With an estimated 1 million pet rabbits in the UK (O'Neill DG et al, 2019), rabbits make up a considerable and growing proportion of the caseload in small animal practice (Meredith and Lord, 2014), for both preventative health care and when veterinary treatment may be required for a disease process.
The different breeds of rabbits show variations, including in size, temperament and acceptance of human company, and ensuring pet rabbits are healthy involves direct owner communication and education on a range of health and welfare topics. Much information is available through online facilities, which may or may not be accurate.
Making sure owners can access the most up-to-date information is important and in practice this may be the responsibility of the veterinary nurse. Advice should be offered on current vaccination protocols, neutering, diet, housing, companionship and bonding, as well as day to day care. Owners should be aware of how to recognise if their rabbits are happy, and that their welfare needs are being met.
Healthy rabbits
In order to keep rabbits happy and healthy, consideration must be given to their species-specific requirements. As a prey species, rabbits will readily hide signs of pain and illness. This acts as a useful survival mechanism, since rabbits that are ill and infirm in the wild are more likely to be eaten. In a domestic pet rabbit environment, this can make it difficult for owners to recognise subtle signs of illness, and may result in a delay in consulting a veterinary surgeon. Signs of pain in rabbits include: anorexia or inappetence, bruxism, hunched posture, pressing their abdomen on the ground, being uninterested in their surroundings or companion and lack of, or cessation of, faecal pellet production.
The Rabbit Grimace Scale, (RGS) can be a useful addition to recognising pain within a veterinary assessment, in conjunction with clinical signs (https://staff.flinders.edu.au/content/dam/staff/research/ebi/animal/rabbit-grimace-scale.pdf).
Healthy rabbits eat frequently, and pass upwards of 300 faecal pellets daily (Sibbald, 2018), each spherical and uniform in size and shape; they eat their caecotrophs, groom themselves and their bonded companion, are interested in their surroundings and respond to potential dangers. They should move about freely, have no discharge from their nasal passages or hyper-salivation, and have no faecal or urine staining around their perineal area.
How to communicate correct information to owners
At times, communication with owners may prove challenging, since owners may believe they are offering their rabbits the correct care and may not be open to change. Aim to have adequate time for an in-depth consultation; 30 minutes may be required for a rabbit clinic. Trying to rush through information will do little in facilitating understanding of the points you are trying to get across.
Communication models exist, and the first major model for communication was developed in 1948 by Claude Elwood Shannon. Different methods of communication can include face-to-face communication, which is the most common method used in veterinary practice, email, teleconferencing and videoconferencing. All of these communication methods open new avenues of interaction with clients.
Important aspects when communicating with clients include:
- Being an active listener
- Avoiding disruptions and negative questions
- Avoiding being casual or rushing communication
- Following-up after communication
- Being willing to understand, and being sensitive and acknowledging differences or difficulties the owner may have implementing change
- Avoiding using phrases and words that can be misunderstood
- Listening to feedback.
Always aim to focus on the positives, and what owners are doing correctly. Back up the suggested changes with evidence and aim to provide this during the consultation. This may be in the form of written information or leaflets, as well as explaining orally.
It is often the case that several aspects of a rabbit's welfare may need to be changed, such as the rabbit's diet, vaccination status, living conditions and lack of a companion, but prioritising one or two key points may yield the best results, otherwise the owner may not make any changes at all, as the task may seem too difficult to achieve.
The Rabbit Welfare Association and Fund (RWAF) have a handy owner guide, On the Hop (Figure 1), which can be given out during a consultation. Posters displayed in reception and in consultation rooms, can also aim to educate owners on correct care for their rabbits.
Consider running a rabbit client evening or rabbit clinics within practice, where important care topics can be discussed. It may also be possible to design and distribute a rabbit, client newsletter, which would provide an additional way of communicating to clients. In the current time, when face to face consultations are limited, nurses could perform teleconsultations on a one to one basis or even consider a platform such as Zoom for ‘client evenings’, in order to reach clients and offer advice.
To set up rabbit clinics, first decide who will run them, where and when and if you plan on charging for them. Advertise them within the practice on notice boards, as well as emailing clients (who have given GDPR consent) and ask staff to mention them to clients when they bring their rabbits into the practice. Aim to discuss areas of daily rabbit care, such as feeding, housing, vaccinations, neutering as well as offering a health check. Launching these around Rabbit Awareness Week, which runs in June each year, gives an interest to the local press for publicity. Due to the current Covid-19 situation and the effects on veterinary practices and the cases being seen, the 2020 event has yet to be confirmed or if or what form it will take place.
Dietary requirements
Rabbits are strict herbivores, with a digestive system that is adapted for the ingestion of a fibrous diet (Varga, 2013). They feed frequently, up to 30 times per day, consuming each time approximately 2–8 g of food over 4–6 minutes (Mancinelli, 2016).
