First Aid for Rabbits

FIRST AID SUPPLIES:

Rectal thermometer (plastic) and ask your vet to show you how to properly take a rabbit's rectal temperature (normal 101.3-104.0 degrees F)
Stethoscope (for listening to the heart & lungs and intestinal sounds)
Oral electrolyte solution
Critical care formula for herbivores or canned pumpkin

The unthinkable has happened; your wonderful pet rabbit has just been injured in an accident in your home. It is bleeding from a gash in the skin. Do you know how to administer first aid? Do you own a first aid kit and know where it is? Do you have a plan for what to do in an emergency? Do you even know if your regular rabbit veterinarian is available for emergencies or if you need to contact an emergency clinic that will see rabbits? (Not all emergency facilities will see less traditional pets.)

Every rabbit owner should own a well-stocked first aid kit and know how to administer first aid until the beloved bunny can be transported to your vet or emergency clinic. In addition, the owner should also have a list of emergency phone numbers handy and an appropriate sized carrier to safely transport a sick or injured rabbit to the veterinary facility.

So, what would you do if your rabbit was bleeding from an injury? Do you know what to do? Let's learn how to identify emergencies and illnesses and the correct steps to take in an emergency to cause no further harm to your pet rabbit, and to learn how to safely deal with emergencies.

Shock can be a life-threatening situation. Shock may be the result of traumatic injury, blood loss, from an infection or from a medication (called anaphylactic shock). An animal in shock may show pale gums, cool extremities (including ears), glassy or closed eyes, weak pulse, increased rate of breathing and increased heart rate. If you feel that your rabbit may be in shock, wrap it in a towel, provide supplemental heat (if possible) and place the rabbit in a carrier for immediate transport to a vet clinic.

Physical injuries can be commonly encountered due to the inquisitive nature of rabbits. Rabbits that are allowed to play outside of the cage (preferably in a rabbit-proofed room) are at risk for being stepped on, inadvertently kicked, sat on or otherwise injured. If some sort of physical contact has occurred, the most important thing to do (and this holds true for any emergency) is to remain calm. You are no good to your rabbit if you cannot think and act in a calm, composed manner. After a suspected injury, it is always best to perform a brief but thorough physical examination. To best serve your pet, you should ask your rabbit veterinarian to show you how to perform a complete physical exam before you run into an emergency. If your rabbit is in bad shape, forgo the physical and just transport your rabbit to your vet or emergency facility immediately.

If your rabbit is in no immediate danger, it may be best to perform a brief exam so that you can try to pinpoint any damage or injuries. It is vital to use all of your senses to examine your rabbit. Start at the nose, and look at your bunny's nose and whiskers. Always be observant for symmetry, meaning that both sides of your rabbit should look and feel the same. Notice any discharge or swelling. Next, look at the eyes. Using a penlight, shine the light into each eye individually, looking to see if the pupil constricts when exposed to the light. Examine the sclera, the white parts of the eyes, and the iris, the pigmented portion surrounding the pupil. Note any redness, swelling or discharge. If the sclera appears yellowish, this could signify serious liver problems. There is a third eyelid that traverses across the eye, originating at the inside corner of the eye. Lift up the lips and examine the gums and teeth. Make sure the gums are a healthy pink and that the color returns immediately if you push on the tissue with your fingertip. Examine the teeth the best that you can without being bitten or injuring your pet. Notice any swellings along the jaw line and sniff the breath for any foul odor. Run your hands over the head and neck, feeling for any lumps, bumps or swellings. Abscesses may feel hot, and may be swollen or red, and you may feel pus under the skin. If your rabbit is overweight, you may feel excess subcutaneous fat. The dewlap may develop a condition knows as "slobbers" which is a chin dermatitis. Any hair loss, crusts, scabs or parasites should be noted, if discovered. Next, feel the ears for any thickening, and use the penlight to look down the ear canals without pulling on the base of the ears. Ear mites will cause the ears to look inflamed and crusty with lots of foul-smelling debris. Now, using both hands, run your hands down each forelimb from the shoulder to the toes, flexing and extending each joint. Look at each toe and claw. Feel both feet to make sure they feel the same temperature. If any joint or limb has any obvious redness, heat or swelling, do not attempt to manipulate the area, as it is possible to cause more damage by excessive movement. Watch your rabbit breathe and listen for any abnormal sounds. Gently run your hands over the rib cage, along the spine and then around to the belly, gently feeling for any abnormalities. Palpate the mammary glands for any irregular firmness, swelling or redness. The skin may be discolored over the abnormal gland. Next, examine the hind legs as you did the forelimbs. Lastly, examine the tail and the anus, the area around the urogenital opening and skin. Abnormalities in this area might include white, crusting lesions from rabbit syphilis, or this disease might cause redness, swelling, ulcers or scabs. With unspayed does, you might see evidence of vaginal discharge. With non-neutered bucks, you might see enlarged testicles or abscesses on the scrotum. If the rabbit is suffering from high blood calcium, you may see some urine scalding around the perineum and you might feel some gritty "sand" in the area, as well.

