with the older heavier males individual will overcome its fear of humans. Hand-
at the top. Aged males that have been usurped by reared orphans usually grow into fearful adults. Even
younger, fitter rabbits are driven from the group to rabbits that are born as a result of egg transfer from a
become solitary satellite males (Lockley, 1978). wild rabbit to a domesticated tame host retain their
Young male rabbits are also often driven from the shy nature (Adams, 1987).
group when they reach puberty either to join another
warren or to lead solitary lives in the hedgerows. The
females tend to remain within the original group.
1.1.3 Breeds of rabbits
Female rabbits are less aggressive towards each other
than males, but will defend a chosen nesting site fero- Domestication has resulted in a wide range of
ciously. Territories are scent marked with phero- breeds with different attributes. They can be roughly
mones from the scent glands on the chin and divided into two groups: fancy breeds and fur breeds
genital area or by urine marking. Dominant males (Sandford, 1996). The fur breeds include rex, Angoras
will continually scent mark their territory by rubbing and satin rabbits with their beautiful coat textures.
their chins on branches and bushes and leaving piles Fancy breeds include the Belgian hare, and lop and
of strategically placed faeces. They also mark territory dwarf rabbits with their varying physical characteris-
by spraying urine, sometimes on to other individuals. tics. Most pet rabbits belong to the smaller breeds
When wild rabbits emerge from their burrows at such as dwarf lops, Dutch or English. Pedigree rabbit
dusk, they begin to feed. Initially, they graze grass breeders often sell surplus stock to the pet trade and
and vegetation, raising their heads at intervals to sur- occasionally one of the more obscure breeds may turn
vey the surroundings, perhaps chewing through a up as a pet. Pedigree stock is identified by aluminium
long stalk or blade of grass at the same time. After half rings slipped over the hock when the rabbit is
an hour or so, they will start to look around for other 8–10 weeks old. The rings are supplied by the British
palatable plants to nibble. They are constantly on the Rabbit Council in a range of sizes. Each ring has the
lookout for danger and will readily bolt back to their year of birth and a unique number from which the
burrow. Hard faecal pellets are always voided above rabbit can be identified. Many pet rabbits are the result
ground, never in the burrow and soft caecotrophs of interbreeding between pets and are cross-breeds.
are usually consumed during periods of rest under- As with other domestic animals, there are breed predis-
ground, although occasionally rabbits exhibit this positions to disease. For example, dwarf rabbits are

4
 Rabbit Basic Science 1
prone to congenital incisor malocclusion (Fox and prevent the ingestion of caecotrophs, feeding still
Crary, 1971). Dutch, Havana and tan rabbits have a ceases during caecotroph excretion, suggesting that
high incidence of uterine neoplasia (Greene, 1941). cessation of food intake is not associated with gastric
filling (Hörnicke et al., 1984).
The diurnal feeding pattern affects digestive pro-
cesses and caecal motility, which also follow a circa-
1.1.4 Angoras
dian rhythm. Ingestion of food is associated with
Angoras have been bred for wool production for hun- increased caecal motility and the excretion of hard fae-
dreds of years. The wool is plucked or sheared and ces. Caecotrophy is associated with a decline in caecal
either spun on its own or mixed with sheep’s wool. contractions, so caecal contractions are at a maximum
Plucked wool is superior to shorn wool. Commercial when the animal is feeding. If food is withheld
Angoras are kept in a specialized manner to prevent completely, the circadian rhythm of caecal contrac-
staining and matting of the fur. After defleecing, wool- tions is maintained, but at a lower frequency that does
len jackets can be worn for 2–3 weeks to reduce heat not correlate with soft or hard faeces production
loss or a strip of fleece can be left along the back (Lebas (Hörnicke et al., 1984). Absorption of volatile fatty
et al., 1998). Commercial Angoras are not provided acids and their metabolism in the liver shows a circa-
with bedding but are kept on wire mesh floors and dian rhythm parallel to the activity of the adrenal
hay is provided in a rack. The long fine coat is a def- gland. Volatile fatty acid absorption into the portal cir-
inite disadvantage for the pet animal as it difficult to culation is greatest during the hard faeces phase of
keep the rabbit free from knots and mats. It is not sur- digestion, although arterial levels remain remarkably
prising that a high number of Angoras arrive at rescue constant (Vernay, 1987). Bile acid production shows
shelters for rehoming. The breed is prone to intestinal a circadian rhythm (Fekete, 1989). There is a diurnal
obstruction by felts of ingested hair. variation in haematological values (Fox and Laird,
1970), with lowest total white blood cell and lympho-
cyte counts occurring in the late afternoon and eve-
ning in association with increased neutrophil
1.1.5 Diurnal rhythms
counts. Eosinophil counts peak during the afternoon,
Many behavioural and physiological processes of rab- with the lowest values occurring in the morning.
bits show a marked diurnal rhythm. In the late after- Blood urea nitrogen shows a diurnal variation that
noon wild rabbits emerge from their burrows to is linked with feeding patterns. Even body tempera-
feed, explore, socialize and mate. Grazing resumes dur- ture follows a 24-h cycle (Lazarus-Barlow, 1928).
ing the early morning before the rabbit returns to the
warren. Hard faecal pellets are voided during these
periods above ground. During the day, caecotrophy 1.2 Housing and husbandry
(see Section 1.3.1) takes place while the rabbit is resting
in the burrow, typically between 08.00 and 17.00 h.
1.2.1 Housing
Female rabbits give birth in the morning and feed their
young at night (McBride, 1988). Domesticated rabbits The quiet docile nature of the rabbit combined with its
also follow a natural daily rhythm. Laboratory rabbits fertility and rapid growth rate has led to its intensive
that are fed ad lib consume little food between 06.00 h production for commercial and laboratory purposes.
and midday and increase their intake between 17.00 h Units housing several thousand does are found in
and midnight, eating most food during the night. Cae- countries such as China, Hungary and the USA. At
cotrophs are expelled during periods of minimal feed the other end of the scale, in the developing world, a
intake in the morning and sometimes during the eve- few rabbits are often kept as ‘biological refrigerators’,
ning. If food is restricted, caecotrophs are excreted i.e. a source of small quantities of meat that is fresh
approximately 5 h after a meal. If a collar is fitted to and readily available and which can be eaten before

5
 Textbook of Rabbit Medicine

it goes off (Cheeke et al., 1982). The social and beha- animal technicians to group housing by saying they
vioural needs of such animals are ignored when they ‘found it more agreeable to work with rabbits that
are housed individually in small, wire mesh cages or came to the front of the cage when they heard the
confined to tiny hutches. The Royal Society for the Pre- sounds of people, rather than cowering away’ and
vention of Cruelty to Animals (RSPCA), the Depart- ‘it was a pleasure to see the rabbits interact with each
ment for Environment, Food and Rural Affairs other’. Stauffacher (1992) describes in detail many
(DEFRA) and other animal health and welfare associ- ways in which housing for rabbits can be constructed
ations promote the ‘Five Freedoms’ of animal welfare: to permit natural behaviour patterns. Despite these
advances, most breeding and exhibition rabbits still
• Freedom from hunger and thirst live their entire life confined to small cages. Some
• Freedom from discomfort breeders still insist that rabbits should be kept singly
in small cages and that large hutches and runs lead
• Freedom from pain injury and disease
to aggression and behaviour problems (Sandford,
• Freedom to behave normally
1996). At last, the pet-owning fraternity is becoming
• Freedom from fear and distress aware of the rabbit’s social nature and need for exer-
cise. There has been a steady increase in the number of
in order that guidelines for animal husbandry and house rabbits and the status of the rabbit has shifted
nutrition as far as possible advance the welfare of from the child’s pet to a member of the family. A rab-
pet and production animals. There are many welfare bit can be a satisfactory companion for adults that are
implications associated with keeping rabbits in cages, out at work all day and find the needs of a dog or cat
as they are not able to follow their natural instincts. too demanding. Hopefully the days of keeping pet
Abnormal behaviour patterns such as stereotypies rabbits in solitary confinement in a barren hutch at
and restlessness have been recorded. Perpetual wire the bottom of the garden are now coming to an
biting and pawing behaviour has been described in end. There is legislation governing the welfare of rab-
rabbits confined to small cages and does provided bits that is summarized in Box 1.1.
with an open nesting box and no bedding material
to cover the young (Stauffacher, 1992). A proven link
has been established between small cage size and
1.2.2 Hutches for pet rabbits
painful conditions such as skeletal disorders or ulcer- Traditionally, pet rabbits are kept in hutches in the
ative pododermatitis in intensively reared rabbits garden, shed or garage. Hutches are a convenient
(Drescher, 1993; Drescher and Loeffler, 1996). Mor- method of housing rabbits; however, most hutches
phological differences have been observed in the on sale today do not provide sufficient space for rab-
adrenal glands of rabbits kept in wire cages and those bits to display their natural behaviours. It is impor-
kept in group housing conditions on solid floors tant to provide time outside their hutch for exercise
(Drescher and Breig, 1993). each day. At least 4 h daily exercise is required
In recent years, conditions have improved for (Richardson, 2000a). Longer periods or unrestricted
many laboratory rabbits. They can be kept in social exercise are preferable.
groups of four to eight animals with no detriment The hutch should be as big as possible, especially if
to their health (Turner et al., 1997). It has been proven two rabbits are housed together. It needs to be situated
that rabbits prefer to be in proximity with each other in a dry, cool, well-ventilated site protected from wind
as they are a social species with a defined hierarchy. and rain. The minimum recommended size is suffi-
They also ‘interact with enrichment objects’ such as cient space to hop three times in any direction, and
wooden sticks, parrot toys or balls designed for cats high enough for the rabbit to stand up on its hind legs
(Huls et al., 1991). Keeping rabbits in this way not without its ears touching the roof. This space should
only benefits the rabbits but also the people looking be available in both the dark, covered portion of the
after them. Love (1994) described the response of hutch and the open living space. This space

6
 Rabbit Basic Science 1
Box 1.1 Legislation governing the welfare of rabbits
There is legislation governing the welfare of farmed rab- • An alarm on automatic ventilation systems that is
bits in the UK. The advice also applies to pet rabbits independent of the mains electricity and will
kept in hutches although they are not technically cov- give warning when the system fails to function
ered by the legislation. Separate legislation governs the properly.
transport and slaughter of rabbits. A guide to the legal • Daily inspection of stock and the prevention of
requirements for farmed rabbits has been produced by unnecessary suffering or distress.
UFAW (Universities Federation for Animal Welfare) and
can be summarized as follows: • Veterinary care. Prescription-only medicines (POM)
including antibiotics and vaccines can only be
Rabbits must be provided with: supplied by the veterinary surgeon that has the
rabbits in his/her care.
• Adequate lighting to enable the inspection of the
animals at any time.
• Wholesome food that is appropriate and in sufficient In 2006 section 14 of the Animal Welfare Act made pro-
quantity to maintain good health and satisfy nutri- vision for Codes of Practice relating to petkeeping to
tional needs. be formulated and subsequently enforced in Wales,
Scotland and England. Currently only Wales has these
• A daily supply of fresh drinking water.
Codes of Practice in use. The Codes of Practice detail
• Suitable accommodation with a suitably bedded floor the care and maintenance of rabbits and closely follow
for the isolation of a sick or injured rabbit. the concept of the ‘Five Freedoms’, and make it an
• Cages of sufficient size to allow the rabbits to move offence to fail to achieve the required standard of care.
around, feed and drink without difficulty, and allow Currently (2012) there is no similar legislation in force in
all the rabbits kept in them to be able to lie on England. However, the RSPCA has produced some
their sides at the same time. guidelines for rabbit care, which may be found at
http://www.rspca.org.uk.
• Cages of sufficient height to allow rabbits to sit
upright on all four feet without their ears touching There are other national rabbit awareness campaigns
the top of the cage. ongoing, for example Rabbit Awareness Week,
‘A hutch is not enough’ and ‘Make Mine a Chocolate
• Shelter from bad weather including direct sunlight. One’, all sponsored by the Rabbit Welfare Association,
• Daily inspection of all automatic equipment, such as a national welfare agency dedicated to promoting the
drinkers, by a competent person. health and welfare of rabbits in the UK.

requirement should not include the outdoor run. The situate the hutch against a sheltered wall outside,
RSPCA spatial requirements are somewhat greater, rather than in an enclosed garage with potential expo-
the minimum being 1 m (3 ft) wide
2 m (6 ft) sure to toxic car fumes. Placing the hutch in a large airy
long
1 m (3 ft) high for both the enclosed and open shed can be a good option as shelter is provided with
portions of the living area. In any case where two adult the option of protected exercise space. Many rabbit
rabbits live together, the space must be increased pro- owners are now using a whole garden shed as a kind
portionally and suitable hide areas provided so that of ‘super-hutch’ for housing two or more rabbits, pro-
each rabbit can get away from the other if they want. viding ample indoor space. These sheds are then often
The optimum temperature range for rabbits is attached to large aviary type runs to allow outside
15–20 C, which can be checked with a maximum access (See Figure 1.1). Rabbits are tolerant of cold
and minimum thermometer. Above this temperature conditions and can withstand winter weather pro-
rabbits can suffer from heat stress. Poor ventilation vided they have shelter and plenty of bedding mate-
and ammonia build-up predispose to conjunctivitis rial. Thin rabbits with no body fat are more
and respiratory tract infections. It is preferable to susceptible to the effects of cold and need extra

7
 Textbook of Rabbit Medicine

advantage to straw is that it is cheap, easily available

and very good at allowing fluid to drain away from
the surface of the bedding, reducing potential contact
with rabbit skin. Straw can be fairly sharp, depending
on what type of crop it is made from, and can in some
circumstances cause skin and ocular irritation. Rabbits
will sometimes eat straw, which can cause oral trauma
if it is sharp. Oat straw is an ideal option as it is soft as
well as encouraging fluid drainage. Commercial forms
of bedding are also available. These are often recycled
paper products, and are well accepted by rabbits,
although they are not the most economical bedding.
Woodshavings and chips are not recommended
because of the potential for dust to cause ocular and
Figure 1.1 Example of outdoor rabbit housing. respiratory irritation and the possibility of sharp edges
causing skin/mouth/eye wounds. Wood products
protection on cold nights. Hot conditions and direct containing aromatic oils may cause respiratory irrita-
sunlight with no shade are distressing for rabbits. tion and have been reported to cause hepatotoxicity.
These conditions are potentially fatal as rabbits cannot
sweat or pant effectively, and are far more damaging
1.2.3 Exercise
than cold conditions. The ability to get out of direct
sunlight is of paramount importance, and needs to Exercise is of paramount importance for the physical
be considered when providing rabbit accommoda- and mental health of rabbits. Immobile rabbits are at
tion. Rabbits are far more capable of coping with cold increased risk of ulcerative pododermatitis, osteopo-
and even wet conditions, as long as they have the rosis, urine sludging and spinal fractures. There is a
opportunity to shelter and access to enough food proven association between confinement and the
and bedding. When planning rabbit accommodation, development of spinal deformities (Drescher and
allowing the rabbit a choice of positions and therefore Loeffler, 1996). Exercise improves blood circulation
ambient temperatures, access to sunlight and shelter is and prevents pressure sores. The opportunity to
a major benefit. Rabbits produce copious quantities of explore is mentally beneficial. All methods of provid-
urine and faeces, which are usually deposited in one ing exercise should be escape proof, although
part of the hutch that should be cleaned once or twice escapees instinctively remain close to their home ter-
daily. Bedding that is not fouled and remains clean ritory and can usually be found providing they have
and dry can be left in the hutch; however, with any not been carried off by a predator or are in search of a
deep litter system, a full clean should be done at least receptive mate. Any outside exercise area should be as
weekly, or more often if the bedding is wet or smells. large as possible and allow the rabbit sufficient space
Many types of material can be used as bedding. Any to run rather than just hop.
bedding material should be non-toxic, free from dust, Grass and natural vegetation is the ideal diet for rab-
comfortable to lie on and good insulation. Garden bits. Access to a garden, enclosure or pen outside pro-
peat has been recommended to neutralize ammonia vides nutrition as well as environmental enrichment.
and reduce irritation to the eyes and respiratory tract Natural daylight is the best way of providing the correct
(Malley, 1995). An economical bedding material is amount of vitamin D for the animal’s needs. Rabbits
a layer of newspaper covered in hay. This can be rolled enjoy basking in the sun. However, their destructive
up for disposal. The hay provides ad lib high fibre and burrowing instincts, along with a taste for bedding
food in addition to a soft bed that is kind to the hocks. plants, means free access to the garden should be
Other options include straw of various types. The supervised. Free rabbits are also prey to neighbours’

8
 Rabbit Basic Science 1
dogs, cats and other animals such as foxes, so supervi- 1.2.5 Companionship
sion or a well-fenced area or mesh pen is required. Ide-
ally this should be a permanent structure that allows Rabbits are social creatures that benefit from compan-
the rabbit to establish a familiar territory and feel ionship, preferably from another rabbit. A bonded pair
secure. An area of approximately 3 m2 (10 sq. ft) is suf- becomes inseparable (see Figure 1.2). They spend time
ficient, although larger areas are preferable. Branches, grooming each other and there are many benefits to
drainpipes, boxes and other enrichment objects can be mutual grooming, such as reducing parasite numbers
placed in the enclosure to provide cover and recrea- in the fur and cleaning inaccessible places such as the
tion. Planting of suitable weeds/plants inside the face or back of the neck. Occasionally, a dominant rab-
enclosure is also a good idea. bit will barber the fur of its companion. Neutering rab-
It is possible to train rabbits to return to their hutch bits that are kept together is necessary to prevent
at specified times of the day by rewarding them with fighting and unwanted pregnancies. Guinea pigs are
food. Many pet rabbits are tame enough to be picked sometimes kept as companions for rabbits, although
up, especially if they have been handled daily from this arrangement is not as satisfactory as two rabbits
an early age. These animals can be given free access together. There is a small risk of the guinea pig
to a garden during the day, perhaps under supervision, contracting Bordetella bronchiseptica, which is asymp-
and returned to the hutch at night. Alternatively, por- tomatic in rabbits but can cause pneumonia in guinea
table wire mesh runs can be used, the familiar territory pigs. Neutering is required to prevent bullying and con-
being sacrificed for the ability to provide a fresh area of stant sexual harassment of the guinea pig. Regardless,
forage regularly. There are many designs, some of some rabbits will still bully their guinea pig
which can be moved around the lawn, allowing the companion, and hide boxes small enough to allow
rabbits to keep the grass down. Enclosed yards are an the pig in but exclude the rabbit should be provided.
acceptable alternative to a garden. Rabbits can also If the bullying is severe the welfare of the guinea pig
be allowed to exercise in the house. In either situation is better served by breaking up the pair. Choosing
tomato trays planted with edible vegetation (seed to pair a rabbit with a guinea pig should not be advo-
packages of suitable plants are available) can provide cated; however, where a stable pair exists, then the
environmental enrichment. bond is similar to that between two rabbits and should
not be broken unless the welfare of the guinea pig is
suffering.

1.2.4 Burrowing
The opportunity to dig their own burrow is appreci-
ated by many rabbits but not by their owners. Once
they have dug out and established a burrow, most
rabbits appear satisfied and do not start another.
Females are more likely to dig burrows than males
as their instinct is to dig out new nesting sites, espe-
cially during the spring. Pregnant or pseudopregnant
does exhibit marked burrowing behaviour, although
it can still be exhibited by spayed females. Burrowing
can be accommodated in an outside run with a little
imagination, attention to escape potential and bur-
ied wire walls. Despite the potential inconvenience,
allowing rabbits to perform natural behaviours such
as burrowing can make a significant difference to per- Figure 1.2 A bonded pair of rabbits can become
ceived well-being in pet rabbits. inseparable.

9
 Textbook of Rabbit Medicine

Key Points 1.1 Bonding

• Rabbits gain benefit from living in pairs. It reduces • Dominance sign:
boredom and increases contentment. Mounting (either sex).
• In the wild, rabbits are a social species with a defined • Positive signs:
social hierarchy.
1. Initial indifference
• Not every pair of rabbits will bond successfully.
Compatible pairings are more likely to bond; 2. Laying down calmly but separately
several potential partners may need to be tried. 3. Licking the other rabbit’s face
• The recommended pairing is a neutered female with 4. Mutual grooming
a neutered male; however, other pairings are
5. Lying side by side.
possible, depending on the individual rabbit.
• Once the rabbits are comfortable with each other,
• Both rabbits should be neutered prior to attempting
the time spent together can be increased. Ten to
bonding, and ideally should also be tested for E.
15 minutes daily is long enough to start with, but
cuniculi, so seropositive animals are paired with
this can be increased to several short sessions
seropositive, and negative with negative.
daily, or longer sessions depending on the
• Rabbits that are going to be bonded should be behaviour of the rabbits.
housed next to each other, so that they can see
• The next step is to feed the rabbits together.
and smell the other rabbit.
• Once the rabbits are spending time and eating
• It is sensible to place food items near to the barrier
together, then they can be allowed to use the same
between the two rabbits, as eating is a social activity
sleeping area and be left together permanently.
in rabbits, and this should be encouraged.
• Some workers advocate ‘stress bonding’. This is not
• Either bedding should be moved from each
necessary if the bonding process is going well;
enclosure and placed into the other every day, to
however, for two individuals that are proving difficult
allow the scent of the potential partner to become
it may overcome the obstacles to allow a successful
familiar, or the rabbits themselves should be
bond. It involves the use of a stressful situation to
moved into the other enclosure for the same
get the rabbits to take comfort from each other. It
reason, but also to reduce territoriality.
must be recognized that this is a means to achieve a
• Once the rabbits have become familiar with each long-term bond. In the short term it is an adverse
other, they can be physically introduced. This experience to create a long-term benefit.
should take place in a neutral area. Placing
• Stressful situations could include taking both rabbits
rabbits into a bath tub has been suggested;
on a car ride, placing them together in a carrier on
however, a rabbit pen in an unfamiliar room works
top of the washing machine (that is switched on) or
just as well.
next to a switched-on vacuum cleaner. Once the
• Injury and direct fighting should be avoided; rabbits rabbits are snuggling close to each other for
displaying aggression should be separated. Care comfort, they can then be placed into an enclosure
is needed as this is where owners can get in a neutral area to continue to interact in the same
bitten. way as regular bonding. Eventually the rabbits can
• Aggressive signs: be allowed to interact in the neutral area without
being stressed first.
1. Ears held back
• Remember that bonding is a difficult process and
2. Tail raised many rehoming charities provide specialist help to
3. Tension in haunches. bond compatible animals.

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 Rabbit Basic Science 1
Rabbits have distinctive personalities and strong predators, rabbits can be kept outside during the win-
individual likes and dislikes of other rabbits. It is ter. Thin or ill rabbits or those that have not been
not possible to predict accurately whether newly intro- acclimatized should not be kept in this fashion
duced rabbits will form an instant rapport or attack and need to be given extra protection indoors or in
each other. Neutered rabbits of the opposite sex are a hutch or shed during inclement weather. They
most likely to bond, although it is possible to keep can be allowed outside if the weather is good. If rab-
same sex pairs together. Pairs of male rabbits need bits are not exposed to natural daylight during the
to be castrated to prevent fighting. Ideally, rabbits winter months, vitamin D deficiency can occur.
should be introduced on neutral territory with plenty Undetectable vitamin D levels have been found in
of room for escape and hiding places to retreat into. If blood samples taken in spring from pet rabbits
this is not possible, introducing the female to the male housed in hutches over winter (see Figure 1.5)
on his territory is more likely to be successful than the (Fairham and Harcourt-Brown, 1999).
reverse. When they are first introduced, most rabbits
spend a period chasing each other around and pulling
some hair out, but will settle down eventually. A rabbit 1.2.7 Free-range rabbits
that has spent its entire life confined to a hutch may
Stauffacher (1992) described the behaviour of rabbits
not realize that it can run around and is daunted by
under ‘near-to-nature’ or free-range conditions. The
both the great outdoors and its new companion. It
rabbits were kept in an open-air turfed enclosure with
is not unusual for such rabbits to remain quiet and
several trees and bushes. They were kept in groups of
immobile for several days before they gain confidence
up to 30 animals and their daily activities followed a
and start to explore. If possible, a period of separated
double diurnal rhythm with periods of rest alternating
proximity is advisable to allow rabbits to become
with periods of activity around dusk and dawn. Dur-
accustomed to each other’s presence before they are
ing periods of rest, the rabbits sought out places with a
introduced. Adjacent pens separated by wire mesh
good overview of the enclosure under bushes or near
allow rabbits to sniff each other; also change around
trees where they would huddle together and engage in
the bedding to get the rabbits used to the scent of
mutual grooming. This method of husbandry permits
the proposed companion in their own territory. It is
natural behaviour patterns, encourages grazing and
a promising sign when the two are found lying side
normal caecotrophy and allows animals to groom
by side on either side of the mesh. Some rabbits never
themselves and each other thoroughly, thereby
bond; others accept any new companion readily.
removing skin debris, dead hair and parasites from
the coat. In a study by Harcourt-Brown and Baker
(2001) blood samples from rabbits kept under free-
1.2.6 Winter housing range conditions had higher red cell and lymphocyte
counts than rabbits kept in hutches, suggesting that
The advice is often given that rabbits should be given
they were healthier (see Figure 2.1).
shelter from the winter weather by bringing the
hutch into a shed or garage. As a result, many rabbits
do not come out of their hutch for 6 months of the
1.2.8 House rabbits
year because owners fear their pet will ‘catch a chill’.
It is important to provide exercise during the winter In recent years, there has been a trend to give pet rab-
as well as the summer. Free-range rabbits that are bits the run of the house. House rabbits make good
kept outside all year round often choose to sit in companions and can be trained to use a litter tray.
the rain and snow despite having a hutch full of They are usually provided with some sort of sleeping
warm bedding to go into if required. They seem accommodation to which they can retreat and can be
impervious to cold and as long as they have access confined while their owners are out at work. Many
to shelter, plenty of food and protection from house rabbits have their own room that contains an

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 Textbook of Rabbit Medicine

open hutch or childs ‘wendy-house’ for sleeping. Most Organic solvents in litter materials derived from
house rabbits are neutered, especially males, to reduce preserved pine wood shavings or cedar chips have
territory marking by spraying or defecating outside been reported to cause hepatotoxicity and are
the litter tray. Rabbits can bond closely with human therefore inadvisable (Rabbit Health News, 1991b).
owners and make entertaining responsive pets. They Hay or clean, chopped straw can be used in rabbit
will play with toys, beg for treats and follow their litter trays.
human companion around the house. Dogs and
cats can learn to tolerate rabbits as companions. Rab-
bits can also learn not to view dogs and cats as Key Points 1.3 Environmental requirements
predators.
• Hutches are not suitable for rabbits to be kept in all
the time.
• Daily exercise is vital for physical and mental health
1.2.9 Litter trays of rabbits. At least 4 h exercise daily is recom-
mended, including during the winter months.
Large cat litter trays or gravel trays from the garden
centre can be used for rabbits to urinate and defecate • Rabbits benefit from companionship and form close
in. Hay, straw, cat litter, peat, soil or ‘natural’ litters bonds. The ideal companion is another rabbit,
preferably of the opposite sex. Neutering is required.
made from hemp, corn cobs or reclaimed wood
pulp are all used as litter, materials for rabbits. • Rabbits can be destructive, so they should be
Clay litters are not advisable as some rabbits will either restricted or supervised when out for exer-
eat the litter, which can then impact the caecum cise in the house or garden.
(Brown, 1997). • All rabbits must have access to ad lib hay and
fresh water at all times. In winter water bottle noz-
zles can freeze, so if rabbits are housed outdoors,
this should be checked regularly.
Key Points 1.2 Litter training
• Most rabbits naturally use a litter tray (see Key
• Rabbits are clean animals and can often be easily Points 1.2). Spot cleaning of the environment
litter trained. should be undertaken at least daily and a thorough
• Most rabbits will have specified areas within their clean done weekly.
living area that they use to urinate. • Rabbits benefit from somewhere to hide in the
• Place a litter tray lined with newspaper and filled face of potentially stressful situations. One hide
with hay or straw in these areas and positively area per rabbit, plus one so that they can run from
reward rabbits when they urinate/defecate in the one to another, is ideal. It is also worth having a
correct area. variety of sizes of hide boxes, so that some will
fit both rabbits but others will fit only one.
• With newly acquired rabbits (where latrine areas
have not been established), placing litter trays in
each corner can be successful.
1.2.10 Thermoregulation
• While using hay in the litter tray is controversial
(because rabbits will often eat this and it can be Rabbits are unable to sweat or pant effectively to dissi-
one way that encephalitozoonosis can be spread) pate body heat. The main thermoregulatory mecha-
sometimes it will make the difference in success- nism is by heat exchange in the ears, which have a
fully litter training a rabbit. This is because rabbits large arteriovenous anastomotic system. In the nose,
will often eat when using their latrine areas in the the nasal glands moisten inspired air, which also has
wild, and having a food source in the litter tray rein-
a role in thermoregulation. Rabbits are unable to toler-
forces the use of the litter tray.
ate high ambient temperatures, which can prove fatal.

12
 Rabbit Basic Science 1
the substance that is ingested by rabbits as it is not
1.3 Digestive anatomy, physiology and
waste material but nutritionally rich caecal contents.
nutrition The terms soft faeces and night faeces are sometimes
used to describe the capsules of caecal material
1.3.1 Digestive physiology known as caecotrophs. The term night faeces is mis-
The alimentary tract of the rabbit is adapted for leading. Caecotrophs are produced during the day
the digestion of large quantities of fibrous food in wild rabbits. They are produced 4 to 8 h after feed-
(Figure 1.3). Rabbits have developed a strategy of ing during a quiet undisturbed period, which is dur-
high feed intake and rapid food transit through the ing the day for a wild rabbit in its burrow but can be
gut to meet their nutritional needs from a nutrient during the night or early morning for a domestic or
dilute diet. Rabbits are hindgut fermenters and rely laboratory rabbit in its cage or hutch.
on microbial fermentation of food within the cae-
cum to provide nutrients. In the stomach and small
1.3.2 Ingestion of food
intestine, digestion and absorption of nutrients is
similar to monogastric mammals. The end-products The rabbit has a wide visual field that allows it to
of the digestive processes are separated in the colon watch for predators while it is grazing. The visual
into indigestible material and substances that can field does not include the area immediately under
be metabolized by caecal micro-organisms. Separa- the nose. Food selection and ingestion is based on
tion of the ingesta depends on particle size. The prox- smell and from tactile information gained from the
imal colon of the rabbit is specially adapted for the sensitive vibrissae around the nose and lips.
separation of large particles of indigestible fibre from The teeth are adapted for the ingestion of a fibrous
smaller particles that can be degraded and used as a diet. All the teeth are open rooted and grow continu-
substrate for bacterial fermentation in the caecum. ously. The incisors are adapted to cut through vegeta-
The two components are simultaneously sent in tion. The two large upper incisors have two tiny
opposite directions. secondary incisors situated immediately behind them.
Indigestible fibre passes down the colon to be rap- The two lower incisors occlude just behind the upper
idly eliminated as hard, dry faecal pellets. Smaller primary incisors and wear against them to form a sharp
particles and fluids pass into the caecum where bac- cutting edge. There is a thick layer of enamel on the
terial fermentation releases volatile fatty acids and anterior aspect of the upper primary incisors but no
synthesizes proteins and vitamins. Pellets of soft cae- enamel on the posterior aspect (Hirschfeld et al.,
cal contents (caecotrophs) are periodically expelled 1973). The enamel on the lower incisors is evenly dis-
from the anus and re-ingested as a source of nutri- tributed on all aspects. The distribution of enamel in
ents. This digestive strategy utilizes bacterial fermen- combination with the occlusal positioning of the
tation to synthesize nutrients and avoids the need to upper and lower incisors allows the teeth to be con-
store large volumes of food in the digestive tract. Veg- stantly sharpened. Wild rabbits are capable of chewing
etation can be efficiently digested below ground through aluminium (Adams, 1987). The rate of growth
without the need to spend long periods grazing of the upper incisors is approximately 2 mm per week
and exposed to predators. (Shadle, 1936). Canine teeth are absent and there is a
The rabbit’s characteristic of consuming caeco- wide diastema between the incisors and the premolars
trophs directly from the anus is known as caecotrophy, and molars, which are grossly indistinguishable from
although the term coprophagia is still used in some each other. The premolars and molars form a row of
texts. Coprophagia is defined as ‘the ingestion of five or six cheek teeth that are used for grinding the
dung or faeces’ (Blood and Studdert, 1999). Faeces food before it is swallowed. The food is ground
are defined as ‘body waste discharged from the intes- between the cheek teeth with jaw movements of up
tine’ and so, strictly speaking, faecal material is not to 120 per minute (Brewer and Cruise, 1994).

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 Textbook of Rabbit Medicine

Pancreas
Descending duodenum Sublingual salivary gland
Distal colon Buccal salivary
gland

Appendix
Parotid salivary gland
Body of caecum Mandibular salivary gland

Ileum
Oesophagus
Pylorus Cardia
A
Ampulla Stomach [15% GIT volume]
Bile duct
Proximal colon Spleen
Descending duodenum
Base of caecum E Ascending duodenum Left lobe of
Right lobe of pancreas
Ampulla caecalis coli
Sacculus pancreas
Jejunum
rotundus Transverse duodenum
Ileocaecocolic complex
B Mesentery

Vermiform caecal appendix

C
Accessory pancreatic duct
Ileum
Caecum [60% GIT volume] [40 cm]

Sacculus rotundus Ileocolic valve

Ampulla caecalis coli Warzen
D haustra
Proximal colon [10 cm]
taenia
3 taeniae; 3 haustra

Ascending colon Proximal colon [20 cm] Mesentery

1 taenia; 1 haustrum taenia
Fusus coli [4 cm] haustrum
No haustra

Transverse colon

Distal colon [80–100 cm]

No haustra
Descending colon

Rectum

Anus

Figure 1.3 See legend on opposite page.

14
 Rabbit Basic Science 1
Saliva is continuously secreted and contains amy- is weaker than in other species. There is always food
lase. Hunger is stimulated by a dry mouth and con- material in the stomach. Together, the caecum and
tractions of an empty stomach or by a decrease in the stomach contain over 80% of the digesta (Lang,
blood levels of metabolites such as glucose, amino 1981a) and the amount of material in them is depen-
acid, lactic acid or volatile fatty acids (Fekete, 1989). dent on age, breed, diet and time of day. Water and
large quantities of acid are secreted into the stomach.
The postprandial pH can fall to 1–2, which effectively
sterilizes ingesta before it passes into the small intes-
1.3.3 Anatomy and digestion in the
tine. The stomach pH of suckling rabbits is higher at
stomach and small intestine
approximately 5–6.5, which permits the passage of
The stomach comprises about 15% of the volume bacteria through the stomach to the hindgut to colo-
of the gastrointestinal tract (Cruise and Brewer, nize the caecum. During the digestion of caecotrophs
1994). It has a well-developed cardiac sphincter that the stomach pH rises to 3.0 (Blas and Gidenne, 1998).
prevents vomiting, and a muscular pyloric area, Transit time of food through the stomach is approxi-
although in general the muscular layer of the stomach mately 3–6 h (Carabaño and Piquer, 1998).

Figure 1.3 Schematic diagram of the anatomy of the alimentary tract of the rabbit. (A) The alimentary tract of the rabbit is
adapted for the digestion of large quantities of fibrous food. The teeth continually grow and wear against each other to maintain their
shape. The incisors are worn to a fine cutting edge that can be used to slice through vegetation or gnaw hard substances such as
bark or wood. The occlusal surfaces of the cheek teeth are worn to an effective grinding surface that is used to reduce food particles
to a small enough size to be swallowed. There are a number of well-developed salivary glands. The cardia and pyloric sphincter are
muscular and well-developed. The relatively voluminous stomach is simple in type and always contains food. The stomach contents
comprise approximately 15% of the contents of the gastrointestinal tract. (B) The duodenum forms a loop with descending,
transverse and ascending parts. It has an extensive mesentery. The duodenum begins with a slight enlargement approximately 1 cm
from the pylorus that receives the bile duct. The right lobe of the pancreas is widely dispersed in the mesoduodenum as many isolated
lobules. The main body and left lobe of the pancreas run in the mesentery that attaches the transverse colon to the stomach and
spleen (see Figure 8.2). A single accessory pancreatic duct opens into the junction between the descending and transverse
duodenum. (C) The jejunum is long, convoluted and relatively free of attachments. It occupies the dorsal half of the left flank and the
caudal half of the abdomen (see Figures 1.13–1.15). The ileum is closely associated with the mesentery that connects part of the
ascending colon to the caecum to form the ileocaecocolic complex (see E). The end of the ileum is expanded into a thick-walled
sacculus rotundus. (D) The caecum and appendix are shown as a straight tube, but are in fact a coiled spiral (see E). The thin-walled
caecum is a large organ that ends in an appendix that is heavily endowed with lymphoid tissue. The ascending colon of the rabbit can
be divided into four sections. The first section is approximately 10 cm long and has three longitudinal flat bands of muscular tissue or
taeniae that separate rows of haustra or sacculations. Small protrusions, ‘warzen’ (warts), approximately 0.5 mm in diameter, can be
seen on the mucosa in this section of colon. The second section of ascending colon is approximately 20 cm in length and has a single
taenia and fewer, smaller haustra. The third portion of the ascending colon is termed the fusus coli and is a muscular area about 4 cm
long. The fusus coli opens into the fourth section of ascending colon that is histologically indistinguishable from the transverse and
descending colon. Because the fusus coli forms such a natural division between two morphologically and functionally distinct
sections of the rabbit colon, the terms ‘proximal’ and ‘distal’ colon are sometimes used instead of ascending, transverse and
descending colon (Snipes et al., 1982). The proximal colon includes the three taeniae section, the single taenia section and the fusus
coli. The distal colon is 80–100 cm long and runs from the fusus coli to the rectum. (E) A ventral view of the ileocaecocolic complex,
which occupies more than half of abdomen, mainly on the right side (see Figures 1.13–1.15). The complex has been slightly unrolled
in order to illustrate its component parts. There are mesenteric attachments between the caecum, appendix, proximal colon, ileum,
distal colon and descending duodenum. These organs form a complex three-dimensional structure in rabbits. The term
‘ileocaecocolic complex’ is used to describe the structure in this text. The body of the caecum has a spiral form consisting of one and
a half turns, ending in an appendix that extends to the right flank. The axis of the spiral is the base of the caecum that receives the end
of the ileum in the form of the sacculus rotundus. The ileum lies between the concavity of the body of the caecum and the convexity of
the upper ascending colon and is attached to these two structures by peritoneal folds. Because of their peritoneal attachments to the
spiral caecum, the ileum and upper ascending colon are also arranged in a spiral, and are integral components of the ileocaecocolic
complex. The upper ascending colon begins as a smooth oval dilation, the ampulla coli, that forms the junction with the sacculus
rotundus and the caecum. Parts of the descending colon and descending duodenum are attached to the distal end of the caecum by
peritoneal folds. The left lobe of the pancreas lies in the peritoneal fold between the descending duodenum and descending colon.

