Pain in Rabbits
In New Zealand that sad truth is that many veterinarians are not sufficiently trained or experienced enough in regard to recognising and treating pain in rabbits. The consequences of this are that far too many rabbits suffer severe and unnecessary pain following procedures such as desexing due to woefully inadequate levels of analgesia.
Rabbit expert vet Martin Earles recommends a dose rate of 0.3mls/kg of Dog Metacam (1.5mg/ml), twice a day post desex.
World renown Rabbit Veterinarian Molly Varga has addressed Rabbit Analgesia in the following article which considers the recognition and treatment of distress and pain in this species -
Analgesia and pain management in rabbits - Molly Varga (2016) Analgesia and pain management in rabbits, Veterinary Nursing Journal, 31:5, 149-153, DOI: 10.1080/17415349.2016.1164449
Article Link: https://doi.org/10.1080/17415349.2016.1164449
Supported by current research which investigates the dose and dosing intervals of the use of Meloxicam in rabbits (per Carpenter, Pollock, Koch, & Hunter, 2009; Cooper, Metcalf-Pate, Barat, Cook, & Scorpio, 2009; Delk, Carpenter, KuKanich, Nietfeld, & Kohles, 2014; Fredholm, Carpenter, KuKanich, & Kohles, 2013) Ms Varga states -
"Rabbits require a much higher dose than a dog of the same weight
(approximately eight times the dose) and require this more often (twice daily rather than once daily dosing)."
Ms Varga concludes -
"Recognition of pain and implementation of appropriate pain relief can significantly improve both the welfare and the clinical outcome of our rabbit patients."
Pain relief doses for rabbits are constantly being reviewed by experienced rabbit vets. The following chart is sourced from a 2023 webinar by Dr Sophie Jenkins which was hosted on The Webinar Vet website. - Pain Management in Rabbits - More than just Meloxicom.
The chart below; sourced from the webinar, illustrates how much the recommended doses has changed recently and how vital it is to use the correct dose.
Dr Sophie Jenkins BVetMed PgC EAS CertExAP MRCVS, Advanced Practitioner in Zoological Medicine, is a Veterinary Surgeon based in South Wales. Sophie graduated from the Royal Veterinary College in 2008. She went on to follow her passion for exotic animals and gained a General Practitioner Certificate in Exotic Animal Practice in 2011. In 2016 , Sophie completed a PgC in Exotic Animal Studies and was subsequently granted status as Advanced Practitioner in Zoological Medicine (one of only a handful of veterinarians in the U.K.). Sophie gives CPD talks / lectures to Vets and Nurses on exotic medicine and surgery. Sophie is a member of the Rabbit Welfare Association and Fund. Sophie was recently awarded the Burgess excel Winner of Rabbit Vet of the Year 2020 and finalist in 2021. She is judging the 2022 awards.
Sophie owns Origin Vets Clinic where, alongside her colleagues, she offers first and second Veterinary opinion as well as referrals for reptiles, rabbits, small mammals, birds, amphibians and fish. Sophie's exotic vet work covers rabbits to rhinos, sugar gliders to skunks, chameleons to camels as well as birds such African greys, owls, falconry species, and also amphibians, fish and inverts.
Sophie has over 28 years experience of keeping and breeding various reptiles including bearded dragons, multiple species of chameleons and several species of geckos. Sophie has a rescue dog and cat, 2 large fish tanks, including a Discus set up and a gourami set up, a rescue Horsfield Tortoise and a rescue Bearded dragon. Sophie also has a big soft spot for Rabbits and currently has 4 rescue Lionheads.
How Do Rabbits Show Pain?
Hiding or laying more - This is seen in most species.
* Rabbits in pain tend to hide or sleep more.
* You may not see them at all or as much.
* This is to protect themselves both from predators (our pets believe there may still be one) and make sure their injuries don’t get worse.
Less Active
* Rabbits in pain move around less as they avoid doing anything that hurts.
* This may not be as obvious as them stopping moving completely; many are still active at times.
* However, if you scare them or go to pick them up (something which most rabbits hate) painful rabbits will usually still dart away.
Eat and Drink Less
* Studies have consistently shown that rabbits in pain eat and drink less.
* To see if your rabbit is in pain you can just compare how much they eat and drink compared to what they usually have.
