Nasotracheal intubation can be used as an easy, less traumatic method of rabbit intubation when compared with orotracheal intubation.
Nasotracheal intubation takes advantage of the fact the rabbit is an obligate nasal breather.
Rabbits normally have their epiglottis entrapped on the dorsal surface of the soft palate, thus allowing direct passage of air from the nasopharynx into the larynx and trachea. A tube placed nasally will naturally traverse this pathway from the nasopharynx into the larynx and trachea.
Disadvantages
Potential complications include the possibility of introducing pathogens into the lungs and need for high oxygen flow rates. However, rabbits that received nasotracheal intubation in one study were observed over two months, and no clinical signs of respiratory disease were noted. In addition, high oxygen flow rates were unnecessary.
Metabolic bone disease is a common condition seen in almost all house rabbits with dental disease.
House bunnies, restricted from sunlight and eating a diet low in calcium, cannot maintain calcium levels.
The disease is similar to osteoporosis in humans, where there is lack of calcium in the bones. The actual disease is complex and many factors are involved.
The three most important elements involved in metabolic bone disease are calcium, vitamin D and parathyroid hormone. These three factors work closely to maintain calcium homeostasis in the blood.
Calcium retrieval
Bone acts as a storage point for calcium and phosphorous, when blood calcium is low, the body retrieves calcium from bone to maintain calcium stasis.
Dietary calcium needs to be more than 0.44% for blood calcium to remain normal in rabbits. Rabbits eating a diet with lower than 0.44% calcium (most rabbit mixes) will have low levels of calcium in the blood.
Kept in the dark
Exposure to sunlight is crucial for vitamin D synthesis. Vitamin D is essential for absorption of calcium in the gut. Animals with low blood calcium often compensate by producing vitamin D (with exposure to sunlight), and thus absorbing calcium in the gut. This is assisted by parathyroid hormone.
House bunnies, restricted from sunlight and eating a diet low in calcium, cannot maintain calcium levels, and therefore obtain calcium from the bone. Bone then weakens, resulting in dental disease.
Metabolic bone disease is probably the main reason why house bunnies develop dental disease so often. Wild rabbits have adequate exposure to sunlight and free access to grazing. Acquired dental disease is not seen in wild rabbits at all.
Antibodies to E cuniculi in rabbits can be detected on a blood test. Hence, a rabbit that has been infected by E cuniculi will produce antibodies that will produce a positive test.
However, some rabbits appear to clear the infection completely and over time their blood test will become negative again.
Have or have not
Until recently, tests available in the UK could not distinguish between current and past infection. A negative result basically ruled out E cuniculi as the cause of illness but a positive result only told you the bunny had been infected at some point in time, and did not help to determine whether the infection was recent and ongoing.
However, quantitative tests that can actually measure the levels of antibody in the blood sample (not just whether they are there or not) are now available in the UK, introduced by Medlab in Cheshire.
By testing two separate samples (taken with an interval between them) it is now possible to determine if a rabbit is mounting an immune response to an active E cuniculi infection.
Anorexia in rabbits is a medical emergency and should be treated aggressively.
Anorexia in rabbits is a medical emergency and should be treated aggressively.
Subcutaneous, intraperitoneal or intraosseous warm isotonic fluids given several times daily will improve hydration and help stabilise the rabbit. Fluids can be given using a 20 or 22 gauge needle into the medullary cavity of the femur.
Syringe feeding nutritious high fibre slurry will increase nutritional status, help prevent ileus and rehydrate stomach contents.
Commercial products such as Critical Care, or homemade diets – such as yoghurt mixed with pureed vegetables, ground feed and glucose solution or baby pablum with a small amount of psyllium fibre and probiotic powder – have also been used successfully.
A venipuncture site should be chosen where the skin is clean and has no obvious inflammation or infection. The marginal ear vein or the lateral saphenous vein are usually good choices.
The fur should be clipped and the skin cleaned. EMLA cream can be applied over the site 45-60 minutes prior to venipuncture and covered with a dressing or cling film. The site should then be wiped with surgical spirit.
The vein is raised and the needle should be inserted at a very acute angle, almost parallel to the skin.
Gently does it…
Use only very gentle pressure to draw back on the syringe plunger, to prevent the vein from collapsing.
Too great a pressure may also damage the blood cells, especially when using a small gauge needle. Rotating the needle around its long axis so the bevel faces sideways or downwards may improve blood flow if the vein appears collapsed.
After taking the blood, pressure over the venipuncture site should be applied as rabbit veins are prone to haematomas.
It is generally accepted rabbit anaesthesia can be challenging, but we do a lot of rabbit neutering as part of our work for an animal charity and use a protocol that has proved very safe and effective.
We also use yellow gauge catheters placed into an ear vein for IV administration.
Combine these drugs in one syringe and inject subcutaneously 20 minutes before procedure.
Rabbit will become quiet and relaxed.
Ketamine 0.2ml/kg diluted with 1:10 saline (that is, 0.2ml ketamine in 2ml saline).