15
 Textbook of Rabbit Medicine

The duodenum begins with a slight enlargement and absorbed from the small intestine in addition to
that receives the bile duct. The right lobe of the pan- the amino acids and vitamins present in the caeco-
creas is diffuse and is situated in the mesoduode- trophs. Amylase is produced by bacteria within the
num of the duodenal loop. The body and the left caecotroph that converts glucose into carbon dioxide
lobe of the pancreas are much denser than the right and lactic acid, which is absorbed from the stomach
lobe. The left lobe lies between the stomach and the and small intestine (Fekete, 1989).
transverse colon and extends as far as the spleen. Hydrochloric acid and pepsin initiate digestion in
A single pancreatic duct opens at the junction of the stomach that continues in the small intestine in a
the transverse and ascending loops of the duodenum manner similar to that of other mammals. Pancreatic
(see Figure 1.3B). This is the accessory pancreatic amylase production is relatively modest. There are
duct. The terminal part of the main pancreatic duct alternative sources of amylase such as saliva and cae-
disappears during embryonic development. The cotrophs. In rabbits, ligation of the pancreatic duct
accessory pancreatic duct communicates with both does not result in pancreatic insufficiency (Brewer
pancreatic lobes. The jejunum is long and convo- and Cruise, 1994). Proteolytic enzymes and chymo-
luted. The end of the ileum is expanded into a spher- trypsin can be found in the intestinal lumen within a
ical thick-walled enlargement known as the sacculus few weeks of the operation. It is thought that small
rotundus that forms the junction between the ileum, pancreatic ducts that connect directly with the duo-
caecum and proximal colon. The sacculus rotundus denum are the source of the enzymes. Bicarbonate
is unique to the rabbit and has abundant aggrega- is secreted into the duodenum and neutralizes the
tions of lymphoid tissue and macrophages in the acidic digesta as it leaves the stomach. In the jejunum
lamina propria and submucosa. An ileocolic valve bicarbonate is absorbed rather than secreted. Transit
controls movement of digesta from the ileum into time through the small intestine is fast. Estimated
the sacculus rotundus and also prevents reverse flow retention times in the jejunum and ileum are
into the small intestine. Motilin, a polypeptide 10–20 and 30–60 minutes, respectively (Carabaño
hormone secreted by enterochromaffin cells of the and Piquer, 1998).
duodenum and jejunum, stimulates gastrointestinal
smooth muscle. Fat stimulates and carbohydrate
1.3.4 Anatomy of the hindgut
inhibits its release. In the small intestine, motilin
activity is decreased aborally. It disappears in the The anatomy of the rabbit’s digestive system is illus-
caecum and reappears in the colon and rectum trated in detail by Barone et al. (1973) and Barone
(Brewer and Cruise, 1994). (1997). A schematic representation of the rabbit’s
Digestion and absorption of nutrients in the stom- digestive system is given in Figure 1.3. The ileocaeco-
ach and small intestine are similar to other monogas- colic segment is illustrated in Figure 1.3E and the
tric animals. Caecotrophs are digested in this section topographical anatomy of the small intestine and
of the gastrointestinal tract. Caecotrophs contain colon is described in Figure 8.2.
micro-organisms and are the products of microbial The sacculus rotundus opens into the ampulla cae-
fermentation such as amino acids, volatile fatty acids calis coli, which forms a T-junction between the
and vitamins. They are encapsulated in a gelatinous ileum, caecum and proximal colon. The ampulla cae-
mucous coating that protects them from the acidity calis coli, caecum and proximal colon are specially
of the stomach. Some fermentation takes place within adapted for mixing and separating large quantities
the caecotrophs as they lie in the gastric fundus of food. Large particles of indigestible fibre are sepa-
for 6–8 hours before being digested. Lysozyme rated from small fermentable particles and fluid. The
is secreted by the colon and incorporated into the cae- large particles are sent distally along the colon while
cotroph during its passage through the large intestine the small particles and fluid are sent proximally into
(Camara and Prieur, 1984). The bacteriolytic activity the caecum where bacterial fermentation takes place
of lysozyme enables microbial protein to be degraded (Figure 1.4). The thin-walled caecum ends in a

16
 Rabbit Basic Science 1
narrow blind appendix that is heavily endowed with
lymphoid tissue. The appendix is often described as
‘vermiform’ due to its worm-shaped appearance. The
gut-associated lymphoid tissue (GALT) of the rabbit
is predominantly in the hindgut and represents over
50% of the total lymphoid tissue, which may account
for the relatively small spleen of rabbits (Percy and
Barthold, 1993).
The ascending colon of the rabbit is divided into
Ileocolic valve four sections. At the proximal end, the ampulla caeca-
Prostaglandin closed lis coli opens into the first section, which is approxi-
Fusus coli
mately 10 cm long and has three longitudinal
Aldosterone
flat bands of muscular tissue or taeniae separating
rows of haustra or sacculations. Small protrusions,
Strong contraction Gentle contraction approximately 0.5 mm in diameter, can be seen
on the mucosa in this section of colon. These
cauliflower-like protrusions have been termed warzen
(warts) and are believed to be unique to lagomorphs.
Soft faeces
They represent an increase in the surface area of the
Hard faeces
phase phase colon that would favour increased absorption. The

Hard pellets, dry, large, Caecotrophs, smaller, (B) Periodically, the motility of the caecum and proximal colon
don’t stick together softer, stickier, smellier alters completely. Haustral activity ceases and the caecum
contracts, sending caecal material swiftly along the large
Figure 1.4 The activity of the digestive system during intestine. In the fusus coli the material is formed into soft
excretion of hard and soft faeces. (A) The motility and pellets that become encapsulated in mucus (see Figure 1.5).
function of the hindgut can change depending on the type of This is the soft faeces phase of excretion when caecotrophs
faeces formed within the colon. The formation of hard faeces is pass through the colon to be expelled from the anus. Expulsion
known as the hard faeces phase and the expulsion of of caecotrophs coincides with a decrease in rhythmic motility of
caecotrophs is known as the soft faeces phase. The phases of the caecum and proximal colon, and increase in motility of the
excretion follow a marked circadian rhythm. The hard faeces distal colon. Soft faeces or caecotrophs are expelled once or
phase is shown in black. The soft faeces phase is shown in twice daily, at least 4 h after feeding, usually during periods of
green. Exchange of water, electrolytes and nutrients across the rest. The transit time for soft faeces through the colon is
intestinal epithelium alter with the phase of faeces excretion. 1.5–2.5 times faster than that for hard faeces. Motility in the
The direction of water and electrolyte exchange is indicated by upper gastrointestinal tract remains the same during the hard
arrows. The proximal part of the ascending colon is able to and soft faeces phases. The differences in colonic motility
separate digesta into two fractions that are simultaneously sent during the hard and soft faeces phase of excretion are most
in opposite directions. During the hard faeces phase, water is pronounced in the second section of proximal colon that has a
secreted into the proximal colon and the intestinal contents are single row of haustra. The fusus coli is a specially adapted area
thoroughly mixed by contractions of the caecum and colon. of the colon that acts as a differential pacemaker for the
Large indigestible particles (> 0.5 mm) tend to accumulate in initiation of peristaltic waves in the proximal and distal colon
the lumen of the proximal part of the ascending colon and are that alter with the phase of faeces excretion. The fusus coli is
moved distally, whereas smaller particles accumulate at the highly innervated and is influenced by hormones such as
circumference in the sac-like haustra. Haustrum is the Latin aldosterone and prostaglandins. During the hard faeces
term for a pump. Haustral activity sends the small particles and phase, the intestinal contents lose considerable quantities of
fluid proximally into the caecum where bacterial fermentation water, potassium and sodium during their passage through the
takes place. The indigestible fraction, composed of large fusus coli. Water is mechanically squeezed out of the fibrous
particles, is moved rapidly through the proximal colon to the material before it passes to the distal colon where absorption
fusus coli and distal colon where it is formed into hard, round, of water, volatile fatty acids and electrolytes continues, leaving
dry pellets that are excreted from the anus. Rhythmic caecal the residue of dry, indigestible matter that is expelled as hard
contractility is greatest during the hard faeces phase. faecal pellets.

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 Textbook of Rabbit Medicine

protrusions may also assist mechanical separation of use the terms proximal and distal colon instead
intestinal contents. Histologically, the muscular layers (Snipes et al., 1982). The proximal colon includes
of the taenia contain many autonomic fibres that are the three taeniae section, the single taenia section
part of the myenteric plexus (Snipes et al., 1982). The and the fusus coli. The distal colon is 80–100 cm
second section of ascending colon is approximately long and runs from the fusus coli to the rectum.
20 cm in length and has a single taenia and fewer, The mucosa of the distal colon is smooth with no
smaller haustra. There is an abundance of myenteric surface specialization. The tunica mucosa possesses
plexus in this region. The third portion of the ascend- short crypts with numerous goblet cells reaching
ing colon is termed the fusus coli and is a muscular area into the base. This section of the colon is thin-
about 4 cm long (see Figure 1.5). This area is highly walled and usually contains hard faecal pellets.
innervated and vascular. The mucosal surface of the
fusus coli is distinguished by prominent longitudi-
nal folds and contains numerous goblet cells. The
1.3.5 Motility of the hindgut
fusus coli opens into the fourth section of ascending
colon, which is histologically indistinguishable The motility and function of the hindgut can change,
from the transverse and descending colon. Because depending on the type of faeces formed within the
the fusus coli forms such a natural division between colon. The formation of hard faeces is known as
two morphologically and functionally distinct sec- the hard faeces phase and coincides with feeding
tions of the rabbit colon, many physiological texts activity. The expulsion of caecotrophs is known as
have abandoned the traditional description of the soft faeces phase. The phases of excretion follow
ascending, transverse and descending colon and a marked circadian rhythm. In caged rabbits with ad
lib access to food, feed intake increases from 15.00 to
18.00 h and remains high until midnight. Intake
then reduces until 02.00, when a new phase starts,
with a maximum at 06.00, ending at 08.00 when
the soft faeces phase begins. This natural pattern of
feeding behaviour and faecal excretion can be seen
in pet rabbits, although it may be altered by type
and availability of food, age, pregnancy and lactation
(Carabaño and Piquer, 1998).
During the hard faeces phase, water is secreted
into the proximal colon, which aids the process of
mixture and separation. Intestinal contents are thor-
oughly mixed by contractions of the caecum and
colon that separate the digesta into large indigestible
particles, and small particles including bacteria and
Figure 1.5 Fusus coli. The fusus coli is a highly innervated,
vascular, muscular section of the ascending colon (see water-soluble components. The indigestible fraction
Section 1.3.5). The fusus coli acts as a pacemaker for colonic is moved rapidly through the proximal colon to the
motility that alters with the type of faeces that are passing fusus coli and distal colon before being excreted from
through the colon. It is influenced by the autonomic nervous
the anus. The fermentable fraction is moved in a ret-
system and hormones such as aldosterone and prostaglandins.
The mucosa of the fusus coli is deeply folded and contains rograde direction back into the caecum. The large
many goblet cells. This plate shows the fusus coli of a rabbit that indigestible particles (> 0.5 mm) tend to accumulate
died during the morning when the colon was in the soft faeces in the lumen of the proximal part of the ascending
phase. Pasty caecal material is passing into the fusus coli from
the proximal colon (left). In the fusus coli, the intestinal contents
colon and are moved distally, whereas smaller fer-
are squeezed into pellets that become encapsulated in mucus mentable particles accumulate at the circumference
before being excreted as soft caecotrophs. in the sac-like haustra. Haustral activity sends the

18
 Rabbit Basic Science 1
small particles proximally into the caecum. Caecal 10–15 minutes (Ruckesbusch et al., 1985). The dif-
contractility is greatest during the hard faeces phase ferences in colonic motility during the hard and soft
when the liquid intestinal contents are mixed and faeces phase of excretion are most pronounced in
separated in the proximal colon. Periodically, the the second section of proximal colon that has a sin-
motility of the caecum and proximal colon alters gle layer of haustra.
completely. Haustral activity ceases and caecal mate- During the hard faeces phase, the intestinal con-
rial is moved swiftly along the large colon. In the tents lose considerable quantities of water, potas-
fusus coli the material is then separated into pellets sium and sodium during their passage through the
that become encapsulated in mucus. This is the soft fusus coli (Snipes et al., 1982). The compression of
faeces phase of excretion. Soft faeces or caecotrophs intestinal contents into faecal pellets during the hard
are expelled at least 4 h after feeding, usually during faeces phase can be correlated with the strong muscu-
periods of rest. lar wall of the fusus coli and its dense innervation.
The fusus coli is a specially adapted area of the Water is mechanically squeezed out of the fibrous
colon that acts as a differential pacemaker for the ini- material before it passes to the distal colon where
tiation of peristaltic waves in the proximal and distal absorption of water, volatile fatty acids and electro-
colon (Ruckesbusch and Fioramonti, 1976). The lytes continues, leaving a residue of dry, indigestible
nature and direction of the peristaltic waves alter matter that is expelled as hard, dry faecal pellets.
with the phase of faeces excretion. The fusus coli is
highly innervated and is influenced by hormones
such as aldosterone and prostaglandins. During hard
1.3.6 Caecal fermentation
faeces production aldosterone levels are high, but
they fall during the soft faeces phase of excretion. The end-products of digestion in the stomach and
Prostaglandins inhibit motility of the proximal colon small intestine are separated in the colon into two
and stimulate the distal colon, aiding the elimination components: small particles that can act as a substrate
of soft faeces or caecotrophs (Pairet et al., 1986). for caecal micro-organisms and large particles of indi-
Three types of contractions occur in the proximal gestible lignified material. Small particles are propelled
colon. Haustral activity results from high-frequency into the caecum, which acts as a huge bacterial fermen-
repetitive contractions of the haustral walls that last tation chamber to which nutrients and water are con-
about 3 seconds and coincide with orally migrating tinually added. Studies of the enzymatic activities of
shallow annular constrictions. Segmental activity is the caecal microflora indicate that ammonia use, ureo-
the result of low-frequency deep annular constric- lysis, proteolysis and cellulysis take place in that order.
tions that move aborally and last about 14 seconds. Xylanolysis and pectinolysis also occur (Carabaño and
The third type of contraction of the proximal colon Piquer, 1998). The intestinal contents that reach the
is a monophasic progressive wave of peristaltic con- hindgut are composed of undigested food, excretion
tractions. These peristaltic contractions last about products and substances produced by the digestive
5 seconds during the hard faeces phase and 1.5 sec- tract itself. Small particles of complex carbohydrates
onds during the soft faeces phase (Ehrlein et al., such as oligosaccharides, cellulose, hemicellulose
1982). Expulsion of caecotrophs coincides with a and pectins that are not digested in the small intestine
decrease in motility of the caecum and proximal reach the caecum for bacterial degradation. Plant pro-
colon and an increase in motility of the distal colon. teins that are bound to cell wall constituents are also
The transit time for caecotrophs through the colon degraded in the caecum to form ammonia that is
is 1.5–2.5 times faster than that for hard faeces metabolized to amino acids by the caecal microflora.
(Fioramonti and Ruckesbusch, 1976). Motility in Products of intestinal cellular desquamation and
the upper gastrointestinal tract remains the same digestive enzymes act as a nitrogen source for protein
during the hard and soft faeces phases, with slow synthesis (Fraga, 1998). Soluble ions such as urea are
contractions of the small intestine occurring every osmotically transferred across the caecal wall to be

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 Textbook of Rabbit Medicine

metabolized. High protein diets increase blood urea and diet. Caecal pH shows a diurnal rhythm similar
levels and increase caecal ammonia levels (Fraga, to feeding behaviour and is most alkaline in the morn-
1998). During periods of protein deprivation, urea ing and most acid in mid-afternoon (Brewer and
from catabolism passes into the caecum to provide a Cruise, 1994). Fluctuations in caecal pH have an effect
nitrogen source for bacterial amino acid synthesis on the population of caecal micro-organisms. Ammo-
(Fekete, 1989). Mucopolysaccharides secreted from nia and volatile fatty acids produced by caecal degra-
goblet cells in the mucosa serve as a significant car- dation and fermentation affect caecal pH. Like
bohydrate source for caecal fermentation. Bacteroides any continuous culture system, there are a number
spp. ferment mucopolysaccharides (Cheeke, 1987). of homeostatic mechanisms in place. Bicarbonate
In healthy rabbits, high numbers of large anaerobic secreted from the appendix acts as a buffer. Other sub-
metachromatic bacteria are present in the caecum stances such as fibre also have a buffering capacity
(Lelkes and Chang, 1987). Non-pathogenic, Gram- dependent on the carboxyl, amino and hydroxyl
negative Bacteroides spp. predominate in a flora com- groups (Gidenne et al., 1998). The rate of production
posed of a wide variety of Gram-positive and -negative and absorption of volatile fatty acids is dependent on
rods, cocci, filaments, coccobacilli and spirochaetes. type and availability of substrate. Gut motility affects
Species such as Bifidobacterium, Endophorus, Clostrid- the supply of nutrients and water for microbial fer-
ium, Streptococcus and Acuformis have been identified mentation and the absorption of nutrients. Energy
(Carabaño and Piquer, 1998; Cheeke, 1987). Over appears to be the most limiting factor for optimum
74 strains of anaerobic bacteria have been isolated microbial activity (Fraga, 1998).
from the caecal mucosa and many of these species have
not been identified (Straw, 1988). Lactobacillus and
E. coli spp. are usually absent from the normal gut flora
1.3.7 Expulsion and ingestion
of adult rabbits but may be found in rabbits fed on a
of caecotrophs
high-carbohydrate, low-fibre diet. The intestinal flora
contains many non-pathogenic protozoa. Entamoeba Bacterial fermentation within the caecum results in
cuniculi is a large sluggish amoeba found in large num- synthesis of amino acids, volatile fatty acids and
bers in the lumen of the large intestine. The flagellate water-soluble vitamins. Some nutrients produced
Giardia duodenalis can be found in the duodenum by the caecal microflora are absorbed across the cae-
but does not cause clinical disease. Eutrichomastix, cal wall. The remaining contents of the caecum form
Enteromonas and Retortamonas spp. are non-pathogenic a soft, dark-coloured paste rich in bacteria, amino
protozoa found in the caecum (Owen, 1992). acids, vitamins and minerals. The paste is expelled
Volatile fatty acids are produced by the caecal as soft faeces or caecotrophs. Caecal contents pass
microflora and absorbed across the caecal epithelium into the colon rapidly without mechanical separa-
as an energy source for the rabbit. Caecal contents tion of solids and liquid and the faecal masses are
contain 60–70% acetic acid, 15–20% butyric acid divided in the fusus coli (see Figure 1.5). Lysozyme
and 10–15% propionic acid, although the ratios of is secreted into the lumen of the distal colon during
volatile fatty acids can change in relation to the fibre the soft faeces phase (Camara and Prieur, 1984) and
content of the diet. The caecal epithelium has a high incorporated into caecotrophs. The glandular por-
electrolyte transport capacity suited to the absorption tion of the fusus coli is instrumental in lubricating
of the large quantities of electrolytes present in the the intestinal surface of the colon, facilitating the
luminal fluid (Clauss et al., 1989). The appendix rapid transport of intestinal contents. Goblet cells
secretes an alkaline fluid rich in bicarbonate ions that secrete mucus, which encapsulates the pellets and
buffer volatile fatty acids produced by caecal fermen- inhibits the diffusion of electrolytes. In this way,
tation. The appendix also contains lymphoid tissue. large masses of pelleted caecal contents are pro-
The composition of the caecal microflora does not duced, which are expelled as intermittent bunches
remain constant and is affected by time of day, age of caecotrophs.

20
 Rabbit Basic Science 1
In healthy rabbits, caecotrophs are consumed • Small particles and fluid are directed in a retro-
straight from the anus and are swallowed whole. grade direction from the proximal colon to the
Stimulation of rectal mechanoreceptors, the percep- large caecum where bacterial fermentation takes
tion of the specific odour of the soft faeces and the place. Volatile fatty acids are the products of bac-
blood concentrations of various metabolites and terial fermentation.
hormones trigger the ingestion of caecotrophs from • The substrate for caecal fermentation is com-
the anus (Fekete, 1989). When food is scarce, all cae- posed of undigested food that reaches the colon
cotrophs are consumed. When food is available ad plus excretion products, and substances such as
libitum, the protein and fibre content of the ration mucopolysaccharides and desquamated cells
influence the amount of caecotrophs consumed. from the digestive tract.
Increased levels of fibre increase caecotrophy, • Urea can diffuse into the caecum from the blood-
whereas high protein levels reduce it. stream to act as a nitrogen source for the caecal
bacteria.
• The population of micro-organisms within the cae-
Key Points 1.4 Gut physiology cum is finely balanced and changes with the time
of day, caecal pH and dietary substrate.
• The gastrointestinal system of the rabbit is
adapted for the digestion of large quantities of • Long particles of undigested fibre are propelled
fibrous food. through the distal colon and expelled as hard fae-
ces. Absorption and secretion of water, electro-
• Rabbits are hindgut fermenters with a large cae- lytes and volatile fatty acids in the large intestine
cum that periodically expels its contents into the alter according to the type of faeces passing
colon. Microbial fermentation in the caecum through.
results in the formation of a soft paste containing
amino acids, volatile fatty acids, micro-organisms • Indigestible fibre stimulates intestinal motility.
and vitamins.
• Mucus-encapsulated pellets of the soft caecal
material or ‘caecotrophs’ are ingested as they 1.3.8 Energy metabolism
emerge from the anus and subsequently digested
to supply an additional source of nutrients. This Volatile fatty acids provide an energy source for her-
process is known as caecotrophy bivorous species, such as rabbits, that utilize bacterial
fermentation as part of the digestive process. The pro-
• Digestion in the stomach and small intestine is
portion and type of volatile fatty acids produced
similar to other monogastric animals.
depend on the substrate metabolized and the species
• The colon of the rabbit is adapted to mix and sep- of bacteria present. In ruminants, the predominant
arate large indigestible fibre particles from small
volatile fatty acid is propionate, which is produced
digestible fragments and fluid.
by Lactobacillus spp. present in the rumen but absent
• The indigestible and digestible fibre components from the rabbit caecal microflora (Cheeke, 1987). In
of the diet are simultaneously propelled in oppo- rabbits, acetates predominate, followed by butyrate
site directions in the proximal colon.
and propionate with small quantities of isobutyrate,
• Periodically, the pattern of motility in the large isovalerate and valerate. Increased amounts of fibre
intestine and caecum changes completely to in the diet increase the proportion of acetate that is
expel caecal contents as caecotrophs. produced. Lactate is produced by bacterial fermenta-
• A specially adapted area of the colon, the fusus tion within the caecotroph in the stomach and
coli, acts as a pacemaker to control colonic motil- is subsequently absorbed during digestion of the cae-
ity. The fusus coli is highly innervated and vascular cotroph in the small intestine.
and is influenced by blood metabolites and hor- Considerable energy is required by the hindgut for
mones such as prostaglandins and aldosterone.
the metabolism and absorption of volatile fatty

21
 Textbook of Rabbit Medicine

acids, electrolytes and other nutrients. This energy is The rabbit kidney differs from other mammalian
mainly supplied by butyrate produced by Bacteroides species. In common with neonates and amphibians,
spp. that predominate in the caecal microflora. Rab- there is a wide variation in the number of glomeruli
bit caecal-colonic epithelial tissue metabolizes buty- active at any one time. Hydration, uncomplicated by
rate without the production of ketone bodies. vasoconstriction, leads to a marked increase in glo-
Volatile fatty acids absorbed from intestinal tract pro- merular activity. As much as a 16-fold increase in
vide a regular energy source for the rabbit. Lactate water diuresis is possible without significant change
enters the portal circulation from the stomach and in glomerular filtration rate. When blood pressure is
small intestine while volatile fatty acids originate increased, there is little or no change in renal plasma
from the hindgut. Net absorption from the digestive flow (Brewer and Cruise, 1994).
tract is greatest during the hard faeces phase, which is
matched by increased hepatic metabolism and the
removal of propionate and butyrate from the circula- 1.3.10 Electrolyte exchange
tion, leaving acetate and lactate available for extra-
The absorption and secretion of electrolytes along
hepatic tissue metabolism (Carabaño and Piquer,
the intestinal tract of the rabbit is complex. Saliva
1998). Due to alterations in hepatic metabolism,
is continually formed by a two-stage process in which
arterial concentrations of volatile fatty acids remain
an isotonic fluid with a constant, plasma-like electro-
constant during both hard and soft phases of excre-
lyte composition is modified in the salivary glands
tion, although their absorption and metabolism fol-
(Fekete, 1989). Sodium and chloride are resorbed
low a circadian rhythm parallel to the activity of the
and potassium and bicarbonate are secreted.
adrenal gland (Vernay, 1987).
Bicarbonate is secreted into the duodenum and
absorbed from the jejunum in which there is an
1.3.9 Water metabolism inter-relationship between bicarbonate secretion
and sodium and chloride absorption. The caecal
Rabbits normally drink 50–100 mL/kg/24 h (Brewer
appendix secretes an alkaline fluid rich in bicarbon-
and Cruise, 1994) although this quantity is affected
ate that is also secreted in the proximal colon to mod-
by the water content and composition of the diet.
erate the rising pH due to volatile fatty acid
The complex digestive processes of the rabbit require
production (Fekete, 1989).
water to be continually absorbed and secreted along
The transport of electrolytes across the colonic
the gastrointestinal tract. Saliva is continuously
wall is regulated by aldosterone and is related to
secreted into the mouth and water is secreted into
the type of faeces being produced. During the soft
the stomach. In the caecum, water is absorbed from
faeces phase, aldosterone concentrations are at their
the contents, which contain 20–25% dry matter
lowest and water, sodium and chloride are secreted
(Fekete, 1989). In the colon, absorption or secretion
while potassium is conserved. During the hard faeces
of water varies in each section of the colon and
phase, water and bicarbonate are secreted into the
depends on whether hard or soft faeces are being
proximal colon and water, volatile fatty acids,
formed. During the soft faeces phase, caecal contents
sodium, potassium and chloride are absorbed from
pass through the colon with relatively little change in
the distal colon, thereby conserving water and elec-
composition. During the hard faeces phase water is
trolytes (Cheeke, 1987).
secreted into the proximal colon and mixed with intes-
tinal contents. The water content of the digesta is high-
est immediately before the fusus coli and decreases
1.3.11 Acid–base balance
sharply during the passage through the fusus and along
the distal colon (Snipes et al., 1982). The complex The renal regulation of acid–base balance is different
exchange of water across the intestinal wall permits in rabbits in comparison with other domestic spe-
changes in hydration status without obvious fluid loss. cies. Rabbits have a limited ability to transfer

22
 Rabbit Basic Science 1
hydrogen or bicarbonate ions between blood and than other mammalian species (Buss and Bourdeau,
urine because some metabolic pathways that are pre- 1984). Total serum calcium concentrations reflect die-
sent in other species are absent or restricted. The tary calcium intake (Chapin and Smith, 1967a, b).
enzyme carbonic anhydrase is absent from the thick Hypocalcaemia is rare, although lactation tetany can
ascending limb of the renal tubule of rabbits (Brewer occur in nursing does (Barlet, 1980). Experimentally,
and Cruise, 1994; Dobyan et al., 1982). In other spe- hypocalcaemic tetany can be induced by parathyroid-
cies such as humans, monkeys and rats, carbonic ectomy (Tan et al., 1987) or by feeding diets deficient
anhydrase is present in the ascending tubule epithe- in calcium or vitamin D (Bourdeau et al., 1986;
lial cells in large amounts. The enzyme is required for Chapin and Smith, 1967a).
the rapid formation of carbonic acid, which is an
important step in the excretion of hydrogen ions
and conservation of bicarbonate. This infers a Key Points 1.5 Basic calcium and phosphorus
physiology
reduced ability to deal with acidosis.
In other mammals, ammonia is produced in the • Parathyroid hormone (PTH) is secreted in response
kidney by glutamine deamination in response to a to low calcium. Increased phosphorus has no
fall in plasma pH or a decreased concentration of direct effect on PTH, but increased P can reduce
bicarbonate. Ammonia acts as part of the buffering Ca2þ, thereby stimulating PTH release.
system in the renal tubule by combining with hydro- • PTH increases serum calcium and decreases
gen ions before being excreted in the urine as ammo- serum phosphorus and increases phosphorus
nium ions. In rabbits, glutamine deamination only excretion by the kidney.
takes place in response to reduced serum bicarbonate • PTH causes:
concentrations but not a drop in plasma pH, which
1. Calcium release from bone
compromises the rabbit’s response to metabolic aci-
dosis. In other species there are alternative biochem- 2. Phosphorus excretion by the kidney
ical pathways that result in ammonia synthesis but 3. Accelerated formation of active vitamin D in the
these pathways appear to be absent in the rabbit kidney
(Brewer and Cruise, 1994). 4. Calcium absorption from the gut
The rabbit also has problems correcting alkalosis. 5. Calcium reabsorption by the renal tubules.
A large bicarbonate load can reach the kidney of
• The blood calcium level at which PTH release
rabbits as a result of bacterial fermentation in the
is stimulated in rabbits is higher than in other
gut and from tissue metabolism of acetate. In other
species.
species, bicarbonate is neutralized by the products
of ureagenesis and alkalosis is avoided. In rabbits, • Calcitonin is produced by the thyroid parafollicular
cells in response to hypercalcaemia.
insufficient ammonium may be available from
tissue metabolism to neutralize bicarbonate, espe- • Calcitonin decreases serum calcium and
cially during periods of protein deficit (Brewer phosphorus.
and Cruise, 1994). Alkaline secretion into the gut 1. Inhibits PTH-stimulated bone resorption
increases in response to metabolic alkalosis (Vattay 2. Increases phosphorus excretion by the kidney.
et al., 1989).
• Active vitamin D: formation occurs in the kidney
under regulation of PTH.
• 1,25-Dihydroxycholecalciferol is the metabolically
1.3.12 Calcium metabolism active form of vitamin D.
Rabbits have an unusual calcium metabolism. It is 1. It promotes calcium and phosphorus absorp-
characterized by total serum calcium concentrations tion by the intestinal mucosa.
that vary over a wide range and are 30–50% higher Continued

23
 Textbook of Rabbit Medicine

Key Points 1.5 Basic calcium and phosphorus Table 1.1 Hormones affecting blood calcium
physiology—cont’d
Hormones increasing Hormones reducing
2. It may facilitate PTH action on bone. blood calcium levels blood calcium levels
3. Epithelial calcium transport channels are pre-
sent in vitamin D-responsive tissues Parathyroid hormone Calcitonin
(Hoenderop et al., 2000).
Prolactin Glucocorticoids
• Only ionized calcium is biologically active.
Vitamin D Glucagon
1. Alkalosis decreases serum ionized calcium
concentration. Growth hormone Gastrin
2. Acidosis increases serum ionized calcium con- Oestrogen Cholecystokinin
centration: in rabbits this manifests as reduced Progesterone Secretin
calcium excretion through the kidney and
therefore clear urine. Testosterone

• Phosphorus occurs in various ionic forms and

functions with phosphoric acid as a buffer system and it is difficult to look at calcium metabolism with-
in body fluids. But acid–base balance is primarily
out considering that of phosphorus. Rabbits have
measured via the bicarbonate buffering system
as the phosphorus buffering system is largely
evolved to live on pastures where calcium and phos-
intercellular. phorus levels can vary widely over the year. In certain
seasons rabbits must deal with high dietary calcium
• Serum phosphorus is largely regulated by the kid-
(typically during the summer) while over the winter,
neys. Losses occur when the tubular reabsorption
capacity is exceeded.
both calcium and phosphorus levels are very low. At
times when dietary calcium is very low, rabbits rely
1. PTH may enhance phosphaturia by reducing on active calcium transport (vitamin D-dependent)
tubular reabsorption.
in order to derive enough from the diet. When die-
2. Dietary intake may directly affect serum phos- tary phosphorus and hence blood levels are low, rab-
phorus concentration. bits undergo significant calciuria as a mechanism for
3. Abnormal serum phosphorus concentration is retaining phosphorus (Bourdeau et al., 1990; DePalo
caused by altered dietary concentrations, et al., 1988). In wild rabbits, dietary intake of calcium
decreased renal excretion and hormonal and phosphorus vary annually, and levels of both
imbalances. these nutrients are low in late winter/early spring,
prior to the rapid pasture growth (Table 1.1).
Experimentally, hypocalcaemia or hypercalcaemia
It is not clear why rabbits have higher blood cal- can be brought about by the infusion of EDTA or
cium levels than other species, or why they seem to calcium gluconate. Reciprocal elevations in PTH or
vary over a wide range. Their calcium metabolism calcitonin in response to EDTA or calcium
has been studied extensively. Interestingly, blood gluconate infusion indicates that these hormones reg-
phosphorus levels in the rabbit are tightly controlled ulate serum calcium concentrations in rabbits as in
and maintained at levels very similar to those of other species (Bourdeau et al., 1986; Warren et al.,
other species. This is a situation similar to that found 1989). However, rabbits appear to differ from
in horses, who also have higher and more variable humans in the level at which serum ionized calcium
serum calcium levels than predicted while maintain- is set to initiate a parathyroid hormone (PTH)
ing serum phosphorus levels analogous to those of response (Warren et al., 1989). This tends to main-
other species and rigidly controlled. The relationship tain serum calcium at higher levels. The effect of this
between calcium and phosphorus is well recognized, on serum phosphorus is that renal phosphorus

24
 Rabbit Basic Science 1
excretion is initiated at higher calcium levels. The it is absorbed passively, there is no feedback mecha-
advantage of this is unknown; however, it is sug- nism and calcium is absorbed in proportion to the
gested that it is a mechanism for the rabbit to success- dietary calcium concentration (Cheeke and Amberg,
fully cope with wide variations in dietary calcium and 1973). Blood calcium concentrations increase if die-
phosphorus. An analogy has been made with the syn- tary calcium levels are elevated.
drome of benign familial hypercalcaemia in humans, The rabbit kidney is capable of excreting or conserv-
which is a genetic condition characterized by hyper- ing calcium according to metabolic need. Responses
calcaemia without changes in renal function, blood are mediated by PTH and 1,25-dihydroxyvitamin D3
pressure or any other potential sequels to chronic (Bourdeau et al., 1988). Tubular reabsorption of cal-
hypercalcaemia such as soft tissue mineralization. cium by the kidney increases during periods of cal-
Not only do rabbits have higher total serum cal- cium deprivation (Bourdeau and Lau, 1992).
cium concentrations than other species but also they During periods of high calcium intake the rabbit
are different in the way calcium is absorbed from kidney is capable of increasing the fractional ex-
the gut and excreted by the kidney. Calcium can cretion of calcium into the urine considerably
be absorbed from the intestinal tract either by (Whiting and Quamme, 1984). The excretion rates
passive diffusion or by active transport across of calcium are proportional to dietary intake
the mucosa. In other mammals the amount of cal- (Kennedy, 1965). Calcium precipitates as calcium
cium taken up by the body is strictly controlled; carbonate in the alkaline urine of rabbits and high
however, in rabbits calcium uptake is directly dietary calcium intake results in large amounts of
proportional to the amount found in the diet, and urinary sediment. Normal rabbit urine is turbid
any excess is excreted through the kidney. Active due to the presence of calcium carbonate. Pregnant,
transportation involves a carrier protein that is lactating or growing rabbits or those that are
synthesized in the intestinal mucosa in response anorexic or on a calcium deficient diet can excrete
to 1,25-dihydroxyvitamin D3, the active metabo- clear urine.
lite of vitamin D. A drop in serum calcium con- There appears to be a difference in calcium metab-
centration stimulates PTH release, which, in olism in immature and mature rabbits. Serum cal-
turn, stimulates the conversion of biologically inert cium concentrations are not as variable in growing
25-dihydroxyvitamin D3 to 1,25-dihydroxyvitamin rabbits as in mature rabbits (Gilsanz et al., 1991;
D3 in the kidney, thereby indirectly increasing the Kamphues et al., 1986). Immature rabbits on forced
absorption of calcium from the intestine (Chapin high dietary calcium concentrations do not develop
and Smith, 1967a). soft tissue calcification like their adult counterparts
Calcium is not only absorbed from the gastroin- (Kamphues et al., 1986).
testinal tract but also secreted into the gut across
the intestinal mucosa. This process is independent
of serum calcium concentrations and can take place Key Points 1.6 Calcium metabolism
in a hypocalcaemic animal. It has been demonstrated
• Some metabolic processes in rabbits differ from
that secretion of calcium into the gut continues dur- other mammalian species.
ing periods of calcium deprivation in rabbits (Barr
• The absorption and secretion of water and elec-
et al., 1991).
trolytes along the intestinal tract is complex.
In rabbits, passive intestinal absorption of calcium
is efficient. If dietary calcium concentrations are ade- • Some of the metabolic pathways that correct
quate, it appears that vitamin D is not required for cal- acid–base disorders are absent from the rabbit
kidney.
cium absorption (Bourdeau et al., 1986; Kamphues,
1991). However, vitamin D increases intestinal • In rabbits, calcium homeostasis is mainly regu-
absorption of calcium and is required if dietary cal- lated by the kidney, which is capable of both
cium levels are low (Brommage et al., 1988). Because Continued

25
 Textbook of Rabbit Medicine

The nutritional requirements for pregnancy, lacta-

Key Points 1.6 Calcium metabolism—cont’d
tion, growth and fur production have been well
conserving calcium and excreting large amounts researched but the requirements for long-term main-
of calcium into the urine. tenance of unproductive rabbits has been over-
• Calcium is absorbed readily from the intestine in looked. Nutritional disease is common in rabbits
proportion to dietary concentrations. kept as pets. For owners, providing food that is eaten
• Blood calcium levels in rabbits are higher and not
readily and enjoyed is one of the most rewarding
as closely homeostatically maintained as in other aspects of keeping a rabbit. The visual appearance
species. of food influences the owner when choosing a prod-
uct, so pelleted diets became unpopular and a wide
• Excreted calcium forms calcium carbonate
precipitates in the alkaline urine of rabbits. Normal
range of visually attractive, highly coloured cereal
rabbit urine is turbid. Growing, lactating, pregnant mixes evolved as ‘rabbit food’ in the UK. These diets
or acidotic rabbits may excrete clear urine. are cheap to produce and many are put together by
food compounders that normally make rations for
• Serum calcium concentrations of growing rabbits
are not as variable as in mature rabbits.
farm animals. The choice of ingredients is based on
general nutritional principles combined with cost
and availability of ingredients. Scientific, long-term
feeding trials are not carried out. The nutrient value,
1.3.13 Nutrition
vitamin and mineral content of a diet is calculated by
Rabbits are strict herbivores with a digestive system extrapolating figures taken from data tables of ingre-
that is adapted to the ingestion of a high fibre diet dients rather than analysing the food itself. In recent
(see Section 1.3.1, Digestive physiology). Briefly, years, however, several companies have started to
indigestible fibre is separated from fermentable produce scientifically formulated mono-component
components in the proximal colon and is rapidly pelleted and extruded feeds. These have been based
eliminated in hard faecal pellets. The fermentable on research and feeding trials and are nutritionally
components, which consist of small particles and superior to many of the ‘muesli’-type mixes. The
fluid, are moved back into the caecum where bacte- advantage of these types of premium feeds are a
rial fermentation takes place to release volatile reduction in the likelihood of nutrient deficiency;
fatty acids that are absorbed as an energy source. the disadvantage is the way that many of these pellets
Caecal contents are expelled periodically as mucus- need to be chewed (a more vertical chewing motion,
encapsulated caecotrophs that are re-ingested and compared with the more lateral movement seen
digested as a source of amino acids and vitamins. when a rabbit chews hay or vegetation) that can lead
This strategy permits the digestion of large volumes to dental problems. A good compromise is to feed ad
of fibrous foods without storage in the gastrointesti- lib hay and a small amount of good-quality pellets
nal tract. Digestion can take place when the rabbit and to offer a selection of fresh vegetables daily.
is below ground and not vulnerable to predation. The Rabbit Welfare Association and the RSPCA
Since their domestication, rabbits have been fed support this recommendation. A hay and fresh
on a variety of diets. During the Second World War food-only diet, which is as close to the natural diet
in the UK, when food was scarce, backyard rabbits as possible, should be viewed as the optimum; how-
were kept as a source of protein that could survive ever, many owners can’t or won’t comply with this.
on weeds, household scraps and foods that the pro-
ducer could grow himself. This still occurs in many
1.3.14 Appetite
developing countries where rabbits are fed on a range
of forage materials. Large-scale rabbit production Hunger is stimulated by a drop in blood glucose, lac-
has led to the development of pelleted foods of tic acid, amino acids and volatile fatty acids. Dryness
known analysis suitable for commercial rabbits. of the mouth and contractions of the stomach

26
 Rabbit Basic Science 1
stimulate eating (Fekete, 1989). The volume of food polysaccharides and complexed carbohydrates such
eaten is influenced by its composition and texture as glycoproteins. Alternatively, they can be catego-
and by the individual likes and dislikes of the rabbit. rized into sugars, starches and fibre. Sugars and
Increasing the fibre content of the diet increases the starches are principally found inside plant cells and
total volume consumed (Bellier and Gidenne, may be digested by intestinal enzymes, whereas fibre
1996). Rabbits will eat a variety of foods but show a tends to have a structural function (is found as part of
preference for fibre and may eat hay or straw in pref- the cell wall) and is digested, where possible, by
erence to their compound feed. It can be difficult to enzymes produced by the intestinal microflora.
persuade rabbits to eat new foods once they have Some fibre is expelled undigested (indigestible fibre)
become accustomed to a particular diet. New batches or fermented in the caecum to produce volatile fatty
of food may be refused despite it appearing to the acids (digestible or fermentable fibre).
owner to be exactly the same. Sweet foods are gener- Carbohydrates are an important energy source.
ally palatable. Molasses are used in many commercial They can be digested and absorbed from the stomach
rabbit foods to improve palatability (Cheeke, 1994). and small intestine or degraded and fermented by the
Bitter tastes such as the saponins in alfalfa are well tol- caecal microflora. Simple monosaccharide sugars
erated (Cheeke, 1987). Foods that are palatable with- such as glucose, fructose and galactose are absorbed
out the addition of simple sugars are preferable. from the small intestine in a manner similar to that
Most rabbits enjoy leafy plants. A whole variety of of other species. Starches are polysaccharides that are
plants can be eaten, including many garden weeds abundant in seeds, fruits, tubers and roots and are
and ornamental plants (see Box 1.7). Sunflower broken down to simple sugars during digestion.
leaves were found to be most palatable in a study The reaction is catalysed by amylase that is secreted
by Harris et al. (1983). Rabbits appear to enjoy foods by the salivary glands and pancreas and is also pre-
of different textures. Pellets are preferable to ground sent in caecotrophs as a result of bacterial synthesis.
meal. Biscuits or hard pieces of breakfast cereal are The activity of amylase in the stomach is limited by
accepted readily. Bark is stripped from young trees the gastric pH, and at pH < 3.2 there is little or no
or shrubs. All parts of the plant may be eaten includ- amylase activity (Blas and Gidenne, 1998). During
ing the stem and roots, although the growing tips caecotrophy, where the gastric pH tends to rise, amy-
are usually nibbled off first. Tree leaves are eaten, lase activity increases.
especially in the autumn when the leaves fall. The age of the rabbit, dietary levels and the type of
Like many activities in rabbits, appetite follows starch influence digestion and absorption in the small
a diurnal pattern. Wild rabbits feed at dusk and intestine. For example, cereal starches are more fer-
dawn. Pet rabbits may not be hungry during the mentable than those found in roots or tubers. Starch
day and are most likely to eat in the early evening is found in plants as granules that are insoluble in cold
or overnight. water, but when a suspension of starch in water is
heated, the granules swell and eventually gelatinize.
Gelatinized starches can form complexes with proteins
1.3.15 Dietary requirements of rabbits that reduce the digestibility of both starch and protein
(Cheeke, 1987). Feed manufacturing processes and
1.3.15.1 Carbohydrate exogenous enzyme supplements also affect starch
Carbohydrates are compounds of carbon, hydrogen digestibility (Blas and Gidenne, 1998). Pancreatic
and oxygen with the empirical formula of (CH2O)n, amylase is the most important enzyme, and as dietary
where n > 3. Some molecules contain phosphorus, levels of starch increase, more amylase is secreted. Most
nitrogen or sulphur and not all follow the (CH2O)n starch is broken down into glucose and directly
rule, e.g., deoxyribose C5H10O4. Carbohydrates absorbed. Starch that is not digested and absorbed in
can be classified according to the complexity of their the small intestine passes into the caecum as a substrate
structure, i.e. monosaccharides, oligosaccharides, for bacterial fermentation.

