Lovely. Thanks ever so much, Bruce. OK, thanks everybody for, for joining me.
As Bruce said, we're gonna be talking about running successful rabbit clinics this evening. So let's go. So actually, if we think about rabbit clinics, you may think there's one or two that we could be running, but there's actually 10 different types of clinics straight off the bat that we can, we can go with for these.
Now, if you look through the list here, there's quite a lot, and probably the hardest one of all is the second one down, the new rabbit check. sorry, the, the pre-purchased one, not the new rabbit check. The pre-purchase is the hardest appointment to kind of to get into because people are going into pet shops or getting animals online and they're not coming to us, the veterinary clinic to get their, their correct information.
So this is kind of a hard one to do. But actually, all the others, we, we're kind of doing anyway. Within our, education of our clients, but we need to actually turn these into proper clinics and be able to specialise in this and actually, OK, let's get these animals in, let's get them seen, and let's get them seen properly for specific things, rather than seeing them once a year for a quick general, tidy up and, and try and go through all of this at the same time.
So what do we need to do? We need to think about the preparation, when we're looking at implementing any clinics at all. First off, what is your existing client base?
How many rabbits have you actually got on the books? It's one of those things that people, very often don't. Tell you the rabbit has passed, if it's passed at home and they don't bring it in for cremation.
You know, if you have a look on your, on your list, you'll probably find there's, there's a fair few rabbits there that are in the kind of 30s and 40 years old, which we know is not going to be a thing. So you need to have a look at your current database and see how many rabbit clients you already have. The other thing to do is just put a little questionnaire up on reception, and it's a very quick kind of recap of their details.
You get all owners of all pets to come in and just say, actually, can you just update your details? It's their name and their address and their contact details. But on the bottom, very simply, you have, do you have any other animals at home?
And give them a hint. So say, you know, have tick box for rabbit, hamster, rat, whatever. Just a very simple thing.
Because actually, quite a lot of your clients will probably, you know, they have dogs, but they've probably got a rabbit at home for the kids or something down the bottom of the garden as well. But it isn't actually registered with you. Now, these are the ones we really need to tap into because these are the ones that aren't vaccinated.
They aren't getting their dental checks, may not be neutered, all these things, these are the people that we really need to get to to really improve rabbit welfare. So by having a look through your existing clients, you can, you can kind of see your pool of resource. Now, if you don't already have a lot of rabbit clients on the books, Obviously running clinics is going to be more difficult.
But it depends how well bonded they are. If you've got a small number, but they're actually very proactive, owners, then you're still going to be able to run some clinics. You need to have a think about the protocols.
So, yep, great, we've decided we're going to do clinics, but actually, can we do this? Are we trained to do this? Where is our information from and how up to date is it as well?
So if we're talking rabbit health, we really need to understand, beyond the basics of rabbit health and, and what's going on there. So we need to make sure that whoever's going to be running this has actually taken extra time to do some extra CPD, upstate textbooks, make sure they're no later than the 2014 textbooks that are out, and, and really kind of make sure that you do understand what information you're trying to give across to the clients. Also, who is going to do this?
Is there just one person that's gonna do this in your clinic? Is there gonna be a nurse, a rabbit nurse champion that's gonna do this? OK, that's fine.
However, what happens when this one nurse, if they're on holiday or if they're unwell or if actually the clinics are so popular, have you got more staff that are gonna do it? And if you have got more staff, Doing it. Do you have protocols set up so that actually you're definitely running the clinics in the same way and make sure that you're asking the same questions, and giving, most importantly, giving the same advice because you don't want to end up in a situation where a client potentially sees different nurses, which is fine, but then is given different advice.
OK? So it's really important. Where are these clinics going to take place?
Might sound like an obvious question, but actually, if you work in a small practise and you've only got two consult rooms and the vets are usually in those consulting all the time, where are you going to do your nurse rabbit clinic? OK, so you need to have a consult room. You can't be just in a broom cupboard or in the lab or trying to do it in reception.
You need to have a dedicated space where you can have your own equipment, because obviously you're gonna need no scope, you're gonna need scales, you're gonna need charts and information and all these different bits and pieces. So you're gonna need to have access to that. It doesn't have to be a dedicated consult room.
That's not a problem because you can just have Like a storage tub or something with all your bits and pieces in that is mobile and you can bring it in ready in preparation for the clinic to start. But you do need to make sure you've got that resource assigned and that it's actually put onto the practise management system as well. It needs to be in the book.
It needs to a proper clinic with scheduled time, as well. So it's not something that can be bumped off of the books or the, oh, no, this is more important. I need to use your room.
You know, if we're gonna do this, we, we need to make sure the whole team is invested in this. We need to make sure we've got our support materials sorted before we go live as well. So any handouts and displays we're going to have, and we're gonna talk about, later on, going through an action plan and getting owners to diarize things, giving them diet information and all these other bits and pieces.
We need to have all of this up together. Ready, printed off if we're gonna use printed or the email links ready if we're gonna do it that way. So that we've got everything before we start.
We don't want to get halfway through a clinic and then realise we don't have the tools to finish off. And lastly, but, but very hard to do quite often is the marketing. So some of these clinics can be very hard to get uptake.
I'm not going to lie, these aren't going to be the most amazing clinics that are just going to sell out for your practise 24/7. But they're very, very rewarding because you're often making a big difference to to these animals' lives. So you need to be clever with your marketing, and you need to use a multimodal approach.
So we want to be emailing your current, clients regardless of what they've got at home. Again, you can do this, update your details things, do you have a rabbit? Do you know we, we hold these clinics, so you can do those kind of cold emails and really make the most of social media.
It's Perfect for advertising education, which is basically what you're doing. If we think back to that list of topics, those 10 different clinics we can run. The weather's warming up now, now's the time of year to be looking at fly strike things.
So again, put some information out on your, on your, social media, saying you run summer clinics, get the owners in, get them to talk about this. Same with winter and the other bits and pieces. And don't forget the good old telephone.
We don't tend to use it as much these days, but you can also phone your clients, and that makes a big difference with regards to, the, the continuity of the clinic as well. So once you've already seen them for the first one, we're going to talk about different ways of staying engaged with them. We need to remember this is going to cost.
So although money is a bit of a dirty word, we're a bit too keen to give away clinics for free. Now, in my opinion, registered veterinary nurses are highly trained, highly trained, very well qualified, perfect to do, to run these clinics, and they are professionals within their own right. So in reality, we really should be charging for our time.
