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Hallmark Health Guide

Dr. Jay Hriez, DVM

Written By:


HLRSC Guidebook -7th Edition

The concept of rabbit health catered to a specific breed is relevant in today’s world and especially applicable to a breed as popular as the Holland Lop. Selective breeding has generated an even-tempered small breed of lop rabbit that is popular on the show table and in the homes of many Americans across the U.S. As a result of their popularity, several ailments and health concerns have arisen that are more Commonly found in the Holland Lop compared to the other ARBA recognized breeds of rabbits. This article will focus on these specific problems and discuss treatment options.

In general, breeders should get into the habit of doing regular health checks on their Holland’s. The health check is an under utilized – but powerful and inexpensive – tool that breeders have at their fingertips. This guide will follow what you should be looking for in every Holland from head to tail.

What is Normal?
• Respiratory rate: 30-60 breaths / minute
• Heart rate: 130-325 beats / minute
• Rectal temperature: 101.3 – 104°F
• Food consumption: 5 grams of food / 100 grams of body weight / day
• Water consumption: 5-10 mL (cc’s) / 100 grams of body weight / day
• GI Transit Time: 4-5 hours

There are parameters here that should be emphasized. Rabbits are obligate nasal breathers. They MUST breathe through their nose when they respire. Because of this, they have a high resting respiration rate. As an animal decreases in body weight, the heart rate generally increases as the animal moves from predator to prey. As mentioned before, a rabbit must rapidly adjust its situation when it is in the wild. In general, heartbeats above 250 are difficult to measure.

The first aid kit:
What defines a first aid kit? The average rabbit breeder is NOT a veterinarian. Therefore, it is useful to know some items that can be obtained WITHOUT a veterinarian’s prescription. Here are some common items
that should be in every breeder’s arsenal:
• Antibiotics: PPG (Penicillin-Procaine G), Terramycin ophthalmic ointment (oxytetracycline with
polymixin B), Terramycin soluble powder (oxytetracycline), LA200 (injectable oxytetracycline)
• Antihelmintics (Anti-parasites): Ivermectin, Fenbendazole, Corid
• Anticoagulants: Kwik Stop (Styptic), corn starch
• Bandages: Gauze pads, vetwrap, ace bandage
• Critical Care: Sub-Q fluids (Lactated Ringers Solution, Plasmalyte, 0.9% NaCl), Oxbow Critical Care,
Rabbit Nutri Drops, Acid Pack 4-Way, Fast Track
• Hypodermic needles & Syringes: 22 gauge for injections, 20 gauge for SQ fluids
• Healing: Silver Sulfadiazene, Preparation H
• Teeth & Nails: Toenail clippers, wire cutters

Nose & Respiratory
Nasal discharge is perhaps the most common situation a breeder could be presented with. This can also be associated with a harsh sound produced when the rabbit breathes at rest. Please be aware that chronic nasal discharge in groups of rabbits may benefit from being culled as this may be a herd immunity problem. Regardless, treatment is warranted especially in first time offenders. The only antibiotic that is easily
accessible without veterinary intervention is Penicillin Procaine G (PPG). This is a subcutaneous injectable drug (NEVER NEVER orally!) that has good efficacy against common bugs living in the rabbit’s upper respiratory tract.

The signs of a upper respiratory infection (URI) in rabbits include:
• Unilateral or bilateral mucopurulent discharge from the nares (nostrils), aka “snot”
• Matting of the inner side of the front paws
• Chronic conjunctivitis and/or ocular discharge (weepy eye)
• Frequent sneezing
• Head tilt (usually due to a severe URI)

The following antibiotics that the author uses are in order of preferred use. Should one antibiotic not work, proceed to the next antibiotic. These antibiotics can be obtained from most small animal veterinarians as well as large animal veterinarians.
1) Trimethoprim sulfa/SMZ-TMP
2) Baytril (Enrofloxacin)
3) Chloramphenicol

URIs are relatively SIMPLE to TREAT
URIs are extremely DIFFICULT to CURE

The Holland Lop is separated from its lop cousins by a relatively short face with a wide muzzle and a curved skull when viewed from the side. Short, thick, lopped ears attached to a prominent cartilaginous crown further accentuate the unique attributes of the breed. This adjustment in the shape of the skull and placement of the ears predispose Hollands to a few conditions we see more frequently than over breeds. They are outlined below:

