Any surgery can be physically and emotionally hard on both you and your companion rabbit, since there's really no such thing as a surgery that is 100% risk free. I hope the following information will help you and your rabbit get through either emergency or elective surgery with maximal safety and minimal stress.

Pre-operative Care

1. Be sure to schedule surgery with a veterinarian who is very familiar with the rabbit's unique anatomy and physiology, and who has had a great deal of experience and success with rabbit anesthesia and surgery. You might wish to start with the House Rabbit Society veterinary listings at the House Rabbit Society Veterinarian Listings. Veterinarians specializing in "exotic" species are often rabbit-savvy. But before you commit to surgery, make sure. The House Rabbit Society has an excellent site on how to find a good rabbit vet that should make this easy.

2. If possible, schedule the surgery so that you can bring your bunny home with you the same evening. Spending the night in an unfamiliar place, surrounded by strange people and the sound and smell of potential predators, can add unnecessary stress and lengthen your rabbit's recovery. Very few veterinary hospitals have 24-hour monitoring staff, and your bunny will probably not be watched for at least part of the night if s/he stays in the hospital. Home, where he can be monitored lovingly and regularly, is almost always best.

3. If your rabbit is bonded to another rabbit, it is important to bring them to the hospital together so that the mate can offer moral support in the pre-operative waiting period and during recovery. It also will help prevent the dreaded un-bonding phenomenon that sometimes occurs when one member of a bonded pair comes home smelling of Strange and Scary Hospital. The last thing you want your bunny to suffer after surgery is violent rejection by his/her own mate! Unfortunately, this goes for bonded groups, too. It is best to bring everyone in for moral support and to prevent post-operative social rejection.

4. DO NOT FAST YOUR RABBIT PRIOR TO THE SURGICAL APPOINTMENT, even if the person scheduling your appointment tells you to do so. (Receptionists giving such instructions often recite the rules for dogs and cats, not realizing that the rules are different for rabbits.) Here are the reasons why some (inexperienced with rabbits) clinic staff might suggest fasting, and why these reasons do not hold true for rabbits:

a. Some surgical anesthetics can cause nausea. One of the reasons veterinarians fast most animals pre-operatively is the risk of vomiting during surgery or recovery. This can cause accidental aspiration, the breathing of liquid into the lungs, which can be fatal. However, rabbits lack the vomiting reflex, and are physically almost incapable of regurgitation. In rabbits, the risk of aspiration due to vomiting is negligible.

b. Feeding your bunny before surgery helps the gastrointestinal (GI) tract remain active, which will speed recovery. Rabbits who become inappetant (i.e., not wanting to eat) after surgery are more difficult to "jump start" back to normal eating habits. Even relatively brief periods (24 hours) of anorexia can result in GI stasis and some liver damage in rabbits.

c. Some veterinarians may be concerned that food in the intestine will interfere with their obtaining a correct body weight, necessary for calculating the proper dose of injected anesthestic. This should not be a concern with rabbits because

• Under normal circumstances, the intestine of a healthy rabbit is never empty, and should not be. Rabbit GI passage time is relatively lengthy (approximately 12 hours), so to get the intestine completely empty would take a very long time. Also, since an anorectic rabbit can begin to suffer liver damage in relatively short time when the GI tract is empty, it is not advisable to fast the rabbit before surgery.

• If the veterinarian is using isoflurane or sevoflurane, the gas anesthetic of choice, body weight is not an issue, since the gas is adminstered through the respiratory tract. Even though isoflurane gas is more expensive than injectable anesthetics, it is worth the extra cost to ensure a safer surgery and faster recovery.

  IMPORTANT NOTE: Although intubation allows much more precise administration and monitoring of gas anesthesia, and is safer in case of an emergency cardiac or respiratory arrest during surgery, please be aware that intubation of rabbits is a delicate procedure requiring a great deal of practice and expertise. If your vet is NOT experienced with rabbit intubations, it is probably much safer for the isoflurane to be administered via mask. You might wish to ask your vet about this before you schedule the surgery.

• Injectable pre-anesthetic doses are not likely to be affected by the slight difference in weight of a rabbit with a full intestine.