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 Textbook of Rabbit Medicine

Residual starch that reaches the caecum is fermen-

Box 1.2 The importance of dietary fibre to rabbits
ted by caecal microflora to lactate and volatile fatty
acids and directly absorbed. Excess starch reaching Dietary fibre can be divided into indigestible fibre that
the caecum or ‘carbohydrate overload’ is thought passes straight through the alimentary tract without
to be a predisposing factor in the development of entering the caecum and fermentable (digestible)
enterotoxaemia in young rabbits. Clostridium spiro- fibre that is directed into the caecum and provides
forme requires glucose as a substrate for iota toxin a substrate for bacterial degradation and fermenta-
production and glucose is yielded during bacterial fer- tion by the caecal microflora.
mentation of carbohydrate (Cheeke, 1987). In com- Indigestible fibre is important to:
mercial units, enterotoxaemia is seen in young • Stimulate gut motility that moves digesta and fluid
rabbits in association with high carbohydrate, low into the caecum for fermentation.
fibre diets. However, the situation is different in the • Provide forage material to prevent boredom and
adult pet rabbit where the sensitivity to high starch behavioural problems such as fur chewing.
diets is controversial (Lowe, 1998). Recent work has • Provide dental exercise and optimal dental wear.
indicated that there is a difference in starch digestibil- • Stimulate appetite and ingestion of caecotrophs.
ity between young and adult rabbits. Adult rabbits
appear to digest starch more efficiently than young Fermentable fibre is important to:
• Provide a substrate for caecal microflora.
ones. Very small amounts of starch reach the caecoco-
lic segment of adults. Even in lactating rabbits that • Provide optimal caecal pH and volatile fatty acid
consume high quantities of carbohydrate, almost all production.
the starch is hydrolysed before it reaches the caecum • Prevent proliferation of pathogenic bacteria in the
(Blas and Gidenne, 1998). Therefore the role of starch caecum.
as a predisposing factor for imbalances of the caecal • Increase fibre content of caecotrophs so they are
microflora and the development of enteric disorders of firm consistency.
remains unclear. Experimental work has given con-
flicting results (Blas and Gidenne, 1998; Cheeke,
1987). However, the general consensus of opinion fermenters because the gut flora breaks down and
is that overload of rapidly fermentable carbohydrates ‘digests’ some fibre molecules by microbial fermenta-
in the large intestine increases the likelihood of diges- tion. Therefore, in herbivores, fibre can be either
tive disorders, at least in susceptible, recently weaned ‘digestible’ or ‘indigestible’ and digestibility varies with
rabbits. Dietary starch has no influence on the chem- species and their digestive physiology. The term ‘fer-
ical composition of caecal contents or on the produc- mentable’ fibre can also be used to describe digestible
tion or composition of soft and hard faeces (Carabaño fibre that is broken down by microbial fermentation.
et al., 1988). In rabbits, fibre is separated in the proximal colon into
large and small particles. Particles larger than 0.5 mm
do not enter the caecum and are swiftly expelled undi-
1.3.15.2 Fibre gested. This is the indigestible fibre component of the
1.3.15.2.1 Digestible (fermentable) and indigestible diet. Particles smaller than 0.3 mm are moved into the
fibre in rabbits caecum where they are digested by bacterial fermenta-
Dietary fibre is an important component of the diet for tion. This component of the diet is known as digestible
rabbits (see Box 1.2). Fibre is defined as ‘that portion or fermentable fibre. Within the caecum the digestibil-
of ingested foodstuffs that cannot be broken down by ity of fibre depends on the chemical composition and
intestinal enzymes and juices of monogastric animals size of the particle. The ease with which bacteria can
and therefore passes through the small intestine and degrade fibre particles depends on the molecular struc-
colon undigested’ (Blood and Studdert, 1999). This ture and chemical properties of the fibre and the sur-
definition is confusing in ruminants and hindgut face area to which the bacteria can adhere.

28
 Rabbit Basic Science 1
Fibre is composed of plant cell walls. Plant cell and cellulose combine to provide structural rigidity
walls consist of complex carbohydrates such as to plants. Strong chemical bonds exist between lig-
polysaccharides, oligosaccharides, cellulose, hemi- nin and plant polysaccharides and cell wall pro-
cellulose, gums and pectins, which are embedded teins that reduce the digestibility of these
in a lignin matrix. Most of these molecules can be compounds. Lignin is almost completely indigest-
broken down and digested by caecal fermentation. ible and the lignin content of plants increases with
Some components such as oligosaccharides are age. Lignin is present in large quantities in wood,
water soluble, whereas most components such as hulls and straw.
pectins, cellulose and hemicellulose are insoluble. Therefore, in rabbits, fibre can be classified as
Hemicelluloses and pectins are the substances that either indigestible or fermentable. Indigestible fibre
glue plant cells together. Cellulose is a linear poly- is composed of particles larger than 0.3–0.5 mm.
mer of glucose that forms the skeleton of most plant Their chemical composition is not important, as
structures and plant cells in which it can be closely asso- these particles do not return to the caecum. These
ciated with lignin. Lignin is not a carbohydrate but particles are mostly made up of lignin and cellulose.
a complex cross-linked structure made up of many Fermentable fibre is composed of particles smaller
phenylpropanoid units (this is a structural polymer than 0.3–0.5 mm and the digestibility is greatly
found in plants, synthesized from the amino acid affected by their chemical composition (see
phenylalanine) (McDonald et al., 1996). Lignin Figure 1.6).

Fibre

Fermentable i.e. Undigested food that has Indigestible

(digestible) fibre reached the caecocolic junction. fibre
Small particles Large particles
<0.3mm are moved >0.5mm are moved
into the caecum into the colon
Consists of plant cell
walls composed of:

Caecum Pectins Colon

Small particles are broken Large fibre particles
down and fermented by are expelled in hard
Hemicellulose
caecal micro-organisms. faecal pellets
Ease of degradation or
'digestibility' varies according Cellulose
to structure of molecule.
e.g. Cellulose is less digestible
than hemicellulose. Lignin

Hemicellulose, cellulose and lignin

are bound together to form large particles.
Digestibility can be increased by physically
reducing the particle size by grinding.

Figure 1.6 Digestion of fibre in rabbits. Some precaecal digestion of fibre takes place by enzymes in the stomach and small
intestine. Fibre that reaches the hindgut is either degraded by caecal microflora or expelled undigested. The proximal colon is
adapted to separate indigestible fibre from fibre that can be fermented in the caecum. Large undigestible fibre particles pass into the
colon and are expelled rapidly. Small particles pass into the caecum to undergo bacterial fermentation. Indigestible fibre promotes gut
motility but does not have any nutrient value. Digestible (fermentable) fibre provides nutrients but has no direct effect on gut motility.

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 Textbook of Rabbit Medicine

1.3.15.2.2 Digestion of fermentable fibre within the consideration as it alters the way in which fibre is
caecum separated in the proximal colon. Grinding fibre to par-
In rabbits, there is evidence that partial digestion of ticles small enough to be moved into the caecum
fibre can take place in the stomach and small intes- rather than colon detracts from the beneficial
tine by the action of enzymes such as pectinases effect of indigestible fibre on intestinal motility. There
and xylanases (Gidenne et al., 1998). However, most is general agreement that screen sizes for production
digestion of fibre takes place by the microbial flora of complete compound feeds should be 2 mm. Screen
within the caecum. Digestibility within the caecum sizes of 1 mm induce digestive upsets (Lowe, 1998).
depends on the nature of the plant material and, to Some cell wall constituents, such as pectins and
a lesser extent, processing procedures. Hemicellu- gums, are hydrophilic and tend to form gels in com-
loses and pectins are broken down more easily than bination with water. This property is used to produce
cellulose, which requires degradation by cellulolytic bulk laxatives for use in humans because the com-
bacteria and requires time for attachment of the bac- pound takes up water in the digestive tract and
teria to the cell wall before degradation starts. Degra- increases the volume of faeces and promotes peristal-
dation of cellulose takes longer than hemicellulose sis. In rabbits, these compounds are moved into the
because of its linear polymer structure (Gidenne caecum where they absorb water and increase reten-
et al., 1998), so it is less fermentable than hemicellu- tion time. Caecal impactions have been associated
lose. Cellulose can be closely associated, both chem- with the use of bulk laxatives in rabbits.
ically and physically, with other compounds such as
hemicellulose and pectin and affect their digestibil- 1.3.15.2.3 The importance of indigestible fibre
ity. It can also be combined with lignin. The digest- Rabbits have a natural appetite for fibrous foods.
ibility of fibre within the caecum affects the They will strip and eat bark, will chew roots and
rabbit’s appetite and growth rate. Grinding down lig- dried fibrous vegetation and may eat hay in prefer-
nin so that it passes into the caecum depresses volun- ence to fresh green foods. Indigestible fibre plays
tary food intake in comparison with cellulose that is an important role in maintaining good health in
more fermentable (Chiou et al., 1998). rabbits. Chewing and grinding food wears the
The chemical structure of fibre molecules gives teeth and helps to maintain normal dental occlu-
them a buffering capacity that is dependent on the sion. A diet deficient in fibrous material has been
concentration of carboxyl, amino and hydroxyl implicated in cheek tooth overgrowth (Crossley,
groups (Gidenne et al., 1998). The type of fibre has 1995). Diets low in indigestible fibre predispose
an effect on caecal pH, which, in turn, can affect to gastrointestinal hypomotility and the retention
the balance of caecal microflora. For example, wheat of food and hair in the stomach, which forms tri-
straw tends to increase caecal pH, whereas beet pulp chobezoars (hairballs). Slow gut motility and
decreases it. Balanced sources of fibre such as alfalfa increased food retention time in the hindgut can
do not modify caecal pH (Gidenne et al., 1998). result in alterations in gut flora and the develop-
Particle size within the caecum affects retention ment of enterotoxaemia. The provision of a diet
time for microbial fermentation (Gidenne et al., high in indigestible fibre to house rabbits reduces
1998). Small particles have a larger surface area for the ingestion of non-food items such as carpet
bacteria to adhere to. The particle length of fibre fibres or plastic litter trays. Fur chewing and
depends on the plant source and processing proce- barbering is also linked to low fibre diets
dures. Digestibility of lignified material can be (Quesenberry, 1994). Diets containing low dietary
increased by alkali treatment to dissolve lignin and fibre depress voluntary food intake (Bellier and
release cellulose and other compounds for microbial Gidenne, 1996).
degradation. Grinding down lignin to small particles Fibre has an effect on caecotrophy. The amount of
causes it to be retained in the caecum where it cannot fibre in the diet affects the time that digesta is
be digested. The degree of grinding is an important retained in the caecum for microbial fermentation.

30
 Rabbit Basic Science 1
Carabaño et al. (1988) measured the weight of soft often overlooked. It is known that less than 10%
faeces produced by rabbits fed varying levels of fibre. crude fibre results in caecal acidosis and results in a
The weight of soft faeces was then compared to the high incidence of enteritis. Crude fibre levels of
weight of caecal contents. They found that a relatively 10–15% are recommended for commercial rabbits
small amount of the caecal contents were removed for optimal growth rates (Cheeke, 1987).
each day in rabbits fed diets containing less than In contrast to commercial rabbits, pet rabbits are
14% fibre. In rabbits consuming a diet of greater than not growing and do not need to convert food effi-
14% fibre, the caecal material was almost entirely ciently. The indigestible fibre component of the diet
removed each day. Diets high in indigestible fibre is of greater importance than fermentable fibre. In
increase the rabbit’s appetite for caecotrophs pet rabbits, it is important to promote intestinal
(Fekete and Bokori, 1985). The fibre content of cae- motility and prevent obesity. Lowe (1998) recom-
cotrophs is proportional to the crude fibre level of mends crude fibre levels of 13–20% for pet rabbits
the diet, although their dry matter content is unaf- with a level of 12.5% indigestible fibre. Jenkins
fected by changes in dietary fibre content (1991) recommends a level of 18–24% fibre for
(Carabaño et al., 1988). Indigestible fibre has no pet rabbits, although the type of fibre is not specified.
effect on the composition of caecotrophs because The fibre analysis of some ingredients of rabbit foods
large fibre particles do not enter the caecum and is summarized in Table 1.2. For pet rabbits, a perma-
are excreted in the hard faecal pellets. nent source of indigestible fibre such as ad lib grass or
hay will ensure adequate fibre levels as long as the
1.3.15.2.4 Recommended dietary fibre for rabbits rabbit actually eats it. Soiled, unpalatable hay or
The fibre content of a diet is often expressed as ‘crude underlying dental disease can substantially reduce
fibre’. This term refers to the percentage of the original indigestible fibre intake.
food that remains after boiling in acid and alkali alter-
nately. Crude fibre is mainly a measurement of the lig- 1.3.15.2.5 Sources of fibre for pet rabbits
nin and cellulose component of the diet and does not Concentrated foods usually include a fibre source,
include other fermentable fibre components. Neither such as grass or alfalfa. The fibre must be processed
does crude fibre analysis give an indication of particle in some way to incorporate it into the food, which
length or the effect on gut motility. can affect its digestibility and its effect on gut motil-
An alternative measurement of fibre is ‘neutral ity. Grass and hay are good sources of fermentable
detergent fibre’ (NDF) and ‘acid detergent fibre’ (ADF). and indigestible fibre for rabbits. Hay can be pro-
The NDF is made up of cell wall constituents – pectins, vided in addition to, or instead of, grass. It is not only
cellulose, hemicellulose, lignin, etc. ADF is the residue a source of fibre but also enriches the environment
of NDF after acid extraction of the feed sample and and prevents abnormal behaviour (Berthelsen and
is mainly indigestible lignocellulose complex. Diges- Hansen, 1999). Alfalfa is a source of fibre used in
tible hemicellulose is the difference between NDF commercial rabbit diets in many countries. Alfalfa
and ADF. ADF gives a better indication of indigestible hay not only provides fibre but also has a high cal-
fibre content than crude fibre. cium content. Alfalfa hay is now commonly available
Recommended dietary fibre levels for rabbits vary in the UK. Meadow hay suitable for feeding to pet
between texts. In many cases, crude fibre figures that rabbits is available from most pet shops. Meadow
are not particularly helpful are given. Dietary fibre hay is preferable to alfalfa for pet rabbits. Fresh grass
requirements have been determined for commercial is the ideal food and rabbits have evolved to live on
rabbits but not for pet ones. Rabbits used for meat it. Garden weeds are also a source of fibre and give
production need to grow rapidly and convert food variety to the diet. Pet rabbits that are allowed free
efficiently. The digestibility of the fibre content of access to a garden will browse on a selection of
the diet is an important consideration for peak per- plants. They have their own individual likes and dis-
formance. The importance of indigestible fibre is likes and will eat tough fibrous vegetation as well as

31
 Textbook of Rabbit Medicine

Table 1.2 Fibre analysis of some rabbit foods

Analysis on dry matter basis
Crude fibre: The crude fibre content is determined by boiling an ether extracted food sample in dilute acid and
alkali alternately before burning in a furnace. The difference in weight before and after burning is the crude fibre
fraction. This is not an accurate measurement as many cell wall components are destroyed during process.
Historically, this is the measurement that is included in food analysis tables (Cheeke, 1987).
Neutral detergent fibre (NDF) is the percentage of food remaining after boiling in neutral detergent that leaves
most components of cell wall intact.
Acid detergent fibre (ADF) is the percentage of NDF that remains after boiling in acid, which removes the
hemicellose component.
Indigestible fibre is represented by ADF.
Hemicellulose is represented by difference between NDF and ADF. Hemicellulose is fermented in the
caecum.

NDF 2 ADF
ADF (indigestible (hemicellulose
Ingredient Crude fibre (%) NDF (%) fibre guide) (%) content) (%) Comments

Alfalfa 30.2 49.3 37.5 11.8

Beet, sugar 20.3 32.1 17.9 14.2 High in starch and
sugars
Beans 8 16.8 12.3 4.5
Bran 11.4 47.5 13.7 33.8
Cabbage 17 24.4 13.6 10.8
Carrots 9.4 13.4
Grass, dried 21 54.1 28.2 25.9
Grass growing 13 57.7 29.6 28.1 Fibre content varies
with stage of growth
Hay (poor quality) 38 74.1 45.2 28.9
Hay (good quality) 29.8 65 36.4 28.6
Kale 17.9 24.3 19.7 4.6
Maize 2.4 11.7 2.8 8.9 High in starch
Oats, rolled 10.5 31 14.9 16.1 High in starch
Oats, naked 4.5 11.4 4.2 7.2 High in starch
Peas 6.3 11.6 7.6 4
Straw (wheat) 41.7 80.9 50.2
Swedes 10.0 14 12.5 1.5 High in starch
Reference sources: Cheeke, P. (1987). Rabbit Feeding and Nutrition. Academic Press. San Diego. McDonald, P. et al. (1995). Animal Nutrition, 5th edn.
Longman, London.

32
 Rabbit Basic Science 1
soft new shoots. Tree leaves are eaten, especially in tract by providing the correct substrate for the pro-
the autumn when the leaves have fallen and are liferation of desirable bacterial species such as bifido-
within easy reach. Leaves from apple and hazel are bacteria (Campbell et al., 1997). Certain plants such
especially enjoyed by rabbits (Richardson, 1999). as chicory, asparagus, bananas and artichokes contain
Bark may be stripped from branches and from the fructo-oligosaccharides that stimulate the growth of
base of trees. Exposed roots may be chewed through. Bifidobacterium spp. in the human colon: hence the
Young docks, brambles, raspberry leaves, sow thistle, term ‘bifidogenesis’, which may be used to describe this
chickweed, groundsel, dandelions, clover, plantain, effect. Fructo-oligosaccharides have been called
goose grass, ground elder and vetches are among a ‘prebiotics’, as the principle of their beneficial effects
host of plants enjoyed by pet rabbits. Annual bedding is similar to probiotics, i.e. to encourage the growth
plants, herbs and other decorative garden shrubs of beneficial bacteria and inhibit pathogenic species.
will also be enjoyed and destroyed by a rabbit that is Fructo-oligosaccharides are utilized by Bacteroides
given the run of the garden. These can provide a good spp. that prevail in healthy caecal microflora of rabbits.
source of nutrition as well as environmental enrich- Fructo-oligosaccharides increase calcium, magnesium
ment; however, where damage to these plants would and iron absorption from the colon and rectum of
prove upsetting, garden access should be supervised. rats (Ohta et al., 1995a,b) and reduce serum trigly-
Fresh fruit and vegetables can be fed as an additional ceridaemia in humans (Roberfroid, 1997). In rabbits,
source of fibre, especially when natural vegetation is a reduction in morbidity after the introduction of
scarce. Broccoli, Brussels sprouts, cabbage, spring cab- pathogenic E. coli has been reported in rabbits fed on
bage, carrots, carrot tops, celery, cauliflower leaves, a fructo-oligosaccharide-supplemented diet (Maertens
maize plants, pea pods, swedes, corncobs, spinach,kale and Villamide, 1998). Fructo-oligosaccharides are now
and culinary herbs are all enjoyed by rabbits. Although included in many proprietary rabbit foods.
there can be problems if a single item is fed all the
time, a mixed diet including three different items
each day is safe. Fruit and succulent salad items such as
1.3.15.4 Protein
lettuce, tomatoes and cucumber are poor fibre sources Proteins are made up of essential and non-essential
and can lead to transient uneaten soft caecotrophs. amino acids. Essential amino acids are those not syn-
These should be reserved for occasional treats. thesized by the animal and must be ingested in the diet.
The requirement for essential amino acids is affected by
growth, lactation, pregnancy and wool production.
1.3.15.3 Oligosaccharides Certain amino acids can be partly replaced by other
Oligosaccharides are molecules with a low degree of amino acids. For example, methionine can be replaced
polymerization that are not digested by enzymes in by cystine, and tyrosine can partly replace phenylala-
the digestive tract but are rapidly degraded and fermen- nine. Although rabbits have an essential amino acid
ted by caecal microflora (Blas and Gidenne, 1998). Oli- requirement (see Box 1.3), the situation is complicated
gosaccharides can be classified as ‘soluble fibre’ as they by caecotrophy. Micro-organisms within the caecum
are water soluble. The type of oligosaccharide is synthesize amino acids that are absorbed from the
important in its effect upon the microbial popu- caecotroph during digestion. The amino acid com-
lation. A diet containing gluco-oligosaccharides that position of soft faeces is affected by the microbial
release glucose after hydrolysis in the caecum causes population and the digestibility of dietary protein.
diarrhoea in young rabbits, whereas fructo- or Herbivores such as wild rabbits obtain their pro-
galacto-oligosaccharides do not have the same effect tein entirely from plants, although animal protein
(Lebas et al., 1998). Currently, there is considerable such as fish, meat or bone meal has been used histor-
interest in fructo-oligosaccharides because they are ically in commercial feeds for rabbits (Cheeke, 1987).
reputed to be beneficial in the human gastrointestinal Proprietary pet foods for rabbits no longer contain

33
 Textbook of Rabbit Medicine

maintenance of non-productive pet rabbits that are

Box 1.3 Essential amino acid requirement
prone to obesity. High dietary protein reduces the
of rabbits
rabbit’s appetite for caecotrophs. Excess dietary pro-
Arginine tein alters the caecal microflora and increases the pH,
Glycine thereby predisposing the proliferation of pathogenic
Histidine bacteria (Cheeke, 1994). High dietary protein also
Isoleucine increases ammonia production and excretion and
Leucine reduces air quality in poorly ventilated housing. This
Lysine
irritates mucous membranes, thereby contributing to
Sulphur amino acids:
Methionine þ cystine
the development of upper respiratory tract and con-
Phenylalanine þ tyrosine junctival infections.
Threonine Insufficient dietary protein or essential amino acid
Tryptophan deficiency results in impaired protein synthesis and
Valine poor tissue regeneration. Excessively low protein
diets should be avoided and some consideration of
From Lang (1981a).
the protein quality is important for the pet rabbit
animal-derived protein. Plant proteins can be divided (Lowe, 1998). Rabbits that do not eat their caeco-
into two major classes – seed and leaf proteins. Seed trophs or selectively eat a restricted diet can suffer
proteins are contained in the endosperm and in the from essential amino acid deficiency. Lysine and
outer bran layer. The proteins of forage plants are methionine are most likely to be the limiting essen-
concentrated in the leaves, tightly bound to cellulose tial amino acids. Protein levels of 12–16% are ade-
in the cell wall. The digestibility of protein varies ac- quate for pet rabbit rations (Lowe, 1998).
cording to its source and is also influenced by the age
of the animal. Dietary protein levels are important to
produce good growth rates and performance in com-
mercial rabbits and are a major consideration for 1.3.15.5 Fats
commercial rabbit feeds. High protein levels are not The digestion and absorption of fats in rabbits is
required for maintenance of unproductive pets. similar to monogastric animals. Fat globules are
Grass is a source of protein and amino acids for rab- emulsified by the action of bile salts before being
bits. The protein content of grass decreases with matu- broken down by pancreatic lipase and absorbed
rity, although the relative proportions of amino acids from the small intestine. Fats and oils have been used
do not alter greatly and are similar between plant in rabbit rations to provide an energy source that
species (McDonald et al., 1996). Grass is rich in argi- avoids carbohydrate overload of the hindgut. Dietary
nine, glutamine and lysine but methionine and iso- fat reduces intestinal absorption of calcium due to
leucine are limiting. Cereal proteins are deficient in the formation of calcium soaps in the gut. Fat
certain amino acids, particularly lysine and methionine. stimulates gastrointestinal motility and improves
Legume seeds such as peas and beans are good sources palatability of the diet. Vegetable oils are more
of protein and their high lysine content is often used digestible than animal fats (Cheeke, 1987). The fat
to balance the lysine deficiency of cereals in mixed content affects the keeping quality of pellets and
rations. Supplementation with sulphur-containing the cost of production.
amino acids such as methionine and cysteine is For pet rabbits, high dietary levels of fats and oils
required for wool production by Angora rabbits are disadvantageous due to the propensity of rabbits
(Lebas et al., 1998). to become obese. High fat diets increase the risk of
The optimum dietary protein level for maximum hepatic lipidosis by altering lipid metabolism and
growth is 16% and 18–19% for lactation (Cheeke, promoting ketogenesis and hypoglycaemia during
1994). This level of protein is excessive for the periods of starvation (Jean-Blain and Durix, 1985).

34
 Rabbit Basic Science 1
Obese animals with a fatty liver are at great risk of antioxidants can reduce the loss. Cereals, with the
developing fatal fatty degeneration of the liver and exception of yellow maize, are poor sources of
kidneys if they become anorexic. b-carotene.
Most commercial diets contain 2.5–4.0% fat, but Grazing animals generally obtain more than ade-
treat foods such as chocolate drops or sweet biscuits quate amounts of b-carotene to convert to vitamin A
contain higher amounts. from pasture and build up liver reserves. Deficiency
is rare in farm animals that are fed on silage and
well-preserved hay over the winter months, although
vitamin A deficiency has been reported in cattle housed
1.3.15.6 Vitamins indoors on high cereal rations (McDonald et al., 1996).
1.3.15.6.1 Vitamin A Rabbits housed indoors or in hutches and fed on
Vitamin A, or retinol, is a fat-soluble, organic alcohol cereal mixtures and poor-quality hay are candidates
formed in animal tissues from carotenoid pigments for vitamin A deficiency if they do not eat the parts
in plants of which b-carotene is the most important. of the diet that contain the vitamin and mineral sup-
b-Carotene is converted to vitamin A primarily in the plement. Because of the role of vitamin A in the
intestinal mucosa and is stored in the liver, from maintenance of epithelial tissues and mucous mem-
where it is transported, protein bound, to cells branes, deficient animals are susceptible to disease
according to metabolic need. Preformed vitamin A and infection. A high incidence of enteritis occurs
is only found in animal tissues; plants only contain in vitamin A-deficient rabbits (Cheeke, 1994).
vitamin A precursors. Experimental vitamin A deficiency has been stud-
Vitamin A is necessary for vision, bone develop- ied in rabbits. Retarded growth and weight loss occur
ment, maintenance of epithelial integrity, reproduc- in growing animals with the development of neuro-
tion and immunological response. Retinol makes up logical symptoms in severe cases. Hydrocephalus and
part of a retinal pigment, rhodopsin, which is neces- cerebellar herniation can occur in immature rabbits
sary for vision, especially in dim light. Vitamin A is (Phillips and Bohstedt, 1937). In the adult, eye
required by epithelial tissue and deficiency results lesions can be the first sign of deficiency, with the
in squamous metaplasia and keratinization. Vitamin development of keratitis that progresses to iridocycli-
A also plays an important role in combatting infec- tis, hypopyon and permanent blindness (Hunt and
tion and has been termed the ‘anti-infective vitamin’. Harrington, 1974). Lacrimal gland tissue and the
In several species, vitamin A deficiency is accompa- bone surrounding the optical foramen has been
nied by low levels of immunoglobulins, although found to be unaffected by vitamin A deficiency,
the exact function of the vitamin in the formation although these tissues are affected in other species
of these proteins is unknown (McDonald et al., (Fox et al., 1982; Ubels and Harkema, 1994). Repro-
1996). Growth and reproduction are affected by ductive problems such as fetal malformations, low
vitamin A deficiency, leading to depressed fertility fertility and abortions have been associated with
in both males and females. Excessive quantities of both vitamin A deficiency and excess (Cheeke,
vitamin A lead to toxicity with symptoms similar to 1987). Intercurrent disease such as hepatic coccidio-
those of deficiency. sis due to Eimeria stiedae infection can interfere with
The vitamin A precursor (b-carotene) content of vitamin A metabolism and therefore increase dietary
plants varies considerably. The long hydrocarbon requirement.
chain is easily oxidized, especially when exposed to Vitamin A activity is expressed in international
heat, light, moisture and heavy metals (McDonald units (IU) and the dietary requirement for rabbits
et al., 1996). Exposure to sunlight during the curing has been quoted from 6000 (for growing rabbits)
process destroys much of the b-carotene in hay or to 10,000 IU/kg for breeding does (Mateos and de
alfalfa. Storage and rancidity of feeds also reduces Blas, 1998) to 10,000–18,000 IU/kg (Lowe, 1998).
b-carotene content, although the addition of The National Research Council (1987) recommends

35
 Textbook of Rabbit Medicine

the addition of no more than 16,000 IU as the safe

Box 1.4 Definition of terms relating to vitamin D
upper level. Fresh green foods and grass are good
sources of vitamin A. Vitamin D: A group of closely related steroids with
anti-rachitic properties.
1.3.15.6.2 Vitamin D Vitamin D2 (ergocalciferol, calciferol): An
Vitamin D is a fat-soluble vitamin that is also a hor- exogenous provitamin formed from ergosterol in
mone which plays an important role in calcium and plants when they are exposed to ultraviolet light.
phosphorus metabolism. A vitamin is defined as ‘an Vitamin D2 is converted to 25-OH-D in the liver.
Vitamin D3 (cholecalciferol): An endogenous
organic substance found in foods that is essential in
provitamin that is converted to 25-OH-D in the
small quantities for growth, health and survival’ liver.
(Blood and Studdert, 1999). A hormone is defined Vitamins D4 and D5: These vitamins occur naturally
as ‘a chemical transmitter substance produced by in the oils of some fish.*
cells of the body and transported by the bloodstream Ergosterol: A sterol that occurs in plants. It is
and other means to the cells and organs which carry converted to vitamin D2 under exposure to
receptors for the hormone and on which it has a spe- ultraviolet light.
cific regulatory effect’ (Blood and Studdert, 1999). 7-Dehydrocholesterol: A derivative of chlolesterol
Therefore, vitamin D is both vitamin and hormone that is metabolized to vitamin D3 in skin exposed
and has a range of physiological effects in addition to ultraviolet light.
to its role in calcium metabolism. Vitamin D recep- 25-OH-D (25-hydroxycholecalciferol, calcifediol,
25-dihydroxyvitamin D): A metabolite of vitamin
tors are found in many tissues including the stom-
D formed and stored in the liver. There is a
ach, brain, pituitary gland, gonads, parathyroid negative feedback controlling the conversion of
glands, epidermis, dermis, monocytes and activated provitamins (vitamins D2 and D3) to 25-OH-D.
T and B lymphocytes, although the exact physiolog- 1,25(OH2)D (1,25-dihydroxycholecalciferol, calcit-
ical action in these tissues is unclear (Holick, 1990). riol, 1,25-dihydroxyvitamin D): The active
There are several metabolites of vitamin D that are metabolite of vitamin D formed in the kidney
either ingested in the diet or synthesized in the body. from 25-OH-D under the influence of parathyroid
The number of terms and abbreviations that refer to hormone (PTH) that is released in response to
vitamin D and its metabolites can be confusing. low serum calcium concentrations.
These terms are defined in Box 1.4. *From Blood et al. (1979).
Ultraviolet light is required to convert an endoge-
nous vitamin D precursor, 7-dehydrocholesterol, to
pre-vitamin D3 in the skin. Further conversion to hormone (PTH) released from the parathyroid gland
vitamin D3 (cholecalciferol) takes place before it is in response to low serum calcium concentrations.
transported to the liver, bound to plasma protein. The main function of vitamin D is to maintain
Plants contain a different vitamin D precursor, ergos- serum calcium levels within the normal range. This
terol, which is also converted by ultraviolet light to is achieved by its effects on the intestinal absorp-
produce ergocalciferol or vitamin D2. This process tion of calcium, mobilization of calcium to and
takes place in the plant when vegetation, such from bone and renal regulation of calcium excretion.
as hay, dries in the sunshine. Ergocalciferol is 1,25(OH)2D stimulates intestinal absorption of
transported, protein bound, from the gut to the calcium and osteoclastic activity in bone. High quan-
liver where, like vitamin D3 (cholecalciferol), it is tities of vitamin D causes bone resorption and
hydroxylated to form 25-hydroxycholecalciferol raise blood calcium levels. Low quantities of vitamin
(25-OH-D), which is, in turn, converted to the active D reduce intestinal absorption and renal conservation
vitamin D metabolite 1,25-dihydroxycholecalciferol of calcium and result in a drop in blood calcium,
(1,25(OH)2D) in the kidney. Conversion of which stimulates PTH release. PTH stimulates
25-OH-D to 1,25(OH)2D is stimulated by parathyroid bone resorption to release calcium and restore blood

36
 Rabbit Basic Science 1
levels. Therefore, osteomalacia can result from both 30
deficiency and excess of vitamin D. Elevated PTH con-
centrations stimulate the kidney to conserve calcium. 25

1,25-(OH)2D3 pmol/L
Vitamin D toxicity can be the result of excessive 20
dietary intake. Intestinal absorption of calcium and
osteoclastic activity are increased and result in blood 15
levels that exceed the renal capacity for excretion. 10
This leads to deposition of calcium in soft tissue such
as the aorta and kidney. 5 Free-range rabbits
Vitamin D deficiency can arise from inadequate Hutch rabbits
dietary intake of exogenous precursors, or inade- sem 8.27 sem 0.89
quate exposure to ultraviolet light that is required
for conversion of endogenous precursors. Deficiency Figure 1.7 Mean (sem) plasma vitamin D (1,25-(OH)2D3
concentration in pet rabbits. During the spring, blood
of vitamin D results in rickets in growing animals and
samples were taken from seven rabbits that lived in hutches and
osteomalacia in adults. In humans, vitamin D defi- four rabbits that had been kept under free-range conditions with
ciency is now recognized as a major cause of meta- unlimited access to natural daylight through the winter months.
bolic bone disease in elderly people (Holick, 1996). The samples were spun and the plasma frozen immediately
before shipping in a frozen state to a laboratory for 1,25-(OH)2D3
The role of vitamin D in calcium regulation in rab-
assay. Four rabbits, one from the free-range group and three
bits differs from that in other species. Vitamin D does from the hutch group, had undetectable plasma 1,25-(OH)2D3
not appear to play the same regulatory role in intes- concentrations (< 2.5 pmol/L), indicating that vitamin D
tinal absorption as in other mammals. Studies into deficiency can be present in pet rabbits, especially after the
winter. The rabbits were kept in North Yorkshire where
chronic vitamin D deficiency in adult rabbits indicate winter sunshine is minimal. In laboratory rabbits kept without
that intestinal absorption of calcium is passive and exposure to ultraviolet light and fed on a vitamin D-deficient diet,
efficient and does not require vitamin D (Bourdeau it takes approximately 5 months for serum concentrations of
et al., 1986). However, vitamin D increases intestinal 25-OH-D and 1,25-(OH)2D3 to become undetectable. (From
Fairham and Harcourt-Brown (1999), reprinted with permission
absorption of calcium and is required if dietary levels from Veterinary Record.)
are low (Brommage et al., 1988; Tvedegaard, 1987).
In rabbits, vitamin D plays an important role in
phosphorus metabolism. Vitamin D deficiency results Undetectable serum concentrations of 1,25(OH)2D
in a reduction in intestinal absorption of phosphorus. have been found in pet rabbits during the spring
Experimental studies have shown that chronic vita- after they were confined to hutches for the winter
min D deficiency can result in hypophosphataemia (see Figures 1.7 and 1.8). Pet rabbits kept under free-
and osteomalacia (Brommage et al., 1988). range conditions with unrestricted access to natural
Photosynthesis of vitamin D takes place in the daylight through the winter had significantly
skin of fur- and fleece-bearing animals such as horses higher 1,25-(OH)2D3 concentrations (Fairham and
and sheep, although it is absent from some carnivo- Harcourt-Brown, 1999). Vitamin D deficiency may
rous species such as cats, which obtain vitamin D be a contributory factor in the development of
from prey (How et al., 1994). Sunlight is required dental disease (see Section 5.5.1.1).
for endogenous vitamin D synthesis by rabbits. Rick- Vitamin D is rare in foods. Liver and animal fats are
ets can be induced in growing rabbits by keeping a source of vitamin D for carnivorous species but not
them in the dark or under artificial light (Curry for an obligate herbivore such as a rabbit. Instead,
et al., 1974; Kato, 1966). It takes approximately vitamin D must be metabolized endogenously or
5 months for serum concentrations of 25-OH-D obtained from a dietary source such as sundried veg-
and 1,25(OH)2D to become undetectable in rabbits etation or a vitamin supplement. Irradiated plant ste-
on a vitamin D-deficient diet (Brommage et al., 1988; rols with anti-rachitic potency occur in the dead leaves
Nyomba et al., 1984). of plants or sun-cured hays rather than in the green