When the length of the head was shortened in Holland Lops, so was the route that was taken by the nasolacrimal duct which helps drain tears from the eye. This tortuous canal, beginning in the front of the inner part of the eye, courses through the maxillary sinus of a rabbit and exits on the inner part of the nostrils. The relative length of the nasolacrimal duct has not changed in the breed but the course it takes has since the skull was modified. Because of this, Holland Lops are at a greater risk for weepy eyes or conjunctivitis. Somewhere along the nasolacrimal duct the canal is occluded, tears back up, and irritation occurs around one or both eyes. Because of this, Holland Lop breeders should be prepared to deal with this problem occasionally. The treatment of choice is Terramycin ophthalmic ointment 2-3 times per day for up to 7-10 days. Other prescription eye drops available include gentamycin, ciprofloxacin, and ofloxacin.

Cataracts, masses, and other intraocular lesions are difficult to treat without proper diagnosis of the actual cause (bacterial, viral, protozoal, cancer, fungal, physiologic, etc.). Veterinary intervention or assistance from a healthcare professional is advisable here.

Ear mites are common in outdoor rabbits. This is easily remedied with administration of Ivermectin (injectable) in a subcutaneous injection 10-14 days apart. The dose to administer will vary based on the concentration of the drug – ALWAYS remember to double check the concentration! For a typical 1% Ivermectin preparation, 0.02 mL (cc’s) per pound is sufficient. Please be aware that 0.02 is a SMALL

Skin & Fur
Fur mites, like ear mites, are common pests in rabbits housed outdoors. Luckily they respond to Ivermectin administration described above very well!

Sore hocks (pododermatitis) plague Holland Lops. A severe case of sore hocks involves the entire layer of skin on the plantar surface of the hind food abraded off, active bleeding, scabbing, and/or swelling. A generous amount of a solid surface should be placed in the cage to prevent further damage. In addition, a healing agent should be applied daily. Preparation H is a great first product to reach for. If you have a good relationship with a veterinarian, request a prescription for a tube of Silver Sulfadiazene cream.

Lacerations are common in rabbits because they have very fragile skin (an adaptation for a species of prey). Small, linear lacerations that DO NOT involve muscle can be easily put together after cleaning with skin glue. I do not recommend ever suturing or skin stapling skin on a rabbit unless they are heavily sedated first.

Fractures are very common in rabbits due to their light percentage of skeletal body weight described earlier. Common areas that rabbits fracture include:
• The tibiotarsal joint or the “hock”
• The radius and/or ulna of the front leg
• The metacarpals, metatarsals, and phalanges of the front and back legs (the toes)
• The spine

The first two fractures, which occur in the front and hind legs, can be stabilized with novel instruments. For small breeds of rabbits, a splint can be constructed of popsicle sticks and firmly put into place with vetwrap or an ace bandage. The joint must be stabilized prior to and after the injury so the splint should span well beyond both ends of the fracture. Please be aware that most rabbits are miserable with this apparatus
attached to their leg and will actively try to remove it! The third fracture, to the toes, is unable to be splinted. Cage rest will help the fracture heal. Most fractures in rabbits take on average 4-6 weeks to heal fully. Please be aware that this is a “best guess” method of fracture repair. A mal-union or deformity may result after the joint is healed.

The fourth fracture (the spine), unfortunately, is generally associated with a poor prognosis in most rabbits. Spinal fractures usually do not respond well to immobilization and the back cannot be easily splinted in most rabbits. The quality of life for this rabbit must be strongly considered before anything else is done.

Hooked spines are occasionally noted in Holland Lops. The scientific term for this condition is called thoracic scoliosis or lordoscoliosis (we will abbreviate this as LS). This condition in domestic rabbits tends to follow a pattern as the animal develops. The problem is usually not evident at birth. First signs generally are noted between four and six weeks and continue until sixteen weeks of age. LS usually occurs between
thoracic vertebrae segments 7-10 (the part of the spine that lies above the last few ribs) and is usually accompanied by scoliosis, which is literally an abnormal curvature of the spine. This can be felt as you run your hand across the shoulder region of the rabbit centered over the spine. When examined microscopically, the problem extends below the spinal column and causes the disc material contained in the spinal cord to bulge inwards. This is a genetic problem and should be removed from your breeding program if noted.

Broken teeth are a common problem in rabbits. A rabbit’s dentition continuously erupts throughout life. As long as there is not active bleeding, simply allow the new tooth to erupt fully.

