Bristol Rabbit Pain Scale (BRPS): clinical utility, validity and reliability.

BACKGROUND: The Bristol Rabbit Pain Scale (BRPS) was developed using a combination of methods, focus groups and behavioural observation, that led to a composite pain scale of six categories (Demeanour, Locomotion, Posture, Ears, Eyes and Grooming) with four intensities of pain (0, 1, 2, and 3), and a total score of 0-18. The aim of this study was to assess the clinical utility, validity and reliability of the BRPS. MATERIALS AND METHODS: The clinical utility of the BRPS was tested using a questionnaire composed of ten questions each on a five-point Likert scale ranging from one (strongly disagree) to five (strongly agree). The respondents, (veterinary surgeons and veterinary nurses), were asked to assess up to four rabbits in acute pain, using the novel pain. They then completed the questionnaire which asked whether the BRPS was easy and quick to use and whether it provided information that was clinically useful. The questionnaire was tested for internal reliability using the Cronbach's alpha reliability coefficient. The construct validity (how well the tool measures the concept it was designed for) was measured by observers blindly rating 20 rabbits pre- and post-surgery whilst the criterion validity (the degree to which the tool correlates with a gold standard) was assessed by correlating BRPS scores with scores using a numerical rating scale (NRS) with a total score of 0-10. Inter-rater reliability was tested by quantifying the agreement in the pain scores given by nine participants when assessing the same 40 video clips. The intra-rater reliability was measured by testing how consistent the participants were when rating the same clips one month later. RESULTS: The median score of the ten questions of the clinical utility test was 4 (range 2-5). The Cronbach's alpha reliability coefficient of the clinical utility test was good (α = 0.811) demonstrating good internal consistency. The median (range) pain score of the BRPS and the NRS were 3 (0-14) and 0 (0-8) before surgery and 12 (1-18) and 7 (0-10) after surgery respectively. The BRPS demonstrated high construct validity (Z = -11.452; p < 0.001) and there was a strong correlation between the BRPS and the NRS (Rho = 0.851; p < 0.001) indicating high criterion validity. The inter-rater and the intra-rater agreements were α = 0.863 and α = 0.861 respectively, which is considered good. CONCLUSIONS: This study showed that the BRPS is a suitable tool for quantifying pain in rabbits in a clinically useful, valid and reliable way.

Pain and analgesia in pet rabbits: a survey of the attitude of veterinary nurses.

OBJECTIVES: To gain insight into veterinary nurse knowledge of pain recognition and control in rabbits. MATERIALS AND METHODS: We used a survey to establish current attitudes amongst veterinary nurses towards pain management in pet rabbits and factors that might shape those attitudes. The survey was advertised at national and international veterinary conferences, in veterinary publications and on social media. RESULTS: A total of 284 questionnaires (95% from the UK) were completed and analysed. The majority of respondents (78%) nursed 1-10 rabbits per month and 5.6% of the respondents reported regularly running a rabbit clinic. The respondents were regularly involved in nursing during common procedures such as castration and ovariohysterectomy. Responsibility for post-operative pain assessment was reported to be by "nurses only" (50%), "nurses and vets" (42%) and occasionally by "vets only" (3%). The majority of respondents reported that they did not use a pain scale but often relied on behavioural indicators, while 20% used the Rabbit Grimace Scale. The majority of the respondents reported being "fairly confident" at recognising pain in rabbits. CLINICAL SIGNIFICANCE: Veterinary nurses are involved in many aspects of rabbit care, and they are generally confident at nursing this species. This survey also suggests the need for more data on the use of pain assessment tools in rabbits and the importance of teamwork between nurses and veterinarians.

Effects of probiotic Enterococcus faecium and Saccharomyces cerevisiae on the faecal microflora of pet rabbits.

OBJECTIVES: Probiotics are frequently used in the treatment of gastrointestinal diseases in pet rabbits based largely on anecdotal evidence of a beneficial effect. However, there has been little work performed to assess any such benefit in health or disease. The aim of this study was to determine the effect of probiotics on faecal levels of four important candidate gastrointestinal bacteria (Bacteroides species, Enterococcus faecium, Fibrobacter succinogenes and Clostridium spiroforme) in pet rabbits. Additional aims were to evaluate the effect of probiotics on bodyweight and faecal weight and diameter. MATERIALS AND METHODS: Double-blind triple cross-over study in six healthy rabbits orally administered two probiotic strains, Saccharomyces cerevisiae NCYC Sc47 and E. faecium NCIMB 30183. Levels of bacteria in faecal pellets were subsequently determined by real-time quantitative polymerase chain reaction. RESULTS: Oral administration of probiotic E. faecium NCIMB 30183 was associated with a significant (P = 0 · 042) increase in faecal levels of E. faecium. However, probiotic treatment did not affect faecal levels of Bacteroides species, F. succinogenes or C. spiroforme, bodyweight, or faecal weight and diameter. CLINICAL SIGNIFICANCE: The inclusion of dietary probiotic supplementation using E. faecium NCIMB 30183 can increase faecal levels of certain bacterial flora of healthy adult rabbits. Further work is required to investigate the effects of probiotics in animals affected with gastrointestinal disease.

