Rabbit | Long Beach Animal Hospital

Category: Rabbit

Laser Surgery

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We have been using the carbon dioxide laser at the Long Beach Animal Hospital for over 20 years.  We are one of only a handful of animal hospitals in California that have this capability. It is a highly advanced and technical piece of equipment that we never dreamed about having while we were training to be veterinarians. Its one of the ways we offer state-of-the-art care at Long Beach Animal Hospital.

The laser is a high precision instrument 

It is carefully calibrated for each individual surgery

This video shows how we set up one for a dog neuter, and how the laser checks its circuits and calibrates itself.

You get to wear these cool glasses when the laser is on

Dr.P has taught many surgeons how to use the laser. Here he is teaching one of our externs.

GPig-EyeSx-11

Dr. Ridgeway is using the laser on a guinea pig for eye surgery.  He is using magnifying glasses due to the small size of his patient. Small patients cannot tolerate blood loss, so the laser has been a tremendous tool for surgery in animals that only have a few drops of blood in them to begin with.

Laser-Tortoise

Here he is teaching one of our externs on the use of laser in a tortoise. Veterinary students do not get exposed to the laser routinely while in veterinary school, which is one of the reasons they do an externship at our hospital. Our goal is to impart all of our knowledge to them as they start their careers.

Laser Theory

A carbon dioxide laser emits a high energy beam of infrared (invisible to the human eye) radiation in the form of light waves that has many veterinary applications. If you would like to learn more about the mechanics of lasers in general, including safety procedures, how they work, and why we use the carbon dioxide laser as opposed to other lasers, click here.

Graphic photos on this page.

Advantages

There are several advantages to the COlaser surgery:

  1. Pain Reduction

    Your pet will experience significantly less post operative pain in almost every instance. As a matter of fact, the pain reduction is so great that we perform declaws on cats only with a laser beam. This reduction in pain is a result of the unique characteristics of the laser beam as it cuts nerve endings, preventing the raw ends that are characteristic of scalpel blades.

  2. Swelling Reduction

    Whenever an incision is made in tissue with either a scalpel blade or scissors, inflammation is started in the affected tissue. This inflammation is a result of interaction with the circulatory and lymphatic systems. Because the laser beam effectively cauterizes the lymphatic system, there is much less post operative swelling. This makes your pet much more comfortable while it is convalescing from surgery.

  3. Control of Infection

    The laser beam operates at a temperature of over 200 degrees Fahrenheit. This makes it highly effective at killing bacteria that have the potential to cause an infection. This is particularly important in areas where it is difficult to prevent bacteria from contaminating the surgical site. Examples include abscesses and cat declaws.

  4. Minimal Surgical Bleeding

    When an incision is made with a scalpel blade, small blood vessels are cut in the skin and the layer of tissue just under the skin. These blood vessels can ooze throughout the surgery and even postoperatively. Traditionally they are taken care of by clamping them with hemostats, cauterizing, or holding gauze sponges on them until they stop. All of these procedures take time, which means the surgery takes longer and there is more post operative swelling. The laser beam is a highly effective coagulator of small blood vessels. Less bleeding during surgery means less anesthetic time and faster recovery time.

    Even though lasers are used effectively in many surgical procedures they are not used in every surgery. They are especially useful in oral surgery, neuters, growth removals, and amputations of small extremities. We also use it in small animals, especially birds, because of the laser’s great effectiveness at minimizing bleeding.

    The following sections give specific examples of the use of the carbon dioxide laser in our hospital.

    Neuter

    The laser is particularly advantageous in this surgery. Prior to using the laser we used a scalpel blade to make the scrotal incision and throughout the whole procedure. When using the scalpel like this, the scrotum would swell over several days post operatively as small blood vessels oozed. This was obviously very uncomfortable in such a sensitive area. The laser has eliminated this completely.

    Canine-neuter6

The laser is being use to cut through the outer layer of the testicle, called the tunica vaginalis

Canine-neuter7

The testicle is exposed, along with the epididymis and blood supply. Notice the lack of bleeding.

We neuter a wide variety of animal:

Cats

Rabbits

Dogs

Rats

Bladder Surgery

Bladder stones are not uncommon in animals. The bladder is usually inflamed and highly vascular, causing significant bleeding when we incise the bladder to remove a stone. The laser has revolutionized this surgery. This is a very sensitive internal organ, and anytime we can make an incision in such an organ without any bleeding, the healing period is much faster and less painful.

Surgery-CatLaserBladder

Here is the initial incision in a cat with no bleeding from the bladder

Laser-cystotomystone

This is a dog with the stone being removed from the bladder after the laser incision

Our bladder stone page has much more detail, including a movie of removing bladder stones from a dog. We also have pages that show removal of bladder stones in Iguanas and tortoises (you don’t want to miss this tortoise bladder stone page)!

Feline Mammary Tumor

These tend to be malignant and highly vascular, causing substantial time during surgery controlling bleeding, along with considerable bruising after surgery. The laser has revolutionized this surgery.

In the video note how diseased the subcutaneous tissue looks and the total lack of bleeding in this highly vascular area. Also notice as milk is excreted from the gland as the surgery progresses

Our web site has a detailed page on mammary tumors in animals.

Rat Mammary Tumor

Rats get a mammary tumor under the skin very commonly. The laser is huge when it comes to removing them with minimal bleeding, which is important in a small animal.

Surgery-RatMammary-3

Surgery-RatMammary-4

Click here to see the full surgery

Oral Tumor

A tumor that can be encountered in dogs and cats is called sqamous cell carcinoma. These pictures are of a dog that had one on its left jaw, called the mandible. The only way to completely cure this tumor is to remove the jaw on that side, a surgery called a hemimandibulectomy. In this case the owner decided against it, and will have the growth removed as much as possible with the laser, following up with radiation therapy.

The tumor is identified by the white arrow. It had been removed 1 year earlier, but as expected with this type of tumor, has recurred. This time the surgery will be with the laser for maximum comfort for Jackey.

The post operative appearance immediately after it has been removed by the laser. Minimal bleeding and swelling are apparent.

We were able to suture gum tissue over the defect left by the surgery. It is hard to tell in this picture that any surgery was performed at all.

This tumor is in a Tegu

LaserSurgery-IggieJaw

The arrow points to the tumor

LaserSurgery-IggieJaw-2

No sutures, no bleeding, no pain, and no inflammation

Declaws

This is a request from people that want to keep their cats indoors. Prior to a declaw, we advise keeping the nails trimmed short or the administration of Soft Paws on the nails, along with a scratching post. One of our nurses will gladly give you a demonstration of these options.

We prefer you use other options before thinking about laser declaw, and will show you how to gently trim the nails

If this does not work you need to make an appointment to have your cat examined by one of our doctors and determine if it is a candidate for the surgery. We do not do this surgery routinely.

Prior to the introduction of the carbon dioxide laser all declaws were done with a scalpel blade. It is a very precise surgical procedure that our doctors have performed thousands of times. Unfortunately, the post operative period was painful, the feet were bandaged, and most cats had to stay in the hospital for several days. On older cats this surgery was even harder on the pet.

The advent of declaws with the laser surgery has substantially minimized these drawbacks. There is usually no bleeding during the surgery so a tourniquet is no longer used. Most of them can even go home the day of surgery but we prefer to keep them for observation for 1-2 days. Most cats have so little pain or discomfort they are jumping and running before nature has had time to complete the healing process. Always restrict their activity at home for the first few days to prevent this problem.

This cat’s nails have grown into its pads due to the owner’s inability to care for it properly. This is a painful situation and makes him a candidate for a front declaw.

Feline-NecroticNail

Sometimes the problem is even more severe, and the severely infected toe (on the right) needs amputation. This is where the laser shines.

The following pictures are from an actual declaw that we performed at our hospital.

Surgery-CatLaserDeclaw

The nail is gently pulled forward prior to surgery to open up the area behind the nail where the incision with the laser will be. Bone is not cut during the procedure at any time, only tendons and ligaments are cut.

Surgery-CatLaserDeclaw-4

The laser beam (it is invisible to the naked eye) has started the incision at the top of the toe. It will cut through skin and tendons along with ligaments in between the digits.  The nail, with its attached bone (called phalanx 3), is removed.

The surgery is complete with no bleeding, swelling,  or trauma to any bone. The top arrow in this picture points to the bone at the joint of the 2nd knuckle. The bottom arrow points to the intact pad that has not been touched either. A drop of surgical tissue glue will be put on the pad to cover the end of the bone.

The foot immediately after surgery. There is no need for a bandage.

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Fluid Therapy

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Fluid therapy might just be the most important medical therapy we perform on sick animals. Dehydrated pets feel ill, cannot fight disease well, do not eat well, and cannot metabolize drugs efficiently. Dehydration decreases the circulation to two very important organs, the liver and the kidney. These organs are then unable to perform vital functions, some of which include detoxifying drugs and removing waste products.

We give fluids to a wide variety of species in addition to dogs and cats. They can be ill and needs fluids for many different reasons.

This guinea pig being examined by one of our externs has a problem with overgrown teeth and cannot eat well. This has caused him to become dehydrated, and in need of supplemental fluids.

Before coming in for treatment this rabbit was painful from a broken leg and not eating well and became dehydrated. Supplemental fluids to correct the dehydration, and a splint to take away the bone pain and allow the healing, were needed to get him back to being a normal bunny again. You can see how we treated his fracture here

Yup, we even give fluids to 120 pythons when they are ill or dehydrated. This is probably not something you want to try at home!

Signs of dehydration include lethargy, anorexia (poor appetite), sunken eyes, sticky gums, constipation, and a general feeling of malaise. It is diagnosed based on a history of anorexia, vomiting, diarrhea, or extra fluid loss, in combination with a physical exam and diagnostic tests. During an exam a dehydrated pet will shows signs of dehydration when the problem is greater than 5 %. A blood sample will also give clues to dehydration, especially the total protein level and the hematocrit.

This is the hematocrit test, checking the percentage of red blood cells in the serum, giving us information on the state of your pet’s hydration

After the hematocrit is measured we break the tube in the middle and place the serum on an instrument called a refractometer to check the protein level. In conjunction with the history, exam findings, and hematocrit level, the protein level helps us determine the degree of dehydration.

The page talks about the two primary methods used to give fluids to pets. The first is intravenous, and is performed only by us in the hospital. This is not a treatment method you will do at home.

