By Dr. Laura K. Lathan, DVM.

South Arundel Veterinary Hospital. 85 West Central Avenue Edgewater, MD 21037 (410) 956-2932; (301) 261-4388

Be like a scout, keep these supplies on hand:

• 6 cc dosing ( long tip) syringes
• silver sulfadiazene cream 1%
• 81 mg chewable children’s aspirin
• saline solution (plain contact lens solution)
• mineral oil or hairball remedy (Laxatone etc.)
• Lactobacillus acidophilus culture (dried or Benebac)
• vegetable baby food
• canned pumpkin
• hydrogen peroxide or iodine solution
• antiseptic soap
• styptic powder (Quick-Stop)
• cotton swabs (Q-tips)
• 2 inch self adhesive stretch bandage (Vetwrap)
• 2 inch roll stretch gauze (Kling)
• gauze squares (nonstick and regular)
• strong light (or penlight)
• unbreakable digital thermometer
• tweezers
• blunt end scissors
• cool packs
• heating pad
• towels

More experienced folks may also want to have:

• 1 liter bag of lactated ringer’s solution
• administration (drip) set
• 1 cc and 3 cc syringes
• 18 or 20, 22 and 25 gauge 1" needles
• simethicone pediatric suspension (Phazyme, Mylicon)
• Oxbow Critical Care
• stethoscope

Are we in trouble? - Recognizing an emergency

Although it isn’t always clear whether you have a true emergency on your hands, the list below includes the most common signs bunnies exhibit when they need professional help fast. But remember, you know your bunny better than anyone else, and WHEN IN DOUBT, CHECK IT OUT!

• Unconciousness / Inability to respond to stimulation
• Gasping for air / stretching neck and head up
• Seizures / acting drunk / rolling
• Uncontrolled bleeding
• Blow out diarrhea
• Known ingestion of a toxic substance / poisoning
• Nonproductive straining to urinate
• Limb dangling / Unwilling to bear weight on a leg / Inability to use hind legs

OK, I have an emergency - What do I do now?

1. Take a deep breath and FOCUS. You can help your bunny most if you can stay calm and think clearly.
2. Try to stabilize your bun. Remember that rabbits are particularly sensitive to stress, and try to minimize it. This will probably mean wrapping your bun in a towel and placing him in a dark, quiet carrier. Review this handout to see if there is any home care you can start.
3. Call your veterinarian. Tell them the signs your bunny is exhibiting, what care you have already given, and when you expect to arrive. Make sure you have the vet’s phone number and good directions with you before you leave. Drive carefully! You do your bun no good if you don’t get there in one piece.

CPR: Cardiopulmonary resuscitation

• Is your bunny breathing?
  Watch the chest and nose, place a wet finger in front of the nose to feel for breathing.
  
  • Yes : NEVER attempt CPR on an animal who is breathing. If she is having difficulty breathing, follow the steps listed below.
  • No : If there is something you can put between your mouth and the bun’s to prevent possible disease transmission, do it. Then cover the bun’s nose and mouth with your mouth and give a GENTLE PUFF of air. You should see the bun’s chest rise.
    
• Is your bunny’s heart beating?
  Put your fingers around the bunny’s chest, in the region of the elbows, and feel for a beat.
  
  • Yes : Continue giving breaths every 5 seconds or so and continue monitoring the heartbeat. Get to the vet.

    No: Squeeze the chest with the fingertips of one hand (or in a big bun, use both

    hands), and release. Compress the chest at least once per second (60-120 compressions per minute). Check for a heartbeat and breathing every minute or so.

  • Be aware that CPR is rarely successful. If an animal is in bad enough shape to need CPR, chances aren’t good. Discontinue CPR if there is no response in 5 minutes.