37
 Textbook of Rabbit Medicine

50
intake in the wild. There is also an interaction between
Rejected vitamin A and vitamin D. Vitamin A appears to inten-
Selected sify the severity of rickets and inhibit the ability of vita-
40 min D to cure the disease. Vitamin A administration
Percentage of rabbits surveyed

to rats produced a decrease in total bone ash,

increased the epiphyseal bone width and eliminated
30
the ability of vitamin D to elevate serum calcium
levels in a study by Rohde et al. (1999).
20 Commercial rabbit pellets are supplemented with
vitamin D. In a study by Warren et al. (1989) rabbits
from a breeding farm were found to have blood levels
10
of 25-OH-D ten times higher than their laboratory
counterparts despite comparable 1,25(OH2)D
values. The diet of the farmed rabbits contained
Pellets Grain Oats Maize Peas Biscuit 2200 IU/kg of vitamin D; yet PTH and serum total
(corn) and ionized calcium values were not statistically
different from the laboratory rabbits. Vitamin D toxic-
Figure 1.8 Selective feeding in rabbits. Results of owner
questionnaire: food preference of pet rabbits. Ninety rabbit ity has caused soft tissue mineralization in rabbits
owners completed a questionnaire about the feeding habits that were erroneously fed excessive quantities of sup-
of their pet. All the rabbits were fed on mixed rations purchased plement (Zimmerman et al., 1990). Dietary levels
as ‘rabbit food’. Hay was offered to all the rabbits in the survey
although they did not always eat it. Some rabbits were given
above 2300 IU/kg appear to be toxic (Cheeke,
additional vegetables or allowed to graze in a run periodically 1987). A level of 800–1200 IU/kg is recommended
through the summer months. In nearly every case, a bowl of for pet rabbits (Lowe, 1998). In view of the risk
‘rabbit food’ was left with the rabbit permanently. Discarded of inducing vitamin D toxicity by dietary administra-
food was thrown away and the bowl topped once or twice daily.
This feeding practice allowed rabbits to select their favourite
tion, it seems sensible to expose rabbits to sunlight
food items and eat nothing else. Some rabbits existed on one or so they can synthesize their own vitamin D rather
two ingredients. The low calcium cereals and peas were the than rely on dietary supplementation. Sunlight has
rabbits’ favourite part of the ration. The pellets that contain a many beneficial physiological and psychological
vitamin and mineral supplement were the least palatable part of
the mixture. However, some rabbits would eat the entire mixture effects.
and a minority would select the pellets. (From Harcourt-Brown
(1996), reprinted with permission from Veterinary Record.) 1.3.15.6.3 Vitamin E
Vitamin E or a-tocopherol is a fat-soluble vitamin
that acts synergistically with selenium in most ani-
leaves of growing plants. Therefore vitamin D content mals and prevents oxidative damage to tissues caused
of the natural diet increases when potential for endog- by peroxides. Peroxides are formed during normal
enous synthesis is reduced. Variation in the vitamin D metabolic processes and are detoxified during a pro-
content of hay can occur with different methods of cess catalysed by glutathione peroxidase, which con-
curing. Exposure to irradiation by sunlight for long tains selenium. Vitamin E is a natural antioxidant
periods causes a marked increase in anti-rachitic that inactivates the peroxides that cause widespread
potency of cut fodder, whereas modern haymaking tissue damage. Vitamin E is also involved in blood
techniques with its emphasis on rapid curing clotting, stability of membrane structure and mainte-
tends to keep vitamin D levels at a minimum nance of immunity. Vitamin E and/or selenium defi-
(Blood et al., 1979). Rabbits enjoy eating dried vege- ciency classically results in nutritional muscular
tation such as fallen tree leaves in the autumn and dystrophy, which has been described in rabbits
will often eat them in preference to the grass available (see Section 10.6.1.4). Other effects of deficiency
at that time. This is where they get oral vitamin D include myocardial damage, exudative diathesis,

38
 Rabbit Basic Science 1
hepatosis, increased incidence of lactation problems conditions. Unlike other B vitamins, choline must
and reproductive failure. be synthesized in the liver, and a deficiency can con-
Green forages and cereals are good sources of vita- tribute to hepatic lipidosis and necrosis (Mateos and
min E. Young grass contains more vitamin E than de Blas, 1998). In cases of reduced liver function it
mature herbage. Leaves contain 20–30 times as much may be sensible to consider supplementation. Vita-
vitamin E as stems and up to 90% can be lost during min B12 requires cobalt, which could be a limiting
haymaking, although losses are lower during artifi- factor in the diet.
cial drying. Similarly, the vitamin E activity of cereal
can decline rapidly if the grain is kept under moist
1.3.15.6.6 Vitamin C
conditions (McDonald et al., 1996).
Vitamin C or ascorbic acid is synthesized from glucose
In rabbits, intercurrent liver disease caused by
in the liver by most mammals. In these species it is not
Eimeria stiedae infection affects the metabolism of
strictly a vitamin. It is required for the maintenance
fat-soluble vitamins and predisposes to the develop-
and repair of connective tissue, and plays a protective
ment of muscular dystrophy. The requirement
role in many oxidative biochemical processes. Ascor-
for vitamin E increases with dietary levels of polyun-
bic acid is stored in tissues with high metabolic activity
saturated fatty acids and vegetable oils. A dietary level
such as adrenal glands, hypophysis and leucocytes
of 40–70 mg/kg has been suggested for pet rabbits
(Verde and Piquer, 1986). Rabbits can synthesize vita-
(Lowe, 1998).
min C. However, there is evidence that the vitamin C
requirements of rabbits increase during periods of
1.3.15.6.4 Vitamin K
stress (for example, overheating, transport, subclinical
Vitamin K is a clotting factor. Deficiency causes
disease) when plasma ascorbic acid has been shown
impaired blood clotting, resulting in haemorrhagic
to decrease significantly as synthesis does not match
disorders including lameness in growing rabbits,
demand (Verde and Piquer, 1986). Under these con-
and abortion in pregnant does. Recent evidence sug-
ditions supplementation may be useful (Mateos and
gests that vitamin K also has a role in the formation
de Blas, 1998). Administration of vitamin C in con-
of bone (McDowell, 1989). Vitamin K is produced
junction with vitamin E prevented an increase in liver
by caecal micro-organisms and is a constituent of cae-
enzymes in rabbits experimentally infected with Try-
cotrophs. Grass also contains vitamin K. Deficiencies
panosoma brucei brucei (Umar et al., 1999) and an
are unlikely to occur in pet rabbits. However, in cases
improved reproductive performance in rabbits under
of subclinical coccidiosis or where certain oral medi-
heat stress (Ismail et al., 1992).
cations (e.g., sulphonamides) are being used, vitamin
K supplementation may be warranted, particularly in
pregnant does.
Key Points 1.7 Vitamin requirements

1.3.15.6.5 B-complex vitamins • Intercurrent disease such as coccidiosis increases

The B-complex vitamins are a group of compounds the requirement for vitamins such as A or E.
that have wide-ranging roles within the body. Cho- • Vitamin A deficiency can occur in housed rabbits
line, folate, biotin, thiamine, riboflavin, niacin, pyr- on cereal diets and poor-quality hay;
idoxine pantothenic acid and vitamin B12 make up 500–100 IU/kg can be given as a single dose for
this group. Caecotrophs are a rich source of the B hypovitaminosis A.
vitamins niacin, riboflavin, pantothenic acid and • In most species, vitamin D is required for active
vitamin B12. Primary deficiencies of these vitamins transport of calcium from the gut to the blood-
are unlikely to occur in rabbits, as most diets contain stream but in rabbits with sufficient dietary con-
sufficient quantities, in addition to the amounts syn- centrations, calcium is absorbed efficiently and
thesized by the caecal flora. Niacin and choline defi- passively from the gut in the absence of vitamin D.
ciencies have been induced under experimental Continued

39
 Textbook of Rabbit Medicine

Key Points 1.7 Vitamin requirements—cont’d • Rabbits can synthesize vitamin C but require-
ments vary.
• Passive calcium absorption is dependent on a dif-
• Caecotrophy provides a source of vitamins B
fusion gradient across the gut wall. Low dietary
and K.
calcium results in a lower gradient and less
absorption.
• In rabbits, the regulatory role of vitamin D is due to
its interaction with PTH and its effects on renal 1.3.15.7 Minerals
excretion and conservation of calcium. 1.3.15.7.1 Calcium
• If dietary calcium is low, active vitamin D- Calcium is the most abundant mineral in the body.
dependent calcium absorption may be required In combination with phosphorus it forms the dense,
because the passive diffusion gradient is low. hard material of bone and teeth. It is an important
• Vitamin D-deficient young rabbits can develop cation in intracellular and extracellular fluid and is
rickets and adults develop osteomalacia. essential for blood clotting, muscle contractions,
• Sunlight is required for endogenous vitamin D nerve cell activity, hormone regulation and the main-
synthesis; however, vitamin D can also be tenance and stability of cell membranes. Rabbits
absorbed orally. require a constant supply of calcium for their teeth
that continually erupt at a rate of approximately
• Undetectable vitamin D levels have been found in
pet rabbits. 2 mm per week. Calcium metabolism and its
unusual aspects in rabbits are discussed in
• Chronically vitamin D-deficient rabbits were stud-
Section 1.3.12 and Key Points 1.6. Briefly, rabbits
ied (fed on a diet containing 1% calcium). Findings
absorb calcium readily from the diet and do not
included that mild hypocalcaemia and moderate
hypophosphataemia occurred, with increased homeostatically maintain blood levels as closely as
PTH levels. There was no difference in gut absorp- other species. Total serum calcium levels vary across
tion of calcium in deficient and vitamin D supple- a wide range and are higher than in other mammals.
mented groups. But significant retention of both Increased dietary calcium levels bring about an
calcium and phosphorus occurred in the kidney, increase in serum calcium (Chapin and Smith,
meaning that the net balance for each mineral 1967a), which is excreted in the urine in the form
was more positive in vitamin D-deficient animals of calcium carbonate, which gives the urine a thick
(Bourdeau et al., 1986). creamy appearance (Cheeke and Amberg, 1973).
• Cereal mixes contain supplements that contain Urinary calcium levels are also related to dietary cal-
calcium and vitamin D. Rabbits that selectively cium intake (Kennedy, 1965).
feed may leave the portion of the diet containing Absorption of calcium across the intestinal
the vitamin and mineral supplement uneaten. Pel- mucosa is achieved by two parallel processes: active
leted and extruded monocomponent diets are vitamin D-dependent transcellular transport (uni-
also supplemented and selective feeding can be
directional) and passive paracellular diffusion across
avoided.
a concentration gradient, a bidirectional process
• Vitamin D can be obtained in the diet from (Breslau, 1996). In the rabbit, the main mechanism
sun-dried vegetation such as hay. Modern of calcium absorption appears to be passive diffu-
techniques can dry hay without the need for
sion, although active transport is important if
sunshine and, therefore, hay may be vitamin D
dietary levels are low. Passive diffusion is bidirec-
deficient
tional and depends on the concentration gradient
• Vitamin D toxicity has been recorded in rabbits between the intestinal lumen and the blood.
and causes mineralization of soft tissues, espe-
Calcium is absorbed primarily in its ionic form
cially the kidneys and aorta.
and compounds that bind with calcium to form

40
 Rabbit Basic Science 1
insoluble complexes reduce its availability, e.g., oxa- Calcium absorption can be enhanced by certain
lates (Breslau, 1996). The solubility of minerals such dietary factors. Soluble complexes can be formed
as calcium, magnesium and phosphorus in intestinal with certain amino acids such as lysine and arginine
contents is affected by pH. For example, calcium and antibiotics such as chloramphenicol and penicil-
absorption is increased in horses fed a high fibre diet lin. The soluble complexes prevent the formation of
due to lower stomach pH and increased saliva and insoluble complexes and therefore facilitate calcium
pancreatic secretions that increase the solubility of absorption. Lactose also increases the absorption of
calcium in the gut (Meyer et al., 1992). It is not known calcium from the gut (Breslau, 1996).
whether an analogous situation exists in the rabbit. Many ingredients of rabbit food have a low cal-
Phytates, oxalates and acetates form complexes cium content that decreases the concentration gradi-
with calcium and other minerals and can prevent ent for passive diffusion from the gut into the blood.
absorption (Fowler, 1986). Phytic acid (inositol Vitamin D may not be available for active calcium
hexaphosphoric) is present in high quantities in transport across the gut wall. Undetectable vitamin
grains and beans. Oxalates are present in a number D levels have been recorded in pet rabbits
of plants including swede, spinach and alfalfa in (Fairham and Harcourt-Brown, 1999). Calcium
which 20–30% of the calcium is in the form of cal- deficiency can be a contributory factor to poor tooth
cium oxalate that reduces its availability. In a study and bone quality and dental disease in pet rabbits.
by Cheeke et al. (1985), 49% of the calcium in calcium The selection of cereals and legumes from mixed
oxalate was available to rabbits. Low oxalate, high cal- rations results in a diet containing less in calcium
cium vegetables include kale, broccoli, turnip, collard than the amount required for bone calcification
and mustard greens (Breslau, 1996). Calcium can (Table 1.3) (Harcourt-Brown, 1995, 1996). Excessive
also bind with long-chain unsaturated fatty acids in dietary calcium may contribute to the development
the intestine to form insoluble soaps. of urolithiasis (Kamphues et al., 1986). Therefore,

Table 1.3 Mean calcium (Ca) and phosphorus (P) content (%) of three randomly selected brands of mixed rations
sold as rabbit food

Food A (no Food B (no Food C (no

Sample Food A pellets or grain) Food B pellets or grain) Food C pellets or grain)

1. Ca (%) 0.70 0.26* 0.56 0.46 0.79 0.16**

P (%) 0.35 0.28 0.39 0.30 0.32 0.26
2. Ca (%) 0.63 0.28* 0.51 0.38* 0.87 0.11**
P (%) 0.41 0.34 0.39 0.32 0.36 0.27
3. Ca (%) 0.65 0.39* 0.49 0.48 0.98 0.14**
P (%) 0.41 0.29 0.39 0.32 0.36 0.29
Samples of rabbit food were taken from batches of mixed rations bought from the same three pet shops on three different occasions. One pound
(0.45 kg) of food was sent for analysis. The remainder of the batch was picked over to remove the whole grain and the pellets, which are the ingredients
most likely to be rejected by pet rabbits (see Figure 1.8). One pound (0.45 kg) of the remaining ration (without pellets and grain) was sent for analysis.
Figures in bold denote an inverse calcium:phosphorus ratio.
NB. A level of at least 0.44% calcium has been determined for maximum bone ash and bone density (Chapin and Smith, 1967a).
*Calcium levels below the 0.4% minimum level recommended for rabbits by National Research Council (1977) Nutrient Requirements of Rabbits.
**Calcium level below the 0.22% minimum dietary requirement for rabbits determined by Chapin and Smith (1967a).
Reprinted from Harcourt-Brown (1996) with permission from the Veterinary Record.

41
 Textbook of Rabbit Medicine

the dietary level of calcium is important. The many plants, especially grains, contain phosphorus
calcium requirement for rabbits has been deter- that is released into the digestive tract of some species
mined (Chapin and Smith, 1967a). A minimum due to the action of ruminal or caecal fermentation.
of 0.22% is required to support normal growth Investigations have shown that phytate phosphorus
but a level of 0.44% is required for bone calci- is available to rabbits (Cheeke, 1987). Phytates or
fication. A level of 0.6–1.0% is recommended for oxalates can bind with calcium in the gut and affect
pet rabbits (Lowe, 1998). The calcium and phos- the calcium:phosphorus ratio. The availability to
phorus content of some ingredients of rabbit food rabbits of phosphorus in alfalfa is low (Cheeke
are summarized in Table 1.4. et al., 1985).
Phosphorus deficiency results in rickets in grow-
ing animals and osteomalacia in adults. In some
1.3.15.7.2 Phosphorus areas the soil is deficient in phosphorus and grazing
Phosphorus has many physiological functions. It is animals show symptoms of ‘pica’ (depraved appe-
closely associated with calcium and forms a major tite) where they chew wood, bones and other foreign
constituent of bone. Phosphorus occurs in phospho- material. Growing parts of plants are richer in phos-
proteins, nucleic acids and phospholipids and plays phorus (McDonald et al., 1996). In rabbits, dietary
a vital role in energy metabolism. Absorption and restriction of phosphorus causes hypophosphatae-
excretion is regulated by vitamin D. Dietary phos- mia and an increase in urinary excretion of calcium.
phorus levels affect calcium absorption as calcium The calcium:phosphorus ratio in the diet affects
binds with phosphorus to form insoluble calcium bone density. In rabbits, a low calcium:phosphorus
phosphate in the gut. Phytates that are found in ratio of 1:2 or 1:3 does not affect bone calcification

Table 1.4 Calcium and phosphorus content of some common foods for rabbits

Dry Calcium Phosphorus Calcium: High, medium or

Type of Water matter (% of dry (% of dry phosphorus ratio low source of
food (%) (%) matter) matter) (approx.) calcium

Alfalfa 10 90 1.5 0.30 5:1 High

Apple 79 21 0.06 0.06 1:1 Low
Barley 11 89 0.07 0.39 1:6 Low
(grain)
Banana 76 24 0.03 0.11 1:36 Low
Beans, e.g., 10 90 0.14 0.46 1:3 Low
kidney
Bran 11 89 0.16 0.14 1:1 Low
Bread 36 64 0.09 0.16 1:17 Low
Cabbage 78 12 0.64 0.35 2:1 Moderate
Carrot tops 83 17 1.94 0.19 10:1 High
Carrots 88 12 0.37 0.325 1:1 Moderate
Celery 94 6 0.66 0.47 1:1 Moderate
Chickweed 0.8 0.6 1:1 Moderate

42
 Rabbit Basic Science 1
Table 1.4 Calcium and phosphorus content of some common foods for rabbits—cont’d

Dry Calcium Phosphorus Calcium: High, medium or

Type of Water matter (% of dry (% of dry phosphorus ratio low source of
food (%) (%) matter) matter) (approx.) calcium

Clover 80 20 1.4 1.30 1:1 High

Dandelion 85 15 1.3 0.46 3:1 High
Grass 80 205 0.50 0.37 1:1 Moderate
Goosegrass 1.5 0.4 4:1 High
Kale 85 15 1.60 0.50 3:1 High
Lettuce 95 5 0.86 0.46 2:1 Moderate
Maize 88 12 0.04 0.28 1:7 Low
Oats 10 90 0.03 0.33 1:11 Low
Peas 11 89 0.12 0.41 1:3 Low
Pineapple 75 15 0.14 0.07 2:1 Low
Shepherd’s 2.0 0.6 3:1 High
purse
Sunflower 8 92 0.22 0.68 1:3 Low
seeds
Sowthistle 1.5 0.5 3:1 High
Spear thistle 1.8 0.4 4:1 High
Swede 88 12 0.36 0.32 1:1 Moderate
Turnip 91 9 0.56 0.28 2:1 Moderate
Wheat 11 89 0.16 1.14 1:7 Low
Reference sources: The Nutrient Requirements of Farm Livestock (1976), no. 4; Composition of British Feedingstuffs: Technical Review and
Tables (Agricultural Research Council, London); P. Cheeke (1987), Rabbit Feeding and Nutrition (Academic Press. San Diego); P. McDonald et al.
(1995), Animal Nutrition, 5th edn (Longman, London).

or growth rate unless dietary phosphorus levels are requirement of phosphorus for maintenance of adult
high. If dietary phosphorus concentrations increase rabbits has not been determined. A dietary level of
to more than 1%, then bone density decreases Many 0.4–0.8% has been suggested for pet rabbits (Lowe,
cereals have phosphorus levels greater than 1% and a 1998). The phosphorus content of grass and hay is
calcium:phosphorus ratio that is less than 1:1 and can less than 0.4% (McDonald et al., 1996) and this var-
therefore affect bone density. Rabbits are tolerant of a ies seasonally. Phosphorus levels may be the limiting
high calcium:phosphorus ratio. Growth rate and bone factor in many metabolic processes due to the varia-
density are not affected by increasing calcium concen- tion in supply from the natural diet.
trations to a ratio of 12:1 (Chapin and Smith, 1967b).
The minimum requirement of phosphorus for 1.3.15.7.3 Other minerals
optimum bone strength in growing rabbits is The nutritional requirement of magnesium, man-
0.22% (Mathieu and Smith, 1961). A nutritional ganese, iron, zinc, copper and cobalt have been

43
 Textbook of Rabbit Medicine

determined for rabbits. The precise role of magnesium calcium result in large amounts of calcium carbon-
in rabbit nutrition is largely unknown but deficiency ate sediment in the urine, and predisposes to
has been linked with alopecia and alterations in fur sludgy urine and cystitis.
texture. Experimentally induced magnesium defi-
• A minimum level of 0.44% calcium is required for
ciency results in poor growth, hyperexcitability and bone calcification.
convulsions (Cheeke, 1987). Theoretically, excessive
quantities of goitrogenic vegetables such as cabbage • Rabbits that select cereals and legumes from
cereal mixes will be on a low calcium diet.
and Brussels sprouts could result in iodine defi-
ciency. These vegetables contain glucosinolates that • Poor-quality hay can be deficient in either calcium
convert to thiocyanate, which can cause iodine or vitamin D, or both.
deficiency and goitre. Suggested dietary levels of trace • Some fruit and root vegetables such as apples
elements are given in Box 1.5. and carrots are deficient in calcium.
• Alfalfa contains a high level of calcium.
Box 1.5 Suggested food analysis for adult pet • Grass, weeds and hay contain the correct dietary
rabbits level of calcium for rabbits, but this varies
seasonally.
• Crude fibre: > 18%
• Factors such as pH, phytates, phosphates, oxa-
• Indigestible fibre: > 12.5% lates and fats in the intestinal lumen can influence
• Crude protein: 12–16% calcium uptake from the gut.
• Fat: 1–4% • Phytate phosphorus is available to rabbits.
• Calcium: 0.6–1.0%
• Phosphorus: 0.4–0.8%
1.3.16 Salt licks and mineral blocks
• Vitamin A: 6000–10,000 IU/kg
Salt licks are sold for rabbits and are available from
• Vitamin D: 800–1200 IU/kg
most pet shops. They attach to the cage bars or wire
• Vitamin E: 40–70 mg/kg mesh. There is little evidence that additional salt is
• Trace elements: magnesium, 0.3%; zinc, 0.5%; required but some rabbits like the taste. Mineral
potassium, 0.6–0.7% blocks are also unnecessary as there is no need to sup-
NB. It is especially important to ensure that growing ply extra minerals to a rabbit on a balanced diet. Some
rabbits receive sufficient calcium. Mixed rations are blocks contain high levels of calcium that could be
not suitable for young rabbits that are kept in groups harmful if the rabbit gnaws and eats them in large
where it is impossible to ensure that each individual is amounts. A rabbit confined to a hutch may destroy
eating a balanced diet. and eat the mineral block as a displacement activity,
not because it has a need for additional minerals.

Key Points 1.8 Calcium and phosphorus 1.3.17 Grass and hay for pet rabbits
• The correct amount of dietary calcium is important The natural food of rabbits is pasture grass. Grass is
for rabbits. a balanced source of vitamins, minerals and ferment-
able and indigestible fibre. Rabbits have evolved
• Rabbits teeth grow at approximately 2 mm
to live on grass, which they find palatable and enjoy-
per week and require a constant supply of
calcium. able. Ideally, pet rabbits should be given the
opportunity to graze for several hours a day. If a
• Calcium deficiency results in poor mineralization of
predator-free enclosure cannot be provided, then fresh
the bones and teeth. Excessive amounts of dietary
grass can be picked daily throughout the summer

44
 Rabbit Basic Science 1
months to feed to pet rabbits. Clippings from the lawn The digestibility of perennial ryegrass, Italian rye-
mower are not suitable as they ferment rapidly. There is grass and timothy are similar, although hay made
a small risk of transmitting parasites from wild rabbits, from timothy is slightly higher in crude fibre
dogs and foxes through grass collected from contami- (34.1%) than ryegrass (30.5%). The protein content
nated pasture. Viral haemorrhagic disease vaccination of timothy is lower than that in other grasses
is advisable. If fresh grass is unavailable, then hay can (McDonald et al., 1996).
be provided as a substitute. Hay and grass can be Traditional haymaking is dependent on a period
offered together. Preserved grasses such as ‘Readigrass’ of fine weather, which cannot be relied upon in
are a suitable addition to the diet. The calcium and fibre the UK. The ideal haymaking weather is dry and
content is similar to hay, and it helps to wear the teeth sunny with a mild breeze. Rapid drying techniques
down in a similar manner. using field machinery and barn drying equipment
Natural grasslands are made up of a number of grass have recently been introduced to overcome some
species and include legumes and other wild plants. The of the problems associated with unpredictable
chemical composition of the pasture alters throughout weather. The aim of haymaking is to reduce the mois-
the year. Grass grows rapidly during warm, wet weather ture content of the green crop to a level low enough
and dries out as the herbage matures, leaving a feed to inhibit the action of plant and microbial enzymes.
resource that is sometimes referred to as ‘standing Valuable nutrients are lost during the drying process
hay’ (McDonald et al., 1996). The crude protein con- due to the action of enzymes, oxidation, leaching
tent of pasture grass can vary from 0.3% in mature and mechanical damage. The vitamin content of
herbage to 3% in young heavily fertilized grass. The hay depends on the manner in which it was dried
fibre content tends to increase as the protein and the length of exposure to sunlight. Prolonged
levels decrease. The water-soluble carbohydrates of exposure to sunlight increases the vitamin D content,
grass include glucose, fructose and sucrose and vary whereas rapid drying preserves the vitamin A con-
with the species. The cellulose content is generally tent. Increased drying time allows bacterial fermenta-
20–30% and hemicelluloses vary from 10 to 30% tion to take place and rain on a partly dried crop
(McDonald et al., 1996). Lignin content increases with leaches out minerals and encourages the growth of
age and affects the availability of other nutrients except moulds (McDonald et al., 1996). Ideally, good-
the water-soluble carbohydrates. The lipid composi- quality, sweet-smelling, dust-free fresh hay suitable
tion is low and rarely exceeds 0.6%. The mineral con- for feeding to horses should be selected for rabbits.
tent varies with species, stage of growth, soil type, Lucerne or alfalfa (Medicago sativa) is a legumi-
cultivation conditions and fertilizer application. Green nous plant found in warm temperate areas and is
herbage is a rich source of vitamin A, vitamin E and grown as a forage crop. In the USA, alfalfa is used
many B vitamins, especially riboflavin. The vitamin for grazing and for artificial drying to make hay.
D content increases as grass matures and is present in In the UK, some alfalfa is grown and harvested for
greater quantities in sun-dried hay than in young grass. silage or for artificial drying to make hay. The drying
The species of grass depends on the type of pas- process can affect the vitamin D content. Dried
ture. In the UK, perennial ryegrass (Lolium perenne) alfalfa is approximately 25% crude fibre and is also
is the most important species of sown pastures, but rich in protein, calcium and vitamin A. It is high in
Italian ryegrass (Lolium multiflorum), timothy oxalate that binds with calcium in the gut and affects
(Phleum pratense) and the fescues (Festuca spp.) are absorption. Alfalfa can easily be grown under dry
all common. In older pastures, these are accompa- conditions and has proven to be a useful feed for rab-
nied by ‘weed’ grass species, particularly meadow- bits in many parts of the world. In the UK, alfalfa is
grass (Poa pratensis), Yorkshire fog (Holcas lanatus) recognized as a useful foodstuff for rabbits,and is
and the bents (Agrostis spp.). In moorland pastures increasingly used as a source of both fibre and cal-
other species such as mat grass (Nardus stricta) and cium in many proprietary foods. In tandem with the
purple moor grass (Molinia caerulea) are found. increased interest in lower calcium manufactured

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 Textbook of Rabbit Medicine

foods, there has been a backlash against alfalfa within are meant to be fed as part of a diet that includes
the rabbit community, making it less popular as an other foods, usually hay. Complete diets do not
ingredient, due to its high calcium levels and many require any supplementary food items.
rabbit owners are now very aware that alfalfa hay is The visual appearance of the food is important to
not an appropriate feedstuff. Some breeders use a high the owner but probably not to the rabbit. The rabbit
fibre horse food made from alfalfa to feed to rabbits. has a wide visual field that enables it to observe sur-
Alfalfa is retained in the digestive tract for longer rounding predators while it is eating. The visual field
than plain cellulose, suggesting that it is digested to does not include the area below the mouth, so food
some degree in the caecum (Chiou et al., 1998). selection is based on odour and tactile information
Problems associated with feeding hay include the from the vibrissae. Feeding recommendations for
risk of transmitting infections and parasites to rabbits pet rabbits are summarized in Box 1.7.
from vermin which have inhabited the crop prior to
purchase. In the USA skunks and raccoons harbour
ascarids, Baylisascaris procyonis, for which rabbits act 1.3.18.1 Pelleted diets
as paratenic hosts. Visceral larva migrans can result Pelleted food consists of small cylinders of ingredi-
in tissue damage to a variety of organs including ents that have been ground and compressed
brain, heart and liver. Hay that has been contami- together with a binding agent. Vitamins and min-
nated with raccoon or skunk faeces is a potential erals can be incorporated into the pellet along with
source of infection. Baylisascaris eggs require 30 days sweetening agents such as molasses to improve pal-
outside the host to become infective. atability. Particle size of the ingredients is impor-
Seeds and stems of hay can cause foreign body tant, as it affects the digestibility of the ration and
reactions and are a common cause of disease in pet its rate of passage through the digestive tract
rabbits. A number of conditions including tracheitis, (Lang, 1981a). Small particles tend to accumulate
rhinitis, abscesses, malocclusion, conjunctivitis and in the caecum and lead to an increased incidence
skin irritation are caused by stalks or seeds penetrat- of enteritis (Sanchez et al., 1984). Pelleted diets
ing the oral and pharyngeal mucosa. They can also can be complete or complementary. They vary in
lodge in the nasal passages, nasopharynx or larynx. quality. Coccidiostats are usually incorporated into
Grass seeds may become entangled in the fur and the pellet to reduce the incidence of coccidiosis in
work their way into the dermis causing irritation intensive rabbit units. The actual pelleting process
and infection. Dusty hay can cause conjunctival does not kill any oocysts that may be contaminating
and respiratory tract irritation and predispose sec- the feed (Owen, 1978).
ondary Pasteurella infections. Overhead feeders and The advantages of pelleted diets are that they are
hayracks increase the likelihood of dust and frag- convenient, are easy to store and do not allow the
ments of hay entering the nose or eyes. rabbit to select out certain ingredients. Different for-
mulations can be pelleted to provide diets for rabbit
that are pregnant, lactating or growing. Fibre can be
1.3.18 Types of commercial rabbit food
incorporated into the pellet but processing reduces
A suggested food analysis for adult pet rabbits is sum- some of its beneficial properties and tends to make
marized in Box 1.5. the pellets friable. Pellet binders can be used to over-
There are a variety of rabbit foods available in the come this problem. Substances such as magnesium lig-
UK. The owner’s choice is often based on advice from nosulphate, which is a by-product of the wood pulp
the pet shop or breeder or on marketing and adver- industry, or a clay mineral binder such as sodium beto-
tising literature. There are legal requirements for nite can be used (Lang, 1981a). Disadvantages of pel-
the labelling of rabbit food that are summarized in leted diets are their low palatability in comparison
Box 1.6. Commercial feeds are divided into comple- with mixed cereal rations (often leading to the addition
mentary and complete diets. Complementary diets of simple sugars in order to improve this) and the

46
 Rabbit Basic Science 1
Box 1.6 Labelling requirements for rabbit food
In the UK there are legal requirements covering the • Despite the requirement to display information,
information given to purchasers of rabbit food. Guide- there is no requirement to produce feeds to
lines may be found at http://www.pfma.org.uk and certain compositional standards.
http://www.food.gov.uk • The stated composition of the feed should not,
• Commercially prepared feeds are considered to be although small variation (20%) may be acceptable.
complete, complementary or a food supplement Producers that make false claims are liable for prose-
and this information should be displayed on the cution under the Trades Description Act 1968 but only
packaging. Complete feeds should provide all statements pertaining to some measurable parameter
the nutrients required by the animal in the can be proved to be false. Therefore phrases such as
correct quantities. Complementary feeds require ‘for a happy, healthy pet’ or ‘for the rabbit that has
additional foods to be included in the diet. Feed everything’ are unlikely to be challenged although such
supplements are concentrated sources of statements can be misleading.
nutrients such as vitamins and minerals used to
supplement other diets. Current pet food labelling legislation includes:
• The Animal Feed (England) Regulations 2010 (there
• Labelling should include the name and address of are separate but parallel Regulations for Scotland,
the person guaranteeing that the information is Wales and Northern Ireland). These Regulations
accurate and the name and description of the provide for the enforcement of EU Regulation 767/
feed plus a list of ingredients. 2009 on the marketing and use of animal feed,
• There must be directions for use, storage and a which applied directly in Member States from 1
‘best before’ date. September 2010. The Regulations also transpose
• For food sold loose, the pet shop should display a EU provisions on undesirable substances and
statutory notice indicating the nutritional properties particular nutritional purposes, and set down
of the feed and the species of animal for which the offences and penalties for breaches of feed
the product is intended. The statutory statement legislation.
should be displayed in close proximity to the feed. • EC Regulation 1831/2003 on Feed Additives. This
The minimum requirements, which must be Regulation contains provisions for the control of
displayed, are protein, oil, fibre and ash. feed additives in pet food.
• For pre-packed food the statutory notice should be • EC Regulation 183/2005 on Feed Hygiene. This
displayed on the packaging or on a label attached to Regulation sets out the operating standards with
the packaging of the feed itself. which pet food establishments must comply.

owners’ perception that they look boring. As a com- cooled. The result is a lightweight biscuit that can
plete diet, pellets provide little in the way of dental be any size or shape. It stores well and is virtually ster-
exercise and are not a good source of indigestible fibre. ile. Long fibre particles can be incorporated without
Supplementary hay is required. the pellets becoming friable and disintegrating. Vita-
mins are partly denatured by the processing and need
to be added to the initial mixture in higher quantities
1.3.18.2 Extruded or expanded diets to allow for this. Heat treatment increases starch
Expanded diets are produced by blending and heat- digestibility (Cheeke, 1987) and reduces carbohy-
ing the raw ingredients to a high temperature, before drate overload of the hindgut. Extruded diets are
being extruded and dried. The basic ingredients are more palatable and digestible than pelleted rations
ground and mixed prior to steam heating. A paste (Tobin, 1996). They do not allow the animal to eat
is formed that is forced through a shaped die and an unbalanced diet by selecting out favourite

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 Textbook of Rabbit Medicine

Box 1.7 Feeding recommendations for pet rabbits

• Introduce new foods gradually. Safe plants for rabbits
• Good-quality hay or grass should be available at all • Grass of any type is safe, palatable and ideal for
times, unless a complete diet is provided that rabbits. Vaccination against viral haemorrhagic
specifically states that no other food is needed. disease (VHD) is advisable due to the risk of
Even with a complete diet, additional hay, grass or transmission from wild rabbits/hares.
vegetables will not be harmful. • Wild plants that are safe include agrimony, brambles,
• Feed a wide range of green foods and vegetables chickweed, clover, coltsfoot, cow parsnip (hogweed),
every day. Fruit and succulent vegetables such as dandelion, young docks, goosegrass, ground elder,
tomatoes should be given in moderation. groundsel, knapweed, mallow, mayweed, plantain,
raspberry, sea beet, shepherd’s purse, sow-thistle,
• Follow manufacturer’s instructions when feeding trefoil, vetch, wild strawberry and yarrow. (NB:
proprietary rabbit food. If the rabbit does not eat Many of these plants are illustrated in Virginia
all the mixture, change the diet. Richardson’s book Rabbit Nutrition.)
• If possible, allow rabbits outside to exercise in • Safe cultivated plants include artichoke leaves, apple,
natural daylight. Care is needed to prevent them beetroot, broccoli, brussel sprouts, cabbage,
escaping or being predated. Rabbits can be very carrots and carrot tops, celery, cauliflower leaves,
destructive in the garden. chicory, coriander, corncobs, green beans, kale,
• Feed small amounts of concentrated food, such as kohl rabi, lettuce (in moderation), parsley, peapods,
pellets, cereal mixes or extruded diets, only once a pear, parsnip, radish, spinach, spring greens (spring
day and remove the bowl after a couple of hours. If cabbage), sprout peelings, sunflower plants,
there is food left in the bowl, feed less food the next swedes, sweetcorn plants, turnips and watercress.
day. Hay or grass is available if the rabbit feels hungry. Turnips and spinach should be fed occasionally (not
• No more than 2–3% of the rabbit’s bodyweight of more than once a week) due to their oxalate content.
cereal mixes, pelleted or extruded rations should • Tree leaves can be eaten by rabbits, especially from
be fed daily. fruit trees and hazel.

ingredients. Although extruded pellets can be made are obtained from analysis tables and extrapolated
in a variety of sizes, shapes and colours, they still to formulate a feed based on the requirements of
look less attractive than mixed rations to the owner commercial rabbits. Mixed rations are often sold
and do not provide high quantities of indigestible loose from pet shops with no labelling information.
fibre. Owners are encouraged to leave a bowl full of food
with the rabbit permanently. The rations usually con-
sist of flaked, micronized or rolled cereals and
legumes mixed with highly coloured extruded ‘bis-
1.3.18.3 Mixed rations cuits’ and pellets. Stems of alfalfa can be incorpo-
The composition of mixed rations varies between rated as a source of calcium and fibre. The colour
sources. They can be complete or complementary. of the extruded portions in combination with green
Most mixed rations are complementary and are flaked peas and yellow flaked maize make these mix-
designed to be fed with hay to provide indigestible tures visually appealing to the owner. Molasses or
fibre. Feed companies decide on the formulation liquid sweetening agents can be added along with
according to cost, availability of ingredients and other ingredients such as locust beans or compressed
the experience of the nutritionist. Nutritional data linseed. Some rations contain by-products from the