The second method used to administer fluids is subcutaneously (under the skin) between the shoulder blades. The administered fluid slowly absorbs over several hours. In this hospital and on an out-patient basis, this method is used for pets that are not seriously ill, but just need some additional fluids to maintain hydration, fight a fever, or stimulate the appetite.

Intravenous (IV) Fluids

I.V. (intravenous) catheters are used extensively in pets that are sick or those pets that are about to be anesthetized. These catheters allow us to administer medication directly into the venous system for rapid distribution to the whole body. Medication given this way acts faster and is more controllable, a significant advantage for an ill pet or in an emergency.

Intravenous fluids are important during surgery. We monitor this closely in many ways, especially with the blood pressure.

If your pet is ill and staying in the hospital, or about to undergo anesthesia for any reason, an I.V. catheter to allow fluid administration is one of the most important therapies we can institute, and can literally be life saving.

This dog getting his teeth cleaned was put on IV fluids before the procedure to stabilize the kidneys for the anesthesia. The fluids are continued for the duration of the procedure, and will be administered until this pet is fully awake and its owner is picking it up.  

The placement of the catheter requires technical skill and knowledge, particularly in small or dehydrated pets (the veins in these pets are small and damage easily). Improper placement of the catheter can literally cause more harm than good. Our nurses excel at placing I.V. catheters in all species.

Because the catheter is introduced directly into the venous system, it must be placed in an aseptic (sterile) manner. The hair over the vein is shaved, and special tape is placed over the catheter. 

Comfort is also important when placing the catheter due to the small nature of some of our patients, and the duration the catheter must stay in the vein. This tape and catheter is constantly monitored by our staff for comfort and sterility. After 3-5 days we usually replace the catheter in order to minimize the chance of the catheter causing an infection. 

I.V. catheters are usually placed in one of three veins:

Cephalic Vein-This is by far the most common vein to use. It runs along the top of the foreleg of dogs and cats. The illustration below shows the placement of this catheter in a large dog.

Jugular vein-This vein is in the neck. A catheter placed in this vein allows longer term use and the ability to give larger volumes of medication with different viscosity’s.

Saphenous-This vein is on one of the back legs. It is mostly used when the cephalic vein is unusable, but can be used at any time.

Various other veins are sometimes used, by they are reserved for some of the more unusual species of animals we deal with.

Your pet’s catheter will stay in for the duration of its hospitalization or procedure, and will not be removed until you return to pick up your pet. Your pet may go home with a small piece of tape and cotton where the catheter was. It can be removed several hours later after you return home.

We use many different types of fluids, the most common one being Lactated Ringer’s Solution. The amount of fluids are monitored carefully, and given with a special pump that gives a consistent amount of a period of time.

Each patient receiving fluids has a custom fluid chart outside its cage for close and constant monitoring of the fluids. Our doctors make adjustments in the type and amount of fluids as diagnostic tests like blood panels, and your pet’s response to treatment, are analyzed. 

Subcutaneous (SQ) Fluids

This section on SQ fluids contains  detailed step-by-step descriptions on how to give fluids at home on an ill pet, an older pet, or a pet with kidney disease. When you first read it you might think there is no way I can do all of that. Once you observe us do it in front of you, and then do it yourself, you will realize it is not anywhere is difficult as you think when you read about it the first time.

This video is how we give sq fluids at our hospital. Notice how calm this dog is.

SQ fluids are of special benefit for pets that need long term fluid administration at home, usually older (geriatric) cats or those with kidney disease. This is the animal version of dialysis in people, and it works extremely well. These fluids at home are highly beneficial, and have had cats with chronic kidney disease do well for years with this treatment at home.

If your doctor feels your pet needs SQ fluids at home you will be taught how to administer them by our nursing staff. At first it might seem an impossible notion to give your pet fluids at home. Not only is there the psychological fear of using a needle, or worry about hurting your pet, there is also a worry that your pet will not stay cooperative long enough for the few minutes it takes to give the fluids.

Rest assured that you will not be forced into giving these fluids if you feel uncomfortable, although we have yet to encounter a client that was not able to perform this procedure at home. This is because we have extensive experience in this area, and we teach you at your own individual pace. Only when you feel you are ready will you proceed on your own.

You will be given as many personal demonstrations as necessary, and can return to the hospital at any time for further demonstrations or to make sure you are performing the procedure properly. You are welcome to bring your pet in at any time for assistance in giving the fluids, so do not feel you are on your own. If you are out of town, your house sitter can bring your pet in for these fluids. We consider you part of our nursing team and are willing to give any assistance needed. Before you are given a live demonstration the following basics will help prepare you.

The scariest part of the whole procedure for most people is the actual insertion of the needle into the skin so that the fluids flow under the skin (SQ). You will watch us do this as many times as you need to overcome any fear you might have. When you realize it is not all that difficult by watching us do it, we will hold your hands when it is your turn if needed.

Practicing by inserting a needle into an orange or similar fruit can be helpful. Different sized needles, ranging from 22 gauge to 18 gauge, are used to give SQ fluids. During the demonstration we will show you which one works best for your pet.

The 18 gauge needle, at the top, has the largest diameter. Fluids flow fast through this needle, taking less time to give them. If this size needle is uncomfortable for your pet, we will try the 20 gauge next because it is smaller, although the fluids will flow more slowly. On small pets we might even use the 22 gauge needle. 

During this demonstration you will be told exactly how much fluids to give. For most cats with chronic kidney disease, this is 100ml once or twice daily. The fluid bag has 1000ml (1 liter), so for the average cat you will be able to give these fluids for ten days. This might vary depending on many factors, and your doctor will determine the amount and frequency. Do not change this unless instructed to.

Keep children and other pets away if they are disruptive during the process of giving the SQ fluids at home. Have all of your equipment readily available, usually on the same table as your pet. Depending on the size of your pet, the table should be around waist to chest high. It is helpful to set up one area of your house to give the fluids. Hang the fluid bottle in this room for easy access. It should be at least a few feet above the table for optimum flow. You will be shown how to set this up by one of our staff.

Store the fluid bag at room temperature and cover the bag so no light hits it. We sometimes add medications like vitamins and electrolytes to the bag, and light can affect them.

When you purchase a fluid bag from us it needs to be set up with the IV line. We will show you how to do this in person. You only need to set it up when you purchase a new bag. After that, you give the fluids with a new needle each time, keeping the IV set attached, until the bag is empty.

Never use the needles more than once since they are sterile and very sharp when first opened. Repeated use could cause an infection in your pet, and makes the needles dull, causing discomfort on administration. Needles are inexpensive, so don’t take the chance by re-using them.

When you purchase the bag it comes wrapped in a plastic wrapping. Remove the wrapping at home when you are ready to set it up to give fluids to your pet. After you remove the outer wrapping lay the bag on your table or hang it from a coat hanger. 

Open the sterile IV set and lay it on the table


These are the components of the IV set

The large white end with clear receptacle goes into the fluid bag once the white cap is removed. The clear container above will be filled part way with fluid once attached. 

 At the opposite end of the IV line is a small blue cap. You remove this blue cap when you attach a needle, which you will learn about later. 

The large blue plastic piece in the center allows you to turn the flow on and off, and also adjusts the rate of flow. Make sure the white wheel is in the off position like this when first setting it up. 


Remove the white plug from the bottom of the bag. The cap is in solidly, so you will need to pull hard to remove it.

 You can do this while the bag is hanging, or while it is laying on the table. Discard the white cap, it will not be used again. 

Remove the white cover from the IV set receptacle. It is sterile, so do not touch it to anything at this point. 

Hold the hanging bag steady, or lay it flat while doing this, so you can put it straight in without touching anything else. 

Insert it all of the way into the fluid bag 

Hang the bag, then squeeze the receptacle until the fluid fills half of the receptacle

It should look like this when you are done

Lay the needle next to the end of the IV set that has the blue cap

Remove the clear plastic at the base of the needle by twisting it either direction. The open base of this needle is sterile, so do not touch it to anything until you insert it into the IV line. 

Remove the blue cover at the end of the IV set. Turn the fluids on and let a few seconds of fluids flow through the IV line to remove the air. Let these few drops flow into a small bowel or on to a towel. Do not touch the end of this line to anything. 

A few air bubbles left inside the IV line will not cause any problems 

Insert the needle straight into the opening. Hold you left hand still as you twist clockwise with your right hand to lock it tight

Hang the IV set over the fluid bag. You are now set to give the fluids. 

Every pet reacts differently to the actual giving of the fluids, and they feed off of your emotions, so cool and calm usually works best. If either one of your gets worked up, stop and try again later.

Make sure the location to give the fluids is subdued and calm, with no excessive lighting or noise to alarm your pet. Take your time by bringing your pet to the table and interacting with it by petting it and holding it. You can even feed it while giving the fluids. A towel for restraint, or another person holding the head, might even be appropriate.

Hold your pet to the side, make a small tent of the skin between the shoulder blades, remove the cap over the needle, and rapidly insert the needle between the shoulder blades in one motion.

Insert it all of the way in until the hub touches the skin. Turn on the fluids completely on by moving the white wheel all the way to the top, and give the prescribed amount of fluids. For most pets, this takes only a few minutes of your time daily, a few minutes of your time that will be highly advantageous to your pet. 

When you are finished giving the fluids remove the needle from your pet and cap it. Remove the used needle and place a new sterile needle at the end of the IV set, and hang the IV set over the bag as before. You are now ready to give the fluids again the next time one of our doctors prescribes.

Finally, pat yourself on the back for a job well done, have a seat, and breathe deeply (or get a stiff drink if needed to calm your shaking hands).

Place all used needles in a safe place with no access to children or pets. A sharps container to hold these needles is the best place to put them until disposal. Dispose them according to the guidelines in your community. Here are some local disposal centers for needles. If you are not near one of these areas call us at 562-434-9966 for other locations:

EDCO Recycling and Transfer Center

2755 California Ave.

Signal Hill, CA 90755

562-597-0608

L.A. County Sheriff- Lakewood Station

5130 N. Clarke Ave.

Lakewood, CA 90712

Huntington Beach Collection Center

17121 Nichols Lane

Huntington Beach, CA 92647

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Front Leg fracture

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This bunny was presented to us unable to use his left front leg. After an exam by one of our doctors it was determined that the leg might be broken.  A radiograph revealed the extent of the injury.

