Rabbits non-infectious diseases Flashcards
What are risk factors for skin disease?
- Lack/reduced grooming:
◦ Lack of companion (mutual grooming)
◦ Dental disease
◦ Obesity
◦ Spinal disease, arthritis, neuro problems - Environment:
◦ Type of flooring and bedding - Breed:
◦ Long haired rabbits prone to matting
◦ French lops with excessive skin folds
What are the main problems with skin disease in rabbits?
◦ Matted hairs
◦ Bacterial dermatitis
◦ Pododermatitis
◦ External ear disease
◦ Other problems (e.g. mites)
What are hair matts, what should be done? What can they lead to?
- Long or densely haired breeds = clumped hair
- Clip under sedation + analgesia
*Careful with iatrogenic skin trauma - Bathe and clean skin AFTER clipping matts
- Treat any underlying skin condition and any other health
problem - Frequently have 2ary bacterial dermatitis
What is bacterial dermatitis usually secondary to?
What is the possible aetiology?
What should be done?
◦ Urine scalding
◦ Skin fold dermatitis
◦ Epiphora/blocked tear ducts
◦ Drooling 2ary to dental disease
◦ Matted hairs
- Aetiology = S. aureus, P. multocida, P. aeruginosa
- Treat dermatitis (Antibiotics) + underlying cause
- Painful = NSAIDs
- Supportive Tx = hair clipping, topical Tx
What is pododermatitis?
- Avascular necrosis/pressure sore of plantar surfaces
- “sore hocks” – although can affect front paws as well
- Painful multifactorial condition
- 2ary infections
What are risk factors of pododermatitis?
- Obesity
- Inactivity/lack of exercise
- Inadequate flooring (concrete, wire)
- Loss of plantar hairs
- Other conditions: spondylosis, arthritis, neuro conditions
- Contaminated bedding
What are pathological changes caused by pododermatitis?
- ischaemia + necrosis of skin
↓ - Loss of plantar hairs
↓ - Skin hyperkeratosis
↓ - Skin ulceration + 2ary bacterial infections
↓ - Osteomyelitis + Osteoarthritis
↓ - Displacement of superficial digital flexor tendon
What are 3 key point to manage pododermatitis?
- Relieve pressure:
* Provide adequate bedding
* Extra padding
* Bandaging
* Increase exercise - Analgesia:
* Meloxicam
* Gabapentin - 2ary infections:
* Long course Antibiotics
* Keep skin clean and dry
* Trim hairs around ulcers
* Local treatment:
* Dilute Chlorhexidine
* Hydrocolloid gels
* Manuka honey
What nerve lies close to the tympanic bullae?
- Facial nerve
What are common signs of external ear disease?
◦ Head shaking, pruritus
◦ Discharge, increased amount of cerumen
◦ Swelling at ear base (lop breeds)
◦ Facial paralysis
How would you investigate external ear disease?
1◦ Full clinical exam
2◦ Otoscopy
3◦ Endoscopy under sedation/GA may be more useful
4◦ Cytology – mites, bacterial infection, cerumen
5◦ Skull radiographs under GA
6◦ CT scan
What are common external ear disease?
- Aural hematoma / oedema
- Traumatic lacerations
- Neoplasia
- Otitis externa
What is needed for ear surgery in rabbits? What are possible complications?
- General surgical considerations
- Provide excellent multi-modal analgesia
- Antibiotics depending on c&s results
- Possible complications (with any technique) =
◦ Chronic vestibular disease
◦ Wound dehiscence
◦ Facial nerve paresis/paralysis
What are common urinary disorders in rabbits?
◦ Cystitis/”bladder sludge”
◦ Uroliths
◦ Chronic Kidney Disease (CKD) and renal failure
◦ Acute Kidney failure
What are clinical signs of urinary disorders?