Rabbits separate large fibre particles from small fibre particles in the proximal colon. The large fibre particles are excreted as the hard faecal pellets. The small fibre particles are directed to the caecum, where they under-go bacterial fermentation, releasing volatile fatty acids, which are absorbed as the rabbit's main energy source. The remaining part of this digestion will be excreted in clumps of sticky droppings referred to as caecotrophs. These should be eaten by the rabbit as they are passed; if they are not eaten, they will accumulate around the rabbit's tail area, and this can be a predisposing factor for flystrike (Figure 2).
Rabbits require a constant throughput of high fibre food to ensure maximum gastrointestinal tract motility and function. Added to this, the abrasive nature of hay and grass encourages the correct dental wear.
In the wild rabbits spend many hours eating low calorie vegetation, and need to consume high quantities of this in order to maintain gastrointestinal and dental health, as well as meeting their calorie requirements. This is something that is often lacking in a pet rabbit's diet. A quarter (26%) of owners do not provide hay as part of the main diet for their rabbits (PDSA, 2019). In addition to this, one in five rabbits (21%) are still fed rabbit muesli as part of their main diet (PDSA, 2019). Both of these statistics highlight the misunderstanding that still exists around feeding rabbits.
Rabbits chew in a lateral and horizontal chewing motion when consuming natural vegetation, and can chew up to 200 times per minute (Mancinelli, 2016). Adequate fibre levels will be reached if unlimited grass and hay is provided and consumed by the rabbit (Prebble, 2014). At least 80% of the diet should be made up of hay and grass.
Dried food has its place within a balanced diet to help provide essential vitamins and minerals, but should make up no more than 5% of the daily food allowance, equating to approximately one tablespoon per kilogram of ideal bodyweight for the average 2–2.5 kg rabbit daily. There are many varieties of concentrates on the market, but muesli foods are no longer recommended and have been shown to be a contributing factor to dental disease, because of the sugar content which encourages selective feeding — rabbits are likely to overeat on it meaning they do not eat adequate amounts of hay (Meredith et al, 2015). The best alternative to bowl feeding is to scatter the concentrate food in the hay. This reduces the focus on a specific location and distracts the rabbit from showing aggressive behaviours towards its owner or its companion associated with competition over food (Bradbury, 2019a).
Fresh herbs and greens should be fed daily, and a variety offered, making up around 10–15% of the daily diet. The key to promoting normal gut bacteria and a healthy digestive system in any rabbit is small amounts of different greens, not a large quantity of any one thing (Stapleton, 2019). The Rabbit Welfare Association and Fund (RWAF) website has a comprehensive list of fresh foods that can be fed to rabbits https://rabbitwelfare.co.uk/rabbit-diet/greens-veg-herbs/.
Vaccination
The current recommendation, according to vaccine manufacturer protocols, is to vaccinate with Nobivac Myxo-RHD PLUS (MSD Animal Health), which has been available in the UK since May 2020. This annual vaccination provides protection for myxomatosis and both strain 1 and 2 of rabbit viral haemorrhagic disease (RVHD). Naive rabbits can be vaccinated from 7 weeks of age for the full 12 month immunity. Those previously vaccinated with either Eravac (HIPRA) or Filavac (Filavie) only or in conjunction with Nobivac Myxo-RHD, can be vaccinated with Nobivac Myxo-RHD PLUS as soon their Eravac or Filavac booster is due.
Rabbits previously vaccinated with Nobivac Myxo-RHD only, require either Filavac or Eravac first to ensure RVHD2 protection is stimulated, and then Nobivac Myxo-RHD 2 weeks later (if still available), or Nobivac Myxo-RHD PLUS to ensure no vectored response occurs. An annual booster can then be administered. Onset of immunity after vaccination with Nobivac Myxo-RHD PLUS is 21 days. Advice on switching to the use of Nobivac Myxo-RHD PLUS is available at https://www.msd-animal-health-hub.co.uk/ahp/rabbit-switching
This information must be passed on to clients, as many are still unaware what vaccinations their rabbits should have, what they involve and at what intervals they are required.
Housing and environment
In 2019, one in ten rabbits (10%) did not have a run and just lived in a hutch, and 25% of owners kept their rabbits in inadequate housing provision, compared with 35% in 2017 (PDSA, 2019).