Our friend is nice and cozy just before his radiograph

You can see his fracture/dislocation near the L marker 

A special lightweight but strong plastic splint with foam padding is custom sized for his leg


Several layers of cotton padding are used to hold the leg stable yet keep him comfortable 

It looks heavy but it is actually light. This much cotton is needed to stabilize the fracture.

Once the final cotton wrap is applied and checked for comfort an outside wrap is applied to keep the cotton in place and also keep it clean

Looks like we ran out of “bunny” wrap and had to use “rooster” wrap for the outside bandage

Our friend is good to go and feeling much less pain now that the fracture has been stabilized and the leg is comfortably in the splint

This bunny will need up to 2 months of healing for the fracture to heal. It needs to rest during that time and use the leg sparingly so the fracture can heal. The splint lets him walk on it comfortably, which is an important part of the healing process. Without using the leg slightly the bone has less of a tendency to heal due to the effectiveness of the splint. If this does not heal surgery might be needed. We will keep you posted.

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Urinary Stones and Sludge (hypercalciuria)

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Rabbits make wonderful pets, that need special attention from everyone in your family regarding their health 

Rabbits are prone to problems of the urinary tract.  These problems range from irritating sludge in the bladder, to kidney problems,  to the formation of a bladder stone that needs surgical removal. Sludge is urine thickened by calcium salts to the point of being chalky and thick in consistency, sometimes as thick as toothpaste. This causes problems in the urinary bladder usually, although it can occur in the kidneys or ureters. There are many factors why a rabbit might get this problem, so it is important to address all of them.

Rabbits need routine exams to ensure their health

Graphic photos on this page

Underlying Problem

As opposed to most other animals, rabbits absorb almost all the calcium in their food into their bloodstream. This causes a higher than normal blood calcium level relative to other animals. If an individual rabbit is not efficient at utilizing and eliminating any excess calcium through the urinary tract, a sludge or bladder stone problem might present itself.  Some of the factors we know about that might predispose a rabbit to a urinary problem with calcium include:

Genetics- Some rabbits are not as efficient at eliminating any excess calcium

Rabbits that are not good drinkers

Obesity

Sedentary lifestyle- rabbits that stay in a cage all day

A diet with excess calcium

Soiled litter pan area in a fastidious rabbit

Diseases elsewhere in the body can have an effect on a rabbit’s normal physiology, disrupting it to the point that they can stop eating and get dehydrated, leading to decreased kidney function and sludge or stones in the urinary bladder. You can learn more about them in our Rabbit Diseases section. The more common ones are:

GI Stasis

The dark round area in the center is a greatly distended stomach due to GI stasis

E. Cuniculi

The severe head tilt in this rabbit could be a sign of Encephalitozoon Cuniculi

Teeth Conditions

The point on this molar tooth could cause an inability to eat well over a period of time

Pasteurella

This conjunctivitis could be an indication of Pasteurella

Reproductive Disease

This is the radiograph of a rabbit with a uterus that is greatly distended. That large whitish area in the center of this abdomen is the uterus.

This is that fluid filled and greatly enlarged uterus during the surgery to remove this uterus

This male rabbit has a very large tumor in its left testicle. The surgeon is pointing to a normal sized testicle on the other side. The cancer was removed in a neuter surgery.

Urine that contains excess calcium will have the consistency of sludge. This irritates the bladder and urethra, causing significant inflammation and pain. If the problem persists long enough, a bladder stone (urolithiasis) might form.

In order to make a diagnosis of the problem in rabbits, we follow the tenets of the Diagnostic Process. This is a methodical and detailed way to approach diseases that ensures an accurate diagnosis. It includes:

Signalment- age, breed, and gender of an animal

History- what an owner has noticed at home about a pet’s specific behavior

Physical Exam- the findings from an exam by one of our veterinarians

Diagnostic Tests- What tests are used to make a diagnosis

Response to treatment- if the diagnosis is correct the pet should get better

Signalment

Urinary problems in rabbits can occur in all breeds of any age or gender. Young or old, large or small, male or female, it doesn’t matter.

History

Symptoms are variable, depending on the duration and degree of the problem, along with the individual rabbit’s tolerance for pain and discomfort. Some of the symptoms to watch for include the following:

Lethargy

Poor appetite

Diminished droppings

Urinating more than usual (pollakiuria)

Straining to urinate (stranguria)

Unable to urinate

Blood in urine

Chalky deposits on the fur in the perineal area

Moist or damp rear quarters from urine dribbling

Licking at rear quarters

Rubbing rear quarters

Skin rash in inside of rear legs or perineal area

Grinding teeth (a sign of pain)

Odor to urine

These are also the symptoms of other diseases in rabbits, so at the first sign of any of these problem you should bring your rabbit in for an exam with one of our veterinarians.

Physical Exam

Any sick rabbit gets a thorough physical exam by one of our veterinarians. It starts with body weight and temperature, and progresses to checking your rabbit from nose to tail for any physical abnormalities. Typical findings might include:

Low body temperature (hypothermia)

Underweight (low body condition score)

High heart rate (tachycardia)

Dehydration

Irritation to the perineal area

Neurologic deficits

Painful abdomen upon palpation

Small kidneys upon abdominal palpation

Distended bladder upon abdominal palpation

Bladder stone palpable upon abdominal palpation

Excess amounts of chalky or bloody urine when the bladder is expressed

Diagnostic Tests

Over the decades our body of knowledge regarding normal and abnormal values in diagnostic tests of rabbits has increased to the point that they are crucial for a proper diagnosis.

Blood panel

This test should be performed on all sick rabbits irregardless of the symptoms. It should also be performed yearly as part of the Wellness Exam on rabbits. These animals age rapidly, and oftentimes hide their symptoms, so it is important to have baseline normals on an individual rabbit, and to catch problems before they become entrenched and untreatable.

The blood panel in rabbits checks for a wide array of problems. It starts with a check of the red blood cells for anemia or infection. There are tests of the kidneys and liver, important organs to assess when we suspect a urinary or kidney problem in rabbits. We also check the electrolytes, and especially the calcium level.

This rabbit has blood abnormalities that can happen with a sludge problem, and also many other problems

Urinalysis

This will check for white blood cells, red blood cells, and crystals in the urine. We also assess the specific gravity and the protein and glucose levels, in addition to looking for signs of bacterial infection.

Urine Culture and Sensitivity

If we suspect a urinary tract infection (cystitis) we will take a sterile sample of urine directly from the bladder and attempt to grow out any pathogenic bacteria. If they do group out, we will check many different antibiotics to find out what antibiotic that particular bacteria is sensitive to and will kill it. This report takes 2-3 days.

This pet has a Staph. infection, that is sensitive to several different antiboitics

Radiography (X-rays)

It is important to radiograph any sick rabbit. There are a multitude of problems that can occur on the inside that are not apparent externally during our physical exam.

This is what a radiograph of a rabbit looks like. The important abdominal structures are labeled:

K- kidney

B- urinary bladder

Cecum- our appendix

Did you notice the spinal fracture? Without this radiograph, we would not have known this.

This rabbit is laying on its back for a radiograph. The arrow points to the left kidney because this rabbit has significant sludge in its bladder, and we wanted to assess the kidneys. Do you notice anything else?

The two lower arrows point to the different appearance of the wings of the ileum of the pelvis, which could indicate bone cancer. We would never had known this if we had not taken a radiograph. 

The sludge that occurs in the bladder, and the stones that also might occur, have a large amount of calcium carbonate in them. This means that they are radiopaque, and show up vividly on an abdominal radiograph.

The small whitish area in the center of this radiograph is some sludge in the urinary bladder of this rabbit. This small amount is of no significance in a rabbit with no symptoms of disease.

This rabbit has more sludge in its urinary bladder. This amount may or may not be of significance, depending on how this rabbit is doing, other diagnostic tests, and follow up radiographs.

S- stomach

K- kidneys

This rabbit is not eating well, is lethargic, and has an odor to its urine with urine scalding on the perineum. It needs to be treated for sludge in its bladder. Can you identify other organs besides the sludge in the urinary bladder? The radiograph below labels the organs. 

H- heart

L-liver

S-stomach

The cecum and sludge are obvious. In the radiograph above, did you notice the calcifications in the kidneys, circled in red?

Same rabbit as above, this time laying on its back. The large amount of sludge in the urinary bladder is even more apparent in this view.

You can see the calcification of the kidneys in this view also

This is what a distended bladder looks like at necropsy

In addition to sludge, rabbits with urinary problems can get bladder stones. Other names for bladder stones are urolithiasis and cystic calculi. These stones also occur in dogs and cats. They are handled differently in the rabbit though.

Click here to see how we take care of bladder stones in dogs and cats.

Click here to learn more about how we do surgery at the Long Beach Animal Hospital in a wide variety of animals.

These are bladder stones in the urinary bladder

Bladder stones in rabbits are removed surgically. We take special precautions in all rabbits when anesthetizing them. Our Anesthesia page has more details on anesthesia.

We have a team of people present when we anesthetize a rabbit

They are closely monitored while under anesthesia 

We approach rabbit surgery like any other surgery using aseptic surgical techniques.

Everyone in the surgical suite practices aseptic surgical techniques

We use the laser to make an incision into the bladder and remove the stone. Note the lack of bleeding on this highly vascular urinary bladder when using the laser. 

After any anesthetic procedure we closely monitor our patients until full recovery

Ultrasound

This is a precise and highly accurate way to assess the kidneys and urinary bladder, and it complements radiography. We also check the other organs in the abdomen carefully with ultrasound.

This is an ultrasound of the urinary bladder with a bladder stone

In this ultrasound the kidney it is being measured

Treatment

In the acute phase sludge is removed with gentle manual expression. If your pet has a chronic problem with sludge in the bladder we can teach you how to do this at home. Flushing the bladder, after manually expressing most of the sludge, helps complete the process. We might sedate your rabbit if we need to pass a urinary catheter to flush out of the sludge.

We might need to hospitalize to provide intravenous (IV) fluids in a dehydrated rabbit and to help support the internal organs like the kidneys. Pain medication is commonly used, along with assist feeding for those rabbits not eating.

If a bladder stone is present we will remove it surgically.

