An investigation into how accurately UK rabbit owners identify pain in their pet rabbits.

BACKGROUND: Rabbits are popular family pets. They are prey species and so have evolved to hide signs of illness and pain. Recent research has developed robust pain scales for use in a clinical setting, but to date none has examined rabbit owners' ability to recognise pain in their animals. This study investigated how owners identify pain in their pet rabbits and their ability to correctly identify different levels of pain, in order to determine any need for owner education in this area. METHODS: Owners were recruited via Facebook and a two-part online survey was distributed. Part one collected data on demographics, owners' knowledge of pain signs and beliefs about pain in rabbits. Part two asked respondents to pain score eight videos of rabbits in different levels of pain for comparison to pain scores made by three experts. We used a simplified version of the Bristol Rabbit Pain Score (BRPS) which involved a single 0 to 3 scale. We explored the number of pain signs each respondent could list, the total score given to the videos, and their deviation from the experts' scores. RESULTS: A total of 500 respondents completed part one of the survey and 345 additionally completed Part two. Respondents were on average able to state five signs of pain (range 0-12), but females stated significantly more (p = 0.018), as did those who worked with rabbits (p = 0.004) and those with experience of their rabbit having an operation (p = 0.01). Overall, 98.6% of respondents thought rabbits felt pain as much or more that dogs and cats. In Part two, respondents more frequently agreed with the experts when identifying rabbits in no pain (88.8%) and severe pain (65.2%), but there was lower agreement when identifying mild (28.4%) and moderate pain (43.2%). Respondents overall rated pain lower than experts with an average total pain score of 11.9 compared to 18 given by the experts. CONCLUSIONS: Most rabbit owners are able to list numerous pain signs and are generally able to identify pain-free rabbits and those in severe pain. Owners' ability to differentiate between mild and moderate pain is more limited and could benefit from training in the subtler signs of pain. Veterinary professionals are well placed to educate owners about signs of pain in rabbits and should be aware of areas where owners' knowledge can be improved.

Determining a cut-off point for intervention analgesia in rabbits using the Bristol Rabbit Pain Scale.

BACKGROUND: The objective of this study was to determine the threshold of the Bristol Rabbit Pain Scale (BRPS) indicating the need for intervention analgesia. METHODS: Fourteen members of veterinary staff were recruited to rate rabbits (n = 71) in acute pain. Observers in group A (n = 7) were asked to score each rabbit using the BRPS, while observers in group B (n = 7) independently answered the question 'In your clinical capacity, do you think this animal requires analgesia?' with either 'Yes' or 'No'. The answers from the two groups were then compared. RESULTS: Rabbits for which group B answered 'No' (n = 36) had a median BRPS score (range) of 4 (0-10), while those for which group B answered 'Yes' (n = 42) had a median BRPS score of 9 (1-18; Z = -7.48; p < 0.001). The area under the receiver operating characteristic curve was 0.85 (95% confidence interval: 0.77-0.93; p < 0.001), indicating excellent discrimination of the BRPS with a cut-off score of 5.5 (sensitivity 88.1% and specificity 69.4%). However, for practicality, a score of 5 was deemed a feasible cut-off. LIMITATIONS: The main limitations of this study are the small rabbit sample size and the subjective nature of pain scoring in animals. CONCLUSIONS: Analgesic intervention should be considered in rabbits with a pain score equal to or greater than 5 on the BRPS.

Comparing the Efficacy of a New Clinical Skills Model with a Traditional Method to Teach Tube Feeding of an Avian Patient.

