should not be applied directly into wounds [ 49 ] . This means that EMLA could be used on unbroken skin in myiasis rabbits to relieve pain throughout treatment . This would further relieve stress and could reduce the need for heavy sedation or analgesic medication [ 50 ] .
Benato et al . found that 63 % of VNs [ 11 ] and 64 % of veterinary surgeons [ 30 ] were only ‘ fairly confident ’ in assessing pain in rabbits . This could indicate VNs ' limited knowledge of pain management in rabbits or limitations in the current research and literature . In addition , Banchi et al . [ 38 ] stated that there is no gold standard for assessing pain in rabbits , which reflects the limitations in the current literature . The above research implies that veterinary professionals are not completely confident with pain management , due to their limited knowledge .
Owners ' knowledge is also limited , and many do not know how to care for their rabbit [ 51 ] . This is concerning , as myiasis is a treatable and preventable condition [ 25 ] , and VNs should be educating owners , in accordance with the RCVS Code of Professional Conduct for Veterinary Nurses [ 13 ] . In a study of rabbit owners , more than 40 % obtained their knowledge of management and handling advice from veterinary practices [ 52 ] . Martin [ 53 ] suggests that the use of leaflets and ‘ rabbit awareness ’ weeks would be effective in educating owners on the signs of myiasis , so they can recognise them before the rabbit becomes critical [ 25 ] . This supports the need for veterinary professionals to have a good understanding of the myiasis rabbit so they can educate owners on their rabbit ' s welfare needs .
Conclusions
There are limitations to the current rabbit literature and a lack of knowledge about managing rabbit pain among veterinary professionals . However , the new BRPS is a validated pain scale , with clear descriptions , and it includes lop-eared rabbit breeds . This pain scale provides a way to include stress in the assessment and , by monitoring the patient from a distance , avoids increasing stress .
Intravenous fluid therapy is the gold standard for critical rabbits and should be used routinely in the emergency myiasis rabbit , with hypotensive fluid therapy used in critical cases . To reduce stress induced by catheterisation , EMLA cream can be applied precatheterisation to reduce pain . There is also an indication for the use of EMLA on unbroken skin to relieve pain .
When monitoring and assessing rabbits during hospitalisation , the use of electronic cameras can reduce stress caused by human interaction , which could enable more accurate assessments . The prey response can be reduced by removing repeated human interactions , so that pain can be managed more accurately and efficiently in veterinary practices . These observations from a distance can indicate the need for closer physical examinations in critical emergency situations .
There is also a need to educate rabbit owners , as very few owners check their rabbit ' s perineal area , so their approach to the care of their pet rabbit needs to be improved . Owners should be checking their rabbit ' s perineal area at least once daily . Improvements in rabbit care should be led by veterinary professionals educating their clients .
It is the VN ' s role to educate clients in animal husbandry , nutrition , behaviour and preventative treatment . This education promotes animal health and welfare but also can prevent rapid deterioration , as seen in critical myiasis rabbits . Early detection of the signs of myiasis by rabbit owners could reduce the frequency of emergency cases .
Finally , further research is required , as follows :
• An assessment of the various fluid types that can be used in intravenous therapy for rabbits .
• A study on the effects on recovery in emergency rabbit patients of intravenous fluid therapy versus subcutaneous fluid therapy .
• An assessment of the BRPS used to score rabbits in the clinical environment .
Acknowledgements
The author would like to thank the dissertation supervisor and tutors from Middlesex University for their guidance and support , and Lydia Jenkins , Louise Jenkins , Martina Caruana and others for reviewing the article .
Further reading
To read the full dissertation in the digital version of VNJ , scan the QR code or visit :
https :// vnj . bvna . org . uk / the-nursing-careimplications-for-the-critical-myiasis-rabbitlimited-to-pain-management-and-fluidtherapy / 0701804001690282330
22 Veterinary Nursing Journal