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How To Conduct A Rabbit Health Examination

A brown domestic rabbit on a towel.
Rabbits are great at hiding concerns, so you need to be vigilant about their health!

Updated October 5, 2020

Much like the common advice given to humans, it’s important to regularly check the health of rabbits with a routine physical examination rather than waiting until a rabbit is showing signs of distress or illness. Not only will this help you get to know what all aspects of a healthy rabbit look and feel like, but familiarizing a rabbit with human handling might help them stay more calm in stressful situations, which is particularly important for rabbits as stress can be highly dangerous to them. Be prepared to check them over at least every six to eight weeks*! Rabbits who spend time outdoors, especially during fly season, will need more regular checks to prevent dangerous issues like flystrike. For more information on why regular health examinations are important, check out our resource here.

*An Exam Every Six to Eight Weeks Means Daily Observations
Our recommendation to conduct routine health examinations every six to eight weeks must be done in conjunction with daily observations. Caregivers should be trained to observe animals both for behaviors that are abnormal for the species and also behaviors that are abnormal for each individual, keeping in mind issues that are common in a particular species and their warning signs. Thoughtful observation plays a crucial role in catching health issues before they progress into more serious situations.

Residents With Challenging Backgrounds
Close daily observation can be difficult with certain individuals or groups who come from challenging backgrounds. They may be more likely to hide signs of illness or injury, or may not allow you to come close enough to them to thoroughly assess their well being on a regular basis. Challenging backgrounds may include individuals who are not socialized, have lived feral, or were abused or malnourished. If you care for individuals who came from a challenging background, it is imperative to make time to foster a bond of trust so careful observation is possible. A monthly health exam is recommended for these individuals until they exhibit signs that they feel safe and you are confident that close daily observation is possible.

New Resident? Conduct An Intake Examination!
If you are conducting an initial health examination on a new resident, check out our intake examination resource to learn about what you should check for and document!

Problem Signals

Due to rabbits’ fur and many individuals’ aversion to handling, rabbits require close examination to reveal potential ailments and injuries that you may not notice through a cursory observation. As a survival instinct, rabbits are also generally quite adept at masking pain or distress until the symptoms prevent them from hiding it. By paying regular attention to all your rabbit residents, you may see some subtle cues in the event that something is amiss.

A sick, injured, or otherwise distressed rabbit may:

Conducting The Exam

Ask An Expert
Prior to regularly conducting rabbit health examinations, you should have a veterinarian or compassionate care expert give you hands-on training in order to be the best rabbit health advocate possible. Being trained to rapidly distinguish healthy conditions from abnormalities can be crucial in early health problem detection and effective treatment!

In cases of symptoms such as the ones above, it’s especially important to conduct a health examination on the rabbit. Generally, the examination should begin at their head, working your way back and down, but depending on the individual, you may want to use whatever order causes the least amount of distress, with ample breaks if necessary. It’s important to keep regular documentation of these checkups, including weight and any abnormal findings, in order to keep an easy-to-follow set of information in case a veterinarian needs the rabbit’s history.

Safety First!
Rabbits can become ill with disease that is transmissible to humans. It’s very important to wear gloves when conducting health examinations!

Before stepping into their living space, you should take note of the rabbit’s behavior. Are they acting differently than they usually do? How are they getting along with fellow rabbits? These clues can say a lot about a rabbit’s health.

Stressed Rabbit?
Rabbits who are stressed out by handling or confinement are at substantial risk of injuring themselves, especially their spine or legs. You must be aware of this risk and take all precautions to keep stressed out rabbits from hurting themselves! If a rabbit absolutely does not want to be handled, give them ample time to calm down and ensure that the way you’re securing them cannot lead to injury!

If necessary, you may have to have a second caregiver on hand to help manage the health examination or help keep the rabbit calm. Once you have the rabbit calm and ready, conduct the following observations:

When In Doubt…
Unless you are a qualified veterinarian or have been trained to handle specific conditions, The Open Sanctuary Project strongly advocates that you promptly report any health concerns you find during the course of an exam to your veterinarian or care expert. Unless they’re in a life-threatening situation, you should be your resident’s advocate, not their doctor.