* If you have two rabbits it may be impossible to tell as if one rabbit eats less due to pain the other may just enjoy the extra food it has left to eatso you don’t notice.
*It’s not always the case, some rabbits don’t change their eating patterns at all.
* Also, if your rabbit stops eating there may be a reason other than painsuch as stress or feeling ill.
* Not eating can, in itself, make a rabbit very unwell. A rabbit’s digestive system is designed for them to eat almost constantly. If they stop eating or eat very little this can actually stop their guts from working. This can be life-threatening so if your rabbit stops eating for whatever reason get it checked out ASAP; sometimes even just leaving them a few hours to get checked may be fatal.
* An advantage to checking their food and water is that you don’t have to disturb your rabbit. This is definitely a bonus as they don’t want to be messed with when ill or in pain.
Limping
* If your rabbit has a sore leg they may limp.
* Not all rabbits that are in pain will limp, even if their legs hurt, and not all rabbits limping are in pain. Limping rabbits may have something affecting their brain or an old injury which cause them to limp despite not causing pain.
* However, if your rabbit starts limping and they weren’t before it is likely they are in pain. Just don’t rule out pain because they’re not limping.
Stand differently
* Rabbits with bellyache may stand with their backs arched up similar to what what a cat or dog may do. Or press their belly to the ground.
Move Differently
* Rabbits in pain, when stood, may writhe a bit. This is often seen with belly ache where they are twisting and stretching their bodies to relieve the pain.
* This is not always obvious as it often is done very quickly, each time lasting only a second or two.
They may sleep more
* Rabbits may lie down more when in pain.
* Being in pain is tiring.
* Often they sleep more due to having less energy left
* This means they may be in their bed more.
* Rabbits may also lie with their eyes shut when in pain, even if they’re awake.
They may become more aggressive
Rabbits often don’t want to be played with or lifted by people even when they’re not in pain.
* When they’re in pain this is even more likely as they don’t want people making that pain worse.
* To try to make sure they’re not in more pain, rabbits do all they can to stop people handling them and stop playing with other rabbits.
* This may mean your rabbit becomes more aggressive and may even scratch or bite especially if someone is touching a sore area.
High Breathing or Heart Rate
* Most owners don’t constantly check their rabbit’s heart or breathing rates. But, when a rabbit is in pain, you may notice their chest rising and falling as they breathe quicker.
* Them breathing quicker or their heart beating faster is both a sign of pain and stress so it can be difficult to use this as a method of detecting pain.
* This is especially so for rabbits who become stressed when around people or if people decide to lift them to check their heart rate. In these cases, their heart or breathing rates would rise when lifted even with no pain.
* A vet may notice high heart or breathing rates when examining your rabbit BUT it may be hard to tell if this is due to pain or simply stress.
Changes in Grooming Habits
* If your rabbit is in pain it will tend to clean itself less.
* However, if they’re in pain in an area of the body they can get to they may lick it more.
* Sometimes if a rabbit has surgery and they are in pain they may remove their stitches from nibbling at the area.
Screaming
* As a rule, rabbits do not cry out when they are in pain.
* However, there are exceptions to every rule. In this case, rarely and when in severe pain, a rabbit may scream out.
* It is unlikely that they will scream but it is heard in some cases.
* Sometimes rabbits can be heard making slight whimpering noises but again this is uncommon and is very quiet.
Grinding Teeth
* This may be seen with tooth pain and, uncommonly, with gut pain.
* Sometimes very ill or stressed rabbit’s abdomens bloat up. This may also be caused by certain foods. Bloating is a result of your rabbit’s digestion slowing or even stopping.
* This is incredibly painful and can, sometimes, cause them to grind their teeth, especially if you’re feeling over their belly. Bloat also causes rabbits to writhe.
Weight Loss
* Rabbits in pain over several days or longer may lose weight.
* Your rabbit will both eat less and use up more energy from stress and having higher heart and breathing rates.
* If your rabbit appears to have lost weight then it may be due to pain but there are many other causes too.
Change in Facial Expression
* Pain causes us to screw our eyes shut and open our mouth.
* Many mammals do similar with pain and rabbits aren’t an exception. Some of the signs they show are subtle but all of them together may be due to pain.
* Eyes Closed; rabbits in pain, even when awake, may have their eyes closed or only partially open.
