Rabbits have several unique problems and disease concerns. Understanding these problems will allow you to recognize them before they become life-threatening issues and allow you to better care for your pet.
Dental Disease
Rabbits can be affected by a variety of serious dental issues. It’s important to know that rabbits have 2 upper and 2 lower incisors, as well as 2 small teeth behind the upper incisors called peg teeth. They have 3 upper premolars and 3 upper molars on each side, and they have 2 lower premolars and 3 lower molars on each side, for a total of 28 teeth. The premolar and molar teeth are referred to as cheek teeth.
When the rabbit’s bite structure is out of alignment, it’s called malocclusion. If the upper and lower incisors do not meet properly or if the incisors erupt abnormally, the lower incisors may splay and form a “Y”, with the tooth ends reaching outside the mouth. If the mandible (lower Jaw) is longer than the maxilla (upper jaw), the lower incisors will overgrow, reach the front side of the mouth, and sometimes seem to grow into the nostrils. The upper incisors in this case will also become elongated and curl inward towards the cheeks or roof of the mouth.(Photo of incisor malocclusion in a rabbit, courtesy of Gregory Rich, DVM.)
In these cases, it is essential that an experienced veterinarian trims the rabbit’s teeth to provide short-term relief. Your veterinarian will use a rotary drill to cut the teeth. A permanent resolution is to surgically remove all 4 incisors and the 2 peg teeth; otherwise, the process will occur again in several weeks to months, and the teeth will need to be cut again.
Cheek teeth may have poor alignment or the individual teeth themselves may form sharp edges called dental points on the top ledge of the tooth. Points on the upper cheek teeth tend to form on the cheek side of the tooth, which can cause lacerations or ulcers on the cheeks. Points on the lower cheek teeth point towards the tongue and may cause lacerations or ulcers on the tongue. In both instances, the discomfort caused by the lacerations or ulcerations will cause the rabbit to drool (slobbers), have difficulty eating or stop eating all together. This situation needs immediate attention by an experienced veterinarian familiar with rabbit dentistry.
With these cheek teeth problems, the rabbit will need X-rays of the skull to check for bony issues and dental abscesses, as well as a dental filing of the abnormal dental points under sedation or gas anesthesia. It is generally recommended to have the oral cavity checked every 6-12 weeks to make sure the points are kept under control. If abscesses are forming at the base of the teeth, antibiotic therapy and potential tooth extraction may be required. Photo of lower cheek teeth points in a rabbit, courtesy of Gregory Rich, DVM.)
Dental abscesses often cause large swellings on the jaw or under the eyes. The swellings may be firm at first, as they are penetrating through bone, but they become mushy as they grow. These infections require long-term antibiotics and an extensive surgical procedure that will include extraction of the diseased tooth or teeth.
Gastrointestinal Problems
Diarrhea is often seen in rabbits, and it can be life threatening if not managed properly. Diarrhea is a sign of gastrointestinal problems and can have multiple causes, including incorrect diet (too high in carbohydrates, too low in fiber, or rapid diet changes); bacterial, viral, or parasitic infections; consumption of inappropriate oral drugs (such as certain antibiotics); toxin ingestion; or secondary to other illnesses. t can be challenging to determine the underlying cause.
Rabbits eating a diet that is too high in carbohydrates (typically pellets) are prone to developing intestinal problems because they are not consuming adequate fiber (grass hay). Excessive amounts of carbohydrates change the pH of the gastrointestinal (GI) tract, which upsets the bacteria living there that normally ferment and digest the rabbit’s food. High-carbohydrate, low-fiber diets favor bacteria that produce painful gas and toxins, resulting in decreased appetite, lethargy, dehydration, and typically reduced fecal pellet formation. This situation is termed gastrointestinal stasis (GI stasis), since food stops moving through the GI tract. It is common in rabbits and can be deadly if not treated.
"Rabbits eating a diet that is too high in carbohydrates (typically pellets) are prone to developing intestinal problems because they are not consuming adequate fiber (grass hay)."
Young rabbits often come to the veterinary office with diarrhea. Coccidia, a microscopic parasite, is the most common cause of diarrhea in baby rabbits and, if treated with the wrong medication or not treated early in the disease, it can be fatal. Diagnosis is accomplished by a microscopic analysis of the rabbit’s feces by a member of the veterinary team.
Previously, GI stasis was referred to as “hairballs”, because many rabbits that died from this condition had hair in their stomachs. In fact, rabbits are fastidious groomers that normally ingest hair during grooming and therefore normally have hair in their stomachs. There is generally a separate disease or abnormality that causes the GI tract obstruction.
Rabbits known to have ingested foreign objects, such as carpet fibers, towels, or toys, and that are lethargic or not eating should be seen by a veterinarian as soon as possible so that X-rays may be taken. Since bunnies cannot vomit, those with true hairballs or foreign objects visible in their GI tracts may need surgery to prevent life-threatening GI tract perforation or rupture. Unlike dogs, cats, or even ferrets, rabbit intestinal surgery is very risky and outcomes for return to good health is questionable. Techniques are getting better, but surgery should only be performed by a well-trained veterinary surgeon familiar with the most up-to-date rabbit surgery guidelines.