If your examination has uncovered any abnormalities or injuries, and there is no sign of overt bleeding, the safest thing for you to do is to gently wrap your rabbit in a clean towel, place it in your carrier, call the vet to notify them that you are bringing in your pet, and then head off to the clinic. If you have help, perhaps you can get a friend or relative to call for you so that you can get under way. If you are too worried to drive, see if someone else can drive you, but keep your injured rabbit in the towel inside the carrier.

Rabbits are prone to back injuries, especially if held incorrectly by a novice. Should a rabbit kick out, if the back and hind legs are not properly supported, this can result in dangerous injuries, such as dislocation or fracture. Rabbits have a very delicate skeleton when compared with other species, but they also have very strong, well-developed muscles for running, which is why kicking or struggling may result in fractures to long bones or the spine. If you notice that a limb is dangling or is being held at an incorrect angle, or if a leg or legs cannot more normally, this is a true medical emergency. Gently wrap the patient in a clean towel, place in a carrier and transport it to the vet immediately after calling to alert the office.

Do not attempt to splint any fractures or dislocations. The more the area is manipulated, the more the likelihood of additional injury or damage.

Injuries can occur that result in tearing of the skin. Bleeding will not usually be serious, unless the injuries are deeper than the skin. Lacerations to the skin can occur if two rabbits get into a fight, or if a rabbit is bitten by another animal. Bites are always considered very serious in rabbits and should be dealt with immediately upon discovery. If you see bleeding from a wound and it appears to be pulsing or gushing, this means that an artery may have been damaged. If the blood is seeping, this usually implies bleeding from veins. Using a sterile gauze pad (or if that is not readily available), a clean towel or cloth, apply firm, but gentle, pressure directly over the wound. If a pad becomes saturated with blood, do not remove it, but apply another one over it and continue applying pressure until you get to the veterinary clinic. Make sure you assess the gum color by lifting up the lip and looking at the tissue above the teeth. You can evaluate the capillary refill time by gently pushing on the gum tissue and watching to see how quickly the color returns to the tissue (in a normal rabbit, this should take less than 1.5 seconds).

If possible, bite wounds should be flushed with copious amounts of warm, soapy water (unless the wounds are deeper than the skin, in which case you should wait until you can seek professional care). Povidone iodine solution, diluted to iced tea color in warm water, is wonderful for flushing superficial wounds. In a pinch, antiseptic soap and warm water can be used to clean wounds. If you think that your rabbit may be in shock, do not waste precious time cleaning wounds at home. Flushing wounds may also exacerbate shock by further chilling the rabbit.

Rabbits that have been sat upon, kicked or stepped on may not show signs of external injury but may have internal damage. If your rabbit shows any signs of pain after a traumatic injury, or if the gum color is pale, or if you notice signs of shock, keep your pet warm and transport immediately to the vet. Any weakness or signs of paralysis constitute an emergency. Head tilt and other neurological signs are also an emergency.

If your rabbit has eaten something toxic or poisonous, call your vet to notify the office and then bring your pet immediately to the clinic. Be sure that you bring a sample of anything that it might have ingested, or if possible, bring in the container with the label. There are national pet hotline for poisonings, and also local ones. Keep a list handy. Because of the unique anatomy of the rabbit, they are unable to vomit, so vomiting should never be induced. The most common poisonings occur from inquisitive rabbits nibbling on toxic or irritating plants or from a rabbit finding rat poison and ingesting some. If your rabbit has eaten anything suspicious, take it to your vet immediately, even if you are not sure. There may be no immediate signs of poisoning, or your rabbit may be pawing at the mouth or salivating excessively. Rat poisons usually result in the inability of the blood to clot normally, so you might see unusual bruises on the skin or mucus membranes.

Burns are always serious and should be considered a medical emergency. If a rabbit has accidentally had hot fluid spilled on the skin, or it has been the victim of a chemical burn, immediately flush the skin with copious amounts of cool water, then transport your pet to the vet. Do not apply any type of ointment or butter to the burn, as this will just impede the vet's care. Burns from rabbits biting an electrical cord are very dangerous and require immediate veterinary care.

Rabbits allowed outside to graze in the grass (no pesticides or lawn treatments, please) may encounter a different set of potential problems. The first and most dangerous is exposure to excessive heat. Rabbits do not do well at temperatures above 82.4 degrees F, and don't have protective mechanisms to deal effectively with high ambient temperatures. They do not sweat, except through sweat glands confined to the lips. They also pant ineffectively (which is how dogs can cool themselves down). As the body temperature continues to increase, they cease panting, but will use their ears to try to help regulate their body temperature by opening the blood vessels there in an attempt to lower their body temperature. Unlike other creatures, rabbits may actually decrease water intake when very hot, which can exacerbate the problem. Rabbits must have access to shade if allowed outside. If outside, allowing a rabbit to burrow in the soil is also helpful to allow them to seek relief from the heat. Hyperthermia is very dangerous in the rabbit and can be life-threatening. Predisposing factors include high humidity (over 70%), thick hair coat, obesity, older age, pregnancy, direct sunlight, poor ventilation, insufficient drinking water or only warm/hot water to drink, crowding, recent transportation, confinement in a hot vehicle, delays in transportation, psychologic stress and anxiety. Signs of heat stress include redness (technically called hyperemia) of the blood vessels of the extremities, rapid respirations, elevated body temperature (above 105 degrees F), blue mucus membranes (cyanosis), prostration or death. Blood tinged fluids may be seen in the nose and mouth. Food intake drops greatly, water consumption may initially increase, but then the water consumption drops with increasing ambient temperature. Hypersalivation may occur. At high temperatures (90 degrees F or higher) for days or weeks, males may become sterile. If heat stroke is suspected, spray the rabbit with cool water and transport immediately to the vet.

