16 Apr 2024
John Chitty looks at the data from owners of these pets, and how vets can monitor and advise on welfare.
John Chitty
Job Title
FTR. If keeping outdoor rabbits it is also important to make runs and hutches rodent-proof. As well as avoiding direct physical damage, wild rodents may also carry disease, including yersiniosis, as seen in this case at surgery to remove abdominal abscesses.
For all the species we work with, preventive medicine is probably our most important role. Prevention is always better than cure and so, a lot of our time is devoted to educating owners on how to prevent some potentially fatal illnesses.
It has been a few years since I last wrote an article of this type and I wondered what had changed in this time – with society experiencing so many effects from infectious disease in this period, has this been reflected in our understanding and application of preventive care in rabbits? Similarly, have changes in society and pet keeping occurred that now result in different preventive medicine needs?
To help with appreciating the changes in this, the PDSA Animal Wellbeing Report (PAW; tinyurl.com/23vvpwed) provides an annual snapshot of attitudes and practices by owners and vets, with the latest published in 2023.
Sadly, an awful lot has not changed.
The risk of myxomatosis and RHD-2 are largely unchanged; both are extremely prevalent in the wild rabbit population, which forms a potential reservoir for infection of pet rabbits. This does happen, with 22% vets in the PDSA survey indicating they had seen an increase in RHD-2 cases in the previous two years.
Yet, numbers of vaccinated rabbits are only stable: 52% of pet rabbits appear to be vaccinated, suggesting more than half a million pet rabbits are vulnerable to infection. The most common reason appears to be that rabbits are indoor-kept and so, not at risk. While it is true that indoor-only rabbits are at lesser risk, both diseases may be spread by insects (and RHD-2 via fomites), which does mean that they are not at no risk.
This is especially sad, as improvements in vaccines mean we have two very effective vaccines (one RHD-only; one for myxomatosis and both RHD-1 and RHD-2) that require a single starter dose and then annual vaccination.
Sometimes, it is good that little change has occurred. Ectoparasites appear to still be relatively uncommon and internal parasites are rare in terms of clinical concern.
As a result, regular prophylactic treatments are not usually indicated.
The important exception would be myiasis, with some of the common underlying causes of this still being common. From personal experience, I feel that owners are more aware of these, and flystrike cases seem to have reduced over the past couple of years. However, we did see a few more cases “out of season” – with more unusual weather patterns, we do get some very warm spells each winter, and this is enough to stimulate flies to emerge.
It is, therefore, important not to rely on hygiene and anti-myiasis drug applications in summer only; instead, this should be year-round – especially in terms of identifying and treating/managing risk factors (obesity, arthritis, cleanliness, and so forth).
Diet is a fairly mixed bag, with only 13% of owners now feeding a muesli-type diet, which is a major improvement. However, 27% of owners do not feed hay, and 42% of vets and nurses identified poor nutrition as being one of the five most important welfare issues in rabbits.
In particular, vets and nurses identified 32% of rabbits as being overweight or obese. As obesity may be linked to many diseases, including myiasis, arthritis, liver and heart disease, and so forth, this is clearly a major welfare concern. More worryingly, a huge mismatch still exists in how vets and nurses see these rabbits, and how owners see their rabbits; only 37% of owners knew their pet’s weight and 19% the body condition score – far lower figures than for dog and cat owners.
Interestingly, 52% of owners fed their rabbits treats to provide variety in the diet. This probably reflects a very human view of a good high-fibre rabbit diet appearing boring – in the wild, though, more than 80% of the diet is fresh or dried grass, so perhaps it is not boring to the rabbit.
43% of rabbits are not neutered – a proportion that has barely changed in more than half a decade.
The most common reason given was that the rabbit lived alone. For the owners of 57% of UK rabbits, little understanding appears to exist of the health benefits to the individual from neutering.
While this may be arguable for some male rabbits, uterine adenocarcinoma is still prevalent in females and neutering does prevent this. Somehow, this messaging needs to improve – potentially with less reliance on the birth control effects and more on the individual welfare benefits.
