Behavior Essentials: Clinical Approach to the Rabbit

Introduction

The approach to a prey species like the rabbit often calls for a profound paradigm shift for clinicians used to dealing only with cats and dogs (Fig 1). Rabbits can stress very easily in a clinical setting. Stress-related catecholamine release causes tachycardia, tachypnea, hypothermia, and renal ischemia (Bays 2006). As a result, excessive stress can prevent a positive response to medical and surgical therapy and interfere with normal anesthesia and recovery (Bays 2006).

The clinical approach to a prey species, like the rabbit, must differ from for a cat or dog.

Figure 1. The clinical approach to a prey species, like the rabbit, must differ from that for a cat or dog. Click image to enlarge

The challenge of managing a small mammal like the rabbit increases exponentially when they are presented for illness or injury. The physiologic response to pain can compound the cardiovascular and renal changes described above. Pain further enhances reflex sympathetic tone, which in turn increases blood viscosity, clotting time, fibrinolysis, and platelet aggregation (Bays 2006). All of these potential negative effects of stress and fear can combine to cause gastrointestinal stasis, poor response to anesthesia, shock, and even death.

Recognizing signs of illness and pain

Assessment of pain is challenging in rabbits, as the clinical signs are often quite subtle (Weaver et al 2010). Like other prey species, rabbits tend to mask signs of pain or illness, particularly when frightened and placed in strange surroundings. Therefore it is particularly important to obtain a good history in the rabbit patient.

History

The successful rabbit veterinarian listens carefully to owner observations and takes seriously any behaviors the owner considers abnormal for their pet (Bays 2006). Important non-specific signs of illness in the rabbit can include a wide range of clinical problems (Bays 2012):

  • Anorexia
  • Lethargy, reluctance to move, and/or reduced interest in surrounding environment
  • Absence of normal behaviors including failure to groom
  • Aggression in a normally docile animal
  • Production of fewer, smaller, or no fecal pellets
  • Separation from the group

In addition to failure to groom, stress and/or pain can be associated with over grooming, excessive licking or even fur plucking or self-mutilation. Owners may also describe an increase in water intake and/or loud teeth grinding (bruxism), which are commonly associated with abdominal pain in the rabbit. Polyuria, polydypsia and/or porphyrinuria can also be observed in the rabbit suffering from chronic stress (Klaphake and Paul-Murphy 2012).

Visual examination

Although the exam room setting can be intimidating, even the shy rabbit should appear bright and alert with ears raised and tail erect. If allowed the chance to acclimate to this strange environment, some individuals will begin to groom, and investigate their strange environment by sniffing and head bobbing (Vella and Donnelly 2012, Bays 2006). The normal rabbit may even eat if offered appropriate food items (Bays 2006).

Rabbits possess few muscles of facial expression. Therefore even close observation of the face cannot be used to correctly identify signs of pain in the rabbit (Leach 2011). The only facial region that may provide a subtle clue are the eyes. The painful and/or fearful rabbit may exhibit (Bays 2006):

  • Bulging eyes
  • Half-closed or squinting eyes
  • Dull, unfocused eyes

Instead of studying the face, research confirms that careful observation of the body, including the back and hindquarters, is much more likely to correctly identify pain in the rabbit–even in experienced individuals (Leach 2011). Signs of abdominal pain can include a hunched posture, pressing the abdomen into the floor, and even stretching with the back arched (Table 1). The painful rabbit may also exhibit twitching, wincing, or flinching of the body as well as shallow, rapid respirations with the head extended up and out (orthopnea) (Weaver 2010, Leach 2009, Bays 2006). If allowed to ambulate, lameness or stiff movements may be observed (Bays 2006).

Table 1. Possible signs of abdominal pain in the rabbit (Bays 2006)

  • Anorexia

  • Bruxism or tooth crunching

  • Hunched posture, tucked appearance to abdomen

  • Pressing abdomen into the floor

  • Polyuria/polydypsia

  • Splinting and/or vocalization upon abdominal palpation

Physical examination

As a general rule of thumb, approach the rabbit patient slowly and speak softly (Table 2) (Video 1) (Bays 2006). Quietly explaining what you are doing can help calm both the rabbit and their owner and exhibits a level of compassionate understanding with which owners can connect.