Once your rabbit is stabilized our goal is to help prevent recurrence of  the stone. This is done by you at home in many ways:

Adding water to the food if your rabbit is not a good drinker

Giving supplemental (SQ) fluids under the scruff of the skin to increase urine output

Showing you how to express the bladder

Show you how to assist feed

Keeping the litter box clean

Decrease the weight if obese by feeding less, and increase activity

Using medications as prescribed by us if one of our doctors think it is indicated. This could include:

Pain medication

Antibiotics

Cranberry juice

Vitamin C (ascorbic acid)

Using food that does not have an excess of calcium might be helpful. This means no pellets or alfalfa hay.

Feed only Timothy, Oat, or Orchard Grass hay. A small amount of fruits, and grass hay based pellets can be fed

Also feed fresh leafy green vegetables like kale, mustard greens, dandelion parsley, broccoli leaves and romaine lettuce.

If your water is hard (lots of minerals in it like calcium) you might want to get a water softener.

Follow Up

Any rabbit that has a sludge or bladder stone problem is susceptible to recurrence. Routine monitoring by physical exam, blood panels, and radiographs every 3-6 months is needed to catch the problem early.

Our Rabbit Diseases section has  more information on rabbits, including how we surgically repaired the fractured femur in the radiograph below. This is put here as a reminder that rabbits have powerful back legs in relation to their spine and long bones. If not restrained or held properly they can easily fracture these bones. A femur can be repaired, a fractured spine cannot.

This is called a mid shaft transverse fracture of the femur

Don’t forget to give your bunny lots of TLC, like Dr. Kennedy is doing here on one of her patients

 









 

 

 

 

 

 

 

 

 

 

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Symptoms of Diseases

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Here are 5 basic areas you should observe on a daily basis.

Eating

Watch your pets daily eating habits for :

  • difficulty chewing
  • odor
  • swelling
  • pawing at its muzzle

Since dental disease is so prevalent please follow the link to learn how this can affect your pet’s eating.

Breathing

When your pet is at rest count the number of times it breathes per minute (watch it for 15 seconds and multiply that number by 4). A typical dog or cat breathes 30-40 times per minute, although this can be variable based on breed and external temperature. The important thing to watch for is an increase in its respiratory rate over a period of time. Trend this on a piece of paper weekly so you can see this trend as it gets going. This can be a subtle but very important parameter to measure since an increase here can be for many serious reasons.

Urination

Look for any changes in the following:

  • Urinating more often or in greater amounts than normal
  • Urinating small amounts frequently
  • Straining to urinate
  • Inability to urinate
  • Licking at genitals

In female dogs it can be difficult to assess some of these parameters, so try to pay close attention when she squats to urinate.

Defecation

Any significant change here is important:

  • Continual diarrhea of any type
  • Straining to defecate
  • Licking at anus
  • Scooting
  • Any blood on feces

Walking

Obvious lameness is readily noticed. Also look for a pet that is leaning more towards one leg or the other, tires easily after walking or playing, is slow at getting up after resting, or is reluctant to go up or down any type of elevation like stairs or jumping into a vehicle.

Now that you have observed your pets daily habits lets look at how you can look for problems that are not so apparent by going to our In Home Exam page.

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Cancer

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The scientific word for cancer is neoplasia, meaning new growth. In reality, it is an abnormal growth of cells that interferes with an organ’s ability to function, resulting in a degree of failure in that organ. Some of these abnormal cells break off from the organ and spread to other organs in the body, causing them to fail. This process is called metastasis, and is the hallmark of malignant cancer.

The enlarged sublumbar lymph nodes in this dog’s abdomen are the whitish areas under the circle. A cancer called adenocarcinoma spread to them through the process of metastasis.

This is what severe bone cancer looks like on the front foreleg (radius and ulna) of a dog. It is a malignant cancer called osteosarcoma. Compare it to the normal radius and ulna below to see the signifiant bone destruction. 

A normal radius and ulna on a radiograph

 

Cancer it is not one disease, has many different causes, and can affect every organ. This makes it quite a challenge to diagnose and treat. Even though the cause is not known in many cases, we do know of major factors that predispose pets to getting cancer. An example is squamous cell carcinoma (SCC) in white cats that are exposed to the sun. We tend to see cancer more commonly in our geriatric patients.

A major predisposing factor is dogs, cats and rabbits that are not neutered and spayed when they are young.  Their chances of getting breast, testicular, and prostate cancer increase significantly when they are not altered at an early age. The following pages have detailed information on this:

Reproductive Cancers

Dog Spay

Dog Neuter

Cat Spay

Cat Neuter

Rabbit Neuter

Rabbit Spay

Dog and Cat Non-Reproductive Cancers

Intestine

Kidney

Liver

Lymph node

Mammary (breast)

Mast cell

Spleen (hemangiosarcoma)

Squamous cell carcinoma (SCC)

Ferrets

Adrenal disease

Insulinoma

Liver

Rodents

Mammary (breast)

Ovarian

Reptiles

Tegu oral tumor

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Sarcoptic Mange (Scabies)

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Sarcoptic mange (cats get a version called notoedric mange ), commonly know as scabies, is caused by an external parasite called Sarcoptes scabei  that burrows deep into the skin. It commonly occurs in dogs, not so commonly in cats, unless is it notoedric mange), also occurs in foxes, ferrets, rabbits, sheep, goats, cattle, pigs and guinea pigs.

It is contagious to other pets and occurs in many different animals. It causes intense itchiness, especially affecting the ear margins, elbows, and face. People can pick up this disease from their pet and show symptoms of itching, but it goes away by itself in many cases and usually  does not require treatment in most cases (always check with your doctor).

It is important to note that the diagnosis of this skin condition, like most skin conditions, cannot be made just by looking at a pet. Diagnostic tests are mandatory to arrive at a correct diagnosis and achieve a satisfactory outcome to therapy. Stating that an animal looks “mangey” is not the same thing as making a positive diagnosis of mange. Pets that have Ringworm , Demodex. and allergies can look like they have Sarcoptic mange.

 Life Cycle

This ectoparasite spends it life cycle of 14-21 days entirely on the host it has infected.  Overcrowded conditions increase risk for transmission. Stress from many sources can also be a factor.

History

The following history for an itching pet with sarcoptes usually involves:

  • Severe itching that is non-seasonal
  • Recently adopted or boarded pet
  • Multiple pets in the house
  • Humans in the same house that are itching with red lesions on their skin.

 Symptoms

In dogs most of the symptoms involve intense itching at the ear margins, elbows, hocks and abdomen. Less common areas of itching can include the face and feet. This itching will inflame the skin and cause scabs, with a secondary bacterial infection (pyoderma) occurring due to the trauma. Some pets will shake their ears excessively and cause an aural hematoma (swollen ear). These symptoms can mimic those of other skin conditions, so the rules of the diagnostic process should be carefully adhered to.

Other symptoms that might be present sometimes include:

  • Lethargy and depression
  • Lack of appetite
  • Weight loss

Cat mange (notoedres cati)

In cats, sarcoptic mange is caused by a mite called notoedres cati, a microscopic ectoparasite that burrows in to the skin. It is not as itchy, and occurs more often on the face, ears, paws, and tail.

This is a highly magnified view of notoedres cati as it appears under the microscope

This cat has scabies, but you can’t say that for sure just by looking at it

The top of his head shows how irritating the problem is, especially at the ears

Diagnosis

The primary way to diagnose sarcoptic mange is to do a skin scraping where the patches of alopecia occur. Finding these mites, their eggs, or their feces,  under the microscope can be very difficult in this disease. a pet that has the symptoms of Sarcoptic mange and is negative on skin scrapings for the parasite can still have the disease. In these cases we commonly treat for the disease anyway, because the treatment is highly effective.

In rare cases we will do a skin biopsy, which is a great way to rule out other diseases that have similar symptoms.

Other diseases in dogs that mimic scabies include:

  • Folliculitis
  • Malassezia (fungus)
  • Allergies
  • Contact dermatitis
  • Cancer
  • Pemphigus (immune system disease)

Diseases in cats that mimic scabies include:

  • Demodectic mange
  • Otodectic mange
  • Cheyletellia
  • Herpes dermatitis
  • Allergies

Treatment

The usual treatment for Sarcoptic mange is a drug called Ivermectin. It is an injection given weekly for up to 6 weeks. Most pets decrease their scratching rapidly after the first injection. Some dogs, particularly Collies, Shetland Sheepdogs, and Old English Sheepdogs, do not tolerate the medication well. In these pets we use a dip called Lyme Sulfur that is also very effective.

The disadvantage to the dip is the odor it causes and the staining of white coated animals. All pets in a household should be treated regardless of whether they are showing symptoms or not. Pets that have secondary skin infections from the trauma might also be put on antibiotics. Other common treatments include Revolution (selamectin) topical.

Other pets in the same household are commonly treated if they are in close contact. Treating the environment is usually not needed if all pets in the house are treated.

Some pets itch more in the first few days of treatment due to dying mites. These pets can be put on low dose cortisone for a few days in a reducing dose to get over this phase.

This dog has scabies

This is a picture from the dog above 7 days after its first Ivermectin injection

Prevention

Good nutrition and plenty of play and exercise are always important to maintain the proper balance to fight off disease. All pets in a household that has a pet diagnosed with this disease should also be treated.

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Anesthesia

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One of the most important tools available to veterinarians to thoroughly and painlessly treat pets is the advent of modern day anesthetics. These anesthetic agents allow us to sedate and anesthetize a wide variety of animals with negligible chance of serious side effects.

Modern anesthetics allows us to safely anesthetize high risk animals like this duck with a fractured wing. You can see her surgery in our Wildlife Care page.

The lack of significant complications from anesthesia is due to a combination of expertise, thorough pre-anesthetic testing, and state of the art anesthetic and monitoring equipment. We are equipped to anesthetize any pet from a finch that weighs 15 grams (it takes 454 grams to make up one pound), to pets that weigh several hundred pounds. We are also particularly proficient in anesthetizing senior pets and pets with medical problems like liver and kidney disease.

The most important part of monitoring your pet while it is under anesthesia is our nurse technician that is with your pet the whole time it is under anesthesia

The goals of anesthesia are to minimize anxiety and eliminate pain. In addition, from the surgical point of view, anesthesia allows profound muscle relaxation. This is helpful in every surgery because the procedure will go quicker and incisions can be made smaller when the muscles are relaxed. In certain types of surgery like fracture repair, this muscle relaxation is crucial for success.

