Rabbit Respiratory Disease (Snuffles, Pasteurellosis)

Pasteurellosis in rabbits is most commonly caused by the bacteria Pasteurella multocida. It is highly contagious and can be transmitted by direct or indirect contact. It is one of the most common disease-causing agents in rabbits.

P. multocida is highly infectious and many infected rabbits remain clinically normal until they are stressed and then clinical signs of disease may occur. Rabbits develop little effective immunity after infection.

Infections vary in severity and can cause varied clinical signs. Some affected rabbits die with few premonitory signs others develop more chronic forms of infection.

Discharge from the eyes and/or nares and abscesses are common in affected rabbits.

What To Watch For

• Depression
• Loss of appetite
• Weight loss
• Difficulty breathing
• Discharge from the nostrils
• Swelling of the tissues around the eyes
• Discharge from the eyes
• Moistened forelimbs from rubbing the eyes and nose
• Abscesses
• Blood in the urine
• Vaginal discharge
• Abortion
• Head shaking
• Head tilt

Diagnosis

Accurate diagnosis and treatment of pasteurellosis is important to reduce spread of this bacterium, particularly in multi-rabbit households or rabbitries. Diagnosis is based on clinical signs and isolation of the organism. Tests may include:

• Complete blood count
• Blood chemistries
• Cytology (microscopic evaluation of cells)
• Radiographs (X-rays)
• Serology (testing for antibodies)
• Culture for P. multocida
• DNA probe-based test (PCR) on swabs from the eyes or respiratory tract
• DNA probe-based test (PCR) on swabs from affected tissues

Treatment

Treatment is difficult and may not eradicate the organism. Generally, treatment includes:

• Surgical removal of abscesses
• Flushing of affected areas with sterile saline
• Systemic and local antibiotics
• Fluids and supportive nutrition

Home Care and Prevention

Keep infected rabbits in isolation during treatment. Thoroughly clean and disinfect enclosures, food bowls, water containers and non-porous toys. Discard porous (wood, natural fibers, etc.) objects that cannot be thoroughly cleaned and disinfected and do not replace them until treatment is completed.

On a daily basis, monitor fecal and urine output to assure proper food and water consumption and digestion. Monitor your pet's weight daily.

An effective vaccine has not been developed. Establish the pasteurella status of your rabbit using a combination of an antibody test and a DNA probe-based test.

Keep your rabbit out of direct or indirect contact with other rabbits. Enjoy the rabbit you have. If you decide to add a new rabbit, she should be quarantined for at least 90 days and be examined by a veterinarian at the beginning and end of quarantine.

Have any new rabbit tested using a combination of an antibody test and a DNA probe-based test during quarantine. Purchase young rabbits from sources that provide documentation that each bunny has been tested for pasteurella prior to sale.

Never return a rabbit to a rabbitry if she has been exposed to other rabbits.

Respiratory disease in rabbits is a common condition most often caused by a bacterial infection. Respiratory disease affects rabbits of all ages and results in sneezing, eye discharge (conjunctivitis), and labored breathing. Untreated rabbits become very debilitated as the condition progresses.

Most respiratory problems in rabbits are caused by bacteria and not viruses like in people or in cats. Rabbits do not get "colds". One common bacteria is called "Pasteurella" but there can be other bacteria involved as well like Mycoplasma, Bordetella and Pseudomonas. Some older rabbits can have breathing difficulty from heart disease or cancer and not have infection at all.

Rabbits of all ages are susceptible but symptoms often occur in juvenile rabbits, as they become infected from the mother or other bunnies. Most rabbits are exposed to the Pasteurella bacteria but not all rabbits show symptoms.

There are two components to the respiratory tract and both of these can be affected: the upper respiratory tract and the lower respiratory tract. The upper respiratory tract involves the head, sinuses, the nasal passages and the ear canal. This system is most often involved.

Upper respiratory infections ("URI") result in the "snuffles" syndrome of runny eyes, runny nose and sneezing. Occasionally, a bunny with snuffles will develop a deep ear infection. The lower respiratory system involves the trachea and lungs. Lower respiratory involvement usually means pneumonia (lung infection).

Because rabbits are "obligate nasal breathers" (can only breathe in through the nose), sinus infection can lead to labored breathing and "snorting" during respiration. Some of these bunnies really struggle to breathe.

Most common symptoms include: sneezing, conjunctivitis (eye discharge), loud breathing and lethargy. Inner ear infections can develop and result in a head tilt or circling behavior. Watch for runny eyes, runny nose and dirty front paws in rabbits that clean their face.

