Rabbit Health Check


There are two viral diseases that your pet rabbit should be vaccinated against.


This is transmitted by fleas, flies and other biting insects so can be passed from wild rabbits to pet rabbits – your rabbit does not need contact with another rabbit to become infected. The disease has even been seen in house rabbits that have never been outdoors. All pet rabbits are at risk. The first signs of infection are puffy, fluid filled swellings around the head and face. Within a day or so these can become so severe that they can cause blindness. Eating and drinking will become more difficult for your rabbit. There is no specific treatment for Myxomatosis and it is normally fatal. The Myxomatosis vaccination will protect your rabbit against this disease, although a vaccinated rabbit may still be able to get a mild form of the disease.

Viral Haemorrhagic Disease VHD

This is an incurable disease which is transmitted by direct contact with infected rabbits, but also indirect contact such as contaminated feed or water. Infection can also happen via contact with people, clothing, on shoes or by birds. Affected rabbits can be found dead or severely ill with internal bleeding in the lungs, gut and urinary tract. We can vaccinate your rabbit to prevent this disease. Speak to us about the vaccinations we use.

We aim to send reminders for boosters when they are due. At this appointment your rabbit will also receive a thorough clinical examination where any other health issues can be discussed with your vet.


Unless owners wish to breed from their rabbits, routine neutering is strongly advised. Rabbits become sexually mature quite young. Normally 4-6 months of age. We recommend separating young male and female rabbits at 4 months of age into single sex groups. Male rabbits can be castrated from 4 months of age. Females can also be spayed from 4 months of age but it is good if they are over 1 kg in body weight. There are lots of advantages to neutering rabbits when they are young which include: reduced risk of cancer in females and fewer behavioural problems in males (which may include fighting, biting and urine spraying).

Fly Strike

Fly strike is a horrible condition that can occur in the warmer months. It is essential, particularly if your rabbit lives outdoors, that they are kept as clean as possible. You should check your rabbit twice daily during the summer months for signs of matted droppings, fly eggs or maggots around their bottom. Flies are attracted to faeces, urine and open wounds. Fly strike occurs when the fly eggs hatch into maggots which then feed on your pet rabbit and burrow into their skin. This is a very nasty and potentially fatal condition.

Taking the following steps to ensure that your rabbit is free from flies can prevent fly strike:

Clean out your rabbit hutch regularly, ensuring you remove all faeces and urine soiled bedding.

Put fly paper in or around the hutch.

Never leave old rotting food either in or near your pet’s living quarters.

Check the back end of your pet at least twice daily. If faecal matter accumulates in this area, remove it carefully and speak to us for advice.

Products can be prescribed to prevent fly eggs from hatching into maggots causing damage to your rabbit’s skin and tissue. Please note that these products don’t repel flies in the first place.

At the first signs of any maggots contact us immediately. Any delay in treatment can be fatal for your rabbit.

Encephalitozoon Cuniculi

  • What is Encephalitozoon Cuniculi?
  • How is E. Cuniculi transmitted?
  • What symptoms and disease processes does it cause in rabbits?
  • How is E. Cuniculi diagnosed?
  • What is the treatment for E. Cuniculi?
  • Does my rabbit need routine treatment?
  • Does treatment cure the problem?
  • How can I stop my rabbit getting E. Cuniculi?
  • Can I have my rabbit vaccinated against E. Cuniculi?
  • What is the outlook for rabbits with E. Cuniculi?
  • Quality of Life

What is Encephalitozoon Cuniculi?

Encephalitozoon Cuniculi (E. Cuniculi) is a protozoal parasite. The parasite primarily affects rabbits, but cases have been reported in sheep, goats, dogs, cats, monkeys, guinea pigs, foxes, pigs and humans. It is a recognised zoonosis, but the zoonotic risk seems to be minimal to healthy individuals observing basic hygiene. To date, there have been no reported cases of direct transmission from a rabbit to a human. However, those individuals who are immunosuppressed should implement strict hygiene and, if possible, avoid animals suspected or confirmed of being infected with E. Cuniculi and undoubtedly seek medical advice from their doctor.

How is E. Cuniculi transmitted?

Spores are shed in infected animals' urine and transmission usually occurs from the ingestion of contaminated food or water or, less commonly, by inhalation of spores. Transmission from mother to young (transplacental) also occurs so that offspring is born infected.

What symptoms and disease processes does it cause in rabbits?

One study showed that approximately 52% of healthy rabbits in the UK carry the parasite, but many never show any clinical signs. We still don't understand why some infected rabbits develop the disease and others don't, but it is most likely related to their immune function.

If the rabbit is infected with E. Cuniculi and showing clinical signs, it may exhibit any, some or all of the following:

  • Hind limb paresis (weakness of the hind limbs)
  • Head tilt (torticollis)
  • Paralysis
  • Urinary incontinence and/or scalding
  • Tremors
  • Cataracts and lens-induced uveitis  
  • Collapse
  • Renal failure
  • Death

These clinical signs are caused by the body's inflammatory reaction to rupture infected cells, mainly in the nervous system and kidney. However, many of these symptoms can be associated with other disease processes, so a diagnosis is rarely made on clinical symptoms alone.