Interactive clinical skills models have been demonstrated to be useful for teaching medical and veterinary clinical skills, yet to date, very few exist for teaching skills relevant to zoological companion animals and wildlife species including birds. This two-part study aimed to create, develop, and validate a model. Interviews and a survey were conducted using veterinary and wildlife professionals to select an avian clinical skill that is challenging and performed frequently. Tube/gavage feeding, or "crop tubing" satisfied both criteria; on average it was performed 71 times a year by surveyed respondents was rated 3.4/9 for difficulty of teaching and 3.5/9 for difficulty of learning. Therefore, a new model of a bird, made from a soft toy, silicone, and 3D printed parts, was designed to train students to perform this technique. Forty-two participants were recruited and divided into two groups; one used the model the other watched an instructional video on crop tubing. The students completed a self-evaluated confidence questionnaire, before and after, using either resource. They then performed the technique on a dead bird and their proficiency at 10 different actions that comprised the technique was evaluated by two assessors. The model group performed significantly better than the video group on all evaluated actions (U ≤ 143.5, p ≤ .0031), and reported significantly higher confidence (U = 129.5, p = 0.018). In conclusion, the newly developed model in combination with an instruction booklet offers an effective and inexpensive alternative way to teach crop tubing in a teaching environment, without compromising animal welfare.

Developing guidelines for pet rat housing through expert consultation.

BACKGROUND: Pet care guidelines play an important role in ensuring that owners are well informed about good husbandry practices, allowing them to provide the best care for their animals. However, the development of such guidelines is difficult when there is little appropriate empirical evidence on which to base guidelines, as in the case of pet rats. The consultation of multiple experts can help to surmount this challenge. METHODS: We developed a set of guidelines for pet rat housing by consulting with a group of experts, including veterinarians, veterinary nurses, animal welfare scientists and experienced pet rat owners. The consultation involved two rounds of online surveys (n = 13) and one online discussion (n = 8). RESULTS: The resulting guidelines cover a broad range of features within pet rat housing, including injury prevention, details of suitable refuges and substrates, and suitable cage sizing. The guidelines may evolve as more information about pet rats comes to light but may nonetheless provide a useful starting point for any future guidelines. CONCLUSIONS: At present, these guidelines may not only be useful for pet rat owners and those advising pet rat owners, such as veterinarians, but may also be useful in the design of housing, including for laboratory rodents.

Pet rat welfare in the United Kingdom: The good, the bad and the ugly.

BACKGROUND: To date, despite the substantial literature investigating how rats prefer to be kept in captivity, no research has been conducted to assess the housing, husbandry and health of pet rats. METHODS: To better understand the United Kingdom's pet rat population and the welfare issues they face, we conducted an online survey of pet rat owners. The survey included questions about the owner and their opinions about pet rats, and about their rats' health, husbandry and housing. RESULTS: The results, from 677 complete responses, highlighted areas of rat care that were "good", "bad" and "ugly" (i.e. likely to be highly detrimental to welfare). The good was that many rats were provided with a social companion and enrichment; the bad was that we could not be certain whether rats had a sufficiently nutritious diet or sufficient opportunities to explore or adequate nesting substrate; and the ugly included cases of exposure of rats to predator species within the home and a generally high prevalence of disease. CONCLUSIONS: We conclude that there is much cause for concern about the welfare of pet rats in the United Kingdom.

Development of the Bristol Rabbit Pain Scale (BRPS): A multidimensional composite pain scale specific to rabbits (Oryctolagus cuniculus).

A species-specific composite pain scale is a prerequisite for adequate pain assessment. The aim of this study was to develop a multidimensional pain scale specific to rabbits (Oryctolagus cuniculus) called the Bristol Rabbit Pain Scale (BRPS). The scale was developed over five phases using a unique combination of methods: focus groups and behavioural observation. The first two phases aimed at identifying descriptors to describe a rabbit in pain, and then reducing their number, both using focus groups. A total of 72 pain descriptors were grouped under six categories (Demeanour, Posture, Facial expression, Attention to the painful area, Audible and Other) and 'No pain' descriptors were added. The third phase aimed to confirm, through video observation of rabbits, the categories and descriptors previously described, to reject those terms that were ambiguous, and identify any new descriptors that had not been included in the previous list of descriptors. This led to the rejection of the categories Audible and Attention to the painful area and of 34 descriptors. Seven new descriptors were identified. The last two phases constructed the final format of the BRPS by refining the categories, ranking the descriptors on an ordinal scale and testing the internal reliability of the scale using Cronbach's alpha test. This led to a composite pain scale of six categories (Demeanour, Posture, Locomotion, Ears, Eyes and Grooming) with four intensities of pain (0, 1, 2, and 3), a total score of 0-18, and a high Cronbach's alpha coefficient (alpha = 0.843). This BRPS fills an important gap in the field of rabbit medicine and has the potential to improve the assessment and management of pain in rabbits providing veterinary professionals with a novel multidimensional pain assessment tool. Further studies will investigate the clinical utility, validity and reliability of the BRPS.