However, This doesn't always go down well with our bosses, and this doesn't always go down well with the clients as well. So we need to think about it, but we need to know how much it's costing us to run this clinic, because it's going to be the room, it's going to be your time, the creating and downloading, printing, collating of the resources. Obviously, we're gonna offset some of this with some second sales and things as we go through the consults.
But we need to be aware of what that base cost is, and then we can make a judgement or the practise manager or whoever can make a judgement on how we set the fee scale for the clinics. We need to propose to our clients. Well, no, of course, we, we don't really need to get down on one knee.
But what we do need is their engagement, OK? And this is key to running any clinic for any species. You have to get buy in from that owner, OK?
And without that, it isn't gonna go anywhere. So you really need to build up this trust, this bond and get really engaged with your clients. So think about education and what have we got around us that can help us?
Well, the Rabbit Welfare Association, has amazing posters. They're on their website and they're free to download. This is one example, and this is one that I really like to have on reception as a bit of a crib sheet for receptionists that, that maybe, Aren't completely au fait with rabbits.
It's a nice quick and easy one to, to, to refer to. I mean, you would hope that haemorrhage and screaming would make anybody concerned on the end of the phone and bring them in. But we can use these on our social media again and our display boards and every sort of poster and bits and pieces of information that we've got.
The more we can share that out, people love looking at infographics. And if you tag it on with a very short, bit of, a bit of commentary saying, you know, we run a clinic for this, a clinic for that, or just even if it's just come and speak to our nurses about rabbit housing or diet, it's a way of getting through the door of peking their interest. The RWAF also create this wonderful booklet called On the Hop, and it's literally the 101 guide to rabbits.
Now, if you're making puppy packs, but for rabbits, this is the booklet you need in there. It's got, Should I get one? What do I feed it?
What do I keep it in, what do I do with it when it goes wrong? OK, so it's literally got everything, and there's even two pages in the back on guinea pigs as well. So this is well worth having.
Now, if you sign up as a member of the RWAF, you can sign up as a personal member or a veterinary membership for the whole practise is only 45 pounds a year, and that will get you a certain amount of these. I think it's 75 of these booklets a year, as part of that membership as well as some other benefits. That's a really good starter.
Otherwise, I think they're about 1 pound each that you can buy from them. So rather than you spending all the time trying to collect bits of information, put it all together in a in a pretty package and then print it all off and use all your costs that way, you can just buy one that's already done for you. And again, keep reaching out to these guys, newsletters, emails, phone calls, that multimodal approach to really kind of push your clinics, but at the same time, you're pushing them via education rather than trying to sell a clinic per se.
So you're saying, you know, you're sharing a poster on diet and you're saying, do you, do you want to come in and have a weight check? You're sharing something about, a winter poster and going, actually, do you know what, have you got an older rabbit, Should we get it in and have a look, for a geriatric? Appointments.
There's lots of things out there that you can pick up and you don't have to recreate the wheel. So some of the basic facts we need to have regardless of what clinic we're running then is husbandry. So we need to know about their diets, and it's very important, the same with our cats and dogs, that we are feeding a life stage diet to our rabbits, OK?
Now, the most important thing is hay, that is a rabbit's diet. Pellets are basically a vitamin supplement. So we need a good quality, dust extracted hay that smells like a sweet summer's day.
If it's it's a bit mouldy or fauty or dusty, then, then we don't want any of that. And that includes what we keep in clinic to sell, but also what we keep in clinic to feed our patients, because I'm sure that, you know, you're with me, the clients that the, the clinics I've worked at, and there's that one bag of hay at the back of the cupboard that sits in there, cause we don't see that many rabbits, but we've got hay in, so, you know, it's been there about 8 months, but I'm sure that'll be fine. And of course, the patients don't eat it because it just tastes horrible after a time.
So, so think about what you're selling, but also think about what's out the back. As I say, pellets are pretty much a vitamin supplement, but they're actually really, really important. They are a vital part of the diet, and we don't want to go pellet free.
Now, the reason being is, if we were trying to give the rabbits, the right range of nutrients that it needs, we would need to know what it's RDA is for its life stage, for its current, body condition score, for any contraindications, any underlying Issues that's going on with this. And then we'd need to compare that to what we're feeding. So that cabbage leaf, for example, we would need to know the nutritional makeup in that leaf of the protein, the calcium, the phosphorus, the, the ash that I could go on.
We're going to need to know all of those minerals and vitamins for every single piece we feed and then do the math and work out where we are over or under supplementing that site. Absolute nightmare. So we don't, we'll just use, we'll use pellets.
Now Supreme Science Selective, I do have a commercial bias. They do sponsor Legalo for me. However, I chose them because technically, when you look at nutritional analysis, they are the best, pellet, extruded pellet food that is, that is out there.
They're the highest crude fibre of 25%. There's no added sugar and it's a fixed formulation as well. So that, that recipe is never going to change, due to the price of, of or availability of ingredients.
So for babies then up to 6 months old, they need to be on a junior pellet. This is a lot more calcium in there, the calcium phosphorus ratio is changed slightly. These guys are on a major growth spurt.
Their metabolism is really quick anyway in rabbits, and when they're growing up, they just need everything, all the energy they can get. So it's a very energy rich food for these guys. Once they're over 6 months, they're gonna wean them onto an adult food.
And this lasts them until they're about 4 years old. Now again, the ratios has changed slightly, so that we're making sure. We're, we're feeding the right bits for their diets.
So then when we get to 4, we're going to move them onto the mature. Now 4 doesn't sound very old, and we think these guys are living to kind of 10 to 12 years depending on some of the breeds. However, the mature food, is pulling back on some of the calcium, not all of it, but some of it is Changing the ratio slightly there.
It's also adding in some bits and pieces that gonna help with, kidney function, prolonging kidney function, and help with bladder health as well. So it's kind of moving into a preventative food as well as looking at it being an old, you know, an older person's food. The other important thing, as you said, with the hay is under 6 months old, these guys need alfalfa hay.
Again, they need that higher nutrient, higher protein, higher calcium hay to go through, and then we're going to wean them off of that at 6 months and move them across to the Timothy and meadow hay that then will make up the majority of their diet for the rest of their life. So the good diet then, this is one of my favourite posters here to to educate owners because actually it shows it within the body shape of the rabbits. You can say every rabbit needs to eat at least a ball of hay the same size as its own body every single day.
