Jo Hedley, Head of the Exotics Service   

Rabbits make up a large part of the caseload at RVC Exotics Service, Based at the RVC Beaumont Sainsbury Animal Hospital in London, it was one of the first practices in the UK to be graded by the Rabbit Welfare Association & Fund as Gold Standard in rabbit care.

We run both a first opinion service for local rabbit patients in Camden (London) and a referral service for more complex cases, which are seen both in Camden and at the RVC Small Animal Referrals in Hertfordshire. Lop-eared rabbits are common patients and are often presented for dental, aural and respiratory disease, which seem to be linked to their brachycephalic conformation.

On initial presentation, it is essential that we understand the extent of the problem and we regularly collaborate with our imaging specialists at the QMHA to use advanced imaging techniques such as CT. This is normally performed under a short light sedation and it enables us to quickly get results and formulate a treatment plan

Dental Challenges

For those with dental disease, imaging helps us identify any underlying abscessation associated with the tooth roots. The rabbit’s response to infection has key differences from those of a cat or dog. Signs of acute inflammation following an initial infection are rarely seen. Instead, animals are usually presented once the infection has become walled off as thick caseous pus within a fibrous capsule. This capsule reduces the ability of drugs to penetrate the infection and the mass effect can cause pain for surrounding structures.

Surgical treatment is usually necessary to either completely remove the abscess and any associated teeth or to marsupialise the site to allow ongoing topical treatment.Surgical procedures can be very invasive and patients require intensive care for several weeks afterwards, but can often be successfully resolved.

Aural Infections

In contrast, aural infections may require a different approach. Some rabbits are presented just for ongoing otitis externa, particularly those with anatomically narrowed ear canals such as the lop-eared breeds. If the tympanic bullae are found to be clear on CT scan, then flushing and application of topical treatment under endoscopic guidance may often be performed. However, often the bulla is full of pus and in these cases, surgical treatment is usually recommended.

There are a variety of surgical techniques, but most commonly a partial ear canal ablation and bulla osteotomy is performed to remove all infected tissue. Patients do require a period of intensive care afterwards, but recovery can be surprisingly quick once the underlying source of pain within the middle ear has been removed.

Respiratory problems 

Finally, respiratory problems are often chronic and may involve either the upper or lower respiratory tract or both. Brachycephalic rabbits seem over- represented, likely due to their narrowed
airways. Concurrent dacryocystitis is also frequently seen. Bacterial infections such as Pasteurella are usually involved, so our first stage is to establish the extent and type of infection and look for any other concurrent pathology. Many animals
can be managed successfully with a combination of medical treatment, but in some cases rhinotomy procedures for nasal and sinus flushing will be required.