Pet Factsheets

Fluid therapy

A rabbit in intensive care receiving intravenous fluid therapy
©Stephen Hernandez-Divers & Maud Lafortune

Fluid therapy is used for various situations and can be given via different routes and at different rates. Rabbits have a complex system of secretion and absorption of water and electrolytes within their digestive system, and dehydration and the loss of electrolytes can rapidly occur if there is any disturbance to the digestive function. The aim of fluid therapy is to restore blood volume and correct electrolyte and glucose levels and plasma pH.

What fluids can be used?

A variety of fluids are used in rabbits, depending upon the situation. These aim to restore the hydration level and blood pressure, and contain electrolytes.

Blood transfusions can be given in cases of excessive blood loss, up to 10% of a rabbit’s circulating blood can be lost with minimal adverse effects, but a loss of 20-25% can result in systemic shock and a blood transfusion may be required.

When is fluid therapy used?

The uses are vast, but fluid therapy may be used in rabbits for:

  • Dehydration: fluids can be used to help restore hydration. Rabbits can be dehydrated for a variety of reasons and may not show outwards signs, (such as skin tenting, sunken eyes, dry mucous membranes, etc), so this is not a reliable way to assess hydration in rabbits.
  • Anorexia: any rabbit who is not eating is also unlikely to be drinking and as a result the GI tract will slow down and come to a standstill. Giving fluids to rehydrate the stomach contents and GI tract is important to help to restore peristalsis in the GI tract.
  • Low blood volume (hypovolaemia): a blood transfusion may be used in this situation, or if this is not available a type of fluid therapy may be used instead.
  • During surgery to help support the kidneys and blood pressure: anaesthetic drugs can decrease blood pressure, so fluids are given to ensure blood volume continues to be delivered to vital organs, such as the kidneys.
  • Kidney disease: fluids can help to ‘flush’ the kidneys through and remove toxins from the blood when the kidneys are unable to. This palliative care can help to make the rabbit feel better for the short-term.

Fluid therapy forms a vital part of a treatment plan and helps to save lives in many situations.

What are the different ways fluid therapy can be given?

There are several ways in which fluids can be given to rabbits. There are pros and cons for each route. The route will be decided by your vet, based on what is best for your rabbit. Common routes of fluid administration include:

  • Oral: this is when fluids are given into the rabbit’s mouth. Some rabbits find this stressful and may not swallow the water. It is also difficult to get large amounts into the rabbit via this route and there is a risk that the rabbit may choke on the fluids if they struggle.
  • Subcutaneous: injecting fluids into the subcutaneous layers of the skin (usually around the scruff of the neck) is a common way to give fluids. Large volumes can be given over a short period of time and will be absorbed well. The fluids may not be effectively absorbed in very ill rabbits, and large amounts can be painful, as well as the stress and pain caused by having to keep injecting the rabbit.
  • Intravenous: these are fluids given directly into the vein, via a cannula. The cannula can be placed in one of many veins and usually placed while the rabbit is conscious. Intravenous fluids are absorbed quickly even in dehydrated rabbits. One of the advantages is that once the cannula is placed the rabbit will not feel the fluids being given each time.
  • Intraosseous: this is usually reserved for very ill rabbits whose circulation is collapsed and it is difficult to place an intravenous cannula. This involves placing a cannula into the bone marrow and is usually performed under anaesthesia or sedation alongside pain relief medication. Often, they are well tolerated, and fluids will be readily absorbed.

Are there any risks?

The risks from all routes of fluid therapy are far outweighed by the benefits. Rabbits may choke or aspirate on oral fluids, so care should always be taken not to overload the rabbit and only give the rabbit small amounts at once, to allow them to swallow what is in their mouth before more is given. The rabbit should always be placed in a normal sitting position and never lied on their back to minimise the risk.

Subcutaneous fluids, which are given repeatedly, may result in small areas of fur loss and soreness, especially if larger volumes are given.

Intravenous and intraosseous fluids run the risk of infection at the site of the cannula. For this reason, extreme care will be taken by the veterinary team to ensure the site is kept as clean as possible, but this risk cannot be removed entirely.

Will I need to give fluids at home?

It is not common for owners to be asked to deliver fluid therapy at home. If your rabbit requires fluids, they are highly likely to be admitted as an inpatient, whereby the fluids and other treatment can be given by the vets and nurses.

There may be some occasions, such as your rabbit being on long-term care, ie kidney disease, when regular subcutaneous injections of fluid at home, can help to slow down the disease process and keep the rabbit as comfortable as possible for as long as possible. If your vet were to ask you to do this, they would demonstrate the technique with you first.

Is it painful?

Most fluid therapy routes are not painful. Placing a cannula into a vein for intravenous access is no more painful than giving an injection and cream to numb the skin can also be used beforehand so your rabbit will not feel it. An intraosseous cannula needs placing under sedation or general anaesthesia, unless the rabbit is in a collapsed and unconscious state and sedation would be too risky. In these cases, the rabbit will not feel the cannula.

Subcutaneous fluids may be uncomfortable as it involves injecting the rabbit numerous times, so this route may not be used in rabbits who are particularly sensitive, or for long-term fluid therapy.

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