The green portion, the leafy greens, is a small handful, no bigger than the rabbit's own head. And with regards to the pellets, you know, you're kind of looking at an ear, unless you've got an English lot, which of course is going to end up with a dog bowlful if we go by its ears. But actually what you're looking for for adult rabbits is 1 tablespoon of good quality pellets per kilo of ideal body weight per day.
Now what that equates to pretty much is 1 to 2 tablespoons per normal size, average size rabbit per day. OK, and it's all grass, grass, hay for the rest of that. What we don't want to be doing is we don't want to be feeding muesli.
We don't want to be feeding all these, these highly coloured treats. I mean, they look like something I wouldn't even get to a child, let alone a rabbit. So nothing with dairy or yoghurt or honey or whole seeds, none of that.
And carrots, actually, we think about what they are. The carrot is a root veg and all root vegetable, basically all that stuff that's underneath the ground. The reason we like it is because it's sweet and it's sweet.
Because it's, it's the energy storage for that plant. So, all root vegetables are very high in starches, which can just really throw off that, multibiome that's going on inside of that gut. So if you know any of this as you're going through history in the clinics, this is where we need to be, to be doing some education and switching them and understanding how to switch them onto a better diet.
We also need to know about enclosures. So the current guidelines is a 10 ft by 6 ft enclosure at all times. So 60 square foot for a rabbit or two rabbits, they should live in pairs, but it would be the same for a single.
Now this sounds like an astronomically large amount of space until you think about how much they would run about in the wild and what they would do. These guys are naturally selective feeders. They're foraging.
They are feeding up to 30 times a day and taking about 6 grammes of food every time they eat in these 30 times across the day. OK. Studies show that they, one female rabbit will roam the same size as an Olympic swimming pool every single day when given the chance.
So all of a sudden that 60 square foot does not seem quite so big. I'm sure you'll all agree these two hutches are absolutely hideous, and we've got to be really careful with what we're doing with that flooring as well. OK, so we don't want wire floors.
They are going to lead to poto dermatitis. They are going to be uncomfortable. They're going to mean the rabbit isn't moving around as much because it's going to have sore feet.
So you've really got to think and understand what a good enclosure looks like. Now if these guys are living indoors, this is Pippin, you can use, now I have to think about this, pop up puppy panels. There's lots of peas there.
And basically they're just panels, that you hook together and that you can make any sort of shape that you want, and they're really handy for indoors. Because you can really make the most of any kind of corner. And you can make, make sure that you're meeting those minimum guidelines.
And outdoors. Again, we want to say, you know, kind of ban the hutch, death to the hutch, and think about enclosures. Hutches were basically a Victorian invention.
And what they do is they just keep rabbit fat so that they get nice and fat for the pot to be eaten. So obviously most clients want, are not going to be eating the rabbits. So we want to, we can use a hutch, but really we're looking at sheds with avery panels attached and things like that so that they, they've got all this space and they should have an exercise run permanently attached.
Now, if we get this diet wrong and we get this housing wrong, these are the consequences that we're gonna see, OK, and just some of the consequences. So some really serious things can go wrong, for these guys, and that's why it's so important to understand the basics and be able to go into this in detail at clinics as you run through them. So moving on to the clinics themselves then, the general health check.
Now this 10 point check really is something that should be done every single time you have your hands on a rabbit, regardless of whether you're a vet or a nurse, it doesn't matter. And you may think, oh goodness, 10 points, really, but actually, you're going through this stuff already. You're just maybe not necessarily thinking about it, quite so much.
For me, I go from the bitey end to the non-bitey ends, but I do leave the jaw and teeth till last for the otoscopic examination because that's the thing that stresses them out the most. So we wanna make sure we understand the general health check and we can really tick this off, bit by bit as we go. What I recommend to do is when they come into the consult room, you put the carrier on the floor.
And just open it and let flopsy come out at their own discretion and see what happens. Are they shooting straight out, are they being reticent? Are they coming out and bobbing around as they normally would, having a good look around?
Are they limping? Do they look a bit too fat? Do they look a bit too thin?
Is there anything that's going on? You know, you can get some real good behaviour cues from just them, them being allowed to, to run around the, the consult room, allow them to get used to your voice as well, because obviously they won't know you, but they can build up a little bit of trust with understanding you, taking the history from the owner at the same time as the rabbits in the room. Obviously, we don't want any bolt holes or open doors, so we don't want to get rabbits stuck behind sinks and those sorts of things.
So make sure it is a secure area. And take that rest break visually before you go anywhere near the rabbit. So before you touch it, take a look at the abdomen, see if you can see a rest break.
And get that ticked off, because as soon as you start touching it, it's going to artificially increase these values. So the next thing to do after our respir break, we want to do the heart rate, and we want to get that done as quickly as possible after we've, we've put hands on the rabbit. Now you can do this on the floor, or you can lift the rabbit up onto the table.
Either way, make sure you've always got a towel because they just are so much more settled if they're sat on a towel and you can then wrap into burrito if you absolutely have to. Obviously, we're making sure those nose and eyes are nice and clear. There's no, crusty bits or weepy bits or anything that shouldn't be there.
And the same with the ears, we're gonna look through, through the ears as well. Now with regards to the ears, regardless of whether they're a lop or not. Always, always check those ears with both hands at the same time and make sure you go all around the base of the ear and palpate it really nicely as well as just looking inside because ear-based abscesses are, are very common in rabbits, both up ears and lops, more so in lops.
And this can feel anything from like a, a, a grain of rice to a pea to a ping pong ball, and can be very hard to, to spot if you're not actually looking for it sometimes. Think about the, the warmth of those air bases. Do they feel the same?
Is it any, any changes that you feel, is it bilateral or unilateral? Because if it's unilateral, then pretty much there's something you've got to look at there and you're gonna need to get the vetting to, to have a look and, and, air your concerns to. Get the otoscope out, have a look down those ears again.
You know, the otoscope is not the property of the vets. It's fine. You can use it as a registered veterinary nurse as long as you've had the training to do so and you feel confident to do so, then that's great.