Table 2. Prey Species Clinical Do’s

  • DO speak softly

  • DO move slowly

  • DO approach the rabbit at eye level, whenever possible

Video 1. Created by Ontario Veterinary College, this video describes how to approach and calm the rabbit in a clinical setting.

Monitor the rabbit not only for signs of stress or pain, but also fear or aggression. It is particularly important to approach these latter bunnies slowly as fear or aggression can be associated with lunging at and scratching or biting the handler (Bays 2006). The fearful and/or aggressive rabbit often sits in a back corner, facing outward its body in a crouched position with the feet tucked underneath and the head extended out and down. The eyes frequently bulge with fear or stare with hostility, and the ears are laid back against the head (Bays 2006, Bradley 2000).

During the physical examination, avoid touching the rostral aspect of the muzzle since contact with this blind spot can startle the rabbit (Vella and Donnelly 2012). This region also contains vibrissae that assist the rabbit in distinguishing plants when grazing for food making it a sensitive place to touch during examination or when medicating (Brewer and Cruise 1994). Save evaluation of this region as well as the oral exam for the end of the physical.

After being handled, the normal rabbit will groom fastidiously. If your patient does not attempt to clean itself, potential underlying problems include obesity, painful conditions like degenerative joint disease, spondylosis, and dental disease, intense pruritus caused by ectoparasites, and of course any generalized illness causing lethargy (Bays 2006).

Pain management

Like many prey species, the painful rabbit can be very stoic. If pain is a known component of the procedure or existing disease process, pain management is crucial.  When indicated, analgesia may need to precede any additional diagnostics or treatments. Consider a multimodal approach to pain management whenever possible (Weaver 2010).

Measures to reduce stress

Stress, including the stress of illness, injury, pain, or poor husbandry, can affect rabbit behavior and the likelihood of clinical success (Jenkins 2001). Fortunately even before the rabbit enters your exam room, there are things the owner can be instructed to do to minimize anxiety (Bays 2006):

  • Habituate the house rabbit to the kennel carrier:  The crate is set out in the open, providing ready access for the rabbit. Placement of small amounts of hay or even the occasional treat in the carrier will mean the pet is less frightened when confined to the carrier for transport
  • Road trips:  Brief, occasional car rides in the crate can habituate your patient to this process and reduce the likelihood of being presented with a patient already on the verge of collapse even before evaluation begins.

When hospitalizing the rabbit, decreasing stress will increase the odds of success for your medical or surgical patient (Bays 2006).

  • Whenever possible, hospitalize prey species like the rabbit in a quiet area separate from the sight, sound, and smell of potential predator species like the dog, cat, or ferret (Graham 2012, Bays 2006).
  • Offer familiar food items like greens and grass hay (Bays 2006).
  • Indulge the instinctive need to burrow by providing some form of visual security like a cardboard box, kennel crate, or the sturdy, plastic hide box shown here (Fig 2) (Bays 2006). If a timid rabbit is hospitalized long-term, ensure it does not spend all of its time in the hidebox, lying in urine and feces (Bays 2006). If a large enclosure can be provided, offer two hide boxes so the shy rabbit can use one to sleep in and the other as a latrine.
Provide hospitalized rabbits with visual security—and a bonded companion—whenever possible.

Figure 2. Provide hospitalized rabbits with visual security—and a bonded companion—whenever possible. Photo credit: Porsche Borsseau via Flickr Creative Commons. Click image to enlarge.

  • Also provide a litter pan to the hospitalized rabbit.
  • Allowing a bonded companion to stay with the hospitalized patient can reduce stress and improve clinical outcome. “Sleepovers” also reduce the risk of territorial spats over social hierarchy that occur when a rabbit is removed and then returned to the home environment (Bays 2012, Bays 2006, Bradley 2000).
  • Finally, if the individual’s personality allows, stress can also be reduced and gastrointestinal motility improved, if the rabbit patient is occasionally allowed exercise outside of its cage.

