tpvets_logo.jpg (2726 bytes)TOA PAYOH VETS

Date:   19 January, 2010  
Focus: Small animals - dogs, cats, hamsters, guinea pig & rabbits.

Toa Payoh Vets Clinical Research
Making veterinary surgery alive
to a veterinary student studying in Australia
using real case studies and pictures

Dr Sing Kong Yuen, BVMS (Glasgow), MRCVS. Some cases are recorded below.
Case 1 recorded: 11 May 2005, Case 2 in 2007
 Case 3 in 2008, Case 4 in 2010.
Report Updated:  19 January, 2010 
Be Kind To Pets
Veterinary Education
Project 2010-0006

CASE 1. Sarcoptic Mange in Rabbits in Singapore follow-up after an anti-mite ivermectin injection

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Singapore rabbit - sarcoptic mange on nose 5 month-old Singapore rabbit with sarcoptic mange Singapore rabbit with Sarcoptic Mange mites
  Singapore rabbits with sarcoptic mange mites Singapore rabbit with mange mites

Crusty nose, ears and paws

Singapore rabbit - crusts have dropped off nose and paws Singapore Rabbits - 11 days after anti-mite injection Sarcoptic Mange Singapore rabbits recovering from sarcoptic mange
  Rabbit -11 days after anti-mite injection Sarcoptes Singapore rabbits recovering from Sarcoptic Mange infestation

11 days after the injection, I could see the red noses of the rabbits. The skin was still inflamed but growing new normal skin. The rabbits were sent home and should be recovering
 well if the mites had been eliminated in their cages.

Microscopic insects called sarcoptic mange mites burrow into the skin of the nose, feet, ear edges and eyelids of rabbits, causing itchiness and big crusty skin.  It is not known why the crusts of the nose keep growing bigger and bigger instead of sloughing off.  Do not abandon the rabbits.  Your veterinarian will be able to get one or two injections to eliminate the mites.  The mites don't infest human skin.  Singapore rabbit 5 days after anti-mite injection Sarcoptes Singapore rabbit 5 days after anti-mite injection Sarcoptes
  5 days after an anti-mite injection, the skin of the crusty noses is almost back to normal as the crusts drop off and the skin is cleaned. 
  Singapore rabbit 5 days after anti-mite injection. Sarcoptic Mange. Rabbit sarcoptic mange is a curable disease.  Owners need not use any cream or wash.  One or two injections by your vet should eliminate all the mites.  Consult your vet promptly.
Sore hocks develop suddenly in a rabbit used to standing on hind legs to beg for food. As the rabbit bears weight mainly on the hind legs, the lower part gets injured. This rabbit (picture below) lives in an apartment and likes to stand on its hind feet to beg for food.  It is free to roam the apartment and has not been kept in a cage for a long time.  

It does not stomp its hind feet angrily, according to the owner.  So how did it get sore hocks? Could it be the standing on hind feet?  It is hard to say.  It does walk on tiled floors. 

Sore hocks need veterinary attention. After that no more contact with the wood shavings in its cage for the next 30 days.  Daily washing of the sores will be necessary.  Newspapers are the cheapest bedding for such cases and the sores will heal quickly after the veterinary injections.

SORE HOCKS.  The black and white and the brown and white  rabbits had circular skin sores on the underside of its legs. These are sore hocks.
CASE 2 recorded in 2007. Death attributed to the ivermectin injection
Rabbit Sarcoptic Mange for past 4 months. Toa Payoh Vets.Many Singaporean pet owners ignore or buy some medication from pet shops to treat the sarcoptic mange in their rabbits. When they find that the medication was ineffective, they might consult the veterinarian. By that time, the rabbit is thin and in poor health.

Now, many Singapore owners wanted one visit and not need to consult  the veterinarian anymore. If the rabbit is already in poor health, one anti-mite injection may kill him. When the rabbit dies, family members may get angry with the vet and wants to know why.

In this case, the brown rabbit died over a week after the injection. The owner who was not present at the consultation asked me why.

