Giving medicines to your rabbit

To be most effective treatments have to be given regularly and for a sufficient length of time. If medicines are not given correctly active ingredients may be lost, or poorly absorbed, which reduces the dose that the patient receives. Always dispose of unused medications and consult your veterinary surgeon before giving your pet any new treatments.

There are two elements to medicine administration:

• Ensuring effective administration of treatment
• Ensuring safety of both the patient and the personnel involved in the procedure.

In almost all cases it is far easier to administer treatment effectively if there are 2 people to help one to restrain the rabbit and the other to give the treatment. However, it is possible for experienced owners to give medication by most routes to a reasonably co-operative patient.

Many medicines are designed to be given by mouth largely because this is a convenient route for owners to administer at home. Oral medicines can be given as tablets, capsules, liquids and pastes. Most medicines given by mouth enter the stomach but pass through into the intestine before they are absorbed into the blood. The presence of food in the stomach helps absorption of some drugs but prevents others from entering the body. The timing of administration of oral medication in relation to feeding can be critical.

Oral administration of medication obviously involves dealing with the animals mouth. This may be a real problem in aggressive patients and alternative routes of medicine administration should be used if there is a significant safety risk.

Tablets and capsules

Tablets are made from compacted, powdered drug (usually mixed with something like chalk to make the tablet the right size, and often with a flavour to make it more palatable). Capsules contain powdered drug inside a gelatine case once inside the gastrointestinal tract the gelatine dissolves to release the drug. Some tablets have special coatings to protect the drug from the action of stomach acids the coating is dissolved in the stomach and the drug released once the tablet is in the intestine.

Tablets are often put into food, but often the rabbit simply refuses to eat the food containing the tablet. The tablet can be hidden in a tasty morsel (or specially designed treat) and given to the animal to eat. This can work quite well but if an animal bites into the tablet they are likely to spit it out and will be reluctant to be fooled by the same trick again. It is far more effective to give the tablet by hand (see section Administration of tablets below) so that you can be sure the rabbit is receiving its medication regularly. It is becoming a less popular route of administration – most treatments are now available in liquid form.

Pastes

Drugs mixed into pastes can be particularly useful for use in rabbits. The sticky paste is smeared onto the tongue and the rabbit is unable to spit it out so has no alternative but to swallow. Some of these medications can be smeared onto an area of fur for the rabbit to lick off while grooming.

Liquid formulation

Liquids can be very tricky to administer effectively to rabbits unless they can be mixed with food. If they are mixed with food it is important to ensure that the medicine is thoroughly mixed in and that the patient eats all the food containing the medication. The best way to achieve this is by adding the medication to a small amount of food to ensure it is eaten and then give the rest of the diet but as rabbits are all-day browsers you cannot easily assess when they are hungry and will eat at times the medication is needed.

Some liquid medications taste unpleasant so need to be mixed with quite a large volume of strongly flavoured food to disguise them. Powdered or canned fruit flavoured baby food can be used but always consult your veterinary surgeon before doing so. Animals will often refuse to eat contaminated food or eat around bits of food containing the drug if it has not been mixed in well.

Liquid medications are usually administered directly into the mouth using a syringe. It is very easy for rabbits to refuse to swallow liquid medications and to dribble it from their mouths. When giving liquids by mouth, great care must be taken, to ensure that the patient swallows the medication and does not breathe it in. Oily medications, e.g. liquid paraffin in the lungs, can cause severe pneumonia.

Topical application of medicine can be used to treat specific areas or as a simple way of applying medication which will then be absorbed through the skin to affect the whole animal. A lot of drugs are readily absorbed through the skin and if given frequently, or for prolonged periods, can build up in the body causing side effects, e.g. corticosteroids put onto the skin can cause signs of Cushings disease.

Most animals, particularly rabbits, will lick off any topically applied medication they can reach. This should be prevented by the use of dressings, Elizabethan collars or other protective devices.

Topical treatment for local effect

Ocular treatment

Eye conditions are not uncommon in domestic pets and are often most effectively treated by application of topical therapy. Eye treatments come as drops or creams/ointments. Drops can be easy to apply to the eye (see section Ocular administration of treatment below) but are washed out quickly and may need to be given many times daily. Ointments and creams persist in the eye for longer and some only need to be given once daily.

Aural (ear) treatment

The inside surface of the ear canal is just modified skin. However, this skin is very sensitive, so only treatments specially made for use in this area should be put into the ear canal. Drops or creams can be used effectively (see section Aural administration of treatment below).

Before giving medicines into the ear it is important to check that the tympanic membrane (ear drum) is intact as many drugs can damage the middle ear if they are able to cross this barrier. This should be confirmed through consultation with your veterinary surgeon.

Skin treatment

To be effective, a topical treatment must come into contact with the skin. If necessary, hair should be removed from the area to which the treatment is applied. The skin surface should be cleaned to remove grease, previously applied medication and any build up of crusting or secretions.

Medication for topical application can be mixed with oily or water-based carriers to produce gels, ointments or creams. Creams or ointments are massaged gently over the skin surface until they are absorbed into the skin.

