RABBITS – common problems, illnesses and conditions

CottonTails Rabbit & Guinea Pig Rescue > Information & Resource Centre > Health and Welfare > RABBITS – common problems, illnesses and conditions

Here, you will find helpful advice to correctly identify diseases and common problems associated with rabbits and how to manage or even resolve the symptoms.  We start with a really important topic – how to administer medications.  Throughout the article are extensive descriptions of diseases and common problems, illustrated throughout with photos and films.

Giving a rabbit medication by mouth

This can be a challenge, no matter how tame and friendly your rabbit may usually be!  If the medication is in powder form, mixing it into something the rabbit will enjoy is easier.  For example, measure half a tablespoon of dry “Critical Care” and mix it with an equal amount of fruity baby food, then add the medication.  If the medication is in liquid form, it is sometimes easier to add something sweet, such as Ribena, as the rabbit is far more likely to take it if it is flavoured with something tasty.

Moulting or Shedding

It can be alarming to find your usually perfectly-furred rabbit suddenly looks like it has been dragged through a hedge backwards, with large clumps of fluff dropping off or sticking out at strange angles.  This is usually just moulting and is normal.  However, there are exceptions to this.


Rabbits go through periods of moulting or shedding regularly, starting with the change of coat at a few months old when their baby coat is replaced with their adult coat.  From that point on, they may moult once a year or several times a year depending on the individual and also their environment.  House rabbits, for example, are often in perpetual moult, and this can cause significant problems with the constant shedding of fur all over carpets and furniture.  Grooming affected house bunnies can help keep this to a minimum.

The most common place the moulting starts is at the head end, working its way towards the tail. This process can take from under a week to a month or more.  The pattern also varies; some will moult in patches, some in clumps or waves with clear marks between the old and new fur.  The new fur is often darker, which can cause colours to change visibly over a season.  This is especially noticeable in Sable rabbits, which are almost orange in the summer and go very dark in the winter.


Most rabbits manage their moults themselves, but it is sometimes best to gently brush or comb the loose fur out to prevent too much from being consumed.  Although gut stasis is not caused by hairballs, having a large quantity of fur in the stomach or digestive system will not be helpful.

Although moulting is expected, some ailments can have a similar appearance, so you must first check to ensure that all is well.  Check for:

  1. Patches of thick flakes of white dandruff – burrowing mites are the cause that needs treatment.
  2. Pregnant females or females with false pregnancy – such females will pull fur from their bellies and sides to make a nest.
  3. The skin looks sore, red or itchy – possibly a fungal infection which needs treatment.
  4. Bald patches appear without signs of a moult – possibly a hormonal cause, stress-related alopecia, or even nutrient deficiency.  Vet advice should be sought.

Neutered male pulling out his fur and running around with hay in his mouth

Female rabbits that have not been spayed will sometimes pluck fur from their dewlap or abdomen to make a nest.  This behaviour is often accompanied by the carrying of hay in the mouth.  Some females go to such an extreme that they will strip the whole hutch of bedding and pile it up in their chosen spot.  On the basis the female is not pregnant, the condition is called a false pregnancy, and her hormones drive her to behave in this way as she is convinced she is about to give birth.  She may also get moody and aggressive during this time.  False pregnancies are often triggered by another rabbit mounting her, male or female, as this stimulates her body to ovulate in preparation for conception from a fertile mating.

Rabbits are induced ovulators (as are cats and ferrets), so they do not have a regular reproductive cycle, and although mounting behaviour is the main trigger for a false pregnancy, it can also be triggered if other rabbits are nearby.  This condition can last from a few minutes of fur pulling to several days of frantic behaviour, and you are best to leave the nest intact until the female has lost interest in the whole thing and only then clear it away.  Below is a short film of a female pulling fur from her dewlap and then running off to place it carefully in the nest area.  The photo below shows Florence’s nest – she gave up after a few minutes, so it is not the best example of a fur-lined nest!  It is best to neuter both sexes of rabbits and females, especially for health and behavioural reasons.

nest with fur 21.12.13

Overgrown claws

Rabbits’ claws can grow quite quickly, especially if they are on a soft surface such as grass or soft bedding.  The claws must be clipped regularly to prevent them from growing too long and causing problems to the rabbit, but this can vary from rabbit to rabbit.   Some need claws cut every three months, and others only once a year.  The part that needs to be kept short is the section beyond the live bit.  It is easy to see the pink live part on white claws, but dark nails make it harder to see how far to cut.  If you are not confident about clipping the claws, do not attempt it until your vet or another competent person has shown you. Otherwise, you could cause bleeding, pain or distress to your rabbit. If you are confident that you know what you are doing, the following may help:

When I clip rabbits’ claws, I usually sit with the rabbit on my knee and turn them gently upside down so the head is held between my side and my left arm (I am right-handed). This makes it easier to access all four paws, and most rabbits do not struggle in this position. The more you practice, the better you will get at it.  For dark claws, it is usually easier to see the live bit by looking from underneath the claw, as there is a change of shape and a slight change in colour between the live and “dead” bit.  Do not cut right on the line; leave a few mm’s so you are not cutting too close.  Another method is to use a torch for dark claws and shine it through the claw to show the live part clearly. The photo below shows what can happen if a rabbit’s claws are not clipped regularly, especially if confined to a hutch or carpeted area.

rabbit care 57 12.4.13

Remember to check your rabbit’s dew claws, too – these are the claws on the front paws in the “thumb” position, slightly higher up the leg on the inside.  If not checked and clipped regularly, the claw may grow in a semi-circle and grow into the rabbit’s paw, causing injury and lameness.  The photo below shows such a claw before it was trimmed.  Thankfully, it was spotted before it had pierced the skin.

dew claw curled 19.11.14

Encephalitozoon cuniculi (E. cuniculi)

Although head tilt in rabbits is commonly caused by infection with the parasite E. cuniculi, there are other possible causes too:  bacterial infection such as pasteurellosis; tumour; abscess; trauma such as fractured skull; disease affecting blood circulation; bacterial meningitis; toxoplasmosis; ear mites; neurological disease; virus.  Encephalitozoon cuniculi is a single-celled parasite of rabbits.  Common symptoms are head tilt, loss of power or movement in the hind limbs, inability to keep balance, increased drinking (although this can indicate other illnesses), and urinary incontinence, and rabbits may show one or several symptoms.  E. cuniculi can cause partial or complete paralysis, kidney and eye diseases, and often kills.  At least half of all pet rabbits have this parasite, possibly even more.  Wild rabbits are not usually the source of infection as it rarely occurs in wild rabbit populations, although it is known to be present in rats and mice.

A rabbit becomes infected by eating or drinking the spores passed in the urine of infected rabbits, or it can be passed from mother to babies before birth. Rabbits often show no sign of the infection but will remain carriers until additional factors such as stress or illness trigger the disease.  Treatment with Panacur or Lapizole should eliminate the parasite from the rabbit’s body. However, some of the effects of E. cuniculi infection are irreversible, and treatment will only stop the progression of the disease.   It is important to remember that spores survive in the environment, and disinfection of runs, hutches, bowls, and other equipment is therefore necessary to avoid re-infection.  It is still unclear whether treating rabbits not showing symptoms is worthwhile, but the usual rule of thumb is treatment for nine days as a precaution and 28 days if the rabbit is showing symptoms.

