RWAF conference 2011 - My notes

Sorry this has taken so long to get written up, it was a bit of a mammoth task!
If any of you have any questions, I'll do my best to answer them, as I do remeber a lot of it! More specific questions I can probably get answers for, as I'm in touch with most of the experts.

There were six speakers, I've put them in the order we heard them.

Sharon Redrobe BSc(Hons), BVetMed, CertLAS DZooMed MRCVS, RCVS

Clinical Associate Professor of Zoo, Wild and Exotic Animal Medicine & Director of Life Science, Twycross Zoo.

A Hutch is not enough, Really? A scientific study at last. A comparison of hutch, pen and runaround systems.
Sharon talked through the premise that a hutch is not enough, and then discussed the fact that we don’t actually know this at all – it is an assumption we make based on the amount of land that wild rabbits use.

The measure for indicating a rabbit’s ideal environment is the amount of natural behaviours they exhibit – so people who do have a bun in a small hutch are likely to think of it as ‘boring’ because it doesn’t do much!

Without this actually being proved, there is no reason for anyone involved in rabbit welfare legislation etc to change anything. However, if this can be proved, then this strengthens the law and the campaign to end small hutches.

Sharon headed a team of students at Nottingham with an observational study using 6 pairs of rabbits in three different environments.

They monitored the amount of natural behaviours in each of the 3 environments:
(hutches were all 6x2x2)

A hutch with no outside access
A hutch with a run underneath, and ramp to ground
A hutch and ‘runaround’ system, which was fairly extensive.

The data is yet to be published, so I can’t give you all the facts, but this is roughly how it was done.

Each pair of rabbits spent a week in a different system. The were acclimatised for 3 days, then observed for 4 days.

The rabbits were rotated round each system.

Results:
The rabbits displayed the lowest activity in the hutch alone.

With the Runaround system attached, they used the outside space more, and their natural behaviours were slightly increased.

With the under-hutch run, the rabbits spent a lot of time on the run, and displayed more behaviours than in either other system.

Conclusion – A hutch is not enough!

I asked if there were any particular rabbits that preferred the hutch, even though they could get outside, and there weren’t – however this doesn’t mean that some buns would prefer to be in a hutch – just not the 6 she was working with.

John Chitty BVet Med Cert Zoo Med CBiol MSM MRCVS

JC Exotic Pet Consultancy Ltd, Salisbury, Wiltshire.

Skin diseases

Whilst skin problems are fairly easy to treat, they reflect an underlying issue, and unless the underlying issue is addressed, reoccurrence can happen. Basic gist of that is that is that we need to look at skin issues holistically. From my experience with John as Bertie’s vet, he is a vet who looks at everything holistically, and investigates thoroughly underlying problems.

He gave some examples-

Sore Hocks:
Keratin reaction to substrate
Hygiene
Carpet
Urine reactions
Lack of space
Weight bearing
Arthritis in foot
Tumours

General skin problems can be caused by:
Spinal issues
Abdominal disruption
Dental issues
Middle ear disease
Urine disease
Renal disease/stones

To diagnose, a general examination is needed, a body X Ray, and urine and blood samples taken.

This needs time and funds – which he acknowledged is not always available, but skipping a step reduces the chance or accurate diagnosis.

Dermatological investigation
1: History taking – Very important – be truthful, vets are not there to pass judgement on your husbandry! He gave an example of a bun with respiratory probs, there was no clear indication as to why. When the problem returned, the owner came into the surgery in decorating clothes…the gloss paint had caused the probs in both cases, but the owner hadn’t thought to mention it.

2 Clinical examination – prod & poke!

3 Skin exam – thoroughly inspect rabbit

4 Sample taking (see below)*

5 Diagnosis

Therapy/management. Some skin issues have to be managed, but will never be cured.

*Sample taking.

• Scrape – easy & cheap, usually done with a conscious bun except sometimes for feet and/or nose
• Trichogram – hair analysis – cheap and easy, good for ear mites and ringworm
• Bacteriology
• Acetate – using sticky tape to lift cells that can be examined under a microscope (Cytology)

Biopsy
Should be done asap, it’s expensive and owners expect a lot from the results, however, vets can hope that it gives a definitive diagnosis, but sometimes it will show the groups of bacterias involved, which can help with diagnosis and medication.

Additional tests – all expensive and/or difficult
Intradermal test
Food trails
Environment trails
Drug trials – these are beneficial if there has been no or little response from ABX for at least two weeks.