Malocclusion is a very common problem in domestic rabbits. There is a hereditary component to it and therefore care must be taken to cull rabbits that are passing this trait down. “Wolf teeth,” the more severe of the two forms of malocclusion, must be addressed with regular clipping of the teeth. Reflect the cheeks back and stabilize the rabbit. Use a regular pair of toenail clippers or wire cutters (cleaned beforehand) to
clip the excessively growing teeth. Ideal occlusion of the teeth have the front incisors just barely laying over the bottom incisors.

Major gastrointestinal problems are common and the Holland Lop is no different. What most Holland Lops and rabbits are encountering is some type of “enteropathy.” This vocabulary implies that this is not necessarily a single disease but a collective group of signs that many rabbits exhibit. The staples of an enteropathy in domestic rabbits include:
• Anorexia (no appetite) or anorectic (reduced appetite)
• Lethargy (can range from mild to severe)
• Hiding and exhibiting signs of pain
• Decreased stool production
• Excessive gas and/or bloating
• Quick progression (rabbits can be dead within 24-48 hours)

These signs are usually quickly recognized and unless intervention is initiated rabbits can succumb to the condition quickly. What follows are the most common causes of an acute enteropathy:

Stressful events: Significant fluctuations in temperatures, lack of water or food for prolonged periods of time, difficult pregnancy, stressful travel, trauma, pain, and much more.

Poor diet: Too low of fiber. This promotes hypomotility and prolonged retention of material in the cecum. In addition, an increased amount of soluble carbohydrates allows for proliferation of E. coli and Clostridia species. Toxins in the feed can lead to this as well.

Underlying disease: Gastric stasis (ileus), enterotoxemia, intestinal coccidia, or a foreign body.

The following treatments are warranted in rabbits that are sick and/or dying from gastrointestinal disease:

Fluids: Subcutaneous fluid administration can be done on the nape of the neck once a day for rabbits that are severely dehydrated (tacky gums, skin tents). The common products are Lactated Ringers Solution (LRS), Plasmalyte (P-lyte), or 0.9% NaCl. The author prefers a 60 cc syringe hooked up to a butterfly set. The gauge of the needle is typically 22g or 20g. The AVERAGE rabbit can receive between 75-100
mL (cc) of fluids per day.

Nutrition: If the rabbit is willing to eat, hay supplementation is absolutely necessary. For those that are not eating, force feeding is warranted. Oxbow Critical Care is the supplement of choice as it can be fed via syringe to rabbits reluctant to eat. This is a powdered herbivore diet that is high in soluble fiber, which is necessary in GI stasis. The consistency of the feedings is similar to “runny toothpaste” and can be given in
small feedings of 10-15 cc’s 2-3 times per day with a feeding syringe.

Pain: An enteropathy is generally considered by most exotic animal veterinarians to be a painful sensation. In particular GI stasis due to bloating in the stomach, small intestine, or colon are of particular discomfort. The common pain medications we administer are Buprenorphine, Tramadol, and Meloxicam. These must be obtained via a licensed veterinarian.

Motility stimulators: These are intended to get the gut moving once again. The staple drug in rabbits is Metoclopramide. It is given orally two to three times a day (every 8-12 hours) at the dose of 0.5 mg/kg.

Antibiotics: In cases where diarrhea is present, Metronidazole is an excellent choice for helping potential GI pathogens and also has a slight effect of decreasing inflammation of the gut. The dose is 20 mg/kg by mouth twice a day (every 12 hours) for 10 days.

Abdominal massage: The principle here is to relieve pressure due to gas. Care must be given to not massage too aggressively as very tympanic (bloated) rabbits can perforate various organs of their GI tract if massaged too aggressively

Anti-Gas Products: These include Simethicone (Gas-X). The drop form is best for rabbits. This product is relatively safe and can be given as frequently as every 6 hours (1-2 drops at a time).

Probiotics: These products promote normal gastrointestinal flora. It is similar to the reason why yogurt works in people with gastrointestinal problems. This includes Bene-bac, Proviable for rabbits, and soluble electrolytes in the water.

Nutritional supplements: These items are readily available in your grocery store and include pineapple pieces, pineapple juice, papaya, and parsley. These treatments rely on your rabbit having an active appetite.

Other Treatments: These may include, but are not limited to:
• Dexamethasone: A potent anti-inflammatory (steroid)
• Vitamin B12 Complex: An injection of this will assist with helping rabbits eat again. Use approximately
0.25 cc’s subcutaneously.