It is normal for you to have concern if your pet is about to undergo a procedure that requires anesthesia. Because of this fact, we invite you to be a part of our anesthetic team. Your primary responsibility is to let us know of your concern. You will have access to your doctor to discuss any of your concerns and to set up a custom protocol for your pet, taking its specific needs into consideration. Only when you are comfortable with the situation will we proceed any further. Also, to alleviate your concern on the day of actual anesthesia, we will call you immediately after your pet wakes up, if you so desire. Please leave a number where we can reach you on the day of surgery.

Pre-Anesthesia

A pre-anesthetic exam is performed just prior to anesthetizing any animal. We are looking for any problems, particularly with the heart and lungs.

We perform this exam just prior to anesthetizing your pet

Even our more unusual patients get an exam prior to surgery

One of the precautions we take to minimize the risk of anesthesia is to perform pre-anesthetic diagnostic tests. A pet can pass its pre anesthetic physical exam and still have significant internal problems, so it is important that we perform more than just a physical exam. This is because animals cannot tell us of their problems, have high pain thresholds in comparison to people, and have defensive mechanisms allowing them to hide symptoms. Pre-anesthetic diagnostic tests are designed to alert us to internal problems that are occurring without any symptoms.

We prefer to perform an exam and blood panel about one week prior to surgery. We send this blood panel out to our lab for a thorough analysis of important organs like red blood cells, liver, and kidney.

 This report is showing a kidney problem

 

In an emergency, or when we cannot send the blood out to our lab several days prior to surgery, we can perform an analysis in our hospital by our blood analyzer

We can have this report in 30 minutes. This is how it checks the CBC (Complete Blood Count). It also gives us a biochemical report like the one above that checks the internal organs like the kidneys.

Those pets that have infections (especially tooth infections) might be put on antibiotics ahead of time. They make pets feel better, and help support internal organs.

Older pets, or those with medical problem,s are given intravenous (IV) fluids prior to and during the anesthetic procedure. Giving fluids prior to the surgery greatly reduces anesthetic risk. This is particularly important in older pets and those with kidney or liver disease. Most pets that have significant dental disease will also be given IV fluids.

IV fluids are one of the most important treatment modalities we have for a wide variety of medical situations in addition to surgery

Pre-Anesthetic ECG

For elderly pets, those with heart murmurs or heart conditions, we perform an electrocardiogram just prior too surgery.


This one has a potential problem that needs to be addressed

Blood Transfusions

For those pets that are anemic, or in surgeries where we anticipate significant blood less, we give whole blood before, during, and after the surgery. This is important in surgeries like splenectomies.

This is what anemia looks like in a CBC from our in house blood machine

Dog do not have iso antibodies, so in an emergency, and if the dog has never received blood before, we can give blood from most any dog donor. It is not our preferred way of doing a blood transfusion.

Before we give the blood we prefer to do a cross match

We use whole blood that is specially prepared and stored

Injectable Anesthesia

Injectable anesthetics are used for many purposes. One of their primary uses is to sedate pets before giving the actual anesthesia (called pre-anesthetic). By sedating ahead of time we dramatically minimize anxiety, cause a smoother recovery, and minimize how much anesthetic we need to administer during the actual procedure. In addition, some injectable anesthetics minimize vomiting, a common problem when waking up from anesthethesia.

Injectable anesthesia is given intravenously, and rapidly induces relaxation so that we can put in a breathing tube

Injectable anesthetics are also used to give complete anesthesia for short periods of time. This is used for C-sections and minor surgical procedures. Injectable anesthetics are ideal to sedate a pet for radiographs (x-rays).

As new anesthetic agents evolve, the trend is towards using injectable anesthetics more and more for complete surgical anesthesia. They are very effective, very safe, and allow for rapid recovery from anesthesia. They also protect the environment because there are no anesthetic gases vented into the atmosphere.

Gas Anesthesia

The mainstay for general anesthesia is gas anesthesia because it is very safe and highly controllable. We use a safe and effective gas anesthesia  called Isoflurane. It is so safe it can be used in creatures as small as tiny birds.

Lisa is watching carefully as this budgie is being anesthetized for a surgery to remove a growth on its cloaca

Gas anesthesia requires specialized equipment and training. Several precision components are used to administer and monitor anesthesia:

Oxygen

All pets put under gas anesthesia are given 100% oxygen from the moment they are anesthetized until they wake up, dramatically increasing the safety of the procedure.

We have a special machine in surgery that generates 100% oxygen

As a backup,  oxygen is stored in large tanks under high pressure. The oxygen in these tanks is delivered to the anesthetic machine via special piping throughout the hospital. This allows us to have anesthetic machines in several hospital locations.

A pet can be brought into radiology after its surgery and still be kept under gas anesthesia, while the surgeon reviews post operative radiographs to ensure everything is in order. This is especially helpful when orthopedic surgery is performed.

Keeping a pet under anesthesia is important in orthopedic surgery to make sure the plates, pins, or screws are properly placed and in alignment. If they are not, this can be corrected before a pet wakes up completely. 

Endotracheal Tube

Oxygen is routinely delivered to your pet by a breathing tube (endotracheal tube) in its windpipe. It is the preferred method to administer oxygen because it is very efficient, will prevent any vomitus from entering the trachea (vomiting rarely happens because of fasting and pre-anesthetic sedation), and allows us to gently inflate the lungs during surgery so that they work at maximum efficiency. Besides oxygen, the anesthetic gas (Isoflurane) is also administered through the endotracheal tube. Medications can even be administered via this special tube.

 

The endotracheal (ET) tube is placed directly into the windpipe

This x-ray shows the breathing tube (follow the arrow) as it passes over the tongue and down the trachea (windpipe)

We can easily breathe for your pet and inflate your pet’s lungs by gently squeezing the bag connected to the tube, monitoring the amount of pressure we are exerting with a gauge on the anesthetic machine. Each size and species of pet requires a different sized endotracheal tube. The tube is not removed from your pet until it is literally waking up. This ensures that the swallowing reflex is present, and your pet is now safely able to breathe on its own.

Vaporizer

An instrument called a precision vaporizer is used to deliver the Isoflurane anesthetic gas within the oxygen. It is a very precise instrument allowing us to make fine adjustments in anesthetic level. Without this vaporizer we would not have the wide safety margin that we currently enjoy.

We can precisely and easily change the level of anesthesia during the procedure as needs change

For most surgeries we administer the anesthetic at a setting of 1-3 %. This small percent of anesthetic, added to the 100% oxygen the pet is breathing, is all that is needed to achieve complete surgical anesthesia. Before the surgical procedure is finished the anesthetic is lowered before it is turned off completely. As the surgeon is finishing the procedure your pet is in the beginning stages of waking up. This decreases anesthetic time,  another way we minimize anesthetic risk.

Monitoring

Our surgeon is one of the best monitors, because he/she is literally visualizing the blood in the circulatory system. Any change in the blood is readily noticed because pets that are breathing 100% oxygen should have bright red blood.

In addition to all the high tech monitoring equipment we have, our anesthetist is hands-on in monitoring your pet. Here Brianna is using  her stethoscope to check the heart, even though the heart monitor behind her is doing the same thing. 

After listening to the heart she keeps a close tab on oxygen flow and the anesthetic level of our precision vaporizer

We keep detailed records of fluid rate rates, anesthetic and oxygen levels, and physiologic parameters, during the surgery

We keep a close tab on the heart with the stethoscope on all of our more unusual surgical patients

Since our small patients can easily become hypothermic due to the anesthesia and surgery, we monitor temperature continuously.

Surgery-GPigWaterBlanket

Surgery-GPigWaterBlanket1

All of our patients, especially the smaller ones like this guinea pig, are kept on warm water water blankets to prevent hypothermia before during, and after any anesthetic procedure.

Anesthetic Monitor

This highly accurate and sensitive monitor gives us detailed information on your pets physiologic status while under anesthesia.

It is a sophisticated instrument that gives us an early warning sign of impending problems with your pet’s physiology

It is calibrated prior to surgery to ensure accuracy

Watch it in action, and see if you an figure out what all these numbers mean

We sometimes use other instruments to monitor you pet while it is under anesthesia, even though the Surgical monitor does this also. It pays to be redundant. The two most important additional instruments we use are:

Pulse Oximeter (Pulse Ox)

The portable pulse oximeter is an instrument that measures the oxygen saturation of you pet’s red blood cells (to be more specific, its hemoglobin). It is an extremely sensitive instrument that gives us an indication of problems that may be arising long before your pet suffers any ill effects. In addition to measuring oxygen saturation, it measures heart rate, pulse character, and respiration.

This instrument does its magic by measuring the hemoglobin that is oxygenated, and comparing it to the hemoglobin that is not oxygenated. It does this by shining a light on an artery, and then measures how much of this light is absorbed. It gives us an answer in PaO2– the partial atmospheric pressure of oxygen.

This Guinea Pig has the pulse oximeter sensor attached to his foot in preparation for surgery

The Pulse Oximeter measures oxygen saturation of 92%  and a heart rate of 87 beats per minute (BPM). Both of these are normal on this pet, which is a pot bellied pig.

The pulse oximeter has several different types of sensors that can be attached in various locations depending on the procedure being performed.The pulse oximeter can also be used on pets that are not anesthetized. It is useful for pets that are having difficulty breathing (dyspnea) from many different causes. It is also used to monitor pets that are in a state of shock. One of the most common reasons for pets to be presented to us in a state of shock is from trauma, especially being hit by a car (HBC).

Blood Pressure Monitor

We also monitor the blood pressure when pets are under anesthesia for the longer surgical procedures. This is done with our anesthetic monitor.

Blood pressure can also be checked manually at any time

Our hypertension page has a video of the doppler blood pressure monitor in action when we use it in an exam room.

Capillary Refill Time

To complement these high tech methods of monitoring, our anesthetist technician uses several hands-on techniques as a backup. One of the easiest of these is called capillary refill time (CRT). By pressing on the mucous membranes in the mouth, and noting how long it takes for the blanched area to turn pink again, we get a basic assessment of your pets cardiovascular status. A normal pet’s pink color returns within 2 seconds. This technique is used in other situations besides anesthetic monitoring. It is especially helpful when a pet is in shock or is dehydrated.

