By Laura Sullivan MRCVS – Vet

(Blocked tear duct)
Dacryocystitis is a common condition in rabbits, where the tear ducts become infected and inflamed. The duct becomes obstructed, tear flowstops and prevents natural flushing from the duct causing accumulationof debris and complete blockage.

What causes it?
The nasolacrimal duct in rabbits is very bendy and runs very close tothe roots of their cheek teeth (molars). It is often related to dentaldisease due to root overgrowth or infection.

rabbit-ailmentsWhat are the signs?
• White pus-like discharge: can be seen at the corner of the eye
• Pain/swelling around the eye
• Skin scalding: the area around the eye can become red and ulcerated
• Tear staining: on the fur around the face
• Can be both eyes or just one

What is the treatment?
The mainstay of treatment for this condition is to unblock theobstruction by flushing the tear ducts. There are small openings to the tear duct in the corner of each eye. We can place a small tube (cannula) into this opening to allow us to flush the tear duct with sterile saline. This procedure can usually be done while the rabbit is conscious, after administering some topical local anaesthetic drops into the eye. If the flushing is initially unsuccessful then it may need to be repeated after treatment with some topical antibiotic eye drops. This condition can become recurrent, dependent on the cause. It is important for the vet to check the teeth properly to determine the primary cause of the blocked tear duct and dental x-rays can be of benefit here to assess the length of the tooth roots. Sedation or anaesthesia will be required to evaluate the cheek teeth and their roots fully.

Can I prevent this from happening?
Feeding a good quality, high fibre diet will help prevent dental disease. See the ‘Rabbit Nutrition’ handout for more information.

Dental Disease
Rabbits teeth grow continuously throughout their life; this applies to both their incisors (front teeth) and molars (back teeth). In fact, their incisors can grow at a rate of approximately 2mm a week! The normal length is maintained by the wearing action of the upper and lower teeth working against each other. Sometimes, these teeth can overgrow; the front teeth become very long and curl or stick out at angles, and the sharp spikes form on the molar teeth.

What causes the teeth to become overgrown?

  • Inherited: some rabbits are born with a congenital malocclusion (present from birth) – rabbits with this condition should not be bred from.
  • Diet: lack of a good quality, high fibre diet prevents the teeth from wearing down appropriately.
  • Trauma: young rabbits can damage their incisor teeth pulling or gnawing on the wire on their cage.

What problems can overgrown teeth cause?

  • Pain: dental disease can cause immense pain as the incisor teeth can grow up or down into the opposing lips, molar teeth rub on the inside of the mouth causing ulcers on the cheeks or tongue.
  • Runny eyes: this is a common sign of dental problems, as the overgrowth of the upper molar roots can impinge on the rabbit’s tear duct, causing an overflow of tears on to the rabbit’s face, which makes the area around their eye very sore and matted.
  • Abscesses: the roots can grow up into the eye or down into the lower jaw Common symptoms include; weight loss, salivation, going off certain foods, runny eyes, lumps under the chin, grinding teeth, or loss of interest in their surroundings.

How is this condition treated?
Overgrown incisors can be temporarily corrected by burring down the overgrown incisors with a dental burr. This can be done while the rabbit is conscious, but it may need to be repeated every 3-4 weeks. The incisor teeth can be removed to solve the problem.
To treat malocclusion of the molar teeth, regular dentals under anaesthetic are required to allow better visualisation and examination of the molars and rasp down the rough spiky edges.
It is important to realise that long term management is essential and corrective dental work may need to be repeated.

Can I prevent my rabbit’s teeth from becoming overgrown?
Yes – prevention is better than cure!

  • Buy your rabbit from a reputable breeder, who can assure you that only rabbits with no dental disease have been used in the breeding line.
  • Feed an appropriate diet – one that mimics what wild rabbits eat. They should have unlimited access to good quality hay and grass, which is high in fibre and abrasive and will help to wear the teeth down. Avoid ‘muesli-type’ diets as they are low in fibre and rabbits selectively feed, so instead feed small quantities of a pellet mix.
  • Check your rabbit’s teeth on a regular basis.

Encephalitozoon Cuniculi (E.Cuniculi)
E. Cuniculi is a microscopic protozoan parasite that causes disease in rabbits. It colonises in the rabbit’s brain, eyes and kidneys. Rabbits are infected by ingesting or inhaling spores which are excreted in the urine or faeces of infected animals – it can live in infected areas for several weeks. E. Cuniculi can potentially be transferred to humans but appears not to affect healthy humans. Severely immunocompromised people should avoid animals confirmed or suspected with carrying the parasite.

What are the clinical signs?
Clinical signs can be non-specific, but some of the following signs may be noted:

Nervous signs

  • Head tilt/neck twisting
  • Paralysis
  • Weakness of the hind legs
  • Eventually leading to tremors/fits and then a coma

Eye disease

  • Cataracts and blindness

Kidney disease

  • Increased drinking and urination
  • Urinary incontinence/scalding
  • Kidney failure

Heart disease

  • Myocarditis (inflammation of the heart muscle) can be a cause of sudden death.

