Having rabbits as pets brings with it a variety of potential health problems. This page should provide you with information to help you understand your pet's body and health. It is not meant as a substitute for seeking veterinary care, but can guide you in knowing when to seek professional care and what to expect at the vet. Remember that you need to find a vet who is capable of caring for rabbits. They are considered exotic animals, not small animals like cats and dogs. For help, visit our Veterinary References page.
Below, you will find descriptions of the most common ailments affecting pet rabbits. It is also important to note that veterinary costs vary widely around the country. We tried to include some basic costs, but these are always changing and without knowing what explicit treatment is being given, it is nearly impossible to know what each vet will charge. Most vets will give an estimate before any major procedures. You can even get veterinary insurance for your rabbit, but not all insurers cover them.
Download the PDF below for instructions on emergency rabbit care for bunnies who are not eating. Also, see the section below on GI Stasis.
Upper Respiratory Infection
Upper respiratory infections (U.R.I.s) are quite common in pet rabbits. One of the most common seen is caused by the germ Pastuerella. However, all U.R.I.s cause the same symptoms.
Symptoms: They can cause nasal discharge, frequent sneezing and, in severe cases, difficulty breathing. If you see any symptoms, get your rabbit to a qualified veterinarian as soon as possible. You may notice nasal discharge(it can be white, gray, green or yellow), eye discharge or sticky patches on their front feet where they tried to wipe it off. If the rabbit has stopped eating, it is an emergency. Unfortunately, Pastuerella and other U.R.I.s can be difficult to cure. Some rabbits end up having light symptoms for life or they may have recurring bouts of U.R.I.s.
What your vet will do: They will take the bunny's temperature to check for fever. Your vet may want to do a culture. This is important as it tells them what bacteria is causing the infection and what antibiotics should be used to treat them. If they think the lungs are involved, they may suggest a chest x-ray.
Treatment: Usually, a vet will start them on oral antibiotics right away. Early intervention and longer treatments give you a better chance of curing the infection. Do not give a rabbit another animal's antibiotics, they can die very quickly if given a dog's medicine. Antibiotics such as Clindamycin, oral Penicillin or Amoxicillin can kill them in hours by stripping their G.I. tract of all necessary bacteria. This alone is one major reason to seek a qualified vet. The good news is that unlike guinea pigs and other small animals, rabbits are less prone to pneumonia. There are many safe medications that can be given to rabbits, such as Bactrim or Baytril. They can even have injectable penicillin, but it must be given by someone qualified to prevent accidental ingestion. For severe or chronic cases, a nebulizer may also be used.
Vet costs. Having a pet rabbit is equally as expensive as a cat or dog. A vet visit for U.R.I. in the Midwest will run around $50. Meds can be anywhere from $10-$100. X-rays may need to be done if the vet feels there is lung involvement, these typically run about $90 per view. Cultures are over $100, as is bloodwork.
Urinary Tract Infection and Stones
Urinary Tract Infections(U.T.I.s) are also fairly common in rabbits. They are usually easy to treat, but can be recurring.
Symptoms you may notice: When a rabbit has a bladder infection, you may see them urinating more often or straining in their litter box. You may actually hear them cry. U.T.I.s are very painful. They may also have accidents outside of their litter box. Look for any color changes. Rabbits can have naturally dark urine, sometimes it's even orange. So, looking for blood can be tricky. Typically, there will be a darker spot in the middle of the urine. It may be red or pink if diluted. When it dries, it will turn brown/black. Normal urine shouldn't do this. Another big clue is smell. U.T.I.s often have a strong bacterial odor.
What the vet will do: A vet will want to obtain a sample of urine, it can help if you bring one along. You can try putting your bunny in an empty litter box after feeding them greens. Use a syringe to collect the sample. It won't be the cleanest sample for a culture, but they can look for the presence of blood. Rabbits with blood in their urine may also have bladder stones or sludge. The vet may want to culture the urine or start them on antibiotics right away. Make sure to ask for pain meds. A rabbit in pain may stop eating, thereby causing a whole host of other problems.
Treatment: They will typically be prescribed oral antibiotics and pain meds (meloxicam) and you should see improvement in 48 hours.
Vet costs: Urinalysis is around $60. Cultures are over $100. Visit is around $50. Meds can be $10 to $100.
