— Dr Di Girolamo, you specialise in curing exotic animals — birds, reptiles, turtles, and also rabbits. But in most cases, people believe that rabbits are anything but exotic pets and they can be treated the same way as cats or small dogs breeds. How do you think, why did it happen? In particular, there is still no such profession as an exotic vet in Russia, and quite often rabbits, especially in distant regions, do not receive suitable treatment, as vets apply cats/dogs/meat and fur productions’ standards, which is frustrating.
That’s a wonderful question. I guess that on some occasions veterinarians feel more comfortable treating rabbits than treating a reptile or a bird, so the owners don’t necessarily understand that the fact that if veterinarians try to treat rabbits is no necessarily meaning that they are able and capable of doing that, that they are adding all the obligatory medical tools. Treating rabbits is extremely difficult and even if I treat rabbits every day and that’s my main focus — that’s probably my most common patient — I still have to invest a lot of money and time in developing new procedures in order to make everything safer for rabbits.
It is true that maybe a rabbit is anatomically similar to a cat or a dog more than a reptile, but this doesn’t mean that rabbit does not require very specific care. Rabbits are herbivores and their gastrointestinal system is so complex and so different from any other animal. A very good example is the presence of the appendix. In fact, rabbits are the only domestic animal that actually has an appendix. So it’s very very important to be aware of these differences whenever treating rabbits and always look for someone who has extensive experience in their treatment.
— Could you please clarify, which exact training is required for a vet to become a specialist in rabbits?
The actual path for specialisation in veterinary medicine is pretty similar to what is currently happening in human medicine. So, in human medicine, you can study for a cardiologist or an ophthalmologist, the same happens in veterinary medicine. Now, specifically for rabbits, there are several different board certifications — that’s the way we call them — that you can get to become a specialist in rabbit medicine. There are three ways.
The first one is the American College of Zoological Medicine. The American College of Zoological Medicine covers all the species including rabbits and has a special emphasis on rabbits in regards to companion animals. For example, I am board certified by the American College of Zoological Medicine. Then, there is the European College of Zoological Medicine. The European College of Zoological Medicine has a small section that is called small mammals. That one focuses specifically on rabbits, rodents, ferrets, hedgehogs and other pocket pets.
And then finally there is the third board certification which is called the American Board of Veterinary Practitioners. This American Board of Veterinary Practitioners specialisition have a speciality which is titled Exotic Companion Mammals, ECM. So whoever is a specialist in Exotic Companion Mammals can be also considered a specialist in rabbit medicine.
These are the three board certifications that are recognised around the world. There are a lot of veterinarians that achieved different paths and they consider themselves specialists in rabbit medicine through other things, like for example via doing a doctorate degree or doing some certification or some courses, but that’s not actually being a specialist. In fact, it is incorrect and illegal to brand as a specialist if you do not have such certifications as the ones that I’ve described above.
In order to achieve this specialisation, you need to do what is called a residency, in most of the cases, which means that you have to work together with a specialist for several years. That way you learn about things, then you need to publish papers, the way you understand the publication process, and then you need to publish some case reports, the way you communicate and evaluate if you’re a good practitioner or not. So always search for a board-certified exotic animal specialist if possible.
— You mentioned that rabbits are probably your most common patient. Could you share your opinion on the question of whether rabbit in whole is suitable for domestic life with humans? A dog, for example, is orienteered on people and does not suffer without the company of another dog, but rabbits are advised to be kept in pairs or more. But for that, they need to be castrated.
Isn’t that an indirect indication that rabbits mostly are not domestic pets, but wild animals, e.g. as hares?
That’s a wonderful question. Actually, I think quite the opposite. I think rabbits are the pet of the future. Think about that. Rabbits are vegan, so that decreases a lot the impact the rabbits have on the environment as compared to a dog or a cat. These may sound unpopular, but you know you don’t need to kill any animal to feed the rabbit, you need just some veggies and hay. I know that a lot of people think that rabbits always need to live in pair, but I would argue with with — it really depends on how you keep rabbit. If you keep rabbit fully free roaming in a house, if they completely free of moving around — they are very happy also by themselves, like a cat.
For the last, rabbits should be neutered. Especially female rabbits should always always be neutered. If you have a veterinarian that knows how to neuter a female rabbit safely, because of the risk of complications. Male rabbits can be neutered or can also be left intact or entire — depending on how you wanna call it. Yet, I may suggest you need always neuter also male rabbits to prevent some diseases that they get when they get older — these diseases can be difficult to treat when rabbits are older, and neutering or castration can keep them safe.
So, to answer your question, I think the rabbit is probably right now in my opinion the best possible domestic pet for humans. I think that the most important thing the human need to understand is that rabbits are by no mean different, for example, from a cat in terms of their need. There is no justification to keep rabbits in cages. Rabbits should live free into a house, if possible, or into certain room of a house. As an owner, you need to make sure that they are safe and there is no electricity, no wires, nothing that they can eat or chew on land. In those regards I completely agree. But rabbits are great pets.
