• Clinical examination
• Treatment technique
• Zoonotic conditions of rabbits
• Anesthesia and Tranquilizer
• Common Emergencies and Clinical Condition
•  (Handle) ˇŇĂÍŘéÁˇĂеčŇÂ
• POSTERIOR PARALYSIS AND PARESIS
• Precaution from recovering of anesthesia
• Rule out chart for rabbits based on clinical signs
Clinical examination
            The clinical examination of all exotic and domesticated species begins by obtaining an adequate and detailed history which should include the following points:
            The length of time that the animal has been in the possession of the owner; if this has not been the majority of the animal’s life , details of the history while in the previous owner’s possession must also be obtained.
            The type of husbandry. Does the animal run free in the garden or is it confined to a hutch or run ? It is very important for the clinician to be aware of the aspect of these enclosure and to ascertain the prevailing climatic conditions as very frequently the animals are exposed to cold winds and squails or even to excessive sunshine with resultant stresses.
            Contact with other rabbits and with other species must be recorded.
• Observation of the subject
• Lacrimal apparatus
• The skin
• The thorax
• The abdomen
• The mouth
• Limbs
 Treatment technique
            Subcutaneous fluid administration is acceptable in noncritical cases. Estimate daily maintenance fluids at 100 ml/kg/24hours.
            An indwelling catheter is preferred in critical cases.
            Administer oral medications into the lateral cheek pouch. Use liquid or paste preparation when possible , because rabbits have a long , narrow oropharynx that makes pill administration difficult.
            Forced-feed anorectic animals with a paste nutritional supplement , a commercial nutritional formula or a gruel made of moistened rabbit pellets.
            Place nasogastric tubes in medium-to -large rabbits. The technique that follows is similar to that for placing a tube in a cat.
            Lactobacillus spp. May aid in the treatment of enteritis by -
• Repopulating the gastrointestinal tract with healthy bacterial flora
• Decreasing intestinal or cecal pH
• Competing with bacterial pathogens for mucosal attachment sites
• Commercial products in paste form are available for administration.
            Zoonotic conditions of rabbits
- Campylobacter
- Rabies
- Tularemia
- Toxoplasmosis
- Tuberculosis
- Salmonellosis
- Dermatophytosis ( Trichophyton )
- Fur mite acariasis ( Cheletiliasis )
- Psoroptes sp.
- Multiceps serialis
- Taenia taeniaeformis
- Plasteurella multocida cutaneous infection in susceptible people
- Bacteria infections from rabbit bites or scratches
- Sarcoptes sp.
 Anesthesia
            Rabbits are anesthetic risks and require specialized anestheti techniques. It should be noted that the ingesta-filled ceca can cause falsely elevated body weight values in rabbits. In addition , duration of anesthesia effects can be longer in animals anesthetized in the afternoon due to changes in hepatic metabolic activity evident in nocturnal animals. Fasting rabbits before anesthesia administration is controversial. Rabbits do not vomit and it takes approximately three days to clear the gastrointestinal tract of ingesta; therefore , fasting is usually not needed. Most practitioners,however, fast rabbits two to eight hours before anesthesia is given.
            Tranquilizer
            Acepromazine maleate 1 mg/kg
            Diazepam 5 - 10 mg/kg
            Ketamine hydrochloride alone provides poor analgesia and skeletal muscle relaxation in rabbits.
            Injectable tranquilizers are suitable for short diagnostics or surgical procedures.
            Atropine can be given subcutaneously at 1 - 3 mg/kg if desired; however , it should not routinely be given without just cause.
            Inhalant anesthesia is necessary for long or painful surgical procedures . Isofluran is very safe and is the preferred inhalant anesthetic. Halothane is potentially hepatotoxic and is associated with anesthetics-related death.
                A. 1 - 2 % Isoflurane
                B. 35 - 50 mg / kg ketamine PLUS
                        0.75 - 1 mg /kg acepromazine PLUS
                        3 - 5 mg / kg xylazine IM
                C. 1 - 4 mg/kg diazepam with ketamine 25 - 40 mg /kg IM
                        or 5 - 20 mg/kg IV
                        Provide good relaxation and sedation.
            All rabbits should be closely monitored during any anesthetic episode.
 Common Emergencies and Clinical Condition
            Gastrointestinal
Anorexia > 24 - 28 hr.
Diarrhea or lack of stool
            Trauma
Fracture ( limb ob back)
Wounds ( self-inflicted , environment ,or from another animals )
Ophthalmic (underlying pathology may be Pasteurella)
Sore hocks (husbandry , problem with secondary bacterial infection.
            Geriatric condition
Neoplasia Cardiac (arteriosclerosis , cardiomyopathy , atherosclerosis )
Neurologic signs (seizure ,convulsion)
            Encephalitis
Encephalitozoonosis
Otitis interna
Intoxication (lead)
Metabolic disorders
            Respiratory
Dyspnea
Pneumonia
            Integumentary
Severe pruritus - flea
Myiasis - cuterebra
            Heatstress / stroke
            Fever
            Dystocia , mastitis
            Some causes of GI disease in rabbits
Hairball impactions
Foreign material
Too little roughage in diet
Cecal stasis : ( Clostridium spp.) "enterotoxemia" with other bacterial involvement
Severe coccidial infection with secondary bacterial overgrowths
Teeth overgrowth/malocclusion ( often secondary to Pasteurella infection )
Physical inpairment to eating
             Rabbit viruses 
 

