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Whipworm Infection in Dogs and Cats

This worm is one of the “big four” intestinal parasites with which our canine friends must often contend: roundworms, tapeworms, hookworms, and whipworms. The whipworm that affects dogs (Trichuris vulpis) is substantially smaller than the other worms (a mere 30-50 mm in length, about two inches maximum) and is rarely seen as it lives in the cecum (the part of the large intestine where the small and large intestine meet). The head (or, more accurately, the digestive end of the worm) is skinny versus its stout tail (or reproductive end), which gives the worm a whip shape, hence the name.

In the host’s digestive tract, food passes from the mouth to the esophagus to the stomach to the small intestine to the large intestine to the rectum, and then to the outside world. This means the large intestine is one of the last stops for nutrients, and by this point in the journey, nutrients have largely been broken down and absorbed. The large intestine is the home of the whipworm. The adult worms bite the tissue of the intestine, actually embedding their heads inside, and suck blood there.

Eggs are laid inside the large intestine and pass with the stool. Once in the outside world, the eggs require about two-to-four weeks to form embryos and become capable of infecting a new host. (This means that contaminated soil is the source of infection, not fresh feces.)

The new host is infected by consuming the egg, usually during grooming. After the host eats it, the egg hatches in the host’s small intestine releasing a larva.

The larva dives into the local glandular tissue and, after about a week, emerges into the small intestine and is carried downstream into the large intestine with the digested food. Once in the cecum or large intestine, its permanent home, it embeds in the tissue there, and after a total of 74 to 87 days from the time the egg was swallowed, the young whipworm is ready to mate.

Signs of Infection

A few whipworms generally do not pose a problem for the host, but if large numbers of worms are embedding themselves in the large intestine tissue, tremendous inflammation can result, leading to bloody, gooey diarrhea. Usually, there is not enough blood loss to be dangerous, but diarrhea readily becomes chronic and hard to control. A second syndrome of infection has emerged but is not well understood: signs mimicking those of Addison’s disease (hypoadrenocorticism). Here, waxing and waning weakness with the inability to conserve salt ultimately creates a dehydration crisis. The syndrome mimics Addison’s disease in every way except that testing for Addison’s disease will be negative and deworming yields a complete recovery.

Because female whipworms only periodically lay eggs (whereas other female worms lay eggs continuously), a fecal sample tested may easily be negative for eggs. This makes confirmation of a whipworm infection a challenge. It is common to deworm whipworms if the symptoms are suggestive of their presence, even if the fecal test is negative. Most common deworming agents do not work on whipworms, so something special must be selected. The most common products are fenbendazole (Panacur®), and febantel (Drontal Plus®).

Thanks to the long maturation cycle of young worms, a second deworming some 75 days or so after the first deworming is needed to fully clear the infection (easy to forget). Often another deworming in between these doses is recommended to further control the whipworm numbers.

Products Effective against Whipworms

More recently, regular heartworm prevention products have been developed to remove and control whipworms: Milbemycin-based heartworm preventives (such as Sentinel®, Interceptor®, and Trifexis®) will cover whipworms, and their regular use covers the second deworming as well. Moxidectin based heartworm preventive, such as Advantage Multi® and similar products, will also cover whipworms. 

Soil contaminated by whipworm eggs is contaminated for years. It is virtually impossible to remove the eggs from the soil or kill them. This potential for environmental contamination is concerning, but while there are scattered reports in the medical literature supporting human infection, the Companion Animal Parasite Council does not consider the canine whipworm to be transmissible to humans until there is stronger evidence.

Feline Whipworm Infection

There are species of whipworms that can infect cats: Trichuris serrata in North America and Trichuris campanula in Europe. Cats are clean animals and fastidious around feces, and they rarely get infected. When they do, worm numbers are so small that symptoms hardly ever occur. Whipworms are more of an interesting incidental finding in cats when whipworm eggs happen to come up on a routine fecal check. In other words, feline whipworm infection is generally not considered to be much of a problem.

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Workups for Itchy Dogs and Cats

Pruritus, or itching, in dogs and cats, can involve scratching and licking, chewing, or biting the skin. Pruritus is the most common symptom of skin disease in veterinary medicine. Many conditions can cause pruritus, including allergies, fleas, and other skin parasites. Some skin problems are more common in younger animals, while others are diagnosed more often in older pets. 

Medications are available to manage pruritus, but unless the underlying cause of the pruritus is diagnosed and addressed, it will return once the medication is stopped. Some anti-pruritic medications, such as steroids, can result in other health issues. Providing your dog or cat’s medical history can sometimes help your veterinarian determine the cause of the itching. 

A lack of response to some medications can help your pet’s veterinarian narrow down the possible causes. Additionally, some medications can actually cause itching.

When Did the Pruritus Start?

It can be helpful to know when the itching started. If allergies cause itching, it is beneficial to know if the problem is worse at different times of the year.  

Other Health Problems 

Sometimes, skin conditions develop secondary to another health problem. Your veterinarian will ask questions about other symptoms that could point to a specific cause of pruritus. For example, pets with food allergies may have frequent bowel movements or soft stools.

Location of Skin Lesions

Some pruritic skin conditions cause skin lesions more commonly in one body region than another.

Type of Skin Lesions

Although most pruritic skin conditions look the same to pet owners, there are actually many types of skin lesions, and some skin lesions occur more commonly with specific skin conditions. However, if the pruritus has become chronic, many pruritic skin conditions look similar to each other. Your veterinarian may need to run some tests to help determine the cause of the pruritus.

What Tests are Used to Diagnose the Cause of Pruritus?

Below is a list of some common tests for diagnosing the cause. Your veterinarian will select tests based on your pet’s medical history and examination findings. 

Skin Scrapings

To look for skin parasites, a scalpel blade is used to gently scrape the skin layers to collect cells and any skin mites. The sample is then examined under the microscope.

Skin Cytology

To look for bacteria and yeast organisms, skin cells and debris samples are collected and placed on a glass slide for examination under the microscope. This test can also help determine what types of cells are in the skin.

Parasite Therapy Trial

For some parasites, the only way to determine if they are the cause of the itching is to treat the parasites. A decrease in pruritus after the anti-parasite therapy would be consistent with the parasite causing the pruritus.

Ringworm Testing

To determine if a dog or cat’s skin is infected with ringworm (a disease caused by a fungus called a dermatophyte, not actually a worm), your veterinarian may start by examining your pet under a special ultraviolet lamp called a Wood’s Lamp. If the hairs glow (fluoresce), this may mean your pet has ringworm  Those hairs are collected for further testing. In a fungal culture, hair and skin samples are placed on a fungal culture plate. If a dermatophyte grows, the dog or cat is diagnosed with ringworm. In a dermatophyte PCR test, (a test that looks for viral diseases) the hair and skin samples are checked for dermatophyte DNA. 

Food Trial

A prescription or home-cooked diet is fed for several weeks with no other foods or treats to diagnose food allergies. Unfortunately, there is no reliable skin or blood test in dogs and cats to diagnose food allergies.

Allergy Testing

Skin or blood allergy testing is used in dogs and cats that have had other causes of pruritus ruled out through other tests. It is mainly used to select allergens for a type of allergy treatment called allergen-specific immunotherapy. There are no reliable hair or salivary tests to diagnose allergies.

Skin Biopsy

A sample of skin can be obtained through minor skin surgery. Skin biopsy is especially helpful for diagnosing some less common causes of pruritus, such as skin cancer. However, a skin biopsy cannot be used as an allergy test and cannot diagnose the cause of a pet’s allergies.

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When You Need Antibiotics for Your Pets, and When You Don’t

Antibiotics can be literal life savers for your pet when they have the kind of infection that responds to the medication. However, when given for something where they are not appropriate — such as a virus — antibiotics can create a long-lasting problem of antibiotic resistance, lessening the future ability of antibiotics to cure.

Using antibiotics for viral illnesses such as colds simply doesn’t do anything to get rid of the cold, but it may create drug-resistant bacteria that are much harder to kill because they no longer respond to typical doses of regular antibiotics. Using large doses of less commonly used antibiotics may not treat the problem either or may simply cause more resistance.

Both bacteria and viruses are germs and can make dogs or cats (or people) sick. The two types of germs can cause diseases with similar symptoms, but each one has a different way of multiplying and spreading disease. Diarrhea, for example, can have several different causes, some of which are bacterial, and some are viral.

The difference between the two types of germs is that bacteria are living organisms and viruses are not. Bacteria are only single-cell organisms, but they are still considered alive. Viruses are essentially a collection of molecules that work together to replicate, so they only grow and reproduce after they’ve invaded living cells. Like all other species, their main goal is to replicate. Antibiotics fight living organisms – the bacteria – by killing them or stopping their growth and reproduction, but they can’t do that for viruses.

Your own immune system can successfully fight some viruses, but sometimes, such as after catching a common cold, viruses must simply run their course and there is little anyone can do to shorten the time frame. You can treat symptoms such as coughing and headache, but not the disease itself. Your pets are the same way.

