When does the physical exam begin? The exam starts the moment the patient is presented to you.
What do we mean? Take your time to observe the patient prior to physically picking them up.
We often learn a lot from observing rabbits in their cages since they are often more relaxed there than when they are on the examination table.
When should a technician do a physical exam? You should perform a physical prior to placing any patient under anesthesia, even if the veterinarian already has performed an exam.
At least once daily on all hospitalized patients, preferably prior to being treated. Be sure rabbits are housed in a quiet area of the hospital and spend a few minutes observing them prior to your exam. The cage should also be examined for consistency of droppings, quantity of urine, signs of nesting, and signs of appetite.
It is recommended that all patients receive a physical examination at least twice a year; in saying this rabbits often present for their initial visit and then only when ill. If rabbits required immunizations we would most likely see them more often, so the initial visit is at times the only time we can educate our rabbit clients. Take time at this visit to discuss diet, housing, husbandry, neutering, behavior issues, and health concerns. See our Specialty Folder for an Initial Medical History Checklist.
It is always best to perform the examination in the same order every time, this way you are less likely to miss anything. Everyone has their own system for performing an examination but always start with observation.
Observation – A normal rabbit will rest compactly on all four limbs with regular twitching of the nostrils. A timid rabbit may vocalize or “thump” their hind legs; these are warning signs and shouldn’t be ignored.
Weight – Obtain a weight in pounds and kilograms and document it in the patient’s chart. For smaller patients it may be necessary to use an infant scale which will give you a more accurate weight. It is also a good idea to note which scale was used; for future visits always try and use the same scale.
Fur/Skin – Examine the fur and skin for hair loss, skin lesions, moist dermatitis, flaking, or Ectoparasites. In most breeds, other then the Rex, the fur should be sleek, full, and smooth. When examining the ventral side of the body you should lift the rabbit without turning them over; not many rabbits will tolerate being flipped on their side or back.
Eyes – The eyes should be clear and bright. The periocular area should be clean, dry and have no missing fur.
Ears –The ears should be clean and without odor. An ear smear should be performed due to the fact that rabbits are prone to ear mites and the earlier it is caught the faster it will be cleared up. There should be no fur missing and the skin should have no abrasions.
Nose – There should be no sign of nasal discharge or odor.
Mouth/Lips/Teeth – The lips should be examined for ulcers, crusting and odor. Malocclusion of the incisors and molars is very common and needs to be corrected. With proper restraint and the use of an Otoscope with an appropriate- sized cone you can examine most patients; if necessary a small amount of sedation can be used.
Paws/Legs – The paws and legs are examined for any signs of irritation, abrasions, hair loss, tumors, malformation of the legs, toe nail length or pain. The fur on the under side on the paws is to be thick and unmatted, but should not need to be trimmed.
Abdomen/Body – Gentle palpation of the body should reveal the ribs and vertebrae intact, non painful and not covered in too much body fat or no fat. The abdominal organs should be palpated for size, texture and signs of discomfort. Palpate lymph nodes for enlargement and uniformity.
Urinary/Genitals/Anus Area – The urinary and genital openings are located below the anus.
The testes should be examined but due to the open inguinal canals they may be retracted into the abdomen. Gentle pressure can allow the testes to be placed back into the scrotum where they can be palpated.
The mammary chain should be palpated for any signs of mastitis or tumors; this needs to be done on spayed and intact females.
It is important to check the perineal area for evidence of urine scalding, soft stool or fecal impaction.
Heart/Lungs – When listening to the heart rate which is normally between 180-250bpm keep in mind the rabbit’s stress level. Rabbits who are used to being handled may have a slightly higher heart rate at the beginning of the exam due to not knowing what to expect but by the end of the exam should be much more relaxed. Timid rabbits may never relax enough to get an accurate heart rate. Most owners can be taught how to take a heart rate at home when the rabbit is calm.
Be sure to listen to all four chambers of the heart and both right and left lung lobes during the exam.
Hydration Status – Assessing hydration can be done easily two ways, through skin turgor or corneal moisture.
References:
Exotic Animal Care – Tully and Mitchell
Exotic Animal Medicine for the Veterinary Technician – Ballard and Cheek