— From your point of view, is rabbits’ castration a simple procedure for the vet? Our «personal» rabbits are older than 10 years old (11,5 and about 9 years). Recently, this procedure was held without anaesthesia, rabbits were simply immobilised and some died because of the shock.
What do you think, is every clinic nowadays can provide special gas anaesthesia and necessary standards for this procedure?
When you talk of rabbit castration you mean male neutering, I assume. Removing the testicles from a male rabbit is pretty safe and easy surgery. To say that, even if it’s easy and safe, it needs to be performed properly. It is insane for me to hear that some rabbits have been neutered without anaesthesia — this is brutal! The veterinarian doing that should’ve been sued. That is animal abuse, it’s as simple as that. Such a procedure can not be done without anaesthesia.
Rabbit neutering is safe if it’s performed properly. Also remember, if anaesthesia is not balanced and there is no proper analgesia, which means pain medications, the rabbits are gonna stop eating for one or two days, and then they’re gonna get into intestinal problems as a consequence of that. So, our purpose is always to have surgery done as safer and as swiftly as possible. I also don’t use gas anaesthesia most of the time, because gas anaesthesia can create other problems. Nowadays we have very very nice and good injectable protocols, which are very safe for neutering rabbits. However, if you’re talking about female rabbits’ castration, that’s a completely other business and we can talk about that more.
— You said earlier that it is obligatory to operate female rabbits, and added that it is a more complex issue than males’ castration.
What age of the animal and which technique is optimal for this procedure? How can rabbits’ owners realise that they can trust the doctor with this difficult operation?
That’s a great question. The age for the rabbits’ spay is actually something that is debated in veterinary medicine. Different veterinarians have different preference. In my opinion, the best thing is to spay female rabbits when they are between eight and ten month old. That’s the best period, because, first of all, it’s very very rare for them when they are eight to ten months old to have significant uterine problems. But at the same time their anesthesia is much safer and the uterus is more developed than a female rabbit that is just four or five months old, so the surgery is easier. Some of veterinarians, even specialists and professors, suggest to spay rabbits when they are just four or five months old, and that to me it’s a wrong thing. At this age, the uterus is very small, is very tiny, so the surgery is more complex than when they are older. Plus, since they are too young and their anesthesia is not as stable, it is not as safe as when they are a little older. You can compare this procedure with human medicine — you don’t want to put under general anesthesia a kid unless it’s really, really needed, right? That’s the same concept for rabbits. So you don’t want them too young when you’re anesthetizing them.
It’s very hard to tell who is a good veterinarian for spaying rabbit and who is not. I would actually like to create us network in which we can share and keep our records transparent, so the owners would know exactly how many spay every veterinarian is doing, how many neuters and how many problems they had with them. That would be very helpful. For now, you just have to kind of rely on the external appearance. If there is any board certified veterinarian in you area, definitely try to have them do the surgery. If there is no board certified veterinarian in your area or your country, then you will have to go for the veterinarian who do mostly rabbits.
Also, it’s very important to spend a lot of time talking to the veterinarian. Don’t worry, remember, spay or neutering is very important part of a rabbit’s life, and you need to make sure if you’re comfortable with the veterinarian that is doing this procedure for you. Spend some time talking to them, try to understand if they are knowledgeable about rabbits, try to ask what type of anesthesia they’re gonna do. If they say that they’re gonna spay a female rabbit without intubation, which means putting little tube into their trachea, that’s a very bad sign. That’s very dangerous! A lot of veterinarians don’t intubate rabbits because it’s difficult for them, but that’s wrong. Female rabbits should be intubated for spay. These kind of questions can help you understand if a veterinarian is good or bad.
— Could you please tell us is there a common price for castration procedures? Which sum approximately should an owner expect in order to be confident in the procedure’s quality?
That’s a wonderful question. I guess the pricing depends on the country, but usually, if it’s a little bit more expensive it’s gonna be safer. But you should understand that you can not rely solely on the cost. I can tell you that whether you want to go somewhere make yourself aware that the price is not too cheap. Of course, going to the cheapest place is going to result in people that don’t use the proper analgesics, don’t care enough about rabbits and other issues. You can’t just use price to evaluate the quality of castration or a spay of a rabbit, but seeking, actively searching for the cheapest place is not a good idea. In the United States, it also really depends on the state, but if somewhere it costs 350 dollars for a spay it’s probably gonna be safer than going into a place where it costs just 50 dollars.
— You shared a wonderful thought that rabbits are animals of the future… For their feed you don’t have to kill anyone, and bunnies themselves are vegans. Though we should mention that vegan movement is far from popular in Russia… Still, rabbits as pets could give an invaluable example to their owners.