Many diseases veterinarians see are only viral in nature and that’s the point at which you do not want to give your pet antibiotics. Such viruses include:

  1. Distemper
  2. Upper respiratory infection (rhinitis or bronchitis, such as kennel cough)
  3. Viral infections in the eye (keratitis or conjunctivitis)
  4. Parvovirus
  5. Influenza
  6. Rabies
  7. Feline immunodeficiency virus (FIV)

Some bacterial diseases develop after a virus has made it easier for bacteria to infect. Examples include:

  1. Upper respiratory infections
  2. Eye infections
  3. Pneumonia (after, for example, distemper)
  4. Bacterial septicemia (bacteria in the blood) after parvovirus

Many organs can be infected with bacteria. Bacterial infections include:

  1. Ear infections, usually combined with yeast infections
  2. Leptospirosis
  3. Tick-borne infections such as Ehrlichia, Lyme’s disease or bartonellosis
  4. Clostridial diarrhea
  5. Tetanus
  6. Gingivitis or stomatitis
  7. Pyothorax (infection in the chest cavity)
  8. Respiratory infection, including pneumonia
  9. Urinary tract infections in the bladder (cystitis)
  10. Pyelonephritis (kidney infection)
  11. Enteritis or Colitis
  12. Bacterial conjunctivitis
  13. Pyoderma (infection of the skin)
  14. Deep wound infections

Taking antibiotics too often or for the wrong reasons can change bacteria so much that antibiotics don’t work against them. Giving antibiotics when they are not indicated can have two effects that can profoundly impact the health of your patient.

The first is killing healthy bacteria. Not all bacteria are bad, in fact most are probably beneficial. Beneficial bacteria protect from disease-causing bacteria, promote a healthy immune system, and help the body with metabolism. Bacteria in the gut are particularly important, however, bacteria are crucial to the health of many organs.

The second effect of antibiotic use is the potential for antibiotic resistance. This means that when a pet has a bacterial infection that could have been treated by antibiotics, the drugs may not be able to help end the infection; your pet will still be sick despite treatment. This can be true if the pet already has received antibiotics, even a different antibiotic.  One example is skin infections.  In some cases, pets can end up with methicillin-resistant Staphylococcus pseudintermedius (MRSP or MRSA). MRSA and MRSP are resistant to numerous drugs and adapt quickly to the immune system, so they are a big concern in the veterinary community. Another common organism that rapidly develops resistance is Escherichia coli, (usually called E. coli), which usually infects the urinary bladder.

Your veterinarian understands these risks and may suggest that antibiotics not be used if alternative treatments might be better. Examples include: 

  1. Mild skin infections (bathing).
  2. Ear infections (cleaning the ears).
  3. Feline bite wound abscesses (opening the wound).
  4. Gingivitis (cleaning the teeth).
  5. Asymptomatic bacteriuria (bacteria in the bladder but your pet does not act like they have an infection).
  6. Most diarrheas (Kaopectate in dogs or cats or bismuth subsalicylate [Pepto-Bismol] in dogs might be better).

Thankfully, you can help your pet avoid antibiotic resistance in several ways:

  1. Let milder illnesses (especially those caused by viruses) run their course.
  2. Take antibiotics for the entire time as prescribed by the veterinarian. Otherwise, the infection may come back stronger than it was, and it will be harder to get rid of than it was in the first place.
  3. Don’t give your pet antibiotics longer than prescribed.
  4. Do not use leftover antibiotics or save extra antibiotics for next time. The reason bacteria are cultured is to find out which antibiotic has the best chance of fighting the specific bacteria.
  5. Don’t give your pet antibiotics that were prescribed for another pet or person.
  6. Use the same caution about antibiotics for pets for everyone in your family. Antibiotic resistance affects people too.
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Weight Loss for Obese Cats

Obesity is a common disease in cats, affecting almost 50% of the patients seen in veterinary clinics across the United States. Just like in humans, excess fat is accumulated in cats due to an imbalance between the number of calories being consumed and the amount of energy being expended during daily activity. Unfortunately, obesity is much more than just a little extra cat to love! Obesity can lead to many secondary problems including diabetes, arthritis, kidney and pancreatic disease, cardiovascular issues, and infections, all of which can ultimately lead to a reduced lifespan for our four-legged friends. 

In fact, weight loss alone has been shown to reduce risk and even reverse some of these conditions in cats, particularly with diabetes. 

Fortunately, obesity is a preventable and treatable disease. Avoiding obesity in our pets can be accomplished by choosing quality food, providing an appropriate amount of food and treats, promoting exercise, monitoring weight changes, and adjusting the amount of food that they receive based on those changes. As with other diseases, prevention is the best approach to ensuring the health of our pets, but sometimes we do not realize just how much weight our cats are gaining between visits to the vet.

The ideal weight for your cat is determined by their body condition score (BCS), which is measured on a 9-point scale that your veterinarian will assign based on your cat’s silhouette as well as the size and location of their fat stores. Using this BCS, veterinarians can establish an ideal weight for each individual cat, which gives us a reference point for weight loss goals and progress. Cats are considered overweight if they weigh 10-20% more than this ideal weight and obese if that number rises to over 20%.

The first step in weight loss is to determine your cat’s ideal body weight based on their BCS. A score of 4-5 is considered an appropriate body condition, so anything greater than 5 is overweight, and anything under 4 is underweight. The general rule is that every 1-point increase or decrease from the ideal BCS score (4-5) is about 10-15% of their weight. For example, if your cat is given a BCS of 6, they need to lose 10-15% of their body weight in order to return to their ideal weight, whereas a cat with a BCS of 9 would have to lose 40-60% of their body weight. With this ideal weight in mind, you and your veterinarian can set a weight loss goal for your cat of losing 0.5-1.5% of their body weight per week. It is important that they do not lose weight too quickly, as we do not want your cat missing out on any essential nutrients that could lead to other problems, like hepatic lipidosis (fatty liver disease). 

Next, you’ll need to assess the current food intake of your furry friend; this includes the type of food they eat, the amount they receive, how often they are fed (2-3 times per day, free feeding, etc.), and the number of treats or extra food they are given. If your cat is being given a lot of treats or has unlimited access to food throughout the day, one of the first things you want to do is start feeding them isolated meals, spreading their total daily food ration over 2-3 meals per day. Eliminating treats and extra food from the table is another quick and easy way to decrease calories. Many veterinarians will recommend switching to a veterinary therapeutic weight loss diet that is specifically formulated to decrease calories while still maintaining all of the nutrients that your cat needs. You may also want to consider trying canned food instead of dry food if your cat will eat it, as canned food typically has a lower calorie content due to the increased water content of the food.

Finally, it’s time to put your plan into action. There is an equation that can be used to calculate the number of calories that your cat should be consuming each day, however, many veterinarians do not rely on this alone as it is based on an average and can vary dramatically between individual cats. Somewhat severe dietary restriction is often necessary to achieve these weight loss goals, so you will typically start by decreasing your cat’s food intake by around 20% and monitor their progress by weighing them every 2-3 weeks. Monitoring their weight is one of the most important parts of this process, as you may need to further decrease the amount of food they are receiving if they are not hitting that goal of losing 0.5-1.5% of their body weight per week. It is best to use a small gram scale to weigh your cat’s food before each meal so you know exactly how much they are getting, as measuring cups and scoops can be inaccurate for measuring kibble.

Measuring your cat’s weight can be done by weighing yourself, holding your cat, weighing again, and then subtracting the difference. This may not be as accurate as your veterinarian’s scale, but will do in a pinch and beats having to get your cat to the vet every week. You can also weigh your cat in the cat carrier, then weigh the carrier alone and subtract the difference.

To help increase your cat’s weight loss and keep that weight from being put back on, you can also try various types of enrichment (toys, wands with toys at the end, food mazes, or outdoor catios) to help your cat become more active and burn more calories each day. Once your cat has returned to their ideal weight, it is important to continue these new lifestyle changes and work to find a feeding plan that allows them to maintain that healthy weight.

Obesity is a common problem that many of our pets face, but fortunately, it is something we can reverse with some simple lifestyle changes. With an appropriate amount of quality food, a consistent feeding schedule, and a little more exercise, there is no reason a healthy cat should not be able to return to that ideal weight. Avoiding obesity can help reduce your cat’s risk of many life-threatening conditions, improving not only the length of their life but also the quality. Although it may be challenging for both you and your cat to adjust to some of these changes, it will certainly be worth it. 

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Xylitol Poisoning in Dogs

Sugar substitutes are big business. Less sugar can mean weight loss, improved health, diabetic control, and even reduced tooth decay. The quest for products that can sweeten and cook like sugar is ongoing. Xylitol (also known as birch sugar) is a common sugar substitute, especially when it comes to sugarless gum, toothpaste, and more recently certain brands of peanut butter for bodybuilders. It is worth noting that even though birch sugar sounds natural and xylitol sounds like a chemical both are toxic to your dog. Not only does xylitol offer sweetness with 40% of the calories of sugar, but it also has antibacterial properties in the mouth so it can reduce periodontal disease and has been found to have far-reaching health benefits in other areas of the body. Xylitol may help with osteoporosis, prevent ear and throat infections, and may reduce the risk of endometriosis, uterine fibroids, and even breast cancer.

