Exotics: Rabbits Non-infectious Disease Flashcards
What are the risk factors for rabbits skin disease?
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
What is the approach to skin disease in rabbits?
- 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
What are the main problems of skin disease in rabbits?
- Matted hairs
- Bacterial dermatitis
- Pododermatitis
- External ear disease
How are hair matts treated?
- 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
- What can bacterial dermatitis in rabbits be secondary to?
- What are common isolates?
- How does is commonly present?
- How is it treated?
- Urine scalding, skin fold dermatitis, epiphora/blocked tear ducts, drooling, matted hairs
- S. aureus, P. multocida, P. aeruguinosa
- Superficisl to deep pyoderma, ocassional abscess
- Treat dermatitis and underlying cause- painful
- What drugs are frequently used for bacterial dermatitis?
- What supportive treatment can be given?
- NSAIDs- meloxicam, ABs (TMP+sulfa, fluoroquin)
- Hair clipping may be required, keep areas dry, topical treatments (dilute chlorohexidine solutions, fusidic acid, silver sulfadiazine)
- What is pododermatitis?
- What are risk factors?
- What are the pathological changes?
- Avascular necrosis/pressure of sore plantar surfaces- secondary infections
- Obesity, lack of excercise, loss of plantar hairs, arthritis, contaminated bedding
- Ishaemia and necrosis of skin, loss of hairs, hyperkeratosis, skin ulceration and infections, osteomyelitis, displacment of SDFT
How is pododermatitis managed?
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
What are the functions of the rabbits ear pinnae?
Sound amplification, thermoregulation
What external ear disease are lop breed predisposed to and why?
Easy build up of cerumen: ear canal, ear-base diverticulum
Gap between tragus and annular cartilage- diverticulum
External ear canal kinked and narrowed
- What are common signs of ear disease in rabbits?
- What is the process to diagnosis?
- Head shaking, pruritis, discharge, increased cerumen, swelling at ear base, facial paralysis
- Full clinical exam, otoscopy, endoscopy under sedation/GA, cytology (mites, bacterial infection, cerumen), skull radiographs, CT
What are common causes of external ear diseases?
- Aural haematoma/oedema
- Traumatic lacerations
- Neoplasia
- Otitis externa: very common in lop breeds, cleaning under GA/sedation
What more extensive surgeries can be required for external ear disease?
- Parital ear canal ablation
- Total ear canal ablation
- Lateral bullae osteotomy
What are considerations of ear surgery in rabbits?
General for all surgeries
Provie excellent multimodal analgesia
ABs depending on case
Possible complications:
* Chronic vestibular disease
* Wound dehiscence
* Facial nerve paresis/paralysis
- What are common presentations of urinary disorders?
- What are common urinary signs?
- Cysitis ‘bladder sludge’, uroliths, CKD, acute failure
- Non-specific, pollakiuria, PUPD, incontinence, Haematuria, Urine scald
How is renal function different in rabbits?
How does drug use vary?
- 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
How is urinary disease investigated in rabbits?
- Urinalysis: usually cloudy and variable colour, dipstick, sediment analysis
- Blood biochem
- Haematology
- Abdominal ultrasound
- Radiography
- What are common signs of cystitis/LUT disease?
- What are the predisposing factors?
- Dysuria/pollakiuria, Painful urination, PUPD, Urine scalding, Abnormal urine
- Loss of mobility (spinal disease, obesity, pododermatitis etc), high calcium diet, lack of social interactions, limited excercise areas
What does this image show?
What causes it?
‘Sludgy Urine’
* Urine retention
* bladder calcium sediment forms thick paste
* Causes cystitis, incontinence, scald
* Further urine retention
How is ‘sludgy urine’ managed medically?
What other supportive care may be needed?
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
- What are uroliths?
- What are predisposing factors?
- What should always be included in diagnosis?
- Uroliths- calcium carbonate, oxalate and phosphate
- Urinary obstruction, reduced water intake, outflow, high Ca diet
- Bloods (renal failure), radiographs (size and location), US
How is urolithiasis managed?
Bladder- cystotomy
Urethral- retropulsion into bladder, cystotomy
Renal/nephroliths- medical (analgesia and ace inhibitors), monitor closely
- What are the possible causes of renal disease?
- What are the possible outcomes of acute and chronic renal failure?
- Congenital, infections, neoplasia, renal amyloidosis, E. cuniculi, obstruction, calcification, toxins, stress, degenerative
- Outcomes:
Acute: USG isothenuric, azotaemia, increased P, normal Ca
Chronic: PUPD, weight loss, USG variable, Azotaemia, Ca and P inceased, anaemia
- How is acute renal disease managed?
- How is chronic renal disease managed?
