Basic principles of nursing rabbits. Firm restraint is also a bad idea. Picking rabbits up. Firm restraint is also a bad idea. 27 th October 2017

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1 Common nursing procedures Basic principles of nursing rabbits Reduce pain Reduce stress Reduce fear Also Provide correct diet Administer medications Perform diagnostic procedures Clean wounds etc. etc. Picking rabbits up Being picked up is stressful for most rabbits Being grabbed adds to stress Grabbing by ears or scruff is definitely not a good idea It is the way a predator would hold it Never necessary Firm restraint is also a bad idea Hindlegs are like a coiled spring Often said that rabbits must be restrained firmly But injuries can be the result of rabbits kicking out when restrained across the shoulders Firm restraint is also a bad idea Vertebral fractures and dislocations Vertebral column is inflexible dorsoventrally What happens if the rabbit kicks out with shoulders restrained? 1

2 Correct (in my view) way to pick a rabbit up Stress A specific response by the body to a stimulus, such as fear or pain that disturbs or interferes with the normal physiological equilibrium Not how a predator behaves A visit to the vets, the reason for the visit and what happens when they get there can all be stressful Emotional stress- examples Isolation Entire males within sight or smell of females Giving birth with nowhere to make a nest Fear An emotion induced by perceived threat Fear induces a number of responses Variety of responses between individuals and species Lots of literature and information In any species- fear evokes a stress response Fear in rabbits Is this a state of fear? Many predators: - Birds of prey - Foxes - Dogs - Cats - Stoats and weasels - Humans Immobility response or tonic immobility 2

3 Trance or terror? Feelings run high about this question Some tame rabbits want to lie on their backs Tame rabbits do not need to much restraint to become immobile Some lie on their back voluntarily Tonic immobility (TI) is often used to describe any rabbit on its back Cradling rabbits on their backs Cradling a rabbit like a baby is a useful method of restraint Can: - Clip claws - Examine perineum - Examine hocks - Examine teeth - Clip away lumps of soiled or matted fur Rabbits are not in a trance Trancing or hypnotising a rabbit My rabbit- Earl Need quiet environment Gentle, handling with no sudden movement Forgiven Difference in susceptibility Inducing immobility response only works in docile, tame rabbits Wild or lively rabbits need sedation 3

4 Method of restraint is important Restraining a rabbit on it s back If a rabbit is grabbed by the scruff and turned on its back it will probably go into a state of terror This is what you would have to do to a wild rabbit or one that was lively or frightened Restraining a rabbit on it s back will make it immobile and scared Not same as relaxed rabbit lying on its back or in a trance My Opinion: A tranced rabbit is not same as rabbit in tonic immobility Literature about tonic immobility Lots of conflicting information Tonic immobility is often used interchangeably with playing dead to deceive predators An immobility response can be induced in many species Some often quoted, but unpublished studies in rabbits Difficult to separate effects of handling and taking blood samples from effects of turning rabbit on its back What is Tonic immobility Scared stiff Humans undergo tonic immobility when they are subjected to a serious attack (e.g. rape, murder or war injuries). They find they are unable and unwilling to use voluntary muscles during the event and feel neither anger nor pain. They are emotionally numb, as if anesthetized but the general impression conveyed by such patients is one of profound mental anguish and their immobility is induced by severe mental shock. Is this a state of terror? Is this fear? Is this tonic immobility? My opinion- from reading and personal observation: The immobility response is not the same as tonic immobility Blood glucose levels do not rise in response to placing a rabbit on its back Rabbits will accept food on their back Impossible to induce IR in wild rabbits or lively pet ones without terrifying them Easy in docile pet rabbits 4

5 Would I do it to my rabbit? Yes-if it was required Many benefits Helps full clinical examination Means that the fur from under the tail can be clipped off easily Useful for radiography without sedation Also other proceduresultrasound etc. Procedures I wouldn t want to do to my rabbit Taking abdominal radiographs GI tract full of food Can be done without sedation Very useful diagnostic technique Utilises the immobility response Nurses are good at it Underlying problem with urination Too little calcium in bones 5