Check their weight and body condition
It’s important to keep regular measurements of a rabbit’s weight. If a rabbit has lost a lot of weight, this could indicate a sickness, malnutrition, worms, or other parasites. If a rabbit is mature and has gained a large amount of weight in a short time, it’s critical to ensure that you aren’t overfeeding them, especially with alfalfa, treats, and snacks. Obesity-related complications can regularly lead to dangerous conditions and death in rabbits.
Check their head
How are they holding their head? It’s best if they’re holding it up on their own volition. If they’re shaking, hunching, tilting, or tucking their head, this can be a sign of illness or injury.
Check their eyes
The rabbit should have bright, clean, alert eyes. They should be free of discharge and clear. Cloudy, watery, dry, swollen, constantly blinking, reddened, or crusty eyes indicates likely illness or injury. The above symptoms could be signs of conjunctivitis, which could potentially be contagious to other animals and humans. Particularly cloudy eyes could be a sign of glaucoma, which should be treated with great concern. Their pupils should be about the same size and react properly to bright light (get smaller and then return to normal). If their mucous membranes are excessively pale, it could be a sign of anemia. Like many species, rabbits have a nictitating membrane (which presents like a thin “third eyelid”), which could indicate a stressed individual if it is quite prominent.
Check their ears
Their ears can have a modest amount of earwax or debris in them, but should be clear of any ear mites. Excessively sticky, yellow, or odorous earwax needs addressing. You can use a gauze pad to clear out excess earwax or to sample potential ear mites. Ear infections are common in many breeds of rabbits, and can be identified by individuals scratching their ears a lot, losing appetite or energy, or tilting their head frequently.
Check their nose
The rabbit’s nose should be free of any discharge, fluid, crustiness, or blood. Their nose should be soft and not cracked. An excessively runny or blocked nose could be a symptom of an upper respiratory infection like snuffles.
Check their mouth and teeth
You shouldn’t be able to hear a rabbit breathe in ideal circumstances, but you should be able to see their nostrils flare. Their breathing should not be labored, loud, wheezy, rattly, sneezy, whistling, or squeaky. Generally, a mature rabbit should have between 30-60 breaths per minute. They should not have a dry cough. Abnormalities should be immediately reported to your veterinarian. If they’re reluctant to eat, they might have a problem with one or more of their teeth that needs to be managed. Rabbit teeth grow their entire lives, and there are a number of dental issues that can arise that greatly decrease their quality of life. If a rabbit has particularly bad breath, it could be symptomatic of an infection and require deeper examination. There is a scent gland under their chin which can cause a waxy buildup that can be wiped off with a little bit of warm water on a gauze pad or clean cloth. If their chin looks to be quite inflamed, you should consult with your veterinarian to ensure there isn’t a problem.
Check their fur and skin
Check around the rabbit’s entire body to ensure healthy skin, parting their fur where necessary. This is the time to ensure you are checking and feeling every area of the individual’s body, not just those included in this list. This thorough section of the exam is critical to ensure that nothing that can be addressed early is missed.Their skin should not have lice, fly eggs, itchiness, mites, nits, lumps, cuts, cysts, bruises, gangrene, larvae, maggots, dry patches, blisters, or pressure sores. Their hair should be shiny, and their skin should be bright and not tough. Their hair should not be standing on end. Ensure they do not have any patchy fur loss or loss of pigmentation in their fur, which could be a sign of parasites or a mineral deficiency. During fly season, rabbits should be checked thoroughly for any fly eggs, maggots, or signs of cuterebras– individuals spending lots of time outdoors during fly season may need to be checked quickly for these conditions a few times each week.