She did not bring the rabbits for treatment but her representatives were informed that the injection was risky as the rabbits were thin and in poor health. It would be better if they had been treated much earlier.

The representatives (friends of the owner) decided to proceed with the injection and had accepted the risks. Only that one of the two cards dealt was the ace of death. Unhappiness resulted and explanations were demanded. When a pet dies, seldom do the owners trust the veterinarian. No second chance. They do not consult him anymore nor ever forgive him.

CASE 3 recorded in 2008. Delay treatment in high-fevered rabbits
  Rabbit. Fever & Sarcoptes. Not Eating 5 hours ago. Now eating after antibiotic injection. Toa Payoh Vets
"Crusty nose, ear edges and paws in this rabbit suggested sarcoptic mange infestation," I said to the mother. "Usually the eyelids are infested too."

"There is one crust on the eye, " the elder sister's sharp eyes pointed to a small barely visible 3-mm rough skin crust on the upper eyelid of one eye.  This 7-year-old girl, as willowy as her mother, has the eagle eyes of an excellent scientist or doctor. The rabbit ate some 3 hours after an antibiotic injection. More faecal lumps are seen when the rabbit started to eat.  
In Dec 7, 2008, the owners of the rabbit with Sarcoptic Mange complained that the rabbit was not eating and had crusty ears as well as paws.

"Get a skin scraping to show the mites," I told my assistant Mr Saw. "It is best for owners to see the mites under the microscope."

"I can take your word for it," the mother said. "I was told by my family members that the rabbit has mange."

Mr Saw left the consultation room promptly to get a scalpel blade to scrape the skin to get the mites buried in the skin.

"No need to do that," I stopped Mr Saw. There are some raw skin areas with blood in the right ear. Mites would be found in the bleeding spot (see picture). He got the skin scraping onto the slide and put on some oil. Actually there was no need to use oil. Water would do but since he had done it, I did not comment.    

Now, what will be the management of this case at least cost for the owner?

1. Treat the fever by antibiotic injection for 3 days either by daily visit to the Surgery or by warding the rabbit. The rabbit was warded at Toa Payoh Vets
2. Give the anti-mite injection when the rabbit has recovered from fever fully in 3 days' time.

1. On Day 2, the rabbit had a normal temperature of 39 deg C. The owners were happy. He was eating as evident by lots of round stools blanketing the wood shavings. "2 days before we  consulted you, the rabbit just would not come out of his crate as he normally would hop out quickly," the mother recalled on the 3rd day of visit at Toa Payoh Vets. "We thought he was afraid of the cat."
2. On Day 4, the rabbit's temperature went up to 40.1 deg C. As he was eating and passing more solid stools all over the wood shavings, I decided that he had to be treated with the ivermectin injection SC. The rabbit went home. The mites had to be eliminated fast, otherwise this rabbit would get high fevers again and would not eat. The total veterinary cost was around $120.00 in this case.  

3. Infection was due to another rabbit during a visit of a friend who brought in 2 rabbits some 4 months ago.    

The rabbit sarcoptic mange is 100% curable. Rabbits do not die if they are in good health (no fever, eating) when given the anti-mite injection. If the owner insists on treatment despite poor health, the owner has to be given a written advice that he has been informed. This is to avoid misunderstandings and anger in the event of death from other members of the family.
Case 4 recorded in 2010.  In some rabbits, 2 injections of ivermectin are necessary as shown in pictures below.

SOME RABBIT REFERENCES - Ileus in Rabbits - Dental Problems in Rabbits - Urinary Problems in Rabbits - Respiratory Problems in Rabbits - Head Tilt in Rabbits

Singapore Toa Payoh Vets in 1990sToa Payoh Vets (left) before renovation, prior to 2005. 
Be Kind To Pets
Veterinary Education
Project 2010-0006
tpvets_logo.jpg (2726 bytes)Toa Payoh Vets
Clinical Research
More cases are at: Rabbits & Guinea Pigs

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