How is it diagnosed?
If your rabbit is showing clinical signs that point towards E. Cunicili then the vet may suggest doing a blood test which will show if they have been exposed to the parasite. If the result comes back negative this is generally conclusive and E. Cunicili can be ruled out; unless the sample is taken very early on in infection and the immune system is too weak to allow antibodies to be produced. A positive result isn’t quite as easy to interpret. A high result, together with clinical signs is usually enough to confirm the diagnosis, but a low positive result can be a problem as many rabbits carry the parasite without symptoms (asymptomatic). In this case the blood sample is repeated a few weeks later, and if the levels have risen this indicates an active infection.

How is it treated?
If E. Cuniculi is diagnosed or suspected then a 28 day course of Fenbendazole is recommended.
This is available in a paste form which is given by mouth, on a daily basis. Anti-inflammatory drugs can also be given. Supportive therapy is sometimes needed depending on the severity of clinical signs, as some rabbits with severe head tilt are unable to move around or feed themselves adequately. In some cases the treatment does not improve clinical signs – usually
if it is going to work, and improvement will be seen in the first week of treatment. For those rabbits who aren’t responding then euthanasia may be the only option if the rabbit has no quality of life.

What is the prognosis?
The prognosis depends on the severity of clinical signs, the response to treatment and the frequency and severity of any flare ups. The main thing to bear in mind is your rabbit’s quality of life, which you should discuss with your vet.

Can I stop my rabbit from getting E. Cuniculi?
First of all, you need to be 100% sure that your rabbit isn’t already a carrier of the parasite – so speak to your vet about having a blood test for E. Cuniculi. If the result comes back as negative, then the best way of preventing your rabbit being infected is by preventing contact with other rabbits – domestic or wild. Bearing in mind the parasite is primarily passed on from infected urine, good hygiene is vital – routine disinfectants should kill the spores. Other measures like raising food and water bowls off the ground to prevent urine contamination may be helpful. preventing contact with other rabbits – domestic or wild. Bearing in mind the parasite is primarily passed on from infected urine, good hygiene is vital – routine disinfectants should kill the spores. Other measures like raising food and water bowls off the ground to prevent urine contamination may be helpful.

Fly Strike
Fly Strike is a serious condition affecting rabbits that occurs in the summer months. In hot, humid conditions flies are attracted to dirty or soiled hindquarters and will lay their eggs around the base of their tail. The eggs hatch within hours and turn into maggots, which feed on the rabbit’s flesh, eating away at the skin and releasing toxins. This causes serious damage to the rabbit and if left can be fatal.

Rabbits at highest risk are those that suffer from:

  • dental problems: if your rabbit has overgrown teeth or sharp hooks (spurs) on their molars this will cause pain, preventing your rabbit from grooming properly
  • diarrhoea: or caecotroph impaction
  • arthritis: your rabbit may suffer from arthritis as they get older, and will make it harder for them to turn around and groom themselves properly
  • skin wounds: as flies are attracted to wounds on the skin, where they lay their eggs
  • overweight: your rabbit will have difficulty cleaning themselves

It is essential to check your rabbit’s back end and underneath at least twice a day to ensure they are clean and dry. Fly Strike can occur within a few hours!

Can I prevent my rabbit from getting Fly Strike?
YES! To protect your rabbit from getting Fly Strike, pop your rabbit down to your local practice and our qualified nurses can apply a prescription insecticidal repellent (“RearGuard”) that is rubbed in to their hindquarters. This repels flies and their larvae and needs to be applied every 10 weeks throughout the spring and summer when flies are about.

How is Fly Strike treated?
If you find any maggots on your rabbit then it is important to take them to the vets straight away. We treat Fly Strike by carefully removing the maggots and eggs, clipping the fur and gently cleansing the damaged area. Supportive therapy and hospitalisation is often essential – including painkillers, antibiotics, and a drip. Fly Strike can progress very quickly and if the damage is very extensive then sometimes unfortunately euthanasia may be recommended.

Gut Stasis
Gut Stasis or ileus is a serious, but fairly common condition in rabbits where food stops moving through the gut. If a rabbit stops eating or reduces its intake of food for any reason then its gastrointestinal system will slow down, or even come to a complete standstill. This can be fatal, even within just a matter of hours. As the guts stop moving, bacteria build up in the intestines, which release gas causing painful bloating. This further reduces the rabbit’s appetite, so the rabbit becomes more dehydrated. The contents of the guts become compacted making it more difficult for the rabbit to pass them.

What are the causes of Gut Stasis?

  • There are many reasons a rabbit could reduce or stop eating and drinking, such as;
  • Pain
  • Dental problems
  • Low fibre diet
  • Dehydration
  • Stress (predator, change in environment or diet, loss of a partner, extreme heat or cold)
  • Lack of exercise

What are the signs of Gut Stasis?