Mucoid enteropathy is a distinct diarrheal disease of young rabbits that also can be fatal. The diarrhea contains a large amount of mucus with a gelatinous consistency. The cause is unknown, but predisposing factors include dietary changes, low dietary fiber, antibiotic treatments, environmental stress, and intestinal infections with other bacteria. Proper diet is critical for prevention.
"Specific treatment for GI stasis, intestinal parasites, mucoid enteropathy, or dietary imbalance will be determined by your veterinarian. Hospitalization may be required in many cases."
Treatment of diarrhea in rabbits involves identifying and treating the cause, if possible. Specific treatment options vary among veterinarians, but usually fiber in the diet is increased (often nothing but hay may be offered for several days to weeks). Specific treatment for GI stasis, intestinal parasites, mucoid enteropathy, or dietary imbalance will be determined by your veterinarian. Hospitalization may be required in many cases.
To the inexperienced owner or veterinarian, diarrhea can be easily confused with normal cecotropes (cecal droppings, nocturnal droppings, or night droppings). See “Coprophagy” below for more information on cecotropes. If your rabbit has loose stools, always consult a veterinarian familiar with rabbits.
Bladder Stones
Rabbits, like many pets, can develop bladder stones. Bladder stones in rabbits are typically composed of calcium. Signs include decreased appetite, lethargy, weight loss, teeth grinding (due to pain), frequent urination, straining or hunching up to urinate, urine staining around the hind end, and/or blood-tinged urine. Your veterinarian may be able to palpate (feel) the stones during a physical examination, but not always. Abdominal X-rays may be recommended to confirm the diagnosis.
Surgical removal of the stones will resolve the problem temporarily, but stones may recur. Sometimes a stone is not present, but an accumulation of crystalline sediment or sludge forms in the bladder, causing irritation of the bladder lining. To minimize stone formation, adult, non-breeding rabbits that have been eating a diet high in calcium (including alfalfa hay, alfalfa-based pellets, and high-calcium vegetables, such as kale, dandelion greens, parsley, and spinach), should be weaned onto a diet lower in calcium (such as timothy or other non-alfalfa hay). Growing or lactating rabbits can consume high-calcium alfalfa hay and vegetables.
Sore Hocks
The hock (ankle) joint forms the junction of the foot and the shin bone. The underside of a rabbit’s hock has a thin covering of hair/fur. Rabbits housed on a hard surface or wire flooring may get pressure sores or abrasions on the hock. As these pressure sores become inflamed, they cause pain for the rabbit and, if there is a break in the skin, bacteria may invade the tissue and create an abscess that often progresses to infect the hock joint. These conditions need immediate attention and may need surgery to resolve. If caught early, anti-inflammatory medications, foot wraps, and a change in the flooring may resolve the problem without surgery.
Antibiotic-Induced Toxicity
Certain antibiotics such as penicillin, ampicillin, amoxicillin, lincomycin, erythromycin, cephalosporin, or clindamycin, should never be given orally to rabbits. These antibiotics suppress the normal, healthy bacteria in the gastrointestinal tract and allow toxin-producing bacteria to grow and take over, leading to severe diarrhea and the release of toxins into the body. This is called “fatal dysbiosis”. Antibiotic-induced toxicity is one reason to make sure that your veterinarian is properly trained in treating pet rabbits. Discuss any concerns about antibiotics with your veterinarian. If your rabbit develops diarrhea while being treated with any medication, stop giving the medication and call your veterinarian immediately.
Coprophagy
Rabbits engage in coprophagy, which means they eat their own feces. While this may be a problem in other animals, it is a normal and healthy behavior in rabbits. Rabbits typically do this overnight, so owners never see it. The fecal pellets rabbits ingest are different from the ones normally excreted and seen by owners. They are called cecotropes, cecal droppings, nocturnal droppings, or night droppings, and are usually small, soft, pasty, darker, and have a strong fermented or sweet smell. These pellets serve as a rich source of nutrients for the rabbit, specifically protein and vitamins B and K. While cecotropes are softer than normal fecal pellets, they should not be confused with diarrhea.
Heat Stroke
Rabbits tolerate cold better than heat and are very sensitive to heat stroke because they cannot sweat. It is critical to keep their environmental temperature at or below 80°F (26°C), and make sure their enclosure is well ventilated. Ideally, they should be housed inside, or if outside, they should have plenty of shade and water. Rabbits may even develop heat stroke on a hot day in the car on the way to your veterinarian. Rabbits with heat stroke are lethargic, have difficulty breathing, and may collapse. Heat stroke is a medical emergency and must be managed properly by a veterinarian.