Breathing Difficulties

Rabbits are well known for their twitchy noses and relatively fast breathing, and identifying what is normal for your rabbit is essential so you can spot any changes immediately.  Breathing problems are severe and can have several causes, such as chest infection, lung issues such as tumours, and even heart disease.  The film below illustrates a rabbit with chronic lung disease and its associated symptoms.  If you think your rabbit may have similar symptoms or other indications of illness, you should contact your vet immediately.


Excessive grooming of one rabbit by another

Occasionally, a rabbit may exhibit obsessive grooming, which can cause fur damage and even skin infection due to an area being almost constantly licked.  This can occur in males and females, although I have encountered more cases where the offender is a neutered male who appears to be obsessive regarding mounting behaviour, repeatedly pulling at the fur on the back of the neck of the other rabbit.  I have had some success hanging up several salt and mineral blocks around the run and hutch, especially where the rabbits like to sit, as this is often where the offending behaviour occurs.  Although I am not in favour of these blocks in general, they can be very helpful in persuading the rabbit to turn their attention towards the blocks when the urge to groom occurs.  Some products are available that can be lightly sprayed on the rabbit’s fur, being “chewed,” and due to the unpleasant taste, it can also assist in helping the rabbit change their ways.

Something to also be aware of is the reaction of some rabbits to vaccination.  Some react badly and form a weeping or dry sore on the nape of their neck and across the shoulder blades.  This can attract the attention of another rabbit, who will lick the area for long periods.  You may jump to the wrong conclusion if you are unaware of the cause.  Vaccination sores usually get better independently;  just keep the area clean and dry. Lightly applying baby talcum powder to the area may prevent another rabbit from paying it too much attention.  Although not a cause in itself, excessive hair consumption may be the final trigger for the onset of gut stasis in a rabbit that is prone to this often fatal condition, so this issue should be taken seriously.

Female rabbit making a squeaking sound

The film below illustrates well the sound that some females make if persistently mounted by either a male or another female, and this should not be ignored if she continues to make this sound for more than a day or so as it indicates she is distressed and anxious.  It can be a common sound when bonding a neutered female with a neutered male and usually fades after a few days when the male’s interest reduces, and she starts to trust her new friend.

In the case of the two sisters in the film below, there was clearly an imbalance in the pairing, and shortly after the film was taken, they were separated and subsequently spayed and each matched with a suitable neutered male.  The squeaky female did not make her sound again, not even when bonded with a male, and was much happier.


If your rabbit never appears to hear you coming and only seems to respond to vibration or visual cues, they may be deaf.  This is uncommon, but I have encountered this in some individuals; my latest case was an albino lop.  It is best to check that there are no external problems, such as ear mites or infections, as this would cause hearing loss, too.  Also, bear in mind that rabbits’ hearing is different from ours in respect that they cannot pick up lower frequencies but can hear higher frequencies than we can, as discussed in the following scientific paper: www.lsu.edu/deafness/HearingRange.html

Paddling with hind feet or front feet

An owner may notice that their rabbit is shifting from one foot to another, giving the appearance of paddling, and this can be either the hind feet or front feet.  This indicates severe pain and should not be ignored.  In rex rabbits, it may mean that the balls of the feet are infected and sore, and an affected rabbit will often flick the front feet around in desperation to ease the discomfort (see the full description of the sore hock issue further down).  However, this should not be confused with the flicking of the paws before a rabbit washing its face.  Paddling of the back paws can also indicate pain in the lower abdomen, often accompanied by the drawing in of the abdomen muscles, giving a very pinched appearance.  A vet opinion must be sought quickly as any rabbit in pain is prone to the onset of gut stasis, a severe and often fatal condition.

Chin Rubbing

The photos below show rabbits rubbing their chins on various surfaces.  This is typical scent-marking behaviour and usually increases in frequency if the rabbit is put into new surroundings.  The rabbit is simply saying, “This is mine now”!

rabbit care 58 12.4.13

rabbit care 59 12.4.13

Infected scent glands

Most pet rabbit owners are unaware that a rabbit has two scent glands on either side of the genital area just in front of the tail.  There is a long pouch-like structure on either side into which small amounts of “scent” are secreted, and in normal circumstances, this is not a problem.  However, sometimes, the secretions can allow an infection (bacterial or fungal) to develop, and this causes discomfort to the rabbit. The odour is attractive to flies, too, increasing the risk of fly strike.  Rabbits that are overweight can be particularly prone to this condition.

The photo below shows a rabbit with the start of an infection in one of the glands.  The black colour is just the dried-up secretion and is not a problem, but the creamy puss that accumulates underneath is a concern.  The area should be cleaned gently but thoroughly with a moistened cotton bud and a soothing antiseptic or antifungal cream sparingly applied.   If the skin appears very red and sore, the rabbit may need a topical antibiotic cream from the vet to help the area heal.

rabbit care 60 12.4.13

Diarrhoea/gut stasis/bloat

Please also take a look at a separate article on this subject.  Mucoid enteritis, diarrhoea, bloat and gut stasis are the commonest killers of rabbits, the first three conditions being widespread and severe for rabbits under six months of age.  Diarrhoea in baby rabbits is prevalent when a rabbit is initially purchased, and the stress of the change of environment and diet changes the gut’s acidity, resulting in often fatal diarrhoea.  Gut stasis is associated more with adult rabbits, as diarrhoea in adults is relatively rare.  Bloat tends to come on suddenly without warning and can occur as a condition in its own right or the final stages in a rabbit with gut stasis or mucoid enteritis.  Gut stasis occurs when the gut motility slows down or grinds to a complete halt so nothing can get through, and gases build up.  Mucous in the droppings and diarrhoea usually indicate mucoid enteritis.

Mucoid enteritis may be triggered by stress, such as moving to a new home, fighting with another rabbit, changing diet, etc., but there is also an infectious form that can kill high numbers within a herd.  The onset of symptoms is sudden and includes some but not necessarily all of the following:   loss of appetite, few or no droppings, small misshapen droppings, sitting huddled in a corner or stretched out in obvious pain, bloated stomach, diarrhoea, jelly-like substance (mucus) being passed.  This condition is severe, and the rabbit must be taken immediately to the vet.  60% of rabbits under six months of age affected with this illness will die, with adults having a better recovery rate with only 30% fatalities. The photo below shows a normal dropping along side a dropping encased in thick jelly-like mucus, indicating that the rabbit concerned has severe gut inflammation.

rabbit care 61 12.4.13

How can you prevent the onset of this condition?  Be aware of your rabbit’s regular feeding, behaviour and dropping patterns; any deviation from the norm needs a closer look.  Some bunnies will go slightly off their food, but with a nice piece of vegetable or some tasty grass or dandelions, their tummy gets going again without needing medication or a stressful trip to the vet.  I always feed my rabbits in the morning and watch them to see that they are coming forward readily to eat and are actually eating, not just nibbling and walking away.  Also, I give a fixed amount of dried food, which they always finish within a short time, so if there is any left by the next day, I know there is a problem.  If there appears to be something wrong, my next step is to offer something tasty to eat and see if that is accepted.  If not, I then start on the following medications, but bear in mind most owners will not have such medicines on the shelf unless the rabbits have had a history of this problem.