◦ Non-specific: weight loss, anorexia, gut stasis
◦ Pollakiuria/dysuria, pain while urinating, etc
◦ Pu-pd vs urinary incontinence
◦ Haematuria – can also be related to reproductive disease in females
◦ Urine scald – contact dermatitis
What is the function of kidneys in rabbits?
- Acid-base balance = Alkaline urine, Limited capacity to excrete H+ and very sensitive to systemic acidosis
- Not as sensitive to loop diuretics
- Stress significantly reduces blood renal flow
- Calcium metabolism =
◦ Efficient intestinal ingestion of Ca2+ independent from Vitamin D
◦ Calcium is mainly regulated by their kidneys
◦ Excrete large amounts of Ca2+ in urine (excess that was absorbed in GIT)
◦ Calcium carbonate crystals = whitish precipitate
How would you investigate urinary disease?
- Urinalysis - dipstick, USG + sediment microscopic exam
- Blood biochem + haematology
- Abdominal ultrasound
- Radiography
What are common signs of cystitis / lower urinary tract disease?
- Dysuria/pollakiuria
- Painful urination
- Pu/pd vs incontinence
- Urine scalding
- Abnormal urine: haematuria, abnormal colour or turbidity
What are predisposing factors for cystitis?
- Loss of mobility/balance =
◦ Spinal disease
◦ Osteoarthritis
◦ Pododermatitis
◦ Neuro disease
◦ Obesity - High calcium diet
- Lack of social interactions
- Limited exercise areas
What is medical therapy of rabbits with sludgy urine?
- Analgesia =
◦ Meloxicam
◦ Buprenorphine
◦ Maropitant - Antibiotics (ideally with c&s) =
◦ Fluoroquinolones
◦ TMP + Sulfa - Diuretics = Bendroflumethiazide
- Managing urine scald + dermatitis =
◦ Clip and clean skin (under sedation)
◦ Topical zinc oxide, fusidic acid
What is supportive care of sludgy urine?
- Identify and treat any predisposing cause
- Increase exercise
- Provide dry clean bedding
- Increase water intake
- Reduce Calcium intake
What is surgical management of sludgy urine?
- Catheterize and flush bladder =
◦ Under sedation/GA
◦ Flush with sterile saline until comes clear
◦ Radiograph before AND after flushing - Perineal dermatoplasty + tail amputation =
◦ Redirects urine stream away from perineum
What are predisposing factors for uroliths? What tests should always be included if suspecting uroliths?
◦ Urinary obstruction (e.g. adhesions, sludgy urine, masses, etc)
◦ Reduced water intake
◦ Reduced urine outflow
◦ High Calcium diet and urolithiasis connection is NOT proved
* ALWAYS include:
◦ Bloods – possible renal failure
◦ Radiographs – uroliths size and location
◦ Ultrasound
How should you manage different urolithiasis?
- Bladder uroliths = Cystotomy
- Urethral uroliths = Retropulsion into bladder, Cystotomy
- Renal uroliths/nephroliths =
◦ Nephrectomy if unilateral?
◦ Medical management (analgesia + ACE inhibitors)
◦ Monitor renal function closely
What are possible causes of renal disease?
- Congenital
- Infections (abscess, pyelonephritis, etc)
- Neoplasia
- Renal amyloidosis
- E. cuniculi – nephritis + fibrosis
- Urinary obstruction (sludge, urolith, etc)
- Renal calcification (2ary to high Ca2+ blood levels)
- Toxins
- Stress and reduced renal blood flow
- Degenerative
How can you treat acute / chronic renal failure in rabbits?
ACUTE RENAL FAILURE =
* Identify and treat main cause(s)
* IV fluids:
◦ Maintenance 75-100ml/kg/day
◦ Calculate dehydration/losses
◦ Careful with OVERHYDRATION
* Reduce stress
* Analgesia
CHRONIC RENAL FAILURE
* Identify and treat main cause(s)
* Treat any other signs (e.g. gut stasis)
* Fluid therapy SC
* Increase water intake
* ACE inhibitors
* Phosphate binders
* Anabolic steroids? E.g. Nandrolone
What are common presentations of neurologic and muscoskeletal disease
◦ Lameness
◦ Abnormal gait/posture
◦ Head tilt +/- facial nerve paresis
◦ Ataxia, seizures
* Can be subtle and 2ary to other diseases/problems
What are different causes of lameness in rabbits?
