Division of Zoological Medicine, Faculty of Veterinary Medicine, Utrecht University, Utrecht, Netherlands
After the dog and cat, rabbits are the most frequently seen companion animals in practice. Owners are willing to spend more and more money on these animals, thereby making it possible to provide more advanced treatments compared to one or two decades ago. Before going into the possibilities that have become available, it is important to give attention to the change in regulations on the use of antibiotics in (veterinary) medicine. Due to the staggering amount of multi-resistant bacteria causing infection in people, but also in animals, the World Health Organisation (WHO) compiled a list of critically important antimicrobials by applying the WHO developed criteria to rank antimicrobials according to their relative importance to human medicine. Fluoroquinolones, 3rd and 4th generation cephalosporins, macrolides and glycopeptides have been classified as those of the highest priority. The most commonly used antibiotic in rabbits of de past decade (enrofloxacin - Baytril®), may not be automatically used in rabbits anymore. Alternatives are luckily available, thereby making it still possible to effectively treat rabbits with bacterial infections.
It has also become clear that pharmacokinetic studies on a variety of drugs are needed to ensure that effective plasma levels may be achieved. The need for these studies can be demonstrated with 3 examples: 1) Selamectin in rabbits needs to be given in a dose of 20 mg/kg every 7 days to be effective in treating flea infestations. This is 4 times more frequent compared to dogs. 2) Meloxicam needs to be given in an oral dose of 1 mg/kg (at least 5 times higher compared to the dose in dogs) to reach plasma levels which are known to provide analgesia in other species. In a following study the research group was able to demonstrate safety of the use of this drug for at least 29 days. With these data becoming available, it triggers the veterinarian to rethink the use of other analgesics for which no pharmacokinetic data are available, but also on the longevity of treatment protocols for those animals that need long-term analgesic therapy. 3) The depot-GnRH agonist deslorelin has been found effective for non-surgical neutering in dogs, cats and ferrets. Although an initial case report showed a promising effect of the use of this hormone containing implant, a recent study has shown that in bucks deslorelin does not result in decreased testosterone concentrations, nor in the absence of spermatogenesis. This drug is therefore not considered a suitable alternative for surgical castration in bucks.
Another treatment option frequently used in dogs and cats is the use of prescription diets for which a large range has been developed and is commercially available. Recently, some prescription diets have become available for rabbits as well. Long-term feeding trials will, however, need to be evaluated to establish the true efficacy of these diets, as currently no evidence on their efficacy is lacking.
Aside from the medical and nutritional therapeutics, new surgical procedures have become available. A good example can be found in the book on ear surgery which has recently come available in which not only provides an excellent overview of the anatomy, but also description of surgeries to alleviate inner ear problems which were hardly recognized a decade ago. This book not only provides a good description of the surgeries, but also contains high quality images and instruction videos.
Finally, treatment modalities such as radiation therapy have become available and have proven to be successful in the treatment of thymoma in rabbits. With this technique it has become possible to considerably decrease the tumour in size, prolong a considerable period in which the rabbit is disease free and thereby increasing the welfare of the rabbit.
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