Bladder Stones and sludge. Rabbits are more prone to bladder stones than other mammals. It appears to be genetic, but there is some thought that diet plays a role. No connection has been proven, but if your rabbit has sludge or stones, you may want to quit feeding them anything high in calcium, like spinach.
Symptoms: So, the stones are what they sound like, hardened balls of mineral deposits. Sometimes, you may see the minerals(usually calcium) excreted in a rabbit's urine. If you see white discharge like chalk in the center of your rabbit's urine, that's it. This is O.K.--it means they are naturally excreting the minerals. However, if you see brown, muddy substances in their urine(it looks like chocolate milk, sorry), this is sludge and needs to be monitored.
Here is a extra large bladder stone removed from a bunny. It's about an inch in diameter.
Bladder Sludge on x-ray
What the vet will do: Your vet will want x-rays to make sure the sludge was all excreted and that they don't have stones. They may take a urine culture.
Treatment: If blood was seen, they may be given antibiotics. If the sludge was not excreted, they may flush the bladder. Make sure your rabbit gets lots of fluids to help. Unfortunately if they find stones, surgery is the method of curing them. There is a high chance of recurrence.
Vets costs. The visit will cost around $50. Meds can be anywhere from $10 to $100. Flushing is a procedure and more expensive, over $100. X-rays are about $90 per view. Surgery is over $300.
More information: View this article for more information https://rabbit.org/bladder-stones-and-bladder-sludge-in-rabbits/
Ear infections are quite common in rabbits. They are even more common in lop-eared rabbits due to the narrowing of their ear canals(stenosis).
Symptoms: You may see ear twitching, frequent ear scratching or whimpering while scratching, a sudden dislike to having their ears touched, an odor and finally discharge or blood in the ear. You need to see a veterinarian as soon as possible if your rabbit has any of these symptoms. If the infection worsens, it can travel to the middle or inner ear and cause more problems.
What the vet will do: The vet will likely culture or at least swab the ear to check for infection. Cultures will be sent out and are more expensive. The cause can be bacterial or fungal. They will check the rabbit's temperature, you can even do this at home if you learn how. Here is a video from the National House Rabbit Website. As rabbits' normal temperatures can vary from 100-103F, it is a good idea to know what your rabbit's normal base temperature is.
Treatment: If your rabbit has an ear infection, they will probably be given ear drops, sometimes in combination with oral antibiotics. Ear infections can spread to the upper respiratory tract and vice versa, so look for symptoms. Pain medication is often given for the first few days. The NSAID Meloxicam is the most commonly used in rabbits. They may also be given an ear flush or a treatment that involves placing an ointment deep into their ear. If the bunny has recurring infections, your vet may show you how to clean their ears to help prevent them. Use all the meds given and do not use meds from other animals or any flush with steroids. Steroids can be very dangerous to rabbits and are only used as a last resort. Do not put anything into your rabbit's ears without your vet's recommendation.
Vet Costs: Vet visit is around $50. In-house cytology will run around $25-40. Cultures can cost over $100. Meds will run anywhere from $20 to $100.
Severe recurrent ear infections can cause infection of the middle ear cavity, called the bulla.
Gastrointestinal stasis may be the most common reason that rabbits go to the vet. They often get gas, a partial blockage of the G.I. Tract or a full blockage and stop eating. Any rabbit who is not eating, is in immediate need of veterinary care.
Symptoms: What you may notice is a rabbit who is suddenly or gradually not interested in food, even when offered their favorite treats. If gas is the cause, even partially, you may hear very loud gut sounds. The rabbit will show pain by grinding their teeth and shifting their weight around trying to get comfortable. They may also sit hunched up, much like a human with a stomachache. If the blockage is in the stomach, the rabbit will show extreme pain, they will stretch out trying to avoid putting pressure on their stomach. They will move around. They may also make a yawning motion, seemingly trying to remove the pressure. Rabbits cannot burp or vomit to relieve the pressure. A stomach blockage is often referred to as bloat, it is life threatening.