How is E. Cuniculi diagnosed?

If the rabbit is showing clinical signs that may be suspicious, then a blood test might be recommended. Nowadays, the test most commonly used is the ELISA test that measures serum antibody levels. This detects whether the rabbit has been exposed to the parasite.

A negative result is generally conclusive and can rule out E. Cuniculi as the problem, unless the sample is taken very early on in infection or the immune system is so weak that the rabbit doesn't produce antibodies, since so many rabbits carry the parasite without symptoms (asymptomatically). 

Another available test is the PCR test, which detects the parasite itself, usually in a urine sample. A positive result means that the rabbit is shedding the parasite and is thus infected, but a negative may mean either that the rabbit is not infected, or that it is infected but just not shedding spores at that time.

What is the treatment for E. Cuniculi?

Treatment aims to reduce inflammation and prevent formation of spores. If a diagnosis is made or clinical symptoms indicate E. Cuniculi to be the cause of disease, a 28-day course of oral fenbendazole, e.g. PanacurT, at 20 mg/kg once a day is the general treatment of choice, plus anti-inflammatory drugs such as corticosteroids.

However, many new treatments are being trialled and looked into, so your vet may decide to treat your rabbit with a different drug or combination of drugs. If a secondary bacterial infection is also present, the treatment regime will probably also include antibiotics.

Does my rabbit need routine treatment?

This is where people differ in their opinions. Routinely treating against E. Cuniculi is recommended by some vets but deemed pointless by others! Some vets feel that treating your rabbit 2-4 times a year can help reduce the incidence of E. Cuniculi developing to a point where clinical signs are seen. However, other vets feel that preventive treatment is pointless because as soon as the course of treatment is finished, the rabbit is no more protected than it would have been if it hadn't been treated. This is an area where more research is needed.

If you choose to use preventive treatment, there are products that are licensed for this purpose. It is usually a 9-day oral course given once daily at the same dose as what would be used to treat an infected rabbit (20mg/kg) and can be done every 3-6 months. Please contact your vet, who will be happy to advise you.

Does treatment cure the problem?

We don't really know. One study showed that a 28-day course of fenbendazole does eliminate the parasite, but this may not be the case with all rabbits and some people feel that once a rabbit is infected with E. Cuniculi, it will be a life-long carrier. The disease process will generally take one of the following routes...

Treatment improves the clinical signs - If this is the case, after 28 days the treatment is usually stopped. At this point, if the rabbit deteriorates again, treatment can be recommenced. It isn't known for sure what triggers a flare-up of the disease but stress is thought to play a part, or if the rabbit's immune system is weakened by another disease and can no longer keep the parasite at bay. Also, don't forget that a rabbit can become re-infected if it is exposed again to spores from the environment.

Some rabbits need lifelong medications, whereas others need it sporadically to control clinical signs when they manifest themselves. Others only need a one-off treatment course and never seem to develop clinical signs again. However, it should be stated that treatment might not be sufficient for the rabbit to make a full recovery and some level of clinical signs often continue.

Treatment does not improve the clinical signs - Generally, if treatment is going to work, some improvement in clinical signs is seen in the first week or so, with a gradual improvement. For those rabbits that fail to improve, euthanasia is the only humane option if the clinical signs are debilitating and the rabbit has no quality of life.

How can I stop my rabbit getting E. Cuniculi?

Firstly, you need to be 100% sure that the rabbit isn't already carrying the parasite. Ask your vet if they would be willing to perform a blood test on your rabbit. If the result comes back as negative, the best form of defence is to stop your rabbit coming into contact with any other rabbits, be this domestic or wild. As previously mentioned, spores from the parasite are primarily passed on in the urine of infected rabbits, so removing this route of transmission is your rabbit's best form of defence. Good hygiene is vital as spores can easily be killed by routine disinfectants.

Can I have my rabbit vaccinated against E. Cuniculi?

E. Cuniculi is a parasite, not a virus. Therefore, there is no vaccine against E. Cuniculi.

What is the outlook for rabbits with E. Cuniculi?

This depends on the rabbit's response to treatment and the frequency and severity of any flare-ups.

Generally speaking, a lot of rabbits who develop problems due to E. Cuniculi can go on to do well and lead full lives, but treatment needs to be prompt, otherwise the parasite will cause more damage and clinical signs will be more severe.

Quality of Life

It is important to keep your rabbit's quality of life in mind when dealing with E. Cuniculi. For example, if your rabbit has a head tilt but is otherwise eating, drinking and managing to get around, they are probably perfectly happy.

Rabbits don't worry about what they look like; this is more of a concern to the owner.

However, a rabbit that is continually scalded with urine, miserable, rolling/falling over or unable to move due to hind limb weakness or paralysis is not a happy rabbit. You should think seriously about whether your rabbit has an acceptable quality of life.

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