5. Take a bit of your rabbit's normal food (pellets and hay) along as well as a small bag of favorite fresh herbs. Ask that the foods be offered to your bunny after the anesthesia has worn off. The sooner bunny starts nibbling after surgery, the quicker the recovery.

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Post-surgical Care

Pain Management

Any surgery, including a neuter or (especially) a spay, will make bunny sore for one to several days.

Pain management in rabbits is critical to uneventful recovery.

Most experienced vets routinely administer analgesics such as metacam/meloxicam, Banamine (flunixin meglumine), buprenorphine, tramadol, etc. before or shortly after surgery, so the bunny will be as comfortable as possible while waking up.

Ask the veterinarian about this before scheduling surgery. If no pain medications are going to be given to your rabbit, you should probably seek a different vet!

Before bringing your bunny home, ask your vet about follow-up pain management at home, when the initial dose wears off.

Post-surgical monitoring and care
1. Warmth

• Immediately after surgery, keep your bunny warm and quiet.
• Provide a warm water bottle or other heat source (that can't leak, burn, or cause injury) wrapped in a soft towel for bunny to lean against or move away from, at his/her discretion. DO NOT use any type of electrical heating source that could be an electrocution risk, should bunny chew on it!
• Rabbits will tolerate a soft, light blanket better than a heavy one.

2. Post-surgical Contact and Handling

• Don't hover. A bunny after surgery may feel groggy and unhappy, and not in the mood for cuddling.
• Unless you know that your rabbit wants cuddling, it's best to let him/her recover quietly and without more human interruption than is necessary to ensure that all is well.

3. Post-surgical Monitoring for Trouble

• Be sure to carefully (and gently) check the sutures daily for a few days after surgery to be sure the bunny isn't chewing them.
• Many vets use subcuticular (under the skin) sutures that cannot be chewed out, and may even put a line of surgical glue over the incision for extra strength. Ask your vet about this before surgery, so you will know what to expect.
• Be alert for excessive bleeding (a bit of oozing is not unusual, but outright bleeding is a cause for concern)
• Excessive redness or signs of infection such as swelling or pus are not normal.
• If you see anything that causes concern, call the vet immediately for further instructions.

The Healing Process
If all goes well, your bunny will start to perk up noticeably by the second day after surgery. Healing begins quickly; adhesions (normal tissue repair) usually start to form within 24 hours of surgery in rabbits. In the case of spay/neuter, a male will usually recover more quickly, since a neuter is less invasive than a spay.

• A male is usually ready for normal activity within a few days of surgery.
• A female might take a bit longer to recover from a spay.

Recovery time will depends on the type of surgery, the surgeon's technique, the surgery itself, and any complications.

1. Post-operative Preventive Care

• Under normal circumstances, rabbits do not require post-surgical antibiotics to prevent infection.

• Except in very unusual cases, an E-collar ("Elizabethan collar" -- that plastic cone around the neck that prevents suture chewing and makes your companion look like a satellite dish) is not necessary for a rabbit, and will cause more stress than it's worth.
• If your bunny does try to damage her incision and ends up wearing an E-collar for a day or two, you will have to hand-feed cecotropes, since s/he will not be able to reach them for normal ingestion.
• This is how much we love our bunnies.

  2. Monitoring the Poop: Signs of Recovery or Trouble

  • It is not unusual to see a few soft or mucus-covered stools after surgery. Fecal pellets should return to normal within a day or two, once your bunny has regained normal eating habits.
  • If you continue to see mucus in the fecal matter beyond a day or two, or if fecal production stops, consult your veterinarian immediately.
  • If your rabbit hasn't eaten anything within 24 hours of surgery, contact your veterinarian.
  • Monitor the output of fecal pellets closely. If fecal output slows or stops after surgery for more than 36 hours, your bunny may be suffering from ileus, an uncommon but serious post-surgical complication. If this happens, refer to Gastrointestinal Stasis: The Silent Killer for emergency information.