Metoclopramide injection (repeated every 8 hours as required), which stimulates the gut to start moving again; Metacam given by mouth, which provides pain relief (once daily for a few days only); a sachet of probiotic Bio Lapis (Protexin) mixed with warm water to make a cream which is then syringed into the mouth of the rabbit (I give as much of this as they will take, and give this two or three times a day, thankfully they usually like the taste).

There is some evidence that Infacol (available from chemists in the high street) may be helpful if the problem is gas in the stomach or small intestine as it works by joining all the tiny gas bubbles into one bigger one, which is easier then to pass along and out the body.  Warmth is also important, and I use a heated microwave pad and place it beside the rabbit so they have the choice of lying on it or moving away.  Fluids must be given if the rabbit is dehydrated, but the vet usually does this as the saline needs to be injected subcutaneously or given as a drip. The photo below shows a rabbit in the advanced stages of bloat.

rabbit care 62 12.4.13

The most important thing is to quickly notice that something is wrong and get the rabbit straight to a good vet if they don’t respond to the offer of a treat.  Sadly, in most cases of severe bloat/gut stasis/mucoid enteritis, the rabbit usually dies within five days despite anything that you do. Still, if it is caught early enough, there is a chance of survival.  There appears to be an infectious element involved in some cases, especially when litter is affected, as it can wipe out the whole lot of them.

I have found that keeping the E. cuniculi levels down by giving Panacur increases the chances of survival and may also even offer some protection against gut stasis.  Some owners find that providing no dried food to their rabbits cures them of recurrent gut stasis, so this is worth considering.  However, you must ensure copious amounts of good quality hay and suitable green vegetables are available. On the subject of pain relief, there seems to be enough evidence to show that Metacam is far safer than Rimadyl (Carprofen), which some vets will suggest using.

Rimadyl can and does cause more issues with liver problems and stomach lining irritation than Metacam, so do check what medication is being used.  Have a look at this site for more info: forums.rabbitrehome.org.uk/showthread.php?t=65230

Spotty rabbit syndrome – there appears to be a genetic predisposition in certain breeds of rabbits to gut stasis issues, particularly in the English (dalmatian) type rabbit, but this does not mean that every spotty rabbit will have a problem!  It is undoubtedly the case that once a rabbit has had a bout of gut stasis, it may be prone to further issues, possibly due to a narrowing of the gut due to the effects of the previous inflammation.

A rabbit prone to gut stasis issues may occasionally be triggered into this condition by consuming large quantities of fur during their own or their partner’s moult if the moult is excessively heavy.  With such a rabbit, it is wise to make sure that you remove excess fur from themselves and their environment daily as a precaution.

Bladder stones and sludge

Although most rabbits never develop stones or sludge in the bladder, there is a minority of individuals who are, for a variety of reasons, prone to this severe condition.  It can affect any breed, at any age, and both sexes. It isn’t easy to treat due to a high rate of re-occurrence.  Symptoms vary but can include an increase in urination; urinary incontinence where the rabbit becomes wet around the tail and back legs from urine dribbling out; straining to pass urine; blood in the urine; the urine appearing to be very much thicker than usual; generally appearing to be unwell.  Some rabbits only show one of these symptoms, or the symptoms are so subtle that an owner may miss them.

To complicate the situation further, these symptoms can also have other causes, so it should not be assumed that bladder stones or sludge are the cause.  Veterinary advice must be sought immediately.  It is not known why a small minority of rabbits form stones whilst some form sludge, but it would appear that bladder sludge does not go on to form stones.

Most rabbit urinary stones are made of calcium carbonate (chalk) and can be found in the kidney collecting ducts, the ureters, and the bladder. Sometimes, a stone can be passed by the rabbit via the urethra and left behind in the litter tray. A larger stone occasionally gets stuck in the urethra, entirely or partially blocking urine flow.

If a stone is found in the litter tray, you should not assume that is the end of the problem, as others may still be present. Bladder sludge is a thickening of the urine with calcium salts, resulting in urine that does not flow properly.  Sludge can also form in the kidneys and ureters, but most is formed in the bladder.  The sludge can be as thick as toothpaste or have a runny, grainy texture, and an experienced rabbit handler can feel this if the lower abdomen is gently palpated.  In such cases, the bladder often feels distended and “doughy”, and sometimes the sludge can be voided manually if done carefully.  However, bladder stones or sludge will reoccur if the cause is not found and dealt with.

Humans and most domestic animals only absorb the calcium from a meal needed by the body at that time; any excess is either left unabsorbed or processed by the liver and excreted in faeces.  Rabbits, however, appear to absorb calcium in excess to their needs and excrete it mainly in urine in the form of calcium carbonate.  This is what makes rabbit urine cloudy compared to human urine, and you may have noticed that when rabbit urine dries on the bottom of a litter tray, it has the appearance and texture of chalk.  A rabbit’s blood calcium level is always significantly higher than that of many other domestic animals, and this is normal for rabbits, which should be borne in mind if the vet carries out blood tests. Factors that can predispose a rabbit to bladder sludge or stones are many and include the following:

  • Not drinking enough water.  This could be caused by a frozen or faulty water bottle, overturned bowl, or contaminated water (some rabbits don’t like vitamins added to the water, nor the taste of water from a bottle covered in green algae).  Ensure the water source is clean, working correctly, and always available. Adding some natural fruit juice to the water may be worth trying to encourage increased consumption for a rabbit that drinks very little.
  • Being overweight and inactive.  A rabbit that sits around all day is not healthy from any point of view, and urgent steps must be taken to correct the diet and encourage exercise.  You can increase the chances of the rabbit moving around more by ensuring access to exercise at all times and providing items like wicker baskets, cardboard boxes, tubes, and other items to stimulate interest. If the rabbit is on its own, it is worth considering doing a match-up, as rabbits often exercise more if living with a compatible partner. There are tips on diet, accommodation and company elsewhere on this website.
  • Some rabbits are very fussy about where they urinate, so it is essential to provide a suitable litter tray or quiet area that the rabbit can access at all times.  If a rabbit hangs on for too long before urinating regularly, this will cause the urine to become more concentrated.  This can be an issue if transporting a rabbit somewhere in a pet carrier regularly, as many rabbits will refuse to urinate whilst in there.
  • Other health issues such as kidney or bladder disease.
  • Giving food that contains high calcium.  Although it has been shown that feeding rabbits on a diet that contains high calcium does not cause bladder stones or sludge, it would make sense to choose a diet that is lower in calcium and avoid products that contain alfalfa.  A good quality meadow or timothy hay is vital to a rabbit’s health, but pet stores’ concentrated dried grass products include alfalfa and should be avoided.  Vegetables such as kale and spinach should be given as an occasional treat only, but other dark green leafed vegetables are an important part of a rabbit’s diet as they contain large amounts of water and should be given daily, building the amount and variety up slowly to avoid digestive upsets.  Herbs should only be provided once a week.  Grass, of course, is the best food a rabbit can eat!