Sounds wonderful and maybe it is if you are a human. If you are a dog, xylitol (birch sugar) is potentially lethal. In this video, the FDA says deaths have occurred in as little as one hour.

Two Deadly Effects of Xylitol

Hypoglycemia


In dogs, the pancreas confuses xylitol with real sugar and releases insulin to store the “sugar.” Even worse, the canine pancreas releases 3-7 times the amount of insulin that it would release to address a similar amount of actual sugar. Blood sugar levels plummet resulting in weakness, disorientation, tremors, and potential seizures.

It does not take many sticks of gum to poison a dog, especially a small dog (see below for toxic doses). Symptoms typically begin within 30 minutes and can last for more than 12 hours but, since xylitol can be absorbed into the body slowly, symptoms may not begin until 12 hours after the xylitol was eaten. Symptoms begin with vomiting and then progress to incoordination, collapse, and seizures.

Hepatic Necrosis

The other reaction associated with xylitol in dogs is the destruction of liver tissue. How this happens remains unknown but the doses of xylitol required to produce this effect are much higher than the hypoglycemic doses described above. Signs take longer to show up (typically 8-12 hours) and surprisingly not all dogs who experience hepatic necrosis will have had hypoglycemia first. A lucky dog experiences only temporary illness but alternatively, a complete and acute liver failure can result in death. Internal hemorrhage and the inability of blood to clot are commonly involved.

How Much Xylitol is Dangerous?

The hypoglycemic dose of xylitol for dogs is considered to be approximately 0.075 – 0.1 grams per kilogram of body weight (about 0.03 – 0.045 grams per pound). Chewing gum pieces have surprisingly variable amounts of xylitol depending on their flavor. (For example, most flavors of Orbit gum have about 0.009 grams of xylitol but their strawberry mint flavor has over 0.3 grams per piece). A small dog can easily be poisoned by a single stick of gum depending on the gum, how much the dog ate, and the size of the dog. It is important for you to bring the packaging for the xylitol product in question to the veterinarian’s office so that the amount of xylitol consumed can be estimated.

Treatment

Ideally, the patient can be seen quickly (within 30 minutes) and can be made to vomit the gum or candy. Beyond this, a sugar IV drip is prudent for a good 24 hours. Liver enzyme and blood clotting tests are monitored for two to three days. Blood levels of potassium are ideally monitored as well. Elevated blood phosphorus levels often bode poorly, and patients that develop hepatic necrosis usually do not survive.

What about Cats?

Xylitol toxicity appears to be limited to dogs. Cats have no significant ill-effects from xylitol.

What about Xylitol-Containing Mouthwashes for Pets?

The oral health benefits of xylitol do seem to hold true for dogs if appropriately low doses of xylitol are used.

Several products have been marketed for canine oral care, specifically for dogs that do not tolerate other methods of dental home care. These products are mixed in drinking water to provide antibacterial benefits. Aquadent®, for example, comes in a 500 cc (a half liter) bottle that contains a total of 2.5 grams of xylitol. It also comes in small packets to mix in drinking water. Similarly, Breathalyser Plus® from Ceva is similarly packaged. If you follow the dosing instructions on the bottle or packet, there should be no problems.

Trouble could occur if there are animals of different sizes drinking from the same water bowl or if a dog is on medication or has a disease that causes excessive water consumption.  One should dose for the smallest animal to use the bowl to be sure overdose is not possible. Alternatively, a dental water additive that does not contain any xylitol can be used. Ask your vet what he or she recommends. A dog finding the bottle and chewing it up, drinking a substantial quantity of the undiluted product could easily be poisoned, depending on the dog’s size.

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Zinc Poisoning in Dogs and Cats

Red Blood Cell Destruction

Most people have at least a passing familiarity with hemoglobin. Hemoglobin is the iron-containing protein that is responsible for the red color of blood. It binds the oxygen we breathe in and carries it to our tissues, exchanging oxygen for carbon dioxide and carrying that to our lungs to be exhaled away. Our red blood cells have no nucleus and no DNA, and they do not participate in most normal cellular functions; they are simply bags of hemoglobin being conducted around our blood vessels.

A normal canine red blood cell lives approximately 120 days (60 days for feline red cells), and it dies when it either becomes too stiff to fold itself through tiny capillaries and bursts trying to do so, or it simply cannot generate enough energy to keep itself alive.

The spleen is responsible for removing old red blood cells. The spleen possesses many tortuous, winding blood vessels where red blood cells may break if they are not supple enough to pass through. The spleen then collects the hemoglobin for recycling, but since hemoglobin by itself is not safe for release into the bloodstream, a conversion is necessary. The hemoglobin is broken into a protein part (which is broken apart and recycled), iron (also broken off even further and recycled) and heme which is converted into a substance called bilirubin for transport. Bilirubin is sent to the liver to be chemically processed for removal (the process is called conjugation). This process enables the bilirubin to dissolve in water so that it can be excreted in bile and disposed of through the intestinal tract. Bilirubin is responsible for the brown color of feces.  

If too many red blood cells are being destroyed at once, the systems described above get overwhelmed.

What is Hemolysis?

Hemolysis is the destruction of red blood cells. Red blood cells may be destroyed by:

  • immune-mediated pathways (in which the immune system treats red blood cells as foreign cells to be destroyed) 
  • the spleen’s pathways described above 
  • parasites that live in or on the red blood cell (such as Mycoplasma haemofelis). 
  • toxins such as zinc or copper 
  • infections or tumors.

When too many red blood cells are destroyed, the body’s mechanisms for processing hemoglobin are overwhelmed, and bilirubin builds up. The patient may be obviously yellow (jaundiced or icteric) when the mucous membranes are examined. The serum may be yellow when checked in a blood sample. If the blood cells are being destroyed in the bloodstream rather than in the spleen, the urine will turn red or rust-colored. Hemoglobin is toxic to the kidneys, and kidney failure is a strong possibility. Excessive hemolysis must be stopped.

Zinc

In 1983, the U.S. government began minting pennies made of zinc wafers coated in copper rather than out of pure copper. As it is not uncommon for young animals to swallow pennies, zinc toxicity became recognized.

Other zinc sources include nuts, bolts, zippers (some metal zippers contain zinc), and zinc oxide-based skin creams, such as diaper rash cream and sunscreen.

You can see a penny or other radiodense object of about the right size on a radiograph, or there may be a known history of penny eating. It is important to rule out immune-mediated hemolysis as this is a common condition requiring specific (and very different) treatment.

Clinical Signs

The clinical signs of zinc toxicosis include:

  1. vomiting
  2. diarrhea
  3. red urine
  4. icterus (yellow mucous membranes)
  5. liver failure
  6. kidney failure
  7. anemia

Vomiting and diarrhea generally precede the destruction of red blood cells. How zinc produces hemolysis is not known. With zinc-containing ointments, usually, only stomach upset is seen after the ointment is licked, but if the ointment is applied and licked regularly, full zinc toxicity can develop.

Treatment

If an object possibly made of zinc is seen on an X-ray, it should be removed promptly. This might involve surgery, endoscopy, or possibly inducing vomiting if the object does not have sharp edges. Support then becomes crucial. Fluid therapy is important to keep adequate circulation to the kidneys and help prevent failure. Transfusion may be necessary to combat anemia, and anti-nausea therapy is justified. Zinc is corrosive to the stomach so medication to protect the stomach will be needed. Antacids are helpful in reducing the absorption of zinc, which is enhanced by stomach acid. Research is looking at methods for binding excess zinc in the circulation similar to the way lead poisoning is treated.

Once the zinc source is removed, most pets are able to recover within 48-72 hours with supportive care, but of course, this depends on the severity of the poisoning.

The ASPCA National Animal Poison Control is available 24 hours a day at 888-426-4435. Expect an initial consultation fee of around $100.00 and additional follow-up is at no charge. You will be assigned a case number your veterinarian can use to communicate with a toxicology specialist before beginning treatment.

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Parents’ Guide to Selecting a Small Pet for Children

Many adorable small pets are available to you and your children, but which one suits you, your children and your lifestyle? Do you want to be able to have young children hold them, or is it enough for your kids only to watch their pets as entertainment?

It’s helpful to think in advance about what small pet would best suit your lifestyle before your children spy a desperately desired impulse purchase.

Rabbits

Pros: Adorable, often very playful and social. Can be kept solitary or in small groups.  Should be spayed/neutered, which allows for “mixed sex” groups.

Cons: Expensive and high maintenance to take care of properly

Best for children old enough and responsible enough for significant cleaning duties as well as food preparation; early teens and up.