The RWAF recommend the minimum set up for two rabbits is a 6 x 2 x 2ft hutch and an 8ft run (https://rabbit-welfare.co.uk/rabbit-care-advice/rabbit-housing/outdoor-rabbit-housing/). This should allow the rabbits to take a minimum of three consecutive hops, and should be high enough to allow the rabbits to stand up on their hind legs and lie at full stretch. Often a better option is a shed with a secure run attached. Runaround.co.uk are one of the companies that specialise in providing tunnels and boxes which can link hutches and sheds to runs, to allow the rabbits choice about where to spend their time, and ensure the rabbits do not need to be handled to place them in their run (Figure 3).
Companions and neutering advice
Half (49%) of UK rabbits live on their own, but only 18% of owners thought their rabbit was lonely in the annual PDSA Animal Wellbeing (Paw) Report (PDSA, 2019). Rabbits require the companionship of other rabbits for a good life (Bradbury, 2018) (Figure 4).
Rabbits kept on their own suffer more ongoing stress than rabbits kept in pairs or groups. Stress does not just cause emotional distress; it affects many aspects of an animal's physiology (Bradbury, 2019b).
The best combination is a neutered male and neutered female rabbit. Companion rabbits will groom each other, sleep and eat together, offer a look out while the other rests and be a constant source of security to each other.
Males (bucks) can be castrated from 12 weeks of age and females (does) from 16 weeks of age. Males are fertile for up to 6 weeks post castration and must be kept away from entire females (RWAF, n.d.). Discussion with owners on the benefits of surgery should take place prior to neutering.
Bonding must take place on neutral territory, no sooner than 6 weeks post neutering, and close observations must take place, especially during the initial stages for any signs of distress or fighting between the rabbits (Stapleton, 2016).
Environmental stimulation
Rabbits kept outside are exposed to a range of changes throughout the day: changing temperatures; light levels; ambient noise’ presence of birds; weather conditions, and all of these provide environmental stimulation (Bradbury, 2018). Rabbits should have the choice of where to spend their time. This should be in a secure environment that is protected from predators, either from ground or sky level, or from potential theft. They should have access to shade, shelter, differing levels (underground and over ground) and exposure to sunlight and rain. Many rabbits like to sit out in the rain but are often denied this by well-meaning owners. If they have the option of shelter they will seek this if they desire.
In the wild, rabbit burrows have several entrances and exits — therefore if a potential predator enters, they have several escape routes (Figure 5).
Toys can be useful to provide entertainment, but rabbits are often fearful of new objects in their environment and it may take some time for them to accept them. The most suitable toys fulfil more than one requirement; they are pleasant to eat, food can be hidden in them and rabbits can move through them or sit on top of them (Bradbury, 2018). Objects which may then be suitable include: tunnels to run through or sleep in; digging boxes filled with soil or children's play sand; cardboard boxes (care needs to be taken to ensure the rabbits do not consume the cardboard); fresh apple or willow branches and logs to chew and eat; and feeding puzzles or balls.
Happy rabbit behaviour
Rabbits may display both audible and physical signs of happiness. Binkying is the term used to describe when rabbits run, jump and leap in the air and such behaviour is often performed when the rabbit feels safe in its environment, or when they are moved from a confined area to a larger area (Bradbury, 2018).
Short sprints may be performed with or without a binky. This behaviour may be triggered by an external stimulus, such as the presence of a predator in the vicinity or used as a play behaviour (Bradbury, 2018).
Young rabbits chase and displace each other as a form of play behaviour, which helps to establish social hierarchies at a young age and is a positive behaviour (Bradbury, 2018).
Relaxed rabbits will flop onto their side and lie completely still. These rabbits are completely off guard and happy within their environment (Figure 6).
Soft tooth grinding is notably different to the bruxism noise that rabbits perform when in pain. A rabbit often chatters its teeth quietly when it is relaxed, calm and finds a situation pleasurable. This sound is often heard when a rabbit is being groomed by a companion rabbit or by their owner. Owners, who are frequently observing these behaviours, have rabbits that are happy and feel safe.
Conclusion
Veterinary nurses can play an important role in guiding rabbit owners on how to care for them correctly. This will help to ensure their health, welfare and behavioural needs are met, helping to avoid diseases that may arise from incorrect care.
KEY POINTS
- Rabbits should be kept in neutered, compatible pairs or groups.
- Rabbits should have enough space to be able choose where they spend their time.
- Rabbits should be kept in large, secure enclosures.
- Rabbits should be provided with mental and physical stimulation.
- Rabbits should be offered a diet that is high in fibre and encourages consumption of large quantities of grass and hay.
- Feeding can be made fun to encourage activity and a natural feeding pattern.
- Rabbits should only be handles when necessary.
- Rabbits should be vaccinated annually with Nobivac Myxo-RHD PLUS, but the correct transition needs to be followed to ensure full protection.
- Owners that become familiar with their rabbit's behaviour will find it easier to spot signs of illness at an earlier opportunity.
- Recognising signs of pain will enable the appropriate action to be taken.