  Breathing difficulties

  • Signs: Open mouthed breathing, panting, extended head and neck, greyish blue tongue, big movements of the chest and abdomen during inhale. Usually accompanied by a reluctance to change position or lie down.
  • Make sure your bun’s nose is clear of any blockage. If you see any "snot," hold a warm wet washcloth against her nose for a minute or two (be careful not to obstruct the mouth) and then gently try to remove the blockage with your fingers or tweezers. Be sure to go slowly - this is a sensitive area and you don’t want to add any stress!
  • Once you’re satisfied that her nose is as clean as you can get it, wrap her loosely in a towel (be careful not to cover her head) and place her in a cool, dry, dark carrier. Get to the vet.

  Heat stroke

  • Suspect heat stroke any time your pet has been exposed to temperatures above 80-85° F and is nonresponsive.
  • Signs include weakness, incoordination, seizures, unconciousness, and a rectal temp above 104° F.
  • The ears may or may not feel hot to the touch.
  • DO NOT use ice or alcohol! Instead, spray or immerse your bunny in tepid water, paying special attention to the ears. You can also aim a fan at your bun to speed evaporative cooling. Advanced bunny caregivers can give subcutaneous fluids.
  • Monitor rectal temperature closely, as it can fall to temps BELOW normal (below 101° ) quickly. Discontinue cooling measures when rectal temp = 102.5° or less.
  • Get to the vet.

  Seizures/Convulsions

  • Can result from many different conditions affecting the brain.
  • Signs include disorientation, collapse, paddling motion of the legs, eyes rolled back in the sockets, tremors, possible uncontrolled urination and defecation.
  • Clear the area around the bunny to prevent him from hurting himself. Don’t put your hands near his mouth. Talk soothingly to him. Most seizures resolve in 1-2 minutes.
  • Place the bunny in a cool dark place after the seizure and get to the vet.
  • If the seizure doesn’t resolve in 1-2 minutes, place the bunny in a well-padded box or carrier and get to the vet. If you have easy access to them, put cold packs around the outside of the carrier.
  • If your bun is falling/rolling but not seizing, he probably has a bad case of head tilt. Wrap him firmly in a towel, call your vet and make an appointment ASAP.

  Uncontrolled bleeding

  • Many kinds of trauma can cause bleeding, but most bleeding stops on its own.
  • To help it stop, apply direct firm pressure with a clean absorbent cloth or gauze.
  • Do not remove the cloth if it gets saturated – this will dislodge the clot. Simply place another layer on top and continue to apply pressure.
  • Once the bleeding appears to have stopped, wrap all the cloth/gauze with tape or adhesive bandage to secure it in place, and get to the vet.
  • For nosebleeds, apply a cold pack to the bridge of the nose and call your vet for an appointment.
  • For bleeding toenails, apply styptic powder, flour or talc directly to the nail tip. You may have to repeat the application several times. Despite the way it looks, no rabbit has ever died of exsanguination secondary to a toenail trim. J

  Diarrhea

  • Diarrhea comes in many types and degrees. Although ALL diarrhea is a sign that something is wrong, the more liquefied and voluminous the stool, the more urgent the situation. Never "wait and see" if your bunny has blow-out, soupy stool – take action immediately!
  • Collect a sample of the stool in a ziplock bag or other clean container.
  • Advanced caregivers: give subcutaneous fluids.
  • Get to the vet.
  • We will cover low-grade diarrhea under "GI Stasis."

  Poisonings

  • We all know how much bunnies love to explore with their mouths. This makes them particularly susceptible to poisonings.
  • Signs are variable, but include coughing, seizures, diarrhea, incoordination, depression and/or excitability.
  • Collect a sample of the suspected poison. If it is a chemical, try to get the product label.
  • Depending on the severity of signs, either get to the vet or call:

    (Human) Poison Center 1-800-492-2414 (free service)

    ASPCA National Animal Poison Control Center 1-888-426-4435 ($45 fee)

  Urinary Blockage

  • Due to excess calcium in their urine, bunnies can form bladder stones which may get lodged in the urethra, causing inability to urinate. This is most common in males.
  • Signs include straining to urinate, abnormal posturing, vocalization, and teeth grinding.
  • Check the litterbox to see if any urine is being produced. If you’re not sure, clean the litterbox, then put a very small amount of litter in and observe your bun closely for the next 30-60 minutes. If he continues to strain, but no urine is produced, he is probably blocked. Get to the vet.
  • If small amounts of urine are produced, especially if the urine is bloody, he probably has a bladder infection. This is not as urgent, but you should still make an appointment with your vet ASAP.