Taking care of a rabbit is similar to expense and effort required to care for a dog or cat.  They require daily out of cage social time and playtime, large amounts of leafy green vegetables to eat every day, and therefore also produce lots of poo to be cleaned every single day. They should be spayed/neutered and require regular veterinary care particularly as they age.

Mice

Pros: Small and inexpensive pets. Can be kept solitary and in small groups.  Learn routines and food games quickly. With enough in cage stimulation, do not always require handling.

Cons: Fast moving, smelly, and may be nippy

Good for even very small children if they will not be handling, but older children (8 and up) if they want to hold the mice.

Mice are engaging and very personable pets which can be reasonably content in a confined space if provided lots of enrichment. However, they do have very stinky urine, and so steady cleaning is required to keep their environment healthy.

Rats

Pros: Very engaging and interactive pets, intelligent, social, learn games quickly.

Cons: Short life expectancy and relatively expensive to maintain

Good for children of all ages if they are old enough/mature enough to be able to gently hold the rats.

Rats are wonderful pets, and full of personality.  They are best kept in small groups of 3-4 animals, and need a LOT more room than you might expect to be happy.  They also require a lot of social engagement and environmental enrichment.  Rats will eat themselves into oblivion, and it takes care and attention to prevent obesity. Unfortunately, they are sadly short lived, rarely making it more than 3 years, and often requiring a significant amount of veterinary care in that time period.

Hamsters

Pros: Amusing pets which are relatively content in a fairly small space. Can be kept as a solitary pet. Will create and play games entirely by themselves, but also often enjoy human interaction.

Cons: Nocturnal, can be very nippy, and fairly short lived.

Hamsters are best kept by older children who are able to gently hold a fast-moving animal and are responsible enough to wash their hands after contact.

Hamsters are delightful little animals – at 2 o’clock in the morning. Their nocturnal habits and tendency to be grouchy during daylight hours make them often poor pets for children.  They also can carry a number of diseases which can be contagious to humans. These adorable creatures are most appropriate for night owl adults.

Gerbils

Pros: Active, entertaining, maintenance-light animals. Can be kept in small social groups, and when neutered, can be in mixed sex housing.

Cons: Need lots of space to maneuver

Good pets for children old enough to gently restrain them, likely mature 6 year olds and up.

Gerbils are wonderful and active small animals, but they do need plenty of space and good ventilation for their antics.  They also require regular cleaning and careful feeding to stay healthy long term.

Guinea Pigs

Pros: Friendly, social, interactive pets. Often love human interaction, toys, and developing games. Can be kept in small groups or solo.

Cons: Delicate and require careful handling

Guinea pigs are good pets for even very young children, although they should not be allowed to handle them until they are significantly more mature – such as 8 and up.

Guinea pigs, with their funny looks and even funnier sounds, are great pets and make good family pets with careful adult supervision when they are handled.  Their short and squat body type isn’t forgiving of being manhandled or dropped. They also require some careful attention to be sure they are being fed a properly supplemented diet, and may require some regular veterinary care.

Chinchillas

Pros: That adorable little face. Friendly and engaging, active, entertaining, and often quite social and playful.  Females can be kept in small groups, or solo, males are best kept solo.

Cons: The mess, the chewing, and the nocturnal habits

Chinchillas are not frequently handled – they prefer keeping themselves busy, so they are appropriate for even small children to watch at play.

Chinchillas are an adorable pet just begging for an impulse purchase at the pet store.  However, they are very high maintenance in the cleaning department, leaving small dry poo everywhere they go.  They also tend to leave much harder to repair tooth marks in anything that they can manage to chew. Combine this with their need for a lot of time out of the cage, nocturnal habits – and these animals need just the right household to fit in.

Ferrets

Pros: Amusing, busy antics – almost like the blend of a puppy and a kitten that never grows up. They are intelligent, interactive, and best kept in small groups.  Because they typically come already neutered, mixed sex groups are possible.

Cons: Finding trouble everywhere they go, high maintenance, and significant veterinary costs

Ferrets are best pets for older children, those approaching their teens.

Ferrets are incredibly fun pets, acting with reckless abandon for most of their 5-7 year lifespan.  Unfortunately, this abandon combined with a strong tendency towards serious medical problems makes them extremely expensive to maintain – and not all veterinarians will treat ferrets.  The level of care that they require can easily match or exceed that of a dog or cats.

Parakeets

Pros: the beautiful colors and engaging personality. Some learn to talk, most do interact with whistles and other sounds. Can be kept solo or in small groups.

Cons: Can be nippy and difficult to train

Most parakeets are not excited about being handled, and as such – they are appropriate for even very young children who will be able to watch their antics without touching them.

Parakeets are often thought of as good “first birds”, but they tend to be more of the independent sort, and although they crave attention, it is on their terms.  They can be difficult to train, and are known to deliver swift nips when things are not going their way. Many were raised on “bird seed” – which is not an adequate diet and can lead to very expensive medical problems which are avoided with proper feeding.

Finches

Pros: The barrage of entertaining noises and watching the interactions between birds. They are active, engaging, and enthusiastic in their behavior. Best kept in small groups of single sex birds.

Cons: largely a caged pet – not one amenable to handling

Finches are not birds that enjoy handling, so they are appropriate for children of all ages to enjoy them playing within their cage.

Finches can be great fun for someone looking to have a bird that is content to spend all of its time in a (large) cage.  Finches should be kept in small groups – and watching them interact is great fun.  Do be aware that they can be quite messy, and be prepared to clean flung food and poop not only within the cage, but also well around it.

Bearded Dragons

Pros: Very social, interactive, and inquisitive. Best kept as a solo animal. Large and bright cages can make for a “center piece attraction” to a room

Cons: Expensive to maintain properly, requires a lot of attention to detail

Bearded dragons can move unexpectedly and surprisingly fast, and should not be handled by young children, but while in their cage can be enjoyed by children of all ages.

Bearded dragons are often considered a “starter reptile” – but this does not mean that they are “easy.”  There is a lot of special equipment required to take good care of a bearded dragon, and attention to the details of temperature and humidity are needed to keep them healthy.  That being said, they often crave attention and are one of the more social common reptile pets.

Geckos

Pros: Able to be maintained in a smaller enclosure than many other pet reptiles, interesting to watch. Best kept as a solo animal. Good starting point in to the world of reptiles.

Cons: Nocturnal, high maintenance, and requires a lot of attention to detail

Geckos are not typically fans of lots of handling, and as such, are best enjoyed by children of all ages within their cage.  Older children may be able to safely handle them, but not likely before the age of 8-10.

Geckos are very fascinating creatures, and watching them maneuver in a well-enriched enclosure can bring hours of enjoyment.  However, to stay healthy, they do require careful attention to the particulars of their husbandry and careful feeding, and can be prone to some very expensive medical problems – so these are appropriate pets for those with the inclination and means to care for them.

Sugar Gliders

Pros: Extremely engaging and entertaining animals. Active, full of personalities, and can be neutered to allow for mixed sex groups. Do best when kept in small groups.

Cons: Nocturnal, very smelly urine, high maintenance, and expensive to care for

Sugar gliders do not enjoy being awakened during the day and can be very grumpy about handling when they are tired, and so I recommend them for older/teenaged children and adults.

Sugar gliders are adorable, engaging pets – but are most active at night, which can keep the grumpy pet owner awake!  They are high maintenance and are fairly expensive to care for properly. Males should be neutered for population control if males and females are housed together. Females can be safely spayed by a veterinarian knowledgeable in sugar glider anatomy, however, it is a more difficult surgery and we do not yet know if there are benefits from a health perspective. If not fed properly, they are likely to develop some costly medical problems.

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Rabbit Care Questions and Answers

How do I know if my rabbit is overheating?

Don’t put a heating pad under a small cage in which a rabbit is confined unless directed by a veterinarian for a specific reason. Never leave your rabbit in the car on warm days (anything over 65F) while you run a quick errand.Most importantly, avoid placing your rabbit in a situation where it can overheat. Rabbits can overheat in temperatures 80F or higher, especially if the humidity level is high. Do not leave rabbits outside in high temperatures and high humidity without a cool shelter. Do not leave cages unattended in direct sunlight indoors even in the winter, because glass windows can intensify the heat from the sun. During hot weather if your house is not air-conditioned, place your pet in the coolest area (basement) and use a fan to circulate air. Consider purchasing a room air conditioner for at least one area.

Overheated rabbits will initially become quiet and start panting. They may stretch out and keep their eyes half closed. The ears have large blood vessels near the surface of the skin so they can be used as natural “air conditioners” to release extra heat. The ears in an overheated rabbit will become very warm. The rabbit’s gums and conjunctiva, which is the pinkish tissue under the eyelids, will become dark red and look congested. At this stage it is usually possible to reverse the effects of the overheating by cooling the rabbit.

As overheating progresses, the brain become affected as well as other organ systems and the rabbit starts to go into shock. Signs seen with severe overheating include sudden collapse, complete unresponsiveness, hyperactivity, bizarre behavior or seizures before collapsing or collapse with overexaggerated breathing. When a rabbit collapses he falls to the side, the eyes are usually open and dull looking, and he is not responsive to being touched. The gums and conjunctiva turn muddy brown, eventually to white, as the shock condition deepens. The ears may become cooler because shock causes blood to flow away from the extremities.