A note on hypnosis

During “hypnosis” of the rabbit, the animal is placed on its back with the neck extended and sometimes the rear legs restrained. The ventrum is gently rubbed while the handler speaks softly in a monotone voice (Fig 3) (Bays 2006). Although some clinicians successfully use hypnosis for non-painful, non-invasive procedures, this technique puts the patient in the most vulnerable position imaginable for a prey species. Ideally hypnosis should only be performed on rare occasions in select patients with which a relationship of trust has already been established. This technique should never be used for painful or surgical procedures (Bays 2006).

In clinical practice, hypnosis is used on rare occasions for non-painful, non-invasive procedures.

Figure 3. In clinical practice, hypnosis is used on rare occasions for non-painful, non-invasive procedures. Click image to enlarge.

Viewing the body

Sometimes when all of our clinical efforts are unsuccessful, the question must be raised on how to proceed with the death of a bonded rabbit. The loss of a companion can lead to what is perceived as depression or grieving in the surviving rabbit. Social rabbits may isolate themselves, aloof individuals may suddenly demand more attention, and some individuals may frantically dig or chew. The individual often eats less, drinks more water, and appears lethargic. To reduce these adverse effects, it may be helpful to allow the surviving rabbit to view the companion’s body after it has died (Bays 2012).

Conclusion

Exotic animal veterinarians must often rely on the concept of “One Medicine” and the ability to extrapolate information from one species to another. As always, the One Medicine concept must be balanced against the importance of species-specific information and nowhere is this caveat more accurate than with behavior. The ability to truly understand rabbits and to accurately recognize stress, fear, and pain in this special species will improve the clinician’s ability to not only diagnose and treat medical conditions, but to also improve the quality of life for our patients.

References

References

Bays TB. Behavior of small mammals. In: Quesenberry KE, Carpenter JW (eds). Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery (3rd ed). St. Louis, MO;Elsevier Saunders; 2012: 545-549.

Bays TB. Rabbit behavior. In: Bays TB, Lightfoot TL, Mayer J (eds). Exotic Pet Behavior: Birds, Reptiles, and Small Mammals. St. Louis, Mo: WB Saunders: 2006: 1-49.

Bradley T. Rabbits: understanding normal behavior. Exotic DVM 2(1): 19-24, 2000.

Graham. Basic approach to veterinary care. In: Quesenberry KE, Carpenter JW (eds). Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery (3rd ed). St. Louis, MO;Elsevier Saunders; 2012: 175.

Jenkins JR. Rabbit behavior. Vet Clin North Am Exotic Anima Pract 4(3):669-679, 2001.

Leach MC, Allweiler S, Richardson C, et al. Behavioural effects of ovariohysterectomy and oral administration of meloxicam in laboratory-housed rabbits. Res Vet Sci 87(2):336–347, 2009.

Leach MC, Coulter CA, Richardson CA, Flecknell PA. Are we looking in the wrong place? Implications for behavioural-based pain assessment in rabbits (Oryctolagus cuniculi) and beyond? PLoS One 6(3):e13347, 2011.

Vella D, Donnelly TM. Basic anatomy, physiology, and husbandry. In: Quesenberry KE, Carpenter JW (eds). Ferrets, Rabbits, and Rodents: Clinical Medicine and Surgery (3rd ed). St. Louis, MO;Elsevier Saunders; 2012. Pp. 169-171.

Weaver LA, Blaze CA, Linder DE, et al. A model for clinical evaluation of perioperative analgesia in rabbits (Oryctolagus cuniculus). J Am Assoc Lab Anim Sci 49(6):845-851, 2010.

To cite this page:

Pollock C. Behavior basics: Clinical approach to the rabbit. May 13, 2011. LafeberVet Web site. Available at https://lafeber.com/vet/behavior-basics-clinical-approach-to-the-rabbit/