Lapis ISSN 2398-2969

Wound: management

Contributor(s): Aidan Raftery, Glen Cousquer

Introduction

  • Rabbits have thin skin that is protected by their thick coat of hair, which consists of a soft undercoat and stiff guard hairs.
  • Where these defenses are breached, damage to the epidermal and dermal tissues are likely to result.
  • The protective nature of the hair coat is perhaps most developed over the distal limbs. In particular, rabbits have a thick covering of fur over their front and hind toes and metatarsals, instead of foot pads. 
  • Removal, or wear, of the hair covering a rabbits hocks is likely to result in the development of pododermatitis or hock sores   Ulcerative pododermatitis (Bumble foot)  .

Hair should not be clipped from the base of the hocks or base of the feet.

  • A wide range of traumatic, parasitic and infectious factors can result in wounds in rabbits.
  • Careful evaluation of the rabbit and its history is required to identify the factors that have given rise to the wounds.

Take care during clipping of the fur as it is easy to tear the delicate skin.

Etiology

  • Traumatic wounds may arise as a result of conspecific or interspecific bites, road traffic accidents, clipping and a range of other causes.
  • Ulcerative pododermatitis   Ulcerative pododermatitis (Bumble foot)  arises where ischemia and necrosis gives rise to pressure sores over the bony prominences of the rabbits hocks   Pododermatitis: corn formation    Pododermatitis: sore hocks 01  . Extension of any infection can ultimately result in osteomyelitis   Osteomyelitis  .
  • Folds of skin, the chin, perineum and particularly the dewlap of female rabbits, are prone to moist dermatitis   Moist dermatitis      Dewlap: conditions and treatment  .
  • Moist dermatitis may also develop in rabbits with dental disease   Teeth: dental disease - overview    Dental malocclusion / overgrowth  and ptyalism, as well as in rabbits with urine scalding   Perineum: urine scald      Perineum: urine scald  , diarrhea   Diarrhea: overview      Feces: diarrhea  or other forms of coat contamination.
  • Subcutaneous abscesses   Abscess   are commonly seen in rabbits. They are usually caseated and well encapsulated. Complete surgical excision   Surgical techniques: overview  will usually be the treatment of choice and consideration must therefore be given to the management of any resulting wound.
  • Peri-apical abscesses are particularly commonly in rabbits and occur secondary to dental disease, which must also be addressed if treatment of the abscess is to be successful.
  • Methicillin-resistant Staphylococcus arueus(MRSA) can be a cause of dermatitis in rabbits:
    • Hospitalized pets and veterinary staff have been reported to pass the organism back and forth.
    • MRSA has been isolated from a pet rabbit.

If dermatitis is not responsive to antibiotics, submit a sample for culture and sensitivity.

 Fusobacterium necrophorumis a zoontoic disease and can be transmitted to humans via animal bites or wound contamination with infected animal feces.

  • Dermatophytosis   Ringworm  in rabbits is often symptomatic:
    • Commonly caused by Trichophyton mentagrophytes  Trichophyton spp   in outdoor and laboratory rabbits whereas Microsporum gypseumand canis  Microsporum canis  are more commonly found in pet rabbits.
    • Alopecia, crusty, dry +/- pruritic lesions are often found around the head, legs, feet and nail beds.
    • Rabbits can become infected from other animals or humans.

Treatment is recommended because of zoonotic potential.

  • A number of parasites are capable of causing skin damage in rabbits   Dermatology: parasitic disease - overview  :
    • Ear mites ( Psoroptes cuniculi)   Psoroptes cuniculi  can cause an intensely pruritic otitis externa. The resulting damage is superficial and the crusty exudate   Ear: otitis externa - psoroptes cuniculi 01    Ear: otitis externa - psoroptes cuniculi 02    Ear: otitis externa - psoroptes cuniculi 03  is readily eliminated following successful treatment of the mite.
    •  Cheyletiella parasitovorax  Cheyletiella parasitovorax  are a type of fur mite that cause mild scaling and crusting but again, this damage remains superficial.