You can have a look in and look for any signs of redness, mites, or sores or anything like that. Working down the body, we're gonna flick through the skin and the fur, having a look for any mites, seeing any areas, are there any matted areas anywhere? Any, any barbed areas, all of this can be a sign of pain or dental problems.
Obviously we're gonna weigh this guy, and get a weight for them, but we want to go one step further. We wanna make sure with body condition scoring them as well. It's really important that we do this, because it's gonna help us working through what's going on with these guys.
And we need to do that every time we see them. So looking at the gender and tail there, obviously we don't want to be trancing rabbits. We don't want tipping them onto their back or anything, any such thing.
The myth about, oh, as long as their heads higher than their heart is not true. Basically you're just triggering their stress response, their prey response, and, and the, . The study by Anne McBride clearly shows that, that stress calcomamines are released and and these guys are very stressed if we're tipping them the wrong way up.
They're prey species, OK? They're very stressy, so we want to keep them the right way up at all times as much as we can and also make sure those feet are touching something. So you can see in the photo here, to have a look at the genitals and the tail area.
You can hold the rabbit against your body, and, and have the front legs. Up and then also have the back legs along. You can just tip the bottom slightly away from you.
OK. So if you've got a nurse holding or the owner holding, or you can do this yourself in front of a mirror and you can tell the owners to do it in front of a mirror when they're checking at home. Again, this means you can see what you need to see, but you don't need to tip the rabbit in the wrong way.
So again, we're looking for these genitals to be clean and clear and no problems. So they are going to have scent glands down there, and they, they are really not nice smelling at all. As long as they don't need cleaning, they just need checking, and there's going to be goo in there because it's a glands, and that's what glands do.
And the more we try and clean it out, the more goo they're going to produce. So we don't want to be cleaning them. However, if it's got rock solids like literally like these These flakes of, of really rock solid black tarry goo in there.
We do need to just pop those out gently with a bit of lube on a cotton, cotton bud just to eke those out because they will be quite, quite irritant and quite sore down there for these guys and a bit of a fly strike risk. So we have a look at the feet and the nails, make sure they're OK. We want to keep those nails short at all times to avoid polar dermatitis and catching nails, catching nails in, in wire and bits and pieces like this.
And make sure there's no twisty weird ones going on as well. And then we're gonna come back up to the head area, as I say, and do the jaw and the teeth. Now, this involves you want to again use both your hands and you're going under the mandible, and you're feeling all the way along on the outside and on the inside as well, .
Inside edges and outside edges, not putting your fingers inside the mouth, to really feel to make sure there's no lumps and bumps and also check to see if that rabbit is flinching at any point. Now there can be a bit of a guinea pig about this in so much as, you know, guinea pigs, you show them in the needle, therefore they squeak before you even touch them. So if your rabbit is flinching whenever you touch it anywhere, obviously we need to disregard that because it's just a flinchy bunny.
But if it's OK with you touching and then and then unilaterally, you've got a bit of a flinch going on, then, then there's something not quite right on that jaw. Feel across the nasal bones, feel across the, the underside of the zygomatic arch as well, and across the edges of that mandible. Just to see if you can feel any bony changes because if there's any problems with the root apices, then they're often gonna show some you're gonna feel those changes before you may pick up on or the owner may pick up on any dietary bits and pieces.
We're gonna go into how to look at the, the teeth and inside the mouth a bit later on. And very important is vaccination status, OK? We need to know what's going on with these guys.
Are they currently vaccinated? If not, why not? And, and let's get them on a programme.
And the expert in that room at that time is going to be the owner. Now, they can be the worst donor in the world, however, they know that rabbit's personality a lot better than you do. So you really do need to take a really good history.
You can get forms in the BSAVA rabbit manual. That can help with this, as well as on the Supreme website and other, other places as well. So that you're just making sure you're covering everything and getting everything down about where they're living, who they're living with, are they indoors, outdoors, what they, what they're eating, all these sorts of things.
OK, so finally on, on what we're looking for, the importance of poop. It is all about poo with rabbits, and anyone that's ever heard me speak before will know I'm obsessed with rabbit poo. I've recently released this chart.
If you want to copy, just email me, it's fine. I can, I can email one out to you for free. And it's just identification and it's really important.
I'm not going to go into it too much, this evening. But it's important to know what normal faeces look like, both types of secret rose and the hard faeces, and then the abnormal ones as well, and what this can mean. OK?
So we need to know it as veterinary professionals, but we also need our owners to know this as well, because then if they're picking up on this early, we, we've got more chances of treating these bunnies, more successfully and in a quicker way. So let's start with the, with the clinic number one and the pre-purchase appointment, the hardest one of the bag to actually get people to come in and have. Now, If we do manage to get someone through the door, the two important things are what do they want and what do they need.
Now, these aren't necessarily exactly the same things. Certainly this time of year, it's Easter, everyone's Think about rabbits, I've been spending the last 3 weeks telling everybody to not buy rabbits. Anyone that will listen.
So, but typically we're gonna see lots in the next couple of weeks that have been bought for Easter. But if you're talking about a pre-purchase appointment, you know, try and find out why it's rabbits they want, OK? And work that out.
And it's a really good book by Emma Milne called Are Rabbits The Right Pet for you. And it's the Pet Detective series, and there's the same, there's she's got one for cats and dogs and small fairies as other small fairies as well. And it's a really useful book to go to, to recommend to clients to get them to, to look into before they take on, ownership of these pets.
But of course, we can't just assume that they're numpties and they don't know anything. So we also need to assess how much they already know. So don't kind of launch into a spiel about this, this, and all the rest of it.
Actually ask them some questions and give them a chance to tell you what they know, because it could be you've got an owner that has actually decided to do some research, and come in, and the fact they're there and coming and speaking to you before they've got the animal is quite a good start. Anyway, so they may already know what's going to go on. And from that you can make your recommendations.
You can go, actually, do you know what, you've got a 3 year old and this really isn't the best pet for a 3 year old. Have you thought about this something else instead? Or you might want to change this or actually you've got a flat with no access to to outdoors.
Is that the best animal? You can just, what would you recommend in this, in this scenario? And it could well be that yes, you recommend to go ahead and get the rabbit.
And of course, we wanna, we want to help them with the purchase. So we want to talk about adopting rather than shopping as much as possible if, but if that's correct for that owner. Now rabbits are quite different in my opinion to cats and dogs in so much as you've not got one breed that's going to be more friendly or more chilled out or you know, that it's all about handling and socialisation, which we know is the same for all species, but owners don't tend to.