  • Small faeces
  • No faecal production
  • Reduced appetite
  • Lethargy
  • Hunched posture
  • Swollen or firm abdomen
  • Grinding teeth

How is Gut Stasis treated?
If you notice any of the above signs in your rabbit then you should take them to your vet straight away. Treatment needs to be aggressive and started immediately. They are usually admitted for hospitalisation and fluid therapy (via a drip in their ear vein) to rehydrate them and help get their guts moving again. The vet may administer medication to help kick start the guts such as pro-kinetics, as well as pain relief to alleviate the discomfort due to gas build up in the intestines. Antibiotics are sometimes given. It is very important to encourage their appetite, so fresh hay and greens are offered, as well as syringe feeding a high fibre critical care diet to ensure they get the essential nutrients.

If the rabbit is treated at an early stage (after only a few hours of not eating) then the prognosis is good. The longer the treatment is delayed then the less likely a good recovery is. Some rabbits require several days of hospitalisation and treatment to recover.

Cheyletiella sp also known as ‘Walking Dandruff’ is a fur mite that causes mild dermatitis in the rabbit.
The mites are transmitted either by direct contact with another infested animal or from contaminated bedding or hay (as the female mite can live off the host in the environment for several days).

What are the signs?
The most common sign is skin irritation along the back and neck area – you may notice;

  • hair loss
  • scaling (dandruff)
  • itchiness
  • redness
  • scabs

How is it diagnosed?
It is usually possible to diagnose the condition from the clinical signs and identification of the mite. This can be done with the naked eye, brushing the coat and examining the scale (dandruff) on a dark surface, you should be able to see the mites moving around (hence the nickname ‘walking dandruff’). They can also be viewed under a microscope.

How is it treated?
There are a range of treatments available – including a course of fortnightly injections or topical spot-on preparations which kill the mites. Your rabbit should be re-examined at the end of the course of treatment to ensure that it has all cleared up. Any other rabbits in contact with the infected one should be treated, as the mite is very mobile and is easily transferred from rabbit to rabbit. It is important to use an appropriate insecticide as directed by your vet, as many preparations are toxic to rabbits.
It is important that the environment is treated properly to avoid re-infestation. All of the bedding and hay will need to be removed and destroyed and the hutch and living quarters thoroughly cleaned and disinfected.

Myxomatosis is a very serious and deadly viral disease that infects and kills thousands of rabbits in the UK. It infects both wild and pet rabbits, and is widespread among the wild rabbit population.
It is a highly contagious disease and your rabbit can catch it from wild rabbits via direct contact, but also from fleas and other blood sucking parasites transmitting the virus. All breeds of rabbit are at risk, including indoor rabbits. Transmission of the disease is higher during the summer due to the increased numbers of fleas.

Clinical signs
A rabbit may have the disease for 5 – 14 days before showing any signs, and in this time is infectious to other rabbits. Common symptoms include:

  • puffy eyelids
  • purulent (pus-producing) conjunctivitis
  • fluid filled swellings under the skin around the eyes, ears and genital region
  • lethargy/fever
  • noisy, laboured breathing

It is usually fatal within 2 – 3 weeks; unfortunately most rabbits with the acute form are put to sleep on humane grounds to prevent unwanted suffering.
A milder/chronic form may be seen in partially immune rabbits, where the symptoms present as solid lumps over the ears and head. They may be single or multiple, and in some cases lumps may appear on the rest of the body. With proper nursing they can survive but the lumps may take over six months to disappear.

How can the disease be controlled?

  • Vaccination – A combined vaccination for Myxomatosis and Viral Haemorrhagic disease is now available for rabbits which can be given once a year. Vaccination can be started at any time, in rabbits over 6 weeks of age, but is best given around May – June, ahead of the peak Myxomatosis season in late summer/autumn. They will need a yearly booster to remain protected.
  • Parasite control – Keep wild rabbits away from pets and use a rabbit-specific flea treatment available from your vet. If you have other pets that come in to contact with your rabbit, like cats or dogs, ensure they are up to date with their preventative flea treatment too.

Viral Haemorrhagic Disease
Viral Haemorrhagic Disease (VHD) is a highly contagious viral disease that affects rabbits.
All rabbits are at risk, even indoor rabbits. The virus is spread by direct contact between rabbits (both wild and pet rabbits), as well as by indirect contact via people, clothing, shoes, inanimate objects and fleas. The incubation period is up to 3 days but many rabbits die suddenly without showing any clinical signs. If clinical signs are apparent then they may display the following symptoms;

  • lethargy/collapse
  • anorexia
  • fever
  • fits/convulsions
  • difficulty breathing
  • blood stained nasal discharge
  • paralysis

Unfortunately there is no cure available and it is almost always fatal once contracted as the virus attacks the major body organs, especially the liver, causing massive internal haemorrhage. Given the horrendous death experienced by affected rabbits, we strongly recommend that you vaccinate your rabbit.
You can protect your rabbit against this deadly disease – vaccination is essential and successful. There is a combination vaccination available which vaccinates against VHD and Myxomatosis in one simple innoculation in the scruff of the neck. Your rabbit will need a booster once a year to remain protected.

Other precautions should be taken to prevent your rabbit contracting VHD;

  • maintaining good hygiene, always washing your hands before and after handling other rabbits
  • regular, up-to-date flea treatment for all in-contact pets in the household, with a suitable product from your veterinary practice, as these are potent enough to ensure the fleas and their eggs are killed.

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