What the Vet will do: A vet will take the bunny's temperature. Often times with bloat and stasis, they lose heat quickly. When temperatures plummet, they are at risk for shock. They will palpate the abdomen. Many times, bloat can be felt as a bulging of the stomach. A hardened lower abdomen indicates an intestinal problem. They will listen for bowel sounds. Lots of sounds means gas, lack of sounds may indicate a blockage. They will take x-rays of the G.I. Tract. If the rabbit has bloat, they may need to remove the pressure by placing a siphon tube down the rabbit's esophagus to remove any excess fluid and gas. The most common blockage is hair. This is why brushing your bunny is life-saving and important. After the blockage is removed, they will be given motility meds and you wait to see if they start eating on their own. Never force feed without asking the vet first. Critical Care is an excellent source of emergency food.
Treatment: If it was a stomach blockage, you will wait and see if they start eating and massage the stomach very gently. Keep the bunny warm, you can buy heated disks to place in their carrier under a towel. You can also keep them on a towel next to you on top of a heating pad. Never place the bunny directly on the pad or leave them unattended with a corded pad. The vet will give them a few meds, some to be given for several days. The motility meds Reglan (Metoclopramide) and Cisapride (propulsid) are common choices. Cisapride works on the lower G.I. and Reglan works on the Upper G.I. Tract. Meloxicam helps with pain management. Cerenia is an injectable which calms the abdominal muscles--it helps with pain. The vet will direct you as to whether force feeding is needed.
For Lower G.I. blockages or gas. Treatment is similar to above, though recovery may be faster since they likely did not have a procedure. Massaging the abdomen helps the rabbit, as does keeping them hydrated. The vet may have given Sub-cutaneous fluids. Cisapride or Reglan may be given, as well as Meloxicam. Baby gas drops may be given. They are over the counter and very safe. Simethicone is the active ingredient. You may have to find a compounding pharmacy for Cisapride--but they can make it banana flavored. You are looking for the bunny to start eating and pooping. Pellets are often restricted during this time since you want them to eat lots of fiber, like hay. Recovery can take days before they eat normally. If they aren't eating on their own in a couple of days or get worse, take them back to the vet immediately.
Vet costs: Visit $50. X-rays: $90 per view. Procedures: Over $200 Meds: over $100 for all.
A good article on GI Stasis may be found here.
"Psst--this is my belly!"
The black spots at the bottom of the abdomen are gas pockets in the intestines.
Intermittent Soft Cecotropes
Intermittent soft cecotropes are fairly common in rabbits. It can cause messy bottoms and large piles of messy cecotropes in their cage. Rabbits should be eating their cecotropes, but if they are unformed or there are too many, they will not eat them. This can lead to a bacterial imbalance in their gut, though the rabbit may appear healthy. They are not indicative of true diarrhea, which is rare in rabbits.
Symptoms: Runny or poorly formed cecotropes with pudding like consistency. They should resemble bunches of grapes and are rarely seen in healthy rabbits as they are ingested. They should still be producing normal stool.
What your vet may do: They may run bloodwork to check for liver problems. X-rays may be taken to rule out tumors.
Treatment: It is most often caused by poor diet, although antibiotics can produce these symptoms, especially if they are on them for a long time. An increase in hay is usually called for and a decrease in pellets, some vets may have you remove them altogether. Occasionally, some greens can cause digestive upset, if you have added anything new, try removing it from their diet. Probiotics may help as can cecotropes from a healthy donor bunny. If your bunny is producing too many cecotropes, eliminate all sugar. No fruit at all, no treats. Ask your vet before making any major dietary changes other than eliminating sugars.
True diarrhea is rare in rabbits. There are many causes including toxins, antibiotics, clostridium, E. Coli and Coccidia. It is an emergency and veterinary care needs to be sought immediately.
Symptoms: True diarrhea is an emergency in rabbits, they will become dehydrated quickly. Unlike overproduction of cecotropes, you will not see any normal stool and the stool you see may be watery.
What Your Vet will do: Your vet may do bloodwork, take the bunny's temperature, test their stool, take an x-ray and give sub-cutaneous fluids.
Treatment: If they were given the wrong antibiotics or had a reaction to rabbit approved antibiotics, Flagyl may be given. They may also prescribe Loperamide or Cholestyramine. Cholestyramine has been shown to reverse diarrhea caused by Clindamycin toxicity in rabbits (Clindamycin is deadly to bunnies and no rabbit vet should ever prescribe it).
