Exotics: Rabbits Non-infectious Disease

Question 1

What are the risk factors for rabbits skin disease?

Answer 1

Lack/reduced grooming:
* Lack of companion
* Dental disease
* Obesity
* Spinal disease, arthritis
Environement- flooring and bedding
Breed: long haired rabbits prone to matting, french lops with skin fold

Question 2

What is the approach to skin disease in rabbits?

Answer 2

• Complete clinical exam
• Skin disease usually reflects underlying disease
• Diagnostic tools-
  skin cytology: hair plucks, scrapes, tape strips, FNAs, biopses, culture
• Seasonally moult- some areas of alopecia normal sometimes

Question 3

What are the main problems of skin disease in rabbits?

Answer 3

• Matted hairs
• Bacterial dermatitis
• Pododermatitis
• External ear disease

Question 4

How are hair matts treated?

Answer 4

• Clip under sedation and analgesia
• Careful of iatrogenic skin trauma
• Bathe and clean skin after clipping matts
• Treat underlying skin condition and any other health problem
• Frequent secondary bacterial dermatitis

Question 5

1. What can bacterial dermatitis in rabbits be secondary to?
2. What are common isolates?
3. How does is commonly present?
4. How is it treated?

Answer 5

1. Urine scalding, skin fold dermatitis, epiphora/blocked tear ducts, drooling, matted hairs
2. S. aureus, P. multocida, P. aeruguinosa
3. Superficisl to deep pyoderma, ocassional abscess
4. Treat dermatitis and underlying cause- painful

Question 6

1. What drugs are frequently used for bacterial dermatitis?
2. What supportive treatment can be given?

Answer 6

1. NSAIDs- meloxicam, ABs (TMP+sulfa, fluoroquin)
2. Hair clipping may be required, keep areas dry, topical treatments (dilute chlorohexidine solutions, fusidic acid, silver sulfadiazine)

Question 7

1. What is pododermatitis?
2. What are risk factors?
3. What are the pathological changes?

Answer 7

1. Avascular necrosis/pressure of sore plantar surfaces- secondary infections
2. Obesity, lack of excercise, loss of plantar hairs, arthritis, contaminated bedding
3. Ishaemia and necrosis of skin, loss of hairs, hyperkeratosis, skin ulceration and infections, osteomyelitis, displacment of SDFT

Question 8

How is pododermatitis managed?

Answer 8

Relieve pressure:
* Adequate bedding
* Exra padding
* Bandaging
* Increase excercise

Analgesia:
* Meloxicam, Gabapentin

2nd Infections:
* Long course ABs
* Keep hairs skin clean and dry
* Trim hairs around ulcers
* Local- chlorohex, hydrocolloid gells, manuka honey

Chronic:
Surgery- abscesses, debriding

Question 9

What are the functions of the rabbits ear pinnae?

Answer 9

Sound amplification, thermoregulation

Question 10

What external ear disease are lop breed predisposed to and why?

Answer 10

Easy build up of cerumen: ear canal, ear-base diverticulum

Gap between tragus and annular cartilage- diverticulum
External ear canal kinked and narrowed

Question 11

1. What are common signs of ear disease in rabbits?
2. What is the process to diagnosis?

Answer 11

1. Head shaking, pruritis, discharge, increased cerumen, swelling at ear base, facial paralysis
2. Full clinical exam, otoscopy, endoscopy under sedation/GA, cytology (mites, bacterial infection, cerumen), skull radiographs, CT

Question 12

What are common causes of external ear diseases?

Answer 12

• Aural haematoma/oedema
• Traumatic lacerations
• Neoplasia
• Otitis externa: very common in lop breeds, cleaning under GA/sedation

Question 13

What more extensive surgeries can be required for external ear disease?

Answer 13

1. Parital ear canal ablation
2. Total ear canal ablation
3. Lateral bullae osteotomy

Question 14

What are considerations of ear surgery in rabbits?

Answer 14

General for all surgeries
Provie excellent multimodal analgesia
ABs depending on case
Possible complications:
* Chronic vestibular disease
* Wound dehiscence
* Facial nerve paresis/paralysis

Question 15

1. What are common presentations of urinary disorders?
2. What are common urinary signs?

Answer 15

1. Cysitis ‘bladder sludge’, uroliths, CKD, acute failure
2. Non-specific, pollakiuria, PUPD, incontinence, Haematuria, Urine scald

Question 16

How is renal function different in rabbits?
How does drug use vary?