So, Again, if we can get them talking to, to rescues and things rather than going into, into pet shops, that, that's always a better thing. And give them some information as well. And this doesn't have to be done in the clinic.
This can be done completely online. This can be done by email, by telephone. It doesn't matter.
It's just making that first touch. It could even be a notice board, OK, in, in reception where owners can go and have a look and have a think about what's right for them. So what you are going to see and what you're gonna see quite often is the new rabbit check.
Certainly if you work in a veterinary practise that is inside of a pet shop, I believe they, they, when they get sold the rabbits, they then get a voucher to come and have their free health check and their nutrient within a certain amount of weeks after that. So all of these clinics you're gonna do the general health check, but the important thing about this one is sexing these rabbits, and you're gonna want to do it a couple of times. And you're certainly going to want to keep doing it for the 1st 3 or 4 times you see that rabbit on subsequent visits just to make sure because they're tricky little things to get your head around sometimes, OK?
So just check, check and check again. And if you're not sure, be really honest and just mark it in the notes and say to the owner, I'm not sure. OK, there's nothing wrong with that.
You can get a second opinion, but it's much better to say I'm not sure than say, oh yeah, yeah, yeah, it's a girl, and then they take it home and it ends up, you know. Being a boy and, and getting the mother pregnant again. So these things do happen.
Again, it's a new rabbit check. This is, this is the first time you've ever seen that rabbit, that client, what do they know? The easiest way to start is to find out what they can tell you, and then you can fill in, fill in the blanks.
And again, you're going to need to go through all the bits and pieces, the vaccination, neuting, diet, enclosure, bonding, and really do give out that new rabbit pack because there's so much information in these clinics. Now all of these clinics, I recommend you spend 20 minutes doing. Because that's a really valuable amount of time to go through things without feeling like you're bombarding them.
OK? So we wanna, we want to get this done and find out where they are with different bits and pieces. So are they already vaccinated?
Have they had vaccinations to cover all three diseases, or do they still need something topping up and, and bits and pieces like that. So that new rabbit packet is perfect for them to go home, go home and reread about stuff that you've told them. Speaking of vaccinations, we can have vaccination clinics.
Now, the important thing in here is it's synergistic with the vet. So we want that general health check to be taken by the vet because we cannot diagnose health ready, currently ready to give. Injected to give a vaccination.
Now, what we can do is they can book the appointment with the nurse for 20 minutes for a vaccination appointment. The vet can come in at the start, halfway through at the end, doesn't matter when, and do the general health check to make sure the thumb thumping the breathe breathe and all those bits and pieces are working perfectly fine. Then they can just say, yep, I'm prescribing the, the vaccinations, and, and you can give them under, under veterinary discretion, as long as you and the vets are happy to do so.
So this is very much a way of having it still gives you the time to talk to the owner about, about vaccinations and the importance of bits and pieces, but also it, it's, it's more than just a quick 10 minute appointment with the vet to make sure that actually it's OK on a vitals level, but we're not getting anything of the holistic side to understand what's going on. Hopefully, lots of you will have healthy pet clubs, and if so, I really hope you've got both vaccine or all three diseases, so the two different vaccinations included. So we are covering myxomatosis, RHD1 and RHD2 on those healthy pet clubs.
That's one of the most important things that you can do. If you're thinking about doing an en mass vaccination clinic, just be slightly wary because if we think about how RHD2 is shared, it is spread. I tend to think of it like wet paint.
OK, so if I touch wet paint on the bannister, I come in, touch my nose, touch the wall, touch, touch, touch, touch, touch. This wet paint's going everywhere. So if we think it's a jolly good idea to get 20 rabbits in our waiting room at the same time to come through our consult rooms one after the other, and yeah, we're spraying the table.
But we're not actually looking at doing a shoe dip or we're not changing our tunic, or, you know, all these bits and pieces. We're potentially spreading that virus, from these unvaccinated animals around our clinic and to our other clients. So I'm not a fan of en mass clinics.
We did have to do them when it kind of 5 years ago, when RHD2 raised its head over here and we were just trying to get people, get these animals covered. But in general, try and move away from them unless you've got really strong biosecurity. So as I mentioned, you've got the Noviva combo.
Now that covers you from Mixo and RHD1. This is, usually the first one that's given, because it can be given from 5 weeks of age. So at that first appointment, that first health check, that may be when you say, right, OK, we're gonna give it then or book you in for a vaccination check.
On top of that, you then need to leave at least 2 weeks before you give the RHD vaccine, and you have two choices. You can either use the Filiac, which is RHD1 and RHD2, or you can give the Aerovac, which is just RHD2. Now it doesn't matter which one you use.
As long as you do wait those two weeks because that's standard, immunological, struggle with that, advice just to make sure because we don't know how these two vaccines into play. And also, we don't want to over challenge the rabbit system by giving it too much to fight in one go. We don't have any data on giving the RHD1 twice, so giving double of that.
There's nothing, there's no data there, as to how that, how that works, if there's any side effects or any problems with that. To date, we haven't really seen any problems with that since we've been using that method. So the Fiivac can be given from, 10 weeks of age, and, the Aerovac can be given from 30 days of age.
Now the Fiivac has a licence for a year. And some specialists are using it every 6 months in hotspot areas. However, pretty much all of the UK is a hotspot now.
The Aerovac, be aware, it's only licenced for 9 months, so that can be a wee bit tricky on the vaccination schedules and owner compliance as well. But it's currently only licenced for 9 months, and that's because they're the, it's challenge tested to 9 months. They've got serology up to 12, but the licence in the UK is just the 9 months.
So don't mind what you use as long as you're using them and recommending that all of these 3 diseases are covered. So the pre-op elective consultation. Now this is, this is one of my favourite clinics and one that we really tend to do very badly in practise.
We end up with the owner. Coming in, we may have never even seen that rabbit before. We go, that's OK.
We'll, it will come in on the day of his operation. The vet can check it in, and that's fine. The vet does a health check and checks that it's got a heart and it's got lungs, and that's probably as far as we go.
And then we think, yeah, that's great, let's cut it open. Actually, we need to go so much beyond that because so much of this holistic stuff, I mean, this is a webinar in its own right, but so much of the holistic stuff, makes a direct, difference to your ASA grade of your patient. So if they're on the wrong diet, for example, that see, the, the multibiome has all the wrong bacteria in there.
