In 2019, PDSA reported that an estimated 900,000 rabbits were kept as pets within the UK (PDSA, 2019). With lifespans of around 8 to 12 years if provided with the appropriate care, it is highly likely that a pet rabbit will need some kind of veterinary treatment within their lifetime. This likelihood is further heightened by the evidence that only one in seven owners adhere to preventative healthcare and only 70 percent of owners had their rabbits registered at a veterinary practice (PDSA, 2019).
While often perceived as “easy” pets, rabbits are complex creatures who have a high natural prey response. Having not been domesticated as completely as dogs, they retain this innate behaviour to hide signs of illness, pain and sickness for as long as they physically can in order to minimise risk of predation. As such, at presentation for hospitalisation it is likely that illness has already sufficiently progressed and intense clinical care is required to stabilise and monitor for the best possible outcome.
In order to minimise stress, rabbits should be kept away from predators and placed in areas with low traffic and minimal noise interference. Ideally, they should have their own wards but if this is not possible then they should be housed in alternative areas (eg a vacant isolation area).
While noise is undoubtedly an important factor causing stress, care should also be taken with regards to smell, as this is often overlooked and can result in high levels of unseen stress (Lord and Meredith, 2014). Thorough cleaning of the ward to remove any predator smells prior to the hospitalisation of a rabbit should be viewed as a requirement, not an optional choice.
Minimising stress during hospitalisation
The ability of a patient to react positively to treatment during their hospitalisation is greatly increased by providing a secure, home-like environment for them during their stay (Varga, 2013). So, when rabbits are admitted into hospital, the owner should be encouraged to provide their pet’s customary food items as well as information regarding their usual dietary, toilet and interaction habits. This information allows the patient’s stay to be tailored to their everyday routines which can diminish uncontrolled anxiety, with the ultimate aim of allowing the patients the security of their own personal space (Cumberbeach, 2015).
Ensuring adequate animal welfare
Within the patient’s own personal space, the fundamental five freedoms of animal welfare should always be strived for. The first – freedom from fear and distress – has already been discussed; however, a patient is ultimately admitted for a reason and so fear and/or distress will never be completely negated throughout the course of their stay. Some practices use diffusers and other similar products available on the market to reduce anxiety (Richardson, 2000).
By providing the patient with suitable food and water in appropriate vessels that they are used to using, you can ensure that their nutritional requirements are being met (Lord and Meredith, 2014).
The provision of hiding areas is essential to provide a secure resting area for rabbit patients. This fundamental aspect of animal welfare can be met by introducing cover in the form of a hide or even doing something as simple as covering half of the kennel with a towel.
A suitable area for toileting should be provided with the patient’s usual habits considered. Newspaper is often used in practice for ease of maintaining the cleanliness of the kennel (Wiseman and Benato, 2016), but newspaper is rarely used by owners in the home environment. You should consider providing the patient’s normal substrate, whether this is achieved by providing a litter tray or any other substrate. Care should be taken to ensure that inpatients do not eat the newspaper if used, as doing so can lead to obstruction.
Maintaining an open line of communication with the rabbit’s owner is important, both from a business and a welfare perspective. The owner will likely know their pets best, and by keeping in touch they can answer any queries or observations that the practice may have, allowing for the continual development of the care plan for each individual patient.
Companions during hospitalisation
The admission of a patient’s companion is often dependent upon the reason for hospitalisation in the first place. If the reason for hospitalisation is a procedure, then the companion could be reintroduced once the patient has reached a suitable level of post-operative recovery. However, if the patient is in for treatment of gastrointestinal stasis, then it may be best not to house them together so as to allow a greater ease of monitoring faecal output. These are two brief examples but, ultimately, a blanket rule cannot be applied for all as it depends on multiple factors, such as the individual’s condition, the level of bonding with their companion, the reason for their stay, and so on. Therefore, decisions should be made on a case-by-case basis after due consideration of the patient’s conditions.
Interactions during hospitalisation
During their hospital stay, a patient will be interacted with frequently, often multiple times a day and with differing levels of interaction. These interactions can range from patient assessment to cleaning, and from procedural work to more “painful interactions” such as wound manipulation. Therefore, handling technique is crucial to reduce stress and it is important to bear in mind throughout any patient interaction that rabbits are a prey species (Rosewell, 2015).
Scooping fast from above will mimic a bird of prey, while pulling a rabbit out of a hide area or place of safety can be reminiscent of being caught or dug from a burrow by a predator. A slow and face-on approach so the patient is aware of your intentions is best, before scooping one hand under the rear and placing the other under the sternum. Keeping the rabbit near to the trunk of the holder’s body and their head within the crook of the elbow will help provide security for the patient and allow greater control for the handler (Lord and Meredith, 2014). Never turn the rabbit onto its back or scruff them as this is unethical and outdated. If the rabbit is fractious or requires medicating, then the use of a towel for the “bunny burrito” technique on a suitable surface is best to safely restrain the patient and minimise risk of injury (Richardson, 2000).
It is important to know the signs of pain that can present in rabbits who are hospitalised. There are multiple pain scales available with differing scores to suggest whether analgesia should be provided or not; however, as a brief overview the key areas of interest to review are: ear position, orbital tightening, nose shape, whisker/lip curling and cheek flattening (Banchi et al., 2020). Rabbits are often highly responsive to pain which can negatively affect the outcome of a patient’s treatment or even lead to other complications, so frequent monitoring is essential to aid a successful hospitalisation outcome (Malik, 2021).
Rabbits are often viewed as “simple” but this could not be further from the truth. They are animals who require tremendous input in order to meet their needs and ensuring these requirements are met within a hospital setting can be challenging. Ultimately, reducing stress and encouraging familiarity is key to achieving a positive hospitalisation outcome with a high welfare capacity.