Dealing with Medical Emergencies

Scene 1:You arrive home from work at 7:30 PM to find your rabbit lying unconscious on the living room floor. Next to her is a frayed lamp cord.

Scene 2: It is Sunday morning and you are hard at work on your fall planting. You enter your home to discover Beloved Bunny happily chewing on the last of your dozen newly purchased “King Alfred” daffodil bulbs.

Scene 3: You are making a last minute reconnaissance tour of the kitchen prior to the gang’s arrival for your famous New Year’s Eve party. You start to scoop the rabbit’s litter box and realize there are no fecal pellets present to scoop; come to think of it, there weren’t many when you cleaned the box 2 days ago either.

These are 3 typical situations where a rabbit owner has to decide on seeking out-of-hours care for their pet. Few owners would hesitate regarding the first extreme example of a comatose rabbit, but what about the second? And what about the third? And where can one take an ill rabbit at 1 in the morning or on a Sunday afternoon? Knowing the answers to these questions before a possible emergency ever arises not only decreases the amount of emotional turmoil experienced but will likely make a difference in the ultimate outcome for the rabbit. As prosaic as it sounds, the best way to deal with an emergency is to prepare well before one occurs.

This preparation starts with your regular veterinarian. What are her/his days and hours of operation? Some veterinarians keep extended hours on certain weekdays. Does your veterinarian refer to a certain emergency clinic? If your veterinarian works with many non-traditional animal species he/she will probably know which emergency facility in your area also treats these animals.

If your will have to go to another location with an out-of-hours rabbit emergency, have the name, address, phone number and directions posted prominently in your house as well as on your address book. Make a trial run by driving to the facility at least once so you have an approximate idea of how long it will take you. Fumbling through the Yellow Pages when you are half asleep or copying directions over the phone when you are shaking is stress you do not need and costs time your rabbit may not have.

Many house rabbit owners are concerned about finding an emergency clinician with expertise in rabbit problems and this is certainly the ideal. However, most emergencies require the same kind of treatment whether the patient is a cat, a rabbit or a pterodactyl! A bleeding wound in a house rabbit will be treated the same way it is in a Doberman. Good emergency room veterinarians are experienced in problems across species lines. Do not hesitate to bring a critically ill rabbit to an emergency room because the doctor is not a “rabbit expert”: there is not yet an Academy of Rabbit Internal Medicine and Surgery in the AVMA.

There are some simple assessments of your rabbit’s condition a house rabbit owner should be able to make. These should not take up a lot of precious time, but may help you to describe your rabbit’s condition to the emergency room personnel.

First feel the pulse either by placing a hand gently around your rabbit’s chest or by placing a finger in the groin area. If you do not feel anything, do not assume the worst. A rabbit in shock may have a slow, faint pulse that is difficult to detect. Next lift up your rabbit’s lip to check her gum color. It should be a healthy pink. Bluish or pale gums indicate a severe circulatory problem. Last is temperature. All pet owners should have a baby thermometer. Apply some lubricant to the thermometer, insert it gently into the rectum, and hold it there for about 1 minute. Normal rabbit temperature is about 101o F to 103o F.

First aid equipment necessary is minimal. You should have a thermometer, a heating pad or hot water bottles for shock or hypothermia, alcohol, cotton pads, and gauze bandaging material. Never place a heating pad directly on a chilled rabbit, as it is quite possible to burn him. First wrap the rabbit in a towel, then wrap the pad or bottle around the towel. If your rabbit’s temperature is above 106o F, a quick alcohol bath followed by cold towel wraps can be helpful before dashing to the emergency clinic.

Bleeding wounds should have a pressure wrap placed using cotton pads and gauze wrap. Do not apply tourniquets; permanent damage can be caused.

Once you have arrived at the emergency hospital, be sure to check in with the technician on duty. This is the time to speak up if you feel your rabbit is in critical condition. All emergency facilities use the triage system in which severely ill patients are seen first. Ask the technician to look at your rabbit if you are in any doubt. If your rabbit is comatose when you arrive at the hospital, tell a member of the staff immediately so that she can bring your pet straight to the back. Realize that you will not be allowed to go with your rabbit and understand why: there may be three or four critical emergencies being treated at one time. The doctor and technical staff must concentrate on the patients and extra bodies are most definitely not helpful. If your rabbit is stable, he will be seen after earlier arrivals and, of course, after any critical patients who come in later.

