Changes

Pododermatitis is the '''epitome of a husbandry related disease'''. It is a complex, multifactorial condition involving musculoskeletal as well as integumentary systems.

Pododermatitis is the '''epitome of a husbandry related disease'''. It is a complex, multifactorial condition involving musculoskeletal as well as integumentary systems.

The hind-leg stance of the rabbit is naturally '''digitigrade'''. Contact with the ground is through the claw and the plantar aspect of the hock. Most of the weight is taken on the hind limb. The superficial digital flexor is constantly under tension to facilitate immediate response to predators. The animals is therefore well adapted for life on grassland of turf.

The hind-leg stance of the rabbit is naturally '''digitigrade'''. Contact with the ground is through the claw and the plantar aspect of the hock. Most of the weight is taken on the hind limb. The superficial digital flexor is constantly under tension to facilitate immediate response to predators. The animal is therefore well adapted for life on grassland or turf.

All too frequently the pet rabbit is kept on '''unsuitable substrate''' and '''cannot bear weight normally''' on the claws. If weight-bearing is transferred to the plantar aspect of the metatarsus, '''pressure sores''' develop on the skin in that area. These can spread to subcutaneous tissues and, in advanced cases, the superficial digital flexor is displaced, which is a frequent finding in adult rabbits, particularly heavy adult bucks of which the feet become ulcerated due to contact with a dirty cage floor.  

All too frequently the pet rabbit is kept on '''unsuitable substrate''' and '''cannot bear weight normally''' on the claws. If weight-bearing is transferred to the plantar aspect of the metatarsus, '''pressure sores''' develop on the skin in that area. These can spread to subcutaneous tissues and, in advanced cases, the superficial digital flexor is displaced, which is a frequent finding in adult rabbits, particularly heavy adult bucks of which the feet become ulcerated due to contact with a dirty cage floor.  

'''Poor anatomical conformation''':

'''Poor anatomical conformation''':

:large rabbits: giant breeds, obesity

:large rabbits: giant breeds, obesity

:lack of guard hairs: rex breeds, clipping of feet for surgey

:lack of guard hairs: rex breeds, clipping of feet for surgery

'''Husbandry problems''':

'''Husbandry problems''':

:locomotor lesions such as spondylosis, ataxia

:locomotor lesions such as spondylosis, ataxia

The most important factors is flooring construction and substrate, and wire mesh is the most likely to cause pododermatitis.

The most important factors are flooring construction and substrate, and wire mesh is the most likely to cause pododermatitis.

==Clinical Signs==

==Clinical Signs==

This condition is usually seen in the '''hind limb''', but occasionally occurs on the palmar surface of the metacarpals.

This condition is usually seen in the '''hind limb''', but occasionally occurs on the palmar surface of the metacarpals.

The hock area may be '''erythematous with alopecia'''. There may be discharge from the skin. '''Ulcerations''' occur early on, and progress raised, thickened lesions covered in '''necrotic debris'''.

The hock area may be '''erythematous with alopecia'''. There may be discharge from the skin. '''Ulcerations''' occur early on and progress to raised, thickened lesions covered in '''necrotic debris'''.

There may be '''cellulitis''' and the area involved may spread to include most of the tarsal and metatarsal area.  

There may be '''cellulitis''' and the area involved may spread to include most of the tarsal and metatarsal area.  

'''Secondary infections''' will exacerbate the ulcerations and may progress to involve the bone with osteomyelitis.

'''Secondary infections''' will exacerbate the ulcerations and may progress to involve the bone with [[Osteomyelitis – Rabbit|osteomyelitis]].

The pain may lead to '''ileus''' which will present as reduced faecal output and anorexia.

The pain may lead to [[Non-Obstructive Ileus – Rabbit|'''ileus''']] which will present as reduced fecal output and anorexia.

==Diagnosis==

==Diagnosis==

If a mass is present, it can be biopsied or an aspirate taken to rule out neoplasia and granulomas.

If a mass is present, it can be biopsied or an aspirate taken to rule out neoplasia and granulomas.

A '''sterile, deep sample''' should be taken from the affected tissue, and '''culture and sensitivity''' should be performed to choose the best antibiotic therapy.

