Info Sheets

Hip surgery in rabbits can be required for a variety of conditions – these may be traumatic in occurrence or inherited.

Normal pelvis VD radiograph ©Vetstream

The hip joint is a ball and socket joint, which describes it well and makes it easy to imagine how it looks. The top of the ‘ball’ section of the femur is known as the femoral head. The femoral head sits in the part of the pelvis called the acetabulum (the socket), and it is the femoral head and acetabulum which form the ‘ball and socket’ of the hip joint.

Rabbits naturally hop. Walking is abnormal for rabbits, or how they may move if they are approaching something they are unsure about. When rabbits hop, the ball slides inside the socket of the hip to allow the back legs to move. This allows rabbits to hop, leap in the air and kick.

Rabbits can be affected by a variety of hip problems and diseases. Your veterinarian will need to examine your rabbit and perform diagnostics in order to determine what is wrong with your rabbit’s hip/s and what the treatment options are. The following conditions may affect your rabbit’s hip/s:

• Hip luxation: luxation of the hip is when the ball of the hip joint comes out of the socket, instead of normally sitting nicely in contact with each other. Often this arises from trauma from landing awkwardly when running or jumping or being dropped/falling. It can also happen if they kick out and twist their hips and spine which is possible when they are trying to escape from a potential predator or overzealous with binkies (when rabbits leap and run to show happiness).
• Hip fracture: these are often caused by traumatic injuries or if the rabbit is dropped or jumps from a great height, causing the ball of the hip to break off from the femur.
• Splay leg: this is a non-specific term used to describe any condition affecting the limbs that prevents the rabbit from standing. There are several congenital abnormalities that affect the skeletal system and result in subluxations or limb deformities that stop the rabbit being able to move and stand properly. Usually, the condition is due to an inability to move the limbs towards the center of the body (adduction of the limbs). The hindlimbs are most frequently affected, although splay leg can also be seen in the forelimbs. The condition can affect one side of the rabbit, but more commonly affects both sides. Some rabbits cope well with disability, and each rabbit should be assessed on an individual basis. Treatment is not feasible in most cases and sadly, euthanasia is usually advised at an early age.

Being able to see what is happening to the hip joint and surrounding areas is essential. X-rays are usually required, or more advanced diagnostics, such as a CT scan, may be recommended if more detailed images are required, especially if surgery is being considered.

As rabbits are so apt at hiding pain, whilst they may not show obvious pain, such as vocalizing and aggression, the conditions are as painful as they are in humans, cats and dogs and we should not assume otherwise.

Some conditions may not require surgery and may respond to conservative treatment with pain relief and rest. If your rabbit has a hip fracture and the ball of the hip has become detached, or in some cases of hip luxation, it can be possible to completely remove the ball part of the hip. This is known as a Femoral Head and Neck Excision (FHNE). Whilst this may sound drastic, removing the ball of the hip will, in time, improve the rabbit’s movement of the hip. The body will form a false joint, made up of fibrous tissue, which will be pain free and functional for the rabbit.

Performing any type of hip surgery is not without risks. Firstly, there are the anesthetic risks to consider. Whilst anesthesia is much safer than it used to be, the longer the surgical procedure, the increased risk to the rabbit. Rabbits’ bones are fragile and can easily split or shatter during surgery, especially when attempting to drill screws and pins into the bone. The smaller the rabbit, the harder surgery is. Older rabbits can have some degree of osteoporosis (brittle bones), making surgery more difficult. Any infection during surgery can be serious and potentially fatal. Infections during orthopedic (bone) surgery are serious and can be extremely difficult to treat, especially in rabbits for whom using certain types of antibiotics is not possible, due to the adverse effects on the gastrointestinal system. All precautions are taken during surgery to make sure the surgical field is sterile, but despite all attempts, an infection is always a possibility. There is a risk of hemorrhage during surgery. There are some large blood vessels around the hip area, and when performing surgery there is always the risk that one or more of these can be damaged and bleed. The blood volume of a rabbit is around 55-65 ml/kg, so an average 2.5 kg rabbit only has 162.5 ml of circulating blood. A loss of 15% blood volume (around 24.5 ml) can be critical for the rabbit. The potential risks of hip surgery can be a scary thought. The surgeon and team performing the surgery will take all necessary steps to prevent any of them from occurring, but when deciding if surgery is right for your rabbit, you need to be aware of them.

You may need to be referred to a veterinary surgeon who specializes in orthopedics if surgery is being advised. Many orthopedic surgeons are more used to operating on dogs and cats and may not have much experience operating on rabbits. You may need to travel to find one who is experienced in performing surgery on rabbits. The cost of hip surgery will vary depending upon where in the country it is performed, if it is performed by a specialist orthopedic surgeon or your own veterinarian, the size of the rabbit, what diagnostics are performed and the surgery required, the cost could vary from £1000-£5000/US$2000-10000. If you have health insurance for your rabbit this may cover the full cost or part of it. This is something you will need to discuss with the company, before your rabbit has surgery.

All rabbits with hip problems will need a period of rest and pain relief, some rabbits will respond positively to this whereas others will go on to have hip surgery. If your rabbit has surgery, then physiotherapy may be offered in order to gain full movement of the hip and to help prevent muscle mass loss. Your veterinarian will be able to guide you and put you in touch with a physiotherapist who has experience treating and caring for rabbits. Whether or not your rabbit has hip surgery, much of the time the outlook is good.