Making your veterinary practice rabbit friendly

Francesco Cian presents the case of an eight-year-old cockatoo seen by a referring veterinary surgeon for a traumatic foot lesion.

Francesco Cian | December 16 2019

Does your practice need to pay more attention to rabbits?

There are around one million pet rabbits in the UK, making them the UK’s third most popular pet. You may not encounter as many rabbits as you will cats and dogs in practice, but they still require the same levels of care and attention, and, in many cases, represent an untapped client base. A growing number of rabbit savvy vets are capitalising on the lack of care and attention that some rabbits are receiving and research shows that many rabbit owners will seek out practices that specialise in rabbit care over those who don’t.

It’s clear that there is more work to do to ensure rabbit owners are equipped with up-to-date, professional guidance covering the welfare needs of these charming and charismatic pets. Investing some time into creating an environment within your practice which rabbit owners feel has been built around them and their furry friends does more than just provide an opportunity education and engagement – it can also drive return visits and encourage new clients to register, too.

Knowing the rabbit basics

Most vets graduate with a relatively basic level of rabbit knowledge, despite the fact that most will encounter rabbits in their practice on a daily or at least weekly basis. Whilst there’s been a steady increase in the number of rabbits registered with a vet (71% this year [1]against 56% in 2001) many admissions are still made as a result of preventable diseases. The most common causes of death recorded by vets[2] are flystrike (10.9%), anorexia (4.9%), collapse (4.9%) and gut stasis (4.3%). The most common medical issues are overgrown nails (16%), overgrown molars (7.6%), dirty bums (4.5%), overgrown incisors (4.3%) and gut stasis (4.2%). There’s a common theme here: diet.

Most of the issues that rabbits are admitted into practice for are associated with poor diet and it’s widely recognised that diet is a key welfare issue to be addressed in rabbit ownership. Despite the complexities of their digestive system, advising on the best diet for rabbits is comparatively simple. Rabbits should be fed a diet that closely replicates their natural diet in the wild: constant access to high quality feeding hay (which should make up between 85-90% of their diet) and water. This should be supplemented with high quality nuggets, fresh leafy vegetables and the very occasional treat. Where possible, rabbits should be encouraged to forage for their food to help keep them stimulated.

Hay is absolutely integral to a rabbits’ diet for a number of reasons. Rabbits are prone to dental issues and their teeth grow continuously throughout their lives. Gnawing at hay helps to wear their teeth down, preventing overgrown or misaligned teeth (known as malocclusion). Molar malocclusion and incisor malocclusion can both be fatal if they are not identified and treated. As a prey species with limited means of communicating, rabbits often suffer in silence and eventually stop eating, which causes further health issues through reducing gut motility leading to increased pain and eventually death.

You can advise rabbit owners to follow the Burgess Excel Feeding plan, an easy to follow five-step plan recommended by 92% of UK vets.

Move Away from Muesli

It’s widely known as ‘rabbit food’, but research[3] has shown that rabbits fed muesli diets will selectively feed, which is where rabbits only eat the high-sugar elements of the muesli mix. Selective feeding has been linked to a variety of potentially fatal health issues in rabbits, ranging from gut stasis due to slower gut motility, obesity and even flystrike as a result of uneaten caeactrophs.

Muesli mixes remain popular due to their palatable appearance, convenience and comparatively low price. If you encounter any rabbits in your practice that are still being fed muesli, it’s imperative that the food is completely phased out in favour of a diet rich in hay, supplemented with good quality nuggets, over a 4-week period.

One of the main challenges you may encounter with muesli feeders is the difficulty that arises from encouraging rabbits to eat more hay as an alternative. Despite the simplicity of their dietary requirements, rabbits can be incredibly fussy eaters and inherently suspicious of new or different foods. Encouraging natural foraging behaviour, which can be done by placing hay in hanging baskets or in willow balls, will encourage rabbits to play for their food by emulating their behaviours in the wild.

Be sure to ask owners about the type of hay that any rabbits you encounter in practice are being fed. The quality of feeding hay can vary dramatically, but many owners are unaware of this, with purchasing largely driven by price. High quality timothy and meadow hays are the most suitable (and enjoyable) for rabbits.  Hay of an appropriate quality should look and smell fresh, rather than dry and dusty and should always be purchased by a reputable retailer. Encourage owners to bring samples of all the food and hay they feed to the appointment with them – this gives you the opportunity to really assess the diet.