To combat the growing concern of enteropathies in our domestic rabbit population, PREVENTION should be practiced regularly. The following are some steps breeders can take to ensure their rabbits are safeguarded against potential devastating outbreaks:

Establish a good relationship with your feed provider and take not when feed does not appear to look fresh or compromised. Avoid major fluctuations in fiber, protein, or carbohydrate concentration in your feeds.
• Provide fresh, clean, cool water regularly to your rabbits. Take measures to ensure that they are never
without hydration.
• Consider treating your herd prophylactically for coccidiosis every 6 months to a year.
• When large shifts in temperature are anticipated, take precautions to ensure your rabbits do not suffer
the wrath of this giant gain or loss in temperature.
• Pregnant does should be monitored closely for signs of stress and these problems should be corrected
• Consider worming your rabbits every 6 months with the following medications:
-Fenbendazole (Safeguard or Panacur) or Ivermectin for Pinworms
- Piperazine for Pinworms (added benefit that you can dilute it in water, 100 mg per 100 mL of water)
-Praziquantel (Droncit) to treat tapeworms and flukes

This is quite possibly one of the most frustrating conditions that a rabbit breeder will encounter. While many theories exist as to why this may occur, the most important piece of information to take home is that there are many ways your rabbit can develop an enteropathy. When the signs first appear in your herd, take steps to assure that this will not rapidly develop into an epidemic. Your rabbits gastrointestinal health is worth it!

Intestinal coccidiosis is the most common presentation noted by rabbit breeders and can be diagnosed with fecal flotation at most small animal veterinary clinics. Rabbits become infected with these species by ingesting oocysts of the organism, which is usually from other feces or fecal contamination. The most common age group that’s affected is young rabbits. Signs include:
• weight loss
• diarrhea +/- blood +/- mucous
• dehydration

It is important to note that since the disease is common in younger rabbits, the situation generally deteriorates rapidly once diagnosed. Quick intervention is often needed. Breeders with multiple rabbits showing these signs should pool a fecal sample for diagnosis via a fecal float.

Treatment of intestinal coccidia is most commonly achieved with Sulfa based drugs.
The most common of which are:
• Sulfamethoxine (Albon) at 75 mg/kg/day PO for 7 days
• 0.02% Sulfamerazine sodium via drinking water
• Trimethoprim-sulfa at 30 mg/kg PO q12h x 10d.
• Amprolium 9.6% (Corid) in drinking water (0.5 mL / 500 mL / 17 oz.)
• Ponazuril (Marquis in horses) at 20 mg/kg PO q24h X 7 d.

Vent disease is common in breeding bucks and occasionally does. The genital area is scabbed, reddened, malodorous, and painful. It is NOT necessarily an emergency but certainly stop using these animals if you are breeding them temporarily! The two treatments, which should NEVER EVER be given by mouth, are:
• Penicillin G benzathine-penicillin G procaine given at 42,000 to 84,000 IU/kg once a week for 3 weeks
• Penicillin G procaine at 40,000 to 60,000 IU/kg intramuscularly once a day for 5 to 7 days

Dystocia or a difficult birth is common in small breeds, mothers with a large number of kits, and many more reasons. If a mother has not given birth after 36 days, intervention is needed. This involves intramuscular injection of oxytocin that will stimulate uterine contraction and is sometimes all that is needed to help the doe give birth. Oxytocin is obtained via a veterinarian.

A head tilt is most commonly caused by the following conditions:
• An ascending middle ear infection usually from Pasteurella multocida
• The protozoal parasite Encephalitozooan cuniculi
• Trauma (the rabbit has blunt trauma to the head)
• Cancer (chance generally increases with age)

Middle ear infections will respond well with a treatment regiment similar to treating an upper respiratory infection. Infections with E. cuniculi are treated with Fenbendazole once a day for 28 days. It can be obtained via a veterinarian or at your local feed store, and is sold in the two common forms of Safeguard (horses) and Panacur (dogs and cats).

This list is not exhaustive. It is merely a brief tour of the major organ systems in a Holland Lop and problems that can commonly occur. Despite our best efforts, many times what we have at our disposal is not sufficient to bring a rabbit back to adequate health. These situations include advanced infections that are refractory to the antibiotics at hand, fractures that are complex and cannot be splinted, injuries where significant pain control is needed, and situations where advanced diagnostics are needed (x-rays, ocular exam, skin scrape, etc.). For situations like these, the breeder will need to seek advanced help from a veterinarian. Before bringing your rabbit to a veterinarian, please make sure he or she is comfortable seeing rabbits! Clinics that are “exotic” friendly are a good place to start.

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