48
 Rabbit Basic Science 1
human food industry, such as stale breakfast cereals.
Key Points 1.9 Common feeds and ingredients
Whole grains are incorporated to prevent the rabbit
picking out the kernel and leaving the fibrous husk. • Grass is a balanced source of vitamins, minerals
However, most rabbits are able to separate and eat and fermentable (digestible) and indigestible fibre
the kernel and leave the husk uneaten. Wheat has a for rabbits.
tendency to be pasty (Lowe, 1998) and is usually • The digestibility of the species of grasses found in
extruded into a coloured biscuit that is included in UK pastures are similar, although timothy (Phleum
mixed rations. Pellets are added to the mixture as a pratense) has a slightly higher crude fibre and
vehicle for a powdered vitamin and mineral supple- lower protein content.
ment. Some brands now incorporate the supplement • Alfalfa (lucerne, Medicago sativa) is used for graz-
into the extruded wheat portion or spray the whole ing and haymaking in warm countries, although it
mixture with a supplemented coating. is now available in the UK.
The advantages of mixed rations are that they are • Alfalfa has a high fibre and calcium content.
universally available, palatable, cheap, convenient
• Infections may be transmitted to pet rabbits from
and visually attractive to the owner. They are avail- hay that has been contaminated by vermin (VHD
able from pet shops, supermarkets, agricultural sup- and Baylisascariasis).
pliers, garages, garden centres and wholesalers under
• Seeds and stems of hay can become lodged in the
the universal name of ‘rabbit food’. Apart from the
eye, mouth, nose, nasopharynx or larynx and are
general problems associated with feeding ad lib con- an underdiagnosed cause of clinical disease.
centrated foods (obesity, insufficient dietary fibre,
dental exercise and foraging), mixed cereal rations • Commercial foods for rabbits are composed of
pelleted, extruded or mixed rations.
have the additional disadvantage of allowing rabbits
to select out their favourite ingredients and leave the • Pelleted diets consist of ingredients that have
rest uneaten (see Figure 1.8). Discarded food is gen- been ground and compressed.
erally taken away by the owner and replaced with a • Extruded foods are ground, blended and cooked
fresh bowlful for the rabbit to select from. Owners to form a lightweight biscuit that is sterile and pal-
worry about their pets being bored or hungry and atable, and stores well.
sometimes refill the bowl several times a day so the • Mixed rations vary between sources and contain a
rabbit may exist on only one or two favourite ingre- range of ingredients including flaked, micronized,
dients. In order to be nutritionally balanced, this type rolled or whole grains such as corn, wheat, oats
of food must be fed full to empty bowl. The pellets, and barley plus legumes such as peas and beans.
which contain the vitamin and mineral supplement, Dried vegetables such as carrots and leeks may
are often left uneaten. The most palatable portions of be added. Most mixed rations also contain pellets
and/or extrusions.
these diets are the flaked peas and flaked maize
which are deficient in calcium and have a low • Mixed rations that are available in countries outside
calcium-to-phosphorus ratio. Selection of these the UK contain other ingredients such as sunflower
seeds, peanuts, corn kernels and dried peas.
ingredients results in a diet with calcium concentra-
tions below the rabbit’s known dietary requirement
(Harcourt-Brown, 1996). Demineralization of the 1.3.19 Problems associated with feeding
bones and teeth results in dental problems (see
Section 5.5.1.1). A balanced diet is especially impor- 1.3.19.1 Toxic plants
tant to juvenile rabbits that are growing rapidly and Owners are often worried about the possibility of
therefore susceptible to metabolic bone disease. plant toxicity if they pick natural vegetation or give
Selection of low calcium cereals and legumes from their rabbit the freedom of the garden. Rabbits will
mixed rations at this stage can have life-long detri- eat almost anything, including plants known to be
mental effects on bones and teeth. toxic to other species and so it is not easy to reassure

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 Textbook of Rabbit Medicine

owners that their pet will not suffer any adverse A condition known as ‘head down disease’ is caused
effects. Toxicity varies and depends on a number of by ingestion of woollypod milkweed (Asclepias erio-
factors, such as the amount ingested, the part of carpa) in the USA. Affected animals develop paralysis
the plant that is eaten and the frequency of ingestion. of the neck muscles and loss of coordination. Drool-
Drying can cause an increase or decrease in toxicity or ing, rough hair coat, subnormal temperature and
have no effect at all. tar-like faeces occur. Recovery is possible (see Sec-
Many plants that contain toxic compounds are tion 10.6.1.2). The toxic principal is a resinoid. Woolly
acrid and unpalatable. Irritant compounds cause oral milkweed does not grow in Great Britain.
discomfort and are unlikely to be ingested in large The houseplant Dieffenbachia is reputed to be poi-
quantities. Many plant poisons are not fatal and so sonous to rabbits, Avocado leaves are also toxic to
the fact that a pet rabbit has eaten a known poison- rabbits, although the toxicity of the plant varies with
ous plant does not necessarily mean it will die. Con- the variety. Mexican avocados are less toxic than Gua-
versely, plants that are considered safe can be toxic if temalan varieties. Post-mortem examination shows
ingested in large quantities or daily over a period of lung congestion (Craigmill et al., 1984).
time. Examples in other species include apples or clo- Daffodil bulbs and horse chestnuts are poisonous
ver, both of which can cause digestive upsets in rumi- to dogs if they are eaten in quantities (Campbell,
nants. In general, if no ill effects are observed within 1998) and many other garden plants can cause toxic
6 h of the ingestion of a potentially poisonous plant, symptoms, such as gastrointestinal effects, although
then it is unlikely that signs will develop (Veterinary they are not necessarily fatal. Examples include cotone-
Poisons Unit, personal communication). aster, honeysuckle and pyracantha. Plants used for
There are few definite reports of plant toxicity in Christmas decorations, i.e. holly, ivy and mistletoe,
rabbits. Instead, rabbits are reported to be resistant are all known to be toxic in other species. The house-
to the effects of pyrrolizidine alkaloids, which are plants leopard lily and Christmas cherry cause vomit-
found in plants such as ragwort and comfrey ing and diarrhoea in dogs (Campbell, 1998).
(Cheeke et al., 1982). Amaranthus species (A. retro- Long-term, continuous ingestion of certain vege-
flexus, redwort pigweed; A. viridis, green amaranthus) tables can cause toxicity. Although the effects of goi-
causes ascites with lemon yellow serous fluid (Lorgue trogenic vegetables such as cabbage, spring greens
et al., 1996). Although Amaranthus spp. are not native and brussel sprouts have not been documented in
to the UK, garden escapes may be found on waste rabbits, there is a theoretical risk associated with
ground (Fitter et al., 1974). Amaranthus retroflexus feeding large amounts of these vegetables. Similarly,
has been used in rabbit feeds with poor results oxalates in spinach, alfalfa and turnips can affect the
(Cheeke, 1987). Amaranthus albus is the common absorption of some minerals such as calcium or mag-
garden plant ‘love lies bleeding’. nesium. Problems with toxic principals in vegetables
can be avoided by offering two or three types daily
and changing the range each day. Grass is safe and
Key Points 1.10 Toxins
can be given ad lib. Plants that may be toxic to rabbits
• Although owners worry about plant toxicity in rab- are listed in Table 1.5.
bits, there are few confirmed reports.
• Rabbits appear to be resistant to many plant 1.3.19.2 Chemicals
toxins such as ragwort, deadly nightshade, com-
frey and laburnum. Cultivated crops do not cause the same amount of
owner anxiety as natural vegetation, and yet there
• Some agrochemicals used as weedkillers are toxic
are health implications for rabbits fed on treated
to rabbits.
vegetation. Although rabbits appear relatively resis-
• Rabbits are sensitive to mycotoxins, such as tant to plant toxins, they are susceptible to some
aflatoxin.
agrochemicals. For example, nitrophenols, which

50
 Rabbit Basic Science 1
Table 1.5 Potentially toxic plants for rabbits
Rabbit owners are often concerned about the safety of feeding naturally growing plants and weeds to their rabbits.
During an extensive search of the literature, few definite reports of plant toxicity in rabbits could be found, although
many plants were cited as potentially poisonous. There are anecdotal reports of bizarre behaviour in rabbits after
presumed ingestion of some species of wild mushrooms. The following table is a list of potentially toxic plants for
rabbits although in many cases, extrapolations have been made from other species.
The following plants can be bought as vegetables or grown in gardens and hedgerows in the UK. Poisonous plants
from other countries are not included.

Plant Toxic principal Comments

Amaranthus: Oxalic acid Redwort is known to be toxic to rabbits.

A. retroflexus Amaranthus albus is the garden plant love-lies-bleeding.
(redwort)
A. viridis (green
amaranthus)
Antirrhinums Known to be poisonous in other species.
Arum Calcium oxalate and Can cause swelling and discomfort of the oral cavity in other species.
other irritants
Buttercups (fresh) Protoaneminin Causes irritation to mucous membranes including GI tract in other
species.
Bracken Thiaminase Toxic in cattle, sheep and horses þ bone marrow suppressant.
Bryony Irritant substance Berries and rhizomes are poisonous.
and histamine
Cabbage Glucosinolate Goitrogenic if fed in large quantities.
Celandines A variety of alkaloids Unpalatable.
Irritant effects. Purgative.
Charlock Poisonous in other species.
Comfrey Pyrrolizidine Hepatotoxic (rabbits appear to be resistant to toxic effects).
alkaloids
Convolvulus Poisonous in other species.
Crotalaria Pyrrolizidine Hepatotoxic (rabbits appear to be resistant to toxic effects).
alkaloids
Dahlia Known to be poisonous in other species.
Evergreens Known to be poisonous in other species.
(except conifers)
Figwort Reputed to be poisonous.
Foxglove Cardiac glycoside Known to be poisonous in other species.
(digitalis)
Hellebore Variety of alkaloids Known to be poisonous in a range of species.
(Christmas rose) Whole plant is toxic especially during flowering.
Continued

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 Textbook of Rabbit Medicine

Table 1.5 Potentially toxic plants for rabbits—cont’d

Plant Toxic principal Comments

Hemlock Variety of alkaloids Whole plant is toxic. Unpalatable.

Henbane Anticholinergic Seeds are most toxic part of the plant.
Unpalatable.
Horsetails Thiaminase alkaloids Toxic to other species (horses) if ingested over long periods. Remains
Silica toxic after drying, i.e., hay.
Irises Reputed to be poisonous.
Ivy Unidentified Whole plant, including berries poisonous.
Large quantities need to be ingested.
Kale Thiocyanates Toxicity reported in ruminants.
S-methyl-cysteine- Needs to be ingested in large quantities.
sulphoxide Can cause haemolytic anaemia in other species.
Nitrates
Antithyroid
Laburnum Alkaloids Seeds especially are known to be poisonous in other species.
Rabbits may be resistant to toxic compounds.
Lily of the valley Variety of alkaloids Variety of symptoms.
Linseed Cyanogenetic Ingestion of > 400 g/100 kg of oil-seed cake can be toxic in other
heteroside species.
Lupins Quinolizidine Most cultivated lupins are of low toxicity.
alkaloids
Milkweed Cardiac glycoside
Monkshood Alkaloid Unpalatable, irritant.
(aconite)
Nightshade Atropine Many rabbits are resistant to poisoning due to presence of
atropinesterase.
Oleander Cardiac glycoside
Poppies Opium alkaloids Entire plant is toxic even after drying.
Potato plants Solanines Can cause haemolysis in other species (cattle and pigs) if large quantities
of leaves or stems are fed or small quantities over a long period.
Potatoes Nitrophenol Potatoes may be sprayed with nitrophenols to prevent sprouting. The
spray can be toxic to rabbits.
Privet Tannins Can be fatal in other species.
Heteroside
Ragwort Pyrrolizidine Hepatotoxic.
alkaloids Rabbits appear to be resistant to toxic effects.
Scarlet pimpernel Reputed to be poisonous.
Speedwell Reputed to be poisonous.

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 Rabbit Basic Science 1
Table 1.5 Potentially toxic plants for rabbits—cont’d

Plant Toxic principal Comments

Spurges Alkaloids Cause intense local irritation to mucous membranes in other species.
Toadflax Reputed to be poisonous.
Tomato plants Solanines Can cause haemolysis in other species (cattle and pigs) if large leaves
or stems are fed or small quantities over a long period.
Travellers joy Reputed to be poisonous.
(Clematis vitalba)
Wild celery Reputed to be poisonous.
Yew Taxine Cut branches more toxic than when fresh.
Very toxic in other species.
Can cause sudden death.
Probably toxic to rabbits.
There are other toxic plants not included in this list that are wise to avoid, e.g., acorns, box hedging, laurel, cypress, verbena, potentilla, rhododendron,
water dropwort. In general, plants that grow from bulbs can be considered to be potentially poisonous.
Reference sources: Cheeke (1987); Gfeller and Messonier (1998); Lang (1981a); Lorgue et al. (1996); Richardson (1999); Sandford (1996).

are used as herbicides, fungicides or antisprouting many species. Aflatoxin is produced by Aspergillus fla-
agents on potatoes, can make the plants extremely vus and may be found in mouldy feeds, especially
toxic to rabbits (Lorgue et al., 1996). Ingestion of peanuts. Subclinical aflatoxicosis affects natural
the toxin occurs by eating recently treated vegetation. defence mechanisms and immunogenesis. Rabbits
The compounds stimulate tissue respiration while are susceptible to aflatoxin toxicity, which causes gas-
simultaneously impairing adenosine triphosphate troenteritis and liver damage. It is not known how
(ATP) synthesis. Hyperthermia, methaemoglobinae- widespread this problem is in pet rabbits that con-
mia, jaundice and pulmonary oedema are among the sume cereals and grains of uncertain age and quality.
clinical signs. Ingestion of hay grown from a mono- In a study by Fekete and Huszenicza (1993), rabbits
culture sprayed with a selective herbicide such as a did not refuse grain that contained sufficient afla-
triazine can cause poisoning. Treated, triazine- toxin to cause immunosuppression and fatal second-
resistant weeds are dried and eaten in contaminated ary bacterial infection.
hay. Symptoms of poisoning in other species
are non-specific and include anorexia, weight loss,
depression, salivation, muscle atonia, weakness 1.3.19.4 Locust beans and dried pulses
and paraplegia or hyperexcitability. Treatment is Locust beans are pods of either the Mediterranean
symptomatic and the prognosis generally good. Gar- carob tree (Ceratonia siliqua) or the African locust
den fungicides that are used to treat lawns also bean (Parkia filicoidea). The pod consists of a woody
belong to the triazine group. Herbicides such as gly- husk that is sweet and palatable to rabbits and con-
cosate and substituted ureas are unlikely to be poi- tains hard shiny beans. The beans are used for the
sonous to rabbits. manufacture of gums and oils in the cosmetic indus-
try. Crushed locust bean husks are sometimes
included in rabbit foods and occasionally a hard
1.3.19.3 Mycotoxins bean can make its way into the mixture along with
Mycotoxins are toxic metabolites of fungi such as the husk. Unfortunately, these beans are too hard
Aspergillus spp. that causes a range of diseases in for rabbits to chew and can be swallowed whole.

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 Textbook of Rabbit Medicine

They pass through the stomach undigested and can soiled fur. Arthritic conditions are exacerbated by obe-
lodge in the small intestine, causing an acute obstruc- sity. Sludgy urine and cystitis are also associated with
tion and death. Dried peas and sweetcorn carry the inactive overweight rabbits (see Section 12.4).
same risk. Because of the risk of intestinal obstruc- Weight reduction can be difficult to achieve in rab-
tion, many leading rabbit food manufacturers no bits. It is sometimes difficult to persuade owners that
longer use locust beans in their rations. their rabbit has a problem. Many obese rabbits have
very little exercise and eating is their main pastime.
Owners often feel guilty about not allowing their
1.3.20 Obesity pet out to exercise and worry about it being bored
Rabbits are animals that convert food efficiently and so they give it lots of food instead. A high fibre, low
are often overfed by indulgent owners. They are used calorie diet that would result in weight loss in humans
as laboratory models to study the effects of obesity in and other animals may not have any effect in rabbits.
humans. Obese rabbits have high resting heart rates The caecal micro-organisms can digest fibre to release
and can develop hypertension and cardiac hypertro- volatile fatty acids that can be converted into fat. Only
phy (Carroll et al., 1996). Hyperinsulinaemia, hyper- lignocellulose in the form of fibrous, lignified vegeta-
glycaemia and elevated serum triglycerides occur in tion such as hay, straw or really tough weeds will pass
obese rabbits and hepatic lipidosis develops readily through the digestive tract undigested.
after short periods without food, especially if the Changing a rabbit’s diet can be fraught with diffi-
rabbit is stressed. Obese rabbits are poor surgical culty. Many rabbits are finicky, even obese ones, and
candidates. will steadfastly refuse to eat anything at all if they are
Fat rabbits are unable to groom inaccessible parts not offered their favourite foods. Starvation quickly
such as the nape of the neck and the base of the tail leads to hepatic lipidosis in obese rabbits. Care should
(Figure 1.9). They are often unable to reach the peri- be taken at the outset to ensure that the rabbit is actu-
neum to consume caecotrophs. Fly strike and cheyle- ally eating its new diet and is passing hard faeces. Quan-
tiellosis can be the result of inadequate grooming and tities of cereal mixtures or pellets should be reduced or
phased out over a couple of weeks. Eventually a diet of
ad lib hay or grass with no concentrates can be given
until the rabbit has lost weight. Small amounts of veg-
etables can be given as treat foods. As much exercise as
possible is important. The weight loss must be main-
tained in the long term, and a return to old feeding
habits avoided. Most companies that manufacture rab-
bit food now produce ‘light’ or low calorie pellets as an
alternative to their adult diets.

Key Points 1.11 Weight management in rabbits

• Obese rabbits have high resting heart rates and
can develop hypertension and cardiac hypertro-
Figure 1.9 Patchy hair loss. Some breeds of rabbit with fluffy phy. They are prone to developing fatal hepatic
coats, notably dwarf lops and minilops, develop hairless lipidosis if they become anorexic.
patches of skin during moulting. The alopecic areas often cause
concern to owners. The bald skin is not inflamed. A typical lesion • High fibre diets that would result in weight loss in
is illustrated. Regrowth of hair is rapid. Dense fur starts to grow other species may not be effective in rabbits. Fibre
at the centre of the lesion within 7–10 days and takes place is fermented by the caecal microflora to volatile
simultaneously with hair loss at the periphery of the lesion. This fatty acids.
is a self-limiting physiological process.

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 Rabbit Basic Science 1
Key Points 1.11 Weight management • The amount of indigestible fibre in the diet is very
in rabbits—cont’d important. Too little results in reduced gastrointes-
tinal motility and digestive disorders. Too much
• Weight reduction can only be achieved in rabbits results in malnutrition.
by providing a diet low in digestible fibre and high
• Grass and good-quality meadow hay are ideal
in indigestible fibre.
sources of digestible and indigestible fibre. Wild
• Many rabbit food producers now have a low plants and garden weeds are also good sources
energy or diet formulation of their adult feeds. of fibre.
• Increased amounts of exercise are an important • It is possible to transmit infectious or parasitic dis-
part of a weight reduction programme. ease from wild animals by feeding contaminated
• Rabbit weight loss clinics can be run in the grass or hay.
surgery in much the same way as those for cats • High levels of dietary protein are not necessary for
and dogs. pet rabbits although they do have an essential
amino acid requirement.

Key Points 1.12 Practical rabbit nutrition

• Pet rabbits should have access to ad lib hay. As a 1.4 Taking a clinical history
general rule an adult rabbit will eat a bundle of hay
approximately the same size as its body every day.
1.4.1 Clinical history
• Pet rabbits should be offered fresh vegetables
every day, a portion size approximately the same It is not always easy to elicit an accurate case history.
size as the rabbit’s head is enough. Owners have preconceived ideas of the correct or
incorrect way of keeping rabbits and will often wish
• A small amount of good-quality pellets can be
to give the ‘right’ answer rather than a truthful one. As
offered twice daily (approximately a tablespoon
per kg of rabbit per day). with any anamnesis it is important to ask non-biased
questions in order to avoid leading owners to the
• Incorrect feeding causes many diseases of pet
answer they think you want.
rabbits.
In addition to discussing the owner’s perception
• Owners are often confused by conflicting advice of the presenting problem, important points to cover
given by breeders, pet shops or food manufac- include:
turers. The advice may be based on anecdotal evi-
dence, marketing material or data obtained from • Diet offered: Has this been changed (new food/
commercial production that is not relevant to the new bag) (Figure 1.10)?
pet animal.
• Diet eaten: Have preferences changed? Is the
• Digestion of starch in the small intestine is affected animal definitely eating?
by the age of the rabbit. Adults digest starch more
• How water is offered: Has this been changed?
efficiently than young animals. Undigested starch
that reaches the caecum can act as a substrate for • Kept indoors or outdoors: access to fresh grass and
bacterial fermentation and predispose to the vegetables? Is there possible contact with wild
development of enterotoxaemia. It can also lead rabbits or hares?
to uneaten caecotrophs. • Presence of bonded companions and their health
• Fibre is important to maintain optimum digestion status: Is there a new rabbit that may be bullying
and a healthy caecal microflora. Digestible fibre the existing ones or introducing infection?
provides a substrate for bacterial fermentation in • Vaccination status.
the caecum. Indigestible fibre stimulates gut motility.
• Neutering status.

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 Textbook of Rabbit Medicine

Effects of anorexia Management factors

• Reduced intake of indigestible fibre and reduced intestinal motility • Poor-quality food
• Slow gastric emptying resulting in impaction of stomach • Change of diet
contents and trichobezoar formation • Loss of companion
• Reduced supply of nutrients to caecal microflora resulting in • Elizabethan collars
changes in caecal pH and balance of micro-organisms
• Gas production in bowel, especially the caecum, causing visceral
distension and pain Dental disease
• Reduced glucose absorption from the gut leading to increased • Common.
mobilization of free fatty acids from adipose tissue that can lead • Usually anorexia is due to spurs on cheek teeth impinging on
to fatal hepatic lipidosis. Obese rabbits are at greater risk as tongue (see Section 7.5.9)
fatty infiltration of the liver is already present • Often associated with weight loss, salivation and lack of grooming
• Disturbances in electrolyte and water balance • Can be sudden onset
• Gastric ulceration • Requires general anaesthesia and treatment
(see Section 7.9.2)

Step 1: History and clinical examination:

Gastrointestinal hypomotility
• General condition and demeanour
• Duration of anorexia • Usually sequel to pain, stress or fright
• Passage of hard faeces. Absent or small hard faeces is a • May pick at food. Progresses to total anorexia
significant finding • No hard faeces are passed
• Dental examination (see Section 7.6) • Impacted stomach may be palpable
• Abdominal palpation: look for gastric distension, masses, • End point is death from hepatic lipidosis
impacted stomach or caecum • Can be treated successfully in early stages (see Section 10.3.4)
• Look for other signs, e.g. diarrhoea, dyspnoea, drooling,
myxomatous lesions
Gastric dilatation
• Sudden onset, severe depression
Step 2: Hospitalization • Often associated with intestinal obstruction and treatment is
• Permits observation of appetite and faecal output surgical (see Section 10.5)
(see sections 3.85, 3.8.6) • Site of obstruction may be identified from gas shadows on
• Nursing is often required (see Section 3.10) abdominal radiographs.
• Intensive medication, injectable analgesics, intravenous fluid
therapy and syringe feeding are often needed (see Section 4.11) Caecal impaction (see Section 10.7)
Slow onset
Step 3: Diagnostic workup May be part of to mucoid enteropathy syndrome (see Section 10.9)

• Low dose Hypnorm [0.2mL/mg] is useful for radiography and

venepuncture) Metabolic disease
• Take blood samples: especially for PCV (should be <40%) • Renal failure, may be associated with urolithiasis
glucose, urea, electrolytes. Lipaemia or extreme hyperglycaemia (see Section 14.5)
carry poor prognosis (see Chapter 6) • Liver disease
• Radiographs show impactions, gas or fluid distensions, uroliths,
tumours, etc. Painful skeletal conditions may be seen
Neoplasia
• Uterine adenocarcinoma and lymphoma are common
Step 4: Surgery
• Anaesthesia is necessary to trim elongated spurs
Systemic disease
• Abdominal surgery is indicated for obstructions, neoplasia etc.
but not indicated for gastric stasis or 'trichobezoars' that can be • Myxomatosis, enterotoxaemia, VHD, pasteurellosis, coccidiosis
treated medically are accompanied by other clinical signs
• Surgery needs to be performed promptly • Toxicity, e.g. lead, plant poisons

Figure 1.10 Approach to the anorexic rabbit. The anorexic rabbit requires prompt diagnosis and appropriate treatment. Chance
medication with antibiotic, vitamin or corticosteroid injections is unlikely to be effective and wastes valuable time.

56
 Rabbit Basic Science 1
• Faecal production: Is this increased/decreased? occur in the post-weaning period. Stress predisposes
Are the faeces normal? Are the caecotrophs being young rabbits to pasteurellosis. Rhinitis is often seen
eaten? in young rabbits that have been taken from breeding
• Is the rabbit walking or hopping? Is it able to colonies and presented for sale in pet shops. Congen-
groom itself (Figure 1.9)? Can it exhibit normal ital malocclusion is seen in the young rabbit, whereas
behaviours such as ‘Binkying’? the incidence of acquired dental disease, neoplasia
• Owners may describe symptoms such as tooth and musculoskeletal problems increases with age.
grinding or a change in demeanour. Some rabbits Neoplasia is relatively rare in rabbits; thymomas
exhibit low-grade neurological disorders such as and a variety of skin tumours are among the types
head nodding or scanning when they are relaxed of neoplasms that have been reported. Although
or appear unaware of loud noises. These tumours are usually encountered in elderly patients,
behavioural clues are unlikely to take place in the it is possible to discover neoplasms in young animals.
consulting room when the rabbit is apprehensive Lymphosarcoma has been reported in an 8- to
and have to be elicited from the owner. 10-week-old rabbit (Cloyd and Johnson, 1978).

1.4.2 Breed incidence 1.4.4 Husbandry

Diseases associated with particular breeds may be It is important to find out whether the rabbit lives on
related to the breed specifications (fur matting leading its own or with a mate. Fur chewing or fights can result
to myiasis in lionhead and Angoras, entropion in in alopecia, wounds or abscesses. Does that are kept
French lops) or simply related to the genetic make- with other does or neutered males are more likely to
up of individuals of that breed independent of the suffer from false pregnancies than those housed on
breed characteristics (splay-leg in New Zealand red their own. Contact with wild rabbits is also a relevant
and white rabbits). Dwarf breeds appear to be predis- part of the history. It is not unknown for does to dig out
posed to developing incisor malocclusion. Giant of their enclosure, escape and return or be found a few
breeds are more susceptible to cardiomyopathy and days later. Myxomatosis or pregnancy can be the result.
arthritic conditions. The giant English and French lops Rabbits kept in enclosures or hutches can be visited
are prone to superficial pyoderma in the large skin folds by wild rabbits, especially during the night. There
that can develop under the chin and around the peri- is often a pile of droppings as evidence of the visit.
neum. Entropion also occurs in these breeds. The thin House rabbits are prone to chewing household
fur on the hocks of rex rabbits makes them susceptible fixtures. Heavy metal toxicity or electrocution is more
to developing sore hocks and the short maxilla and likely to occur in a house rabbit than one kept in a
foreshortened face of the Netherland dwarf can alter hutch outside. They are also at a greater risk of trau-
the anatomy of the nasolacrimal duct so it is prone matic injuries and fractures. The material used in the
to blockage. Dwarf breeds appear to have a susceptibil- litter tray is also an important part of the history. For
ity to developing torticollis due to Encephalitozoon cuni- example, pine shavings can cause hepatotoxicity or
culi infection (Kunstyr and Naumann, 1983). clay materials can cause caecal impactions.
Hutch rabbits are more likely to suffer from dis-
eases of neglect. It is not uncommon for hutch rab-
1.4.3 Age
bits with long-standing conditions such as large
Young rabbits that are newly purchased are more abscesses, advanced dental disease and terminal
likely to be affected by infectious diseases than adult neoplasia to be presented with no clinical history
rabbits kept alone. Newly weaned rabbits are suscep- at all. Hutches kept in poorly ventilated areas pre-
tible to various enteric conditions. Colibacillosis is dispose to pasteurellosis and upper respiratory
more prevalent in suckling rabbits, and hepatic coc- tract infections. Hutches exposed to severe weather
cidiosis and mucoid enteropathy are most likely to conditions predispose to heat stroke or stress-related

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 Textbook of Rabbit Medicine

diseases such as gastric stasis following predator kept in a hutch or lives with another rabbit. Faecal
attack, a thunderstorm or severe frost. consistency, size and output are an important part
of the clinical history. Sometimes there are some fae-
cal pellets in the carrier that can be examined during
1.4.5 Eating and drinking
the consultation. A healthy rabbit, that is eating well,
Rabbits normally drink 50–100 mL/kg/24 h (Brewer passes large quantities of hard faeces and eats the soft
and Cruise, 1994). The composition and water con- caecotrophs (see Table 1.6). The number of hard fae-
tent of the diet affects this quantity. Rabbits that eat ces varies with the fibre content of the diet. A healthy
fresh greens may not drink at all (Cheeke, 1987). High 2.5- to 3-kg rabbit produces about 150 hard faecal
protein diets require a high water intake. Fibrous, dry pellets a day (Lowe, 1998). Hard pellets can be
foods absorb water in the intestinal tract and therefore expelled at any time but are always produced over-
increase thirst. During periods of water deprivation, night. Absence of hard faeces is indicative of anorexia
food intake is reduced, sometimes to the point of or reduced intestinal motility. Small faecal pellets are
anorexia. Conversely, food deprivation results in an produced following periods of reduced food intake.
increase in thirst, with rabbits drinking up to 650% Observant owners may see their rabbit ingesting
more water (Brewer and Cruise, 1994). Some rabbits caecotrophs from the anus. Uneaten caecotrophs
never learn to use automatic drinkers and will only are sometimes seen as shiny clusters of dark pasty
drink out of a bowl. Water deprivation eventually pellets in the bedding of normal animals. Uneaten
leads to dehydration and prerenal azotaemia. caecotrophs are often interpreted as diarrhoea. This
Increased drinking or alteration in food preference is not surprising as caecotrophs have a strong smell
can be early signs of dental disease. and a soft consistency in comparison with the hard
faecal pellets. Obesity, spinal problems and dental
disease are among the many reasons for caecotrophs
1.4.6 Urination and defecation to be left uneaten (see Figure 8.6). Uneaten caeco-
Many owners do not know whether their rabbit is trophs can become entangled in the fur under the tail
urinating or defecating normally, especially if it is and form an unpleasant, malodorous faecal mass

Table 1.6 Significance of faecal output

Clinical
condition Hard faeces Soft faeces (caecotrophs)

Normal Large numbers (150) of hard Usually not seen, although occasional cluster of
pellets produced each day caecotrophs in the bedding is not abnormal
Microscopically consist of strands Microscopically contain an abundance of bacteria,
of undigested fibre protozoa and occasional yeast
Anorexia or Reduced in number and size Not seen
starvation
Gut stasis Absent Not seen (absent)
Enteritis Soft or liquid Soft or liquid. Cannot be differentiated from hard faeces
Uneaten Normal, i.e. produced in large May be seen as clusters in bedding or entangled in fur
caecotrophs quantities under tail
Soft uneaten Normal Periodic expulsion of soft, faecal paste which easily
caecotrophs becomes entangled in fur under the tail

58
 Rabbit Basic Science 1
that in turn can lead to myiasis. Changes in the con- amounts of calcium (see Section 1.3.12). Intestinal
sistency of caecotrophs can follow ingestion of a new absorption is related to the calcium content of the
food or a succulent item such as lettuce or fruit. Soft, diet and excess amounts are excreted by the kidney.
sticky or liquid caecotrophs may be passed. It is Therefore the amount of calcium carbonate pre-
thought that this is due to alterations in the caecal cipitate varies with the calcium content of the diet.
microflora. Rabbits on a high fibre diet have a The hydration status of the animal and pH of the
healthy caecal microflora that can withstand dietary urine also affect the amount of precipitate. The
changes. Uneaten caecotrophs are not life threaten- urine can be clear during periods of high calcium
ing although they are unpleasant for the owner demand such as growth, pregnancy or lactation.
and rabbit, and predispose to other conditions such A small amount of precipitate is a good sign as it
as superficial pyoderma, fly strike and problems with reflects adequate calcium content in the diet. Exces-
urination due to inflamed painful perineal skin (see sive precipitate can form a thick sludge, especially in
Sections 7.7.2, 8.6 and 12.4.3). Discrimination the bladder of rabbits that do not urinate frequently
between uneaten caecotrophs and true diarrhoea is (see Section 12.4). High dietary calcium levels exac-
often possible by checking whether normal drop- erbate the problem. Cystitis, urethritis and urinary
pings are being passed concurrently. If they are, incontinence can be the result. It can be difficult
then the ‘diarrhoea’ noted is likely to be uneaten to differentiate between normal calcium carbonate
caecotrophs. deposits and abnormal amounts of sludge. Normal
Enteritis is signified by excretion of faecal material rabbit urine is often radiopaque. Calcium carbonate
that cannot be identified as either hard or soft faeces. deposits in the urine of an otherwise healthy animal
Microscopic examination of the faecal material can with no sign of urinary tract disease do not require
be helpful (see Section 2.6). Caecotrophs consist of treatment; however, it should be recognized that
a paste rich in bacteria that are easily seen on a faecal if the situation changes the calcium deposits may
smear stained with Gram’s stain. Hard faeces consist become clinically significant. Similarly, triple
of particles of indigestible fibre and little else. Some- phosphate crystals can be a normal finding in
times it is necessary to hospitalize the rabbit to rabbit urine.
observe faecal output.
Urination should take place with no pain or dis-
comfort. Normal rabbit urine varies considerably 1.5 Handling
in its visual appearance. The colour can vary from
the pale yellow colour that is familiar in other species
1.5.1 Handling rabbits during the
through a range of oranges and brown to a deep
consultation
red that can be mistaken for blood. The colour
depends on the diet and is the result of the excretion There are many techniques described for handling
of plant pigments. Vegetables such as cabbage, broc- rabbits (Burgmann, 1991; Mader, 1997; Malley,
coli and dandelions often result in the excretion of 2000; Quesenberry, 1994; Richardson, 2000b). Most
red urine. There are clinical conditions such as uro- pet rabbits are used to human contact and do not
lithiasis and uterine disorders that will cause haema- object to being picked up and examined. Rough han-
turia. Examination of the urine with a dipstick dling and overzealous restraint can be counterpro-
differentiates between blood and plant pigments. ductive and alarm the rabbit and upset the owner.
Alternatively, a Wood’s lamp can be used as urinary A quiet, gentle but firm approach is preferable, with
pigments fluoresce when exposed to ultraviolet light the option to restrain the animal more firmly should
(Benson and Paul-Murphy, 1999). the need arise. Rabbits seldom bite vets in the con-
Normal rabbit urine can be cloudy due to the sulting room even if they bite their owners at home.
presence of calcium carbonate precipitates. The rab- Instead they inflict nasty scratches with their power-
bit kidney is adapted for the excretion of large ful hind feet.

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 Textbook of Rabbit Medicine

It is usually possible to lift pet rabbits out of car- the behaviour of the rabbit being examined and
riers by placing a hand round either side of the chest modification of approach if struggling occurs is less
and lifting them in the same manner as a cat or small likely to result in injury to either handler or patient.
dog. Placing a forefinger around each front leg can be
helpful. Fractious or nervous animals can be lifted by
the scruff with a supporting hand under the rear end.
Key Points 1.13 Rabbit handling
Very excitable or aggressive rabbits can be caught and
removed from the carrier in a towel. Picking rabbits • While most rabbits tolerate handling well, some
up by their ears is not acceptable and is no longer respond by struggling and jumping. This can result
advocated, although it is recommended in some in broken bones and teeth as well as injury to the
older texts. After being removed from the carrier, it handler.
is often useful to allow the rabbit to hop around • Rabbits have spinal muscles strong enough to
the floor of the consulting room as long as this is safe. break their own spines should they contract forcibly,
In this way the rabbit can become acquainted with a for example when trying to kick out with their back
new environment, and important information about legs. Isometric contraction of the spinal muscles
can still result in significant spinal damage, for exam-
its general condition and mobility can be gained.
ple when a struggling rabbit is wrapped in a towel.
Alternatively the rabbit can be held on the consulting
table and observed while a clinical history is being • In the surgery setting, rabbits should be picked up
obtained from the owner. To examine the perineum, from the carrier. In the home setting it is much less
stressful for the rabbit to be approached from its
the rabbit can be restrained in dorsal recumbency
own level.
either by holding the scruff and lying the rabbit on
its back or by cradling it like a baby in the arms of • Rabbits should be picked up by placing a hand
an assistant or the owner. Dorsal recumbency may under their chest and using the other hand to sup-
port the back end of the body. For some aggressive
evoke an immobility response but can be a source
rabbits it is necessary to pick them up using the
of stress, leading to kicking and struggling. An alter-
scruff; however, it is still vitally important to support
native approach is to hold the rabbit upright and rest the body weight at the back end of the body.
its rear end on the consulting table. There are many
• Rabbits should never be picked up by their ears
approaches and each clinician will find a method
that suits them. • Rabbits can often be examined using minimal
Wrapping a rabbit in a towel is a satisfactory restraint, and an owner or nurse simply gently
method of restraint for examination of the face and holding the rabbit in place is enough. For rabbits
that try to escape, covering their eyes with a hand
mouth or for venepuncture. A large towel is placed
is often helpful and calms them down enough for
on the table and the rabbit placed on top of it before
examination.
being wrapped up so the whole body is enclosed with
only the head exposed. An assistant, who may be the • For procedures that are intimidating (looking inside
the mouth) or painful, using a towel to wrap the
owner, is needed to hold the rabbit firmly against
rabbit may be necessary. It is still possible for a
them or pressed gently on to the table. The front legs
rabbit to injure itself in this situation.
can be held. Jackson (1991) found that restraining
laboratory rabbits by wrapping them securely in • Tonic immobility can be used as a means for
restraining rabbits for portions of the clinical
a towel not only reduced the stress of handling but
examination. Some rabbits are resistant to this
also reduced the incidence of gastrointestinal stasis.
technique and it is thought to be stressful.
It is important to remember that rabbits can still
cause themselves harm whilst wrapped in a towel, • Ultimately some rabbits will benefit from sedation in
order to allow complete examination. This is likely to
and isometric contraction of the powerful lumbar
be less stressful than the alternatives.
muscles can result in spinal fracture. Attention to

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 Rabbit Basic Science 1
A good method of carrying a rabbit is to hold it rate. An awareness of external stimuli is maintained,
with its face tucked in under the handler’s elbow, although there is a decreased response to noise and
with the rest of the body resting on the forearm. painful stimuli (Danneman et al., 1988). This
The close physical contact and covering the face trance-like state is induced in the laboratory by plac-
appears to placate fractious animals. This can also ing the rabbit in dorsal recumbency, covering its
be a good method of restraint for venepuncture of eyes with its ears and flexing its chin against the
the lateral saphenous vein, as the restrainer can easily neck. The hind legs are stretched out for a few
raise the vein on the external rear leg. minutes before releasing the legs and gently strok-
ing the chest and abdomen. As long as the head is
flexed, the rabbit remains immobile and restraining
1.5.2 Immobility response (tonic devices have been designed to maintain this posi-
tion (Bivin, 1994).
immobility, freeze response or
There are similarities between the immobility
‘hypnosis’)
response and an opiate-induced state. The exact role
The immobility response is often described as of endogenous opioid systems is controversial
‘hypnosis’, ‘tonic immobility’, ‘the freeze response’ or and there are conflicting reports about the effects
‘trancing’. Hypnosis can be a useful method of restrain- of naloxone which, theoretically, should prevent
ing rabbits for minor procedures (Bivin, 1994). or reverse the hypnotic state (Danneman et al.,
Although hypnosis has been described for more inva- 1988). Sudden noise or painful stimuli can interrupt
sive techniques such as castration (Okerman, 1988), it the trance and there is considerable variation in
is not a humane alternative to anaesthesia or analgesia. individual susceptibility to the technique. In a study
There is controversy about placing conscious rabbits in by Danneman et al. (1988), the immobility
dorsal recumbency at all. On one hand, some practi- response could not be evoked in 25% of rabbits.
tioners lie rabbits on their backs to perform a variety In the consulting room, some pet rabbits can be
of procedures such as nail clipping, oral administration calmed and restrained by placing them in dorsal
of medicines and even inserting mouth gags to exam- or lateral recumbency and gently stroking their
ine or clip molars. On the other hand, there is a view stomach while quietly speaking to them. Blowing
that the immobility response occurs in stressful situa- gently on their face or stroking the bridge of the
tions and that rabbits lying on their backs are terrified nose can also be effective.
and waiting to be eaten. However, it is a useful tech- The physiological response noted in rabbits
nique in some situations. For, example, it is possible following induction of the immobility response is
to immobilize conscious rabbits for long enough to similar to that found following a stressful event. Rab-
take abdominal radiographs. bits having this response induced repeatedly initially
The immobility response is exhibited in prey spe- become sensitized and then habituated to it; how-
cies under conditions that are stressful or threaten- ever, corticosteroid levels remain elevated afterwards
ing. The more highly a species is preyed upon, the (Farabollini et al., 1981, 1990). Fear behaviours were
easier it is to induce the response. The immobility also noted in six rabbits who were tranced repeatedly
response is a transitory and reversible state of pro- (McBride et al., 2006). This supports the assertion
found motor inhibition. The phenomenon is char- that this phenomenon is indicative of a fear-
acterized by lack of spontaneous movement and motivated stress response (Day, 2004). It is therefore
failure to respond to external stimuli for several inappropriate to advocate the use of the immobility
minutes. In rabbits, there is hypotonia of flexor response in order to promote bonding between a
and extensor musculature, abolition of the righting rabbit and an owner; however, its use in veterinary
reflex, depression of spinal reflexes, miosis and a practices in order to avoid unnecessary anaesthesia
drop in blood pressure, heart rate and respiratory is justifiable.