Food items to avoid for a low-calcium diet:

  • alfalfa hay, alfalfa pellets or treats
  • all concentrated rabbit mix (pellets or muesli mix)
  • carrot tops
  • goose grass
  • kale and spinach

Food items to include for a low-calcium diet (but remember to introduce them slowly):

  • dandelion leaves (maximum two leaves a day)
  • cabbage
  • celery
  • chickweed
  • mixed meadow or Timothy hay
  • grass
  • maize (including sweetcorn leaves)
  • swede and turnip
  • watercress 

Overgrown front teeth and molar elongation

For more information on this topic and the results of a 19-year study into breed susceptibility, do have a look at the Dental Disease article on the website

Also referred to as malocclusion, this condition is usually inherited from parents, but incorrect feeding can worsen the situation.  The teeth must either be trimmed every three weeks for the rest of the rabbit’s life or removed altogether.  This severe condition must be attended to urgently; otherwise, the rabbit may starve to death or, at the very least, be in significant pain.  The photo below shows the length of the teeth after only three weeks of having been burred (trimmed) by the vet.  Compare this with the fifth photo below of a rabbit with normal teeth.

The two photos below show a rabbit with border-line malocclusion, as the lower teeth are only just catching on the “peg teeth” (the little teeth immediately behind the top incisors), which are growing abnormally.  Experience has shown that within months, the lower incisors will miss the peg teeth altogether, resulting in the upper incisors growing down towards the chin with nothing to stop them and the lower incisors growing upwards into the roof of the mouth.

A severe case of malocclusion is shown in the photo below.

A rabbit with normal front teeth is shown in the photo below.

Overgrown back teeth (dental disease)

The photo above shows a large back tooth spur protruding into the cheek of the rabbit, making a large ulcer (the red colour is not blood, but the shadow from the flash).  This rabbit showed no external signs of any problem, although he must have been in considerable discomfort. The photo below shows two of the molar spurs removed from a rabbit that again showed little sign of dental disease apart from being thin and rather fussy with his food (the cotton bud is in the photo to indicate size).  The second photo is a shows molar spur before its removal.

Dental disease symptoms may include weight loss, runny eyes, poor appetite, dribbling, and dirty bottom/soft droppings.  This condition causes distress and pain and needs urgent attention. The tooth spurs will usually repeatedly re-grow, resulting in frequent expensive trips to the vet.  Dental disease cannot be cured, and if the rabbit is young, it may be best to consider euthanasia to prevent future suffering.

If the rabbit is over four years old and the dental disease is not too severe, it may be possible to keep it in check with regular tooth burring by the vet, but this is not always an appropriate course of action.  The photo below illustrates how the eyes can be affected by disease of the back teeth, usually caused by the teeth roots growing in the wrong position and pressing on the tear ducts, shutting them flat so tears flow onto the face instead of down the tube and away via the nose and throat (officially known as Dacryocystitis).

rabbit care 69 watermark 12.4.13

There are ways to manage a rabbit with this symptom of dental disease.  Once veterinary opinion has been sought regarding the dental issues, various things can be done to minimise the impact of overflowing tears.  Antibiotic eye drops can be helpful if the eye is inflamed or infected, with eye redness and discharge being the main symptoms.  To manage the condition daily, the matted fur around the eye has to be trimmed back to allow air to circulate, thus decreasing the chances of fungal and bacterial infection developing on the skin around the eye due to the damp conditions.

The rabbit needs to be held gently but firmly, wrapped in a towel if this helps. Take a damp cloth and gently wipe around the area to soak the fur (ensuring water does not go into the eye), making removing the formed sticky mats far easier.  Letting the water soak into the mats for a few minutes can make removing them easier. A pair of short-bladed scissors is needed to gently trim away the fur, gently combing out some of the mats if possible beforehand if this can be done without causing the rabbit distress.  Don’t worry too much if you snip off a whisker or two – they will grow back again.

Make sure the whole area around the eye is trimmed short, and once you have finished, you can gently wipe the eye with a damp tissue to remove any stickiness still lurking.  If you are unsure you can do this safely, do not attempt it and ask your vet to do it.  Depending on how quickly the fur grows, you will likely need to trim around the eye every two weeks.  Daily, gently wipe the eye area with a damp tissue to keep the discharge under control.  You may find that if your rabbit has a bonded bunny friend, the eyes will be kept clean once you have removed the bulk of the matting, as many rabbits seem to find licking the discharge quite inviting!

Although, in most cases, the discovery of severe dental disease means a shortened lifespan for the rabbit, in some sporadic cases, the symptoms of abscesses and osteomyelitis (where infection gets into the bone of the jaw, which swells considerably) can be given a reprieve by medication.  However, the symptoms usually return, so at best, all that can be achieved is to put off the inevitable for a while.  Below is an x-ray of a rabbit skull, showing how long the teeth’ roots are and the gap between the back molars and the front incisors.  This is the gap used by owners when trying to administer medication into the mouth of a reluctant rabbit recipient!  It is also evident from the x-ray why molar root infections can affect the eyes, their position being just below the eyes and the tear ducts.

Red urine

If there are no other symptoms, red urine is usually due to pigmentation from the food, colouring the urine red or brown.  Dandelions can often cause this, as well as apple bark from twigs and branches, and it is nothing to worry about.  However, check that the water bottle works properly, especially in the winter when water may become frozen in the spout.  If unsure, seek veterinary advice as sometimes red urine may indicate the presence of blood, possibly due to a bladder/uterine problem.

Fly Strike

Rabbits soiled with droppings or urine are at high risk from this condition – flies lay their eggs on any area of the rabbit that is wet or dirty (especially around the genital area), and the resulting maggots eat into its flesh with very distressing and often fatal consequences.  This is particularly common in the summer, so check your rabbit daily if it is at higher risk, as the fly eggs hatch in under 12 hours.  A rabbit with maggots must be taken to the vet immediately.  Healthy rabbits that are not dirty around the back end, leaking urine, or obese will not usually get a fly strike, so there is no need to check a rabbit daily unless it fits into one of these categories (or unless it has a one-off bout of soft droppings as can sometimes happen).

A rabbit that has significant health issues needs to be checked and appropriate medication such as Rear-Guard applied, but sadly, even checking a rabbit twice a day would not necessarily be enough to save a rabbit as some go into shock within a very short time indeed once the larvae hatch. Fly eggs are often not spotted – they can be tiny, depending on the type of fly concerned. It is vital that with a rabbit in the high-risk category, the appropriate steps are taken to address the cause of the problem, as many cases are caused by an incorrect diet or too much dried food or vegetables.  However, E. cuniculi, arthritis, infection, tumours and dental disease can all play a part in causing leakage problems, and this is not so straightforward to rectify.