Diagnosis In-depth

Diagnostic tests may include:

• Because this disease is readily identified in rabbits, symptoms are more important in diagnosis than laboratory tests. There are some tests, however, that should be considered in severely affected rabbits or those not responding to routine treatments.
• Radiographs (X-rays). Because it can be difficult in some cases to distinguish between upper respiratory disease and pneumonia, radiographs of the chest can be helpful. Pneumonia results in lung consolidation and sometimes discrete abscesses which can be identified with the chest film. Radiographs can also distinguish between pneumonia and other causes of labored breathing like heart disease and cancer.
• Deep nasal culture and sensitivity testing try to identify which bacteria are responsible for the condition. The veterinarian can then choose an appropriate antibiotic. This sounds simple but it can be difficult to get deep enough into the nose in most rabbits. Sedation or anesthesia can help immobilize the bunny long enough to allow a deep probe into the nasal passages. Also, some bacteria like Mycoplasma may be difficult to grow on a culture medium and a falsely negative culture can result.
• Pasteurella antibody tests. This blood test can lead to interpretation difficulties as it does not always distinguish infected bunnies from non-infected ones. Rabbits infected with Pasteurella should develop an immune response that we measure as antibodies in the blood. But some "normal" rabbits can have antibodies and some infected rabbits may not have developed antibodies at all.

Treatment In-depth

• Antibiotics are the first line of defense against this disease. There are very important guidelines as to which antibiotics can be safely used in rabbits. Oral penicillin, amoxicillin, the cefa drugs and the "mycin" family (clindamycin or erythromycin e.g.) can cause gastrointestinal tract problems in rabbits that can be difficult to reverse. These drugs should not be given to any rabbit. Penicillin can be given by injection only. Make sure your veterinarian is familiar with treating rabbits.
• Safe antibiotics include: enrofloxacin (Baytril®), ciprofloxacin (Cipro®), orbifloxacin (Orbax®), trimethoprim/sulfa combinations (Sulfatrim® or Bactrim® or Septra®), chloramphenicol, tetracycline (Panmycin®), injectable penicillin (Flocillin® or BenzaPen®), metronidazole (Flagyl®) and injectable gentamicin and amikacin.
• Eye ointment or drops are used in cases that have eye discharge. Eye preparations usually contain one of the above listed antibiotics. Eyes that tear a lot may have blocked tear ducts. Once blocked, there is no way for the normally produced tears to drain from the eye. These ducts can be flushed and unblocked in some rabbits but, in long-standing cases, these ducts can be permanently obstructed. These rabbits will have persistent tearing problems but not necessarily infection.
• With severe sneezing and nasal discharge, a human nebulizer can be used to provide relief for the nasal passages. The nebulizer comes with a medicine cup that can be filled with sterile saline and antibiotics. This medicine then becomes vaporized and the affected individual breathes in the fine mist containing the drugs. These units are purchased from medical supply stores and have to be adapted for use in animals. This is simple to do and your veterinarian can help you with the set-up.
• Antihistamines and steroids don't usually work and are not often used to treat respiratory diseases in rabbits. Steroids must be used with great caution in rabbits because they can suppress the immune response.

Optimal treatment for your rabbit requires a combination of home and professional veterinary care. Follow-up can be critical, especially if your bunny does not improve quickly. Follow-up may include:

• Administer all prescribed medications as directed. Alert your veterinarian if you are experiencing problems with the treatments. Diarrhea or inappetance might indicate a problem with the medication. Do not let these side affects go untreated by your veterinarian. Diarrhea can be very serious in a rabbit.
• If the respiratory symptoms do not improve within 2 weeks or if the rabbit gets worse while on the medication, contact your veterinarian for further treatment. Sometimes an antibiotic change can make the difference. In other non-responsive cases, further testing may be necessary.
• Provide a dust-free environment for your rabbit. This may mean removing the shavings and frequent vacuuming of the floors. Decreasing irritation in the nasal passages can help in healing.
• Keep runny eyes clean by rinsing with a sterile eye preparation like saline or a product dispensed by your veterinarian. Warm-water soaked cotton balls can be used to break up crusts around the nose and eyes.
• Try to minimize stress in the home environment. This means no loud foreign noises or menacing pets or children. Rabbits are very prone to stress which can delay healing.
• Separate actively sneezing and eye discharging bunnies from cagemates.
• The best prevention is to not take home a sick bunny and to isolate any bunnies showing symptoms. Once the rabbit is showing symptoms, the disease will run it's course which can be mild or severe. Working closely with a rabbit veterinarian is your best protection against disease progression. Some rabbits will spontaneously recover but the majority of cases need medical therapy and even then some of these bunnies cannot completely recover.