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cystitis, parasitic skin disease, perineal soiling from

1.6 External characteristics and physical
uneaten caecotrophs, fly strike, cardiovascular dis-
examination ease, arthritis, hepatic lipidosis and death. At the
other end of the scale, weight loss is a significant clin-
1.6.1 External characteristics ical finding as rabbits are seldom given insufficient
As prey animals, the external characteristics of the food unless there is serious neglect taking place.
rabbit reflect the need to be aware of their surround- Dental disease, gastrointestinal hypomotility, renal
ings. The defining external feature of rabbits is their or liver disease or neoplasia can cause weight loss
prominent external ears. These can range from despite the rabbit looking lively and well to its
5–6 cm long and upright to 30 cm or more and owner.
draped/lopped to the ground. In the wild rabbit Reusch (2010) proposed a method for body con-
these are constantly used to identify and localize dition scoring in rabbits. Condition scoring relies
potential threats. The eyes are prominent and found on the palpation of certain anatomic landmarks
on either side of the head, giving nearly 360 vision. to assess body fat, rather than relying on just weigh-
The nose is almost constantly moving and twitching ing the animal. With this method, areas of the body
and as well as having an acute sense of smell the nos- associated with body fat deposition (hips, ribs,
trils are sensitive to touch with large numbers of tac- spine) are scored to assess whether a rabbit is obese.
tile vibrissae. In trials conducted at the University of Edinburgh,
Rabbits have a thin skin and dense fur that con- the rib area proved to be the most useful for asses-
sists of a soft undercoat and stiff guard hairs. They sing body fat, with the hips and spine only showing
do not have footpads; instead, the feet are covered appreciable changes at extremes of body weight. The
with thick fur. The skin on the neck is loose and ribs are felt just behind the elbow and the amount of
pendulous and forms a pronounced dewlap in pressure required to feel the ribs is assessed. The
females of some breeds. Scent glands are situated greater the pressure required, the more fat is present
in the deep inguinal spaces found on either side of (Table 1.8).
the anus immediately dorsal to the urogenital open-
ing. In the male rabbit, the testicles are found in
hairless scrotal sacs on either side of the penis. The 1.6.2.2 General demeanour
inguinal canal remains open and the testicles can
be retracted into the abdomen. Retraction occurs A healthy rabbit is responsive and alert, with its nose
during periods of sexual inactivity or during periods constantly twitching. It is aware of its surroundings
of insufficient food. Male rabbits have rudimentary and once comfortable should be eager to explore.
nipples. The response to pain is to become quiet, immobile
and oblivious of the surroundings. Visceral prob-
lems such as gut stasis or urolithiasis appear to be
1.6.2 Clinical examination more distressing to rabbits than the abscesses or
fractures. Occasionally, overt signs of pain such as
A list of differential diagnoses for some commonly tooth grinding can be evident. This is usually asso-
encountered conditions of pet rabbits is given in ciated with visceral pain, especially impactive intes-
Table 1.7. tinal problems such as mucoid enteropathy (see
Section 8.9). Intestinal obstruction is associated
with severe depression and immobility, which gives
1.6.2.1 General condition a characteristic clinical presentation (see Box 1.8).
The general health of a rabbit can be assessed by the The presence of spurs on the molars that traumatize
state of its coat and its body weight. Obese animals the sensitive mucosa of the tongue is also very
are prone to grooming difficulties, sludgy urine, painful for rabbits.

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 Rabbit Basic Science 1
Table 1.7 List of differential diagnoses for some common conditions in pet rabbits

Symptoms Differential diagnosis Comments

Abdominal distension Gastric dilatation

Obesity
Pregnancy
Hepatic coccidiosis Can cause ascites
Liver tumour Can cause ascites
Uterine adenocarcinoma
Cardiac disease Can cause ascites
Abdominal mass Pregnancy
Neoplasia Especially uterine adenocarcinoma
Caecal impaction
Extra-uterine pregnancy
Abscess
Fat necrosis
Full bladder,? urolithiasis
Tapeworm cysts
Renal enlargement Neoplasia, hydronephrosis, renal calculi
Abortion Listeria monocytogenes
Treponema paraluiscuniculi
Anorexia (see Figure 1.13) Unpalatable diet Pain, unfamiliar surroundings, predator proximity, loss
Stress of companion
Dental disease • Spurs on cheek teeth lacerating the tongue
• Elongated incisors physically impeding intake of food
• Fractured teeth causing pain
Gastrointestinal hypomotility Secondary to any stressful situation
‘Gut stasis’, ‘trichobezoars’ Predisposed by inadequate dietary fibre
Intestinal obstruction Acute onset
Associated with severe depression
May be caused by ingested felts of hair, foreign bodies
such as dried peas and pulses
May be due to extramural lesion such as abscesses,
tumours or tapeworm cysts
Mucoid enteropathy Slow onset
Tooth grinding
Absence of faeces or mucus  diarrhoea
Associated with stress
Juvenile rabbits most commonly affected
May have palpably impacted caecum
Continued

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 Textbook of Rabbit Medicine

Table 1.7 List of differential diagnoses for some common conditions in pet rabbits—cont’d

Symptoms Differential diagnosis Comments

Caecal impaction Idiopathic

Excess dietary fibre and inadequate water intake
Ingested clay litter material
Infectious disease Pasteurellosis, myxomatosis, VHD, enterotoxaemia
Systemic disease Renal disease, hepatopathy
Neoplasia
Trauma Jaw fracture
Ataxia Spinal cord compression
Encephalitozoon cuniculi
Ketoacidosis
Starvation
Trauma
Septicaemia
Heat stroke
Lead poisoning
Blepharospasm Keratitis
Keratitis in association with
dacrocystitis
Corneal ulcer
Conjunctivitis May be secondary to poor air quality or dust from hay
Conjunctival foreign body ? Hay seeds
Uveitis
Entropion May be congenital or acquired from fight wounds
involving eyelids
Swollen eyelids Myxomatosis
Treponema paraluiscuniculi
Neoplasia
Abscesses
Deafness Middle ear infection Pus in tympanic bulla as a result of ascending infection
from the eustachian tube
Encephalitozoon cuniculi
encephalitis
Pus, wax and exudate in
external ear canal
Diarrhoea (see Table 8.2) Uneaten caecotrophs Uneaten caecotrophs are often interpreted by owners
as ‘diarrhoea’

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 Rabbit Basic Science 1
Table 1.7 List of differential diagnoses for some common conditions in pet rabbits—cont’d

Symptoms Differential diagnosis Comments

Uneaten soft caecotrophs Soft uneaten caecotrophs can be induced by dietary

change, especially after introduction of succulent foods
such as lettuce
Antibiotic-associated Some antibiotics, e.g., oral penicillin, ampicillins,
diarrhoea clindamycin and lincomycin can induce diarrhoea by
their effects on the gut flora
Enteritis
Enterotoxaemia
Coccidiosis
Exophthalmos: bilateral Fear e.g., short-nosed dwarf breeds
Males in breeding season
Natural appearance
Paraneoplastic disease Thymoma
Bilateral glaucoma
Bilateral retrobulbar
abscesses
Exophthalmos: unilateral Glaucoma Congenital
Secondary to other diseases such as trauma, tumours
or E. cuniculi lens rupture
Retrobulbar disease Abscess
Tumour
Haemorrhage
Tapeworm cyst
latrogenic rupture of nasolacrimal duct and infiltration of
periorbital space with fluid
Haematuria Cystitis (‘sludgy urine’) NB: Blood from the uterus may be voided in urine as the
Urolithiasis vaginal vestibule fills with urine during micturition. Blood
Uterine adenocarcinomas clots may be present
Uterine polyps
Endometrial venous
aneurysms
Chronic polypoid cystitis,
renal infarcts and
disseminated intravascular
coagulopathy have also
been described as causes of
haematuria in laboratory
rabbits
Continued

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 Textbook of Rabbit Medicine

Table 1.7 List of differential diagnoses for some common conditions in pet rabbits—cont’d

Symptoms Differential diagnosis Comments

Head tilt Encephalitozoon cuniculi Granulomatous inflammation of central nervous tissue

Infection of the vestibular Usually ascending Pasteurella multocida from nasal
apparatus cavity via eustachian tube
May be abscesses along vestibular tract
Other CNS disease Trauma, neoplasia, etc.
(In USA) Baylisascaris larva Raccoons are natural host
Increased respiratory rate Stress Due to unfamiliar surroundings or proximity of predators
Metabolic acidosis Ketoacidosis
Heat stroke Hot stuffy shed
Transport by car
Paradoxical breathing Hutch situated in sun
Heatpads
Fear/distress
Trauma ? Predator attack
Penetrating injuries of chest wall
Haemothorax, pneumothorax, etc.
Rhinitis Pasteurellosis
Nasal foreign body, e.g., hay or seed
Tooth root abscess
Obstruction of nasopharynx, Inflammation caused by pasteurellosis
larynx or trachea
Abscess
Foreign body, hay or seed
Exudate from lung disease
Lung disease Primary bacterial pneumonia, e.g., pasteurellosis
Secondary pneumonia, e.g., myxomatosis, mucoid
enteropathy
Viral haemorrhagic disease
Aspiration pneumonia
Primary or secondary neoplasia
Pulmonary abscess
Pulmonary oedema Congestive heart failure
Heat stroke
Electrocution

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 Rabbit Basic Science 1
Table 1.7 List of differential diagnoses for some common conditions in pet rabbits—cont’d

Symptoms Differential diagnosis Comments

Pleural effusion Neoplasia

Cardiomyopathy
Coronavirus
Congestive heart failure
Liver disease Hepatic lipidosis
Hepatic coccidiosis
Viral haemorrhagic disease
Hepatopathy Has been associated with pine wood shavings as litter
material
Aflatoxin
Neoplasia Cysticercus pisiformis
Bile duct obstruction ? Neoplasia
Toxoplasma gondii Adhesions
Polydypsia Anorexia
Food deprivation
Renal disease ? E. cuniculi
? Diabetes mellitus There is debate about incidence of diabetes mellitus in
pet rabbits
Paresis/paralysis Spinal fracture Trauma? predator attack
Spontaneous due to pre-existing bone disease
Degenerative disc disease Disc protrusion may follow trauma
Spinal deformities Kyphosis, scoliosis, spondylosis
Neoplasia Primary or secondary bone tumours can cause spinal
cord compression
Spinal abscess Spinal abscess can cause cord compression
‘Floppy rabbit syndrome’
Pruritus Flea infestation Usually dog or cat fleas
Louse infestation
Allergic skin disease
Compulsive self-mutilation
Ringworm
Renal disease. NB Nephrolithiasis
Continued

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 Textbook of Rabbit Medicine

Table 1.7 List of differential diagnoses for some common conditions in pet rabbits—cont’d

Symptoms Differential diagnosis Comments

Asymptomatic renal E. cuniculi

disease can be present Hydronephrosis
due to benign embryonal Renal calcification
nephroma, congenital
renal cysts or
encephalitozoonisis
Reversible azotaemia can Renal abscesses
occur due to stress, Staphylococcal nephritis
dehydration or water Pyelonephritis
deprivation Lymphoma
Neoplasia
Amyloidosis
Renal agenesis
Toxic compounds
Seizures Encephalitozoonisis
Viral haemorrhagic disease
Toxicity, e.g., lead
Terminal hepatic lipidosis
Arteriosclerosis
Toxoplasma
Idiopathic epilepsy
CNS disease
Skin lesions: alopecia Physiological, moulting Some fluffy haired breeds lose fur in patches
Fur pulling for nestmaking
Treponema paraluiscuniculi Associated with pregnancy or pseudopregnancy
Barbering
Fighting Caused by dominant cage mate
Cheyletiellosis
Ringworm
Nutritional e.g., essential sulphur amino acid deficiency
Skin lesions: crusty Ringworm
Superficial pyoderma
secondary to trauma
Ectopic Psoroptes cuniculi

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 Rabbit Basic Science 1
Table 1.7 List of differential diagnoses for some common conditions in pet rabbits—cont’d

Symptoms Differential diagnosis Comments

Allergic dermatitis
Atypical myxomatosis
Treponema paraluiscuniculi Rabbit syphilis
Rectoanal papilloma
Skin lesions: nodules Primary tumours e.g., fibromas
Circumscribed abscesses
Atypical myxomatosis
Skin lesions: swellings Abscesses
Tumours
Hernias
Subcutaneous Cysticercus Dogs/foxes are intermediate hosts
serialis cysts
Sudden death Enterotoxaemia
Viral haemorrhagic disease
Intestinal obstruction
Choking Especially rabbits with advanced dental disease that
Predator attack can choke on pieces of hay
Trauma
Acute pasteurellosis
Electrocution
Cardiomyopathy
Neoplasia
Poisoning, e.g., yew
Listeriosis Females in late pregnancy
Weight loss (see also Dental disease
anorexia) Gastrointestinal hypomotility
Renal disease
Caecal impaction
Chronic liver disease Hepatic coccidiosis in young rabbits
Neoplasia
Change of diet
Bullying by cage mate
Pseudotuberculosis

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 Table 1.8 Body condition scoring in rabbits

Score 1 Score 2 Score 3 Score 4 Score 5

Emaciated Lean Ideal Fat Obese

• Pelvis and ribs are very • Pelvis and ribs • Pelvis and ribs easily • Firm palpation • Hard to
easily palpated and easily palpated palpated but required to palpate ribs
very sharp and feel sharp rounded edges palpate ribs • Ribs can’t
• Ribs feel like a • Rump area is flat • Ribs feel like a • Rump round be felt
pocket full of rulers pocket full of pens • Rump very
• Concave rump area • Rump area is flat convex

Box 1.8 Intestinal obstruction in pet rabbits

Intestinal obstruction in pet rabbits gives a characteris- • Abdominal palpation. An impacted organ,
tic clinical presentation. The most common cause of intussusception or foreign body may be palpable,
obstruction is a felt of hair that is groomed out of the especially if the rabbit is anaesthetized or moribund.
coat, especially the hind feet, during moulting. Dried • Prompt exploratory laparotomy is indicated.
pulses, foreign objects, tumours and tapeworm cysts
are among other causes of obstruction (see Treatment
Chapter 8). If the condition is recognized early and sur-
gery is performed promptly, there is a reasonable • Motility stimulants are contraindicated prior to
chance of success. If the condition is not recognized surgery. Postoperatively, metoclopramide (with
and treated, the rabbit will die unless the foreign body caution) and ranitidine are required to prevent
happens to pass into the colon. ileus. Cisapride may be used if available.
• Effective analgesia is important. Low dose fentanyl/
Presentation
fluanisone (Hypnorm, Janssen 0.2 mL/kg) provides
• Sudden onset. The rabbit was well until a few hours analgesia, sedation and vasodilation that facilitates
before presentation. intravenous fluid therapy.
• Severe mental depression. The rabbit is unresponsive • Decompress the stomach by passing a stomach
and totally anorexic. tube (a stomach tube should remain in place
• Abdominal distension. The owners may have throughout surgery). This can usually be done
noticed a bloated appearance although it may be after the rabbit has been sedated.
masked by a thick coat. • Fluid therapy. Intravenous (or intraosseous) fluid
• Palpably distended stomach. A ‘strange feeling’ or therapy is essential. Subcutaneous fluids will be
distended abdomen or abdominal pain is a clear ineffective in restoring and maintaining blood
indication for abdominal radiography. pressure and correcting dehydration and
electrolyte imbalances.
• Shock, dehydration and collapse. Depending on the
site of the obstruction, the rabbit’s condition will • Anaesthesia, gradual mask induction with isoflurane
deteriorate rapidly. is recommended. Anaesthesia and perioperative
care are described in Chapter 4.
Diagnosis
• Enterotomy. Midline incision. The obstruction is
• Abdominal radiographs are diagnostic. A stomach
often easy to find. The gas-filled small intestine
distended with gas and fluid is clearly visible (see
can usually be identified and followed to the site
Figure 8.5). A section of gas-filled intestine can
of the obstruction. (Basic surgical principles in
usually be seen radiographically, proximal to the
rabbits are described in Chapter 13.) Fine suture
site of obstruction. If the obstruction moves into
material (5/0 or 6/0 PDS or Monocryl) is required
the colon, gas can be seen in the caecum and
to repair the intestinal incision. A set of fine
proximal colon.
instruments is essential (a detailed description of
• Other causes of gastric dilatation include mucoid surgical procedure is given in Chapter 8).
enteropathy or dysautonomia, both of which carry
a poor prognosis.

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 Rabbit Basic Science 1
1.6.2.3 Gait no comparison can be made. It is often simpler to
sex neonates than animals of 4–6 weeks of age. Adults
It is often helpful to allow the rabbit to hop around
are usually straightforward because entire males have
the consulting room floor, providing the owner and
prominent descended testicles. Bucks tend to be larger
practitioner are confident that the animal can be
and have a broader head than does. Mature, entire
caught again. Slippery vinyl is a difficult surface for
males develop a thick skin, especially around the
rabbits to move about on. Placing a large towel on
scruff and on the dorsum. Females often have a dew-
a slippery floor aids assessment of the patient’s gait.
lap as a secondary sexual characteristic although some
Abnormal gait associated with spinal problems or
males can develop quite a pronounced dewlap, espe-
fractures may be discovered. Neurological deficits
cially if they are castrated or overweight. Pressure on
can become evident and the rabbit’s general demean-
the genital orifice everts either the penis or the vulva.
our is easier to assess. It is useful to note whether the
The vulva can look like a small penis to the novice but
rabbit is hopping or walking. Healthy rabbits will
is shorter, less round and has a slit-like opening rather
tend to hop in most situations even if moving slowly
than the circular orifice of the male (see Figure 1.11).
while rabbits with neurological or skeletal disorders
Testicles descend at 10–12 weeks, although they can
will often walk.
be retracted into the abdomen during periods of ill
health or starvation.
1.6.2.4 Sex, age and sexual maturity There are conflicting reports on the life expectancy
Rabbits can be difficult to sex, especially when they are of rabbits. Five to 7 years is the life span given by
immature, wriggling and presented individually, so Gillett (1994), with a comment that rabbits can live

A B

Figure 1.11 Inguinal skin folds and male and female genitalia. In both sexes, deep skin folds lie on either side of the genital orifice.
These folds contain scent glands. It is normal for the folds to contain a waxy, odorous exudate. In (B), a brown exudate can be seen.
Rabbits can be sexed by applying gentle pressure on the genital orifice to extrude the genital organ. (A) Male genitalia. In the male, the
penis is extruded. Testicles can usually be seen in the scrotal sacs of sexually mature rabbits (> 10–12 weeks) although they can be
retracted during periods of stress, illness or shortage of food. (B) Female genitalia. In the female, the vulva is extruded. The vulva can look
similar to a small penis but is shorter and less round, and has a slit-like opening rather than the circular orifice of the male.

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 Textbook of Rabbit Medicine

to be 15. Many pet rabbits live longer than 7 years can just be seen with the naked eye, especially under
and can easily attain 11–12 years, although geriatric good illumination. A magnifying glass can be used to
diseases are common in this age group. With the examine the fur thoroughly. Microscopic examination
increased availability of good veterinary care many of skin brushings or sellotape strips confirms their
more rabbits are achieving a long life expectancy. presence and gives an idea of numbers. Most rabbits
It is difficult to age living rabbits with any degree have some degree of infestation, which is not always
of accuracy. The epiphyseal line in the tibia closes significant; however, extensive infestation can be a
at approximately 9 months of age. The epiphyses sign that something is causing stress to the animal
of the lumbar vertebrae close much later. Counting or preventing grooming (see Section 7.14.2). The
the adhesion lines in the periosteal zone of the man- areas of skin between the shoulder blades and above
dible by histopathological examination can be used the base of the tail are difficult for the rabbit to reach
to age mature rabbits accurately (Henderson and and groom, especially if it obese or has limited flexi-
Bowen, 1979) but this is not possible during life. bility due to spondylosis (see Figure 1.19). Cheyletiel-
The deciduous teeth are shed at birth and so the only losis often starts to become evident on the back of the
criteria to make an assessment of age during clinical neck and along the dorsum. During the summer,
examination are the size and appearance of the rab- soiled fur at the base of the tail or the perineum must
bit, both of which vary according to breed and state be examined closely for the presence of maggots. The
of health and experience. The claws of the rabbit do area under the dewlap is prone to superficial pyo-
not project beyond the fur until the rabbit reaches derma, predisposed by factors such as poor hygiene,
maturity (Sandford, 1996), but this age varies dental disease or obesity. Some rabbits are unable
according to breed and size. Fanciers may be able to drink without immersing their dewlap in the water
to give an indication of age by feeling the ears, which bowl, leading to wet macerated skin and dermatitis or
are soft in young rabbits and become tougher with myiasis. Excess salivation as a result of dental disease
age (Sandford, 1996). Pedigree rabbits may have can result in a wet dewlap that is prone to bacterial
rings over their hocks on which the year of birth will infection. Fat rabbits with excessive skin folds and
be recorded. Smaller breeds mature at 4–5 months of large dewlaps experience problems grooming and
age and the larger breeds mature at 5–8 months may lick the cranial surface of the dewlap obsessively
(Donnelly, 1997). Bucks reach puberty later than as a type of displacement activity because they cannot
does, so immature females housed with their groom other areas such as the underside of the dewlap
brothers are unlikely to conceive even though the or the perineum which is infected, inflamed and sore.
buck may mount and appear to mate her. Obviously, Steatitis within the fat of the dewlap can also lead to
the two sexes should be separated or neutered at this chronic skin mutilation. This can be the result of pre-
stage if pregnancy is to be prevented. vious trauma.
The forelegs are used to clean the face. Examina-
tion of the inner aspect of the carpus and metacarpus
1.6.2.5 Examination of the skin, fur and may show saliva staining indicative of dental disease.
mucous membranes Dried mucopurulent material can be found in rabbits
A healthy rabbit will spend a lot of time grooming. with ocular or nasal discharges. Examination of the
Rabbits that are kept together groom each other, espe- fore and hind limbs may show evidence of ulcerative
cially around the head. There are many clinical condi- pododermatitis. An area of thin, hairless skin over
tions that can prevent a rabbit from licking and the point of the hock is not unusual. It should be pro-
grooming properly (see Figure 1.9), which are mani- tected by thick fur that is directed across it. Rex rab-
fested by a dull coat full of dead hair and skin debris. bits are very prone to sore hocks due to the lack of
Combing through the fur with a flea comb gives an protective guard-hairs in their coat.
idea of the amount of dead hair and debris and also Felts of densely matted hair are a cause of intesti-
reveals the presence of fleas, flea dirt or mites. Mites nal obstruction if the rabbit ingests them during

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 Rabbit Basic Science 1
grooming. Large felts can accumulate on the plantar adherent caecotrophs, fly strike, perineal fold derma-
aspect of the hind feet. Owners should be advised to titis or diarrhoea may be evident on examination of
groom these animals daily and ensure that loose felts this area (see Figure 1.12).
of hair are removed. It is sensible to be careful when The two deep folds of skin on either side of the
removing hair from the plantar aspects of the feet as anal orifice are the inguinal glands that are normally
this serves a protective purpose and removal of too filled with a yellow-brown odiferous waxy secretion
much hair can cause hock sores. Rabbits with dental (see Figure 1.11B). These glands can become
problems or long-haired breeds such as Angoras are impacted and require the secretion expressing, or
especially at risk. infected, causing production of pus.
The perineum is an extremely sensitive area in rab-
bits. Pain caused by infected, inflamed perineal skin
1.6.2.6 Examination of the perineum can lead to urine retention, urethritis, cystitis and/or
Examination of the perineum confirms the sex of the urinary incontinence. Urine scalding can also be due
rabbit and gives an indication of general state of to urogenital disease or indicative of other problems
grooming. Urine scalding, vaginal discharges, such as vertebral spondylitis, sore hocks or arthritis,

Conditions such as:

urolithiasis, dental disease, obesity,
spondylitis, dietary changes, E. cuniculi,
spinal cord compression, etc. Can lead to:
Urinary Uneaten
incontinence caecotrophs

Reluctance Reluctance to
Cystitis
to urinate groom perineum Faecal mass
adherent to
perineum

Urine scalding Painful perineum

Sore inflamed perineum

Superficial pyoderma

Soiled matted fur

Dirty bedding Fluffy breeds that cannot Fly strike

self-groom, e.g., Angora,
dwarf lops

Figure 1.12 Causes of perineal soiling in pet rabbits. A healthy, short-coated rabbit will meticulously groom its perineum and
keep it clean. There are many inter-relating factors that can prevent effective grooming of this area and result in matted, soiled fur with
or without inflamed underlying skin.

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 Textbook of Rabbit Medicine

which prevent the rabbit positioning itself correctly appearance when dehydrated, the thin skin becomes
to urinate (see Section 12.4.3). Neurological deficits, wrinkled and loses its turgidity. The hairless scrotal
abdominal pain or generalized weakness can also skin of males is a useful site for assessing hydration
lead to urine scalding or perineal soiling. Skin status by tenting the skin. The inguinal skin can be
inflammation in the perineal area may be caused used in females.
by uneaten caecotrophs that have become adherent Mucous membranes can be examined by looking at
to the fur and caused superficial pyoderma of the the colour of the nose or by lifting the lip to see the
skin beneath. Obesity, dental disease and arthritis gums and tongue. Cyanosis is evident in advanced
prevent grooming around the perineum so the fur cases of cardiovascular or respiratory disease. Mild
becomes matted, soiled and infected. This starts a anaemia is more difficult to elucidate, although extreme
vicious circle that can be broken by clipping and pallor is obvious. The mucous membranes can also be
cleaning the perineal area and treating the painful used to assess hydration; as long as they remain wet
dermatitis (see Figure 7.1 and Section 7.7.3). to the touch, the rabbit is well hydrated. Tacky or sticky
Clippers can be used to remove most of the fur. A mucous membranes indicate dehydration.
sharp pair of curved, pointed scissors is useful for
teasing out and cutting matted hair around the
genitalia and under the tail. Dead and matted hair 1.6.2.7 Rectal temperature
can be combed out with a flea comb. It is very easy The rectal mucosa is thin and easily damaged. A ther-
inadvertently to damage the delicate skin. Patience mometer can easily tear the rectal wall if a rabbit
and the correct equipment are required. Sedation struggles during temperature taking. Many practi-
may be needed. The underlying reason for urinary tioners do not routinely take the rectal temperature
incontinence, cystitis, grooming difficulties or unea- as part of their clinical examination because of the
ten caecotrophs needs to be addressed to prevent risk of trauma and the limitations in interpreting
recurrence. its significance.
The appearance of the vulva alters according to the
state of sexual receptivity. When the doe is non-
Key Points 1.14 Basic examination parameters
receptive, the vulva is pale pink and dry. During
receptivity, the vulva becomes swollen, moist and • The normal resting respiratory rate is 32–60
red, becoming darker until it is purple at the end breaths per minute.
of the receptive period. If the doe is mated, the vulva • The normal resting heart rate is 130–325 bpm.
returns to a light pink colour within 24 hours. Murmurs, arrhythmias and pulse deficits should
Inflamed or crusty skin around the genitalia can all be noted.
be associated with Treponema paraluiscuniculi (rabbit • The pulse may be taken using the central auricular
syphilis) or ectopic Psoroptes cuniculi (ear mite) infes- artery.
tation. Ear mites can be transferred from the ears to • These parameters should be checked early in the
the perineal folds during grooming. Examination clinical examination before stress of handling
of the external ear canal of affected rabbits reveals causes significant elevation.
thick crusty exudate caused by P. cuniculi. Rectoanal
• Capillary refill time is less than 2 seconds, and the
papillomas can cause crusty lesions that protrude mucous membranes should be pink.
through the anal sphincter.
• Gut movements may be heard every 30–45 sec-
The hydration status of the rabbit can be assessed
onds, but can be absent on examination.
during examination of the perineum. Dehydration
can occur in the absence of obvious fluid loss because • Immature rabbits can be sexed by everting the
of the redistribution of water and electrolytes associ- genital orifice. The female has a slit-like vulva.
The male has a penis. Testicles descend at
ated with alterations of gastrointestinal motility.
10–12 weeks.
Although rabbits do not take on a ‘sunken eyed’

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 Rabbit Basic Science 1
the right kidney, which lies close to the rib cage.
Key Points 1.14 Basic examination
The stomach cannot be palpated in the normal rab-
parameters—cont’d
bit. In some cases of gastric stasis, the stomach may
• Female rabbits have a dewlap. be felt as a hard round mass just behind the ribs on
• It is difficult to age live rabbits with any degree of the right-hand side. Intestinal obstruction causes
accuracy; the flexibility of the ear cartilages, the gross distension of the stomach with gas and liquid
wear of the teeth and experience may all give (see Box 1.8). The caecum may be felt as a soft pliable
clues. structure in the ventral abdomen. The size and con-
• Examination of the perineum is an essential part of tents vary with diet and time of day. A full caecum
clinical examination. Urine scalding or faecal soil- may be felt as a doughy mass. Caecal impactions
ing may be indicative of other diseases. are felt as a hard sausage-like structure. Gas disten-
• Normal rectal temperature is variable: < 38 C can sion of the caecum can result from gastrointestinal
be considered subnormal, whereas > 40.6 C is hypomotility. In these cases, the caecum may not
significantly high. Taking a rectal temperature be differentiated from other organs or can be felt
can cause rectal tearing so it should be under- as a gas-filled structure that makes a sloshing sound
taken carefully. when palpated. The bladder can be felt in the caudo-
ventral abdomen. It should be palpated with care as
it can rupture easily, especially if the urethra is par-
Normal rectal temperature of rabbits is 38.5–40 C tially obstructed by a urolith. Rabbits suffering from
(103.3–104 F). It is affected by factors such as envi- urolithiasis or cystitis often strain in response to
ronmental temperature and restraint. There is a slight bladder palpation and may void small amounts of
seasonal variation, with temperatures being higher in urine on to the consulting table.
the autumn and winter than in spring and summer. Gut sounds are not always evident in the healthy
Females have a slightly higher rectal temperature rabbit; it is worth listening for at least a minute on
than males (Pericin and Grieve, 1984). Temperatures each side to properly assess this and give the guts a
below 38.0 C (100.4 F) can be considered subnor- chance to move during auscultation. Absence of
mal and temperatures in excess of 40.6 C (105 F) gut sounds does not signify intestinal stasis. Tinkling
are significant and indicative of pyrogenic infection sounds may be heard in distended gas-filled organs
(Toth and Krueger, 1989) or heat stroke. such as the caecum or stomach, indicating a gas/fluid
interface.
The uterus lies in the ventral abdomen, caudal to
the caecum. The broad ligament may contain large
1.6.2.8 Abdominal palpation and quantities of fat that can be seen radiographically.
auscultation An enlarged uterus due to pregnancy or neoplasia
The normal topographical anatomy and relative may be felt. Twelve- to 14-day fetuses can be felt as
position of the abdominal organs are illustrated in olive-sized masses in the caudal abdomen. As the
Figures 1.13–1.15. Radiography can be used to uterus enlarges it falls forward into the abdomen.
differentiate abnormalities detected during abdomi- Abdominal masses may be neoplastic. Common
nal palpation. Ultrasound is also useful. Palpation neoplasms include uterine adenocarcinoma, lym-
of the abdomen should be done carefully and phomas, liver and kidney tumours. Abdominal
gently, as it is easy to traumatize the thin-walled abscesses can occur, secondary to penetrating trauma
viscera. or previous surgical intervention. Areas of fat necro-
The spleen is too small to be palpable and the liver sis may be felt as hard lumps, especially in the rem-
is not felt routinely during abdominal palpation. nants of the broad ligament in spayed females.
Both kidneys can usually be identified. They are The limbs, vertebral column and rib cage can be
mobile structures. The left kidney lies caudally to checked for any obvious fractures or deformities.

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 Textbook of Rabbit Medicine

Ribs

Xiphoid cartilage

Liver

Duodenum
Stomach

Greater omentum
Distal proximal colon

Upper proximal colon

Caecum Ampulla coli

Jejunum

Uterus
Descending colon
Left ureter
Bladder

Figure 1.13 Topographic view of the abdomen, ventral view. The ventral abdominal wall has been resected to expose the
viscera that are illustrated in situ. The diagram was drawn from post-mortem specimens using Barone et al. (1973) as a reference
source.

and 60 breaths per minute. Increased respiratory rates

1.6.2.9 Auscultation and assessment are indicative of stress, pain, hyperthermia, infection or
of respiration respiratory disease. Metabolic acidosis can also be
Rabbits have a small rib cage and thoracic cavity. The manifested by an increased respiratory rate. On occa-
diaphragm, rather than the intercostal muscles, brings sion some rabbits appear to have a very rapid
about respiratory movement. Breathing takes place respiratory rate without significant disease. This cir-
through the nose. Rabbits do not mouth breathe or cumstance is known as ‘paradoxical breathing’ and
pant effectively. Respiratory rate varies between 32 is related to reduced vagal tone causing increased

76
 Descending colon Right kidney
Ascending
Ureter Caudate lobe of liver
duodenum
Ovary Stomach
Uterus
Ribs
Right lung

Bladder
Duodenum

Gyrus of caecum
Ascending Jejunum Xiphoid
colon cartilage
Descending
duodenum Right lobe of liver

Figure 1.14 Topographic view of the abdomen, right lateral view. The abdominal viscera are illustrated in situ after resection of
the right abdominal wall. The diagram was drawn from post-mortem specimens using Barone et al. (1973) as a reference source.

Descending
aorta Left
Spleen Left ureter
kidney Ovary Descending
Ribs
colon
Lung

Bladder
Uterus
Caecum
Stomach Ascending
Liver Jejunum
Xiphoid cartilage colon
First gyrus of caecum

Figure 1.15 Topographic view of the abdomen, left lateral view. The abdominal viscera are illustrated in situ after resection of the
left abdominal wall. The reproductive tract is not illustrated. The diagram was drawn from post-mortem specimens using Barone et al.
(1973) as a reference source.
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 Textbook of Rabbit Medicine

diaphragmatic activity and ‘augmented’ breaths Normal heart rate varies between 130 and
(Whipp, 1987). Upper respiratory tract disease is 325 bpm, which is too fast to differentiate heart
common in rabbits (see Section 11.2.3). Occlusion sounds. Stress increases the heart rate markedly. A
of the nasal passage results in increased respiratory pulse can usually be felt in the central artery of the
effort and may be accompanied by various snuffles, ear (Figure 1.16). A femoral pulse can sometimes
squeaks and whistles. Some short-nosed breeds be found, although it is not as easy to locate in the
always make this type of noise. The differentiation rabbit as in the dog or cat.
between upper and lower airway disease can be made
by observation and auscultation and examination of
the nose. Key points 1.16 Thoracic ausculation
An increase in respiratory rate is brought about by
an increase in diaphragmatic rather than intercostal • The thoracic cavity of the rabbit is small.
movement and can give the impression of dyspnoea. • Breathing takes place through the nose.
Dyspnoea is manifested by cyanosis, mouth breath- • Respiration is brought about by movement of the
ing, depression and distress and may be accompa- diaphragm rather than the intercostal muscles.
nied by an audible respiratory noise. Abnormal,
• The lung field extends from the thoracic
absent or muffled lung sounds may be heard during inlet to the 12th rib but is most easily heard
thoracic auscultation of rabbits with lower respira- between ribs 6 and 12 dorsally. Breathing should
tory disease. Chronic lung disease cannot be ruled be quiet and crackles and wheezes are always
out by auscultation of the chest, although use of a abnormal.
suitably sized paediatric stethoscope can be helpful • The heart in rabbits is small relative to body mass
as it allows more precise examination. Severe lung (0.2% of body mass compared with 0.76% in
changes are a frequent incidental finding during dogs); both sides of the heart should be auscu-
post-mortem examination. Abnormal heart sounds lated. The first heart sound corresponds to closure
can sometimes be detected, although cardiac disease of the atrioventricular valves, the second to closure
is rare in rabbits in comparison with lung disease. of the pulmonic and aortic valves. Gallop rhythms
The list of differential diagnoses of dyspnoea is are always abnormal and indicate structural heart
similar to other species. disease.
• A pulse may be felt in the central artery of the ear.
Key points 1.15 Abdominal palpation

• Care should be taken during abdominal pal-

pation as the thin-walled viscera are easily 1.6.2.10 Examination of the face, head
traumatized. and oral cavity
• Both kidneys can be felt during routine abdominal Some rabbits tolerate examination of the head and
palpation.
oral cavity with minimal restraint. Others jump
• The spleen is too small to be palpated. and attempt to escape, so wrapping these individ-
• The stomach and liver are not usually palpable. uals in a towel is safer. Sedation should be consid-
• The caecum may be palpated depending on ered if the rabbit is very intolerant as it will almost
nature of contents and time of day. always be safer and less stressful for everyone
involved.Visual inspection of the external ear canal
• Palpating the bladder can elicit straining and urina-
may reveal the typical crusty exudate associated
tion in rabbits with cystitis.
with Psoroptes cuniculi infestation or the waxy exu-
• The uterus cannot be palpated in the non-gravid, date often encountered, especially in lop-eared
healthy animal. During pregnancy it may be felt in
breeds. There is a blind ending section of the exter-
the ventral abdomen.
nal ear canal separated by a cartilaginous plate or

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 Rabbit Basic Science 1

Rostral ramus
Caudal auricular a.
Intermediate ramus

Medial auricular a.

Lacrimal a.
External ophthalmic a.
Anastomotic ramus to internal carotid a.
Supraorbital a.
Caudal auricular a.
Buccal a.
Ethmoidal a.
Infraorbital a.

Superior labial a. Medial auricular a.

Caudal auricular a.
Major palatine a.
Superficial temporal a.

Occipital a.

External carotid a.

Linguofacial a.
Facial a.
Lingual a. Inferior alveolar a. Transverse facial a.
Mental a.
Inferior labial a.