In most cases with rabbits that do not like being handled (and that is the majority), the bond between owner and rabbit can be put under severe strain if they are checked even once a day, never mind twice, and a balance has to be reached.  Healthy clean rabbits do not usually get fly strike, so there is no need to put such rabbits through the trauma of checking without good reason.

Rabbits are wild creatures and still retain their basic instincts that if they are up off the ground being held, this usually means bad news (a fox’s dinner perhaps), which must be considered when any contact is needed.  Some rare individuals do not seem to mind being held (or tolerate it, which is perhaps a better phrase), but they are so rare that I have to base the information on this website for the majority. The photo below shows the damaged skin of a rabbit that has recovered from flystrike.  Eventually, the sores will heal, but the skin will be permanently scarred.

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The most common reason a rabbit scratches a lot is that it has some kind of insect infestation (parasite), such as fleas, mites or lice.  Here is a quick guide to help you identify what insect you are dealing with, as the treatment depends on the problem.  Once you have identified the problem, you need to seek the correct medication, and you may be best to contact your vet to confirm your diagnosis and be guided on the best treatment.

Fleas usually show up more as tiny black grit droppings in the base of the fur, and sometimes you will see a flea as well, but more often than not, it is the black grit you see.  Treatment for fleas usually involves a product called Advantage, but your vet may supply a different medication.  If it is fur mites, you will see tiny moving specs of dust in the fur if you move the fur backwards, and treatment for that can also be done by using Advantage or Xenex spot-on.  If it is the burrowing mite (more on this below), you will not see any insects at all, but you will see at least one patch of thick, flaky dandruff close to the skin, often at the nape of the neck or around the rump area.  Treatment for this is usually with Ivermectin injection or spot-on.

Lice are small but long insects visible in the fur, often around the tail area, but can be anywhere. Treatment with Advantage or a pet insecticidal shampoo or powder is usually effective.  For any of these parasite problems, you also have to treat the accommodation, as eggs and larvae will have dropped to the floor and will be ready and waiting to reinfect the rabbit again, so a suitable spray needs to be used in all the areas that the rabbit usually goes in.  If you have more than one rabbit, the chances are high that they will be infected, too, so you will need to treat all rabbits and guinea pigs in the area. Otherwise, the reinfection will keep on happening.  Remember that fleas can be spread easily from cats and dogs to rabbits, so if fleas are the problem, you will need to treat any other pet in the household, as well as carpets and furnishings.

Dandruff and/or bare patches

They are usually caused by mites (Cheyletiella parasitivorax), resulting in skin irritation and the unsightly appearance of the fur.  The dandruff is visible as large flakes, not the tiny dots you sometimes see when the rabbit has a moult.  A course of Ivermectin injections or a spot-on treatment from your vet quickly treats it.  Finish the course; otherwise, the mites will return.  Any other rabbits in the vicinity must be treated also.  A photo of a rabbit with Cheyletiella mites is below.  The rabbit had a large patch of scurf between the shoulder blades and another large patch just above the tail.

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Lump or scab on the back of the neck

This can occur in rabbits vaccinated recently, but thankfully, with the latest combined vaccination, it is now rare for such a reaction to occur. This usually heals on its own.

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Head swaying from side to side

This is very common in red-eyed rabbits or rabbits with brown eyes that glow red in particular light.  This is normal and often occurs when the rabbit is relaxed. However, if the head is tilted to one side, that is a different condition, and veterinary advice should be sought urgently (see also information regarding head tilt above).

Eating its droppings – caecotrophy (coprophagy)

All rabbits, hares, guinea pigs, chinchillas and degus eat a diet that is very rich in fibre but poor in nutrients, so the food has to go through their digestive system twice to extract all the nutrients they need to keep them healthy.  It is normal and essential for a rabbit to eat its caecotrophs (droppings that have gone through the rabbit once) directly from the anus, and these droppings look quite different from the usual hard round droppings that you find left on the floor.  The photos below compare the caecotroph (top) and the normal dropping (lower photo), and you can see that the caecotrophs are softer and shiny, often bunched together like grapes.  If you find such droppings on the floor, it usually indicates that either the rabbit is obese and can’t reach to eat them properly or there is a dietary problem that needs to be resolved (see section on feeding).



The films below illustrate well how a rabbit (or, in this case, a hare) consumes a caecotroph – it is all over very quickly. You will likely never see your rabbit performing this activity unless you know what you are watching for.


Twitching of the muscles around the lower back/rump

Although not every rabbit exhibits this behaviour, it is not uncommon.  Some rabbits twitch their muscles randomly around their rump area, especially when eating their dried food or vegetables, and this can look rather alarming to an owner unaware of what is happening.  There is nothing to worry about, and there seems to be a genetic link in this behaviour, as it is often seen in siblings, mum, and her offspring.  The affected rabbits may exhibit involuntary muscle twitches in response to feeling vulnerable whilst feeding, especially if it is their main meal of the day, where there will also be heightened excitement and anticipation.  I have filmed one of our rescue rabbits showing this behaviour, as shown below.

Urine scalding around the tail and back legs

There are at least four possible causes of urine scalding around the tail and back legs.  If the rabbit is elderly, there may be a touch of arthritis in the hind legs/spine.  This makes it challenging to raise the tail and rump when urinating, so the urine ends up on the legs instead of flowing clear.  It may be worth trying some pain relief for a week to see if that makes any difference.

Secondly, the rabbit could be suffering from E. cuniculi, which commonly causes urinary tract problems – a month’s course of Panacur would at least stop the condition from worsening. It may even make improvements, but all the rabbits in the vicinity would need to be treated simultaneously.

Thirdly, if the rabbit is overweight, it would also be difficult to urinate clear of the legs, and a restricted diet would be in order (see separate article on feeding).

Lastly, an injury or post-castration complication in males can cause either the bladder opening to be set squint (as in the case of injury) or the opening to almost seal up in males (in some rare cases sometime after castration), either scenario causing the urine to exit at an angle and catch the leg and tail.  An operation may be required to return the flow in the correct direction, but in any case, veterinary opinion must be sought immediately to prevent soreness, infection and fly-strike.

In the case of post-castration complications, it can stretch the opening to allow the flow of urine to return to normal.  When the opening is restricted, the rabbit cannot empty its bladder correctly, and the urine trickles out all the time.  Even when the opening is stretched manually, the restriction may return a few weeks later, so this must be checked regularly.

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Scabs/red sores around mouth/chin and/or bottom (cheilitis)

The usual reason why rabbits become red and sore around the genital area is due to some urinary tract problem resulting in leakage of urine and subsequent scalding of the skin (as described above).  However, cheilitis, thought to be fungal in origin, appears to occur in some rabbits without necessarily having the expected urine leakage issues.  It is still likely to have started due to the damp and warm skin, but once it has started, it can spread around the mouth and chin, transferred there when the rabbit is either cleaning itself or consuming caecotrophs.  The photos below show a rabbit that started with a bladder infection, leading to cheilitis.