Most rabbit residents benefit from a gentle occasional brushing, especially longer-haired breeds. NEVER immerse a rabbit in water, because this can cause the individual to go into shock. If necessary, carefully spot clean the individual. Efforts should be made not to move a rabbit onto their back or side during the examination, which can cause distress in rabbits.
Check their joints
It’s important to check the rabbit’s joints in their legs and shoulders for issues. Ensure that the rabbit doesn’t have pain when they move their joints. There should be no cracking or crunching sounds when they move, and they shouldn’t be avoiding putting weight on any of their joints in particular. Joint inflammation could be a sign of arthritis, which is prevalent in rabbits as they get older.
Check their nails and feet
Ensure that the rabbit’s nails are a reasonable length and free of cracks, breaks, swelling, discoloration, or debris. Any of these issues can cause lameness, discomfort, and could possibly contribute to infections and further damage. They should be able to put their full weight on their feet and they shouldn’t limp. If they are limping, check their feet for thorns or other foreign objects, parasites, infection, or foot sores. Foot or hock sores should be evaluated by a veterinarian. If their nails are overgrown, schedule a trimming as soon as you can.
Check their rear end
The rabbit’s butt under their tail should be relatively clean. It shouldn’t have any discharge, excessive accumulations of fecal matter around it, nor should it be crusty or bloody. Ensure that it doesn’t have any mites, lice, tapeworms, or other parasites. Make sure that it isn’t irritated or prolapsed (protruding). If it’s prolapsed, you should consult with a veterinarian. When checking a female rabbit, be sure to check their vulva for any scabbing or discharge. Check their scent glands on either side of their genitals for buildup and clean with a gauze pad soaked in warm water if necessary. If they are particularly smelly or musky, they may need to have their scent glands checked out and cleaned by a veterinarian or rabbit care expert.
Check their poop and urine
It’s important to monitor a rabbit’s poop and to recognize what healthy rabbit droppings look like. Healthy rabbit poop is formed in small, well-formed pellets that are rather hard to the touch, but breakable with effort. If their poop is poorly formed, watery, strong smelling, or bloody, it could be a sign of diarrhea, parasites, illness, or improper nutrition. Diarrhea in rabbits is a sign of a serious health concern and should be promptly investigated. Check out other potential forms of rabbit droppings here. If you’re particularly concerned by a dropping, you can bring it into your veterinarian for analysis, though you should consider fecal testing healthy-seeming rabbits at a regular interval to check for internal parasites. Their urine should be clear to deep yellow, but not brown, very dark, bloody, cloudy, or concentrated. Red urine is not uncommon and is often caused by the rabbit’s diet rather than by blood in the urine, but always discuss any concerns you have with your veterinarian. There should be no chalky sediment in rabbit urine. ANY unexplained change in their volume of poop or ability to comfortably poop should be treated as a serious health problem and they should be seen by a veterinarian immediately.
Isolate If Necessary
If you notice that a rabbit is unhealthy, it’s crucial to consult with a veterinarian or compassionate care expert and prioritize accurately diagnosing the problem. Depending on the health concern, it may be necessary to isolate the rabbit in order to protect other rabbit residents from a potentially infectious disease.  However, with some illness, such as pneumonia, often once a rabbit is showing symptoms, other residents in the same living space have already been exposed. In these instances, you will need to weigh what is in the best interest of all of your residents. A sick rabbit who is isolated from their companions may become more stressed, which could delay recovery.  Depending on the health concern, separating the rabbit with a calm companion might be a good compromise.

Though it may seem like an overwhelming amount of factors to be aware of, once you’ve gotten to know a rabbit and what good rabbit health looks like, you’ll be an excellent rabbit health ally in no time!

Writing It All Down

As you may know, regular documentation is a critical part of responsible sanctuary animal care. In order to maximize the value of your rabbit health examinations, we’ve developed a free printable rabbit health exam form for sanctuaries and rescues!

SOURCES:

Rabbit Health Check: Signs of a Healthy Bunny | Best Friends

What Rabbit Poop Tells You About Their Health | The Bunny Lady

What Pee Tells You About A Rabbit’s Health | The Bunny Lady

Temperature, Heart and Respiration Rates | House Rabbit Society

Red Urine: Blood or Plant Pigment? | House Rabbit Society

Rabbit Physical Exam | SonoPath

Updated on October 5, 2020

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