The prognosis for an overheated rabbit that has collapsed and is showing signs of severe shock is grave. Rabbits in this condition need immediate veterinary intervention including drugs to combat shock and cool intravenous fluids.

If you suspect your rabbit is overheating, immediately remove your pet to the coolest area you can find. If he is still somewhat alert and is still able to sit upright, take a washcloth soaked in cool tap water (not ice water) and wrap it around both ears to try to cool the blood and thus the body. Do not immediately soak your rabbit with water, as this can be very stressful, but try cooling the ears first.

If the rabbit is not improving after about 5 to 10 minutes of ear cooling, then gently wet the fur with lukewarm water, not ice water. If you use ice water it actually may cause the shock to get worse. If your pet is already collapsed, get him out of the hot area, use a cool cloth on the ears and take your pet to a veterinary office immediately. This is an extreme emergency situation.

Is it bad for my bunny to snack on dog or cat food?

Yes, it is dangerous for a rabbit to snack on dog or cat food. These foods are designed for carnivores, not for herbivores. They are high in protein and fat as well as carbohydrates in the form of grains, usually corn. Although rabbits can eat small amounts of dog or cat food and appear to be normal, there can be insidious changes that take place over time. Excessive levels of protein can lead to kidney damage; excessive levels of fat and grain-based carbohydrates can lead to obesity.

However, by far the most dangerous side effect in rabbits who eat dry dog or cat food is the disturbance of the normal intestinal flora that will ultimately lead to intestinal distress and death. We have seen rabbits become seriously ill and some die within 24 hours of eating dog food due to acute intestinal disorders. Please keep all dog and cat food out of the reach of your rabbit!

When I take my rabbit in for a check-up to the vet, what will the veterinarian expect me to know about my rabbit?

When you take your rabbit to a veterinarian for any reason, it is a good idea to be prepared with the rabbit’s history and with questions you might have. Unless you are dealing with an emergency, take a moment before you leave the house and write down as much of the following general information as you can about your pet (this applies to any pet going to the veterinarian). It can be helpful and increase the efficiency of your visit if you give this information when you first check in at the receptionist’s desk.

  • Date of birth
  • Date and place where you acquired the pet
  • Sex of the pet and whether it is surgically altered
  • Description of the environment (cage size, cage furniture, location in house, etc)
  • Exercise (how often, where)
  • Diet (be specific and include all foods including treats, frequency of feeding)
  • Current medications (including vitamins and “natural” supplements/medications)
  • Other pets in the household

If your pet is experiencing a medical problem, the following information is also helpful:

  1. When the condition first appeared
  2. Detailed description of the abnormality
  3. Medications/treatments already tried or being used now
  4. Records from other veterinarians
  5. Other animals/humans ill in household
  6. Your own thoughts on the cause of this condition

It is also a good idea to have a list of questions you wish to ask during the visit. If they are written down, you won’t forget and you can record the answers on the same page for your permanent records.

I suggest that you keep a medical file at home on your pet with the general information as well as records from your veterinary office and questions and answers you have had along the way. You can easily take this file with you if you need to get a second opinion or are traveling.

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Rabbit Care

Rabbits make intelligent, friendly and quiet house pets. The average life span for a bunny is 7 to 10 years with records of up to 15 years of age reported. The following information is provided to help you enjoy a happy, healthy relationship with your little friend. In addition to this handout there are a number of excellent books on the topic of rabbit health care that you may wish to consult.

Diet

Please note that the recommendations for diet in this care sheet are directed towards the pet rabbit and not the production rabbit, such as those raised for meat or fur.  The dietary requirement for rabbits in a production situation differs due to the fact that a more rapid than “normal” weight gain body growth is desired.

Normal Rabbit Weight

Unfortunately, what we thought was a normal rabbit weight in the past has often been an overweight rabbit.

Obesity is a problem with rabbits that eat a diet too high in calories and that don’t get enough exercise. A healthy rabbit should be slim and sleek. You should be able to feel the ribs just under the skin without a thick layer of fat. The hindquarters should not have any folds of skin covering or interfering with the digestive tract or urinary openings. The dewlaps in females should not be so large as to interfere with grooming or eating. If you are in doubt about your rabbit’s proper weight, please consult your veterinarian.

Cecotropes

Rabbits are herbivores with a marvelous gastrointestinal (GI) tract that allows them to extract nutrients from a variety of sources. Rabbits are meant to live on a diet composed of large quantities of grasses and leaves. They also graze on flowers and fruits that can be found at different times of the year. Rabbits are successful at making the most out of the food they eat, food that many other animals could not even digest. One of the keys to their success is the production of cecotropes, which are a type of dropping that is eaten by the rabbit directly from the anus and then digested. These droppings are not made up of waste materials but rather are rich in organisms that have come from the area of the intestinal tract called the cecum. These organisms are packed with nutrients such as amino acids (the building blocks of proteins), fatty acids and a variety of vitamins. In order for the rabbit to get these nutrients, the cecotropes, including the organisms, must be eaten and digested. In this way, rabbits can extract the maximum nutrients from low-energy food materials. They literally produce some of their own food!

Healthy rabbits will eat their cecotropes directly from the anus and you will not see these droppings in the cage. If a rabbit has a medical problem that prevents him from reaching the anus, then you may see cecotropes on the cage floor. Cecotropes are elongated, greenish in color, coated in mucous and have a strong odor. Consult your veterinarian if you see a large number of cecotropes in the cage because your rabbit may be missing vital nutrition. If a rabbit is eating a diet that is too rich in nutrients, such as one that contains mostly commercial pellets, there may normally be a few cecotropes dropped in the cage.

For more information on the workings of the GI tract of the rabbit read Rabbit Hairballs. Cecotropes are a vital part of your rabbit’s diet.

Grass Hay

Grass hay is one of the most important parts of your pet’s diet. Hay should be provided at all times in your pet’s cage. Hay is appropriate for all ages of rabbits, starting at weaning. Hay provides a number of important things for your rabbit’s health.

  • It is rich in nutrients such as vitamins, minerals, and proteins 
  • Provides “food” for the micro-organisms that make up the cecotropes 
  • Provides indigestible fiber that promotes healthy motility (movement of contents) of the intestinal tract 
  • Provides healthy chewing activity to promote proper wear of the teeth (all rabbit teeth grow continuously throughout life) 
  • Chewing also provides healthy mental activity, which decreases chewing of inappropriate objects such as furniture and wallpaper 
  • Provides a full feeling in the stomach that is satisfying and may also prevent inappropriate chewing

Remember that rabbits are designed to live primarily on a diet of grasses and leaves, therefore grass hay can provide a good portion of that diet. There are two basic types of hay available: grass and legume.

  • Legume hays are made from alfalfa, clover, peas, beans or peanuts. These hays are loaded with nutrients but have more calories, calcium and protein than a house rabbit needs. Feeding only legume hays may lead to GI disorders and obesity and for this reason we do not recommend feeding these hays. If you mix legume hay with grass hay, the rabbit may only pick out the calorie-rich legume hay and thus overload himself with calories, so we do not recommend mixing grass and legume hay. There are now several online sources of grass hay so even if you live in an area where you cannot get grass hay you should be able to order it online.  A small amount of alfalfa hay used as a treat is fine but not used as the routine hay source for the house rabbit.  
  • Grass hays are made from timothy, meadow, oat, rye, barley or Bermuda grasses. Grass hay availability varies greatly in different areas of the country and the world. You may only be able to obtain one variety where you live. However, if at all possible, try to feed mixed grass hay or provide two or more individual types. Contrary to some sources it is not necessary to only feed timothy hay and it is much preferable to feed a variety of grass hays if available.  Grass hays are rich in nutrients but provide the lower energy diet appropriate for a house rabbit. These are the healthiest hays to feed. If you have a choice, choose sun-dried hay which has retained more of its nutrients than commercially dried hay. Do not feed straw. Straw is devoid of most nutrients and although it is not harmful in small amounts, it will lead to serious nutritional deficiencies if it is a major part of the rabbit diet.

Sources for hay include veterinary clinics, horse barns, feed stores, pet stores, rabbit clubs and a growing number of online stores.  A few online stores that carry grass hay include the Oxbow Company,   Kaytee, and  Sweet Meadow.

When you buy hay you need to consider the following:

  • Buy hay that smells fresh, never buy damp or old hay 
  • Buy from a reputable source that replenishes the hay frequently 
  • If you buy from a feed store or horse barn, buy hay that has not been on the top of the pile to prevent contamination with animal or bird droppings.