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This condition needs urgent attention, and the rabbit should either be taken to the vet (the vet may prescribe Nystatin cream, which is known to be effective), or you could try treatment at home initially if you have the time and knowledge to do so.  The scabs or thick white skin patches need to be very gently soaked off (this must be done with extreme care and lots of patience as it is painful), and a tincture of iodine (such as Betadine from the chemist) applied sparingly and gently with cotton wool to the affected areas.  Daktarin oral gel available from the chemist is also very effective but must be used for at least 2-3 weeks and is most effective if the scabs are removed first.  Blistex Relief Cream (again available from your local chemist) can also be effective, giving real relief as it has some local anaesthetic effects which soothe the raw areas.  This should be done twice daily for at least 2-3 weeks, even after you are confident that the area has healed.

In stubborn cases, I also use a product called Surolan (available from vets), which I use sparingly once a day instead of the Blistex for three or four days and then swap to the Blistex.  Surolan contains a mild steroid, which is why it can only be used for a short time, as after that, it can delay the healing process.  I have found that it helps get rid of the condition permanently, so if you are dealing with a persistent and reoccurring problem, it is worth a try.  Imaverol, available online or from farm supply shops, is also effective, and the scabs do not need to be removed first.  It is used at 1:50 dilution.  

BRC Metal Exhibition Ring

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The photo above shows how a British Rabbit Council or BRC exhibitor ring (put on a rabbit’s hind leg when it is very young) can cause significant problems later on, especially if the rabbit becomes overweight or something gets caught between the ring and the skin of the leg.  Breeders are meant to remove these rings if the rabbit is sold and will not be used for exhibiting. Sadly, many do not do so, and I have seen several cases where the rabbit’s leg has been cut almost through to the bone by such rings, causing a great deal of pain and distress.

The ring can be easily removed – get a sharp pair of wire cutters and make a snip on the top edge and then another snip on the opposite lower edge.  The ring should then fracture right across.  Repeat this on the other side of the ring; the ring should then split neatly into two halves, which can then be removed.  Take great care not to catch the skin or to twist the leg in such a way as to damage or break the bone.  If the ring has been cutting into the skin, you will need to treat the sores, and this may need veterinary advice if it is severe.  The photos below show how the ring can be removed successfully.

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Panting and sitting still a lot of the time

If the weather is very hot, it is not unusual for a rabbit to seek out a shady, cool spot and lie there for hours, and this is especially obvious if the rabbit is overweight.  However, if a rabbit shows these symptoms and is not hot or overweight, there may be a heart problem, and veterinary advice should be sought quickly.  Suppose the standard medication fails to improve the situation. In that case, you can suggest Fortekor to your vet, which is used for heart failure in cats and dogs (my thanks to Victoria Carey, rodentologist and experienced rabbit keeper, for this information).  The dose is 0.25mg/kg of rabbit, and a month’s course is recommended.  Victoria suggests that the tablet be crumbled in water and given to the rabbit by mouth via a syringe.  Heart problems are sadly common in giant breeds, especially if they have been allowed to become overweight.

Obesity – why is my rabbit fat?


Just like humans, rabbits become overweight if they eat more calories than they use up – it is that simple.  Detailed information on how much to feed and what to provide is in the feeding section of this article. Still, the general rule for an average-sized adult rabbit is one flat egg cup of pellets per day per rabbit, lots of fresh hay, and green vegetables that the rabbit will tolerate, starting gradually with something like celery if the bunny is not used to having fresh food.

Avoid treats and coloured vegetables and fruit, and remember that if the rabbit has access to bird food (or sometimes even cat food), it will eat that, too, so make sure the rabbit cannot get access to these extra tidbits.   An unhealthy, overweight rabbit is at risk of flystrike, a dirty bottom, and poor fur from an inability to groom properly. Their feet and joints can also get sore due to the extra pressure they are under, so you must ensure your rabbit stays in trim.

Exercise is just as important as the correct diet, and you will find your rabbit becomes much more active as the excess weight is lost, and the more exercise they take, the more effective the weight reduction will be.  Suppose an obese rabbit is on an inappropriate diet and loses weight too fast. In that case, they can become ill very quickly due to problems associated with the liver, so sticking to the egg cup a day of pellets, hay, and green vegetables feeding regime should ensure that weight loss is steady and successful.

Some vets now suggest that rabbits can be kept simply on lots of green vegetables and hay, with no dried food at all, but this needs to be introduced gradually, and it will mean you need a constant stock of copious amounts of vegetables!  Grass is an excellent food for rabbits, but this is more of a problem in the winter months.  The photo below illustrates how an overweight rabbit can develop an enlarged dewlap under the chin, making it almost impossible to groom itself or consume caecotrophs, leading to severe problems.


Here is what a grateful owner wrote after I had advised her to change her rabbit’s diet to help with her problems with him: Hi Mairwen, I just wanted to update you on the bunny bottom issue. He is now completely dry underneath (no leaking), and the fur is growing back lovely. The Oral Dactarin seemed to do the trick on the rest, which is also growing back nicely now. It did not drive him as crazy licking as the Flamazine. As you predicted, the diet is now under control. He now comes out to graze and leaves the cage (Hurray!) He looks back to his usual fluffy bunny self. He is much happier and more active, although still grumpy! I cannot thank you enough for your advice. There is no way a vet would have thought to question me on his habits to solve the problem. He is such a small bunny. I would never have guessed he was overweight! So, fingers crossed, for now, he is on the mend. Again, thank you so much for sharing your knowledge. Sarah

Here is a good example of a “before” and “after” situation.  Hercules (now called Honey) was obese when she arrived, and the vet almost refused to spay her as she felt it might be too risky.  Thankfully, all was well, and she has now slimmed down beautifully thanks to a new diet and a new home with a family who love her.  She has been bonded with a friend, Wilfred and is very happy.  The first photo is the “before” shot, as you will see, and yes, they are the same rabbit!

Dirty Bottom

Sadly, a rabbit with a dirty bottom is not uncommon and is almost always due to an unsuitable diet.  Before looking in more depth at the causes of this problem, it is important to know how to quickly resolve the issue of a rabbit with a hardened ball of faeces stuck to its tail.  You will need a washing-up bowl, a large bath towel, another towel, warm water, and an extra pair of hands!

Fill the bowl with warm water to a depth of about 4-6 inches (10-15 cm), depending on the size of the rabbit.  Place the bowl on a table or worktop on top of the towel so the surface is covered all around the bowl.  Put the rabbit in the bowl so he sits right in, ensuring his bottom is completely submerged in the water.  He must sit there for 5-10 minutes until the ball softens enough, allowing you to gently loosen it away with your fingers.  You may need an extra person to steady the rabbit during this process, hence the extra pair of hands.

Do not force the mass to come away, as you could end up tearing the very fragile skin; just be patient and let the water do its job.  You may find you can get some to break away and then leave it for another few minutes to soak away the rest.  The reason for the towel underneath the bowl is two-fold – to stop the bowl from moving around and to catch any overflow if the rabbit tries to get out!  Once you are happy that you have succeeded with loosening and peeling away the mass, lift the bunny out of the bowl and wrap him in the other towel, gently drying him off.  Please do not put him back outside until he is dry, so either keep him inside until he dries off or use a hairdryer on a low setting.