Treatment is recommended because of zoonotic potential.

  •  Leparocarus gibbus  Listrophorus gibbus  is another type of fur mite   Listrophorus (Leporacarus) gibbus mite  that are commonly found on rabbits. Rabbits will often carry these mites asymptomatically, clinical signs (+/- pruritic and alopecic dermatitis on ventral abdomen, back, perineal area and tail) will appear when the rabbit becomes stressed and/or immunocompromised.
  • Other fur mites that cause dermatitis in rabbits include Sarcoptes scabiei  Sarcoptes scabiei    Sarcoptic mange    Sarcoptes scabiei  , Notoedres cati  Notoedres cati    Notoedric mange  , Demodex cuniculi  Demodex cuniculi    Skin: demodicosis  , and Ornithonyssus bacoti(in laboratory rabbits).
  • Myiasis   Fly strike   (fly strike) occurs most commonly in warm summer months, where larvae of Cuterebraspp and maggots of dipterid flies, eg flesh fly Wohlfahrtia vigil, infect rabbits:
    • Blowflies such as Lucilia sericataare attracted to lay their eggs on a rabbit. The developing larvae can cause considerable damage to the cutaneous and subcutaneous tissues   Fly strike 05: severe  .
    • In North and South America, bot fly larvae ( Cuterebraspp) may infect both wild and domestic rabbits, pupating under the skin.
    • Blackfly (Simuliidae family) bites will become inflamed and occur around the lips, eyes and nares. They can also transmit viral infections, including myxomatosis   Myxomatosis  .
    • Flea infestations   Flea infestation  are found most commonly in rabbits that are living with dogs   Ctenocephalides canis  and cats   Ctenocephalides felis  . There are a variety of different species that affect wild rabbits. Flea infestations can cause a patchy alopecia, skin erythema and crusting on the pinnae, face and dorsum. Fleas can also transmit myxomatosis   Myxomatosis  .
    • The rabbit louse ( Haemodipsus ventricosus) is not commonly found in pet rabbits. Severe infestation   Lice infestation  will cause anemia, erythematosus papules, alopecia and pruritus. Haemodipsusmay transmit tularemia   Tularemia  .
  • Cutaneous neoplasia   Cutaneous neoplasia  can occur in rabbits, but rarely associated with viral infections:
    • Lymphosarcoma   Lymphosarcoma: overview  will present as erythematosus, crusty alopecic plaques   Cutaneous neoplasia: T-cell lymphoma 01    Cutaneous neoplasia: T-cell lymphoma 02    Cutaneous neoplasia: T-cell lymphoma 03   and is often associated with systemic neoplastic lymphocytes, eg in the lymph nodes and lungs.
    • Long-term prognosis is guarded.
  • There are behavioral causes associated with wounds in rabbits:
    • Barbering can be the result of a dominant rabbit pulling the hair of a subordinate or self-induced in rabbits fed low-fiber diets, or it can occur in female rabbits that are building nests   Pseudopregnancy: fur pulling - dewlap  .
    • Rabbits will overgroom in response to stress, eg boredom, trauma, overcrowding, aggressive cagemates, etc.

Barbering usually causes an alopecia without any other signs of dermatitis.

  • There are a few skin diseases with unknown causes that affect rabbits:
    • Sebaceous adenitis   Sebaceous adenitis  presents as a non-pruritic, scaly, flaky dermatitis which starts at the face and neck and progresses diffusely.
    • Ehlers-Danlos-like syndrome   Ehlers-Danlos syndrome 02: skin defect   usually occurs in young rabbits that have fragile skin and wounds that are slow to heal.
    • Eosinophilic granulomas have been reported in rabbits and present as raised erythematosus and erosive-ulcerative plaques.

Assessment

  • A complete clinical examination of the patient should be performed prior to the assessment and treatment of the patients wounds.
  • The cause, age and extent of the injuries should be established.
  • The degree of infection, tissue viability and stage of wound healing should be ascertained.
  • A note should be made as to other therapeutic attempts/failures, in order to aid with future case management.