Capillary refill time on this pet is less than one second

Pain Medication

We complete the anesthetic process by giving your pet a pain injection before it wakes up from the anesthetic. Since the gas anesthesia has a small amount of residual analgesia (ability to kill pain), the pain shot kicks in as the gas anesthetic is wearing off. This allows for a very smooth and pain free recovery. We monitor this closely, and will give additional injections as needed. This pain injection will keep your pet calm its first night home from any surgery. We will also send you home with oral pain medication also for several days.

Local Anesthesia

Another excellent way to prevent the pain encountered when your pet first wakes up is to use a long acting local anesthetic at the incision site. We administer it prior to completion of the surgery so it is in full effect when your pet wakes up.

We use the long acting version of this drug which eliminates pain for up to 8 hours

We even have a local anesthesia patch that is used in some cases to bring long term relief for several days if needed.

Pain Patch

We also use Duragesic (Fentanyl) patches for general pain control in the more serious cases. It is preferable to apply it 12 hours before the surgery for maximum effect postoperatively. It provides pain relief for 3 days. It is important to make sure that no children or other pets are allowed to contact the patch in any way. Bring your pet back to us for proper removal and disposal.

The patch is applied in different locations depending on the surgery. Wrapped around one of the legs and between the shoulder blades are common locations. If we put it on the leg it is covered with a bandage. It will be bandaged for protection and to minimize the chance of contact with other pets and children. Please return in 3 days for us to remove it and dispose of it properly.

One of our nurses is applying it in this picture using gloves to ensure she does not come into contact with the active ingredient.

We will commonly staple the patch to the skin if we put it between the shoulder blades

Our surgical patients are monitored closely immediately after surgery. We will verify the pain medication is working, and that there are no ill effects from the anesthetic. It will also allow your pet to completely wake up and walk normally in a controlled environment where it cannot hurt itself.

Our technical staff monitors your pet post operatively until we are certain it is ready to go home

Long term pain control at home is also important during the next several days. We will routinely send you home with an anti-inflammatory medication or pain suspension for long term pain control. The two most common medications we use are Rimadyl and Torbutrol suspension.

Laser Surgery

Even though it is not an actual pain medication, using our carbon dioxide laser when indicated during a surgical procedure dramatically minimizes pain because it decreases inflammation, swelling, and cauterizes nerve endings. By using the laser and stopping the pain cascade before it even begins there is a dramatic influence on decreasing post operative pain.

This video shows you how we calibrate and set the laser for a neuter surgery

Companion Laser Surgery Post Op

For additional pain control we use our  Companion Laser on the incision line before your pet wakes up from anesthesia. This decreases post operative swelling and pain, and makes your pet much more comfortable.


You get to wear cool glasses when we use this laser

Watch it in action

Returning Home after anesthesia

When you bring your pet home after anesthesia it is helpful to follow some common sense suggestions:

Keep contact with other pets and children to a minimum for at least the first 12 hours. Confine it to an area where it cannot hurt itself  because it may not be steady on its feet for up to 24 hours. It might be groggy the first night due to the pain injection it was given.

Use pain medication as prescribed and keep your pet in a warm and quiet area. You can spend time giving unlimited TLC

Even though your pet has probably been fasted for the anesthesia, feed it only a small amount of food and water when first returning home. Give it more later if it eats well and does not vomit (emesis). Most pets return to a normal appetite within 24 hours. If your pet has not fully recovered from the anesthetic by the next day then please call our office.

Please call us in the evening if you have any questions when your pet returns home from surgery or any anesthetic procedure.

To learn much more about how we do surgery at the Long Beach Animal Hospital please visit our Surgery Page and our Diseases Page.

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Worms (Internal Parasites)

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The study of parasites is called parasitology. It is an important discipline because internal parasites cause death and disease worth billions of dollars in animals each year. These parasites have highly evolved life cycles that make their elimination impossible. In addition, many internal parasites affect people with the potential for serious consequences.

Dogs and cats (especially puppies and kittens) are routinely infected with internal parasites, sometimes without apparent evidence of the infestation until it is too late. This means that a pet can have internal parasites even though the fecal sample is negative. It is suspected that internal parasites predispose your pet to IBD (Inflammatory Bowel Disease) later in life.

Fortunately, we have effective medications to treat most parasites. Many of the medications we use to treat internal parasites, called anthelmintics, treat more than one parasite. The advent of these broad spectrum anthelminitcs makes treatment much more effective. We recommend all dogs and cats get a treatment for internal parasites every 6 months.

This best method for treatment is to use flea products on a monthly basis that also kill internal parasites and prevent heart worms. We have several medications, some oral and some topical, to achieve this.

This section will discuss internal parasites that are commonly found in dogs and cats in our area. This includes:

  • Tapeworms
  • Roundworms
  • Hookworms
  • Whipworms
  • Coccidia
  • Giardia

These internal parasites differ from external parasites, which usually affect the skin and ears of dogs and cats. Click here to learn more about external parasites.


Symptoms

Symptoms manifested by pets that are infected with internal parasites can vary, and depend on a pet’s age, nutritional status, parasite load, duration of infestation, etc. One of the most common symptoms of internal parasitism is diarrhea. Other symptoms include poor appetite, lethargy, coughing, and abdominal distention. Some pets don’t show any symptoms while others can die from their infestation. Internal parasites tend to infest older and younger animals most commonly. Internal parasites can also make a pet more susceptible to other diseases. It is not uncommon for a puppy with Parvo virus to have internal parasites simultaneously.

Due to the prevalence of internal parasites in dogs and cats, their lack of symptoms in some cases, and the potential for humans to become infested also, your pets feces should be checked for internal parasites twice a year. Dogs and cats that are outside and exposed to other animals should have their feces checked more often. Routine worming should be performed on all dogs and cats every 6 months, even if the stool check for parasites is negative.


Diagnosis

The majority of internal parasites are diagnosed by microscopic examination of the feces for eggs that are released by the adult female in your pet’s intestine. The number of eggs released in a given fecal sample can be variable, sometimes there aren’t any even though your pet has an adult female parasite in its intestines. This means that a negative fecal report does not guarantee that your pet is free from internal parasites. In many cases we need to run numerous samples to feel comfortable that your pet is free of internal parasites. In some cases our doctor’s will treat for a specific parasite, even on a negative fecal sample, when they feel there is a likelihood of infestation, because some internal parasites eggs are notoriously hard to detect.

In some parasites a diagnosis is made by observation of the mature parasite in your pet’s feces or during an autopsy in your pet’s intestines. This is especially true for Tapeworms. Tapeworm eggs are difficult to detect during microscopic fecal analysis, so observation of the actual worm is how they are routinely diagnosed.

The two primary methods of fecal analysis are direct observation and fecal flotation. In direct observation a smear is made of some fecal material on a microscope slide and the slide is analyzed by one of our nurses for parasite eggs. It is used to detect eggs that don’t show up well during the fecal flotation.

Fecal flotation is the most accurate way to detect most internal parasites. A sample of fresh feces is put into a special solution that causes any eggs that might be present to float to the top and adhere to a cover slip. The cover slip is put on a microscope slide for analysis. This concentration of eggs substantially increases the chance of finding any eggs that might be present. Some eggs, notably Tapeworm eggs, dissolve during this process and might be undetected. This is the reason you can see Tapeworms in your pets stool yet the fecal analysis came back negative.

We have sanitary containers for you to use to obtain a fecal sample from your pet. Once the sample is obtained it should be kept cool until we analyze it. Analysis should be within 12 hours to increase accuracy.

The flotation solution has been added to the fecal container and a cover slip has been placed on the top to collect any eggs that float to the surface after a 5 minute wait

The cover slip is put on a microscope slide and carefully scanned for the eggs of any parasite. High magnification is needed because the eggs are microscopic in size.


Treatment

Internal parasites have very sophisticated life cycles that can make treatment difficult. Some of these life cycles involve mandatory maturation processes in other animals, including insects. Specific treatment modalities are set up to address these life cycles and will be discussed for each individual parasite in the following sections. It is important to follow these treatment regimens precisely.

Some parasites can only be controlled, not eliminated. In these cases it is important to check your pet’s feces routinely and to use medication on a long term basis.

There are new treatments for internal parasites that are very broad spectrum. They kill a wide variety of parasites, and are the medications we use as a routine wormer.

Revolution, will kill fleas, heartwormsear mites, and even internal parasites. We recommend it for cats.

Trifexis kills internal parasites, heartworms, and fleas, and is recommended for dogs.

Please ask our receptionist for brochures on these products.


Tapeworms

By far the most common internal parasite we encounter is Tapeworms. The scientific name for the Tapeworm we encounter in our area is called Dipylidium.

Life cycle

The source of the infestation is a flea that has been swallowed by your pet or a cat that eats infected rodents. The flea gets the Tapeworm in its system by swallowing it during its larval stages, when the larvae eat the eggs that have been passed from pets that are already infested with Tapeworms.

The lifecycle of the Tapeworm is simple compared to other internal parasites

Symptoms

In spite of their prevalence Tapeworms are not a significant cause of disease in dogs and cats. Most pets do not have any symptoms, and if symptoms are present, are mild in nature. Some pets will itch at their anus or scoot on the ground when the worms cause irritation as they pass.

Diagnosis

Most Tapeworms are diagnosed by visualizing the worm in your pets feces, crawling around its anus, or in its bedding. Tapeworms segments crawling on your dog’s anus might cause scooting, although full anal sacs are a much more common cause of scooting. They come in long attachments that usually break off into individual pieces when they exit from your pet. They usually look like pieces of white rice and turn yellow after they have been out of the body for a while.

This is a packet of Tapeworm eggs as viewed under a microscope. It is rare for us to see them in this packet because the fecal flotation solution causes this packet to burst.

 Treatment

Several medications are available that are highly effective at ridding you pet of Tapeworms. The most common treatment is an oral medication that rids your pet of all Tapeworms within 24 hours. This medication also kills rounds, hooks, and whipworms. It does nothing to prevent your pet from re-infecting itself. Proper flea control does.

Prevention

Since fleas are directly responsible for this infestation their control is apparent. We recommend advantage and Program for safe, economical, convenient, and highly effective flea prevention. A new product, called Revolution, will kill fleas, heartworms, ear mites, and even internal parasites. Please ask our receptionist for a brochure.