Use of arterial blood gas analysis as a superior method for evaluating respiratory function in pet rabbits (Oryctolagus cuniculus).

A retrospective study compared invasive (arterial blood gas analysis) and non-invasive (capnography and pulse oximetry) methods of monitoring respiratory function in conscious rabbits. Arterial samples from 50 healthy dwarf lop rabbits, presenting for routine surgical neutering, were analysed on a point-of-care blood gas analysis machine. Reference intervals were obtained for pH (7.35-7.54), PaCO2 (mm Hg) (25.29-40.37), PaO2 (mm Hg) (50.3-98.2), base excess (mmol/l) (6.7-6.5), HCO3 (mmol/l) (17.96-29.41), TCO2 (mmol/l) (18.9-30.5). SaO2 (per cent) (88.8-98.0), Na (mmol/l) (137.6-145.2), K (mmol/l) (3.28-4.87), iCal (mmol/l) (1.64-1.94), glucose (mmol/l) (6.23-10.53), haematocrit (per cent) (23.3-40.2) and haemoglobin (mg/dl) (7.91-13.63). Pulse oximetry (SPO2) and capnography (ETCO2) readings were taken concurrently. There was no statistically significant relationship between SPO2 and SaO2 with a mean difference between SPO2 and SaO2 of 8.22 per cent. There was a statistically significant relationship between ETCO2 vs PaCO2, but a wide range of ETCO2 values were observed for a given PaCO2. The mean difference between these was 16.16 mm Hg. The study has provided reference intervals for arterial blood gas analysis in rabbits and demonstrated that capnography and pulse oximetry readings should not be relied upon in conscious rabbits as a guide to ventilation and oxygenation.

Arterial blood gas parameters in pet rabbits anaesthetized using a combination of fentanyl-fluanisone-midazolam-isoflurane.

OBJECTIVES: Blood gas analysis is a well-recognized method to monitor pulmonary function, blood oxygenation, ventilation and acid-base status during general anaesthesia. The aim of this study was to report blood gas analysis results in pet rabbits (Oryctolagus cuniculus) obtained during general anaesthesia using a portable clinical analyser. METHODS: Thirty-two rabbits were premedicated with 0·2 mL/kg fentanyl and fluanisone. Anaesthesia was induced with 0·2 mg/kg midazolam and maintained with 2% isoflurane in oxygen via endotracheal tube. Arterial blood samples were taken from the central ear artery 10 minutes after induction of anaesthesia. RESULTS: Respiratory acidaemia was observed during anaesthesia. Mean ±sd (range) arterial blood pH was 7·33 ±0·08 (7·15 to 7·48). PaCO2 and PaO2 were, respectively, 55·02 ±10·5 (37·7 to 92·1) mmHg and 370·0 ±120·5 (67 to 561) mmHg. Base excess was 2·8 ±3·6 (-3 to 11) mmol/L, HCO3 was 28·73 ±3·07 (23·7 to 35·4) mmol/L and TCO2 was 30·4 ±3·2 (25 to 37) mmol/L. None of the rabbits developed haematoma during arterial blood collection or ischaemia of the pinna during the hospitalization period. CLINICAL SIGNIFICANCE: Arterial blood gas analysis is a safe and easy to perform diagnostic technique that can contribute to improved safety of rabbit anaesthesia, by providing information on the respiratory and metabolic status of the patient.

A case of antibacterial-responsive mucocutaneous disease in a seven-year-old dwarf lop rabbit (Oryctolagus cuniculus) resembling mucocutaneous pyoderma of dogs.

A seven-year-old, ovariohysterectomised female dwarf lop rabbit (Oryctolagus cuniculus) was referred with severe swelling and erythema of the mucocutaneous junctions of the lips, nares and vulva. Bilateral, severe periocular dermatitis was also present. Heavy pure growths of a member of the Staphylococcus intermedius group were cultured from nasal and aural swabs and skin biopsies. Other possible differential diagnoses were eliminated by standard tests. The clinical features and histopathological characteristics of the biopsies were most consistent with mucocutaneous pyoderma, a dermatosis previously reported in dogs but not in rabbits. Treatment of the bacterial infection with oral marbofloxacin and topical ofloxacin eye drops together with supportive therapy resulted in resolution of the lesions. To the authors' knowledge, this is the first report of mucocutaneous bacterial pyoderma, similar to mucocutaneous pyoderma of dogs, in a rabbit.

Mycobacterium microti infection in two meerkats (Suricata suricatta).

Mycobacterium microti is a member of the Mycobacterium tuberculosis complex (MTC). M. microti is generally considered a pathogen of small rodents, although sporadic infections in a range of other mammals, including domestic animals and man, have been reported. While many human infections have been associated with immunosuppression, an increasing number of cases are being reported in immunocompetent patients. Two cases of M. microti infection in meerkats (Suricata suricatta) are reported. These are the first cases of mycobacterial disease to be described in meerkats outside Africa.