Wound management

Wounds occur from various things such as surgery, ie neutering, wounds that happen accidently, such as after a fight between rabbits or other incident, and wounds which occur due to a disease process, ie pododermatitis or flystrike. The management that these wounds require, will vary depending on the health and temperament of the individual rabbit, and how extensive or contaminated the wound has become.

Wounds occur for many reasons. Rabbits can inflict wounds upon each other during a fight using their teeth and nails. These wounds can be serious, causing tears to the ears, large skin wounds on the body, injuries to the eyelids, nose, and genitals. Rabbits can also suffer wounds caused by sharp items in their enclosures, from other animals, such as cats and foxes and sometimes you may not know what has caused a wound on your rabbit and just notice one.

Other times wounds are a result of your rabbit having undergone surgery, such as when they are neutered, after surgery to remove/debride an abscess, after a limb amputation or enucleation. They can also be the result of a medical condition, such as pododermatitis (sore hocks) or from flystrike.

The way that wounds are treated and heal, depends upon the cause and severity of them.

Wounds can be classified based on if they are clean or the degree of contamination contained within them:

• A clean wound: these are the wounds that are surgically created under aseptic (sterile) conditions (i.e. neutering). These wounds typically heal quickly in optimal conditions.
• A clean contaminated wound: these wounds have some contamination from bacteria or debris but are easily cleaned. These may be cuts or puncture wounds caused by an object in your rabbit’s enclosure. These wounds heal well when they are cleaned promptly and cared for in optimal conditions.
• A contaminated wound: these wounds have a lot of contamination from bacteria or debris and require thorough cleaning and ongoing care to promote healing. They can take a longer amount of time to heal and require close observation to be sure the wound isn’t getting infected.
• An infected wound: these wounds are the most difficult to treat. These wounds have bacteria within them causing infection and inflammation which appears like redness, heat, swelling, and odor. There may be discharge of pus and the rabbit may appear unwell as it tries to fight the infection. Any type of wound can become infected.

The way these wounds are treated is very different.

You should take your rabbit to see your veterinarian at the first sign of any wound. If the wound is large, bleeding, or the rabbit is distressed; it is an emergency, you must take your rabbit to your veterinarian straight away, or if they are closed, then contact the Out of Hours service.

If the wound is small, and is not bleeding and the rabbit is eating, drinking, moving about normally and seems otherwise well, then you should arrange to take your rabbit to see your veterinarian within a few hours, so they can be assessed.

If you examine your rabbit’s wound/s and notice any fly eggs/maggots, even if your rabbit seems well, you must take them to see your veterinarian immediately, regardless of the time of day or night.

Your veterinarian or vet nurse will advise what wound care is required when you collect your rabbit.

Surgical wounds

Wounds that have been sutured together, such as following neutering, lump removals, enucleation, limb amputation require close monitoring for any signs the rabbit is bothering the wound by excessive licking or chewing of the area. Call your veterinarian as soon as possible if you notice the rabbit has removed its wound dressing, or if you notice the wound bleeding, protruding more than normal, or if you notice pain (such as the rabbit paying a lot of attention to the area).

Your rabbit should require no antibiotics, but following surgery, they should be on pain relief for several days afterwards. These wounds should heal fully within 7-10 days. Contact your veterinarian if there is any delay in healing.

Clean contaminated wounds

Your veterinarian will have removed debris from the wound, by flushing and cleaning the wound with sterile saline, which may need to have been performed under sedation or general anesthetic. If possible, your veterinarian will also have sutured the wound together; to enable it to heal quicker, but this depends upon the size and location of the wound. Your veterinarian may recommend antibiotics, and pain relief must be provided.

Your veterinarian will ask you to monitor the wound for signs of infection and wound breakdown and if the wound has been left open, they may recommend you flush the wound at regular intervals, which they will demonstrate to you. Depending upon how large the wound is, and if it is closed or open, these wounds should heal within 7-21 days. Contact your veterinarian if there is any delay in healing.

Contaminated wounds

As with clean, contaminated wounds, your veterinarian will have flushed and cleaned the wound, likely under sedation or general anesthetic, to remove as much of the contamination as possible. As all of the debris is not possible to remove, these wounds are typically not sutured back together so that the skin doesn’t close up over the infection causing an abscess or wound breakdown. Flushing and cleaning of these wounds is important to reduce bacteria and help to keep it clean so that it can heal. Flushing and cleaning of the wound may have to be repeated often over several days, so your rabbit may need to be admitted into your veterinary practice until it can be cared for at home.

Once discharged it is important all wounds are closely monitored. Your veterinarian will advise regular checks and you may need to flush and clean the wounds at home and give pain medication and antibiotics as required. Keep your rabbit in a clean environment, on bedding that will not stick to and contaminate the wound further, ie Vetbed, but make sure hay is available still at all times to eat.

Infected wounds

Infected wounds are often cleaned and left open (not sutured closed) allowing it to heal from the inside out. Leaving these wounds open allows for the bacteria to be regularly flushed out which helps the wound to heal faster. If the wound is large or deep, such as those that follow flystrike or abscesses on the jaw they may require daily or twice daily flushing with sterile saline to keep them clean and encourage faster healing.

As with contaminated wounds, keep your rabbit in a clean environment, on bedding that will not stick to and contaminate the wound further, ie Vetbe), but make sure hay is available still at all times to eat. Antibiotics and pain relief are required for many weeks and these wounds can take weeks or months to heal. The wound may require further treatment and surgery under general anesthetic to remove necrotic (dead) tissue. If the wound does not heal, or the infection spreads, euthanasia may be the most humane option.

For quick healing of wounds, rabbits need rest, warmth, good nutrition, and minimal opportunities to contaminate the wound.

With all wounds it is important to make sure that bedding does not stick to the wound. Avoid materials such as wood flakes, and make sure the environment is cleaned regularly.

Always provide good nutrition to the rabbit as it is critical to promote optimal healing. Hay must be available for the rabbit to eat at all times.

It is important to keep your rabbit warm, and comfortable so that it can rest. Housing them inside, in a quiet safe environment ensures the best opportunity for healing and helps to prevent further contamination. In summer it also helps prevent flies landing on the wound (flystrike) which is especially important with open and infected wounds.

Rabbits need plenty of rest to ensure their wounds have a chance to heal quickly. If you have two rabbits, you will need to ensure the other rabbit allows the one with the wound to rest as much as possible. It is also important that the other rabbit does not interfere with the wound of their companion. For clean wounds or those which have been sutured together, it is usually unnecessary to separate companion rabbits, but for contaminated or infected wounds it may be necessary to keep them separate, but so they can still see and smell each other, by placing a wire divide between them both.

Elizabethan collars should not be used on rabbits. They prevent the rabbit from grooming and eating their droppings (caecotrophs). They also cause the rabbit stress, inhibiting natural movement and rest.

Pet medical T-shirts may be used to cover wounds if the rabbit is bothering it, or if the wound is getting soiled. Your vet will determine if a covering is needed and provide you instructions for use.

Rabbits tend to interfere with their wounds if they are painful, so if your rabbit is licking or trying to chew their wound, it is likely their pain relief if not sufficient and you should speak to your veterinarian.