There's going to be a high level of Clostridia going on in there. . Excuse me, and it's going to be a sluggish gut.
It's not really working very well. We know our general anaesthesia drugs are going to have an effect, a suppressive effect on that gut. We know it's going to slow it down.
So we're setting ourselves up to fail, OK? And all of these things do have a direct relationship back to our SA grade. So for that pre-op elective clinic, We really need to have this 6 weeks before they're coming in for that neuter.
And the 6 weeks is based on that bio, that multibiome, because it's gonna take 6 weeks for, for the structure and the bacteria levels inside of that, I can't, can't speak now, inside of that multibiome to really change, and make this a better, more stable anaesthetic candidate. Are they bonded? If not, then do we want to bond them before they come in or after they come in?
If they are bonded, we want to make sure that they stay with their partner. But this appointment basically goes through everything to do with, with their elective procedure coming up, whether it's a neuter or a dental. And you go through the discharge appointment details as well, because there's no point telling somebody at 8 o'clock in the evening that they've just collected their rabbit from being neutered.
That lives outside. Oh, actually, yes, flopsy needs to stay in overnight, for 24 hours, and, you know, maybe can or cannot go back with its partner and the owner's going, Well, you didn't tell me that. How it lives outdoors.
I've got a pit bull and a, and a 3 year old. What, what am I supposed to do with the rabbit? OK, we need to give them the information and help them be compliant.
So this is very much a continued discussion. We see them 6 weeks before and we see them in the clinic, but then in between those 6 weeks, we don't need to see those rabbits back per se unless we found a problem with them. What we do need to do is keep talking to the owner via email, ideally, because then you can attach it to the notes on most of the price management systems, or via phone, and then you can write your notes up as well.
So it's a continued discussion. And very controversially postpone. OK.
So if they are rocking up in the morning for, for a, for a neutering. For this pre-op clinic, then actually, and they've got a poopy bum, then don't do it. OK?
If you had a dog come in with diarrhoea for a routine castration, I would really hope you wouldn't still be happy to knock it down and go through because that has affected its ASA grade. And it's the same with these guys, just because you think, possibly think, OK, well, it's quite common. Oh yeah, he's always had a bit of a runny bum, don't worry about it.
No, OK, this is going to affect our anaesthesia, so we need to postpone this. Also, parasites, if they're coming in for their pre-op check and they've got any fur mites, any kylatella, leprochaus gibbbus, or any ear mites going on there, I mean, these are quite severe cases. Again, we, this is going to directly affect our ASA grade because their system is under attack.
It's normal that they have these mites on them. They lurk around, certainly those fur mites lurk around all of the time. But they only proliferate when the system gets out of whack, OK?
So if they've got mites, even just a few, but if you can see them, we do not knock them down because instantly they've gone from an ASA 2 because you don't get ASA grade 1 rabbits. They've gone to a 3, and if we think about that in other species, we would stabilise before we, before we knock down if we were looking at an ASA grade 3. So think about the weight management clinics then, that's probably the one that's going to be the most popular, on the uptake.
Now this can be, they need to put on weight, sometimes, but it also is usually that they need to lose weight. This little chart from the PFMA is brilliant, the rabbit seismometer, and it's a really nice way, of getting owners to understand how to body condition score there. Rabbits.
And if you make a fist in front of you at the moment, because we need to understand light touch, so make a fist in front of you and with your other hand, use your fingers to have a light touch across your knuckles. That's too thin, OK? If we flatten out that hand, and feel across, turn it upside down and we feel across the underside of those knuckles, that's too fat.
And if we keep the hand flat but turn it the right way up and fill the top of the knuckles, that's just right. OK, so a closed fist is too thin, the underside of an open hand is too fat across the knuckles, and, and then on the upper side of the open hand is just right. And that's an easy way to get unders to understand, because if you ask them if they can fill the ribs, they'll squeeze their fingers in until they're pushing kidneys together and say, yes, yes, yes, I can feel the ribs.
OK, so we need to explain light touch to these people. So part of this general health condition, this general health check is obviously the body condition score and weighing these guys. But we also need to talk about the diet, the enclosure and the behaviour and how we're gonna make this better.
So in total, we want to look at losing 10% of the total body weight, but we don't want to do that any quicker than more than 1% weekly. So these are very gradual changes. These guys will go into hepatic lipidosis quite quickly.
So we really do want to make sure that they are, that we're doing this nice, nice and slowly and keeping an eye on this. OK? So we want to see them in the clinic for the first time, but then I would actually hand off to the owner and do the rest at home and only see this rabbit once a month in the clinic unless there's any problems.
So at home, we want to adjust, monitor and report what's going on. So we need to, to explain to our clients that they need to weigh these guys at home every week, and then report back to you. Now, obviously, the scales are going to be different.
They're gonna say different numbers, but the incremental changes should be the same amount on both scales, and then you can just catch up, with them, once a month to see the rabbit in clinic, because it's very stressful bringing them in. And if we're just weighing them, and then the rest of the time we're talking about changing the diet and how's it going, and what's the behaviour doing, we don't need flopsy sat in a carrier for 20 minutes, every week to, to do that, OK? Part of this is dietary modifications.
Lots of people feed via egg cups as their dosing regime, whereas if you look at this picture here, 3 different size egg cups, all 3 have wildly different amounts of pellets inside of them. So you need to measure by tablespoons, and these are very cheap and very easy to get an actual cook's tablespoon measure, and then you know for sure they're always getting the right amount. We want to bend that bowl, OK, let's scatter feed for these guys.
Let's get them moving. So as much as you want to change the diet, we want to get them moving around and exercising more because the more they exercise, the more they're going to burn some of this energy off. Use sock holders, sock dryers to hang up bits of veg and herbs and bits and pieces like that.
So they have to stretch up. It's going to strengthen their lumbar muscles, strengthen their leg muscles as well. Make sure that we've said they need a lot of room.
Let's just recheck what size closure they've got. If we've got fat bunnies, why have we got fat bunnies? OK.
Maybe they haven't got a run that's attached, so the runaround tunnels you can see here can instantly revolutionise a rabbit's life by allowing it to have direct access to its run from its hutch at any time of day or night that it chooses to. Make sure they're nice and tall, they need to be at least 3 ft tall, so these guys can properly periscope up. They would normally do this, and we need to do that.