Footnote: ABX for skin problems can take a long time to work, as they are working from the inside of the body to the outside. In curing the problem inside, the skin is the last area to present healing, so owners shouldn’t give up or think that the ABX are not working for at least two weeks after the course started.

Mites: It’s important to know which mite is affecting the rabbit. There are two categories of mite (Walking mites and static burrowing mites) that have, within each category, different mites.

Rabbits become susceptible to mites when under stress – this we know. The stress causes changes in the rabbit’s immune, and whilst mites are usually living on rabbits all the time, the immune’s weakness allows the mites to overwhelm the rabbit.

Myxomatosis
Never let a vet give your rabbit steroids

Keeping skin healthy:
Groom regularly
NO washing/shampooing (spot cleaning if nec.)
Vaccinate for Myxo every 6 months
Keep rabbit healthy! Don’t allow it to become overweight, provide safe and spacious accommodation, ensure plenty of exercise, and look holistically at your rabbit – it’s personal welfare and care are an important factor in overall health.


Aidan Raftery, MVB CertZooMed CBiol MSM MRCVS

Avian and Exotic Clinic, Manchester

Diseases of the rabbit ear. Advances in diagnosis and treatment.
This talk was very visually based, with lots of slides of X Rays and diagrams, so my notes for this are not as comprehensive as the lecture was… these are just things I jotted down quickly.

Of all the talks, Aidan’s was the most vet orientated, and scientific.

Anatomy
Three parts to the ear – External, Middle and Internal

Three parts of cartilage

External ear canal ends at the ear drum

Middle ear:
Infections can be asymptomatic (show no symptoms)
Symptoms include:
Increased scratching
Head tilt
Painful ear
Unbalanced /wobbly

To examine, gently extend (pull) the outer ear to extend the ear canal

Lops
Lops generally have a significant more ‘white’ material in their ears than erect eared rabbits when X-Rayed.
This can be a pre-cursor of wax, but in the case of ear disease, is usually pus - in Pathology, this is much more common

The shape of the ear canal is deformed in Lops, and has a unique fold in it. The lining is redder and there is a lot more wax in Lop ears.

Steroids must be avoided in rabbits with Ear infections, and NSAID’s administered.

When exploring middle ear disease, often the answer will be found in the upper respiratory tract.

Aidan also talked about using ear wicks (aka beads) to treat infection – like a small sponge on a stick, the end is dipped into ABX then inserted into the middle ear canal for topical treatment, showed us X rays of it in place.

He also talked about surgery beyond the ear drum. The ear drum heals afterwards and hearing can return to normal.

There were so many pictures that I wish you could all see.

Richard Saunders BSc(Hons), BVSC CBiol MiBiol DZooMed (Mammalian) MRCVS

Senior Clinical Training Scholar in Rabbit & Zoo Animal Medicine Bristol Zoo Gardens RWA/F Veterinary Resident.

Brainstorming E.Cuniculi. Are we tilting at windmills?

This was a very interesting talk, and seemed to be an update of what we now know versus what we knew a year ago and so on. I haven’t been to an RWAF conf before, but I got the feeling that ths is something that Richard does each year. Richard made no claims that we were much nearer to finding the right treatments, and that there is still a lot of ambiguity and trial/error in treating EC.

Again, I was listening to this a lot, because I don’t know a whole load about E.C., so these are just my jottings, which I’ve tried to formulate.

EC has more in common with Funghi

It’s Zoonotic – can affect humans with immune suppressing diseases, such as HIV

Diagnosis: Difficult.
Often a rabbit is just not quite right.

EC is not prevalent on wild rabbits
Test look for anti-body responses
In a study, 52% of domestic rabbits were seropositive (Showed a positive reaction to a test on blood serum for a disease).

At 4-6 weeks old, rabbits at their most vulnerable – eyes bulging/rupturing – kits in the womb can get this (cataracts). Kits can spread spores for 90 days after being born.

Tests:
Two test – IgM and IgG – IgM is relatively new. You can read more about these here http://www.ncbi.nlm.nih.gov/pubmed/20153117

IgM antibody rises in 7 days, making a diagnosis about when rabbit should be treated with Panacur difficult

IgG indicates if the brain has been affected, and as this is usually when we see signs of EC (head tilt and dragging legs) – although neither of these are exclusive to EC

One test is no longer enough for a true diagnosis. Best testing is either IgG, twice, four weeks apart, or IgG and IgM together.