Public Health Significance

Children can pick up Tapeworms from eating fleas, but it rarely causes any problem. Other species of Tapeworms exist that have significant potential to cause serious disease in people. Fortunately, we do not encounter them in our local area in dogs and cats.

 Roundworms

A common parasite of dogs and cats, especially puppies and kittens, is Roundworms. The scientific name for their group is called ascarids. We routinely treat puppies and kittens for this parasite for 2 reasons. The first is their prevalence, the second is their potential to infest humans. The larval form of this parasite has the potential to cause serious disease in children. Fortunately it is a rare problem, and can be prevented by worming all puppies and kittens early in life. It is all prevented by monthly use of flea and heart worm prevention products like Trifexis for dogs and Revolution for cats, since these products also kill roundworms.

Life cycle

The life cycle of this parasite almost ensures that a puppy or a kitten will be exposed. They can get it from their mother while they are in the uterus (dogs), during nursing, and through contamination with infected feces. Larval forms of this parasite migrate through internal organs, get coughed up and swallowed, and become mature parasites in the small intestines. Intermediate hosts like rodents can become infected by eating eggs, and can then infect a dog or cat when they are eaten. Some larvae migrate to the tissues of internal organs and remain dormant until pregnancy where they become active and infect the developing puppies in the uterus.

 Symptoms

Common symptoms are a distended abdomen and diarrhea. Some puppies and kittens will be vomiting, lethargic and not eating well, while others will not show any symptoms. On rare occasions the parasite load can be so heavy that the intestines become obstructed. Coughing, fever, nasal discharge and even pneumonia can occur in pups that have large numbers of larvae migrating through their respiratory tract.

Diagnosis

In some cases the Roundworm will be present in your pet’s feces, vomitus or crawling around its ansu. This is not a consistent finding, and worms that might be present one day might not be there the next.

It looks like a curled up piece of spaghetti

The vast majority of Roundworm infestations are diagnosed on fecal analysis for eggs. Young puppies can be infected before the eggs of the parasite appear in the feces.

This is one type of Roundworm egg when viewed under the microscope. The thick membrane around the eggs prevent them from drying out when they are laid in the environment.

 Treatment

There are several effective treatments for Roundworms. We can easily treat your pet with an oral version given during a routine office visit. It has to be retreated in 2 weeks due to the migrating larvae since the medication does not kill the larvae. Some pets require several more treatments for a full cure. If you keep your pet on Trifexis or Revolution year round you are treating for this problem monthly. This is the best way to go.

Prevention

Roundworm eggs can remain viable for a long time in the environment. Children will get this parasite by eating dirt contaminated with the eggs, therefore cleaning up your pet’s feces immediately, and eliminating exposure to the feces of other animals when your pet goes for a walk, are important treatment modalities. Litter pans should be changed frequently and washed thoroughly and then allowed to dry in the sun. Keeping cats indoors also eliminates exposure to the feces of infected pets and the eating of infected rodents.

Public Health Significance

Children are of particular vulnerability to infestation because of their propensity to put things in their mouths and their attractions towards puppies. areas that might be contaminated with dog or cat feces should be off limits to children. This might include public areas such as parks or playgrounds. Even though these infestations in children are relatively uncommon, if they occur there can be significant damage to the internal organs like the liver, heart, brain, lungs, and eyes. This reason alone is why all puppies and kittens should be routinely treated for Roundworms, whether or not their fecal exam indicates they have parasites. also, teach your children to wash their hands frequently after handling pets, and not to put anything unnecessary in thier mouths.

Hookworms

Hookworms are blood sucking parasites that live in the small intestine. The scientific name for the Hookworm we encounter in our area is called Ancylostoma. They can be very pathogenic and even cause death due to anemia and low protein level.

Life cycle

Hookworms are spread by eating infected larvae that are in the environment. These infective larvae can also penetrate the skin and enter the blood stream where they mature into adult Hookworms in the small intestine. Puppies can also get infected while nursing or in the uterus prior to birth. Some Hookworm larvae migrate to muscles where they serve as a source of future infections.

 Symptoms

Pets with Hookworms have the potential to be very ill,especially in dogs. Symptoms include lethargy, dark stools or diarrhea, weakness and vomiting. In severe cases they are anemic and debilitated, especially the older and younger pets. The larvae might even irritate the skin when they penetrate between the toes and pads.

Diagnosis

Adult Hookworms are small so they are usually not seen passed in the feces. This diagnosis is made primarily by finding the distinctive egg in your pet’s feces. Any pet that is anemic should have its feces checked for this parasite.

These eggs are more oval than Roundworms, and the membrane is thinner

 Treatment

Infected pets might require hospitalization and even a blood transfusion if their symptoms are severe. There are different types of worming medications used, some require retreatment several weeks after the initial treatment because of the larvae that migrate through the body. All require checking your pet’s feces to make sure the parasite has been eliminated. Long term treatment and surveillance in the form of fecal exams are necessary. Dogs with chronic problems are put on heartworm preventive medication on a monthly basis since this medication also kills Hookworms. Any dog put on heartworm preventive medication needs to be checked for heartworm disease before we start preventive medication.

If you keep your pet on Trifexis or Revolution year round you are treating for this problem monthly. This is the best way to go.

Prevention

Fecal exams should be performed frequently on pets that have a history of Hookworm infestation. Prompt removal of feces helps prevent contamination of the yard with larvae. Larvae are killed in cold climates when exposed to freezing temperatures.

Public Health Significance

Hookworm larvae can penetrate the skin of people and cause significant irritation. These larvae can migrate through the body and cause damage to internal organs. Just like in Roundworms discussed above, puppies should be routinely treated for this parasite at a young age.

Whipworms

Whipworms are blood sucking parasites that live in the large intestine, usually only in dogs. They are called Whipworms because they have a slender end and a thick end, hence the appearance of a whip. The scientific name for the Whipworm we encounter in our area is called Trichuris. They can be as pathogenic as Hookworms, and also cause death due to anemia and low protein level.

Life cycle

Female Whipworms lay eggs in the environment that eventually turn into larvae. Pets ingest these larvae when they ingest soil that is contaminated. These larvae take 3 months to develop into adults capable of causing disease.

 Symptoms

Symptoms of Whipworm infestation include chronic diarrhea, anemia, and weight loss.

Diagnosis

Like most internal parasites Whipworms are diagnosed by looking for the eggs in the feces. They are oval in shape and have a plug at each end that aids in identification. Their thick membrane gives them significant protection. The eggs are shed intermittently, so a negative fecal sample does not guarantee that your dog is free of Whipworms. Adult Whipworms can sometimes be visualized when an endoscope is passed into the rectum of a pet with chronic diarrhea.

 


Treatment

Various oral medication are also used to treat Whipworms. Treatment is commonly repeated in 3 weeks and 3 months due to the life cycle of this parasite. If you keep your pet on Trifexis or Revolution year round you are treating for this problem monthly. This is the best way to go.

Prevention

Control of reinfections is difficult because eggs that have been laid in the environment are very resistant. Feces need to be rechecked and a long term plan for surveillance and treatment needs to be initiated.

Public Health Significance

Human infections with this parasite might occur, although this controversial. Common sense dictates prompt removal of feces from your pet’s environment and washing your hands any time there is a potential exposure.

Coccidia

Coccidia are not technically a worm, but a protozoan parasite that infect dogs and cats primarily, but can be seen in other species.

Life cycle

Coccidia life cycles are complex and involve many stages of development. Coccidia produce cysts instead of larvae and eggs. Dogs and cats usually get the infection from ingesting the cysts in the environment or eating animals like mice that are already infected.

Symptoms

Symptoms usually occur in young animals and include diarrhea and abdominal pain. These young animals can become severely dehydrated and the infection can be life threatening. This is especially true in pets that are stressed or have other parasites. Many pets, especially the older ones, do not show any symptoms when infected.

Diagnosis

Diagnosis of Coccidia infection is made by identifying the very small eggs in a fecal sample. They can be very difficult to detect due to their small nature and variable shedding by a pet. This is why our doctors will occasionally treat a pet for Coccidia even though the fecal exam is negative for this parasite.

 Treatment

Sulfa type medications or sulfa and antibiotic combinations are used to affect a cure. They need to be given for up to 3 weeks.  There is also a medication that requires only 3 days of treatment. Kittens that are very ill require hospitalization and intravenous fluids to help them fight off the infection.

Prevention

Prompt removal of feces helps prevent continued environmental contamination.

Public Health Significance

A version of Coccidia, called Toxoplasmosis, is of particular significance to pregnant women since it can cause disease in unborn children. The most common source of infection for pregnant women is eating improperly cooked meat (especially pork, lamb, and venison), not necessarily from the feces of cats. In a cat that does have Toxoplasmosis, the eggs that are laid in the environment (litter pan) do not become infective until 24 hours have passed. If the litter pan is cleaned twice daily the eggs will not have time to become infective to pregnant women. Wear gloves when you change the litter pan. Better yet,have someone else clean the litter pan. When you garden you should also wear gloves since stray cats may use the soil as a litter pan. Keeping your cat indoors and not feeding it raw meat will prevent it from getting Toxoplasmosis and passing it on.

According to the Centers for Disease Control and Prevention more than 60 million people in the United States are infected with the Toxoplasmosis parasite. Few have symptoms because a healthy immune systems keeps it in check. You may feel like you have the “flu,” swollen lymph glands, or muscle aches and pains that last for a few days to several weeks. However, most people who become infected with toxoplasmosis don’t know it. On the other hand, people with immune system problems, such as those with HIV/AIDS, those taking certain types of chemotherapy, or persons who have recently received an organ transplant, and infants, may develop severe toxoplasmosis, which results in damage to the eye or the brain. Infants who became infected before birth can be born retarded or with several other serious mental or physical problems.

Giardia

Giardia are also protozoal parasites that live in the small intestines. Giarida are found every where in the world, Infection rates are variable, with younger animals having a higher rate of infection. There are various strains that differ in their potential to cause disease. The strain called Giarda lamblis (also called intestinalis or duodenalis) is the primary strain of people, companion animals. and livestock.

This parasite can be found on fecal exams of healthy pets that don’t have any symptoms. It is probably under diagnosed due to the chronic nature of the problem it presents and the difficulty of coming up with a positive diagnosis.