Analgesia in pet rabbits: a survey study on how pain is assessed and ameliorated by veterinary surgeons.

BACKGROUND: In the last 20 years, two studies on the veterinary use of perioperative analgesia in small mammals reported a limited use of analgesics in rabbits but suggested an increasing use over the years. The aim of this study was to better understand how pain is treated and ameliorated in rabbits while under veterinary care. METHODS: An online survey of 60 questions was developed and advertised at national and international veterinary conferences, in veterinary publications and on social media. RESULTS: In total 94.3 per cent of the respondents routinely administered nonsteroidal anti-inflammatory drugs (NSAIDs) to rabbits undergoing surgical procedures such as neutering, 71.4 per cent administered an opioid and 70.3 per cent routinely administered multimodal analgesia, although dosages do not always match current consensus opinion. Buprenorphine and meloxicam were the most common analgesic drugs prescribed by the respondents. The dosage of meloxicam administered both parenterally and orally varied widely. CONCLUSION: Rabbit analgesia has improved over recent years similarly to the trend seen in other companion animals. However, overall it seems that pain assessment is still limited in rabbits. The lack of multimodal composite pain scales specific for rabbits makes this task even more challenging.

Pain and analgesia in pet rabbits within the veterinary environment: a review.

OBJECTIVE: To provide an overview of pain and analgesia in rabbits with the aim of developing a more accurate understanding of these topics. To illustrate and discuss the areas that have advanced in recent years and those that still require further research. DATABASES USED: Three key subject resources were used: Web of Science, Medline and CAB Abstracts. Search terms were rabbits, lagomorphs, laboratory animals, pet, pain, surgical procedures, ovariohysterectomy, orchiectomy, castration, analgesia, opioids, and non-steroidal anti-inflammatory drugs. References from books and articles relevant to the topics were also included. CONCLUSIONS: Rabbit medicine has improved over the last 20 years, but the literature suggests that pain management in this species is still inadequate and veterinary professionals believe their knowledge of pain and analgesia in this species is limited. Assessment and quantification of pain in rabbits can be challenging in a clinical environment not only because, as a prey species, rabbits tend to hide signs of pain but also because there are no validated methods to assess pain, except the Rabbit Grimace Scale, which is based on only one rabbit breed. Current consensus is that perioperative multimodal analgesia is the best practice. However, it is not widely used in rabbits. In rabbits, analgesia protocols and dosages reported in the literature are often poorly researched and do not result in complete pain amelioration with the return of normal. The present literature on rabbit pain and analgesia presents gaps either due to unexplored areas or insufficient findings. Further research should focus on these areas with the aim of improving the welfare of rabbits within a veterinary clinic.

Rabbit Neutering in Primary-Care Education: Insights from a Surgical Clinic.

Involvement in canine and feline surgical neutering clinics is generally considered to be a key element of primary-care veterinary education, yet opportunities for veterinary students to develop their surgical skills with rabbit patients are uncommon. This is despite the fact that rabbits are currently estimated to be the third most popular companion animal species and the fact that the British Small Animal Veterinary Association (BSAVA) recommends that all non-breeding rabbits be neutered soon after they attain sexual maturity. We describe a pilot rabbit-neutering clinic designed to provide high-quality care for rabbit patients while offering opportunities for undergraduate surgical and case-management skills development. We report on the clinical outcomes for patients. Rates of morbidity (n=18) and mortality (n=1) were low. Of complications reported, the majority (n=16) were considered minor. Challenges included ensuring that staff and students were trained in the specific features of rabbit anesthesia and recovery behavior. We conclude that rabbit surgical clinics offer excellent learning opportunities for undergraduate veterinary students. With prior training in handling and close individual supervision, it is possible to achieve good clinical outcomes and to have a positive impact on the welfare of companion animal populations.

Survey of cardiac pathologies in captive striped skunks (Mephitis mephitis).

