MJ's eye :(

Dear Mr Sanchez,

I was given your name by the owner of a rabbit you recently performed cataract surgery on ('Charlie') as I currently have a rabbit (MJ) who has developed cataracts in both eyes.

MJ has been referred to the D1ck Vet in Edinburgh and following an ophthalmology examination, blood tests and EC tests subsequently referred to Batchelor, Davidson & Watson in Edinburgh.

Having now had the consultation with Batchelor, Davidson & Watson I am not feeling entirely comfortable going ahead with the surgery without at least discussing it with someone else. Having read Charlies story and spoken with his owner I understand that you are the leading vet in the country in this area and the only vet in the UK carrying out the surgery that Charlie underwent. I hope you are able to offer some advice, or at least put my concerns to rest.

As previously mentioned, MJ has cataracts in both eyes. The first appeared in November 2014 and was 'mature' within around a week, the second appeared early April this year and again matured within a week. As such MJ has lost his vision very quickly and sadly is not coping very well. I had hoped to have surgery performed on both eyes, however Batchelor, Davidson & Watson have confirmed that they will only carry out surgery on one eye at a time. From my discussions with the vet (Malcolm Davidson) I am not sure that they would be keen to carry out the surgery on the second eye, also I am not sure if I would want to put MJ through the stress of surgery a second time especially as the surgery takes several hours.

Mr Davidson advised that they have never carried out this surgery on rabbits, only cats and dogs. He also advised that the surgery has a 90% success rate with dogs, he would expect that this would maybe be about 85% for rabbits.

If I recall correctly, the surgery involves removing the front of the lens as such MJ will be more long sighted after the operation, I do not know the extent to which this will be different to normal rabbit vision. MJ was particularly keen on running very fast and jumping onto things, I am not sure how much he required near vision for this.

I understand from talking with Charlies owner that the surgery he had was performed on both eyes at the same time and that the lens is replaced.

Not proceeding with surgery is not an option, MJ is very withdrawn, inactive and his appetite is very poor since losing his eyesight. Obviously the poor appetite is quite a serious concern with rabbits. However, I am currently not confident with what appears to be my only option. I do not know if getting a referral to yourselves would be possible, or if so if it would even be possible to travel with rabbits that distance (I am based in central Scotland) as they do not travel well. I would be extremely appreciative if you would be able to offer some advise.

Thank you in advance for your time,

Kind regards,

Dear Gayle,



Thank you for writing with your query on cataract surgery for rabbits.



I remember Charlie very well. I also have the pleasure of knowing Malcom in Scotland.



I have been performing cataract surgery for over a decade and have performed hundreds of cataract surgeries in dogs and cats. It is uncommon to have rabbits with cataracts that present for surgery, this is mainly due to cost. However, as more and more pet-rabbit owners seek better and more specialized care and as more pets are insured or have access to a wallet partially committed to their healthcare, we have seen an increase in referrals for this species.



Cats, dogs and even horses, like humans, have a commercially available intraocular lens implant (we call it an IOL). This is implanted inside of the eye (if surgery in that particular eye permits it) so that the eye can not only see after cataract surgery, but so that it can see in focus (without an IOL an eye that has undergone cataract surgery can see but it is really far sighted).



Cataract surgery in rabbits has been described before in the veterinary literature, but very few surgeries (single digit numbers) have been written about. There were other limitations. One of them is that no IOLs existed for rabbits and, at least historically, the surgery cost has priced out most rabbits, which meant few people would ever approach a veterinary cataract surgeon with a rabbit with cataracts. Lastly, their anesthesia is delicate and not everyone has access to a specialist in anesthesia who can be in charge of the anesthetic event during the surgery. I think this is why Malcom has communicated to you that few cataract surgeries are ever done in rabbits.



There are a small handful of animal IOL manufacturers in the world, and a prominent one is found in Germany (Acrivet). I have a good working relationship with them and I captured their interest to successfully recruit their help in manufacturing an IOL for rabbits. This IOL is not yet commercially available and I have had access to the prototype lens, which I have implanted in several rabbits with good success. I have used all the prototype lenses and I am waiting for a few more to arrive (I am not sure when I will get them but if we did surgery in your rabbit we should be able to plan our timings right). At the RVC we have specialists in anesthesia and they have experience with rabbits, who they like to see and welcome into the service. In addition, the financial director at the hospital here has agreed to have a special rate for cataract surgery in rabbits of £1,200 for one or both eyes (this does not include the initial visit (approximately £90) or subsequent ones (approximately £60) – I normally see rabbits once one week to ten days after surgery, then three months later, six months later and then once yearly). The price includes the ultrasound of the eyes done prior to surgery, the implants, anesthetic, hospitalization and specific eye-related medication to go home with for the first few days (all of this is normally £3,500 for both eyes of a dog or a cat).



We can arrange to see a rabbit one day and do the surgery on that very day, then send him/her home on that evening (normally a dog or a cat would come to the hospital one day, have the surgery the day after and leave the day after that – two night stay). So we minimize the hospital stay of rabbits but the owners have to agree to do the recovery at home (keeping them under observation, warm and using recovery formula if necessary for the first 24-48 hours, etc).



I hope this initial information helps a little.



Please remember if you wanted to book an appointment for an examination, we would need to hear from your veterinary surgeon, who would need to contact our reception team.



Best wishes,