Emergency and Critical Care of Rabbits

hunched rabbit Alamy

 

Lecture outline

rabbit stethescope iStock

  • Emergency triage
  • Cardiopulmonary resuscitation
  • Analgesia
    • Opioids
    • Anti-inflammatories
    • Co-analgesics
  • Fluid therapy
    • Deficit correction
    • Rehydration
    • Maintenance
  • Critical care nutrition

 

Abstract

Intensive care in rabbits requires a thorough knowledge of rabbit anatomy and physiology along with an understanding of basic clinical procedures. Although there is extensive data available on the laboratory rabbit, studies focusing on companion rabbits in an intensive care setting are needed to optimize prognosis and improve quality of care.

When a rabbit is presented on an emergency basis, the first step is triage. As in other species, first observe the rabbit in his carrier and pay particular attention to the animal’s breathing, position, and the level of awareness. If the animal is in respiratory distress or not breathing at all, if the animal is not responding to manipulation, then the rabbit requires immediate stabilization or a resuscitation protocol should be initiated. In other cases, as rabbits hide clinical signs, a precise history should be obtained and a thorough physical examination should be performed.

In cardiopulmonary arrest, mechanical cardiac activity halts leading to hemodynamic collapse. As this is an absolute emergency, the clinic staff must to be prepared. As has been described in carnivores, the “ABCDEFG” sequence can be used, but is adapted to the anatomical and physiological particularities of rabbits.

As rabbits are very sensitive to pain and its consequences can be deadly, one of the first treatments to give to rabbit are painkillers. The analgesic potency of non-steroidal anti-inflammatory drugs is often insufficient and some of their side effects can be dangerous for in the debilitated patient. Opioids, such as buprenorphine, morphine, or fentanyl, can be safely used in most cases. More and more data are also available on co-analgesics like alpha-2 agonists, dissociative agents, and local anesthetics, which could be very interesting to use in critical care.

In many critical cases, clinical signs are often secondary to dehydration or alterations of the electrolytes equilibrium. Fluid therapy should be performed in three steps: deficit correction (hypertonic bolus in order to reach 90 mmHg of arterial blood pressure), rehydration (using isotonic crystalloids to reach normal hydration status), and maintenance (to cover the loss of fluid, electrolytes, and energy in a normally hydrated animal) with electrolytes supplementation as needed.

 

About the presenter

Charly Pignon graduated in 2005 from Alfort National Veterinary School in Maisons-Alfort, France. He then worked at the wildlife rescue center in Alfort and the Paris Zoo (la Ménagerie du Jardin des Plantes). In 2009, Charly completed an exotic animal medicine internship at Tufts University and when he returned to France he created the Exotic Medicine Service at Alfort National Veterinary School. Dr. Pignon is a Diplomate of the European College of Zoological Medicine (Small Mammal) and a Board member of Yaboumba, a French association for continuing education in exotic and wild animals. [MORE]

 

Webinar recording

Note:  Slide 10 – Otitis externa treatment:  PECALBO + AB = Partial ear canal ablation and lateral bulla osteotomy plus antibiotics

 

Post-test

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Expert Q&A

Dr. Pignon was able to answer all questions submitted through the live webinar question and answer feature, however two questions were submitted by live event attendees, one via the chatbox and one via the evaluation form.

Q:  How do you prevent gastric bloat secondary to V-Gel [V-Gel supraglottic airway device] movement during CPR? We try to intubate each time but in the occasions we’ve used a V-Gel have had secondary bloat.

A:  Gastric bloat could be a complication when the size of the V-gel is too small. I usually always take the size above what the company recommends if you follow the table with weight of the rabbit and size of the V-gel.

 

Q:  Do you have any experience with using an injectable ranitidine orally?

A:  I have no experience of using ranitidine orally, and I’m not aware of any article about the oral route for ranitidine, so I would recommend to use it subcutaneously.

 

RACE approval

This program was reviewed and approved by the American Association of Veterinary State Boards (AAVSB) Registry of Continuing Education (R.A.C.E.) program for 1 hour of continuing education in jurisdictions that recognize AAVSB R.A.C.E. approval.

Please contact AAVSB R.A.C.E. program if you have any comments or concerns regarding this program’s validity or relevancy to the veterinary profession.