Nose: nasal discharge - overview

Rhinitis • snot • allergic rhinitis

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  • Cause : a presenting sign potentially caused by a variety of different disease processes or may be a primary problem originating in the nasal passage.
  • Signs : nasal discharge is a commonly seen presenting sign in pet rabbits. It is important to determine the type of discharge present: serous, mucous, bloody or purulent, and which nostril is affected (uni- or bilateral).
  • Diagnosis : risk factors identified from history, clinical examination, hematology, nasal culture and sensitivity, nasolacrimal flush, radiography, endoscopy/rhinoscopy, nasal mucosal biopsy, and CT scan.
  • Treatment : husbandry corrections (diet, temperature, substrate), antimicrobial therapy, non-steroidal therapy, nebulization, nasal flushing, mucolytics and surgical flushing where needed.
  • Prognosis : dependent on severity and cause of clinical signs. With chronic cases, complete resolution of clinical signs may not be possible.
  • Respiratory disease is very common in pet rabbits and is a major cause of morbidity and mortality.
  • Prompt treatment is required.
  • Upper respiratory tract disease, if left untreated, can spread to a number of different locations.

Print off the Owner factsheet on Nasal discharge    to give to your clients.

Presenting signs

  • Nasal discharge: serous, mucoid or purulent secretions visible from the nares. Discharges to the nasal passage can vary in color and consistency. Fur often appears matted at the nares.
  • The 'handkerchief' area on the medial forelimbs, often has matted fur after being used by the rabbit to wipe away nasal secretions.
  • Dyspnea    can include abdominal effort to breathing or flailing nostrils. As obligate nasal breathers, in cases of severe nasal discharge, rabbits can present with dyspnea.
  • Sneezing.
  • Coughing.
  • Open-mouth breathing.
  • Inappetence.
  • Anorexia    .
  • Weight loss    .
  • Lethargy.
  • Exercise intolerance.
  • Depression.
  • Epistaxis.
  • Increased breath sounds, sneezing and coughing may be appreciated.
  • In extreme cases of nasal congestion, open-mouth breathing may be evident; this is a poor prognostic indicators.
  • Dyspnea means grooming may become difficult simultaneous to breathing, and an unkempt coat may result.

Acute presentation

  • Sudden presence of nasal discharge; often serous at first, progressing to purulent.
  • Signs, if noticed, include:
    • Increased respiratory noise.
    • Sneezing.
    • Dirty 'hankies' on forepaws.
    • Lethargy.
    • Inappetence/anorexia.
    • Weight loss.

Geographic incidence

  • Infectious causes of upper respiratory disease are more prevalent in high temperatures and with inadequate ventilation. Hutch-living rabbits are at greater risk.
  • House rabbits can potentially be kept at too high a temperature due to central heating.
  • Nasal foreign bodies are uncommon, but rabbits kept outdoors and allowed to forage or housed on hay are at marginally greater risk.

Age predisposition

  • Risk increased with:
    • Infectious causes: young and old.
    • Nasal tumors: middle-aged to older rabbits.
    • Nasal foreign body: any age.
    • Dacryocystitis and dental disease: any age, but more common in middle-age and older rabbits.
    • Myxomatosis: any age.
    • Trauma: any age.
    • Allergy: rare, any age, but more commonly first noticed when young.

Breed predisposition

  • Thought that Dwarf breeds are more susceptible due to the shortened maxilla and mandible, leading to a reduction in nasal passage size and length. These breeds are also more prone to dental disease, which can lead to secondary nasal disease.

Public health considerations

  • Theoretically a rabbit bite could lead to a Pasteurella wound infection in humans; however it it rare for a rabbit bite to become infected, as long as the wound is cleaned thoroughly.

Cost considerations

  • To obtain a diagnosis from radiology in cases of advanced disease, multiple views are often required. For similar costs, a CT scan can be more cost effective.
  • CT scanning has a higher sensitivity than radiography at detecting subtle changes to the nasal architecture.

Special risks, eg anesthetic

  • Patients with nasal discharge are at a greater risk of anesthetic complications. Prior to anesthetic the patient should be pre-oxygenated for 3-5 min and once anesthetized, an endotracheal tube should be placed as quickly as possible to facilitate breathing.
  • If the patient is housed with other rabbits, the owner should be particularly vigilant for spread if the causal agent is infectious.
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