Viruses	Clinical signs
Myxomavirus (pox)	Facial edema , conjunctivitis , tumor , skin lesions
Papillomavirus	Skin papillomas
Oral papillomavirus	Papillomas in mouth , under tongue
Rotavirus	Diarrhea
Coronavirus (systemic)	Pleural effusion , cardiomyopathy
Coronavirus (enteric)	Coronavirus (enteric)
Calicivirus	Haemorrhage , liver necrosis

 
 (Handle) ˇŇĂÍŘéÁˇĂеčŇ 
•             The important requirement of any method of handling rabbits is tosupport the hindlegs.
•             Rabbits are easily frightened and so it is essential to handle them in a quite area.
•             The examination table should have non-slip surface.
•             If rabbits become more frightened they may struggle violently and kick out. Their hindquarter are powerful and strenuous muscular activity can break the lumbrosacral spine. ----> The need for firm support of the hindlegs.
•             Fear in rabbit may lead to cardiac arrest.
 POSTERIOR PARALYSIS AND PARESIS
            Rabbits that are allow to kick during restraint , become excited in their cages, or are dropped commonly fracture or luxate their lumbar spines.
            Rarely is the trauma mild , with resulting spinal cord swelling and local inflammation that responds to medical therpy and cage rest.
            Usually the damage is severe , with radiographically visible or physically palpable vertebral canal damage and the associated spinal cord damage.
            In these cases, the prognosis is poor and recovery is unlikely . human euthanasia is reccommended for these patients.
 Precaution from recovering of anesthesia
- a quiet area
- retained body heat by heated pads or by wrapping in aluminium foil
- administration of fluid subcutaneous should be considered,depending on the lenght of the procedure and whether they were given during operation
- sit upright and monitoring respiration closely
- post operative therapy may include the use of antibiotics
 Rule out chart for rabbits based on clinical signs
 