Signs:
Renal disease
Urine scolds
Neurological effect to hind end (dragging)
Head tilt. – This was interesting, he talked a fair bit about it – I didn’t realise that there are no neck muscle issues with head tilt. The rabbits brain is simply saying that ‘this’ is the right way up, so the head has moved accordingly – so they are seeing the right way up, just not looking like it. He said that head tilt shouldn’t be a reason to euthanise.

Diagnostic tests:
Kidney biopsy
Brain Biopsy (not possible on live rabbit – will kill it – used for PM only).
PCR (prominent chain reaction) using a DNA trace
Urine (not faeces) test
Head tilt – Skull X Ray
X-ray whole rabbit (spine)
CT Scan
MRI Scan

Drugs of choice:
Panacur – AT present, the only drug to support effects
Bone marrow suppression

Panacur – treatment and prevention doses are affected by your rabbit’s environment.
He found that the 28 day course did leave some rabbits still susceptible, but after 42 days, they were clean.

Metacam – Should be used, but in sever cases, there may be role for short term steroid use. – I got the impression from all the veterinary speakers that steroids for rabbits should be a lst resort, and can easily make a problem a lot worse.

Metoclopramide – it’s also an anti-nausious drug, used fr travel sickness in people, so can help with extreme cases of balance problems

Valium – to calm down a spinning rabbit.

Baytrill – EC creates immune suppression, and Baytill can help with this.

We talked about boarding and rescues. A rescue said that when she has a bun in for a bonding, and then the new pair go home, she recommends that both rabbits are given Panacur for 28 days afterwards. Frances H-B was sitting in on the talk, and agreed that this was a good idea, so did Richard.

If the rabbit in boarding is sharing grass space that other rabbits have used, this increases risk.

In hutch boarding, the hutch should be cleaned with Ethanol to clear infection.

The spores die in 4 weeks

Someone brough up that Lapizol and Panacur are not licensed for rabbits. Panacur is a brand name, that’s all. Owners who are treating regularly can ask for the non-brand version, for cats and dogs, that comes in a litre bottle, and is a lot cheaper.

How to rule out EC - X ray the skull
How to rule in EC IgG and IgM test

Frances Harcourt-Brown BVSc FRCVS

NH & FM Harcourt-Brown Veterinary Practice, Harrogate.

The anorexic rabbit – Is it surgical?
A thoroughly interesting talk about a subject that we all think we know lots about, but there were some startling revelations! The premise of the talk was the distinction between GI stasis and GI Obstruction – and how to diagnose and treat each one.
The talk opened with a look at the wild rabbit living on the iberian peninsular - Frances had been there and photographed them. What was really interesting is the absolutely 'terrible' (as we'd see it) quality of what they live on - it's basically scrub, hardly any grass, dried scrub and bushes, dried grasses, and that was IT! They have one rainy season, and then the buns will eat fresh shoots, and fruit that falls off trees, but that's all.

Frances went into great depth on the process of caecotrophy, and basically, the rabbit can convert the most rubbish foods into what it needs - It is not the quality of what goes IN that matters at all, it's keeping the gut healthy with plenty of coarse fibre - without that, then the caecum gets in trouble, and the quality of what comes OUT is affected , and then we start altering the diet, quickly, to try and remedy that - not good either.

The problem with pet buns is that they are fed these high calorie foods as soon as they are able to eat them, and so they 'learn' that this is food, and like a child, will turn their nose up at what they are supposed to eat, in favour of what is effectively, a learned behaviour - pellets, muesli etc. So pet buns are stuffed (no pun intended) from the outset, so what can you do? ... Train , clicker train, whatever you can do to bring high fibrous foods back into the frame as the norm.

That said, Rabbits adapt to their environment, and here (UK), they will eat a large range of foods in the wild, because there are a large range of foods available. So they choose to eat these, and Anne McBride says, enjoy the variety, but all the foods they do eat are still highly fibrous.

So onto the talk.

GI stasis is medical emergency.
GI (internal) obstruction is a surgical emergency. (adnominal catastrophe)

GI stasis causes hair balls (trichobezoar)
Internal obstruction is caused by hair balls

Sometimes anorexia is the only sign that something is wrong

Other symptoms
Shock
Hypothermia
poor circulation
Depression
Anorexia
Muscular weakness

When is anorexia surgical?
Dramatic and sudden loss of appetite
Hiding
Flopping
Straining (toilet)
Bloated abdomen

Rabbits cannot vomit because the muscles at the top of the stomach close so tight that they will not open to allow food out. Frances demonstrated this with ppictures of a stomach that she inflated, beyond fully, and it wouldn’t open.