And we can have toys and again hanging hay and bits and pieces up to make it interesting for them as well. If we're talking about summer clinics, which obviously is very relevant at the moment, I know we're only technically in spring, but we've got some nice weather coming this weekend. We really want to be getting these guys in and what we can do is we can talk to them about fly strike, and we can actually apply the fly strike for them.
So you can either say, come in for a free clinic, if you buy the fly strike prevention treatment, we will apply it for you and you get a free clinic, or you can say, pay for the clinic and we'll give you the free, we'll apply the, the treatment for you for free. So. There's ways of marketing that.
We want to check those genitals again, looking for that they're clean and clear, and also check the eyes because rabbits with weepy eyes, are also a fly strike risk. They will, I have seen two last year where, the maggot eggs were led along the eyes because of the soft weepy, dermatitis there. Heat stroke is a big problem, especially with the weather at the moment.
It's very see-say, so we're going from maybe 9 degrees, 7 degrees, and then we're whopping up to kind of 23. So these guys are moulting, and, and they're getting hot and then they're getting cold. So have some ice pods or some frozen bottles.
And of course, vaccinations, it's all kind of interplays. You'll see how lots of these clinics interplay with each other, because the more biting insects are out, then the higher risk we've got of those infectious diseases as well. The other end of the scale, if you're cold, so are they.
So if they live outside, then again, we want to get them in in winter to, to give them a good check. Now, what are we looking at, at, at this age? So we want a body condition school these guys if they, if they're very, very thin, obviously they're gonna need a bit more, care.
Not extra food, they don't need extra food for winter, but they do need extra heating and some enclosure adaptations. Now, if they're over 4, they're gonna start to get arthritis and there's so many rabbits really do get, arthritis and it does come in from about 4 years of age onwards. So again, think about where they are on that, on that schedule and, and see how they're moving.
Are they bonded? Do they have a partner or did they lose their partner in the summer and now it's winter? Well, if so, they'd be used to having this other little radiators sit next to and if they've recently lost their partner, then, then they're going to be colder.
And again, something like a snuggle safe is, is really good to, to put in with these guys. You want to think about flooding of the outdoor enclosure, but they also need ventilation as well. So we don't want to shrink wrap these hutches and you see people putting duvets and, and, carpets and everything over them.
Which is fine, but think back to kind of, large animal vetting and your pig boarding. So you want to have ventilation so, you want to have it secure at the bottom and going up to kind of 3 quarters of the environment and then that, that space at the top to allow that ventilation to come through. And it's really important that these guys still get to exercise as well, just because it's winter, they still need to be out running and and mooching around in the same way they would during the summer.
Senior clinics, I really like running senior clinics, and it's really important that we understand, quite often we'll see these guys and, oh yeah, they're losing weight and that's why they want to come in. When you actually body condition score them and muscle conditions score them, you'll find that they're not losing weight, they're losing muscle. And there could be underlying reasons for this that are, enclosure, diet, or obviously health reasons as well with, with arthritis and bits and pieces like that.
There isn't currently a rabbit muscle conditions school, but it's very similar to to the WSABA ones for, for dogs then. I'm just doing a a Lego learn one at the moment, for rabbits. These guys have probably got mobility issues.
So are they on long term NSAIDs? Do they need to be on long term NSAIDs? Do they need to enclosure adaptations if they, you know, if there's jumpy bits, then do we need to change it to a ramp?
These potting trays are perfect to replace litter trays so they're easy access to get into, but they've still got that high back as well. Are they straining or staining, and they have accidents outside of the litter tray. This could show that there's bladder problems, or it could show that there's, there's joint problems going on there.
And you know what, let's just do a dipstick. Let's do a urinalysis in this consult and just have a quick look. Are there any proteins showing?
Spin it down if you've got any concerns. Are there any red blood cells hanging around out there? Have a look at their behaviour and do a good pain score on them and a quality of life score as well.
And even if the rabbits quite well, start talking about quality of life scoring now in these clinics so that the owners are used to doing it by the time we get to the point where we need to properly understand quality of life, and it's not so much of a shock to the owners. Reduced mobility brings its own problems, poo dermatitis and also bladder sludge. Not so worried about calcium intake in, in completely normal healthy rabbits, but if you've got reduced mobility, that is what actually upsets that bladder.
So a little analogy here, is think of salad dressing. If you've got salad dressing in the Fridge, then all of the heavy sediment drops to the bottom and the oil stays on the top. Rabbit bladders are very similar.
The calcium particles are very, very large and other lots of other large debris inside of rabbit urine and hopefully the the exit of the bladder is higher than the bottom of the bladder in rabbits. So if they're not hopping around because they've had a leg chopped off or they've got sore, sore bones or they've got a small enclosure, then all of this sediment like the salad dressing is dropping to the bottom of the bladder. So I'm not saying shake your rabbits daily, but get these guys moving and if they're not moving, start thinking about some, some bladder health and some bladder preventative measures as well.
So the dental check, quickly running through this. Yes, we want to get the otoscope in and look at those teeth, but just importantly, we want to look at the soft tissue as well. So any small white spots can be ulcers, and any small red spots can be, can be damaged as well.
It's very hard to do this consciously, but if you see anything at all, then that is an indication that you get the vetting, and you say, right, OK, we need to get them back for a proper sedation. To have a, or a GA to have a good look at this, because if you see something on a conscious, exam, then you're definitely going to find something a bit, a bit deeper. Be suspicious in brachycephalic animals, they are like more likely to have, dental problems, and also look for any staining and clumping on the fur on the inside of the front legs and around the dewlap area as well.
So the final clinic is Rabbit Awareness Week. It's happening in June this year. It does change its dates, which is slightly annoying.
This year's topic is vaccinations, that fits quite nicely. But in general, regardless of the year, you're gonna do a general health check and look at the skin because quite often, The amount of rabbit clinics I've done, and there are parasites lurking there, fur mites there that are more prolific than they should be. So straight away, you've got a second cell on some, some disc some further treatments that may be needed there.
Get a good history. This is the one clinic that I would say do as a free one because you're gonna snag in. There's, there's national coverage on this, and you could potentially snag in some, some new clients and just use products within your, within your, your clinic.