6 Too much calcium in bones Kidney stones Chronic renal failure????????? Clipping up rabbits with dirty bottoms Caked faecal material under tail is common in pet rabbits May be (mistakenly) attributed to enteric infection Often (mistakenly) attributed to inclusion of vegetables in diet Doesn t respond to antibiotics (or probiotics) 6

7 Uneaten caecotrophs Consistency of caecotrophs Caecotrophs: Are brown Have a smooth pasty consistency Strong unpleasant smell Stick to fur under tail Owners usually call it diarrhoea They could be any consistency of rabbit eats them Reputed to be softer on high carbohydrate diets Increasing dietary fibre does make caecotrophs firmer Consequences of uneaten caecotrophs Not immediately fatal Unpleasant for owners- may leave them abandoned in hutch or worse Sore perineal skin Prone to fly strike Can predispose to urinary incontinence Why don t rabbits eat their caecotrophs Too fat too reach their anus Can t reach their anus because there is so much matted fur Not hungry because there is always a bowl of food in front of them Taints Spinal abnormalities Dietary change can cause transitory period of uneaten caecotrophs Some rabbits always have diarrhoea or soft uneaten caecotrophs with some foods Scoliosis, lordosis, kyphosis Disc disease Spondylosis Common 7

8 Neurological problems Dental disease Spurs on the cheek teeth and a painful tongue can prevent rabbit licking up and eating caecotrophs Non- functional incisors can prevent a rabbit removing uneaten caecotrophs from the fur around the anus Painful perineal skin Reasons include- Urinary incontinence Grooming problems Deep skin folds TREATMENT of uneaten caecotrophs Identify and, if possible, treat underlying cause- radiography may be helpful in making a diagnosis Clip and clean perineum Treat inflamed skin- NSAIDS, antibiotics, antiseptic creams? Surgery for skin folds Flystrike prevention Modify diet? Bathing without clipping Not satisfactory Can be stressful Impossible to remove all caecotrophs Leaves fur soiled and damp Skin underneath becomes sore and infected (like nappy rash) Removing soiled fur Essential Time consuming May need sedation Rewarding Can show owner anatomy and encourage them to keep fur under tail short 8

9 Nicking skin End result Need to be careful and gentle Easy to tear skin when pulling mats out Or nick skin with scissors Or damage skin with clippers Heal really well Tissue glue or stitches only wound is large Need to clip all around tail Rabbit feels much better Skin starts to heal straightaway Breaks vicious circle of urine scalding Some cases require surgery Medication and other treatment Antibiotics if skin is inflamed Meloxicam Antiseptic or antibiotic cream Weight reduction Dietary modification?probiotics?? Modify diet Increase lignin and cellulose content Makes caecotrophs firmer and less likely to stick to skin Hay if the rabbit can eat it More leafy greens for rabbits that don t eat hay i.e. more veg and less (or no) concentrated food Some rabbits will never eat their caecotrophs Will always require fur to be kept short and bedding changed frequently 9

10 Show owners how to clip fur Need to know anatomy Reassure about skin nicks Sell the some pointed curved scissors Can buy battery operated clippers Discuss restraint Other palliative care Clean, dry bedding. A deep bed of hay provides drainage- but care if rabbit has weak hind legs- use VetBed instead Caecotrophs are usually passed during morning.? Clean cage at lunchtime Provide opportunity to exercise Taking blood samples Other sites Marginal ear vein is easiest Can be difficult to collect large volumes of blood Easy to take enough for blood glucose and haematocrit Option for a Cephalic Saphenous Jugular Post-operative care of abscesses Lancing and emptying abscess isn t curative Surgery can be major or minor May be left with large cavity that needs cleaning twice daily Marsupialising abscess cavities Often cited as best treatment Allows drainage Allows cleansing Allows administration of topical antibacterial agents Only curative if focus of infection has been removed 10

11 Fistula formation Removing tooth and marsupialising wound leaves route for food and saliva to go from mouth to skin Is uncomfortable for rabbit and can make skin sore Usually close in 3-5 days Don t flush Post-operative care Remove dead tissue Clean skin Apply drops or other medications Fight wounds Treatment Multiple puncture wounds cause abscesses that track under skin Or skin can go black and die away End result The end 11