  Inability to use a leg/legs

  • First, try to determine which leg(s) are affected. This may mean gently picking your bunny up (supporting her rear) and trying to get her to stand in an area with good footing.
  • If your bun is dragging herself around by her front legs, with her hind legs trailing out behind her, the most likely diagnosis is a back injury. Wrap her snugly in a towel, with the hind end in a natural position (no twisting/bending of the spine), put her in a carrier, and get to the vet.
  • If only one leg is dangling, it is probably broken. Depending on how calm your bunny is, you can either wrap her in a towel or try to place a splint. If she struggles, just use the towel. To place a splint:

    Pad the leg by wrapping it with gauze above and below the area of the break.

    Apply a pencil, popsicle stick, or other firm support to the outside of the leg.

    Wrap securely with tape or self adhesive bandage.

    Wrap the whole bunny in a towel, place her in a carrier, and get to the vet.

  • If your bunny is limping, but can still bear some weight on the leg, it is probably sprained/dislocated/fractured/etc. If your bun is young to middle aged and has no history of kidney or liver disease, you can give her half of a chewable baby aspirin orally. Apply a cold pack wrapped in a towel to the affected leg, and call your vet for an appointment.

   

  Whew! That’s the end of the short list of urgent emergency situations. What follows next is a brief list of commonly encountered problems that you can start treating at home, before consulting your vet. Of course, individual situations vary, and if you have any doubts, consult a professional!

   

  Cuts, bites, and lacerations

  • Wash your hands with antiseptic soap before attending to your bun.
  • If there is hair stuck to or in the wound, clip the fur with clean scissors.
  • Clean the wound – use hydrogen peroxide to clean around the wound (it cuts through blood really well) but try to avoid getting peroxide in the wound, especially if it is deep. For in-the-wound cleaning, rinse with plain saline solution. Rinse until you are fairly sure you have removed all hair, dirt, hay etc. from inside the wound. You may even need to sterilize your tweezers and pick some debris out.
  • DO NOT use a triple antibiotic cream (Neosporin, etc.) on the wound! Bunny will lick it off, and it could cause digestive upset.
  • Instead, use a thin coating of silver sulfadiazene cream. Cover the wound if it is large or deep – use a telfa pad 1^st, then roll gauze, then a self adhesive wrap as the outer layer.

  Warbles

  • These gross little critters are actually fly larvae that set up housekeeping in your bunny’s skin.
  • The classic appearance is a raised bump about 1/2 inch in diameter. They can occur anywhere on your bun, with a small hole (it may appear to be a scab at first) in the center. This is the larvae’s air hole. If you watch closely, you can see the larvae come up to breathe from time to time.
  • Do not attempt to remove these on your own – if you crush the larvae, it can release chemicals causing a serious reaction.
  • Warble sites can become infected, and in rare cases lead to serious complications, including toxic shock.
  • Make an appointment with your vet ASAP.