Cardiac disease is a common finding in small mammals but it is rarely reported in striped skunks (Mephitis mephitis). The aim of this survey was to evaluate the prevalence of cardiac disease in striped skunks and to characterize the types of cardiac disease that might be present. In April 2010, a questionnaire was sent to veterinarians in zoologic collections with membership in the International Species Inventory System. Surveys were distributed to 55 institutions in the United States, Canada, and Europe. Twenty collections with a total of 95 skunks replied to the questionnaire. Of these, five collections reported at least one skunk with cardiac conditions for a total of 11 cases. In these 11 animals, the following conditions were diagnosed: myocardial fibrosis (n = 4), myxomatous valve degeneration (n = 4), hypertrophic cardiomyopathy (n = 1), dilated cardiomyopathy (n = 1), and valvular endocarditis (n = 1). Based on these findings, cardiac diseases should be considered as part of the differential diagnosis in captive striped skunks presenting with weakness, lethargy, and decreased appetite. Cardiac ultrasound also should be considered at the time of annual health examinations to evaluate for possible cardiac conditions at an early stage.

Intervertebral disk disease in 3 striped skunks (Mephitis mephitis).

OBJECTIVE: To describe diagnostic findings, surgical technique, and outcome in 3 striped skunks (Mephitis mephitis) with a history of paraparesis. STUDY DESIGN: Case series. ANIMALS: Skunks (n = 3) with paraparesis. METHODS: Neurologic examination revealed upper motor neuron disease (T2-L2) in 2 skunks and lower motor neuron disease (L3-S3) in 1 skunk. Diagnostic imaging included radiography, myelography, CT, and MRI and confirmed intervertebral disk herniation (IVDH) in each skunk. Because initial treatment with pain medication and cage rest did not result in lasting improvement, spinal surgery was performed. RESULTS: Hemilaminectomy (2 skunks) and dorsal laminectomy (1 skunk) was performed with removal of extruded disk material. The skunks improved after surgery but all had minor residual neurologic deficits when examined at various times postoperatively. CONCLUSION: Thoracolumbar intervertebral disk herniation occurs in skunks, and must be included in the differential diagnosis of paraparesis.

Serum concentrations of vitamins and trace elements in clinically healthy greater flamingos (Phoeniconaias phoenicopterus rubeus) and lesser flamingos (Phoeniconaias minor).

Analysis of vitamins and trace elements has gained importance in avian medicine in recent years. It has become evident that interpretation should be based on species-specific reference intervals due to differences in intervals between species. This study was performed to evaluate the blood concentrations of vitamins A (retinol), B1 (thiamine), C (ascorbic acid), and E (alpha-tocopherol) and trace elements copper, selenium, and zinc for greater flamingos (Phoeniconaias (Phoenicopterus) rubeus) and lesser flamingos (Phoeniconaias minor). Reference intervals of vitamins and trace elements are presented for clinically healthy flamingos. Thirty-six clinically healthy greater flamingos, divided into male and female groups, and 14 healthy lesser flamingos were evaluated. There was no significant difference in the vitamin and trace element concentrations between male and female greater flamingos, but there was a statistically significant difference between greater flamingos and lesser flamingos for ascorbic acid, copper, and selenium. Blood concentration of ascorbic acid was greater (P < 0.001) in lesser flamingos (122.66 +/- 31.53 microM) than in male and female greater flamingos (40.53 +/- 13.83 and 30.44 +/- 11.43 microM, respectively). Blood concentrations of copper and selenium were greater (P < 0.001) in greater flamingos (copper: 5.57 +/- 1.3 microM for males, 5.65 +/- 1.53 microM for females; selenium: 2.74 +/- 0.43 microM for males, 2.54 +/- 0.7 microM for females) than lesser flamingos (copper: 2.45 +/- 1.96 microM; selenium: 0.45 +/- 0.29 microM). The mean +/- SD of vitamins A, B1, and E and zinc are reported as entire group (male and female greater flamingos and lesser flamingos): vitamin A, 1.54 +/- 0.45 micromM; thiamine, 0.49 +/- 0.07 jM; vitamin E, 31 +/- 9.8 micromol/L; and zinc, 29.52 +/- 6.49 microM.