Giardia exists in 2 forms; trophozoites and cysts. The active and motile form, called trophozoites, are the stage which lives in the intestines of an affected mammal. These trophozoites produce non-motile cysts which are shed into the environment. The cysts remain viable in the environment for months, especially in cool and moist areas. They thrive in clear and cool water, a good reason not to drink running water in the outdoors, no matter how pristine it looks. The cysts are killed by freezing, boiling, and extended contact with disinfectants.

It is theorized that giardia make pets prone to food allergies. By interfering with the intestinal lining they let in proteins that stimulate the immune system to cause an allergic reaction.

Life cycle

The cysts in a contaminated environment are transmitted to mammals or birds upon ingestion. Gastric acid and pancreatic enzymes work on these cysts in the stomach and intestines, causing them to release 2 trophozoites. These motile trophozoites attach to the lining of the small intestine where they interfere with digestion. Within 2 weeks they encyst and are passed in the feces to contaminate the environment and await another host.

 Symptoms

In many pets there aren’t any symptoms, while in others that do show symptoms, the problem might resolve by itself. The most susceptible pets are puppies and kittens, pets with other internal parasites, and debilitated pets. Diarrhea that occurs can be severe and can be accompanied by poor appetite and dehydration. Vomiting, weight loss and blood in the stool are occasional symptoms.

Diagnosis

Giardia can be hard to diagnose because the parasite cysts become shriveled in the routine fecal solution that is used to bring eggs to the surface and adhere to the cover slip. Special fecal flotation solutions (zinc sulfate) are a more accurate manner to make the diagnosis. Cysts can be shed intermittently, so several samples are sometimes needed to make this diagnosis.

Fresh fecal samples that are not put in the fecal solution can sometimes show the parasite. We sometimes send fecal solutions to our outside lab for special tests when we suspect the problem yet we don’t find the parasite. Just like Coccidia, our doctors might treat for this disease even on negative fecal samples.

 Treatment

Flagyl is the drug routinely used to treat Giardia, although it does not cure all Giardia infections. The usual course of therapy is for 5 days, although our doctors will vary this dose depending on specific circumstances. Other medications are sometimes used if the Flagyl is not effective. There is no drug that is 100% effective against Giardia.

We recommend treating pets that are positive for Giardia even if they don’t have any symptoms. This helps eliminate environmental contamination, and helps minimize spread to people. If one pet in a household has Giardia we recommend treating all pets.

Prevention

Giardia cysts in a kennel are relatively easy to destroy with routine disinfectants, and are susceptible to drying and heat. Once an environment like a lawn is contaminated though, it can be almost impossible to eliminate this parasite.

  1. Treat all in contact animals in the household.
  2. Recommend to bathe all pets every 7-14 days with mild hypoallergenic  shampoo like Hilyte or and oatmeal shampoo.  If unable to bathe then to wipe down with separate clean damp cloths/towels once a day or once every other day especially around the anal area (please save this area for last).
  3. Wipe feet and anal area  of affected pet at least once a day especially after going outside with a clean damp cloth/towel.  OK to use baby wipes around anal area.
  4. Prevent licking on surfaces outside, prevent from eating grass, and prevent from drinking water from communal water dishes at dog parks or from ponds or ditches as much as possible.
  5. Give bottle water or filtered water or water that has been boiled.  This filters should filter out up to Giardia and Cryptococcus organisms from tap water.  Boiling the water  will kill any organisms present in the tap water.
  6. Thoroughly clean food and water dishes daily with soap and hot water and sterilize the food and water dishes weekly.
  7. Pick up feces immediately or as soon as possible.  Recommend to thoroughly clean out litter boxes daily and to disinfect and sterilize the boxes at least once a week.
  8. Once done with medications bathe all pets or at least bathe both dogs and wipe down all feline pets in the house with separate clean damp cloths/towels. Also clean and vacuum entire house and clean all bedding.
  9. Once done with course of medications please bring a fecal sample the same day or the next day that the medications are finished.  If the fecal results are negative then do another fecal analysis in 30 days post-treatment.  If the fecal results are still  positive for Giardia then will recommend to proceed with other possible causes of this persistently high infestation with Giardia i.e. immune system problems that are preventing her from getting rid of this protozoal parasite.

Good nutrition, avoiding overcrowding, general parasite control, and proper sanitation procedures are all critical in prevention. Cleaning up feces on a daily basis goes a long way to preventing contamination.

A vaccine available for dogs is very helpful in persistent infections

Public Health Significance

According to the Centers for Disease Control and Prevention, Giardia is one of the most common causes of waterborne diseases in humans in the United States. Many people get Giardia from other people and and contaminated water. Symptoms in people include diarrhea, abdominal cramps and nausea. They appear within 2 weeks of exposure to the parasite.

Exposure comes from many sources. They include swallowing water from swimming pools, lakes, rivers or streams that have been contaminated with animal or human feces. Fruits and vegetables that have not been washed (with Giardia free water!), along with accidental ingestion from hands contaminated by using toys, bathrooms, changing tables, etc., are also sources of infection. This emphasizes the importance of routine washing of hands. Boiling drinking water for one minute will kill this parasite.

We routinely treat pets with Giardia in their feces, even if they are not showing any symptoms, because of the potential for people to pick up this disease. Washing your hands frequently after touching your pet and bathing your pet frequently will help minimize exposure. We have a vaccine for dogs that do not respond to routine treatment. This will help prevent human exposure.

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Rabbit Spay

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A common surgery performed on female rabbits is a spay. The medical term is an ovariohysterectomy (removal of ovaries and uterus), abbreviated as an OVH. This page will show actual spay surgeries, on a normal rabbit, a rabbit with uterine cancer, and a rabbit with as fluid filled uterus. Like many females, rabbits are prone to cancer of the uterus, so removal of the uterus at a young age will prevent this problem.

The following page contain graphic pictures of OVH surgeries performed at the hospital.

Uterine Cancer

These two pictures give examples of why we spay rabbits. The first picture of the uterus is a healthy one, the second one has cancer. The cancerous uterus was removed only when this rabbit became ill.

This is what a healthy rabbit uterus looks like during surgery

This is a necrotic uterus that has cancer

Preparation

Pre-surgical preparation is a big part of our surgery. This includes a pre-anesthetic physical exam and blood panel. If we suspect a serious uterine problem we will also take a radiograph.

Before we perform any surgery our rabbit gets a thorough physical exam

We also check a blood panel prior to surgery to make sure there is no anemia and that the liver and kidneys are working normally

It is not easy to take a blood sample on a rabbit. We use a tiny needle since the vein is so small. 

Surgery

Once all of the pre-anestetic exams and diagnostic tests are complete we are ready for surgery.

We use a gas anesthetic that lets them fall asleep without any stress and is very safe. You can learn much more on how we anesthetize a wide variety of animal from our anesthesia page

OVH-rabbitOnce they are anesthetized we clip the hair After we clip the hair, the first step in preparation is the initial cleansing of the skin with a special surgical grade disinfectant

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While our patient is being prepped our surgeon is doing the same thing

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While all of this activity is going on our surgeon is busy getting ready for the surgery

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Time is of the essence any time a pet is under anesthesia, so our surgeon gets all instruments ready while our anesthetist is prepping our patient

All of our surgeries are closely watched  using our surgical monitor. These instruments detect a problem before it becomes detrimental to our patient.

Surgery-Monitor

 

Once our surgeon is comlfortable everything is in order our patient is draped and the procedure begins

OVH-rabbit-4

Surgery

After the skin incision is made a second incision is made in the abdominal muscles. There is a precise location for this incision, called the linea alba. Incisions here have minimal bleeding and sufficient strength to hold sutures when being closed at the end of the surgery.

Rabbits have minimal fat under the skin, so the skin incision is delicately made with a small scalpel blade

OVH-rabbit-5

Once the skin has been incised our landmark is a tendinous attachment of the abdominal muscles called the linea alba. It is seen here as the while diagonal line. It is important that we make our abdominal incision here because there is negligible bleeding and this area gives the sutures holding power to prevent a hernia.

OVH-rabbit-7

When our surgeon has this landmark properly exposed an incision is made into the abdomen

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This incision is continued with a scissors until it is just big enough to remove the ovaries and uterus

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Once the incision is large enough a special instrument is used to gently bring the ovaries out of the incision

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Of all the different species we spay rabbits have the most delicate tissue. If we are not careful in how we handle the uterine tissue it could tear in our hands, so we are very gentle in our tissue handling

Older rabbits have a significant amount of fat around the ovaries (black arrows) and along the uterus (white arrows). Both ovaries will be removed, and the body of the uterus will be removed at the point of the white horizontal line. The head of the rabbit is towards the top on this view.

Younger rabbits do not have as much fat, although their tissue is more delicate and can tear easily. The head of the rabbit is towards the bottom right in this view, opposite of the view above.

OVH-rabbit-11

The ovary is pulled out of the abdomen and clamped for removal. You can see the ovary as the small horizontal cream colored tissue in the center above the clamp. It is removed completely during the surgery.

OVH-rabbit-12

Special care is taken to make sure there is no bleeding after the ovary is removed. Several clamps are used, and several sutures (called ligatures) are put on the vessels that supply blood to the ovary. The next 3 views show our surgeon in the process of accomplishing this before the ovary is removed.

The unseen ovary is buried in the fat at the top, the surgeon is putting  ligatures on the blood supply to the ovary

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The first ligature has been placed

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The second one is in the process

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Once both ovaries and uterine body are ligated and removed the incision in the linea alba is suture. A special non-reactive and strong suture is used, that will slowly dissolve over several month.

OVH-rabbit-16

Our surgeon takes extra care to make sure they are put in properly. If not, we can get a hernia and intestinal organs can come out.

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The final row of sutures in the linea

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The final row of sutures in the skin. This will be removed at 10-14 days

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Before our patient wakes up we use the companion laser to minimize post operative swelling and enhance the healing process. Any natural thing we can do to aid the healing process is part of our approach of treating our patients like we want to be treated if we are in a similar situation. This includes the pain injection we give before our patient wakes up, and continues to the pain medication used at home. Far too often people have the attitude that pets don’t have pain because we just don’t see it. We prefer to err on the side of more pain medication than less pain medication.

Our nursing staff closely monitors all patients immediately post operatively and keeps them warm until they are fully awake

Rabbit-nursepostop

Once they are on their foot they are given lots of TLC and closely monitored for pain

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