Rabbits can regurgitate small pieces of food, but if they do this, they are likely to die.

Caecotrophs are NOT faeces – they are food !

Despite us owners talking about over feeding starch and protein rich foods, there is no evidence that rabbits cannot process these foods – they can. The problem with them is the potential for obesity, which does kill rabbits.

GI stasis – slow gut motility
Stops eating
Food doesn’t move in GI tract
Blood glucose goes down (this is important will discuss later)

Treatment: syringing 50:50 Heinz (or other) baby cereal with Critical care/recovery. The cereal should be vegan. 10-20 ml per Kg

This increases the glucose levels in the blood, creates fibre.

Go and pick/feed grass and dandelion/plantain leaves.

If no improvement in 24-48 hours, see vet.

Intestinal obstruction
Very common in rabbits
Usually matted hair
Leads to bloat
More prevalent during moulting time

During moult time, rabbits can re-ingest hair pellets from stolls which can contribute to a bigger hair ball
Med – Large ones can causes a blockage

Intestinal tumours are the other common cause

Foreign objects

Diagnosis:
Obstruction occurs suddenly, if rabbit was healthy at night, and anorexic in morning, then it’s more likely to be obstruction

acute abdominal pain and depression
Rabbit will show signs of discomfort – Like Hid – flop out, shift around.
Stress – Blood sugar levels RISE

If the obstruction passes, the rabbit will suddenly seem better – although the pain may then cause a gut stasis.

When to elect for surgery?
Difficult to know
Foreign body can pass through ok
Surgery may causes rupture

An obstruction can usually be felt on the Left Hand side, just under the rear of the ribs – it will feel like a balloon – not nec the obstruction, but gas (bloat).

Do not syringe feed bloat. Owners that use Infacol are not helping the condition at all – any signs of improvement are purely coincidental and the obstruction has worked through the rabbit.

Frances has developed a blood test to correctly diagnose whether the rabbit is experiencing GI stasis or GI obstruction. Not only that, but has got the variant degrees of blood glucose to determine each course of action.

This paper is currently under review for publication by the Vet Journal.

However, she was more than happy to share it with us, so I’ll share it with you!

Blood can be taken from the main artery in the ear, using a hypodermic needle. The skin needs to be exposed (shaved).

Blood glucose test kits can be bought for £10 from Lloyds, and are ideal for this. Frances is encouraging her clients to do these readings at home before deciding if rabbit needs to make the trip to the vet.

Blood glucose is measure in mmol/ml (millimoles/litre)

Normal: 4-8 mmol/ml

2-4 mmol/ltr – needs food – rabbit is experiencing gut stasis
If less that 2 mmol/ltr, call vet

8-15 mmol/ltr Rabbit is stressed, but can stay at home
More than 15mmol/ltr, less than 20 – Call vet, start to worry…
More than 20 mmol/ltr, needs surgery.


The last talk was on diagnostic imaging, and was very interesting, but solely visual, and apt for vets, not nec owners. Was given by Elisabetta Mancinelli, DVM MRCVS CertZooMed.
I took no notes for this one, sorry, but Elisabetta was explaning the differences in technologies for diagnostic purposes – and talked about CT, Radiography, MRI and Ultra sound, and their different uses

Thank you for that Jay. Some interesting stuff there.

Very interesting stuff, particularly the GI stasis stuff (for me).

Very interesting that you can test the bun at home (as we all know that the stress of taking bun to the vet can make things worse).

Did they say what the next steps were in using the findings from Hutch is not Enough study?

Thank you for that, it was a really interesting read. I really wish I'd gone, but being able to read the info has been great value.

Thanks for this Jay. Very interesting.

Something that stood out for me was the blood glucose testing to destinguish between bloat and stasis.

It states these tests can be done at home, but surely an owner would need some traning from their vet in order to do this? A friend works at my vets, she has the title VN but shes not registered so cant call herself an RVN. Apart from the initials, she said one of the things she cannot do is insert needles intraveinously. So is it right for owners to do this? Are there any other ways of getting a sample of blood? I know people can just do a finger ***** test...
Just wondering.

ETA: Is there any way of saving this? Possibly make it a sticky? It may be useful for future reference. If something came up re the buns health, there may be one or two things i could suggest to my own vet.

marleyNfriends wrote:Thanks for this Jay. Very interesting.