Give this slow IV to effect.
Most rabbits use half a syringe, but occasionally I have had to use the whole syringe. If it is not having an effect, flush the catheter, and mask with isoflurane if required.
Rabbit will react if it goes extravascular;
once induced, spray Intubeaze and intubate – listen to breath sounds; there is usually no cough.
Rabbit can usually be maintained on 2% isoflurane.
Slower to wake up, but eating.
Hypnovel must be discarded within 24 hours, so better to try to book in all rabbits on the same day.
Sticky bottom syndrome in rabbits is most often caused by feeding a badly balanced diet, or simply feeding too much food, resulting in over-production of caecal droppings. Rabbits will not eat the excess pellets.
Fat and elderly rabbits (especially females with large dewlaps) are also at risk as they may not be able to reach their bottoms to practice coprophagia and to clean.
Rabbits with dental disease may not eat their caecal pellets and won’t groom themselves properly either, also putting themselves at risk.
Pet rabbits can get worms (usually if fed on green food collected from areas frequented by wild rabbits), but clinical problems are said to be rare. However, some rabbit owners report sticky bottom problems clear up after the rabbit is wormed.
With pre-exam stress in full swing for most of us, we welcomed a break in the form of the Glasgow Vet School Rodeo last weekend. The annual charity event took place for the 53rd time this year.
Poster for the 53rd Glasgow Vet School Rodeo
Traditionally (from what I can gather), it used to be somewhat like a country show, with stock showing, sheep herding and the like. Now, it’s more of a family day out with many displays and stalls of different natures, though all loosely animal-related.
Entertainment throughout the day included displays such as falconry, duck herding and dog sledding. There was have-a-go dog agility and dog showing for the public to enter their pets into. For the children, there were pony rides, bouncy castles, laser quest and a climbing wall. Of course, there was a marquee full of craft stalls and all sorts of different tombola and raffle stands supporting various animal related charities.
The proceeds from the entry tickets and the main raffle went towards four key charities: The Riding for the Disabled Association, Canine Partners, The Scottish Society for the Prevention of Cruelty to Animals (Scottish SPCA) and The Vet Fund (James Herriot Scholarship Fund). In addition to these, many other animal and breed-specific charities had their own stalls.
It is a vet school tradition that first years “volunteer” on the day. My friend and I spent the morning helping out on the “small animal” stand – there were a selection of small furries including rabbits, hamsters, mice and guinea pigs available for the public (mainly children) to handle. Our role was to help get the animals out of their cages and make sure there were no escapees. Other than my small disagreement with a rat (it sank its teeth into my finger in response to being picked up), we enjoyed our time chatting to people and brushing up on our handling skills.
In true Glasgow style, the day ended with a ceilidh – a great day and evening was had by all of us at the vet school!
Organisers of Rabbit Awareness Week (RAW) are calling on the UK veterinary profession to help highlight and educate about the importance of preventive health care for the nation’s third most popular pet by signing up to the free initiative. (more…)
Everyone knows that there’s an ancient feud between vet and medical students. Glasgow is no exception – only the other day, I had a heated debate on the topic with another student (who, annoyingly, wasn’t even a medic).
While, for the most part, it’s just friendly banter, there is some truth in both arguments.
A doctor will usually have one area of focus and will spend his whole career becoming more and more specialised in that particular field, whereas a vet will be the GP, surgeon, physio, neurologist and much more for several different species, not just one. As a first year student, it’s sometimes a little scary and overwhelming to think about the broad spectrum of knowledge we need to gain in just five years.
When the medics graduate, they’ll become junior doctors and from then on will begin narrowing down their fields of interest until eventually finding themselves as “left toe specialists”, or something. In 4.5 years, we’ll be let loose into the world of veterinary and, at the end of day one, will have probably already spayed a cat, pregnancy tested a few cows and euthanised a dog, with a rabbit or bird thrown in somewhere too.
Not only are the medics likely to be more specialised than us, they also “go further” than we do in terms of treatment. In my interview for Glasgow vet school two years ago, after expressing an interest in orthopaedics, I was asked the ethical question: “How far is too far?”
The Bionic Vet
I didn’t really have an answer but tried to reason my way through it, discussing things like kidney transplants in cats in America and The Bionic Vet, and came to the conclusion that every case must be treated individually, having weighed up the pros and cons of “heroic treatments” in each situation.
Now I realise that these heroic treatments are fairly uncommon in the veterinary world. Kidney transplants, for example, which are routine in medicine, are non-existent in veterinary in the UK. Is this a consequence of lack of funding and resources or lack of experience and knowledge in the field? Probably a little of both.
The GP vet will play the role of all these specialised fields to some extent (some being more qualified to do so than others). While we can specialise and work in referral practices, the average mixed or small animal vet will find themselves becoming a “Jack of all trades and master of none”.
Does that make us more intelligent than the medics, or just more well-rounded? Is it better to have a broad spectrum of knowledge and practical skills or to be very skilled at a few specific procedures?