Coccidia is a parasite that can be seen through microscopic examination of a stool sample. It is commonly seen in outdoor rabbits and is the most common cause of stool problems in baby rabbits. Antiparasitics will be prescribed. Ponazuril is very effective.
For further information, a great article can be found here.
E. Cuniculi and Head Tilt
Head tilt in a bunny is exactly what it sounds like, their head turns sideways. It is also sometimes called Wry Neck.
Symptoms: A rabbit with Head Tilt can be perfectly fine one second and falling down the next. Or, it may start slowly with a slight cock of the head and some balance troubles. The important thing is to get the rabbit to the vet A.S.A.P. It can be a very scary condition and may be mistaken for injury or even seizures. A rabbit in severe head tilt can spin, literally flopping over and over on their sides. They are trying to make their world upright again. Anyone who has ever experienced vertigo can understand why. Their world is literally upside down. The extreme bend in their neck is their way of dealing with it.
What the Vet may do: There are two usual causes of Head Tilt. One is an ear infection. This is typically a middle or inner ear infection. It may be the result of a missed outer ear infection, an U.R.I. or it may have started in the inner or middle ear. It is much less likely to be something such as a brain tumor, but it is possible. Your vet will check their ears. They may do a skull x-ray to check for middle ear involvement. They will typically treat the rabbit for 2 disorders at once: E. Cuniculi and an ear infection. For the ear infection, a vet will usually prescribe injectable penicillin, which may be given in weekly intervals at the vet. An injectable is needed because the area of infection is much deeper than what a drop or even an oral antibiotic can reach. Typically, a rabbit will also be prescribed Panacur, a low cost dewormer used for horses, in case the rabbit has E.C. Testing for E.C. may be done at some vets, but most rabbits will test positive and it can be hard to tell whether the infection is active. The drug is safe and well-tolerated by most rabbits. Meloxicam will also be used for pain and inflammation.
Treatment: Even if you are following the treatment schedule, it may take awhile to see improvement. Many people report improvement after the second or third injection of penicillin. It is important to complete the treatment prescribed by the vet, stopping too soon will cause a relapse. Until the spinning stops, it may be necessary to syringe feed your rabbit with Critical Care. Your vet will tell you how much they need per day. Many rabbits will try and eat as soon as they feel under control, even if they are still "crooked". Make sure they can reach their water bowl. Also, if they are spinning, you may want to line their cage with extra padding. Place some towels under the area where they prefer to sit. Line the edges of their cage to prevent them from injuring themselves on the metal. They will likely not have bladder or bowel control until the spinning ceases, so change their cage pad often to prevent urine scald. It is also important to note that some rabbits do not recover from Head tilt. Some retain a slight cock to their neck. Others remain in full tilt permanently.
E. Cuniculi is a disease that most rabbits have been exposed to. It was long thought to be a protozoal infection, but has just recently been determined to be a fungal infection. Regardless, treatment has not changed. Rabbits are only contagious for a few weeks after they have been exposed. It is present in their urine during this time. E.C. is most commonly associated with Head Tilt but also can cause damage to nerves throughout the body. It can cause liver disease, hind leg paralysis, incontinence, difficulty swallowing and even cataracts. Once thought to be a disease of only older rabbits, it can actually strike at any age and tends to occur after other major health issues.
What You vet may do: If your rabbit has Head tilt, the treatment is listed above. For other E.C. complications such as hind leg paralysis, the vet will still likely treating with Panacur and meloxicam. It is important to get to the vet A.S.A.P after noticing these symptoms. Only rabbit vets will be well-versed in this disease. Testing for E.C. in asymptomatic rabbits is contested amongst vets. It is believed that as much as 80% (or higher) of rabbits have been exposed, so testing would only tell you that they have been exposed. If they have no symptoms, treatment might not do anything.
Treatment: Give the full month's dosing of Fenbendazole. Make sure to watch your rabbit's food intake and check for new symptoms. Check for pain. As listed above, make their cage as comfortable as possible. If they do become paralyzed, consider getting your rabbit a cart--many bunnies do quite well with them.