Something that stood out for me was the blood glucose testing to destinguish between bloat and stasis.

It states these tests can be done at home, but surely an owner would need some traning from their vet in order to do this? A friend works at my vets, she has the title VN but shes not registered so cant call herself an RVN. Apart from the initials, she said one of the things she cannot do is insert needles intraveinously. So is it right for owners to do this? Are there any other ways of getting a sample of blood? I know people can just do a finger ***** test...
Just wondering.ETA: Is there any way of saving this? Possibly make it a sticky? It may be useful for future reference. If something came up re the buns health, there may be one or two things i could suggest to my own vet.

It's pretty much as you've said above - it's just a pr!ck test. You just need to get a tiny blob of blood and get it onto a card (looks a bit like a memory card for a camera etc but smaller) and the small digital machine measures the glucose in the blood. It's a really simple process. The only difficult bit (for me anyway) is actually sticking the needle in the vein. A vet showed me how to do it with Elijah and he didn't even flinch when the needle went in.

Havent had time to read all of it as rushing this morning, but really interested in the econiculli part as Rory seems to have suffered with it in different degrees for most of his life- will definatley come back to this, thanks Jay, really useful x

Thanks for that Jay, it was really interesting

Big Ears wrote:

marleyNfriends wrote:Thanks for this Jay. Very interesting.

Something that stood out for me was the blood glucose testing to destinguish between bloat and stasis.

It states these tests can be done at home, but surely an owner would need some traning from their vet in order to do this? A friend works at my vets, she has the title VN but shes not registered so cant call herself an RVN. Apart from the initials, she said one of the things she cannot do is insert needles intraveinously. So is it right for owners to do this? Are there any other ways of getting a sample of blood? I know people can just do a finger ***** test...
Just wondering.ETA: Is there any way of saving this? Possibly make it a sticky? It may be useful for future reference. If something came up re the buns health, there may be one or two things i could suggest to my own vet.

It's pretty much as you've said above - it's just a pr!ck test. You just need to get a tiny blob of blood and get it onto a card (looks a bit like a memory card for a camera etc but smaller) and the small digital machine measures the glucose in the blood. It's a really simple process. The only difficult bit (for me anyway) is actually sticking the needle in the vein. A vet showed me how to do it with Elijah and he didn't even flinch when the needle went in.

Thanks, its definitley something id consider doing. Save a lot of time and money for both myself and the vets. Its clipping the ear to get the the vein that id stress over!

Brilliant idea re-panacur when your bunny has been at a rescue bonding.
When we brought Lilly home after she'd been at the rescue bonding with Ronnie, 2 days later she suffered head tilt/EC.
I didn't know about the 'muscles in the neck' thing either.
I think the vet who told me to put her to sleep should swot up on this.
So if I would have known about treating both with panacur when coming back home we could have had to rabbits happily married and not Lilly who has been left brain damaged who wants to kill Ron everytime she she's him.
Thanks Jay, will make a note.

Katieb wrote:
Did they say what the next steps were in using the findings from Hutch is not Enough study?

No, except that they hope it will will encourage a bigger study which will be definitvely conclusive. it was done for a master's degree paper.
There were a couple of expert niggles about the study - main one being that the study was in an enclosed courtyard, so safe from ground predators, but the runaround study didn't take into account that the rabbits may not have used it as much IF there were birds flying above.
Also, the run wasn't a seperate out in the open run - again, with an under hutch run, the rabbits would have been safe from birds, and would have known this.

The study wasn't preliminary as such, and has drawn some valuable conclusions, but those conclusions can are still open to scrutiny.

very interesting stuff, thank you Jay x

I just wanted to clarify the details regarding taking blood samples for the glucose testing. It is indeed hypodermic needles that are needed, it's the reason I've been having trouble getting the blood sample because the little needles for the finger pr!ck in the blood glucose test kits aren't suitable for purpose for inserting into the rabbits' ear veins for getting the blood for the reader. FHB very kindly today gave me some hypodermic needles to use with my glucose testing kit but they are available from VetUK as in link below. They come in different sizes but the ones I have been given, same as the one used for the demonstration I was given today, are 25g ones.

http://www.vetuk.co.uk/veterinary-supplies-needles-c-141_895/hs-hypodermic-sterile-needles-outer-box-p-4069

This is the blood glucose monitor recommended:
http://cgi.ebay.co.uk/ws/eBayISAPI.dll?ViewItem&item=300620885639

Thanks Alison