This article was first published in Rabbiting On Summer 2019

Registered veterinary nurse, Rachel Sibbald, explains how to nebulise your rabbits

A standard nebuliser unit
Photo credit: R Sibbald

A nebuliser is a piece of equipment used to administer liquids/medicines directly into the respiratory tract. A nebuliser converts liquids (saline is commonly used) and medicines into a fine mist that is breathed in.

What is nebulisation used for?

In human medicine it is commonly used by asthma sufferers or people with chronic obstructive pulmonary (lung) disease. In small mammals like rabbits, nebulisation is used primarily in cases of upper or lower respiratory infections such as chronic or acute Pasteurella infections.

How does it help?

Nebulisation helps to hydrate the lining of the respiratory tract (mucous membranes) and moisten/dilute exudate (pus) so that it can more easily be expelled by the rabbit via sneezing/coughing. Additionally medication can be added to the saline solution and this may have additional benefits. Some examples of commonly used medications include:

F10 can be used with saline to nebulise
Photo credit: R Sibbald

Antibiotics – Aminoglycosides are a group of antibiotics that are rarely used parenterally (by injection) or orally in rabbits due to potentially severe gastrointestinal side effects. However, where resistant strains of pathogens have been identified in the respiratory tract (by swab and culture) by your vet, aminoglycosides may be prescribed for nebulisation where the risk of unwanted side effects is vastly reduced. More common antibiotics used in rabbits such as enrofloxacin can also be used, avoiding systemic absorption of the drug and delivering a more targeted treatment.

F10 – This is a disinfectant that at diluted rates can be helpful in treating bacterial, fungal and viral respiratory disease by nebulisation.

Mucolytics – These aid in the loosening of respiratory secretions and make it easier for the rabbit to expel them.

Bronchodilators – These help to widen the airways, encouraging expulsion of material and

How to nebulise

Place the mouthpiece into the carrier
Photo credit: R Sibbald

1 The appropriate equipment will initially need to be purchased, on average nebulisers are between £70-90. However, if the rabbit is suffering chronic respiratory disease the expense at the outset may ultimately be cheaper if disease progression can be managed effectively at home. Meadows Animal Health provides nebulisers suitable for small mammals and birds. You will also need a carrier or container to restrain your rabbit whilst they are being nebulised. Plastic pet carriers are most commonly used as most people will already own this for transporting their animal and can easily be cleaned. You will also require a thick towel or black bin bag to surround the carrier.

2 Accustom your rabbit to the sound of the nebuliser. Before starting therapy it is sensible to ensure the correct working order of the equipment. Some nebulisers are quieter than others and initially your rabbit may be spooked by the noise. To try and avoid it becoming a negative experience for your rabbit, turn the nebuliser on for short periods and allow your rabbit to investigate.

3 The length and frequency of nebulisation should be discussed with your Vet. Fifteen to twenty minutes twice daily is normal at the beginning of treatment. As clinical signs regress this may be reduced. Do not put food in with your rabbit as this can be contaminated by the aerosols produced by the nebuliser – this is especially important if medications are being used. Place the rabbit’s container in a quiet, calm and familiar place.

Cover the carrier but leave a gap for ventilation
Photo credit: R Sibbald

4 Secure your rabbit in the carrier/container and drape towels around 3 sides of the carrier or alternatively a black bag can be put around the carrier – careful your rabbit doesn’t try to nibble at either! This is to keep the mist contained within the carrier as much as possible.

5 Fill the nebulisation chamber with the desired solution and pipe the ‘mouth piece’ end into the carrier. N.B. many nebulisers will come with a human face mask – this should be removed. Most rabbits will not tolerate any mask over their face and maintaining a low stress approach to the situation is always beneficial to any rabbit suffering respiratory disease.

6 Turn on the nebuliser and monitor your rabbit constantly. Some rabbits may initially appear uncomfortable with the situation and may dig or try to chew at items in protest. As long as your rabbit is not becoming severely distressed, perseverance is key and your rabbit will adapt. Plastic carriers and boxes can quickly overheat, especially when airflow is reduced by covering with towels or plastic bags, so it is imperative not to leave your rabbit unattended during the nebulisation.

7 Once the treatment has finished turn the nebuliser off and allow your rabbit to exit the carrier on their own terms. A favourite treat or toy can be rewarded to your rabbit during the first few treatments.

At the start of treatment (especially if mucolytics or bronchodilators have been used) your rabbit may actually sneeze or cough more. This is normally indicative of respiratory secretions moving up and out the respiratory tract. However, if prolonged sneezing attacks or signs of respiratory distress are observed, treatment should stop and your vet consulted.

Nebulisation provides good adjunct therapy to managing respiratory conditions in rabbits and can be used safely and effectively