  The classic ADR (ain’t doin’ right) bunny

  • Classic signs include mild lethargy, decreased appetite, changes in stool consistency and amount.
  • Causes are multiple, and you need to get to the root of the problem by working with your vet, but:
  • Anytime your bunny goes off food, you should immediately start addressing the problem of GI Hypomotility (slow motion of the digestive tract) to keep it from progressing to GI Stasis (stoppage of the digestive tract).
  • Remember, bunnies are walking digestion vats – anything that affects the rest of the body can affect the digestive tract, and anything that affects the digestive tract can affect the rest of the body.
  • So – until you get to the root of your bunny’s problem, your #1 job is: KEEP THE RABBIT EATING!
  • Ways to do this include:
    1. Make sure you are offering fresh, clean water. You may have to force extra water with a syringe. You can also try offering unsweetened pedialyte or fruit juices.
    2. Make sure you are offering fresh, wet leafy veggies. Try herbs such as mint, basil, parsley, and dill to entice the appetite.
    3. Make sure you are offering a good quality hay – it should be light green, not brown, and should smell sweet, not moldy. You may have to resort to alfalfa hay if bunny refuses her regular fare.
    4. Force feeding pellet mush: soak pellets in water or chamomile tea, then mix in a little canned pumpkin or vegetable baby food. Feed at least 15-20cc of this mixture by syringe 3-4 times daily. Feed slowly to avoid food inhalation.
    5. Abdominal massage – back off if bunny expresses pain. You can even try a vibrating massager!
    6. Lactobacillus acidophilus powder can be added to the pellet mush.
    7. Mineral oil or hairball remedies may help in some cases.
    8. Simethicone liquid – 0.5 - 1 cc by mouth 2 times daily will help keep the gas moving through your bun’s digestive tract.
    9. And finally, for experienced caregivers: subcutaneous fluids 1-2 times daily.

  Giving Subcutaneous Fluids (or, how to turn your rabbit into a camel)

  • The basic idea here is that we are giving your bunny fluids that are physiologically very similar to the fluid that is already circulating in his bloodstream. Because your average person takes quite a bit of practice to reliably access the bloodstream of a rabbit, and since your rabbit probably won’t appreciate being practiced on, we aren’t going to put the fluid directly in his bloodstream. Instead, we are going to put it into the subcutaneous space (the space between the skin and muscle, where the fat lives) and from there it will gradually be absorbed into the bloodstream. This technique is quite effective at treating and preventing mild dehydration.
  • Don’t give subcutaneous fluids if your bunny has a breathing or heart disorder, unless specifically instructed to do so by your veterinarian. Fluids can make those conditions worse.
  • The fluids that we will use have several names, the most common being Lactated Ringer’s Solution, 0.9% saline solution, Plasmalyte-R, and Normosol-R.
  • Use the largest bore needle your bunny will tolerate. This is because fluids can be administered MUCH faster with a larger bore needle – it can mean the difference between giving the fluids in 3 minutes or 15 minutes! We typically use an 18-22 gauge needle.
  • Make sure you have fresh solution. If the bag has been open for more than 5-7 days, throw it away.
  • Location: you can give the fluids anywhere you can "pinch an inch" on your bunny – that is, anywhere there is loose skin. The most commonly used area is in the vicinity of the shoulder blades.
  • Dose: 10-15cc per pound of rabbit, 1-2 times daily. For example, a 6 pound bunny would receive 60-90 cc of fluids at a time.
  • Technique:
    1. Set up your fluids (make sure you can see your drip chamber) and attach the appropriate needle. Leave the cap on the needle for now.
    2. Secure your bun in a towel, or get a helper to hold the bun for you.
    3. Create a "skin tent" over the selected area on your bun by lifting the skin between your thumb and fingers. Feel the area to be injected with your other hand to determine the exact area of the injection. You may want to wet that area down with a small amount of alcohol.
    4. Remove the needle cap and insert the needle firmly under the skin.
    5. Hold the needle in place with one hand, and open the fluid valve with the other.
    6. Make small adjustments in needle position until you can see fluid running smoothly through the drip chamber. Check the fur to ensure the fluid is actually going INTO the bunny, instead of ONTO the bunny.
    7. Hold everything until the appropriate dose of fluids is reached. Your bunny should now have a soft, jiggly bleb under the skin.
    8. Turn off the fluid valve.
    9. Withdraw the needle and gently pinch or press the area where the needle was. A small amount of fluid leakage is normal.
    10. Change the needle. Discard the old one in an empty plastic soda container.

  Congratulations! You have just done your bunny a world of good. You can use a similar technique to give medications under the skin if necessary. You can even give most injectable medications with the fluids, so that your bunny will only have to be poked once instead of twice. She’ll appreciate that – just ask her!

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