Answer 16

• Alkaline urine- limited capacity to excrete H+- sensitive to systemic acidosis
• Stress significantly reduces renal flow
• Not as sensitive to blood renal flow

Calcium metabolism
* Efficient intestinal indigestion independent of Vit D
* Calcium regulated by kidneys
* Excrete a lot in urine
* Calcium carbonate crystals- whitish precipitate

Question 17

How is urinary disease investigated in rabbits?

Answer 17

• Urinalysis: usually cloudy and variable colour, dipstick, sediment analysis
• Blood biochem
• Haematology
• Abdominal ultrasound
• Radiography

Question 18

1. What are common signs of cystitis/LUT disease?
2. What are the predisposing factors?

Answer 18

1. Dysuria/pollakiuria, Painful urination, PUPD, Urine scalding, Abnormal urine
2. Loss of mobility (spinal disease, obesity, pododermatitis etc), high calcium diet, lack of social interactions, limited excercise areas

Question 19

What does this image show?
What causes it?

Answer 19

‘Sludgy Urine’
* Urine retention
* bladder calcium sediment forms thick paste
* Causes cystitis, incontinence, scald
* Further urine retention

Question 20

How is ‘sludgy urine’ managed medically?
What other supportive care may be needed?

Answer 20

Medical
* Analgesia- meloxicam, buprenorphine, maropitant
* ABs- fluoroquinolones, TMP and sulfa
* Diurectics- bendroflumethiazide
* Urine scal- clip and clean topical zinc oxids, fusidic acid

Supportive
* Identify and treat predisposing cause
* Increase excercise
* Provide dry clean bedding
* Increase water uptake: fresh greens wet, multiple water bowls, small amount of fruit juice in water, dandelion
* Reduce calcium intake- avoid alfalalfa hay, carrot tops, kale, broccoli, watercress, remove any vitamin/mineral supplements

Question 21

1. What are uroliths?
2. What are predisposing factors?
3. What should always be included in diagnosis?

Answer 21

1. Uroliths- calcium carbonate, oxalate and phosphate
2. Urinary obstruction, reduced water intake, outflow, high Ca diet
3. Bloods (renal failure), radiographs (size and location), US

Question 22

How is urolithiasis managed?

Answer 22

Bladder- cystotomy
Urethral- retropulsion into bladder, cystotomy
Renal/nephroliths- medical (analgesia and ace inhibitors), monitor closely

Question 23

1. What are the possible causes of renal disease?
2. What are the possible outcomes of acute and chronic renal failure?

Answer 23

1. Congenital, infections, neoplasia, renal amyloidosis, E. cuniculi, obstruction, calcification, toxins, stress, degenerative
2. Outcomes:
   Acute: USG isothenuric, azotaemia, increased P, normal Ca
   Chronic: PUPD, weight loss, USG variable, Azotaemia, Ca and P inceased, anaemia

Question 24

1. How is acute renal disease managed?
2. How is chronic renal disease managed?

Answer 24

1. Identify and treat main cause:
   IV fluids- 75-100ml/kg/day
   Reduce stress
   Analgesia
2. Idenfity and treat main cause
   treat any orher signs
   Fluid therapy SC
   Increase water intake
   ACE inhibitors
   Phosphate binders

Question 25

What are the common presentations of neurologic and musculoskeletal disease in rabbits?

Answer 25

* Lameness * Abnormal gait/posture * Head tilt ± facial nerve paresis * Ataxia, seizures

Question 26

1. What are possible causes of a lame rabbit? 2. How should you approach a clinical exam of the lame rabbit?

Answer 26

1. Trauma: fractures, dislocations, soft tissue trauma Pododermatitis Spinal disease Arthritis Osteomyelitis Neoplasia Hypertrophic osteopathy 2. Full clinical exam Let the rabbit move freely on consult room Neurological exam Brief orthopaedic exam: localised pain, joint enlargment/crepitus, bone swellings, always check plantar/palmar surfaces

Question 27

What is difficult and easy to assess for a rabbit neurological exam?

Answer 27

Difficult (prey): * Menace reflex inconsistent * Freezing response * Might not clearly respond to painful stimuli Easy to Assess: * Paresis/paralysis * Proprioception * Some spinal reflexes: panniculus, patellar, patellar, perineum, withdrawal

Question 28

1. What are the frequent clinical signs? 2. What are some possible causes?

Answer 28

1. * Head tilt, torticollis * Ataxia, paresis, paralysis * Seizures, falling and rolling * Facial nerve paralysis * Nystagmus 2. * E. cuniculi * Pasturelosis * Toxoplasmosis * Neoplasia * Head trauma * Baylisascaris procyonis

Question 29

1. What can cause central vestibular disease? 2. Peripheral vestibular disease?

Answer 29

1. Central vestibular disease * Brainstem lesions * Vertical/positional nystagmus * Intention tremours possible * Hemiparesis possible * E. cuniculi 2. * Lesions on cochlea, middle ear or vestibular nerve * Only horizons and rotational nystagmus * No intentional tremors * No hemiparesis * Usually not E. cuniculi

Question 30

What is the diagnostic plan for vestibular disease?