All emergency facilities are equipped with oxygen, X-ray and surgical equipment, and a variety of drugs to treat critical patients. After examining your rabbit, the doctor may wish to hospitalize her if her condition is not stable, especially if she needs oxygen or fluid support. This is in the best interests of your rabbit. Be sure to ask when you should pick your rabbit up and if there will be any special instructions for her care.

You should always take your rabbit to be re-examined by your regular veterinarian after a trip to the emergency room. In some critical instances where your rabbit needs continuous round-the-clock care, you may be transferring her directly to your regular veterinarian from the emergency room. With less serious problems, your pet will be discharged from the emergency room with a record detailing what type of treatment she received. Make sure you take this copy to your regular vet. Your regular veterinarian needs to see your pet both to make sure she is recovering as expected from the emergency and to be informed of this latest development in your rabbit’s history.

Good routine health care and a “bunny proofed” home can prevent most emergencies. But the unexpected can happen to any rabbit and any rabbit owner. Some forethought and planning and some hint as to what to expect may make the trip to an emergency clinic less frightening.

The question of what is a critical emergency is another problem for the rabbit owner. The following categories may serve as a guide:

I. Life-threatening-emergencies:

  1. Coma, stupor: Any situation where your rabbit is recumbent and minimally or nonresponsive to voice and touch. The rabbit may be in cardiac arrest from chewing on an electrical cord or in shock from a dog attack
  2. Seizures or sudden neurological changes: Falling to one side, head tilt, nystagmus (eyes moving constantly in one direction). Possible causes are systemic Pasteurella infection or hypoglycemia.
  3. Severe continuous bleeding: This can result from any type of trauma; dog attack, fall, run-in with an automobile.
  4. Hypo- or hyperthermia: In the first situation your rabbit will be ice cold to the touch usually recumbent and nonresponsive. In the second, your rabbit will be burning hot, panting, and sometimes seizuring.All of these situations require that you grab your rabbit, your car keys and go immediately to the emergency room. This is where your advance planning can save your rabbit’s life; you may have only minutes. Please find a good rabbit vet near you.

II. Serious Emergencies:

  1. All animal attacks: Even if your rabbit has only a small would and appears fine, he should be examined by a vet. Serious puncture wounds may be hidden under a thick coat of fur. Also, the trauma of the attack can cause extreme changes in your rabbit’s blood pressure and other homeostatic mechanisms; this is what is meant by “shock”.
  2. Maggots: Although far more common in rabbits housed outdoors, house rabbits are not immune. Maggots are fly larvae; flies lay eggs in open wounds, abraded skin, or areas where feces or urine have accumulated. Besides causing physical damage by burrowing into the rabbit’s flesh, maggots release toxins which can cause a severe infection or shock.
  3. Suspected poisoning: A wide variety of chemicals and plants can be toxic to rabbits. Many substances can cause delayed symptoms (such as daffodils), so do not be lulled into a false sense of security by apparently normal behavior. Be sure to take the suspected poison with you to the emergency room.
  4. “Minor” electrocution/drowning: These are lumped together because both of these accidents can cause pulmonary edema, fluid in the lungs. Pulmonary edema is evidenced by difficulty breathing and sometimes blue gums. Rabbits who nibble on electrical cords can also suffer severe burns. In the same vein, a rabbit which seems shaken but otherwise unharmed after being rescued from a swimming pool should still be examined by a veterinarian. The effects of pulmonary edema are not always manifested immediately.

III. Possible Emergencies:

  1. Respiratory problems, nasal or ocular discharge: Here the degree of distress your rabbit is showing must be evaluated. A minor snuffle or sneeze or a clear discharge from the eyes in a rabbit that is sassy and active can probably wait until regular hours. However, if your rabbit is breathing audibly with increased abdominal motions, she may well have an acute pneumonia.
  2. Diarrhea/constipation: Both of these can be extremely dangerous in a rabbit. A few soft stools just noticed today should not necessarily set off the alarm bell. But severe watery diarrhea may lead to dehydration even overnight. Conversely, scant hard fecal pellets indicate a possible obstruction or other gastrointestinal problem. If it has been two days since you have seen any pellets in the litter box and you know your veterinarian is closed for the weekend, the rabbit should certainly be seen at an emergency facility.
by Bronwyn Dawson, D.V.M.
Volume II, No. 4