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What causes sore hocks in rabbits?


Mama Doe
Recently one of Buddies Bunny rescues vets, Elisabetta Mancinelli DVM CertZooMed MRCVS ECZM (Small mammal), carried out a study looking into what really causes sore hocks (pododermatitis) in rabbits. Many of buddies rescues were involved in the study :)
Elisabetta kindly put this brief together for us :)

Survey into husbandry related risk factors associated with “sore hocks” in domestic rabbits

Pododermatitis, often called “sore hocks”, is a chronic skin disease which most commonly affects the hind feet of rabbit. Less frequently, the front feet may be also involved, and often this occurs secondarily to a shift of the rabbit’s weight from the hind to the front feet in an attempt to relieve the pain associated with this condition. Pododermatitis usually starts with a hairless spot localized on the sole. The skin is initially inflamed and red, may then become thickened and flaked, with necrotic tissue in the middle of the wound as the disease progresses. Ulcers and abscesses can be present in advanced stages. The bacterial infection can be accompanied by the presence of caseous white pus. If the wounds remain untreated, the infection will spread to the inner tissues potentially leading to the involvement of the underlying bones and tendons with loss of their function. The rabbit is usually painful, restless, with a decreases appetite and weight loss. There may be reduced grooming, soiling of the perineum with urine and/or faeces. Rabbits are now becoming very popular pets, but the majority of the publications
on pododermatitis in this species have been derived from studies performed in animals kept under laboratory or farm conditions. For commercial rabbits, factors predisposing to pododermatitis are multiple and may include the animal origin, weight, body condition, age, sex, and concurrent diseases. Furthermore, shearing forces, pressure and friction may act locally on the hock area predisposing to the development of pressure ulcers (similar to bedsores in humans). Recently, a survey has been done to acquire information relative more specifically to pet rabbits. From the collected data, it appears that many of the risk factors previously identified as potentially increasing the incidence of pododermatitis in commercial animals, are similar for pet rabbits.

Owners were asked to complete a questionnaire which covered details of their rabbit’s signalment and husbandry (e.g. sex, age, breed, substrate, indoor/outdoor enclosure, diet). A full history was obtained and a complete physical examination was carried out on every rabbit. Rabbits were checked for pododermatitis and were clinically scored from 0 to 6 based on the degree of pododermatitis present. A total of 179 domestic rabbits were surveyed, including entire and neutered females, entire and neutered males ranging in age from 2 months to 9 years. One hundred and three rabbits were owned and seventy six were held in a rescue centre. Different breeds were encountered including Dwarf lops, Crossbreed, Lion-head, Netherland dwarf, Rex, Dutch, Continental giant and English. Out of the 179 rabbits surveyed, only 11 showed no signs of pododermatitis with the remaining 168 rabbits showing varying degrees of lesions. A larger study allowing investigation of a greater sample population would certainly aid our understanding of the causes of pododermatitis in pet rabbits and enable the production of clear recommendations for the prevention and management of this serious condition in pet rabbits. Nevertheless, this study provided clear evidence that husbandry and captive management have a great impact on the developmentof this condition.

In the study, the relationship between the prevalence of pododermatitis and several possible risk factors including sex, neutered status, age, breed, weight and body condition score was examined to assess their relevant effect. The findings suggested that young rabbits are at a lower risk of pododermatitis compared to older rabbits. This would be simply consistent with the theory that pressure related ulcers are the product of compression over a period of time. Female domestic rabbits are more predisposed to pododermatitis than males, with a prevalence of 97.8% compared to 89.7% respectively. Furthermore, 100% of the neutered females showed clinical evidence of hock lesions, and these were more severe. This is more likely due to the fact that neutered females may be less inclined to movement and more predisposed to obesity compared to neutered males, hence the higher incidence of sore hocks. Animals that were overweight also had a higher prevalence of pododermatitis compared to those rabbits considered to be at an ideal weight. It is generally accepted that the type of substrate on which a rabbit is housed has a great impact on the development of sore hocks as it can affect the weight distribution. Furthermore many types of flooring are abrasive and can cause friction, increasing the likelihood of sore hocks developing. It was demonstrated that hay, compared to other types of bedding (including carpet, hard flooring, newspaper, straw, shavings, towels, blankets, recycled paper bedding, carpet or foam mats) is associated with a reduced incidence of pododermatitis whereas 100% of the rabbits housed on beddings different from hay presented various degree of pododermatitis. These findings further confirm the fact that house rabbits which, in the majority of cases, are kept on rough carpeting or hard flooring are more susceptible to developing pododermatitis compared to those that spend most of their time sitting on hay. Pododermatitis is a serious and painful condition which can rapidly progress and potentially compromise the health and welfare of pet rabbits by causing chronic pain and suffering. Our survey showed that pododermatitis is frequently encountered with 93.8% prevalence in the pet rabbit population examined. Around 67,000 rabbits end up in rescue centres in UK every year according to figures released by the Rabbit Welfare Association and Fund (RWAF 2012). Our study showed that 58% rabbits examined were in fact acquired as “rescues”. Similarly, there was a high proportion of rabbits acquired from a breeder or home bred (19%), while pet shops supplied 23% of the rabbits examined. However the origin of the rabbit seemed to have no impact on the incidence of pododermatitis. This study provided clear evidence that, regardless or the rabbit origin and breed, there are many risk factors potentially increasing the incidence of pododermatitis in pet rabbits and that incorrect husbandry and captive management have a great impact on the development of this condition. We hope that these results will represent the first step towards increased awareness of this extremely common problem that many pet rabbit owners are unaware of and which is often underestimated by many veterinarians.
Elisabetta Mancinelli DVM CertZooMed MRCVS ECZM (Small mammal) eligible
Joanna Hedley BVM&S DZooMed (Reptilian) MRCVS; Royal Veterinary College, London
I totally concur with the statement about hay being the best substrate for Rabbits. Having had numerous Rex Rabbits, who have a predisposition to developing sore hocks, I can testify that all substrates except hay exacerbate the problem.

I also wonder if the higher incidence of sore hocks in Does is hormone related. Spaying= reduced oestrogen=thinner skin :?