Costs: Vet visit $50. It depends on the vet as to whether you are charged for every visit requiring an injection. A peniciliin injection usually runs between $25 and $40. Many vets only charge for the shot or a tech visit fee. X-rays can cost upwards of $90. Meds are inexpensive. Fenbendazole is OTC and only cost about $15 a tube. It is a horse med. You may need two tubes depending on rabbit size.
Resources: Check out rabbit.org for more info. https://rabbit.org/encephalitozoon-cuniculi/ and https://rabbit.org/head-tilt-causes-and-treatment/
Skin Parasites and Infections
There are a variety of skin infections and parasites that can affect a rabbit. This section is just an overview of a few common infections. Prevention is the best course of action and most of these are highly unlikely to occur in a rabbit housed indoors. Fur mites, ear mites, fleas, ticks, botfly, flystrike and ringworm are all fairly common in rabbits.
Symptoms: A very itchy rabbit. You may see flaky skin and redness on your rabbit's back.
What your vet will do: Take a skin scraping to check for mites--you can't see them too easily.
Treatment: Revolution(the cat flea med) will be applied to your rabbit once a month. The vet may require a re-check to see that it has cleared. This is easily spread to other bunnies, so have them all checked if one of yours is positive. Absolutely no baths should be given.
Symptoms: Your rabbit will scratch constantly. You can see the fleas when brushing them and if they've had them for awhile flea dirt(feces) will be present.
What your vet will do: Check for fleas or take your word that you saw fleas on your rabbit.
Treatment: Revolution once a month for three months. They are rare on a truly indoor rabbit and may have been transmitted by another pet. Treat everyone and vacuum everywhere.
Symptoms: Seeing a tick embedded in your rabbit's skin.
What your vet will do: Help you remove the tick if you cannot.
Treatment: Revolution again.
Symptoms: A crusty build-up inside your rabbit's ears.
What your vet will do: Take a scraping of your rabbit's ear.
Treatment: Revolution applied once a month.
Photo of a rabbit's ear encrusted with ear mites.
Also referred to as Cuterebra.
Symptoms: Small lumps on the rabbit's body. You may feel them move.
What your vet will do: Remove all the larvae. These have been laid in the rabbit's body and need to be surgically excised. It may take more than one treatment. Antibiotics may be needed for infection.
Treatment: Care for the wounds as directed by your vet and give all the antibiotics, keep an eye out for recurrences.
Symptoms: Visible wounds on your rabbit's body. These wounds are severe and life threatening. The flies were attracted to a wound already on your bunny. Whether it was a sore hock, infected eye or even a tooth, they laid their eggs in the wound. The maggots then hatch and begin to eat the rabbit.
What your vet will do: Debride the wounds and remove the maggots. There can be hundreds and
this will require ongoing care and wound management.
Treatment: Wound care as prescribed by your vet.
Pain meds and antibiotics. Not housing your rabbit outside prevents flystrike and botfly infestations.
Cuterebra infestation removed.
Cuterebra "hole" seen in skin.
Symptoms: Visible scratching by the rabbit. Raised patches of skin usually round in appearance. Humans can pass this to rabbits. It is a fungus, not a parasite. Treatment is important as infection can become severe.
What your vet will do: Take a skin scraping.
There are a variety of dental issues which can affect your rabbit. Malocclusion of the molars and incisors is very common in rabbits, especially dwarf rabbits. Molar abscess can cause infection that travels throughout their nasal passages and even their eyes.
Malocclusion: A misalignment of the teeth.
Symptoms: You should always check your rabbit's incisors to make sure they are not overgrowing--it will prevent them from eating. Weight loss, drooling, swelling of their cheeks and overall lack of appetite are the main symptoms.
What your vet may do: If the incisors are overgrown, they can be trimmed. This can sometimes be done without anesthesia. The teeth could have to be trimmed as often as every 4 weeks. In those cases, extraction may be recommended. Incisors are not needed to chew, just to grab food(and bite). Rabbits can live healthy, full lives without incisors. If their molars have points, they can grow into their tongue or cheek and cause a lot of pain for your bunny. The rabbit will have to be anesthetized for grinding down the points. It is more rare to remove a molar(unless there is an abscess) as complications can arise. X-rays may be taken to see whether the roots of the teeth are growing up into the nasal cavity--both ends of a rabbit's teeth can overgrow(root and tip).
