Health Special: Malocclusion in Rabbits

Malocclusion, referring to the misalignment of teeth, is a common ailment of the house rabbit. As with dogs bred to have “cute” smushed-in faces, certain breeds of rabbit, like the dwarf varieties, are especially prone to congenital deformities of the mouth. What makes malocclusion so serious for bunnies, however, is that rabbit teeth grow continuously. Normally, their teeth match up perfectly, so they’re kept ground down by the action of chewing. (Just one more reason giving your rabbit unlimited hay is so important!) Since maloccluded incisors don't match up, the teeth don’t file down and instead continue growing endlessly. As the incisors become overgrown, eating and drinking become harder and harder for the rabbit, all the while causing significant discomfort inside and outside the mouth as the teeth grow into the roof of the mouth and dig into the surrounding skin of the face. Untreated, this malformation can cause a slow and painful death.

Trimming teeth is not recommended because microfractures, a common sequelae, can lead to tooth root abscesses. Grinding down the teeth every two months or so is sometimes the only viable solution for the cheek teeth; but maloccluded incisors can also be extracted, fixing the problems permanently.

Recently, a rabbit with malocclusion and severely overgrown incisors arrived at the local shelter. Due to his complicated and chronic medical condition, he was slated for euthanasia. 

I, on the other hand, wasn’t ready to give up that easily. After consulting with some fellow rabbit experts at House Rabbit Network, I learned that extracting the rabbit's incisors could give him a chance at being healthy, and therefore, adoption. It seemed simple enough—the defective six front teeth would be removed, and after the mouth healed, he would learn to use his lips to pick up food and use the rest of his 22 teeth to grind his food. I spoke with a fantastic veterinarian at the VCA Wakefield Animal Hospital who explained that the surgery was relatively straightforward, the recovery was minimal, and, she said, the rabbit would be as good as new when it was over. In fact, he would even have a slight advantage over rabbits looking for homes—with no front teeth, rabbit-proofing would be a breeze!

I immediately brought the rabbit, who I had named Charley, home. He was severely underweight and malnourished from weeks of eating difficulties, so I spent a couple days feeding him a high-calorie, high-fiber, easy-to-chew diet, which included Critical Care, oatmeal, canned pumpkin, vegetable medley baby food, chopped strawberries, collard greens and cilantro, and even timothy hay broken into small, bite-sized bits. He chowed down for two days straight, and proved his will to live by bouncing all over my house and spending hours sleeping in my lap. Fortunately, House Rabbit Network had offered to foot the bill for the surgery, so after he had regained some strength, we were ready. On an early Wednesday morning, we drove up to Wakefield and Charley had his six front teeth pulled (he was also neutered at the same time). I picked him up that evening, and he was, though drugged, already acting a little feisty. By the next morning, he was eating Critical Care and pumpkin mush and three days later was eating entire bowls of pellets, chopped up greens, and even his hay.

He’s now a happy, rambunctious little guy, and might I add, perfectly adoptable. I hope this story inspires other owners and shelters with rabbits with dental problems to consider this alternative. As Charley sprints around my living room like a maniac, I can say with full confidence, that incisor extraction is a fantastically helpful surgery, a procedure we would both recommend to anyone.

Charley Before

Charley After

Health Special: Lead Poisoning

While it is widely know that pregnant women and children are at risk for lead poisoning, the danger faced by pets is less recognized. Of household pets, rabbits at an elevated risk due to their nibbling nature--from ingesting, in addition to inhaling, paint particles when they lick or chew on the walls.
Lead poisoning is a relevant danger in areas with older buildings, especially in New York and Massachusetts. Unfortunately, in these areas, virtually all apartments built before 1978 used lead-based paints. In greater Boston, where homes are often 100 or more years old, the incidence of lead poisoning in rabbits is alarmingly high; yet, there is little literature or verbal warning available to owners. Lead poisoning is all too often lethal in rabbits, with excruciating belly pain and possible neurological affects, but the good news is that it is preventable.

Some preventative measures:
-Talk to potential landlords before moving in to get an accurate history of the place and know your tenant rights.
-Look into the possibility of deleading your apartment. This can be quite pricey but in some instances the landlord is legally obligated to take care of it.
-Paint. The more layers there are over the lead-based paint, the less of a chance of inhalation or ingestion.
-When remodeling, follow specific guidelines to avoid exposing lead-laced dust particles. Look into the EPA's report on dos and don'ts.
-Put up adhesive contact paper around the baseboards and lower walls that the rabbit can access.
-Supervise your rabbit. A house with lead can never be 100% rabbit-proof. You should always be aware of where your rabbit is and what she is doing.

Signs and symptoms of lead poisoning:
Signs and symptoms of a lead poisoned rabbit include loss of appetite, decrease or cessation of fecal droppings, diarrhea, listlessness, depression, sudden change of litterbox habbits, and even some neurological changes. If you notice any of these symptoms, especially the diet and behavioral changes, get your rabbit to an experienced veterinarian immediately, where a simple blood test can determine the presence of lead.

Treament of lead poisoning:
Treatment for lead poisoning is chelation therapy. Your vet will also administer fluids and pain medication and may need to syringe feed your rabbit to overcome ileus (arrested stomach contractions).Sometimes right after syringe feeding, your rabbit will be willing to eat a few bites of fresh food. Offer her favorite foods, anything to get the stomach going again. Fresh, aromatic herbs such as cilantro, basil, parsley are good, along with dark leafy greens like romaine. (Though nothing conclusive has been proved, various sources claim that cilantro suppresses lead deposition. Since this herb is otherwise delicious and healthy for rabbits, it's an excellent treat at this time.) The point is to keep your rabbit alive while the chelation removes the lead from the body.
One thing to note is that the chelation therapy can lead to calcium build-up in the bladder, often creating a painful to excrete sludge-like matter. If your rabbit is dribbling, place down Puppy Pads over the carpet and also the cage floor so the rabbit does not have to jump in and out of the litter box.

The bottom line:
Lead poisoning can be serious and devastating, but it is treatable and most importantly, highly preventable if the proper precautions are observed. Spread the news about lead poisoning to all your rabbit-owning friends and acquaintances. You may be saving a life!


*This article is dedicated to Dr. Mickley and Dr. Orcutt at Angell Animal Medical Center in Boston, who treated my rabbit, Graysie, and to my former roommate, M. Offit, who was of life-saving assistance, during Graysie's battle with lead poisoning in November of 2006.