Hay can be stored at home in a dry place that has good air circulation. Do not close the bag of hay but rather leave it open. Hay can be given to your pet in a variety of ways including in a hay rack attached to the side of the cage, in a box or basket within the cage or exercise area, or even placed in the litter box. Rabbits often pass stools when they are eating and placing some hay in the litter box can help with litter box training. They will not eat soiled hay, so you need not worry about sanitation. Always keep hay in the cage or exercise area and replenish as needed. You can also stuff hay into toilet paper rolls and other hiding areas as a fun way to increase mental exercise associated with foraging for food.  Providing a regular source of grass hay is a major key in preventing many diseases in a pet rabbit.

Green Foods

Green foods are the next most important food in the rabbit’s diet. Green foods provide all the same benefits listed for hay. They also contain a wider variety of micronutrients and, importantly, provide water in the diet. Even though you may be providing a water container in the cage, rabbits do not always drink as much as they should. Feeding green foods forces the rabbit to take in liquid and thus helps promote healthy GI function as well as kidney and bladder function. You will notice that if you feed your pet a lot of green foods, he will drink very little water, which is normal.

It is NEVER appropriate to feed your rabbit a diet comprised primarily of green foods.  The green foods available in the grocery stores do not have enough concentrated calories to sustain a rabbit’s normal body weight when this is the primary source of food.  Even in the wild a rabbit would eat dried grasses and tree and bush leaves to obtain more calories. Greens are an important addition to the diet, but should never be the total diet.

If your rabbit has never eaten green foods before, it is important to start her on hay first. This will help to make the appropriate changes in the flora of the GI tract, including improving movement and production of cecotropes. In this way you can avoid the problem of soft stools that is occasionally seen when you give greens to a rabbit who has never eaten hay or greens. This is not a dangerous disease; it is only the rabbit’s intestinal tract making changes from its sluggish state to a more active state. However, these soft stools can be messy, so making the change to hay first for a month at minimum will avoid this problem. Greens are appropriate for any age of rabbit if the rabbit is already eating hay on a daily basis as mentioned above.

When selecting and using green foods follow these guidelines:

  • Buy (or grow) organic if possible 
  • Wash any green foods first 
  • Make sure your rabbit is eating hay well first
  • Introduce greens a little at a time over several days and watch the stools for any change
  • Feed a variety of green foods daily – a minimum would be three varieties – variety provides a wider range of micronutrients as well as mental stimulation for your pet 
  • Feed a maximum of about  1 packed cup of green foods per 2 pounds of body weight at least once a day or this amount divided twice a day.

Occasionally you may have a situation where a select green food causes a soft stool. You will know if this is the case within 12 hours of feeding the offending food. If you are feeding a variety of greens and are not sure which one is causing the problem, then feed only one green food every 48 hours until the offending food is identified and then simply remove it from the diet. This is not a dangerous situation, but it can be messy and there is no need to give a food that is causing a problem. There are many green foods from which to choose.

There are a huge variety of green foods that you can offer your pet. You might even consider growing some yourself! This would include grass that you grow in your yard but it can only be used if there have been no pesticides or other chemicals used on it. You might consider growing a patch of grass just for your bunnies. And don¹t throw away those dandelions when you pull them up, if they have not been treated with any chemicals they are an excellent source of nutrition. In general, the darker green a food is, the higher the nutritional value. This is why, for instance, we do not recommend iceberg lettuce. It is not dangerous, but is extremely low in nutritional content. You can use packages of mixed salad greens s if they contain dark colored greens and are not comprised primarily of iceberg lettuce or romaine lettuce. Please, no salad dressing!

Here are some of the green foods you might consider:

  • Baby greens
  • Bok Choy
  • Borage  Basil
  • Broccoli (leaves and top) 
  • Brussels sprouts 
  • Cabbage (red, green, Chinese) 
  • Carrot/beet tops
  • Celery (leaves are good)
  • Chickory
  • Collard greens 
  • Dandelion greens (and flower) 
  • Dock
  • Endive 
  • Escarole
  • Kale
  • Leaf lettuce 
  • Mustard greens 
  • Parsley (Italian or flat leaf best) 
  • Radicchio 
  • Romaine lettuce 
  • Swiss chard (any color) 
  • Water cress  

Fruits and other Vegetables (Treat Foods)

Depending on the time of year, rabbits in the wild would have access to additional foods such as fruits, vegetables and flowers. Since these items do not make up the majority of the diet, we recommend feeding these treats in limited quantities. Another reason for limiting the amount is because some rabbits like these foods so well that they will eat them to the exclusion of all others, thereby creating a potential for health problems. Foods from this list can be fed daily and you may even wish to use them as part of a reward or training system.

*TIP: Find at least one food in this list that your rabbit likes and feed a small amount daily to check on how good your rabbit’s appetite is.  If your rabbit will not eat her treat food, then there may be other problems brewing and you need to keep a close eye on your pet for health problems.

These treat foods are far healthier (and less expensive) that the commercial treat foods sold for rabbits. Commercial treat foods should generally be avoided because many are loaded with starch and fat and if fed in quantity can cause serious health problems. Read the label on any treat food to make sure the ingredients are not primarily based on grains.  Sticking to natural and healthy treats for your pet is a better alternative.

For treat foods, follow the same guidelines listed above for selecting and using green foods with the exception of the amount.

You can feed your pet a total of 1 tablespoon per 2 pounds of body weight per day of any combination of the foods below:

  • Apple
  • Bean or alfalfa sprouts 
  • Blackberries 
  • Blueberries
  • Cactus fruit 
  • Carrots 
  • Cherries 
  • Cranberries
  • Edible flowers from the garden (organically grown and NOT from a florist) such as roses, nasturtiums, day lilies, pansies and snap dragons
  • Green or red bell peppers 
  • Kiwi Fruit 
  • Mango
  • Melons
  • Papaya
  • Pea pods (flat, NO peas) 
  • Peach 
  • Pear 
  • Pineapple 
  • Raspberries 
  • Squash

Dried fruit can be used as well, but since it is so concentrated, use only one third the amount as fresh.  Instead of one tablespoon use one teaspoon. We do not recommend feeding bananas and grapes as rabbits sometimes become “addicted” to these foods. If you chose to feed them, watch your pet carefully to ensure that he is also eating sufficient quantities of green foods and hay.

Forbidden Foods

A diet of grass hay and green foods with small amounts of fruits and vegetables contains all the nutrition necessary for the pet rabbit. Unfortunately there are many commercial treat foods sold for rabbits that contain high levels of starch and fat. In addition, some people still feel that it is necessary to feed rabbits high starch foods such as cereals, cakes and cookies. Although a pet rabbit can eat very small amounts of starchy or fatty foods without ill effect, the problem is that people often feed excess amounts because the rabbits eat these foods so greedily. Our recommendation is to completely avoid high starch and/or fat foods for your pet. In this way you will avoid any potential problems these foods can cause, including obesity and serious GI disease. It is always easier to prevent than to treat a disease.

Examples of high fat and/or starch foods to AVOID include:

  • Any other grains
  • Beans (of any kind) 
  • Breads 
  • Cereals 
  • Chocolate 
  • Corn
  • Nuts
  • Oats 
  • Peas 
  • Refined sugar 
  • Seeds 
  • Wheat

Commercial Rabbit Pellets

Rabbit pellets should generally only comprise a small portion of a pet rabbit’s diet.  There are much healthier commercial rabbit pellets available now then we had 20 or more years ago; then all the pellets were alfalfa and grain based and although they did successfully produce fast-growing rabbits that put on weight quickly, which was the goal of the commercial rabbit industry, we found they caused a number of serious problems for our pet rabbits.  The idea of producing a uniform and concentrated food source was not a bad idea but when fed to the exclusion of anything else in the diet we see these problems in the pet rabbit:

  • High calorie content can lead to obesity – it’s easy to overfeed because the rabbit is always acting “hungry.” Unfortunately the concentrated and small form of the pellets does not lead to a feeling of fullness that a diet based on grass hay can provide.  Even though rabbits should eat to their caloric needs, in captivity with boredom they will overeat pellets if they are provided free choice.
  • Low indigestible fiber content can lead to a sluggish GI tract and eventually more serious GI disease, including complete GI shutdown. 
  • Doesn’t promote normal tooth wear due to the concentrated nature of the food – a couple of chews and the food is pulverized as opposed to the much longer chewing time it takes to break down hay or greens. 
  • Lack of sufficient chewing activity and a “full feeling” in stomach due to concentrated nature of the food may lead to behavioral problems, such as inappropriate or excessive chewing on furniture, plants, wallboard.  This could be likened to a sense of boredom.  Rabbits in the wild spend a great deal of their day eating. and pellets can be eaten in a few minutes. 
  • Concentrated, dry nature of pellets may not promote normal water intake, resulting in potential urinary tract disease.  A rabbit’s natural diet would not be this consistently low in moisture.

The recommendation for feeding pellets would be that they comprise ideally 10% of the healthy rabbit’s diet and maximally no more then 20%. 