That’s why we also wanted to talk with you about aspect of rabbits’ nutrition. How is it important for domestic rabbits to eat food which is suitable for their kind naturally? We stand for fully organic nutrition: hay, different herbs, grass, vegetables, some fruits. What can you add as a vet? Does nutrition indeed have such a big effect on rabbits health and wealth, their long life, their teeth and gastrointestinal tract?
Yes, of course. Rabbits are the most delicate animals possible in terms of nutrition. The diet of a rabbit must be perfect. I don’t know necessarily in terms of organic versus non-organic food, but what is really important is that rabbits should eat a lot of hay and herbs. Hay and herbs need to be the base for their diet. Then they have to have abundant vegetables and just a very little bit of fruits. That is highly important — fruits should be just a little tiny bit. One common mistake that people do — which I want to clarify here — is to give too much sugar and fruits, e. g. too much banana. When you see those videos on Instagram with the owners that offer the whole entire banana to rabbits — that’s a big no-no-no. Some of these rabbits after you do something like that can get diarrhoea or get really sick, then they need to be brought to the vet. You should never ever do something like that, and never advertise that. By the contrary, if you wanna give a blueberry or a raspberry, a very small piece of a strawberry — that’s fine, you can do that, but it has to be like once a day top. So fruits — very very very very limited.
And yes, the diet is super important for teeth and gastrointestinal health. It has been proven by several studies that if rabbits don’t eat enough fibre then their gastrointestinal tract doesn’t work. As well, if they don’t eat enough actual hay and actual herbs their teeth overgrow. All these things are very important for their health.
— Seeing bunny refusing to eat is one of the owners’ worst nightmares. That is usually connected with gastrointestinal GI stasis. The owners know that the best solution is to visit doctor as soon as possible. But not everyone has this opportunity, sometimes you have to wait for the vet’s free spot. To be fair, for us, owners, this is there dark times happen, as rabbit needs help in the nearest time.
What can an owner do in such situation? Why does GI stasis can happen at all, even if rabbit eats healthy and properly, on a free roam, lives with kindred?
That’s a great question. Let me start by telling you that when a rabbit is not eating or not pooping anymore — we don’t want to call GI stasis. We stopped using that terminology, because it’s actually counterproductive and can create more problem than calling it with a proper name. So, why did we used to call it gastrointestinal stasis? We used to call it like that because rabbits would stop eating, then would come to the clinic and we couldn’t find the problem, and so we would say: «oh, the rabbit has gastrointestinal stasis». But now we are doing way more advanced diagnostics. Basically, every rabbit that I see that is anorectic — I try do to a computer tomography scan, a CAT scan. Due to that we are finding a lot more diseases. It’s very rare right now that a rabbit comes to me because he’s not eating and not pooping and we don’t find an actual cause. So, since there is causes to that and it’s not «oh, it’s gastrointestinal stasis», the question is what is the problem of the rabbit. It’s true that sometimes rabbits may have gastrointestinal colic — in that case, pain is just related to altered flora, an altered gas in their intestinal tract. But most of the time, when they have these type of problems, when they stop eating and stop pooping, there is an actual problem underneath. Sometimes this problem can resolve with no treatment, but it’s always better to have that treated.
So actually there isn’t any solution, to be honest, the solution may be more difficult when we felt before. I would advise at any time when a rabbit is sick, is not feeling well, and there is no objective reason for that — it could happen if rabbit just met a dog or was attacked by a kid, or something like that… But if there is no reason, I would always suggest to bring rabbits to the vet and have the vet to do at least bloodwork — bloodwork is super important to rule out liver lobe torsions. And then, in most situation, also some diagnostic imaging, either radiographs, ultrasound or a CAT scan. This way it’s much most of the time you can understand better what type of problems rabbits have and you can fix them better.
If you are in a situation in which you are very worried for your rabbit and your usual vet won’t take him in because he’s busy or on vacation, you just need to go to another place. I never say no to a rabbit that is not eating or not pooping. If a veterinarian doesn’t understand that he needs to see the rabbit on that same day, it means he’s not a good rabbit veterinarian, as simple as that. You better find a new veterinarian.
— Dr Di Girolamo, thank you so much for your detailed responses and your cooperation! There’s so much more about our beloved bunnies we’d like to discuss, but we don’t want to distract you from your important job.
And our last question — do you yourself have rabbits at home?
Yes, that’s a hell targeted question. Me and my partner, we have two rabbits — one is eleven, almost twelve year old, Benjamin. The other one, Livie, is younger — she’s only six or seven. She has just three legs because her previous owners basically abandoned her and didn’t want to pay for the surgery. Still, she had it, and now she’s in our place. Benjamin had a liver lobe torsion when he was younger and survived surgery, and now he has otitis and a lot of other problems, but they are hang in there.