by Dana Krempels, Ph.D.
Department of Biology
University of Miami, FL

Probably because of their evolutionary history as prey animals, rabbits often show few outward signs of distress when they are ill or in pain. In nature, predators cue in on animals that act sick, instinctively knowing that these particular individuals will be easier to capture. Presumably, over evolutionary time, sick rabbits who had an inborn tendency to hide obvious outward signs of illness were less likely to be selected by predators while they were sick. These "genetically stoic" individuals might thus have been more likely to survive an illness and leave more offspring to future generations than others who showed more obvious signs of weakness. The unfortunate side effect of this evolutionary marvel is that it takes a very attentive "bunny parent" to notice when Bunny is feeling poorly. A symptom as seemingly insignificant as hiding in an unusual place, sitting in a hunched position or refusing a favorite treat can signal that something is seriously wrong. Once you notice these subtle signs, there are several simple diagnostic measures you can take to determine whether an emergency trip to your rabbit-experienced veterinarian is warranted:

1. OFFER A FAVORITE TREAT
If Bunny refuses it, try another. If he absolutely won't eat, it's time to move to step two.

2. TAKE THE RABBIT'S TEMPERATURE
If you do not know how to take your rabbit's rectal temperature, it's a good idea to have your veterinarian show you how to do so before you have an emergency. Always use a plastic thermometer, to eliminate the danger of the thermometer breaking off inside if the bunny gives a strong kick or wriggle.

Instructions: How to Take Your Bunny's Temperature
Normal rabbit body temperature ranges between 101oF - 103oF (38.3oC - 39.4o C).

We've found that a good way to take the temperature is to gently cradle the bunny on his back--either in your lap or on a secure countertop with soft padding. The bunny's head and shoulders should be held gently against your abdomen, and the back allowed to curl into a "C" position, with the footpads facing the ceiling. Be sure the hindquarters and back legs are securely supported so that the bunny doesn't kick suddenly and injure himself. Once bunny is in position and calm, very gently and carefully insert a well-lubricated plastic thermometer no deeper than about 1 inch. If you aren't sure which of the two openings to use, note that the anus is the one that "winks back at you" when you touch it lightly with the thermometer tip, and that it is behind the urogenital opening (i.e., closer to the base of the tail).

The path of the rectum is almost parallel with the lower spine, and when bun is cradled in a "C" position as described, the thermometer will naturally travel almost straight down, perpendicular to your lap.

Be sure to securely support the bunny's back end, and do not allow him to kick or struggle. If he does, carefully release him to a sternal (on his belly) position, supporting his back and hindquarters at all times. Talk reassuringly to him, and stroke him gently, and don't try again until he has calmed down. Depending on the rabbit's personality, you might have to try several times before you're successful, and if you are having trouble doing this alone, get a second person to "spot" for you. Never force anything. If you feel resistance, pull back, change position slightly, and try again. Be very gentle, as the rabbit colon and rectum are very delicate and easily damaged.

What to do in case of Fever
A slightly elevated temperature (around 104^oF/39.9^oC) can be caused by emotional stress (such as a trip to the vet's office or the discomfort of a health problem), heat stress or the early stages of an infection. A very high temperature (105^oF/40.5^oC or higher) should be considered an emergency. Lifesaving cooling measures should be begun even before you leave for the veterinarian¹s office. If the body temperature remains too high for too long, irreversible brain damage can occur, even if the bunny survives the ordeal. A good way to cool the bunny is to use cold packs or even bags of frozen vegetables, placing them under his belly and around his sides. You can rub his ears with an ice cube, but be sure not to cause frostbite by holding the cube there too long, or over-cooling. Rubbing alcohol swabbed on the ears will also help cool the bunny. It will usually take five to ten minutes of ice packs to bring a severe fever to lower levels, and you should continue to monitor bunny's temperature throughout the procedure, as long as it does not seem to be stressing him unduly.

What to do in case of Hypothermia
A temperature lower than normal may be even more dangerous than a slight fever. Abnormally low body temperature (below 100^oF/38.1^oC) can signify shock or the very late stages of systemic infection, and should be considered an emergency.

It is of utmost importance to get the bunny's temperature up to normal levels, as most other medical treatments will not be as effective if the rabbit is hypothermic. To raise the body temperature, fill plastic bottles or ziplock bags with hot water, and wrap them in towels to protect the bunny from being burned. Place the hot water bottles under and around the bunny, and monitor temperature until it is at least 100^oF/38.1^oC. At that point, loosely wrap the bunny in towels warm from the dryer, and get him to the vet right away.

If the hypothermia is due to the late stages of a systemic infection, it means that bacteria in the bloodstream have used up so much of the rabbit¹s glucose (blood sugar) that he cannot maintain a normal body temperature on his own. This must be treated immediately and aggressively, sometimes with intravenous antibiotics and dextrose solution, which must be administered by your veterinarian.

If the bunny is refusing treats, but body temperature is normal, it's time to move to step three.

3. LISTEN FOR NORMAL INTESTINAL SOUNDS
It's worthwhile for every bunny parent to invest in an inexpensive stethoscope. Place the tympanum low on the abdomen, well below the ribs, and listen for soft, intermittent gurgling sounds. If the tummy is silent, you may be facing Gastrointestinal Stasis (ileus)

If the tummy is making very loud gurgles, your bunny might have a bad case of gas, sometimes associated with ileus. Gas pain alone can cause enough stress to send a rabbit into ileus, and it is important to get the gas and its associated pain under control immediately. The simplest home emergency procedures to control gas pain (while waiting for your vet to call you back) are the following

administer 1 - 3 cc of pediatric simethicone drops (available at most pharmacies.

Begin very gentle abdominal massage. Place the bunny on a secure countertop and start very gradually, rubbing the sides of the belly, and gradually working your way deeper by actually holding the belly in one hand and gently kneading it in both forward and backward directions. If bunny shows any sign of pain, back off and massage more gently. It also helps to periodically raise the bunny up on his hindquarters as you massage, so gas bubbles can move about more freely. You can also do the reverse, carefully lifting his hindquarters into the air while gently massaging, being careful to not let him kick, jump, or hurt himself.

If your bunny is truly suffering from ileus, then your vet will probably want to prescribe additional medication, including: analgesia (Banamine (flunixin meglumine) or meloxicam are excellent and safe for rabbits) and/or intestinal motility drugs (Reglan (metoclopramide and/or cisapride)

Remember: If you are in doubt about your bunny's condition, don't hesitate to call your veterinarian immediately. Don't wait for an emergency to find a good rabbit-experienced vet who will be available at odd hours. For a referral to rabbit-savvy veterinarians in your area please visit the House Rabbit Society's site for Veterinary Recommendations.