- Identify and treat main cause:
IV fluids- 75-100ml/kg/day
Reduce stress
Analgesia - Idenfity and treat main cause
treat any orher signs
Fluid therapy SC
Increase water intake
ACE inhibitors
Phosphate binders
What are the common presentations of neurologic and musculoskeletal disease in rabbits?
- Lameness
- Abnormal gait/posture
- Head tilt ± facial nerve paresis
- Ataxia, seizures
- What are possible causes of a lame rabbit?
- How should you approach a clinical exam of the lame rabbit?
- Trauma: fractures, dislocations, soft tissue trauma
Pododermatitis
Spinal disease
Arthritis
Osteomyelitis
Neoplasia
Hypertrophic osteopathy - 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
What is difficult and easy to assess for a rabbit neurological exam?
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
- What are the frequent clinical signs?
- What are some possible causes?
- Head tilt, torticollis
- Ataxia, paresis, paralysis
- Seizures, falling and rolling
- Facial nerve paralysis
- Nystagmus
- E. cuniculi
- Pasturelosis
- Toxoplasmosis
- Neoplasia
- Head trauma
- Baylisascaris procyonis
- What can cause central vestibular disease?
- Peripheral vestibular disease?
- Central vestibular disease
* Brainstem lesions
* Vertical/positional nystagmus
* Intention tremours possible
* Hemiparesis possible
* E. cuniculi - Lesions on cochlea, middle ear or vestibular nerve
- Only horizons and rotational nystagmus
- No intentional tremors
- No hemiparesis
- Usually not E. cuniculi
What is the diagnostic plan for vestibular disease?
- Full clinical exam
- Full neurological exam
- Otoscopy not very useful
- Skull radiographs- assess tympanic bullae
- Blood testing: Serology for E. cuniculi, serology for Toxoplasma
- CT scan ± MRI scan
- What medical treatment can treat vestibular disease?
- What other supportive care can be given?
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
- What are possible causes of spinal disease?
- What is the diagnostic plan for spinal disease?
- Possible causes: congenital (spondylosis, kyphosis, lordosis, hemivertebrae), trauma, degenerative
- Full clinical exam and neurological exam, whole body radiographs under sedation, CT scan/MRI
- What are some clinical signs of spinal diseases?
- What therapy can be given to spinal disease?
- Clinical signs
Loss of flexibility: stiff gait, lack of grooming, urine scald, uneaten caecotrophs, facial dermatitis
Pain: immobolity, gut stasis
Neuro defecits - Therapy
Meloxicam
Gabapentin
Tramadol
Ketamine
Weight loss, stimulate excercise
Padded flooring, nursing
What are some possible causes of ‘floppy rabbit syndrome’?
How does it present?
- 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
What diagnostic tools can be used for neoplasm in rabbits?
What are the therapeutic options?
Diagnostic tools
* FNA/biopsy
* Imaging
* Biochemistry
* Advanced imaging
Therapeutic options
* Surgery
* Chemotherapy
* Radiotherapy
- What is the most common neoplasia of entire female rabbits?
- What is the typical behaviour or the tumour?
- What are the typical signs?
- What is the treatment?
- Uterine adenocarcinoma
- Slow growing, locally invasive, incidence increases >3yo, oestrogen dependent
- Haematuria, palpable uterine horns
- GA and spay
What neoplasm can form secondary to bile duct irritation from eimeria stiedae?
Bile duct adenoma/adenocarcinoma
No specific signs
Incidental
No treatments described: surgical removal
What neoplasm can cause polycythaemia in some cases but is not associated with renal dysfunction or failure?
- Embryonal nephroma
- Usually incidental
- What are most cases of lymphoma not accompanied with?
- How does is usually present?
- How is it diagnosed?
- Not accompanied with leukaemia
- Multicentric, infiltrating different organs including the dermis and eye
- Combintion of cytoloy, US/rads, haematology
What are typical signs of rabbit thymoma?
How is it diagnosed?
Treatment?
- Resp changes
- Heart sounds muffled
- Bilateral exophthalmia
Diagnosis: rads/us and cytologu
Treatment- surgical, chemo, radiotherapy
What are the features of a rabbit with gut stasis?
- 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
What is the therapeutic approach to a rabbit with gut stasis?
Fluid therapy
* IV or SC
Analgesia- meloxicam, buprenophine, maropitant
Gut motility meds
* Metoclopramide
* Cisapride
* Domperidone
* Ranitidine
Supplemental feeding
What baseline and further investigations should be carried out on a rabbit with gut statsis?
Baseline
* Temp
* Weight
* Blood glucose- stress/pain
* PCV
* TS/TP
Further
* Whole body radiographs
* Full bloods
* Abdominal US