    Post-surgical Social Interaction
    

  • Keep your rabbit quiet for a few days after surgery, but try to maintain normal feeding and bonding times.
  • There is no reason to separate bonded pairs or groups as long as the bunnies interact calmly.
  • A post-surgical bunny will usually manage his/her own activity quite well, and knows not to "push it" too soon.
  • If your bonded pair continues to mount or play too roughly after surgery, then it might be necessary to physically separate them for a day or two to avoid injury. This is almost never necessary.
  • However, if you must separate the bunnies, be sure they can see, smell, and touch one another even if they don't have full physical contact.
  • Remember: the rabbit who has undergone surgery needs the emotional support of his/her mate for an uneventful recovery. Allowing them to be in contact reduces the chances that they will fight upon full re-introduction.

    Post-surgical Nutrition
    

  • Offer your rabbit a heavy ceramic bowl of water, even if you usually provide a sipper bottle. A rabbit needs to drink after surgery, but often won't do so if s/he has to "work" for water. A well-hydrated bunny recovers more quickly and feels better in the process.

  • If your bunny is reluctant to eat after surgery, offer a favorite treat. Fragrant herbs such as basil, parsley, dill and mint seem to appeal to a bunny recovering from surgery.
  • Rabbits seem to prefer healthy foods such as fresh greens and hay while they are recovering, rather than starchy treats, which is all for the better.
  • If your bunny does suffer complications from surgery that cause him to stop eating, you may need to hand-feed for a few days afterwards to help get the GI tract back to normal. Ask your veterinarian for advice about whether this is necessary. Products made specifically for recovery feeding include Critical Care (Oxbow Hay Company) and Critter be Better (American Pet Diner). Or you can make your own recovery food:
    • Pour warm water or chamomile tea over a 1/4 cup of pellets in a bowl
    • Allow to sit for about five minutes, letting the pellets "fluff"
    • Add additional water or chamomile tea and mix well to make a pudding-like slurry
    Always use any type of recovery food "slurry" with caution:
    • Never force too much. Allow bunny time to chew and swallow.
    • Use a wide-bore syringe or plastic dropper with the narrow tip cut off to safely administer
    • If the tip is too narrow, larger bits can get stuck. Forcing a stuck chunk through the tip can cause a huge blob of food to enter the mouth too quickly, and could cause aspiration.
    • Squirt the food into the mouth sideways, behind the incisors, not straight back.
    • NEVER try to force feed an animal who is not swallowing normally. Consult your veterinarian immediately if this is the case.

    Special Notes for Neuter Surgeries

    The de-sexing of a male animal is known as a castration, or neuter. It involves removing the testicles and some associated structures. (Some tubules and other structures are left behind, as they are located in the lower abdomen.) The purpose of neutering is to remove the main source of testosterone and to permanently stop the production of sperm. While testosterone has its subjective benefits, it also has its risks: it suppresses the immune system, increases aggression, and generally shortens the lifespan of the individual producing it. For this reason alone, your male bunny may life a longer, more peaceful life if he is neutered.

  • Although most rabbit-savvy vets perform pre-scrotal neuters, in which the scrotum is not cut, a few old-fashioned practitioners still remove the testicles directly through the scrotum. If your male bunny has undergone a scrotal neuter, he may be very sore and swollen (which is why the pre-scrotal method is preferred; ask your vet beforehand, so you will know what to expect.)

  • A sitz bath in a dilute solution of betadine (about 1 tablespoon of povidone iodine per cup of lukewarm water) can be very soothing to a bunny who has undergone a scrotal neuter. But wait until a day after surgery to do this, to allow some recovery from anesthesia and the stress of the surgery itself.

  • NOTE THAT MALES MAY HAVE VIABLE SPERM FOR SEVERAL WEEKS POST-NEUTERING! Do not place your male with an intact female until a minimum of three weeks after his neuter surgery! Some males can retain viable sperm for even longer.

  • Click here for a complete technical overview of rabbit spay and neuter procedures provided by DVM Newsmagazine.

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    The key to success in any elective or necessary surgery is good preparation and attentive care afterwards. A rabbit-savvy veterinarian can make this process as anxiety-free as possible, and will give you all the advice you need for followup care. I hope this makes your job easier, and may all your sutures be removed or absorbed without incident.

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