Answer 30

1. Full clinical exam 2. Full neurological exam 3. Otoscopy not very useful 4. Skull radiographs- assess tympanic bullae 5. Blood testing: Serology for E. cuniculi, serology for Toxoplasma 6. CT scan ± MRI scan

Question 31

1. What medical treatment can treat vestibular disease? 2. What other supportive care can be given?

Answer 31

1. * Meloxicam * Empirical use of ABs- doxycycline, marbofloxacin, Azithromycin * Prochlorpoezine- anti-vergo * Midazolam- in case of seizures * Fenbendazole- confirmed E.cuniculi 2. * Restricted exercise in padded environment * Reduce stress handling * Might require easy access to food/water and suppl feeding * Monitor corneal ulcer development * Ventral bullae osteotomy may help some pasturellosis

Question 32

1. What are possible causes of spinal disease? 2. What is the diagnostic plan for spinal disease?

Answer 32

1. Possible causes: congenital (spondylosis, kyphosis, lordosis, hemivertebrae), trauma, degenerative 2. Full clinical exam and neurological exam, whole body radiographs under sedation, CT scan/MRI

Question 33

1. What are some clinical signs of spinal diseases? 2. What therapy can be given to spinal disease?

Answer 33

1. Clinical signs Loss of flexibility: stiff gait, lack of grooming, urine scald, uneaten caecotrophs, facial dermatitis Pain: immobolity, gut stasis Neuro defecits 2. Therapy Meloxicam Gabapentin Tramadol Ketamine Weight loss, stimulate excercise Padded flooring, nursing

Question 34

What are some possible causes of 'floppy rabbit syndrome'? How does it present?

Answer 34

* Neurological- compression lesions, vascular * Hepatic lipidosis * Hypokalaemia * Toxicity * E. cuniculi * Mysthenia gravis * Vit E/ Selenium defiency Generalised muscle weakness- to paresis to paralysis Self-limiting if other causes ruled out, most rabbits recover in 2-3 days with supportive care

Question 35

What diagnostic tools can be used for neoplasm in rabbits? What are the therapeutic options?

Answer 35

Diagnostic tools * FNA/biopsy * Imaging * Biochemistry * Advanced imaging Therapeutic options * Surgery * Chemotherapy * Radiotherapy

Question 36

1. What is the most common neoplasia of entire female rabbits? 2. What is the typical behaviour or the tumour? 3. What are the typical signs? 4. What is the treatment?

Answer 36

1. Uterine adenocarcinoma 2. Slow growing, locally invasive, incidence increases >3yo, oestrogen dependent 3. Haematuria, palpable uterine horns 4. GA and spay

Question 37

What neoplasm can form secondary to bile duct irritation from eimeria stiedae?

Answer 37

Bile duct adenoma/adenocarcinoma No specific signs Incidental No treatments described: surgical removal

Question 38

What neoplasm can cause polycythaemia in some cases but is not associated with renal dysfunction or failure?

Answer 38

* Embryonal nephroma * Usually incidental

Question 39

1. What are most cases of lymphoma not accompanied with? 2. How does is usually present? 3. How is it diagnosed?

Answer 39

1. Not accompanied with leukaemia 2. Multicentric, infiltrating different organs including the dermis and eye 3. Combintion of cytoloy, US/rads, haematology

Question 40

What are typical signs of rabbit thymoma? How is it diagnosed? Treatment?

Answer 40

* Resp changes * Heart sounds muffled * Bilateral exophthalmia Diagnosis: rads/us and cytologu Treatment- surgical, chemo, radiotherapy

Question 41

What are the features of a rabbit with gut stasis?

Answer 41

* Anorexia * Reduced/no faecal output * Reduced/absent gut sounds * Some cases with abdominal pain * Occasionally hypothermia * Occasionally bloat GI hypermotility Caused by anything that can cause pain or reduced food intake

Question 42

What is the therapeutic approach to a rabbit with gut stasis?

Answer 42

Fluid therapy * IV or SC Analgesia- meloxicam, buprenophine, maropitant Gut motility meds * Metoclopramide * Cisapride * Domperidone * Ranitidine Supplemental feeding

Question 43

What baseline and further investigations should be carried out on a rabbit with gut statsis?

Answer 43

Baseline * Temp * Weight * Blood glucose- stress/pain * PCV * TS/TP Further * Whole body radiographs * Full bloods * Abdominal US