In some cases it may be necessary to feed a higher amount for the following reasons:

  • In households where hay cannot be used due to human allergies or unavailability
     
  • To implement a weight gain most often related to a debilitating illness 
  • When the owners are unable to feed a varied diet of good quality grass hay and a variety of green foods.  Pellets will help to cover some of the trace nutrients that might be missed in a restricted diet.
  • For female rabbits that are used for breeding during the pregnancy and nursing period.  They have a high requirement for calories during these times and it may be necessary to increase pellets during this time period or even to feed them free choice.

When selecting a pellet look for the following:

  1. 18% or higher in fiber 
  2. 2.5% or lower in fat
  3. 16% or less in protein
  4. 1.0 % or less in calcium
  5. Do not buy pellet mixes that also contain seeds, dried fruits or nuts.
  6. Buy pellets based on grass hays (timothy, orchard grass, brome, etc) NOT alfalfa hay (your veterinarian can advise you if an alfalfa based pellet is needed for situations in ill animals where weight gain may be needed).

The amount to feed a healthy rabbit would be approximately ¼ cup of pellets per 4 lbs of body weight daily.  This can be divided and fed twice a day or all fed once a day.  Pellets can even be fed one by one and used in a training program. I recommend 1/4 maximum for other than giant breeds and 1/8 cup maximum for dwarfs, but even less for each if there are medical issues.

For rabbits that have chronic GI problems or have issues of excessive weight, it may be preferable to completely remove pellets from the diet. Please consult your veterinarian about changing to this type of diet if needed.

Water

Water should always be available and changed daily. A dirty water container can be a breeding ground for bacteria. Use either a water bottle or a heavy bowl that is weighted or secured to the side of the cage so that it does not tip over. Do not use medications or vitamins in the water because your pet may not drink the water if the taste or color is altered. Please remember that if your pet is eating a large quantity of greens that the water consumption may be minimal.

Vitamins/Lactobacillus/Enzymes

Vitamins are not necessary for the healthy rabbit. Rabbits will obtain all the vitamins they need from their cecotropes, grass hay and green foods and small amount of pellets. The misuse of vitamins can cause serious disease. If your pet becomes ill, particularly if he/she is unable to eat the cecotropes, then your veterinarian may prescribe vitamin therapy. Do not use supplemental vitamins in a healthy pet. In addition, rabbits on a healthy diet do not need a salt or mineral block.

Lactobacillus or acidophilus are bacteria found in the GI tracts of a number of different species. In some older texts there was a recommendation to feed rabbits yogurt (which contains active cultures of these organisms) to improve the health of the GI tract. However, there is no benefit to feeding these bacteria to the rabbit because Lactobacillus does not hold an important place in the rabbit GI tract and adult rabbits may not be able to adequately digest dairy products. Other products called probiotics, which contain bacteria more specific to the rabbit GI tract, are available but their benefits are still controversial. A rabbit on a healthy diet of grass hay and green foods should be able to maintain a normal population of bacteria without additional supplementation. We do not recommend the routine use of probiotics in the healthy rabbit.

Some older texts recommend feeding digestive enzymes to rabbits to help dissolve hairballs. This is of no benefit to the rabbit because such products do not dissolve hair and the problem is not the hair anyway. (See handout Rabbit Hairballs for more information) Although these products will not harm the rabbit, they are of no use.

Environment

Cage

House rabbits should never be kept completely confined to a cage. Exercise is vital for the rabbit’s health. All too often we hear well meaning but poorly informed people describe rabbits as easy to keep because “they can be caged and don’t take up much space!” This idea has led to many rabbits being caged most of their lives with the distinct possibility of developing both physical and behavioral disorders. They are designed to run and jump and move about a large area.

To confine a rabbit exclusively to a cage can cause several problems:

  1. Obesity – caused most often by a diet too high in calories coupled with a lack of exercise 
  2. Pododermatitis – inflammation of the feet caused by sitting in a damp or dirty environment 
  3. Poor bone density – Rabbits that are continually confined to a small cage can exhibit marked thinning of the bones, which may lead to more easily broken bones when handling 
  4. Poor muscle tone – If the rabbit can’t exercise, the muscles, including the heart, will be underdeveloped and weak 
  5. Gastrointestinal and urinary function – A rabbit that sits all day in the cage with little exercise can develop abnormal elimination habits. 
  6. Behavioral problems – Continually caged rabbits can exhibit a wide range of abnormal behaviors including lethargy, aggression, continual chewing of the cage bars, chewing fur (obsessive grooming), and destruction of the entire contents of the cage.

A cage can be used as a home base for part of the day or it can be open all the time within an exercise area. The cage should allow the rabbit to stand up on his hind legs without hitting the top of the cage, provide a resting area, and have space for a litter box. It should be easy to clean and indestructible, so metal is probably the best choice. The floor can be solid or wire.(I prefer a combination with each type of flooring available.) Keep the cage in a well ventilated, cool area. Basements are often too damp, which can promote respiratory disease. If you must house your pet in a basement, use a dehumidifier and a fan to improve the air quality. The optimum temperature range for a rabbit is 60F to 70F. When the temperature rises into the mid 70s, you may see drooling and a clear nasal discharge. If temperatures reach the upper 80s and beyond, especially if the humidity level is high, there exists a potential for a fatal heat stroke. On hot days when air conditioning is not available, leave a plastic milk jug filled with frozen water in the cage for use as a portable air conditioner.

Rabbits can be caged outdoors if they are provided with a shelter to protect them from rain, heat and cold. In addition, make sure the cage is secure from predators such as dogs, coyotes and raccoons and is kept clean so it won’t attract parasitic insects. In the winter, use straw bedding in the sheltered area for insulation and make sure that the water bowl is changed daily. Your pet can dehydrate rapidly if the water is frozen for more than a day.

Exercise Area

It is vital to the health of your pet to provide an exercise area where your rabbit can roam for a few hours every day. The easiest way to accomplish this is to use exercise fencing panels sold for dogs. These can be found at most pet stores. Buy fencing that is at least three feet high for small and medium rabbits and four feet high for giant breeds. These panels are easily put together with metal pins and can be configured to any size or shape needed. The pen keeps your bunny away from furniture, electrical cords and toxic materials.

The pen can also be used outside as a moveable enclosure to allow your pet access to grassy areas. Never leave a rabbit outside in a pen unsupervised because dogs, cats and raccoons may be able to knock down the fencing or climb over it and harm your pet. Indoors, if you need to protect the floor under the pen you can use a sheet of no-wax flooring, which is available at most hardware stores. It can be easily cleaned and rolled up when not in use.

If you are going to allow your pet free access to your house you need to bunny-proof it. Block all escape routes, cover or block access to electrical, phone and computer cords, cover furniture to protect it from the rabbit’s teeth and claws and remove access to toxic plants, rodenticides, insecticides and other toxic materials.

Litter Box

Rabbits can be litter box trained relatively easily. When beginning training, confine your pet in a small area, either in a cage or a blocked off section of the room, and place a litter box in the corner; try to pick the corner your pet has already used for her toilet. Make sure the sides of the box are low enough so your pet can get in and out easily. It is helpful to put some droppings in the litter box. Some people have also found it helpful to put some hay in the box to encourage defecation there as rabbits usually pass stool while they are eating. In exercise areas, provide one more litter box then the number of rabbits you have and put newspaper or plastic under the litter box to protect your floors from accidents. Never punish your pet while in the litter box.

Pelleted litter makes the best bedding and is preferred over wood shavings, corncob and kitty litter. Pelleted litters are non-toxic and digestible if eaten, draw moisture away from the surface which keeps it drier, control odor well and can be composted. Do not use clay or clumping kitty litter. We have had cases where rabbit ate these products and died from an intestinal impaction. There are a wide variety of pelleted beddings available through pet stores, veterinarians and rabbit clubs.  (I like softer litter than pelleted, especially in buns that spend a lot of time in the litter box.)

Rest/Hide Area

The ancestors of our pet rabbits would have spent a good portion of their day in protected underground burrows. Our pet rabbits retain the same need to have a protected area in which they feel safe and secure. Some rabbits are content to sit in a box full of hay, others like a completely enclosed box in which to hide. Try providing places to hide, such as untreated wicker or straw baskets, litter pans or other shallow boxes filled with hay, cardboard boxes with an entrance hole and the bottom removed, or large cardboard tubes. (Don’t forget the new Oxbow structures, which can be used as edible toys as well.)

Use your imagination! If the cage has a wire floor, provide a solid area on which the pet can rest. Use material that is washable or disposable and absorbent. Some examples might be fake fleece (not long fur) found in fabric stores or absorbent baby blankets (not terry cloth towels). Do not use carpet squares because they are not absorbent, they are abrasive to the feet, and they can not be thoroughly cleaned. (Also carpet can be eaten, which is the number one cause of obstruction.)