Figure 1.16 Arteries of the head. The arteries of the cheek may be encountered during surgery on facial abscesses in rabbits.
The buccal and lingual arteries are in close proximity with the cheek teeth and can be inadvertently punctured during tooth
trimming. The arteries of the ear are also illustrated. A pulse can often be detected by placing a finger on the intermediate ramus
of caudal auricular (central) artery of the ear.

tragus. Examination of both sides of the tragus can bonded companion, and not the patient itself,
be performed with an otoscope. Otoscopic visuali- that keeps the head groomed and cleaned. The
zation of the eardrum is difficult due to the length presence of small scabs in the fur is indicative of
of the auditory canal and the presence of wax a rabbit not grooming perhaps due to pain around
and debris. Using a narrow cone and gently direct- the face. Saliva staining on the chin or around the
ing it around the bend in the ear canal gives mouth is usually indicative of dental disease caus-
the best view; however, this technique can be ing pain on swallowing or pus present in the oral
uncomfortable. cavity causing a bad taste. Moist dermatitis of deep
The skin around the face and head is normally skin folds under the chin occurs in some loose-
clean and free from debris. Sometimes it is a skinned breeds. Epiphora causes tear staining and

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 Textbook of Rabbit Medicine

matted fur on the face beneath the medial canthus also contribute to exophthalmos, which is usually
of the eye, which can lead to superficial pyoderma bilateral (Vernau et al., 1995). The eyelids should
in that area. Occasionally this is associated with be examined for evidence of wounds, ectropion,
spurs on the upper premolars or molar teeth grow- entropion, meibomian cysts or myxomatosis. The
ing into the mucosa inside the cheek. Grooming eyes should be clean and free from purulent dis-
the skin over the area becomes painful. The large charge. The rectus dorsalis muscle can be seen
ears of some lop-eared rabbits can sometimes attached to the dorsal sclera when the upper eyelid
impinge on the eye and surrounding structures is retracted. Applying pressure to the area just below
causing trauma and irritation. the medial canthus of the eye may squeeze pus out of
The head should be palpated and carefully exam- the opening of the nasolacrimal duct in cases with
ined for the presence of abscesses on the side of the purulent dacrocystitis.
face, under the masseter muscles or along the bot-
tom of the jaw. One side of the face should be com-
pared with the other and any asymmetry noted. It Key Points 1.17 Examination of the head and oral
may be useful to view the head from above as soft cavity
tissue asymmetry may be subtle. Pain or bony swell- • Visually inspect the head for ocular and nasal
ings associated with elongated tooth roots can be discharges, areas of asymmetry and mass
detected by palpation of the ventral border of the lesions.
mandible and the zygomatic area (see Section 5.7). • Examine the ears visually and using an otoscope.
The nares should be inspected for signs of nasal Wax and debris may obscure the view, particularly
discharge. in lop-eared breeds. The tragus, a blind-ending
The incisors are easily examined by retracting section of the external ear, must also be carefully
the lips. The molars and premolars can be visual- examined. Pus is a relatively common finding in
ized with the aid of an otoscope or vaginal specu- the external ears of pet rabbits. It may not be asso-
lum. With practice, normal and abnormal cheek ciated with inflammation or clinical signs.
teeth can be differentiated by this technique, • Examine the eyes and surrounding structures
although it is not always possible to determine visually and using an ophthalmoscope. Schirmer
the cause of an abnormality. Dental abnormalities tear tests, fluoroscein dyes and ultrasonography
can be missed on conscious examination alone as are useful adjuncts to basic examination.
soft tissues impinge on the view. Rabbits that • Palpate the skull, paying particular attention to the
resent oral inspection often have problems with ventral mandibles and the zygomatic area. Gently
their cheek teeth. Excessive saliva, halitosis, pres- manipulate the lower jaw to assess its range of
ence of food, blood or pus is indicative of dental motion.
problems and general anaesthesia and preferably • The incisors can be examined by moving the upper
radiography is necessary to examine the mouth lips sideways and back. Make certain all teeth are
thoroughly. present. Pay attention to the occlusion and evi-
dence of damage to the tooth enamel surface.
• The cheek teeth can be examined using an oto-
1.6.2.11 Examination of the eyes scope. This is inserted into the rabbit’s mouth
Exophthalmos or glaucoma can be seen by compar- via the diastema and is used to visualize the buc-
ing the size and shape of the eyes. Fear can cause the cal, occlusal and lingual surfaces of the cheek
eyes to bulge out of the sockets due to engorgement teeth. The view is limited by the oral soft tissues,
saliva and movements of the patient. It is a good
of the orbital vascular sinus (see Figure 1.17) (Eglitis,
initial examination tool but definitve oral examina-
1964). Retrobulbar abscesses, tumours or cysts can
tion must be undertaken with the rabbit
cause a unilateral exophthalmos. Thymoma or other anaesthetized.
mass lesions affecting venous return in the chest can

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 Rabbit Basic Science 1

Intermediate auricular v.

Medial auricular v.

Caudal auricular v.

Medial auricular v.

Transverse facial v.
Ophthalmic sinus

Caudal auricular v.
Superior labial v.
Lateral nasal v.

Pterygoid plexus

Retromandibular v.
Deep facial v.

External jugular v.

Lingual v.
Inferior labial v. Linguofacial v.
Inferior alveolar v.

Figure 1.17 Veins of the head. The veins of the head include the marginal ear vein that is a convenient site for venepuncture. The
large orbital venous sinus is also illustrated. This sinus may be encountered during enucleation of the eye and can be a source of
serious haemorrhage.

Nystagmus may be observed by watching the facilitates examination of the cornea and third eyelid.
movement of the eye for a few seconds. Occasionally The application of fluorescein will reveal corneal
slow nystagmus can be seen in pet rabbits at rest in ulceration. Fluoroscein can also be useful to evaluate
association with nodding of the head. Affected indi- the drainage of the tear duct. In a normal rabbit the
viduals are usually seropositive for Encephalitozoon dye will not overflow onto the face and should
cuniculi. appear at the external nares within a minute or so
Direct illumination of the eye may reveal patho- of application (although it takes longer to appear
logical conditions of the cornea and uveal tract. Evi- than it does in dogs and cats). Where the tear duct
dence of previous lens rupture and cataract is blocked the dye will flow onto the face and
formation is associated with Encephalitozoon cuniculi. fail to appear at the ispsilateral nostril although it
Local anaesthesia with topical proxymetacaine drops may occasionally appear at the contralateral one,

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 Textbook of Rabbit Medicine

suggesting that in some rabbits there is a connection exists. Follicle stimulating hormone (FSH) stimu-
between the tear ducts. The Schirmer tear test has lates ovarian follicles to develop and produce oestro-
been evaluated in rabbits. The test paper is inserted gens that cause the female to be receptive. Follicular
into the lower conjunctival fold in the lateral third development occurs in waves with 5 to 10 follicles on
of the eyelid and is held in place for 1 minute. The each ovary being at the same stage of development
amount of wetness is measured in millimetres. Top- at any one time. When the follicles reach maturity
ical anaesthesia is not used. Normal values range they produce oestrogen for about 12–14 days. If ovu-
from 0 to 11.22 mm/min, with a mean of lation has not occurred during this period, the folli-
5.30 þ 2.96 having been determined. Low values cles degenerate with a corresponding reduction in
are of doubtful significance (Abrams et al., 1990), oestrogen level and sexual receptivity. After about
although absence of tear production can be a sign 4 days a new wave of follicles begins to produce oes-
of dysautonomia. A low Schirmer tear test result indi- trogen and the doe becomes receptive again. Many
cates keratoconjunctivitis sicca in other species but factors influence this cyclic rhythm including
this condition has not been reported to occur natu- nutrition, light, temperature, sexual stimulation
rally in rabbits. Impaired tear drainage due to naso- and individual variation. In general, the receptive
lacrimal duct disease can result in high Schirmer tear period lasts 14–16 days with a period of non-recep-
test results. Excessive tear production can also be tivity for 1–2 days (Patton, 1994). This is slightly lon-
associated with corneal irritation due to conjunctivi- ger than the oestrogen dominant phase, and a good
tis, corneal abrasions, ulcerations or foreign bodies. rule of thumb is that a doe will usually be receptive
Orbital pain may be due to uveitis, glaucoma or ret- while the vulva is red and swollen. Mating stimulates
robulbar disease. ovulation approximately 10 hours post-coitus
Ophthalmoscopic examination of the fundus and (Harkness, 1987). Ovulation can also be induced
internal structures of the eye requires mydriasis. Rab- by proximity of an entire male, mechanical stimula-
bits produce atropine esterase, which can interfere tion of the vagina or by the act of being mounted
with topical atropine eye drops in some individuals. by another female. Some indiviuduals will continue
One drop each of 1% atropine and 10% phenyleph- to be sexually receptive throughout pregnancy,
rine, three to four times during a 15-minute period, although superfoetation (maintenance of two preg-
has been recommended for rabbits (Kern, 1995) or nancies at different stages) does not occur.
0.5 or 1% tropicamide can be used. The optic disc lies
above the horizontal midline of the eye and it is nec-
essary to look upward into the eye with an ophthal- Key Points 1.18 Social and reproductive
moscope to view the optic disc, which has a deep behaviour
natural depression (see Section 9.3). The retina is • Domestic rabbits are descended from the Euro-
merangiotic (partially vascularized). pean rabbit, Oryctolagus cuniculus, and retain
many behavioural characteristics of their wild
1.7 Reproduction and neutering ancestors.
• Wild rabbits live in groups of 6–8 with a well-
1.7.1 Oestrus cycle defined social hierarchy. Males fight for domi-
nance and females aggressively defend their
Rabbits are well known for their ability to reproduce nesting sites.
quickly. Puberty occurs at 4–9 months (or when
• Wild rabbits seldom become tame in captivity
70–75% of mature bodyweight is reached) with
even if they are hand-reared.
smaller breeds maturing earlier than larger breeds.
Like the cat and the ferret, rabbits are induced ovula- • Rabbits are induced ovulators without a defined
oestrus cycle. Females show a cyclic rhythm of
tors. Although they do not show a regular oestrus
sexual receptivity.
cycle, they do vary in receptivity and a cyclic rhythm

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 Rabbit Basic Science 1
Full sexual receptivity occurs every 18 days and is
Key Points 1.18 Social and reproductive
manifested by restlessness and increased chin rub-
behaviour—cont’d
bing. Does are fertile immediately after kindling,
• Pseudopregnancy is the result of ovulation without especially during the summer months. Breeders usu-
fertilization. Ovulation can be stimulated in the ally take females to the buck for mating rather than
absence of mating by the close proximity of a vice versa as they can be territorial and attack the
male, mechanical stimulation or mounting by buck if he is put in her hutch. Sometimes the two
another female. are introduced on neutral territory. In general,
• Lactating does remain in the vicinity of their nest females are mated for the first time at approximately
and defend it but only return once or twice daily 5 months old and are not bred from over the age of
to suckle the young. 3 years (Sandford, 1996). Mating takes place within a
few minutes and can be accompanied by a scream
Biological data are summarized in Box 1.9. from either party, which is deemed to be normal.
Mating may be repeated after a couple of hours to
improve the conception rate. Artificial insemination
1.7.2 Mating and gestation
is a recognized technique in rabbit breeding. Preg-
Rabbits are induced ovulators without a defined oes- nancy can be detected by abdominal palpation.
trus cycle, although females vary in sexual receptivity The best time for pregnancy diagnosis is 10–14 days
and a cyclic rhythm exists (see previous section). The after mating when the fetal units can be felt as olive-
breeding season usually runs from January to Octo- sized masses. Fetal resorption can take place up to
ber and is stimulated by increasing photoperiod. 20 days post-coitus. Mammary development occurs

Box 1.9 Basic biological data for rabbits

Physiological data Reproductive data
Life span: 6–13 years Puberty: 4–5 months in small breeds
Urine volume: 20–250 mL/kg/24 h. 5–8 months in large breeds
Usually about 130 mL/kg/ Descent of 10–12 weeks
24 h testicles:
Water intake: 50–100 mL/kg/24 h Age at which to >3 months for males;
Optimum 15–20 C (65–70 F) neuter: >5 months for females
environmental Interval between 4 weeks
temperature: castration and
Rectal temperature: 38.5–40 C (101.3–104 F) infertility:
Subnormal: 38.0 C (100.4 F) Pregnancy Palpation: 10–12 days
Raised: 40.6 C (105 F) diagnosis:
Heart rate: 130–325 bpm Radiologically after 11 days
Respiratory rate: 32–60 bpm Ultrasonographically day
Erythrocyte life 50 days 8 onwards
span: Gestation: 30–32 days
Blood volume: 55–65 mL/kg Litter size: Average 5–8
Tidal volume: 20 ml (4–6 mL/kg) Milk composition: 13–15% protein,
Gastro 4–5 h 10–12% fat and 2%
intestinal transit carbohydrate
time: Birth weight: 40–100 g
Intraocular 5–23 mmHg Eyes open: 7 days
pressure: Weaning: 4–6 weeks

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 Textbook of Rabbit Medicine

in late pregnancy. Radiographically, pregnancy can litter in its nest. Does are particularly susceptible
be detected after the 11th day. Real-time ultrasound to disturbance in the first few days after parturition
can be used for early pregnancy diagnosis, being reli- and may cannibalize the young. Inexperienced does
able from day 8 onwards (Ypsilantis and Saratsis, sometimes mutilate them. The legs or ears may be
1999). Some does remain sexually receptive during attacked or the skin stripped over the neck, thorax
pregnancy and will continue to be mated by a male or abdomen. Cannibalization and mutilation are
companion; however, superfoetation does not occur. most likely to take place on the day of parturition
Does can be mated soon after giving birth and may and may be an extension of eating the placenta.
be lactating and pregnant at the same time. Sometimes young rabbits are born outside the nest
Gestation is maintained by progesterone that is or the doe rejects them. These kits will die from
produced exclusively by the ovarian corpora lutea. hypothermia unless they are warmed up and
In the absence of fetuses, pseudopregnancy can occur returned to the nest. The doe will usually accept
after ovulation and is maintained by corpora lutea them and the chances of survival are far greater if
that degrade after approximately 17 days (Fekete the kit is reared by its natural mother rather than
and Huszenicza, 1993). In the wild, unfavourable being hand-reared by a human. It is advisable to
winter conditions or lack of food suppress follicular remove other rabbits from the hutch during late
activity. Gestation takes 31–32 days, with litter sizes pregnancy. Female companions can cannibalize
on average being five to eight; larger breeds generally the young and entire males will mate the doe within
have larger litters (Sandford, 1996). It is possible for hours of her giving birth. Females can lactate and be
a doe to have six litters in a year and produce 40 to 50 pregnant at the same time and have a second litter
offspring. During late pregnancy the doe may be seen within a few weeks of the first.
carrying bedding material into her chosen nesting
site. The nest is built from hay, straw or other bed-
1.7.4 Lactation and maternal care
ding material. The quality of the nest varies between
individual does and has a strong influence on the The doe stays in the vicinity of the nest but only feeds
survival of the young. The doe will defend her chosen the young once or twice daily, taking 2–5 minutes
nesting site against potential intruders, especially if each time, during which a baby rabbit can drink
she is pregnant or lactating and can become aggres- 20% of its bodyweight (Donnelly, 1997). Owners
sive towards owners, other rabbits or pets. Hair is often think the young have been deserted and need
pulled from the hip, dewlap and mammary glands reassurance that it is normal for the mother to be
to line the nest. She may consume less food at this out of the nest and that she may be particularly
point and should be tempted to eat, as pregnancy aggressive and protective during this period.
toxaemia is a risk during this period. Otherwise, In the wild, although the doe remains in close
the doe should be left undisturbed. vicinity of the nest, she does not groom the young
or keep them warm. Nests are hidden, well insulated
and secure. The babies drink sufficient milk to last
1.7.3 Parturition
24 h. It is possible for baby rabbits to survive for
Parturition usually takes place in the morning and is more than 24-h intervals between feeds, which
completed in less than half an hour although, occa- explains why females can rear litters that exceed their
sionally, young can be born hours or even days number of nipples (Lang, 1981b). Suckling normally
apart (Adams, 1987). The young are altricial and takes place in the early morning and, if the doe does
born bald, blind and helpless. Most passive immu- return to the nest to feed the young for a second time,
nity is obtained before birth, although some anti- then it is usually in the first few days after giving
bodies are present in the colostrum (Brewer and birth. The baby rabbits spend most of the day buried
Cruise, 1994). When the entire litter has been born, in the warmest part of the nest, tightly grouped
the doe pulls more fur from her body to cover the together conserving heat and energy. After about

84
 Rabbit Basic Science 1
22 h, the whole group becomes active and makes its
1.7.5 Rearing orphans
way to the surface (McBride, 1988). When the
mother arrives, she stands over the babies which Abandoned or orphaned wild or domestic rabbits
suckle, changing nipples and position approximately can be hand-reared, although the mortality rate is
every 30 seconds. After about 3 minutes, the doe high. Baby rabbits can be fed on powdered cat milk
leaves the nest and the babies urinate on the surface replacers; however, these are often less calorie dense,
before digging themselves deep into the bedding to and much higher in carbohydrate than rabbit milk.
sleep for another 22 h. Young rabbits are totally Johnson-Delaney (1996a) advocated the addition
dependent on milk until day 10. They are usually eat- of egg yolk to milk replacer (in this instance Esbilac)
ing small amounts of solid food by day 15 (Kraus in order to increase the fat and protein levels. They
et al., 1984) and start to leave the nest and be weaned will drink 2–30 mL of milk per feed, depending on
at about 25 days of age. how old they are. Baby rabbits should be fed when
The glucose reserve of neonatal rabbits lasts they are restless. Milk replacers are a nutritional com-
approximately 6 h postpartum. Hypoglycaemia promise and do not match the composition of rabbit
results in rapid ketosis and death (Kraus et al., milk. Therefore orphan rabbits may need feeding two
1984). Passive immunity is obtained through the to three times daily, but care should be taken not to
placenta, although there is some evidence that neo- overfeed or force-feed them. Holding newborn rab-
nates absorb antibodies from their intestine in the bits on their backs simulates the natural nursing
first few hours after birth (Brewer and Cruise, position. Hypothermic or moribund rabbits can be
1994). Rabbit milk has low lactose content, is con- given fluids or milk replacers by stomach tube to cor-
centrated and is of high nutritive value, containing rect hypoglycaemia. The babies should be kept warm
13–15% protein, 10–12% fat and 2% carbohydrate. and dry in a quiet place with suitable bedding mate-
The composition changes towards the end of lacta- rial in which to burrow. Shredded tissue paper or
tion when protein and fat levels increase. kitchen roll is satisfactory for making a nest that
Rabbit owners are usually unaware of the natural can be put in a hay-lined cardboard box and placed
lack of maternal behaviour by rabbits and become in a warm environment such as an airing cupboard.
convinced that a nest of babies has been deserted. Most suckling animals are stimulated to urinate
Constant interference and ‘checking to see if they and defecate by the mother licking the perineum
are alright’ increases the likelihood of the mother and lower abdomen. People that have successfully
cannibalizing the young in the first few days. There hand-reared orphans usually advise that baby rabbits
is also a misconception that all baby animals must should also be stimulated by rubbing the genital
be fed every 2–3 h, even during the night. If owners region after each feed. Female rabbits do not stay
are concerned, the nest can be checked once a day with their young and do not groom them, so it
and if the babies are warm, asleep and unwrinkled may not be necessary to stimulate young rabbits in
then they are being fed. Baby rabbits that are not this way. However, it can do no harm and is therefore
being fed will be restless and crawling around on advisable.
the surface of the nest. They take on a wrinkled Mortality can occur from aspiration pneumonia
appearance due to dehydration. It is possible to due to inhalation of milk replacer. A syringe with
cross-foster orphaned rabbits to another lactating a teat or a small amount of tubing cut from a giving
doe. It is not necessary to use any method for destroy- set is a satisfactory method of feeding orphans.
ing the scent of the natural mother or human hand. Healthy babies suck the milk out of the syringe.
Females do not make any distinction of young, even Squirting milk into the mouth carries a risk of chok-
if they are of different colours or sizes (Cheeke et al., ing the rabbit. Enteritis is a potentially lethal com-
1982). Ideally, older rabbits should be introduced to plication of hand-rearing. Rabbits are unusual
a younger litter. The fostered babies should be placed among young animals in having very few micro-
at the bottom of the nest with the natural kits on top. organisms in the stomach and small intestine while

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suckling (Lang, 1981b). An antimicrobial fatty acid

Key Points 1.19 Reproductive data
or ‘milk oil’ is present in the suckling rabbit. It is
produced by an enzymatic reaction in the doe’s milk • The breeding seasons runs from January to
that takes place in the suckling rabbit’s stomach October.
(Brooks, 1997). This milk oil controls the gastroin- • The female will be receptive approximately every
testinal microbial contents of suckling rabbits and 18 days, and cycling starts at around 5 months
protects them from enteric infection. Orphan rab- of age.
bits that are fed on milk from other species do not • Males are fertile from around 4 months of age,
develop this antimicrobial factor and are therefore depending on body size and breed.
more susceptible to bacterial infections introduced
• Pregnancy diagnosis:
during feeding. It is important that boiled water
and sterile syringes and feeding tubes are used to 1. Manual palpation, day 10–14
feed orphans and that each feed is made up just 2. Radiography, day 11 onwards
prior to being given. Overfeeding can cause diges- 3. Ultrasonography, day 8 onwards
tive upsets. In general, it is preferable to underfeed
• Fetal resorption can occur up to 20 days post-
than overfeed. Small babies can soon make up their coitus. Thereafter abortion will occur should the
weight once they are weaned and able to digest fetuses die.
solid food.
• The gestation period is 31–32 days,
Baby rabbits can be offered hay and fresh food
from about 18 days of age. Caecotrophs collected • Pseudopregnancy occurs after a non-fertile mat-
from healthy adults may be fed during weaning to ing or after being mounted by a female. It lasts
colonize the intestinal tract with healthy bacteria for around 16 days and is usually self-limiting.
and protozoa, a practice known as transfaunation. • Parturition often occurs in the morning and is over
It may be necessary to place an Elizabethan collar rapidly. Dystocia is rare. Occasionally babies from
on an adult rabbit for a day or two to prevent them the same doe can be born several hours to days
from eating the caecotrophs, so they can be har- apart and remain viable.
vested. Weaning is a danger period for any young
rabbit, especially orphans. Diarrhoea can result from
colonization of the gut by pathogenic bacteria. Pro-
biotics can be useful in this period, especially if no Key Points 1.20 Hand-rearing orphans
caecotrophs are available. • Maternal care is limited in rabbits, and a doe
suckles her young for 2–5 minutes twice daily.
• Kits that are asleep within the nest and do not have
1.7.6 Pseudopregnancy wrinkled skin have probably not been abandoned
and should be left alone.
Pseudopregnancy mimics true pregnancy. Pseudo-
• Kits that are restless and at the top of the nest and
pregnant does pull fur from their abdomen and chest,
whose skin is wrinkled and dry may need to be
make a nest, develop mammary glands and aggres- hand-reared.
sively defend their nesting site. Pseudopregnancy lasts
• Kitten milk replacer can be used as a substitute;
for 16–18 days, rather than the 31–32 days of true
however, it is higher in carbohydrates than rabbit
pregnancy. Because rabbits ovulate in response to sex-
milk. Egg yolk can be added to increase the
ual stimulation by another rabbit, proximity of a male amount of fat and protein given.
or mating behaviour between two females housed
• Kits should be fed several times a day, in response
together can stimulate ovulation and result in
to increase in activity. A tiny teat or a measure of
pseudopregnancy.

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 Rabbit Basic Science 1
abdominal fat can complicate the surgery. Pre-
Key Points 1.20 Hand-rearing orphans—cont’d
pubescent females can be more difficult to spay
soft drip tubing attached to a syringe can be used. because of their tiny uterus and ovaries that can be
Kits should be regularly weighed to assess weight hard to locate; however, the surgical incision can
gains/losses. be very small, and if haemoclips or a ligasure device
• The stomach of baby rabbits is very susceptible to are used for haemostasis then surgery is extremely
infection when being hand-reared. The addition of rapid. The benefits of a quick surgery, a small inci-
probiotics to the rearing milk should be sion and less tissue manipulation must be weighed
considered. against the difficulty in visualizing the uterus. On a
• Baby rabbits should be offered access to hay and cautionary note, insufficient research has been done
small pellets from day 10 onwards. to allow certainty that early neutering will not cause
• Caecotrophs from a healthy adult rabbit can be adrenal disease in rabbits as it does in ferrets. Males
used to colonize the gut with suitable bacteria at should be left until the testicles have descended.
the time of weaning. Motile spermatozoa appear in the ejaculate from
about 4 months of age. After castration, the male
can be considered sterile after a period of 5–6 weeks.
1.7.7 Advice on neutering
1.7.8 Leg rings
Neutering modifies sexual behaviour in rabbits but
may not abolish it altogether. Increasing day-length Pedigree rabbits are identified by an aluminium ring
can trigger social, sexual and even aggressive actions placed over the hock at 8–10 weeks of age. Some
in neutered rabbits, although the behaviour is usually breeders use right or left legs according to the gender.
mild. In the spring, does may dig out a new burrow Rings are purchased from the British Rabbit Council,
and males may have minor skirmishes. Copulatory who keep records of the numbers. Different sizes are
actions can persist after neutering, as part of domi- needed for different breeds, which are denoted by a let-
nance or excitement behaviour. It is beneficial for rab- ter that prefixes the ring number. The year of birth is
bits to be neutered for similar reasons to the dog or cat. also recorded on the ring. These rings should be
Neutering prevents unwanted pregnancies and pseu- removed as they serve no purpose in the pet rabbit
dopregnancies and permits both sexes to be housed and can trap hair and debris beneath them. Skin necro-
together. Male aggression is reduced or abolished, sis and secondary infection can set in (see Figure 1.18).
so fight and bite wounds are minimized. Neutering In severe cases, the blood supply to the foot is cut off, so
also modifies scent marking by spraying urine or the leg becomes gangrenous and has to be amputated
depositing faeces. Female reproductive disorders such or the rabbit euthanased. If the rings are not removed,
as uterine or mammary neoplasia and endometritis owners must be advised to check them daily.
occur frequently in the middle-aged doe. Spaying is Ring removal may prove difficult in the conscious
indicated to prevent these diseases. Aggressive behav- animal, although in calm rabbits instruments made
iour towards owners can be modified by neutering, for ring removal in birds may be safely used as long
especially if it is hormone related. Male rabbits make as they are cooled with water during use. Sedation or
better pets if they are castrated. Entire bucks can general anaesthesia is required if the ring has caused
attempt to mate their owner’s legs or mount toys, mats soft tissue damage or if some form of power tool is to
or other household objects. be used to cut the ring off. Part of a wooden tongue
Although rabbits can be spayed or castrated at any depressor can be slipped between the ring and the leg
age, approximately 5 months of age is the best time to keep the fur out of the way and give some protec-
for both sexes. It is advisable to spay females after tion to the skin before removing the ring with a hack
puberty but before maturity when large amounts of saw or small saw attachment on a power drill. Care is

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 Textbook of Rabbit Medicine

in the UK a live vaccine (Nobivac Myxo) prepared

from attenuated Shope fibroma virus grown on cell
line culture has been used. Shope fibroma virus nat-
urally affects the cottontail rabbit Sylvilagus floridanus
that is native to North America. It is antigenically
related to myxoma virus and cross-immunity occurs.
Shope fibroma virus is transmissible to the European
rabbit Oryctolagus cuniculus in which it produces
localized benign fibromas. The disadvantage of this
vaccine is that it is less immunogenic than attenuated
myxoma virus vaccines, and the duration of immu-
nity is short. With the introduction of a novel com-
bined myxomatosis/viral haemorrhagic disease
(VHD) vaccine, this stand-alone myxomatosis vac-
cine is likely to be withdrawn from sale. In other
parts of Europe modified live myxoma virus vaccines
have been used; however, these are known to cause
immunosuppresion, which can cause significant dis-
ease problems in large rabbitries.
Figure 1.18 Identification ring occluding the blood supply
The new combined vaccine (Nobivax Myxo-RHD;
to the hind foot. Pedigree rabbits are identified by aluminium
rings slipped over the hock when the rabbit is 8–10 weeks old. rabbit haemorrhagic disease (RHD) is analogous to
The rings are supplied by the British Rabbit Council in a range of VHD) has been manufactured from a laboratory-
sizes. Each ring has the year of birth and a unique number from derived attenuated strain of myxomatosis and a
which the rabbit can be identified. Occasionally, rabbits with
identification rings are sold as pets. It is advisable to remove the
capsid protein from a German VHD virus. During effi-
rings because hair can become entrapped beneath the ring and cacy testing 100% of vaccinated rabbits were protected
occlude the blood supply to the foot. This rabbit was euthanased. from challenge with field strain myxomatosis (n ¼ 11),
although some developed mild pyrexia. All rabbits
required to prevent the metal ring from overheating.
were also protected from challenge with VHD, and
Cotton wool soaked in water can be used periodi-
none of these rabbits demonstrated any clinical signs,
cally to cool the ring during removal.
while all unvaccinated rabbits died within 72 hours. All
vaccinated rabbits showed a significant haemaggluti-
1.8 Vaccination and preventive medicine nation inhibition titre against VHD when compared
to the naive unvaccinated rabbits. The vaccine has been
1.8.1 Vaccination shown to be safe and effective for use in farmed rabbits
where there is commonly an endemic underlying respi-
1.8.1.1 Myxomatosis vaccination ratory disease within facilities that can become clini-
Myxomatosis is a common disease present in wild cally apparent after use of some vaccines. The vaccine
rabbits that can be spread to pet rabbits via insect vec- is also safe for use in dwarf breeds (Spibey et al.,
tors such as fleas and mosquitoes as well as by direct 2012). The vaccine is licensed for use in rabbits over
contact (Chapuis et al., 1994; Houlihan and Lawson, 6 weeks of age with a duration of immunity of
1945) (see Section 14.6.1). Those rabbits that are 12 months. It must be given by subcutaneous injection
kept in gardens visited by wild rabbits are most at into the scruff of the neck to healthy animals. Some
risk. Myxomatosis is a member of the poxvirus family individuals may show a 1- to 2-cm swelling at the injec-
and is almost universally fatal in unvaccinated rab- tion site during the week following vaccination. These
bits. Outbreaks of myxomatosis occur seasonally, generally resolve without treatment. Nobivac Myxo-
reaching their peak in the late summer. Historically RHD should not be used in the first 14 days of

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 Rabbit Basic Science 1
pregnancy, and its safety was not tested in breeding sure the owners are aware of the risk. According to
males, so use in breeding stock is not yet supported. the datasheet, accidental self-injection with the vac-
cine can cause a severe reaction in humans that could
result in the loss of a finger.
1.8.1.2 Viral haemorrhagic disease
Viral haemorrhagic disease (or rabbit haemorrhagic
disease) is a highly infectious lethal disease of rabbits.
1.8.1.3 Simultaneous administration
It is caused by a host-specific calicivirus (see of myxomatosis and VHD vaccine
Section 14.6.2). VHD virus is spread by oral, nasal It is tempting to administer both the myxomatosis
and parenteral transmission and is present in urine and VHD vaccines during a single consultation.
and faeces from infected rabbits. The virus can survive There are data to support the efficacy of simultaneous
for long periods outside the host. It is thought that wild vaccination but no firm conclusions can be drawn
birds carried infection across the channel from Europe because of differences in the type of vaccine.
to wild rabbits in this country. Wild hares form the At the present time, the manufacturers of both the
wildlife reservoir in this country, carrying the virus myxomatosis and the VHD vaccine advise against
without clinical effect. VHD may be transmitted simultaneous immunization. It is common practice
directly from contact with wild rabbits and hares or car- to leave 2 weeks between the injections. Because both
ried on footwear and clothing. Contaminated foods, vaccines can cause a skin reaction, it is wise to vacci-
such as grass or weeds picked from areas grazed by wild nate a rabbit in consistent places in order to verify to
rabbits, can be a source of infection. Hutches and cages which vaccine a rabbit has reacted.
that have been occupied by an infected rabbit require
thorough disinfection before a new rabbit is intro-
duced. Ideally, only vaccinated animals should be
1.8.1.4 Combined myxomatosis
brought in to infected premises. VHD virus can survive and VHD vaccine
outside the host for 10–19 months at room tempera- A novel recombinant vectored vaccine for the control
ture. Exposure to 2% potassium peroxymonosulphate of myxomatosis and VHD has been produced (Nobi-
(Virkon) for 2 h does not inactivate the virus, although vac Myxo-RHD, MSD-Animal Health). This vaccine
a 4% solution is effective; 1% sodium hydroxide or allows once-yearly vaccination with proven duration
10% household bleach is also an effective disinfectant of immunity to both components. Recombinant tech-
(Goodly, 2001; Gorski et al., 1994). nology has allowed insertion of a capsid protein gene
There are two vaccines against VHD available in from the VHD virus into a laboratory-attenuated
the UK (Cylap, Fort Dodge; Lapinject, CEVA). They strain of myxomatosis, giving dual immunity. This
are both inactivated, adjuvanted virus vaccines. Rab- vaccine has not been associated with adverse side
bits over 10 weeks can be vaccinated with a single effects, nor has it been shown to exacerbate underly-
dose. It is safe to vaccinate pregnant animals with ing conditions. It is considered safe for use in both
VHD vaccine. Boosters are given annually. young and intensively farmed animals. Occasionally
The whole 1 mL dose should be given subcutane- small local skin reactions (plaques of thickened
ously. Inadvertent intradermal injection can result in skin without scabs) are noted at the site of injection
tissue reaction (to humans as well as rabbits). After (1–2 cm in diameter, around 1 week post-injection);
subcutaneous administration, it is advisable to mas- however, these resolve without treatment within a few
sage the vaccination area thoroughly and advise the days. There is evidence that rabbits who have been
owner to do the same periodically over the next few previously vaccinated with a myxoma virus-derived
hours. In this manner, the vaccine is dispersed in the vaccine or who have survived myxomatosis may dem-
subcutaneous tissues and is less likely to cause a reac- onstrate a lack of response to the VHD component of
tion. Some judges penalize show rabbits that have an this vaccine. In the UK these cases are likely to be rare
area of dermatitis or a scar, so it is important to make as myxoma-derived vaccines are not used; however,

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rabbits imported from Europe may be affected. The rabbits. Asymptomatic infections have been reported
current suggestion is to vaccinate these rabbits with (Vangeel et al., 2000).
another form of VHD vaccine initially. Protozoal infections such as giardia (Johnson-
Delaney, 1996b) can affect both rabbits and humans
Key Points 1.21 Vaccinations but transmission between species does not appear to
occur. Toxoplasma gondii also affects both rabbits and
• Pet rabbits in the UK can be vaccinated against humans but is only transmitted by eating under-
both myxomatosis and viral haemorrhagic disease cooked rabbit meat. It is not transmitted through
(VHD). rabbit faeces. Encephalitozoon cuniculi has caused ill-
• Myxomatosis vaccine can be given to rabbits over ness in humans but only immunocompromised
5 weeks of age. VHD vaccine is given to rabbits individuals such as AIDS patients, or those on che-
over 10 weeks of age. motherapy. There are isolated reports of human
• Myxomatosis vaccine should not be given to preg- infections with organisms such as Salmonella, Pas-
nant does. VHD vaccine can be given during teurella multocida or Bordetella bronchiseptica after con-
pregnancy. tact with infected domestic rabbits (Gueirard et al.,
• VHD vaccine must be given entirely subcutane- 1995). Other zoonotic infections can occur in wild
ously and dispersed by massaging the injection rabbits such as tularaemia (Francisella tularensis;
area thoroughly. Gill and Cunha, 1997), plague (Yersinia pestis; Cleri
• It is not advisable to administer both myxomatosis et al., 1997) and listeriosis (Listeria monocytogenes;
and VHD vaccine at the same time. At least Broderson and Gluckstein, 1994).
2 weeks should elapse between vaccinations.
• Myxomatosis vaccine administered during late
spring offers protection over the summer months 1.9 Stress
when the disease is prevalent in wild rabbits.
• A novel recombinant myxomatosis/VHD vaccine 1.9.1 Stress
is now available, giving a year-long duration of
immunity against both diseases. The effects of stress upon rabbits are significant (see
Box 1.10). Catecholamines are released in response
to stress and can initiate a number of problems. In
extreme cases, catecholamine release can cause heart
1.8.2 Health risks from keeping rabbits
failure and death. Stress due to overcrowding has
For a healthy human, the risk of serious infectious been used to induce cardiomyopathy in laboratory
zoonotic disease from pet rabbits is negligible. The rabbits (Weber and Van der Walt, 1975). This is
main health risks are associated with handling the important because travel to and handling/manipula-
animal. Rabbits can inflict nasty bites and scratches tion whilst at the veterinary surgery is intrinsically
that can become infected. Owners can develop an stressful to most rabbits and can result in the measur-
allergy to rabbit dander. able physiological changes detailed below.
Parasites can be transmitted from rabbits to Stimulation of the sympathetic nervous system
humans. Fleas can be found on pet rabbits, although inhibits activity of the gastrointestinal tract. Gut motil-
they are not usually the rabbit flea (Spilopsyllus cuni- ity is reduced, which can have a knock-on effect on
culi) but the cat or dog flea (Ctenocephalides felis or caecal microflora and digestive function. Enterotoxae-
canis) caught from other pets in the household. Chey- mia or gut stasis can result from any stressful situation.
letiella parasitovorax is transmissible to humans who Mucoid enteropathy is associated with stressful situa-
handle infested rabbits. The mite causes erythema- tions such as weaning, parturition or re-homing.
tous pruritic lesions in humans, especially on the Stress reduces renal blood flow in rabbits. In a
arms. Ringworm is occasionally encountered in pet study by Kaplan and Smith (1935) into the effects

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 Rabbit Basic Science 1
Box 1.10 Stress in rabbits
Causes of stress of rabbits • Stress is immunosuppressive. Rabbits suffering
• Pain and disease from dental disease have lymphocyte counts
significantly lower than those of healthy rabbits.
• Unfamiliar surroundings
• Stress affects carbohydrate metabolism. Handling
• Transport
alone can cause an increase in blood glucose to
• Rough handling the order of 8.5 mmol/L. Blood glucose levels can
• Proximity of potential predators: dogs, cats, ferrets, be very high (20–25 mmol/L) in association with
birds of prey and, for wild rabbits, humans intestinal obstruction and other stressful diseases.
• A dominant companion and no means of escape • Stress causes anorexia that, in combination with
disruption to normal carbohydrate metabolism,
• Inability to exhibit natural behaviour patterns, e.g., to
can lead to hepatic lipidosis, liver failure and death.
forage, make a nest or interact socially
• Poor husbandry: insufficient food, water and indi- Ways to minimize stress in rabbits undergoing
gestible fibre, excessively high or low environmental veterinary treatment
temperature (see Section 1.2.1 in this chapter • Use analgesics in any situation where the rabbit may
regarding ‘Five Freedoms’ of animal welfare). be experiencing pain.
Effects of stress in rabbits • Use quiet, gentle handling and sedate or
anaesthetize rabbits for painful or uncomfortable
Many of the effects of stress are linked to the release of
procedures.
catecholamines or corticosteroids and can be life-
threatening: • Wrap rabbits in a towel for examination or
• Catecholamine release can cause heart failure and procedures such as blood sampling.
death. Stress due to overcrowding has been used • Keep rabbits away from the sight, sound and smell
to induce cardiomyopathy in laboratory rabbits. of predators, e.g., barking dogs, ferrets.
• Stimulation of the sympathetic nervous system • Provide hay as bedding material for rabbits awaiting
inhibits activity of the gastrointestinal tract. Gut or recovering from surgery. Hay smells familiar and
motility is reduced, which can have a knock-on provides security for timid animals. It is also a source
effect. Gut stasis, trichobezoar formation (hairballs), of indigestible fibre and foraging material.
enterotoxaemia and mucoid enteropathy can all be
• Consider hospitalizing a bonded companion with a
linked with stress.
sick rabbit.
• Stress in rabbits causes a marked decrease in urine
• Minimize stressful procedures or devices, e.g.,
flow, renal plasma flow and filtration rate. Oliguria
Elizabethan collars or nasogastric tubes.
can last from 30 to 120 minutes.
• Stress can increase gastric acidity and cause
gastric ulceration in rabbits.

of diuresis and urine flow, a single dose of 50 mL/ undisturbed could withstand diuresis by increasing
kg of water was given to rabbits before subjecting urine flow.
them to unpleasant or painful stimuli. In all cases Stress increases gastric acidity. Gastric ulcers are a
the disturbing stimuli were immediately followed common post-mortem finding in rabbits, especially
by a marked decrease in urine flow, renal plasma in those that have been anorexic prior to death. In
flow and filtration rate. Oliguria was frequently a survey of 1000 post-mortem examinations by
severe, lasting from 30 to 120 minutes. Some Hinton (1980), 7.3% were found to have ulceration
rabbits died in convulsions. The control group of of the gastric mucosa that was related to the stress of
rabbits that were not stimulated and remained the associated illness. Experimental stress ulcers have