Now, let’s look at the problem in more detail.  The droppings of a rabbit will tell you a lot about its health.  The first photo below shows normal, round, firm droppings; a healthy rabbit will pass lots of these every day.  You can see clearly that they are quite light-coloured, a good size and round, and full of fibrous material such as hay.  The size of the actual droppings will vary with the size of the rabbit. If the size of the droppings changes suddenly and becomes small and hard, this indicates that the rabbit may have the beginning of gut stasis. This severe condition is often fatal (see the second photo below, showing normal droppings compared to those from a rabbit suffering from gut stasis in the latter stages before it stopped passing droppings completely).  Veterinary opinion should be sought straight away.

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Below is a photo of soft, smelly droppings that indicate there is a problem, usually linked to a diet that is not healthy.  This can then stick to the rabbit’s tail and bottom, causing a significant problem.

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The photo below shows droppings that have some fur mixed in, resulting in what is often referred to as a “string of pearls”.  Rabbits usually pass fur without any problems, but if the gut motility has slowed (see above for information on gut stasis), the fur can become lodged and cause a blockage.  It is not the fur that causes the problem; it is only when the gut has slowed down that it becomes an issue.  Giving pineapple juice to help dissolve the fur is a total waste of time (unless the rabbit likes it, of course), as scientific tests have shown that the fur would have to be sitting in a pool of the juice for several days for it to have any significant effect upon the actual hair.

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The photo below shows caecotrophs that are usually ingested straight from the anus.  This is normal behaviour for a rabbit and is crucial for healthy digestion.  Rabbits who do not eat their caecotrophs are generally too fat to reach down to their tails, have arthritis or joint pain, which inhibits this behaviour, or are not well in some way.  The caecotrophs then can stick to the rabbit’s tail, which can cause real issues such as fly strike risk.

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A dirty bottom in a rabbit can have several possible causes, usually diet-related.  However, if it has suddenly occurred with no prior history of this problem, a vet should thoroughly check the back and front teeth.  It is not unusual for rabbits with back teeth problems to have sticky bottoms, so this must be ruled out first.  Also, ask the vet to give the rabbit a general check-over to rule out other health problems. On the assumption that nothing is found (do choose your vet with care, only go to a vet who is knowledgeable about rabbits), then one needs to look at the diet.

Carrots and apples are two of the worst things you can give a rabbit regarding sticky bottoms, so withdraw them immediately.  Going back to basics for a few weeks is probably a good idea – a minimal amount of dried food as described in the feeding section above, and hay and water ad lib.  The dried food should be something like Burgess Excel (or Excel Light if the rabbit is overweight), Science Selective or another vet-recommended pellet brand. The muesli-type food is often a disaster to use, and if the bunny is on this already, you must gradually wean him off over a couple of weeks by adding the new food half and half.

Muesli allows the rabbit to selective feed, picking out the sweet, high-fat bits and leaving the healthy pellets that contain the vitamins and minerals needed to keep the rabbit healthy. The quantity that is fed is vitally important, too.  Most adult rabbits only need a maximum of one egg cup (flat, not heaped) once a day on the assumption that they are not overweight and have an average weight of about 2.5 kg.  Overweight rabbits likewise need a very small amount daily but with lots of hay available at all times.  Hay should comprise 70-80% of the diet, the remaining 20% being dried food and green vegetables or grass.  Some owners find that withdrawing dried food entirely from the diet is the only way to cure the problem, the rabbit being forced to eat large quantities of hay high in fibre.

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Once the rabbit is stable on the new regime (which may take up to a month), you can try introducing some celery.  I have found this vegetable to be very good for the large majority of rabbits, even for those who generally can’t tolerate vegetables.  Give a quarter of a stick a day and go from there.  If all seems well after a week, try introducing a small amount of spring greens and see how that goes.  If the sticky bottom returns, withdraw the greens for a while and try again after a few days but at a much-reduced amount; it is suitable for rabbits to have green vegetables, but sometimes, finding the amount that will be tolerated is tricky.  Some individuals can only tolerate it once a week, but most will get used to a small amount every day if introduced very gradually.

Many plants can be given safely to rabbits, and a comprehensive list can be found online. Another possible cause of a dirty bottom is that of a flabby belly.  Some rabbits that are overweight or have been overweight in the past have folds of skin around the genital area, making it almost impossible for the rabbit to eat the caecotrophs (the soft “bunch of grapes” droppings that all rabbits re-ingest) directly from the bottom, resulting in them being “caught up” in the folds of skin.  If this is the case, a “tummy tuck” operation may be required to remove the excess skin, but this is a last resort and can’t be done until the skin is in good condition, i.e. not red, sore and inflamed.  Putting the rabbit on a strict diet is often enough to solve this problem as the folds get smaller and the rabbit loses weight, but not always.

 Dewlap that is too large

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Most female rabbits (and a very few males) have dewlaps – the pouch of fatty tissue just under the chin – and in most cases, the dewlap causes no problems at all.  However, if the rabbit is overweight or has been obese in the past, the dewlap enlarges out of proportion. It restricts the rabbit’s movement and prevents them from grooming or consuming caecotrophs correctly.  The result is that the rabbit is often dirty at the back end as there is no way to clean itself.  The top photo above (black and white female) shows a rabbit that was seriously overweight recently, and although she lost a lot of excess weight, the dewlap size was not reduced. She needed a dewlap reduction operation, which the vet carried out to resolve the problem.  The photo below shows a rabbit’s position to get into to wash itself, which is impossible for a rabbit with an enlarged dewlap.

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An oversized dewlap can also be an area that flies can target as they lay their eggs in the moist folds of skin underneath. Fungal infections can also flare up, leading to a dire situation unless action is taken.  The moral of the story is never let your rabbit become overweight! 

Sore feet

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This is particularly common in Rex rabbits, but I have also seen this distressing condition in other breeds.   IT IS NORMAL FOR RABBITS TO HAVE A VERY SMALL RED BARE PATCH ON EACH HEEL, UNDERNEATH A GOOD LAYER OF FUR – THIS IS VERY DIFFERENT FROM THE PROBLEM WE ARE DISCUSSING HERE!    Ulcerative pododermatitis, or sore feet, is more common in Rex rabbits as they have less fur on their feet compared to breeds with normal fur, and this can result in sores on the soles of the hind feet and sometimes sore front feet.  Calluses on the hind feet are relatively common in the Rex. Still, when the skin ulcerates and becomes infected, this is very serious indeed, and veterinary treatment needs to be started immediately to prevent possible amputation of toes or worse due to the bones and bone marrow in the feet becoming inflamed.

Rabbits with sore feet sit differently from other rabbits, with their weight rocked forward onto their front paws, or they sit with their hind feet sticking up off the floor.  They are also often reluctant to move around much due to the pain and discomfort this condition can bring.  Some will appear to keep shifting their weight from one side to another to get comfortable, and if all four paws are affected, they go up on their toes when walking or hopping around to put the slightest pressure on the sore areas. If the front feet are affected as well, the rabbit will often shake its front paws and appear to bite them, but this should not be confused with the shaking of the front paws that usually happens just before a rabbit washes its face.

