Plus-Hex CLINICAL
Introduction
Rabbits are becoming an increasingly popular pet in the UK, so it is important to raise awareness of their welfare needs and to understand the common diseases caused by selective breeding.
Lop-eared rabbits are not dissimilar to brachycephalic dogs, having a flat and somewhat in-turned nose; this can lead to dental malocclusion and chronic dental disease, with these patients often requiring regular dental treatment throughout their lives.
It should be noted that some cases may also develop dacryocystitis and other ocular disorders. Alongside this, lop-eared rabbits are more likely to have aural pathology due to the conformation of their ears.
Cerumen( wax) will build up in the ear canal, and the movement of this wax can lead to disease. This thick cerumen could travel laterally and under the skin, causing an ear base swelling, or, alternatively, deep into the middle ear, causing severe pain [ 1 ].
Some rabbits may be likely to develop abscesses, and the pus can rupture the bone of the tympanic bullae [ 1 ]. In more advanced cases, torticollis and facial asymmetry may be present due to nerve damage [ 1 ].
It is important to be aware of the clinical presentation, but also to consider that some cases will be subclinical. Appropriate owner education, particularly for owners of predisposed breeds, is important so that these patients are presented for treatment as soon as possible.
Ear disease is not associated solely with lop-eared breeds of rabbits; all breeds may be affected and some cases may be subclinical.
Background
This article looks at the case of a mini lop-eared rabbit, which had presented with ocular disease for several years before the onset of aural-related clinical signs. The case highlights that not all patients display clinical signs associated primarily with ear disease.
Learning outcomes
• Know the clinical signs of ear disease in rabbits
• Recognise the importance of subclinical cases
• Understand that early diagnosis is key to a better prognosis
Clinical signs and types of aural pathology
Otitis externa
Rabbits with Psoroptes cuniculi ear mite infestation are more likely to scratch, causing regions of alopecia behind the pinna and in the cervical region. A thick brown exudate may also be present [ 2 ]. Commonly, a crusty exudate will be seen extending on to the pinna and pruritus is extensive [ 3 ]. The patient may show signs of pain and anorexia.
Otitis media
This normally affects the middle ear. Pasteurella multocida infection may commonly be seen in these cases. Clinical signs include lethargy, anorexia and gastrointestinal stasis; some cases may be subclinical [ 3 ].
Otitis interna
Otitis interna affects the inner ear. Clinical signs may include torticollis, anorexia, lethargy or irritability and tooth grinding. In some cases,‘ cold’-like signs such as nasal discharge and eye and throat disease may be present [ 2 ]. Ataxia and circling due to dizziness may also be seen. Neurological signs include facial nerve paralysis and Horner ' s syndrome [ 3 ]. More severe forms of the disease will cause neurological signs and the patient is likely to be in pain. Use of appropriate analgesia is indicated.
Due to the conformation of the lop ear, bacteria are more likely to become trapped and cause otitis externa and media.
Management and diagnostics
Computed tomography( CT) is the preferred method of diagnosis, compared with radiography, as the patient can also be checked via CT imaging for dental disease along with respiratory complications, and the eustachian tubes can also be examined more closely [ 4 ].
Masses in the ear base are easily palpated and exudate can be observed. Taking swabs of discharge is indicated for culture and sensitivity testing to ensure that if surgery is undertaken an appropriate antimicrobial can be prescribed. This will lead to better treatment outcomes and reduce the likelihood of antibiotic resistance.
It is also advised that a sample be taken for culture and sensitivity testing directly from inside the abscess capsule, as the pus itself can be sterile and the bacteria actually sit inside the capsule surface [ 4 ].
Volume 40( 5) • October 2025
41