So spray the towel with pet remedy and just explain what it does, and then just use a Zoom group. The cat zoom groom is the best one for grooming all bunnies. And the fur's gonna come out like mad and the owner's gonna go, Oh my goodness, what's that brush?
That's amazing. Just go, yeah. It's a cat zoom groom.
They're at the front, they, you know, 5 pounds or whatever. You don't need to sell it any harder than that. You just use the products, and then the owners will go ahead and, and quite often buy them afterwards.
So. It's quite a nice, one for that. You can get a pack from Rabbit Awareness Week that will give you some posters and information and also if you contact Supreme Pet Foods, they are more than happy to to send you samples as well, because Rabbit Week is run by Burgess and the Rabbit Welfare Association.
They send you some bits and pieces, but you can also contact Supreme and some of the other manufacturers, and they will help send you some bits and pieces as well. So we need to make an action plan for all those 10 clinics and the activity diary that I spoke about right at the beginning, this is what I recommend, those 7 steps to be looked at. And this is based on the quality of life scoring.
So I just think it's really good to get owners thinking in a nursy way from very early on, because we're used to doing this. We score this all the time. But what as an owner, if you're told to start keeping a diary on your animal, it can be really quite stressful and worrying.
And especially if there's a terminal illness or a really bad illness that you're doing at the same time, you're emotionally very charged and drained at the same time. So if we get them doing this when they're young for a summer clinic or a winter clinic or a weight clinic, they're used to scoring their animals, OK? So when we do come to a time when it's a bit more emotional, then they're already one step ahead of the game.
Make sure everyone understands the end goal, but also the weekly goal and any potential side effects. So if that rabbit's losing weight too quickly, what do we do? If it refuses to eat the new food, what do we do?
If it suddenly goes lame, whatever it is, just understand what's going on. Regardless of what clinic they have attended, we want to be weighing and body condition scoring these guys weekly at home as part of their journey and get the owners to do a general health check as well, excluding the really fiddly bits like the teeth and whatnot. But just that general, how do they feel, how do they look?
Is their fur OK? Are they bright and well? And think about how this is going to affect the bonded mates, because if we're doing a diet trial, or we're doing a mesan trial or something like this, and they've got a bonded mate, we've got to make sure that we're also catering to their needs.
We, we don't want one rabbit getting too fat or too thin or, you know, being stressed out by the changes. So we've got to, we've got to take that. Look at everyone that's going on.
And it really is about communication. Just because you see them once in the clinic, you can then follow up most of these clinics, digitally or on the phone, so that actually that animal isn't having the extra stress of coming back into the clinic, but you'll still maintain that communication with the owner. These clinics may come about because of concurrent treatments.
So it could be the animal has come in for stasis and it gets treated for stasis, but then the vet has referred it to the nurse clinic for weight management, for example, OK? Or it could have had a leg amputated, so it's been referred to a clinic for, for dietary management to look at the urinary tract health. Alternatively, it could have come through a clinic and then you find poo dermatitis.
So then you need to send it to the vet so that you can get it on some pain relief and some Sudocrem, bits and pieces like that. So very much this you're gonna have some sort of concurrent treatment going on with these clinics and this is a way of second selling, so you are getting revenue from it, but obviously you're not inventing these illnesses. You are going to find stuff, and, and the other way around, get vets used to.
The fact that actually they've come in, the vet has fixed the problem, they fixed the stasis or the, or the urine skull, that's great. But now let's talk to the nurse about the holistic, the husbandry, the diet and make sure this doesn't happen again. Why are we doing this?
Why do we even want to do clinics? It's for these end goals, OK, a beautiful lean body shape, amazing poos, healthy toes, healthy nose, and really good teeth. OK, so we want these guys to be happy, healthy and happy.
So putting it all together then, we want to make sure we, we've got our training and our protocols sorted before we even get into the stage of running these clinics. Take the time to plan it and market it. And the activity diary really is important, and make sure there's rewards as well.
So make sure the owner understands what those rewards are. Now, if they have children, then they can have a star chart at home for, for the bunny. Oh yeah, flopsy's lost this much weight or flopsy's now play.
With the scatter ball or whatever it is, make a reward so that they understand what's going on, but also they understand what the physical mental reward is for that patient, why it's important to do these things. But these are going to take time to set these clinics up and people are gonna need to be really, focused and want to be. Part of this.
It's all about communication. We've got to keep those lines open, and that can be challenging. Some people are not going to want to communicate with you.
Other people are going to want to communicate with you all the time. So just manage and balance those expectations. And of course, don't forget to propose to your clients, but because, you know, we want them to be engaged with us, but you don't have to go down on one knee.
Thank you very much. Oh, that was absolutely amazing and I love the way that you say we do all these things but we just don't think about them. It's so true.
And just, you know, telling us or reminding us to think about it and have a plan, absolutely fabulous. Thank you so much. You're, you're welcome.
Sarah's got a question and says that she has a, pains or a rabbit grimer score chart. Which one do you use and is there something better? Yeah, thanks, Sarah.
So the, the score, the grimace score chart from Nottingham is the only one we've got at the moment. And if you're used to doing with rabbits, you get it. If you're not, then it's really hard to interpret because one whisker is 1 millimetre higher than another and the eye is slightly tightened and off.
So what I recommend is you do it in conjunction with that particular patient. So, Most owners have pictures of the rabbits on their phone, but actually, if you've got informed consent on your consent forms to take photos, what I would always do is when you see that rabbit for the first time when it's healthy and happy and lovely, take a head-on shot and a side on shot, OK? And then you can use this to compare with the Grimmest score chart, and see actually how that rabbit's changed.
So that's its normal one. So maybe that's an The morning before it's neutered. And then after it's neutered, when it's in recovery, take another photo, and then just before home, take another photo.
And when you're looking at that actual particular personality, you will then be able to see the cheek flattening, the orbital tightening, the, the where those whiskers are laying. So I think it's a great score chart, but use that in conjunction with, that rabbit's own parameters. Excellent advice.
Really great. Joe, I, I can't tell you how much I've enjoyed tonight and there's comments coming through that other people agree with me. It was, it was absolutely fabulous and such useful information for vets and nurses alike.
So thank you for your time and thank you for coming back to us on the webinar vet. Oh, my pleasure. Thank you.
We will hopefully have you back again in the future. Folks, don't forget to fill in the The form, the survey form and give us feedback on it. Remember this is, this is our channel, this is your channel.
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