Preventative healthcare and infectious diseases  

Rabbits are at risk from a variety of fatal diseases. The three biggest killers are rabbit viral haemorrhagic disease (RVHD), a second, mutated strain of the virus (RVHD2), and myxomatosis. Due to the highly infectious nature of these diseases, rabbits must be vaccinated against them – especially as rabbits with RVHD2 display few or no symptoms and can die within 24 hours.

Feedback from rabbit owners who were contacted as part of this year’s Rabbit Awareness Week Protect and Prevent campaign highlighted there are areas of misinformation that need addressing by the veterinary sector. There are still far too many rabbit owners who are being incorrectly advised on the proper vaccinations they require – if the owners book their vaccinations in the first place.

Vaccination figures are still shockingly low for rabbits (current compliance levels suggest that just over 4 out of 10 vaccinated rabbits are not protected against RHDV-2) and feedback from owners has highlighted that some vets fail to convey the seriousness of vaccinating against RVHD2 where they have not encountered it in practice.

Both practices and rabbit owners need to be made aware that RVHD2 is now more common than RVHD1 and vaccination covering Myxomatosis, RVHD1 and RVHD2 is essential as a result.

RVHD2 in particular is highly infectious and has been reported all over the UK. There is no excuse for not vaccinating rabbits against this horrific disease. As it’s transferred via contact, whether that’s via insects or entering the house on the bottom of shoes, it’s imperative that even rabbits living indoors are vaccinated against RVHD2.

In addition, every veterinary practice should be stocking the appropriate vaccines to protect rabbits the rabbits in their practice area.

With the advent of Nobivac Myxo-RHD PLUS, due to be released in June, which covers all three viral diseases, this only requires a single vaccine to be administered annually.

This vaccine can be given as a single dose from five weeks of age onwards, with immunity shown to develop by 3 weeks after that. It’s essential that vets and vet nurses are conveying the importance of vaccinations and annual boosters to every client with pet rabbits, and we have received the following advice for transitioning rabbits onto the new triple vaccine:


  • Rabbits not previously vaccinated with Myxo-RHD: Vaccinate asap with Myxo-RHD PLUS
  • Rabbits previously vaccinated with both Myxo-RHD & an RVHD2 vaccine: Vaccinate at next booster time with just Myxo-RHD PLUS
  • Rabbits previously vaccinated with Myxo-RHD but not with an RVHD-2 vaccine:

Vaccinate with Filavac or Eravac as soon as possible.

Follow up with a dose of Nobivac Myxo-RHD or Nobivac Myxo-RHD PLUS (as using the triple vaccine here means they would get 2 RHD2 vaccines, using up old Nobivac Myxo-RHD stock on these rabbits is less wasteful and avoids unnecessary dose repetition)

From next year onwards boost with Nobivac Myxo-RHD PLUS at the time when the RHDV-2 vaccination falls due. It’s essential that vets and vet nurses are conveying the importance of vaccinations and annual boosters to every client they encounter with pet rabbits.


Husbandry and companionship

Rabbits need access to a large open space that provides them with the right environment to display natural behaviours such as foraging, burrowing and digging. As a prey species, rabbits must feel safe in their environment have plenty of space to hide – whether that’s in tubes, boxes, bedding or additional housing. Outdoor ‘runs’ should be attached to hutches so rabbits can choose whether they want to be outdoors or indoors and care should always be taken to ensure outdoor environments are secure and protected against the threat of predators.

84% of rabbits live in hutch sizes that are smaller than the recommended size provided by the Rabbit Welfare Association & Fund[4]. Be sure to advise any rabbit owners visiting your practice about the minimum recommended hutch size provided by RWAF, rather than the legal minimum standard, as rabbits kept in cramped conditions can suffer with stress and frustration. Rabbits kept in poor accommodation are at risk of developing obesity and skeletal abnormalities.

Rabbits are intelligent and highly sociable animals that should be kept in a minimum of same pairs. Same sex and mixed sex couples all work well providing the rabbits are neutered – which they always should be. Rabbits have unique personalities and these should be considered during the bonding process. Developing strong relationships with good, local rescue centres can help provide support during the bonding process.

Rabbits kept on their own will become lonely and this may lead to depression and stress, which can have a negative impact on health. Unfortunately, it’s challenging to treat depression in rabbits other than advise on remedying their loneliness through adding a companion. If you encounter an owner who is concerned about the behaviour of a lone rabbit, signs such as excessive hiding, overgrooming and lack of appetite may indicate stress and depression.