The clinical examination is our opportunity to identify both current and potential issues. It is arguably as important as the actual vaccine in the annual health check.
Interestingly, a higher percentage of rabbit owners (compared to dog and cat owners) indicated they took advice from vets and nurses – so, we are listened to. We should, therefore, maximise the opportunity to help improve rabbit welfare, perhaps with a little more time for rabbit vaccine appointments.
Perhaps we should also educate owners more about the advantages of a check-up; even if they feel they do not need to have their rabbit vaccinated, a well-rabbit check is potentially of great benefit.
As with other species, we are beginning to be more aware of age-related disease in rabbits. With awareness, we can educate owners as to some of the subtle signs of ageing and we can also use those annual checks to look for these ourselves.
Of particular importance is arthritis, which we know causes considerable pain, yet is hard to spot, with rabbits showing little in the way of overt signs of pain. Of course, rabbits are also very unwilling to move and show lameness in the consulting room. However, it is worth asking owners to bring (or send in advance) photos and videos of their rabbit in the home environment; these provide really useful information about posture and gait that simply cannot be detected in the clinic.
What can be detected in the clinic, though, is muscle wastage which may be generalised or localised, the latter being particularly useful in identifying affected joints. A good palpate is always valuable.
It is not all bad news. Much more education on the rabbit is available for vets and nurses, and some excellent campaigns are being run in Rabbit Awareness Week and year-round by the Rabbit Welfare Association. In particular, these have highlighted how important husbandry is to the health of the pet rabbit.
I have already described diet effects, but the physical environment is also of importance and this applies to both indoor-kept and outdoor-kept rabbits. An important part of the health check, therefore, is to request photos and videos of the pet’s environment, which allows for an even more holistic assessment.
Modern technology and the ability to communicate these videos and pictures is a definite improvement in our ability to assess and treat pets.
“As vets and nurses, we are in a unique position to help these pets by educating their owners…”
So, which areas should we focus on, and how do they affect the rabbit?
“A hutch is not enough” is a great phrase to have in mind when considering a rabbit environment. Rabbits need space, which is true wherever they are kept. This includes space to move around and forage; to run, dig and play; and enough height to stand fully upright. Importantly, exercise is a good way to reduce the development of obesity. In the PAW Report, more than 20% of rabbits are still living in too cramped a space.
The hutch itself is important, even with a run, and the following factors must be considered.
Floor substrates are also important both indoor and out. Foot problems are common; again, this may reflect underlying disease (especially spinal or hip/stifle arthritis), but may also indicate substrate issues. One study indicated that only grass or hay substrate prevented pododermatitis. Therefore, even indoor-kept rabbits should be given a large pen of deep litter hay to move round in; soft carpets are not as kind to rabbit feet as they are to ours.
Enrichment is important; rabbits spend many hours a day obtaining food.
It is all too easy in the pet environment, and this may be another reason why owners feel the need to vary diets with treats that cause other health issues. Awareness is growing of the need for these, and many different feeding enrichment toys are available. Owners can be inventive and, importantly, see which their pet prefers.
Probably the most concerning issue raised in the PAW Report was that approximately 48% of rabbits are not kept with another rabbit. This is better than a decade ago, but the trend has been worsening since 2020.
Rabbits are social and require the companionship of at least one other rabbit; guinea pigs and humans simply do not replace this. Lack of companionship results in chronic underlying stress, which does affect disease susceptibilities. It certainly affects the activity levels of lone rabbits; again, this is an underlying cause of obesity and lack of muscle tone.
It can be hard to provide space for more than a single rabbit – especially when keeping indoors. However, this is a vital aspect of ensuring rabbit well-being, and if companionship cannot be provided, then it must be considered that a rabbit is not the most suitable pet in that situation.
Overall, improvements are occurring in the welfare of pet rabbits. However, many worrying areas also exist which have either not improved or even worsened in the past few years.
As vets and nurses, we are in a unique position to help these pets by educating their owners – hopefully by means of positive messaging about how we can all help. If nothing else, data suggest that rabbit owners do listen to us.