Toys

Rabbits get a fair amount of mental exercise from their diet of grass hay and green foods, but additional toys are appreciated. Rabbits like to chew, so give them branches from untreated trees (dry the wood for at least a month to prevent any adverse reactions to the sap), wooden chew toys designed for birds, or unfinished unpainted wicker or straw baskets. They like things that make noise such as keys on an unbreakable key holder, empty plastic or metal cans, hard plastic baby toys and jar lids. They like things that both move and can be chewed such as toilet paper or paper towel rolls, small empty cardboard cartons and small piles of shredded paper.  To make a toy more interesting, you can hide in it healthy treats, as described in the diet section, or stuff hay in hiding areas, toilet paper rolls and old tissue boxes.  Giving the rabbit a sense that he or she is foraging for food is an excellent mental activity. They like air-filled balls they can nose around.

Handling

There are a number of ways to pick up your pet depending on how calm she is and her size. The main thing to remember is to always support the hindquarters to prevent serious spinal injuries. Rabbit backbones are fragile and can fracture if the hind legs are allowed to dangle and the animal then gives one strong kick. Unfortunately these injuries are usually permanent and frequently result in euthanasia, so prevention is the best policy. Never pick up a bunny by her sensitive ears because it’s painful and totally unnecessary! It is better to grasp the loose skin over the shoulders or scoop up under the chest and then place your other hand under the back legs to lift your bunny from the floor. Work near the floor when first learning to handle your pet so that if she jumps out of your arms there isn’t a chance for a fall.

Ask your veterinarian or an experienced rabbit handler about other methods used to handle rabbits. Some restraint methods are particularly useful when your rabbit needs to be medicated. Wrapping your pet securely in a towel is one easy method and your veterinarian can instruct you on the proper procedure.

Medical Problems

We have many handouts available that cover medical problems encountered by pet rabbits in detail. I encourage you to ask your veterinarian for information on a specific topic that interests you. As mentioned before, the number one group of diseases that we see in rabbits is caused by an inappropriate diet and is often preventable. The following is a brief discussion of a few of the medical conditions that you should be aware of.

Spay/Castration

Uterine adenocarcinoma is a malignant cancer that can affect female rabbits over two years of age (although I have seen it in an 18-month old rabbit). The best prevention for this disease is to remove the reproductive organs (ovaries and uterus) in a surgical procedure commonly called a spay. The procedure can be performed in females over four months of age. Spaying a rabbit also prevents pregnancy and can help control some aggressive behavior.

Male rabbits can also develop disease of the reproductive organs (the testicles) but with much less frequency than females. However, some male rabbits have a tendency to become aggressive in their adolescence (8-18 months of age) and can also start spraying urine on vertical surfaces outside the toilet area to mark their territory. Surgical removal of the testicles, called castration, can control these behaviors if it is done before the behavior occurs or shortly thereafter. Male rabbits can be neutered anytime after four months of age.

Consult our handouts To Neuter or Not to Neuter and Taking the Fear out of Rabbit Anesthesia and Surgery for more information on this topic.

Dental Disease

Dental disease can be the result of a variety of factors including trauma to the face, genetics (jaw is too short or malformed such as seen in the lop-eared breeds of rabbits), nutritional disease, infectious disease and diet. Rabbit ancestors ate a diet that was tough and abrasive, therefore they developed teeth that grew throughout their lives. Without this constant dental growth, the teeth would wear down quickly and the rabbit would be unable to eat and eventually die. Any condition that causes a rabbit’s teeth to be worn down improperly or causes mal-alignment can result in serious dental disease.

The best prevention for dental disease is a healthy diet including grass hay and green foods. But even with this good diet, some rabbits develop disease due to other factors, particularly genetics. The treatment of dental disease is based on the cause and severity of illness. Your rabbit should have a dental examination performed by a veterinarian at least once a year. You should never attempt to trim a rabbit’s overgrown teeth without consulting your veterinarian. An improperly performed tooth trim can lead to serious dental disease. Consult our Rabbit Dental Disease handout for more information.

Loss of Appetite

Rabbits are little eating machines and if you notice that your pet has changed his eating habits, there is cause for concern. The most common reason a rabbit stops eating is in response to pain. If every day you give a small amount of a healthy treat that your rabbit loves, as outlined in the Diet Section, you will quickly know when your rabbit’s appetite is changing.

The rule of thumb regarding the seriousness of the loss of appetite is:

  • Loss of appetite but otherwise acting normal should be investigated within 48 hours. Some rabbits may go through a slow down and then pick up again in a day. The key here is that the rabbit is still active and alert, and is still producing stools 
  • Loss of appetite accompanied by obvious lethargy or depression should be considered an emergency and should be investigated immediately. This can be a sign of an intestinal obstruction or toxin ingestion. Another important sign is that no stools are being produced.

Respiratory Signs

Rabbits can exhibit sneezing, coughing and excess tearing. Not all these signs are related to respiratory disease. Common environmental causes include perfumes, sprays, cooking fumes, ammonia fumes from accumulated urine in toilet area, fabric softener on bedding, dust, poor air circulation, damp environment and hot environment. Dental disease can also cause signs that may mimic respiratory disease, such as excessive tearing that stains the eyes. Please consult your veterinarian if your pet is showing these signs.

“Hairballs”

Hairballs are often cited as a reason for rabbits to stop eating. The problem is not hair in the stomach (which is always in a normal rabbit’s stomach due to grooming) but abnormalities in GI tract motility. A rabbit on a healthy diet with lots of grass hay and other foods as described in the diet section will not have a problem with hairballs.

The only exception is that, rarely, longhaired breeds of rabbits such as Angoras and Jersey Woolys, can accumulate an abnormal amount of hair in their stomachs even if they are on a good diet. Brush these breeds regularly to prevent the ingestion of large amounts of long hair. Remember that these rabbits do not have the normal rabbit haircoat of the ancestral rabbit so we humans have artificially created this problem! Consult our handout on Rabbit Hairballs for more information.

Diarrhea

True diarrhea, where all the stool being passed is purely liquid, is rare in the pet rabbit eating a healthy diet. More commonly we see a situation where the rabbit has both normal and soft pudding-like stools in the toilet area. This is not diarrhea, but a problem with GI motility usually caused by an inappropriate diet. You can read more about this in our handout Intermittent Soft Stools in Rabbits.

If you should notice true diarrhea in your pet, you should consider it an emergency situation and consult your veterinarian immediately.

Urinary Disease

The normal color of rabbit urine can range from yellow to dark orange-red. The color comes from plant pigments in the food or from normal pigments produced in the wall of the bladder. The urine can be clear or cloudy with a white precipitate. The white precipitate is excess calcium excreted through the urine. Rabbits can develop disease of the bladder or kidneys and may exhibit signs such as blood in the urine, straining to urinate, inappropriate or frequent urination, or the complete inability to urinate. If your pet is exhibiting any of these signs, consult your veterinarian immediately.

The best prevention for urinary disease is an adequate water intake, which is accomplished through the feeding of green foods and providing fresh water daily. See our handout Bladder Stones and Bladder Sludge in Rabbits for more information.

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Rabbit Pee Carries E. cuniculi

Urine from healthy animals is typically considered to be of little to no risk to people. This is generally true, at least for the otherwise healthy human population, but like with most things in infectious diseases, there are exceptions. An interesting one in rabbits is a bug called Encephalitozoon cuniculi. This microorganism (now classified as a fungus, but previously considered a protozoal parasite) is very common in healthy pet rabbits. In fact, the majority of rabbits has antibodies against E. cuniculi and may have it living in their bodies, particularly in the kidneys. It can cause infection of the brain, and is an important cause of neurological disease in rabbits, but more often than not it lives within the rabbit without causing any problems. Rabbits can shed spores of this organism is their urine, although they mainly do this only in the first few weeks after they’ve become infected, and shedding after that may be intermittent.

E. cuniculi is one of a group of microorganisms that became much more important when the HIV/AIDS epidemic hit. While rarely a cause of disease in people in the pre-HIV era, E. cuniculi is recognized as a potential cause of infection in people with compromised immune systems, particularly people with AIDS. Infections of people with normal immune systems are extremely rare.

It’s always a challenge deciding what to do with a microorganism that can be shed by a large number of healthy animals. One reference “strongly advises” routine testing of rabbits, but that makes no sense to me. Here’s why:

  1. Screening always comes down to a question of what you would do with the results. If you get a positive antibody test, it means that the rabbit has been exposed sometime in its life, but that does not mean that it is necessarily still infected or shedding spores – so it’s not really convincing. 
  2. Tests can be done to detect spore shedding but they are not particularly reliable. Since infected animals shed spores intermittently, a negative result here isn’t convincing either. 
  3. If the animal is positive, what would you do? If the household has no immunocompromised people, I’d say do what you’ve always done, and pay attention to good hygiene. 
  4. If the animal was “negative,” I’d say do what you’ve always done, and pay attention to good hygiene… same as for a positive rabbit. 
  5. If there is an immunocompromised person in the house, I wouldn’t say to get rid of the pet, since there’s no evidence that’s necessary. There is also no evidence that treatment is useful to eliminate E. cuniculi shedding rabbits. If the animal is positive, immunocompromised persons should avoid contact with urine and feces, and use good personal hygiene… just as they should do if the rabbit is negative!