Rabbits are much better at dealing with cold temperatures than the heat. They may shiver if initially cold, which should be a clue that you might need to provide some additional warmth and shelter for your rabbit. However, if allowed to acclimate, rabbits tolerate cold very well, as long as they have shelter from the elements.

Hypothermia is not likely to occur if a rabbit is housed outdoors, is acclimated to the temperature and has adequate shelter. However, an abnormally low body temperature (less than 100 degrees F) is very dangerous. This may occur if a rabbit is suddenly housed outdoors during the winter, if the rabbit does not have adequate shelter or if it gets wet. Hypothermia may also occur as a result of shock or in the late stages of a systemic infection. It is very important to bring the rabbit's temperature up to normal (101.3 to 104.0 degrees F.) as quickly as possible. A cold rabbit will shiver, as it does not have brown fat. If the rabbit cannot seek shelter to get warm, it will become lethargic, the limbs and ears will feel cool to the touch and look pale, and eventually the breathing will become very shallow and the heartbeat will become weak, and the rabbit will appear as if in a stupor. This can progress to coma and death if not discovered in time. Warm towels out of the dryer can be used to wrap the rabbit in to provide warmth. Use rubber gloves or a hot water bottle to provide heat, taking care to not allow them to burn the rabbit. There are chemical packets that release heat when opened (called hand-warmers and sold for skiers and others who spend time outdoors in the cold). These can be used to provide heat in an emergency or if the power is out. Seek veterinary care immediately.

Rabbits housed outside may suffer from insect bites and stings. One sting from a bee or wasp will cause some localized swelling and discomfort, but is usually not life-threatening, unless the pet is allergic. Signs of allergic reaction include difficulty breathing, swelling of the face and/or respiratory tract and signs of progressing shock. This won't usually occur with the first bite or sting, but occurs after repeated insults. If the stinger is still lodged in the skin, consult your rabbit veterinarian for advice on what to do next.

Ant bites are also a problem. In the southeast of the United States, fire ants are particularly vicious. Usually, they will climb onto the victim and upon their signal, they all begin biting and stinging at once. The wounds usually result in red, raised bumps that may progress to a pus-filled lesion in a day or so. A few bites will cause localized swelling and reaction, but a significant number of bites can be life-threatening. If you notice an ant swarm nearby, check your rabbit for any signs of welts. Immediately apply cool water to the bites, then call your vet for advice.

It is obviously not normal for a rabbit to stop eating and/or drinking. Common causes are hairball formation in the stomach, ileus (lack of normal waves that propel food through the gastrointestinal tract), bacterial infection, toxemia issues, viruses (not common), parasitic problems, problems from antibiotic therapy, malocclusion of the teeth, bone infection secondary to tooth problems or nutritional problems. Rabbits with mouth problems often are slobbering excessively or drooling. A rabbit with back teeth problems may act hungry, and even pick up food but then drop it from the mouth, and it is usually losing weight.

It is not, however, up to you to discover why your rabbit is not eating, as this is what your vet will work to accomplish. It is important for you to know that it is very serious if a rabbit does not eat for 24 hours, as dangerous changes may begin to occur in the liver. Unexplained weight loss should always be investigated by your vet. Be prepared to provide your vet with detailed information about your rabbit's regular diet, treats and habits and it is also a good idea to bring in samples of the foods you offer.

If a rabbit stops passing fecal pellets for eight hours or more, this is an emergency. Diarrhea is also dangerous and requires veterinary attention. Gas may cause bloating, and gas pains can significantly stress a rabbit. If you hear loud gurgling sounds, this can also signify other gastrointestinal problems. If you have a stethoscope, and you listen to the abdomen, you should hear intermittent gurgling sounds (called borborygmus). If the belly is silent, this can mean ileus, meaning that the guts have stopped the normal movements. This is serious and potentially life-threatening, so call your vet immediately if you notice any of these signs. Your vet may recommend administering simethicone orally to help with gas problems until the rabbit can be seen.

It is important to learn the essentials of first aid, but this information should not replace veterinary care. You should use your observational skills to determine whether or not your rabbit might be suffering from an illness or traumatic injury. If in doubt, consult your rabbit vet for advice and follow this advice carefully. By rabbit proofing your home, providing prophylactic veterinary care and carefully observing your rabbit daily, you should be able to enjoy a long, healthy relationship with your pet rabbit.