* Tense Whiskers; their whiskers may become tense and instead of pointing outwards from their face and moving quite a lot, they may be held very close to the face, together and be held downwards
* Nose Changes; Rabbits normally have a U shape to their nostrils when relaxed. When in pain, however, this alters as the bottom part of their nose is tensed causing it to become smaller and leaving their nostrils to form a V shape. This is very subtle though
* Ears Closed; Rabbits normally have nice open dome-shaped ears which are help upright. When in pain this completely changes. Their ears may be held back, sometimes lie along their backs. Their ears also close leaving the opening very narrow.
* Cheeks may flatten. This is very hard to spot. Rabbits cheeks are usually very rounded and easy to see. However, when they’re in pain these become tense and no longer stick out but, instead, flatten and may even curve inwards.
What Should I Do if my Rabbit is in Pain?
The first step is recognising pain. Once you’ve noticed your rabbit may be in pain you should take them to your vet. As rabbits stop eating when they are in pain and them notIf your rabbit stops eating you must take them to a vet straight away as not doing so could, along with the pain, make them severely unwell.
Vet checks may be scary for both you and your rabbit but they are the only way to find out exactly what is wrong and treat it. As rabbits don’t like being handled they may find it even more stressful than other pets but if they’re in pain then getting them checked is definitely the best thing.
If your vet finds out what is wrong with your rabbit and they need medications, don’t worry the majority of these for rabbits are liquids. These medications can be squirted straight into their mouths and your rabbit may like the taste of some of them. The quicker you find the cause of their pain and start their treatment, the better and the less stressed and ill they’ll become overall.
Quick Recap
The main signs of pain in rabbits are changes in their facial expression, an increase in their heart and rates, them eating less, wanting to be left alone, sometimes becoming aggressive, and being quiet.
If they’re in pain take them to the vet to find and treat the problem.
Shared with permission from the author - Kim Halford.
Kim is a qualified vet, animal behaviour and welfare advisor. She is dedicated to improving the welfare of animals. She wants to work with organisations to improve the education of animal welfare and behaviour as well as improve the bond between animal and owner.
Recognising Pain in rabbits
This manual describes the five action units that comprise Rabbit Grimace Scale (RbtGS) and how these action units should be scored. These action units have been shown to increase in intensity in response to post-procedural pain (Keating et al. 2012).
Rabbit Grimace Scale Poster (RbtGS) Manual
Further Reading:
”Rabbits, like other companion animals, are being taken to veterinarians in increasing numbers. Over the last two decades there has been an explosion of knowledge about their medical and surgical care in the veterinary community. Rabbits are living longer and thus have the potential to experience the discomfort of illness or surgery at some time in their lives. Veterinarians have an increasing number of safe choices for managing pain in rabbits. The first step for pain management is to recognize the signs of pain in the rabbit.”
The Importance of Analgesia/Pain Control for Pet Rabbits - House Rabbit Society
”Any surgery can be physically and emotionally hard on both you and your companion rabbit, since there's really no such thing as a surgery that is 100% risk free. I hope the following information will help you and your rabbit get through either emergency or elective surgery with maximal safety and minimal stress.”
Pre- and Post-operative care of Rabbits - Dana Krempels
“The number of rabbits kept as pets has increased dramatically over the last decade. The veterinary profession has made huge strides in knowledge over this same period of time and now an abundance of published and lecture material available to the practitioner. We now have veterinarians who have established themselves as “rabbit specialists”, however, there is still confusion regarding the use of analgesia (pain relief) in the rabbit.”
Analgesia – Pain relief - Missouri House Rabbit Society
“With the increasing popularity of rabbits as household pets, the complexity of diagnostic and surgical procedures performed on rabbits is increasing, along with the frequency of routine surgical procedures. More practitioners are faced with the need to provide adequate analgesia for this species.”
Rabbit Analgesia - PubMed
Rabbits in the wild are at the bottom of the food chain. It’s hard-wired into them not to show any sign of weakness. If they show any sign of illness or disability, to make them look slow and vulnerable, they’ll end up as somebody’s dinner. This instinct is present in our pet rabbits too.
Pain Management for Rabbits - RWAF
AIMS: To determine the perceptions of a sample of veterinarians in New Zealand regarding pain and pain management in rabbits and guinea pigs.
Attitudes towards perception and management of pain in rabbits and guinea pigs by a sample of veterinarians in New Zealand