A '''sterile, deep sample''' should be taken from the affected tissue, and '''culture and sensitivity''' should be performed to choose the best antibiotic therapy. Bacteria commonly isolated include ''[[Pasteurella multocida]]'' and '''''Staphylococcus aureus''''' - human strains of the latter often cause renal infarcts in rabbits. ''[[Corynebacterium pyogenes]]'' may also be involved.

 

Bacteria commonly isolated include ''Pasteurella multocida'' and '''''Staphylococcus aureus''''' - human strains of the latter often cause renal infarcts in rabbits. ''Corynebacterium pyogenes'' may also be involved.

==Treatment==

==Treatment==

'''Nursing care''' involves: caging on soft, dry bedding may be sufficient in early disease. More severe disease requires frequent debridement and flushing of exudate and necrotic tissue and bandaging.

'''Nursing care''' involves: caging on soft, dry bedding may be sufficient in early disease. More severe disease requires frequent debridement and flushing of exudate and necrotic tissue and bandaging.

'''Bandaging''': this is usually only necessary in open or debrided wounds. Wet-to-dry bandaing may be required until granulation tissue is formed. Silver sulfadiazine cream can be applied under the bandage.

'''Bandaging''': this is usually only necessary in open or debrided wounds. Wet-to-dry bandaging may be required until granulation tissue is formed. Silver sulfadiazine cream can be applied under the bandage.

'''Activity''' should be restricted until the wounds have healed, but should be encourage in the long-term.

'''Activity''' should be restricted until the wounds have healed, but encourage in the long-term.

'''Diet''' is an important consideration, as rabbits should never stop eating. Good quality grass hay and fresh greens should be offered. Critical Care formulas may have to be syringe-fed if the rabbit is reluctant to eat.

'''Diet''' is an important consideration, as rabbits should never stop eating. Good quality grass hay and fresh greens should be offered. Critical Care formulas may have to be syringe-fed if the rabbit is reluctant to eat.

'''Medical therapy involves''':

'''Medical therapy involves''':

:long-term '''antibiotic therapy''': ideally based on cutlure and sensitivity results, for 4-6 weeks minimum.

:long-term '''antibiotic therapy''': ideally based on culture and sensitivity results, for 4-6 weeks minimum.

:acute '''pain management''': opiates such as buprenorphine or morphine, and NSAIDs such as carprofen or meloxicam, should be given

:acute '''pain management''': opiates such as buprenorphine or morphine, and NSAIDs such as carprofen or meloxicam, should be given

:long-term pain management: NSAIDs such as carprofen or meloxicam.

:long-term pain management: NSAIDs such as carprofen or meloxicam

'''Client education''' is paramount: underlying diseases and husbandry problems need to be addressed for a successful outcome. Appropriate bedding needs to be used and wire flooring is not appropriate.  

'''Client education''' is paramount: underlying diseases and husbandry problems need to be addressed for a successful outcome. Appropriate bedding needs to be used and wire flooring is not appropriate.  

Appropriate hutch substrates should be provided that are '''clean and soft'''.  

Appropriate hutch substrates should be provided that are '''clean and soft'''.  

A separate litter box can be provided to prevent the rabbit sitting in soiled litter for too long.

A separate litter box can be provided to prevent the rabbit sitting in soiled litter for too long. Soiled substrates should be cleaned daily and bed wetting should be avoided (rain, spillages).

 

Soiled substrates should be cleaned daily and bed wetting should be avoided (rain, spillages)

Obesity should be avoided by '''providing plenty of grass hay and fresh greens''' and avoiding muesli-type diets.

Obesity should be avoided by '''providing plenty of grass hay and fresh greens''' and avoiding muesli-type diets.

Saunders, R. (2005) '''Notes on rabbit internal medicine''' ''Wiley-Blackwell''

Saunders, R. (2005) '''Notes on rabbit internal medicine''' ''Wiley-Blackwell''

[[Category:To Do - Exotics]][[Category:To Do - Medium]][[Category:Bacterial_Skin_Diseases_–_Rabbit]]

[[Category:Rabbit Locomotory Disorders]]

[[Category:Expert Review - Exotics]][[Category:Bacterial_Skin_Diseases_–_Rabbit]]