Clinical signs	Differential diagnosis
Abdominal enlargement(acute/subacute)	Intestinal disorders Enteropathies Obstruction Foreign bodies Trauma Peritonitis Coccidiosis (hepatic form) Pyometra Metritis Uterine adenocarcinoma
Abdominal enlargement (subacute/chronic)	Neoplasia  Obesity Ascites Cardiomyopathy Heart failure
Alopecia	Hair pulling Nest building Hair chewing Idiopathic overgrooming Rubbing/scratching Pruritic response Flea allergy dermatitis with secondary bacterial infection Fur mite ( Cheyletiella sp.) Genetic hairlessness Hypotrichoses Dermatophytosis Seasonal molt
Anemia	Renal disease Lead toxicosis Uterine adenocarcinoma Endometrial hyperplasia Chronic metabolic disease
Anorexia	Malocclusion Tooth root abscess Trichobezoars Cecal stasis Gastroenteropathy Pneumonia Respirotory disease Sinusitis Coccidiosis (hepatic or intestinal) Pain Unpalatable feed Abrupt feed change Stress / heatstress Insufficient water Renal disease Lead toxicity Pregnancy toxemia Septic mastitis Urolithiasis
Constipation	Trichobezoars Enteropathy Anorexia Dehydration/insufficient water
Cutaneous or subcutaneous swelling	Bacterial abscess Cuterebriasis Coenurust cyst Neoplasia (fibromatosis , papilloma , lymphosarcoma epidermal carcinoma Hematoma
Cutaneous or subcutaneous	Lactation swelling(mammary gland) Mastitis Mammary neoplasia Cuterebriasis Neoplasia Hematoma
Dermatitis	Ectoparasitism Earmite Furmite Mange mite Lice Flea Pododermatitis (ulcerative dermatitis) Bite wounds Moist dermatitis Bacterial dermatitis Necrobacillosis Dermatophytosis Myxomatosis
Diarrhea (+ nonspecific enteropathy)	History of inappropriate antibiotic administration (oral pennicillins , erythromycin , clindamycin , lincomycin)
Diarrhea	Mucoid enteropathy Tyzzer’s disease Clostridium piliformis (acute haemorrhagic typhlocolitis) Enterotoxemia Colibacillosis Pseudomonas aeruginosa Low dietary fiber Cecal stasis
Dyspnea	Heat stress ,Pneumonia (rule out : Pasteurella Klebsiella Bordetella Staphylococcus Pseudomonas)Metastasis of neoplasia Pregnancy toxemia or ketosis Pseudopregnancy Postpaturient Pyothrax Conjunctivitis and rhinitis due to bacterial
Dystocia	Stillbirth Uterine inertia Infection Metabolic Breeding size parity
Fever	Septicemia ( esp. Pseudomonas, Pasteurella ) Pneumonia Mastitis Pregnancy toxemia Ketosis Enterotoxemia Colibacillosis Myxomatosis Bacterial cellulitis Acute severe pain Heat stress
Hematuria ( stranguria , urolithiasis secondary to calcinosis , cystitis pyelonephritis )	Rule out bacterial component  Systemic hypercalcemia
Incoordination , convulsion, seizure	Traumatic injury Otitis interna Encephalitis and brain abscess Toxicities (-insecticides -fertilizers -toxic plants -lead ingestion) Pregnancy toxemia / ketosis Agonal phenomenon Congenital / epilepsy Magnesium deficiency
Infertility	Immaturity or senescene Environmental stress Incompatible pair Bacterial infection (-endometritis -pyometra -orchitis -venereal spirochetosis -Treponema cuniculi) Endometriosis or cystic endometrial hyperplasia Uterine adenocarcinoma Nutritional deficiencies Pseudopregnancy
Litter desertation or cannibalism	Maternal inexperience Environmental disturbance Stresses Spitness Agalactia Mastitis Insufficiency nesting material Deformed young Thirst Water deprivation Dehydration Malnutrition
Nasal discharge	Rhinitis Upper respiratory disease/infection (-Pasteurella spp. -Bordetella spp. -Klebsiella spp. -Myxomatosis) Pneumonia Lower respiratory infection/disease Allergy Heat stress (serous nasal discharge)
Paresis , paralysis Muscular weakness	Paraplegia - vertebral fracture or luxation(usually L6 space) Skeletal trauma (other than vertebral fracture) : long bone fracture soft tissue trauma
Polydipsia	Lactation Heat stress Febrile disease Enteropathy Diabetes mellitus or insipidus
Prenatal (& perinatal) mortality	Pregnancy toxemia Ketosis Malnutrition Nitrates in feed/water Congenital abnormalities Environmental stress Noise Uterine adenocarcinoma Infectious disease ( Pasteurella Listeria Salmonella Chlamydia ) Uterine crowding before 17 day gestation Handling trauma at 17-23 days Crowding
Ptyalism or wet dewlap	Malocclusion Pasteurella tooth root/bone infection Genetic Molar overgrowth Abrasion on feeder Rule out: Obstruction Stasis Diarrhea Enteropathy Abdominal pain
Pyrexia	Pasteurellosis , other bacterial disease Heat stroke Mastitis ( septic ) Orchitis Acute cellulitis ( P. multocida S.aureus ) Myxomatosis Viral haemorrhagic disease
Seizure / convulsions	Metabolic Hypo/hyperglycemia Hypo/hypercalcemia Ketosis Mg deficiency Pregnancy toxemia) Cardiovascular compromise Otitis interna Trauma Torticollis Encephalitis Brain abscess Toxicities Epilepsy Severe pain GI obstruction Neoplasia Agonal phenomenon Azotemia
Sudden death	Hypo/hyperthermia Heat stress, stroke Septicemia Toxemia Ketosis/pregnancy toxemia Stravation Dehydration Chronic disease Litter abandoned Congenital abnormality Myxomaosis/Lymphosarcoma Toxicity
Testicular swelling	Interstitial cell neoplasia Myxomatosis Pasteurellcsis Orchitis bacterial
Torticollis (see also incoordination, seizure)	Facial/head trauma (cranial nerve VIII) Pasteurellosis Encephalitozoonosis Listeriosis Otitis externa Vestibular dysfunction Central vestibular / cerebellar disease - encephalitis Fungal brain infections Lead intoxication General intoxication - insecticide , fertilizer
Urine scald	Hypercalciuria Urolithiasis Posterior paresis Obesity Renal failure Polyuria / poludipsia
Vaginal discharge	Endometrial hyperplasia Uterine adenocarcinoma Pyometra Dystocia Uterine torsion ( rare )
Weight loss	Dental disease Trichobezoars ( gastric stasis ) Malnutrition/nutritional deficiencies/’agroceriosis’ Chronic disease Pasteurellosis Renal failure Chronic enterotoxemia / enteritis Parasitism Pulmonary disease Calcinosis ( systemic hypercalcemia) Urinary calculi Uterine adenocarcinima Lead toxicosis Pain - trauma , arthritis, chronic disease Arteriosclerosis Cardiomyopathy

 

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