Alternatively, application may be means of washes or shampoos. Remember when treating skin lesions that the area being treated may be sore to touch, so be gentle and ensure that the patient is adequately restrained, also the owner should wear gloves and clean their hands so not to introduce infection to open skin and wounds. In many cases a combination of topical and systemic treatment is used, eg shampoos and antibiotic tablets.

Topical treatment for systemic effect

The advantage of administering medicines by this route is that they do not have to pass through the gastrointestinal tract and so this method is effective for drugs that would be destroyed in the gut.

Flea treatment

Some of the topically applied flea treatments are absorbed through the skin and then enter the blood stream. Spot-on treatments are dropped onto an area of the coat that the rabbit cannot reach when it grooms – the hair is parted to reveal the skin on the back of the neck and the flea treatment dropped onto the skin. It is best to do this just before the rabbit is to be left alone for a few hours as any petting of the fur will remove some of the medication onto the handler’s hands and therefore potentially medicating the handler as well. The active ingredient is absorbed through the skin and enters the blood, fleas ingest the drug when they next bite.

Pain relief

Sticky patches containing some forms of analgesics (pain killers) are now available. These can be applied to hairless areas of skin in the recovery from anaesthesia and slowly release small doses of the drug over several hours. This gives the patient a pain free recovery from surgery, without the need to keep re-administering medication. Remember that drugs can be absorbed even more easily through human skin so gloves should always be worn when handling topical treatments.

• Most treatments given by mouth are usually available in liquid form as they are easier to administer than tablets. If tablets need to be given you may be able to crush them and mix them with water – advice should be sought from your veterinary surgeon to ensure whether the tablets are coated and need to be swallowed whole.
• The handler restrains the patient in a sitting position on a non-slip surface so that it feels secure (preferably with its back to a corner). It is often easier to restrain rabbits at a working height so place a towel or blanket on a table. If a rabbit struggles a lot or tries to scratch it may be necessary to wrap it in a towel.
• The person administering the medicine selects the correct dose of tablets in one hand.
• The patient’s chin should be cupped in the other hand to secure the head and ensure no movement. The rabbit’s lip at the side of the mouth should be slightly lifted and the syringe should be gently put into the side of the mouth between the incisors and the molars. Rabbits have a natural gap in their teeth called a diastema which enables easy access into the mouth rather than pulling the jaw open. A small amount of medication or food should only be given at a time and the rabbit should be allowed to swallow several times (by removing the syringe). If a larger volume needs to be given, this procedure stops the potential of the rabbit aspirating leading to pneumonia.
• If the rabbit is to given tablets or capsules, a ‘pill popper’ might be easier to use as the rabbit’s mouth may be too small to get both your finger and tablet into, especially to place at the back of the mouth to ensure the rabbit swallows it.
• The patient should be watched closely immediately after medicine administration to ensure they do not spit the tablet out again.

• The handler restrains the patient in a sitting position on a non-slip surface so that it feels secure (preferably with its back to a corner). It is often easier to restrain rabbits at a working height so place a towel or blanket on a table. If a rabbit struggles a lot or tries to scratch it may be necessary to wrap it in a towel.
• The handler should cup the rabbit’s chin in one hand and gently tilt the rabbit’s nose upwards to allow better access to the eye. The lower eyelid can also be gently pulled downwards with one finger.
• Alternatively, the head can be secured by placing your hand over one side of the head with the fingers wrapped under the chin and the thumb over the head to slightly pull the eyelid upwards.
• The person administering the medication should hold the bottle or dropper above the eye and gently squeeze so that the correct amount of medication flows over the eye – care should be taken not to touch the surface of the eye as injury can occur, also contamination of the rest of the medication. With creams or onitments a small thin line should be trailed along the eye again without the tube touching the eye, then it may need to be gently touched onto the lower eyelid to detach it from the tube.
• Resting the side of the hand against the muzzle whilst holding the applicator btween thumb and forefinger helps to steady the applicator away from the eye.
• Keep the rabbit restrained for a few seconds to allow the treatment to spread over the surface of the eye, blinking will also help with this process.
• If the rabbit has an infection in one eye but both are to be treated, then two tubes of medication could be used, or the good eye should be medicated first then the bad and then thoroughly cleaned before the next usage.

• The handler restrains the rabbit in a sitting position on a non-slip surface so that it feels secure (preferably with its back to a corner). It is often easier to restrain rabbits at a working height so place a towel or blanket on a table. If a rabbit struggles a lot or tries to scratch it may be necessary to wrap it in a towel.
• The handler restrains the patient from the side cuddling it to them with the head held gently but firmly with the ear pinna (flap) lifted, this exposes the ear canal to the person applying the medication.
• The ear canal must be cleaned to remove any discharges or previously applied medication before putting in new treatment.
• The nozzle of the treatment applicator is passed into the ear canal and the correct amount of drops or cream administered into the ear canal. You do not have to place the nozzle deep into the ear as when the nozzle is removed with gentle massaging of the ear canal, the medication can be dispersed even further into the ear.
• Take care as you release the patient as they are likely to indulge in vigorous head shaking.