First aid

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Wound debridement

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Topical medications and dressings

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Surgical management

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Laboratory studies

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Further Reading

Publications

Refereed papers
  • Recent references fromPubMedandVetMedResource.
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  • Walther B  et al(2008)Methicillin-resistant Staphylococcus aureus(MRSA) isolated from small and exotic animals at a university hospital during routine microbiological examinations. Vet Microbiol127(1-2), 171-178PubMed.
  • Bayat M, Asgari-Moghadam Z, Maroufi M, Rezaie F S, Bayat M & Rakhshan M (2006)Experimental wound healing using microamperage wound stimulation in rabbits. J Rehab Res Dev43(2), 219-226PubMed.
  • Cousquer G O (2006b)Veterinary care of rabbits with fly strike. In Pract28, 342-349.
  • Mogford J E, Liu W R, Reid R, Chiu C P, Said H, Chen S G, Harley C B & Mustoe T A (2006)Adenoviral human telomerase reverse transcriptase dramatically improves ischaemic wound healing without detrimental immune response in an aged rabbit model. Hum Gen Ther17(6), 651-660PubMed.
  • Van Rooij P, Detandt M & Nolard N (2006)Trichophyton mentagrophytes of rabbit origin causing family incidence of kerion: an environmental study. Mycoses49(5), 426-430PubMed.
  • Weese J S et al (2006)Suspected transmission of methicillin-resistant Staphylococcus aureusbetween domestic pets and humans in veterinary clinics and in the household. Vet Microbiol115(1-3), 148-155PubMed.
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  • White S D et al(2000)Sebaceous adenitis in four domestic rabbits ( Oryctolagus cuniculus). Vet Derm11, 53-61WileyOnline.
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  • Seps S L et al(1999)Oropharyngeal necrobacillosis with septic thrombophlebitis and pulmonary embolic abscesses: Lemierre's Syndrome in a New Zealand White Rabbit. Contemp Topics Lab Anim Sci38(5), 44-46PubMed.
  • Celayir S, Dervisoglu S & Buyunkunal S (1998)A modified Mitrofanoff procedure using the rectus abdominis muscle flap technique: a preliminary report in a rabbit model. Br J Urol81(1), 83-86PubMed.
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  • Taylor G, Gianoutsos M & Morris S (1994)The neurovascular territories of the skin and muscles: anatomic study and clinical implications.  Plast Reconstr Surg94(1), 1-36PubMed.
  • Garcia B, Nieto S, Gomis E, Pendas L & Batalla N (1990)Delayed myocutaneous flap of the pectoralis major: study of survival. Acta Otorrinolaringol Esp41(1), 1-6PubMed.
  • Swaim S (1990)Skin grafts. Vet Clin North Am Small Anim20(1), 147-175PubMed.
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Other sources of information

  • Hess L & Tater K (2012)Dermatologocal diseases.In: Ferrests, Rabbits & Rodents. Clinical Medicine and Surgery. Eds: Quesenberry K E & Carpernter J W. 3rd edn. Elsevier. pp 232-244. ISBN: 978-1-4160-6621-7. 
  • Vella D & Donnelly T M (2012)Basic Anatomy, Physiology, and Husbandry.In: Ferrets, Rabbits & Rodents. Clinical Medicine and Surgery. Eds: Quesenberry K E & Carpernter J W. 3rd edn. Elsevier. pp 159. ISBN: 978-1-4160-6621-7. 
  • Vella D (2013)Rabbits. Pododermatitis.In: Clinical Veterinary Advisor. Birds and Exotic Pets. Eds: Mayer J & Donnelly T M. Elsevier. pp 407-409. ISBN: 978-1-4160-3969-3.
  • Cousquer G O (2006a)Veterinary Care of a Giant Lop Rabbit with Severe Fly Strike. World Wide Wounds- Last accessed 2nd August 2007.


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