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 Textbook of Rabbit Medicine

been induced in the gastric mucosa of laboratory rab-

Key Points 1.22 Creating a rabbit-friendly surgery
bits by administering intraperitoneal injections of
adrenaline (Behara et al., 1980). • Rabbits are a prey species. In threatening situa-
Stress can alter the differential white cell count in tions catecholamine release prepares them for
any species. Rabbits are particularly susceptible to the flight.
effects of stress. A car journey to the surgery, a period • Catecholamines can have negative physiological
in the waiting room next to a barking dog or the effects on rabbits. These can include causing
excitement of handling can be reflected in the blood gut stasis, oliguria, flare-ups of subclinical infec-
picture. Adrenaline and cortisol affect the distribu- tion and in extreme cases death.
tion of lymphocytes throughout the body. Adminis- • It is desirable to ensure that any interaction with a
tration of exogenous adrenaline to rabbits results in rabbit is as stress-free as possible.
redistribution of lymphocytes from spleen and bone • Potential stressors include:
marrow to peripheral blood, lungs and liver (Toft
1. The journey to the vets. Owners should try and
et al., 1992a). Conversely, exogenous corticosteroid minimize travel time, make certain that the
administration results in a redistribution of lympho- rabbit does not become too hot or cold, pro-
cytes from the peripheral blood, bone marrow and vide suitable food for the rabbit, consider bring-
spleen to the lymphatic tissue in rabbits (Toft et al., ing the bonded companion and cover the
1992b). Prolonged periods of stress cause lymphope- rabbit’s cage whilst in transit to reduce visual
nia. Rabbits suffering from clinical symptoms of den- stimuli.
tal disease have significantly lower lymphocyte 2. The waiting room. Veterinary staff should try to
counts than healthy rabbits kept under free-range avoid having rabbits exposed to potential pred-
conditions (Harcourt-Brown and Baker, 2001) (see ators for long periods; an alternative waiting
Figure 2.1). area is preferable. In cases where the proximity
Carbohydrate metabolism is affected by stress. of dogs and cats is unavoidable, waiting times
Handling alone can cause an increase in blood glu- should be kept to the minimum and the rabbit
cose to the order of 8.5 mmol/L. Blood glucose levels perhaps kept under supervision outside in the
can rise to 20–25 mmol/L in critically ill rabbits, such car, or taken into a preparation room or quiet
ward until the consultation.
as those with an intestinal obstruction (Harcourt-
Brown and Harcourt-Brown, 2012). Disruptions in 3. The consultation. Rabbits that are handled
carbohydrate metabolism have potentially serious calmly and gently are much less reactive. Pain
consequences that can result in hepatic lipidosis, relief should be given promptly for any condi-
tion that is potentially painful, and examination
liver failure and death.
under sedation considered. Some rabbits will
As a prey species, rabbits have many physiological need to be restrained using a towel; however,
and behavioural responses to adrenal hormones. The many respond to just a gentle covering of the
response to danger is either to ‘freeze’ or to jump and eyes and stay still.
flee. Although the majority of pet rabbits are used to 4. Hospitalization. Ideally rabbits should be
being handled by their owners and are not particu- housed separately from cats, dogs and ferrets.
larly stressed by clinical examination, there is always Finding a quiet place in the clinic is beneficial;
potential for them to suddenly spring up and attempt however, staff must be able to perform ade-
to escape. Broken bones or fractured teeth can be the quate observations. Rabbits should be pro-
consequence of a leap off the consulting table. Strug- vided with familiar food, litter and bedding
gling rabbits can inflict injury by scratching with the materials. Any medical treatments should be
hind legs or, very occasionally, biting. carried out in the least stressful manner possi-
Owners are often unaware of the stressful effect ble. Use of sedatives such as midazolam at very
low doses can be considered when an animal
or the physical danger posed to their rabbit if it
appears very distressed in hospital.
is sitting on their knee in full view of other animals

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 Rabbit Basic Science 1
in the waiting room. They may be next to potential result in a nibbling response. Young rabbits nibble
predators such as ferrets, dogs, cats or birds of prey. objects as part of their development and can extend
Even the sound or smell of predators such as ferrets this exploratory behaviour to include their owners.
can be stressful. Loud noises, unfamiliar surround- People that smell of other rabbits or animals can
ings and car journeys all add to the stress levels of be attacked as part of defensive territorial behaviour.
rabbits that are visiting the surgery. The effects of In general it is preferable to approach nervous or
stress can be minimized by encouraging owners to aggressive rabbits from above. As in other species,
leave their rabbits in the carrier in the waiting room, pain can result in aggressive behaviour. A rabbit that
quiet gentle handling in the consulting room and the is normally docile but starts to be aggressive should
routine use of analgesics to all animals that may be be examined carefully for a source of pain. Dental
in pain. disease and the formation of sharp hooks on the
molars can be extremely painful. Rabbits are also
prone to painful musculoskeletal disorders such as
arthritis or vertebral spondylitis.
1.9.2 Behaviour problems and aggression
Deafness has been reported as a cause of aggres-
Like other species, rabbits respond to handling from sion in rabbits (Rabbit Health News 1991a, 1993).
an early age. A rabbit that associates humans with Deaf rabbits may be startled by owners coming up
pleasurable experiences is less likely to be timid, on them unexpectedly and sometimes their res-
scared or aggressive than a rabbit that is left to its ponse is to bite. Deafness can be caused by Psoroptes
own devices for most of the time and is chased or cuniculi infestation occluding the external auditory
handled roughly when it does have human contact. canal with mites and exudate. Many lop-eared rab-
A study into the effect of early handling has suggested bits have external ear canals full of wax and debris
that baby rabbits that are picked up and handled anyway. In some rabbits, the tympanic bullae are
between the ages of 26 and 42 days are more willing full of inspissated pus as a result of ascending
to approach humans and will remain closer to them Pasteurella multocida infection from the nasal cavity.
(Der Weduwen and McBride, 1999). Inspissated pus in the horizontal ear canal is a com-
Owners frequently seek advice about aggressive mon post-mortem finding in many pet rabbits.
tendencies in their rabbits. Sometimes the reason Granulomatous encephalitis caused by Encephalito-
for the aggression is obvious. Two entire males that zoon cuniculi could also cause deafness (see
are kept together are likely to fight and will need to Section 10.4).
be separated or castrated. Female rabbits are strongly
influenced by their hormones and will vigorously
defend their ‘nesting site’, i.e., a hutch or a run,
and attack intruders, including other rabbits and 1.10 Hospitalization and clinical
humans. These rabbits may be quite docile when techniques
they are out of their hutch. For this reason, it is advis-
able to clean out hutches when they are unoccupied.
1.10.1 Hospitalization of rabbits
Spaying usually cures this type of aggression,
although it may take some weeks to settle down. There are many advantages to hospitalizing rabbits.
Female rabbits can vigorously protect their young Conditions such as digestive or respiratory tract dis-
and aggressive behaviour can be extended to include orders require more intensive nursing than many
the protection of a bonded companion. owners are willing or able to provide at home. As rab-
Straightforward aggression is not the only reason bits are good at hiding, illness and significant alter-
for rabbits biting their owners. Occasionally fingers ations in condition may pass unnoticed without
are mistaken for food, especially if the fingers smell regular knowledgeable observation. Medication in
of sweets or biscuits. Overzealous grooming can the form of intravenous fluids, daily injections or

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nebulization may be necessary. Regular syringe feed- (0.5 mg/kg acepromazine plus 0.1 mg/kg butorpha-
ing, clipping and bathing may be required. Observa- nol) can be given by subcutaneous injection and
tion of behaviour, appetite, faecal and urine output is has the advantage of vasodilation that facilitates
easier if the rabbit is kept on its own under the careful venepuncture. Alternatively, fentanyl/fluanisone
eye of competent nursing staff. A stress-free environ- (0.3–0.5 mL/kg) (Hypnorm, Janssen) can be used
ment is required. Accommodation needs to be away but it is given by intramuscular injection, which is
from barking dogs and the sight and smell of preda- more distressing to patient and owner than a subcu-
tors. Ideally rabbits would be housed in a separate taneous injection. Subcutaneous (50 mg/kg) keta-
quiet room, where the nursing staff are able to spend mine with or without other agents can be used.
time observing their patients as well as performing Medetomidine is an effective sedative but causes
tasks such as assist feeding and medicating. Hospital- peripheral vasoconstriction, which can make the
ized rabbits should be provided with a bed of good- lethal intravenous barbiturate injection difficult.
quality hay to nibble and lie on. The familiar smell of Medetomidine in combination with buprenorphine
hay gives them security. All rabbits should be pro- results in rapid loss of consciousness with little
vided with some kind of hide, such as a cardboard peripheral vasoconstriction. This combination needs
box or short length of plastic drainpipe. House rab- to be given intramuscularly.
bits can be very particular in their choice of litter
material and may be reluctant to use a tray that does
not contain the correct type of litter. Most owners are 1.10.3 Clinical techniques
willing to bring in the correct type of material for
their rabbit’s litter tray. Fresh water needs to be pro- 1.10.3.1 Chemical restraint
vided in a drinking container that the rabbit is famil- Chemical restraint is useful for the diagnosis and
iar with. Some rabbits will not use a sipper bottle. It is treatment of many conditions in pet rabbits. It is eas-
worth considering hospitalizing a bonded compan- ier to collect a blood sample or take a well-positioned
ion of a sick rabbit as rabbits can become stressed diagnostic radiograph if the patient is immobile and
if they are separated. The decision should be based compliant. Soiled, matted fur or maggots can be
on the welfare of the well rabbit, as hospitalization removed from sedated rabbits and a period of seda-
must be less stressful than separation. tion and analgesia allows time for inflamed skin to
respond to treatment. Rabbits with gastrointestinal
disease that results in gas-filled viscera such as the
1.10.2 Euthanasia
caecum or stomach can benefit from a period of anal-
Euthanasia is defined as ‘an easy or painless death’ gesia. Intravenous fluid therapy is much easier in a
(Blood and Studdert, 1999). The traditional sedated animal.
approach of an intravenous overdose of barbiturate The properties of sedatives and tranquillizers are
can be difficult to accomplish easily in rabbits. The described in Section 4.4. Fentanyl/fluanisone
marginal ear vein is accessible but many rabbits will (0.2–0.3 mL/kg) (Hypnorm) is a particularly useful
jump up suddenly in response to venepuncture, for rabbits and is the only product licensed for rab-
which can be distressing for owner, vet and rabbit. bits in the UK. Fentanyl/fluanisone is vasodilatory,
The application of a transdermal local anaesthetic which, in conjunction with its sedative properties,
cream (EMLA) may be sufficient to allow intravenous makes venepuncture for the blood sampling or intra-
injection in very sick animals. Sedation prior to venous therapy simple. It is a satisfactory method of
intravenous barbiturate injection is preferable if chemical restraint for radiography, dematting or
the owner wishes to be present. The owner may wait maggot removal. An alternative to fluanisone/
with their rabbit until the sedative has taken effect. fentanyl is a combination of acepromazine and butor-
A combination of acepromazine and butorphanol phanol (0.5 mg/kg acepromazine plus 0.1 mg/kg

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 Rabbit Basic Science 1
butorphanol). This combination is also sedative and The jugular vein is a satisfactory site for the collec-
vasodilatory. However, it should be used with care tion of good-quality samples in most rabbits. The
in dehydrated animals or those with cardiovascular dewlap of female rabbits does not pose a problem.
disturbances (Flecknell, 2000). It may be difficult to visualize the vessels in obese ani-
The use of subcutaneous midazolam can be help- mals. The rabbit should be wrapped in a towel and
ful for rabbits that are very stressed in hospital. The held securely by an assistant. The head is extended
use of very low doses (0.25 mg/kg) can be enough backwards and the hair over the throat clipped off.
to facilitate intravenous catheterization, supportive The jugular vein can usually be visualized in the jug-
feeding and in some cases radiography. The added ular furrow and is raised by occluding the vessel by a
advantage is that this drug is very safe. finger at the thoracic inlet. Up to 10 mL of blood can
There are many other combinations that can be be safely collected from any sized rabbit from this site.
used as chemical restraint in rabbits, especially in Difficulties can arise with short-nosed breeds such as
the USA where fentanyl/fluanisone is unavailable the Netherland dwarf or animals with upper respira-
(Mason, 1997). Anaesthesia and analgesia are dis- tory tract problems that can become distressed or even
cussed in Chapter 4. cyanosed when the head is extended backwards. Alter-
native sites such as the cephalic or lateral saphenous
veins can be used instead. The lateral saphenous vein
1.10.3.2 Blood sampling is more easily accessible and is often a larger size than
There are several superficial veins that can be used to the cephalic vein. The vessel is very superficial and col-
collect blood from rabbits. Sites for venepuncture lapses easily if too much negative pressure is applied.
and intraosseous fluid therapy are illustrated in Large haematomas can occur if adequate pressure is
Figure 1.19. Although laboratory rabbits are some- not applied after the blood sample has been taken.
times bled by cardiocentesis, this procedure is not It is a good idea to make a blood film in addition
suitable for a pet rabbit. Rabbit blood clots extremely to placing the blood in sample tubes. The film can
fast and must be collected quickly but in a manner be quickly stained and examined for a differential
which does not cause haemolysis. Heparinizing the white cell count, which, in addition to a PCV, will give
syringe and needle can be helpful. As a rough guide, an immediate assessment of the rabbit’s health status
it is safe to take up to 1% of the animal’s bodyweight in the absence of sophisticated laboratory equipment.
of blood (Ramer et al., 1999). Analysers such as the I-Stat (Heska) require heparin-
The marginal ear vein is easily visualized and ized blood but are useful pieces of equipment in the
accessible but is too small in some breeds for the assessment of critically ill rabbits as they can measure
blood to flow freely. Blood can be taken quickly from parameters such as electrolytes, glucose and urea,
the central ear artery, but this procedure carries a using only a few drops of blood.
small risk of permanent damage to the blood supply
to the pinna if the artery is damaged. Part of the
pinna may subsequently slough off. Conscious 1.10.3.3 Urine collection
rabbits can jump suddenly and dislodge a needle Urinalysis is covered in Section 2.5. Urine samples can
from an ear vein in response to venepuncture. This be collected from house rabbits and from many hutch
response can be avoided by the application of a local rabbits by providing a clean but empty litter box
anaesthetic cream (EMLA, Astra). EMLA is a mixture of placed in the site where the rabbit usually urinates.
lidocaine and prilocaine that produces anaesthesia Cystocentesis is an alternative method of urine collec-
of full skin thickness. The cream is applied over the tion if the bladder can be easily palpated and dif-
marginal ear vein before covering the site with an ferentiated from other structures such as a gravid or
occlusive dressing or clingfilm. After 45–60 minutes neoplastic uterus or an abdominal abscess. Care
a blood sample can be taken (Flecknell, 2000). must be taken not to puncture the gut inadvertently.

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 Intravenous catheter
placement

1 Proximal
humerus
2 Tibial
crest

4
3 Proximal
femur

Trochanteric Jugular vein

fossa

4 Cephalic vein

Saphenous vein

Figure 1.19 Sites for venepuncture and intraosseous fluid therapy plus difficult-to-groom areas. The jugular, cephalic and
saphenous veins are in similar positions to those of other domestic animals such as dogs and cats. All these sites can be used
for blood sampling and intravenous injections in rabbits. The jugular vein is the greatest in diameter and is the best site for taking blood
samples. The ear vein is also satisfactory in large breeds or for collecting small volumes. The needle and syringe may need to be
heparinized as rabbit blood clots very quickly. Suggested techniques (Further information is given in Section 1.10.3). Jugular
blood sampling: good restraint is required for taking blood from the jugular vein. The rabbit should be wrapped in a towel, placed
on the edge of a table and held by an assistant. The head is raised and held back, either by the assistant or by the person
collecting the blood. It is important to ensure that the head is held straight. The fur over the jugular furrow is clipped off. Usually, the
vein is easily visualized and can be raised by placing a finger at the thoracic inlet. A good-quality sample of 5–10 mL of blood
can be collected quickly from this site without either haemolysis or clotting. Intravenous fluid therapy. A simple method of
venepuncture for intravenous fluid therapy is to use a 21- or 23-gauge butterfly catheter (see Section 1.10.4.2). One wing is removed
before inserting the needle, bevel up, into the marginal ear vein (caudal auricular vein). The remaining wing is ‘superglued’ to
the fur on the ear after the needle has been inserted into the vein. The wing provides a large surface area of contact with the ear.
In sedated or moribund rabbits, no bandaging is necessary to keep the needle in place, although a piece of bandage tied
around the rabbit’s neck can be used to hold the giving set out of the way. An intravenous catheter may be used instead of the
butterfly set, but is not as satisfactory because the wing does not have as large a surface area for the bonding agent. Alternative
sites for intravenous fluid therapy are the cephalic and saphenous veins. Intraosseous fluid therapy. In all intraosseous sites, a
spinal needle is preferable because the stylet prevents bone clogging the needle. A spinal needle is stronger and more able to
penetrate the bone. Possible sites for intraosseous administration: 1. Proximal humerus: this is the easiest site for access to a
medullary cavity. An imaginary straight line is made using the greater trochanter of the humerus and the elbow joint as landmarks. The
needle is inserted through the greater trochanter and directed along the imaginary line to penetrate into the medullary cavity. 2.
Tibial crest: an intraosseous catheter can be inserted just caudoproximal to the tibial crest. However, the lateral wall of the tibial
cortex curves medially and the needle must be directed towards the medial aspect of the tibia in order to penetrate the
medullary cavity. If the needle is mistakenly inserted along an imaginary straight line towards the hock joint, it will go into the cortex of
the tibia and miss the medullary cavity. 3. Proximal femur: this is the least satisfactory site for intraosseous fluid therapy
because of the well-developed trochanteric fossa. This can be seen on the caudal view of the femur. The path of an intraosseous
catheter must pass through this fossa to gain access to the medullary cavity. Therefore, to gain access to the medullary cavity
three layers of cortical bone must be penetrated. 4. Difficult-to-groom areas. The areas of skin that are difficult for a rabbit to
reach and groom are shown as green shading. Obesity or other flexibility problems hinder grooming in these areas and allow dead
hair, skin debris and parasites to accumulate. Signs of skin disease often begin at these sites. The area between the tail and
the dorsum can become contaminated by urine, faeces and is often the site that flies choose to lay their eggs. These are the areas
that owners should pay particular attention to when grooming their pet.
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 Rabbit Basic Science 1
Ultrasound can be used to identify the bladder. Repet- exception of some anaesthetic agents. Subcutaneous
itive puncture of the bladder can cause inflammation injections are well tolerated and even owners can
and subsequent stone formation. Rabbits are more inject their rabbit without problems. Occasionally
prone than other species to developing calculi along subcutaneous injections of antibiotics or vaccines
a cystotomy suture line (Kaminski et al., 1978). can result in a skin reaction that may not be noticed
until a few days later. These reactions can be mini-
Key Points 1.23 Hospitalization facilities mized by making sure that the needle has penetrated
the skin and the medication is injected subdermally
• Hospitalization facilitates administration of medi-
rather than intradermally. Massaging the area after
cation and food and permits observation of
giving the injection is also useful. The loose skin over
demeanour, appetite, thirst and urinary and faecal
output. the scruff is the usual subcutaneous injection site.
Older rabbits may have a thick dermal shield that
• A stress-free environment is required for hospital-
can affect the ability to inject in this area. Subcutane-
ized rabbits.
ous fluids (10–20 mL/kg) can be administered into
• A bedding of hay provides a familiar smell, a sense either the scruff or the loose skin over the chest.
of security and a source of indigestible fibre.
• Some house rabbits will only use a litter tray con-
taining a familiar substrate. 1.10.4.2 Intramuscular injections
• Peaceful euthanasia can be accomplished by
There are a few products that need to be given intra-
the administration of 0.5 mg/kg acepromazine
muscularly to rabbits. Large volumes (> 0.5 mL/kg)
þ1.0 mg/kg butorphanol given subcutaneously
10–15 minutes prior to intravenous barbiturate should be divided and given in two sites. The cranial
injection. muscle mass (quadriceps) of the hind leg is the pre-
ferred site. The caudal muscle mass can be used, but
• Rabbit blood clots quickly. The marginal ear vein
the sciatic nerve must be avoided by palpating and
can be used for blood collection in large rabbits.
The jugular and cephalic veins may also be used. identifying the semimembranosus, semitendinosus
and biceps femoris muscles and ensuring that the
• Although cystocentesis can be used to collect
injection is given into the muscle. Self-mutilation
urine samples, repetitive puncture can cause cal-
of the foot has been reported in rabbits as a result
culus formation.
of nerve damage during intramuscular injection of
ketamine and xylazine into the caudal muscle mass
Urine can sometimes be collected by manual
(Beyers et al., 1991). Tissue damage and muscle
expression of the bladder, although this procedure
necrosis were found at the injection site. The lumbar
is not without risk. The bladder is thin-walled and
musculature is an alternative site for intramuscular
can rupture during manual expression, especially if
injection.
there is a urethral obstruction. Chronic cystitis causes
thickening of the bladder wall, making it less suscep-
tible to rupture. Rabbits with cystitis or urolithiasis
often urinate in response to palpation of the bladder 1.10.4.3 Intravenous injections
and void urine that can be collected, if a suitable con- The usual site for intravenous injection is the mar-
tainer is easily available. ginal ear vein that is accessible and easily visualized
in rabbits (see Figure 1.19). Rabbits can be restrained
1.10.4 Administration of medication by wrapping them in a towel. Topical local anaesthe-
sia with EMLA cream (see Section 1.10.3.2) or chem-
1.10.4.1 Subcutaneous injections ical restraint can be used to prevent head shaking and
The subcutaneous route is suitable for the adminis- the needle being dislodged. Placing a catheter will
tration of most parenteral medications with the make intravenous injections safer and less stressful.

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Small-gauge needles or catheters, adequate light and to use the intravenous route but there are occasions
good eyesight are required, especially in dwarf when intraosseous administration of drugs and espe-
breeds. An alternative site is the cephalic vein similar cially fluids can be life-saving. Some practitioners
to the dog or cat. The rabbit’s short legs sometimes prefer this method of fluid administration and use
make raising the vein difficult. Other veins such as it routinely. Disadvantages include the risk of intro-
the jugular, lateral saphenous or femoral veins can ducing infection and causing osteomyelitis. The rate
be used (Malley, 1996) and the choice is largely a of administration can be slow. These problems can
matter of individual preference. be overcome by using careful aseptic techniques
The choice of sites is limited for intravenous cath- and multiple sites. Immature bones with active
eterization and fluid therapy (see Figure 1.19). The growth plates and diseased or fractured bones are
femoral and jugular veins are impractical. Usually not suitable. A needle is used to bore a hole through
the marginal ear vein or cephalic vein is used because a bony prominence into the marrow cavity. Direct
of the ease of keeping the rabbit in the correct posi- penetration of the marrow cavity is easier in the
tion for intravenous fluids to run once the drip is set tibia or humerus of the rabbit than the femur. The
up. Intravenous catheters can be held in place with anatomy of the head of the femur requires penetra-
adhesive tape or a few drops of skin glue (Vetbond) tion of the trochanteric fossa so the cortical bone
or superglue. A simple method is to cut one wing off is penetrated three times instead of once (see
a 21-gauge or 23-gauge butterfly set before placing it Figure 1.19). The humerus is the preferred site. In
in the marginal ear vein. The remaining wing can be conscious animals, local anaesthetic is infiltrated
superglued to the fur on the pinna to keep the needle around the injection site, which is clipped and asep-
in place. No bandaging is required to keep the needle tically prepared prior to the introduction of the
in place in sedated or moribund patients, although a needle. A 20- to 22-gauge needle that is about half
piece of bandage tied around the rabbit’s neck can be the length of the bone is required, i.e., 4–6 cm
used to hold the giving set out of the way. Most rab- (1.5–2.5 in.). Spinal needles with a stylet that pre-
bits tolerate the procedure well. Superglue is not as vents a plug of bone clogging up the bore are most
satisfactory for keeping intravenous catheters in suitable but ordinary hypodermic needles can be
place because they have a smaller wing that does used with a smaller gauge needle, catheter stylet or
not provide a large surface area for the bonding a length of wire acting as the stylet. The bone is pen-
agent. In this case making a butterfly of tape around etrated by using the needle as a drill. The needle
the hub of the intravenous catheter facilitates wither should be kept straight when boring the hole in
gluing or securing the catheter using tape. the bone; this is easier to achieve if the needle is
attached to a syringe that is then used as a handle.
Moving the needle from side to side results in a larger
hole than is required and leakage of fluid around the
1.10.4.4 Intraosseous route injection site. Penetration of the cortex can be felt as a
This route introduces fluids and drugs into the med- sudden lack of resistance. The needle may need to be
ullary cavity of long bones so they are absorbed into redirected slightly to push it down the medullary cav-
the venous circulation. Anything that can be admin- ity. It is important to be certain that the tip of the nee-
istered intravenously can be given intraosseously. dle is in the medullary cavity and not pushed against
There are several advantages to this technique, which or penetrating the cortex. At this point the stylet is
avoids the necessity of cannulating a small collapsed removed and a syringe attached to the needle to aspi-
vein in moribund patients. The intraosseous route is rate bone marrow which confirms correct placement
often used for small exotic animal patients such as of the needle. If there is any doubt, radiography is
birds, reptiles, guinea pigs and pot-bellied pigs where indicated. If the needle is not placed correctly, it
it is difficult to find a peripheral vein. Most rabbits should be withdrawn and a different bone selected
are large enough and have sufficient accessible veins to attempt the procedure again. Once the needle is

98
 Rabbit Basic Science 1
placed it can be glued or sutured in place. Dressings accept a piece of bread that has been sprinkled with
and antiseptics can be used for protection and to powder. Liquids can also be given in this way.
reduce the likelihood of infection. Heparin should Many rabbits are easy to dose with oral liquids. In
be introduced into the catheter every 4–6 h. The nee- fact many of them enjoy sweet compounds and will
dle should not be left in place for longer than 72 h. readily accept paediatric syrups or medication mixed
When it is removed a light dressing and some anti- with honey or fruit juice such as Ribena. Otherwise
septic can be applied to the site (Anderson, 1995). the rabbit can be wrapped in a towel and the liquid
slowly squirted into the mouth using a syringe
inserted in the diastema. Owners can be shown
1.10.4.5 Intraperitoneal route how to do this and most manage well. One note of
caution is that overenthusiastic oral dosing can lead
This route is seldom required for the treatment of pet
to trauma of the soft tissues inside the mouth or hard
animals and is more often used in laboratory rabbits.
scabby lesions at the lateral commissures, both of
Ideally the bladder should be empty and care is
which are painful and can discourage a rabbit from
needed to avoid the thin-walled caecum that lies in
eating and grooming.
the right ventral abdomen (see Figure 1.13). The injec-
tion should be given caudal to the umbilicus so there
is little chance of penetrating the liver, kidneys or
spleen. The inguinal quadrant is the site described 1.10.5 Nutritional support
by Malley (2000). It is important to draw back on
Nutritional support can be life-saving in rabbits.
the syringe to check for intestinal contents, blood or
Their metabolism is geared to a constant supply of
urine, in which case the syringe should be withdrawn
nutrients from the digestive tract. Anorexia can have
and another attempt made. This method should not
dire consequences, especially in fat rabbits as keto-
be viewed as acceptable if an alternative is available;
acidosis and hepatic lipidosis can develop rapidly
however, it can be life-saving in moribund patients.
as a result of mobilizing fat reserves. Oral liquids
soften and lubricate impacted stomach contents. In
the short term, nutritional support is required to pro-
1.10.4.6 Oral administration vide calories, nutrients, fluids and electrolytes. A
There are therapeutic agents that need to be given by readily available source of carbohydrate is required
the oral route. Medicating the drinking water is to provide glucose for absorption from the stomach
unsatisfactory as many preparations flavour the and small intestine and prevent hypoglycaemia and
water and make it unpalatable. Adding sucrose to the mobilization of the free fatty acids. In the long
the water has been advocated as a means of overcom- term, indigestible fibre and fermentable fibre are
ing this problem. It is also difficult to ensure the cor- required to maintain gut motility and optimal condi-
rect dosage when medication is given in the drinking tions in the caecum for bacterial fermentation.
water and there is experimental evidence to show Although fermentable fibre can be administered
that antibiotics administered by this route are inef- through a syringe, it is not possible to provide indi-
fective (Okerman et al., 1990). gestible fibre in this way because it has to be ground
Rabbits can be given tablets, which can be placed down to a fine powder in order to pass through the
in the mouth or administered with a pill giver. Plac- nozzle. The beneficial effect of long indigestible fibre
ing tablets in food such as breakfast cereals can be particles is lost by being ground down to a size smal-
successful and the occasional rabbit will eat tablets ler than 0.5 mm because particles below this size are
voluntarily. Crushing tablets and mixing the powder moved back into the caecum to undergo bacterial fer-
with honey or baby cereal can also be successful. mentation rather than passing into the colon and
Powders such as vitamin and mineral supplements stimulating gut motility. Therefore, it is important
can be given with food. Most rabbits will readily to encourage sick rabbits to eat as soon as possible.

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They need a source of palatable indigestible fibre, It is easier to place a nasogastric tube in a mori-
even if they do not appear to be eating. Hay, grass bund or anaesthetized rabbit as the nasal mucosa
or dandelions are often the first item to be eaten vol- is sensitive and the introduction of a tube can cause
untarily and are often eaten in preference to other sneezing and distress. In the conscious animal, local
foods. anaesthetic can be sprayed (Intubeze, Arnolds) or
In most instances, nutritional support can be dropped (Opthaine, Ciba) into the nostril. Sufficient
given by syringe feeding three or four times a day. time (2–3 minutes) should be allowed to elapse for
Liquid food (10–20 mL/kg) can be introduced into the anaesthetic to take effect before the tube is intro-
the mouth through a syringe with or without a small duced. Paediatric tubes (4–8 French) are suitable for
section of tubing attached. Several commercial this purpose or customized veterinary products are
foods are made for this purpose (Supreme Recov- available in varying sizes (Cook Veterinary Prod-
ery/Recovery Plus, Oxbow Critical Care/Fine grind). ucts). The tube is measured against the rabbit and
Baby foods can also be used; however, the fibre marked to give an idea of the position of the tip as
content is too low and the sugar content too high the tube is being placed: 3FR–4F urinary catheters
for prolonged use. Meat or dairy-based products can be used if a nasogastric tube is not available
and those designed for dogs and cats should be but holes need to be cut in the side and these can
avoided. They are useful in the short term as an catch on the nasal mucosa as the tube is introduced.
immediate source of energy and digestible fibre. To place a nasogastric tube, the rabbit’s head is
Alternatively, extruded monocomponent rabbit grasped and elevated and the tube introduced into
food (Supreme Selective, Supreme Petfoods, Alstoe the ventral meatus and directed slightly ventrally
VetPet Rabbit food, SupaRabbit Excel, Burgess) (see Figure 1.20). The head is then flexed as the tube
can be moistened and mashed to a paste for syringe passes through the nasopharynx into the oesophagus
feeding, although the fibrous particles tend to block and down into the stomach. Occasionally resistance
the syringe. This can be avoided by mixing a small is encountered in the nasal passage due to an elon-
amount of puréed babyfood to this paste. The food gated tooth root. In this instance, the other nostril
needs to be ground to a powder, which detracts can be tried.
from its motility stimulatory properties. Many It is possible to pass a nasogastric tube through
anorexic rabbits, especially those suffering from the larynx and into the trachea and it is important
dental problems, will eat softened nuggets of to ensure that the tube is not placed in the trachea
extruded food from a dish. Eaten in this way, the before introducing food. Keeping the head flexed min-
food is a source of indigestible fibre. imizes the risk of tracheal intubation. If the tube has
been measured up against the patient prior to place-
ment, the length of the tube that has been passed will
indicate whether the end is in the trachea or in the
1.10.5.1 Nasogastric tubes oesophagus. Palpation of the oesophagus, listening
Very occasionally a situation can arise where syringe for breath sounds in the tube or instilling a few drops
feeding is impossible and it becomes necessary to of water or saline can be helpful to confirm the correct
place a nasogastric tube to provide nutrition. This placement of the tube in the stomach. If in doubt, a
technique should be used as a last resort because radiograph can be taken to check the tube’s position.
nasogastric tubes stress rabbits and stress reduces gas- The nasal end is secured to the skin of the nose and
trointestinal motility and impairs digestive function. between the ears using tape butterflies and sutures
An Elizabethan collar is required to prevent a rabbit or superglue. Alternatively it can be secured to the Eliz-
removing a nasogastric tube and this is not only abethan collar, which is required to prevent the rabbit
stress provoking but also prevents caecotrophy. In removing or damaging the tube. Nasogastric tubes can
most cases, syringe feeding is satisfactory and naso- be left in place for several days. The rabbit is able to eat
gastric tubes can be avoided. with the tube in place.

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 Rabbit Basic Science 1
Ethmoidal nasal conchae
Olfactory bulb
Middle nasal concha
Optic nerve
Dorsal nasal concha Pituitary gland
Ventral nasal concha Soft palate
Incisive bone
Ventral meatus
Opening of
nasolacrimal duct
Cerebellum

Oropharynx
Nasal opening
Atlas
Upper incisor
Nasopharynx
Tongue Axis
Laryngopharynx

Larynx
Lower incisor Hard palate
Mandible Epiglottis
Maxillary palatine process

Thyroid cartilage Oesophagus

Trachea

Figure 1.20 Sagittal section through head. This diagram was drawn from a prepared sagittal section of a rabbit’s head using
Barone et al. (1973) as a reference source. The structures of the nasal cavity and the position of the ventral meatus can be seen. The
larynx is difficult to visualize through the oral cavity because of the large base of the tongue that occupies most of the nasopharynx and
obscures the view.

Complications associated with nasogastric tubes causing breathing difficulties or aspiration pneumo-
include inadvertent introduction of the tube into nia. It is also possible for the rabbit to chew through
the trachea and iatrogenic damage to the mucosa. the tube and inhale or swallow a section. A gag can be
The nasal mucosa is the primary site for Pasteurella used to prevent the rabbit from chewing the tubing.
multocida bacteria to reside and trauma to the tissues A piece of wood with a hole drilled through it can be
can stir up infection. Epistaxis can also result from placed in the diastema.
the passage of a nasogastric tube. Despite the difficulty of endotracheal intubation
in anaesthetized rabbits it is surprisingly easy to pass
a stomach tube into the trachea. Selection of a large
1.10.5.2 Stomach tubes tube should prevent this happening. The tube can be
There are occasions when it is necessary to pass a measured against the animal and an estimate of the
stomach tube. The most common indication is to length required to reach the stomach made. It is then
decompress the stomach of rabbits with intestinal lubricated before it is passed over the tongue into the
obstruction. These patients are usually either mori- oesophagus. After placing the tube, the animal’s
bund or sedated. Some clinicians use stomach tubes respiration should be watched for a moment or
for nutritional support or to administer medication. two and the colour of the mucous membranes
The technique carries a risk of inadvertently trauma- checked. A small amount of water can be introduced
tizing the larynx or passing the tube into the trachea, before giving any medication or food. If in doubt, a

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radiograph can be taken to check the placement of patient from removing the tube once it is placed
the tube. In rabbits with gastric dilation, gas and liq- and these are not well tolerated. In the long term sig-
uid readily pass up and out of the tube as the stomach nificant intra-abdominal adhesions can develop fol-
decompresses. lowing the use of PEG tubes. These will in turn
affect long-term gut motility and cause discomfort.

1.10.5.3 Pharyngotomy and gastrotomy

tubes 1.10.6 Elizabethan collars
There are clinical situations where syringe feeding is
Elizabethan collars are used in other species to pre-
impossible and a nasogastric tube inadvisable: for
vent interference with surgical incisions, wounds,
example, rabbits with skull injuries or a purulent nasal
catheters or dressings. There are circumstances when
discharge. A technique for placing a pharyngotomy
collars need to be fitted to rabbits but there are serious
tube has been described for laboratory rabbits
disadvantages. Rabbits fitted with Elizabethan collars
(Rogers et al., 1988). Under general anaesthesia a 1-
can become depressed or even anorexic. The collars
cm incision is made 5 mm from the midline just ante-
are stressful and are most likely to be fitted at a time
rior to the larynx on the left-hand side. A tube is
when it is important to minimize stress levels such
passed through the oral cavity into the oesophagus
as after surgery or during periods of anorexia. Signi-
and down to the stomach. The tube is grasped with
ficant elevations in plasma glucose levels have been
artery forceps through the mouth and pushed against
found in rabbits fitted with collars (Knudtzon,
the wall of the pharynx to cause a bulge under-the-
1988). Elizabethan collars also prevent a rabbit from
skin incision. The muscle overlying the bulge is care-
consuming caecotrophs. Caecotrophs are rich in
fully incised using the hard tip of the artery forceps in
amino acids and vitamins and necessary for optimum
the pharynx as a guide. The pharyngeal wall is incised
nutrition and wound healing. Collar edges also dam-
and the oral end of the stomach tube exteriorized
age the external pinnae of all but the shortest-eared
through the incision. The tube is then anchored at
rabbits, and this can contribute to discomfort. Good
the pharyngeal incision before being run through
surgical technique, buried subcuticular sutures and
the subcutaneous tissues to emerge at the base of
the correct choice of suture material reduces the need
the ear where it is anchored with skin sutures. Pharyn-
for Elizabethan collars postoperatively. If collars are
gotomy tubes placed in this manner have been left in
deemed necessary, then padding the edges to avoid
laboratory rabbits for 6–12 months to ensure accurate
ear damage, having supervised periods without the
doses of the drugs that were being tested. The catheters
collar to allow caecotrophy and considering the use
were well tolerated and the rabbits continued to eat
of clear collars to maintain field of vision can be help-
and drink without losing weight. This technique could
ful. For some areas (for example, to dewlap or rostral
be applied to pet rabbits. Soft feeding tubes designed
third of the body) soft collars are suitable for prevent-
for oesophagostomy in cats (Cook Veterinary Prod-
ing self-trauma.
ucts) would be suitable for this purpose.
Percutaneous endoscopical gastrotomy (PEG)
tubes have been used to administer enteral nutritional
1.10.7 Nebulization
support to rabbits (Smith et al., 1997). This technique
does not appear to be as useful in rabbits as it is in Nebulization has been described as an adjunct to
dogs and cats. It is difficult to pass an endoscope treatment of upper and lower respiratory tract disease
through the rabbit’s mouth and pharynx. In order in rabbits (Callaghan and Raftery, 1998). A variety of
to have a good endoscopic view, the stomach should medications, such as antibiotics, mucolytics and anti-
be empty, which is difficult to achieve in rabbits even septics, can be mixed with warm saline (38 C)
if they are prevented from eating caecotrophs. Elizabe- and administered twice a day, via a nebulizer, into
than collars or bandages are required to prevent the the air space of a small cage containing the rabbit. It

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 Rabbit Basic Science 1
is important to use isotonic saline as the vehicle. • A tempting palatable source of indigestible fibre
Experimental nebulization of rabbits with hypertonic should be available for all sick rabbits. Grass is
saline (3.6%) caused extravasation of water into the ideal; however, dandelion leaves and coriander
sub-epithelial tissue of the airway wall. The formation are also favourites.
of oedema was associated with a decrease in compli- • Any rabbit not definitely seen eating for 12 h
ance and gas exchange (Hogman et al., 1997). should be assessed and support feeding initiated,
except where intestinal obstruction or bloating are
concerns.
Key Points 1.24 Fluid therapy and nutritional
support

• Subcutaneous injections are well tolerated by rab- 1.10.8 Cerebrospinal fluid (CSF)
bits, and in rabbits that are not massively dehy- collection and myelography
drated large volumes of fluids can be given
subcutaneously. The maximum volume in a single The increase in status and popularity of rabbits as
site is 10 mL. companion animals has resulted in greater owner
• Intravenous fluids can be given into the marginal expectations of veterinary treatment and there are
ear vein. A butterfly cannula can be superglued times when myelography and spinal surgery are
to the pinna for easy administration; intravenous required. Cerebrospinal fluid analysis can also be
catheters can also be secured and are well toler- helpful in the differential diagnosis of neurological
ated. The fluid rate for maintenance is 100 mL/kg/ disease. Cisternal puncture in the rabbit is widely
24 h, but ongoing losses and illness factors also used in laboratory rabbits and the procedure is sim-
need to be accounted for. ilar to that for dogs and cats.
• The proximal end of the humerus is the preferred
site for intraosseous fluid therapy. The trochanteric
fossa at the head of the femur precludes direct pen- References
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Anything that can be administered into a vein can Abrams, K.L., Brooks, D.E., Funk, R.S., Theran, P., 1990.
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