- Trauma = Fractures, Dislocations, Soft tissue trauma
- Pododermatitis
- Spinal disease (e.g. discospondylosis)
- Arthritis (degenerative, septic)
- Osteomyelitis
- Neoplasia
- Hypertrophic osteopathy
What are secondary signs of neuro disorders?
- Lack of grooming
- Urine scald
What are possible causes of vestibular disease? What are the signs seen?
◦ E. cuniculi
◦ Pasteurellosis
◦ Toxoplasmosis
◦ Neoplasia
◦ Head trauma
- Frequent clinical signs =
◦ Head tilt, torticollis
◦ Ataxia, paresis, paralysis
◦ Seizures, falling and rolling
◦ Facial nerve paralysis
◦ Nystagmus
Where are lesions with central vestibular diseases? What can be seen?
- Brainstem lesions
- Vertical/positional nystagmus
- Intention tremors possible
- Hemiparesis possible
- E. cuniculi possible
Where are lesions with peripheral vestibular diseases? What can be seen?
- Lesions on cochlea, middle ear or vestibular nerve
- Only horizontal and rotational nystagmus
- No intentional tremors
- No hemiparesis
- Usually not E. cuniculi
How would you treat vestibular disease?
- Meloxicam
- Empirical use of antibiotics = (Doxycycline, Marbofloxacin, Azithromycin)
- Prochlorpoerazine – anti-vertigo
- Midazolam – in case of seizures
- Fenbendazole - confirmed E. cuniculi cases
- SUPPORTIVE CARE =
- Restricted exercise in padded environment
- Reduce stress and handling
- Monitor for corneal ulcer development
What are possible causes of spinal disease?
- Congenital - spondylosis, kyphosis, lordosis, hemivertebrae
- Trauma
- Degenerative
What is seen with spinal disease?
- Loss of flexibility =
- Stiff gait
- Lack of grooming
- Cheyletiella parasitovorax
- Urine scald
- Uneaten caecotrophs
- Facial dermatitis
- Pain – immobility, gut stasis, etc
- Neuro deficits
What is Therapy of spinal disease?
- Meloxicam - long term
- Gabapentin
- weight loss, stimulate exercise
- Padded flooring, nursing care
- Poor prognosis for rabbits w paralysis +/- incontinence
What is ‘floppy rabbit syndrome’?
- Generalized muscle weakness → paresis → paralysis
- Poorly understood. Possible causes for muscle weakness =
◦ Neurological – compression lesions, vascular
◦ Hepatic lipidosis
◦ Hypokalaemia
◦ Toxicity
◦ E. cuniculi
◦ Myasthenia gravis
◦ Vitamin E/Selenium deficiency
SELF LIMITING
What are common neoplasias in rabbits?
- ** Uterine adenocarcinoma ** - entire females (CS = haematuria + palpable uterine horns)
- Bile duct adenoma/adenocarcinoma - 2ary to bile duct irritation + hyperplasia
- Embryonal nephroma
- Lymphoma
- Thymoma
What are features seen with gut stasis?
◦ Anorexia (total/partial) for >12-24h
◦ Reduced/no faecal output
◦ Reduced/absent gut sounds
◦ Some cases with abdominal pain
◦ Occasionally hypothermia
◦ Occasionally bloat
How do you treat gut stasis?
- STABILIZE FIRST
- Fluid therapy - IV / SC w glucose (careful with overhydration)
- Analgesia - meloxicam +/- buprenorphine +/- maropitant
- Gut motility meds = metoclopramide, cisapride, domperidone, ranitidine
- Supplemental feeding