In addition to veterinary advice, you may find a spray that can be bought from a chemist particularly useful.  It is a “liquid plaster” spray, and there are various brands to choose from, but they all appear to do the same job.  The spray puts a “second skin” over the sore area, protecting the skin underneath.  You apply it every day for ten days until the new fur grows underneath.  You can spray over mildly broken skin, but ensure the area is thoroughly cleaned with a good disinfectant and dry before applying.

Hold the rabbit gently upside down in your arms until the spray dries, and the first time you use it, apply two coatings, letting it dry between coats (it only takes two or three minutes to dry, but you need to keep the feet away from any contact whilst they are drying).  This will resolve the skin issues but will not resolve any trapped nerve-type problem, which can be responsible for persistent chewing (I think this probably causes a “pins and needles” type of sensation, hence the constant niggling of the area by the rabbit).  I successfully treated a very stubborn case with a nerve problem, and the rabbit eventually stopped chewing her feet completely, so I am confident this treatment will help.

Sometimes, a fungal infection sets in, but keeping the feet dry and protected with the spray often resolves it.  A beneficial product to use on feet that are red and inflamed before the spray is Hibiscrub, a handwash readily available from the chemist, as it contains an anti-fungal agent that I find very effective.  This would be done before starting the plaster spray treatment the first time.

Another product I have had success with before the plaster spray is athlete’s foot cream (available from chemists), which you apply sparingly to the sore area and gently massage into the skin.  The plaster spray is then applied. Prevention is far better than cure, so ensuring the rabbit does not get overweight, keeping the area clean, and giving soft bedding or matting for the rabbit to sit on will undoubtedly help.  Certain conditions, such as E. cuniculi or other illnesses that cause hind-end semi-paralysis, can also predispose any rabbit to this condition. Still, heavy-breed rabbits such as the Rex and giants such as the Flemish Giant will always be at higher risk.

Testicular tumour

This only develops in intact (non-neutered) males and is uncommon.  The symptom to watch for is an enlarged testicle compared to the other one.  Although a tumour in both testicles simultaneously is possible, I have never seen this and have only seen rabbits with one testicle affected.  Depending on the rabbit’s age and general health, the tumour can be removed entirely by castration. Still, it is possible that if the condition is cancerous, the tumour could have already spread elsewhere.  A swollen testicle could also be caused by fluid, which can build up due to various medical conditions, such as an enlarged or cancerous prostate.

Although a syringe can draw off the fluid, it will simply fill back up again unless the cause is treated, but sadly, this is not always possible. A decision has to be made to decide whether there is still a good quality of life or whether the rabbit should be put to sleep.  The photo below shows a rabbit with a sizeable testicular tumour.

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Rabbit making a strange “quacking” noise

Some rabbits make a very odd noise when handled, which is usually linked to stress as they breathe much harder and faster.  It can be related to a very low-grade sinusitis condition, which ordinarily does not give any other symptoms and only appears when breathing is accelerated, such as when given medication.  If the rabbit only makes a noise when handled, it is probably a good idea to reduce the handling to a minimum if no improvement is found within a couple of weeks.  If there are other symptoms, the rabbit must be seen by an experienced rabbit-friendly vet to rule out respiratory and other possible problems.

Ear Mites

Ear mites are not just a minor irritation – they can be fatal.  Caught early on, this condition is quickly resolved by either Canaural drops available from the vet or a course of Ivermectin injections (again available from the vet) or a combination of both treatments as the drops have a soothing effect on the ear.    Unfortunately, an average pet rabbit owner will not be aware of a problem until it is advanced. By then, the rabbit is in severe pain with ears full of deep crusts and pus, affecting hearing, general well-being, and sometimes balance.

Typical symptoms include the rabbit scratching frequently and intensively inside its ear or ears with its hind leg; holding its head slightly to one side (the side with the worse ear as often one is more severely affected than the other);  shaking its head slightly as if trying to get rid of the vile stuff deep inside. Ear mites are very painful as the delicate skin within the ear is partially destroyed by the crusts built up by the mite damage, so trying to peel away the crusts without using soothing drops to loosen the crusts is not an option.   In such cases, I run some Canaural drops inside both ears and put the rabbit somewhere quiet and away from other rabbits for 10-15 minutes. Once I am happy that the drops have done their job, I gently peel away the crusts using small tweezers and carefully dispose of them as they are full of crawling mites. Any other rabbits in contact with the infected one need to be treated also, as the chances are high they will have them, too.

If there is any distress to the rabbit, the procedure must be stopped, more drops applied and then tried again.  Do not attempt this at all unless you are experienced with rabbit care, as you could do damage and cause distress, and you are better to let either the crusts come away on their own with treatment or let the vet clear out the ears if you are not confident to carry out the procedure.  The disadvantage of allowing the crusts to come away on their own is that there will be a significant risk of spreading the mites over an extensive area. Hence, as mentioned earlier, any rabbit in the immediate vicinity must also be treated.

As you gently proceed towards the inner part of the outer ear, you will likely find a large plug of crusts, with pus and maybe blood at the base. Be very careful with the cleaning in this area, and again, if you don’t know what you are doing, do not go any further and let an expert take over. It is very gratifying to see what relief the rabbit feels once the ears have had this intensive treatment, and the ears usually heal within days.  However, continuing the treatment as recommended on the container is essential. Otherwise, the infestation will return. The photos below show the crusts inside a rabbit’s ear that has severe ear mites, and the third photo shows some of the crusts removed from inside the ear (you can see the scale of the crusts from the cotton bud in the photo).

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Respiratory disease

This is often called snuffles or Pasteurella (the common cause).  It is usually a chronic condition that many rabbits carry without showing symptoms.  Often, the signs that the disease is present only show when the rabbit is stressed in some way or has some other health issue developed in addition to it.  Sadly, chronic Pasteurella is not curable but can often be managed by giving antibiotics for some time when it flares up.  Sometimes, the condition can be fatal by developing into pneumonia, from which a rabbit rarely recovers.  The photo below shows a rabbit with severe respiratory disease.

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The photos below show more typical symptoms of rabbits with snuffles, photographed before the rabbits concerned managed to wipe away the evidence with their front paws.  Often, the only proof that a rabbit has this disease is that the fur on the inside of the front paws is caked hard with constantly wiping away the nasal discharge, and this should be looked for when examining a rabbit that you suspect is sneezing.

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Flesh-eating disease

This is rare but must be treated immediately to prevent severe infection.  The rabbit shown below caught the disease ironically when she was at the vet for the removal of a facial abscess.  Initially, her ear looked red, swollen and sore, and it was only after antibiotic treatment and anti-fungal creams (Preparation H, available from the chemist) were underway that it became clear that some of the flesh of the ear had been eaten away.  Thankfully, she made a full recovery but has been left with a damaged ear, which does get a bit hot and red when she is stressed.

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