Treatment: Providing a rabbit with a balanced diet of hay can do wonders for preventing overgrown teeth, but in some rabbits, their genetics simply override environment. Keep an eye on the growth of their incisors and bring them in for trims when needed. If their incisors were removed, tearing lettuce and other greens into smaller pieces can help a rabbit eat.
Costs: Trims are expensive and considered minor surgery. X-rays will be around $90 per view, more if they required anesthesia. A molar trim can run up to $300. Pain meds also may be given after molar trims.
Properly aligned teeth should stay short.
Photo of a molar spur courtesy of Hope Animal Hospital.
Symptoms: Drooling, lack of appetite, mouth odor, swelling in their face, runny eyes or nose.
What your vet may do:The vet will check the rabbit's teeth with either a speculum or otoscope. They may need to anesthetize your bunny to get a better look inside their mouth. X-rays may be taken. The abscess may cause sepsis if not treated and it will need to be surgically excised. Antibiotic beads may be placed inside the pocket to cure the infection. Having a rabbit specialist is very important as this is a difficult surgery requiring specific expertise.
Treatment:Make sure the rabbit is eating. Syringe feeding will probably be necessary at first as this is major surgery and their mouth will be sore. Make sure they stay hydrated, subcutaneous fluids may be necessary(injections of ringer's lactate under the skin.) Give any antibiotics prescribed until they are gone. Give pain meds as needed.
Costs: This is major surgery and quite expensive, upwards of $300.
A Sore hock is inflammation on the heels of a rabbit's hind legs. They are most often caused by improper housing. The grids in most pet store cages or hutches dig into a rabbit's feet and damage the tissue in their heels.
Symptoms: Limping, weight shifting when standing or sitting. Bleeding from the feet.
What your vet may do:Check the feet for signs of infection. Debride the wound if they are severe. X-rays may be taken if the wounds are severe to make sure the bones have not been affected. Antibiotics may be given if infection is suspected. Other balms or sprays might be prescribed. Meloxicam may be given for pain management.
Treatment:Apply any meds to the feet as needed. make sure they have lots of soft cushy bedding in their cage. change it frequently to prevent infection. Give pain meds as needed.
Costs: Vet visit $50. Antibiotics around $25.
The inflamed callus on the bottom of the foot is from being housed in a cage with wire floors--10 years ago.
There are many possible parasites that can infect a rabbit. Following is a very brief overview of the most common parasites. Rabbits who live indoors are at a drastically lower risk for contracting these parasites. Regular vet checks and fecal tests offer more assurance that your pet is parasite free.
Tape Worms, Pinworms, hookwroms, whipworms
Symptoms: Perhaps none, possible weight loss, itching, redness around anus. Some worms may be excreted in their feces.
Treatment: We de-worm all rabbits that come into our shelter. If your dog has been found to have tapeworms, ask your rabbit vet about treating your rabbits(they might not get the same meds--do not share). Indoor rabbits rarely get these parasites, but a fecal test performed at your regular vet check can assure owners that their rabbits are parasite free.
Myxomatosis(Myxo) is a virus spread in European rabbits(domestic rabbits only in the U.S.) with a 99% mortality rate. Luckily, in the U.S., domestic rabbit outbreaks of the disease have been limited to Western states. It is believed that cottontail rabbits have some immunity to the disease and that is the reason why the disease has not spread further. In Europe, a vaccine has been developed and is given to all pet rabbits. It is spread through mosquitoes, fleas, mites and flies and infected rabbits.
Symptoms: high fever, swollen lips, eyelids and genitals, lethargy, breathing difficulty. They will die within two weeks. No cure is available. We have no vaccine approval in the U.S.
Viral Hemorrhagic Disease
Viral Hemorrhagic Disease (VHD), also known as Rabbit Hemorrhagic Disease is a calcivirus that only affects wild and domestic European rabbits. Like Myxo, U.S. cottontails are believed to be immune. It is spread rabbit to rabbit or by items that have been in contact with infected rabbits, including humans. Birds and rodents are believed to be intermediate hosts. There is a vaccine available in Europe. There have been intermittent U.S. outbreaks, but the vaccine is not available here.
Symptoms: Loss of appetite, high fever, spasms, sudden death. Death occurs in 48 hours. No treatment is available.