Male and female rabbits should be neutered from four months of age and five months of age respectively, so it’s important that care is taken in mixed sex pairs to avoid early pregnancies. Rabbits should not be reintroduced immediately after neutering – male rabbits can take up to six weeks to become sterile after being neutered.

Neutering is important because as well as preventing unwanted litters, neutering rabbits prevents unwanted behaviours such as aggression and fighting too – especially amongst males. Unneutered female rabbits have a high risk of developing uterine cancer, which is totally prevented by spaying.

Enticing rabbit owners into your practice

In recent years, there has been a gradual increase in the number of rabbit owners visiting their local vet but this number is still nowhere near as high as it needs to be. It really helps if rabbit owners feel immediately welcome from the moment they walk into your practice. One of the most effective (and cost-effective!) ways of doing this is ensuring your waiting room/ reception area and notice boards are displaying useful rabbit information and materials. These may range from rabbit care guides for owners to posters displaying the foods that rabbits should avoid eating. The Rabbit Awareness Week website has lots of downloadable materials that can be printed and displayed in waiting rooms, as well as information that may be repurposed for any internal guides.

Many rabbit owners will favourite veterinary practices with separate waiting areas for small animals. Separate waiting rooms, away from the sights and sounds of noisy prey animals, will provide a less stressful experience for rabbits. If space allows, having a separate waiting room for rabbit owners can make your practice worth travelling to. This is a pre-requisite for being an accredited RWAF Rabbit Friendly practice.

Use your practice social media channels to your commercial advantage to drive engagement with new and existing clients and to help educate rabbit owners. There are lots of enthusiastic rabbit owners online who will happily share your information and posts with their networks. You never know who your posts might reach online; highlighting the dangers of diseases such as RVHD2 and the importance of vaccinations may make a real impact on the bottom line of your practice.

Taking part in the annual Rabbit Awareness Week (RAW) campaigns can help boost footfall into your practice too. Every year in June, RAW addresses a major issue affecting the lives of rabbits in the UK with thousands of veterinary practices supporting the campaign by offering free or discounted health checks every year. Taking part in RAW is an opportunity to showcase your commitment to rabbit care and gain a commercially valuable reputational boost from PR opportunities.

Ultimately, any kind of activity your practice is involved in that promotes responsible ownership and better care of rabbits will help you establish a trust and rapport with rabbit owners. There are plenty of ways (and many of them are free) to brush up on your rabbit knowledge, from the free CPD hosted on the Rabbit Awareness Week website to the RWAF Conference and CPD roadshows that take place throughout the year. Demonstrating your excellence in rabbit care will improve the lives of rabbits and help create longstanding relationships with rabbit owners, all while boosting your commercial potential within this, largely misunderstood, target market.

Box 1 – Are you a rabbit-savvy vet?

Members of the Rabbit Welfare Association & Fund (RWAF) can apply to feature on the RWAF’s list of rabbit-savvy vets and become a Silver or Gold Rabbit Friendly Practice. Dr Richard Saunders BVSc DZooMed MRCVS BVSc will oversee an assessment of practice facilities and vets that will be judged on specific critera, spanning rabbit wards and waiting rooms to pain management, diagnosis and veterinary skills.

Box 2 – What are the benefits of taking part in Rabbit Awareness Week?

Rabbit Awareness Week was created by Burgess Pet Care nearly 15 years ago to improve the lives of rabbits living in the UK. RAW addresses a key welfare issue facing rabbits every year and vets are able to benefit from an extensive selection of free marketing materials, samples and PR support throughout the week.

“We always have an excellent response during RAW and owners flock in. It reaches out to people who have rabbits but may not be aware of the changes in advice on husbandry, diet, vaccines or the medical care available.” – Jemma Hilldrew BVSc GPcert(ExAP) CertAVP(ZooMed) MRCVS

“RAW offers a great opportunity to engage with our clients and educate members of the public on the needs of these specialised creatures. The rabbit clients that get involved with us during RAW each year have given us such positive feedback.” – Gemma Graham BVMS MRCVS



[1] PDSA Animal Wellbeing (PAW) Report 2019

[2] Royal Veterinary College, Research from VetCompass™ programme (

[3] A.L. Meredith, Food and water intake and selective feeding in rabbits on four feeding regimes, (Animal Physiology and Animal Nutrition, volume 98, issue 5, pages 991-1000)

[4] Mullan, S.M., Main, D.C.J.  2006. Survey of the husbandry, health and welfare of 102 pet rabbits.  Vet. Rec. 159: 103-109.