Pain in Rabbits – Analgesia

Pain in rabbits and guinea pigs can be fatal, regardless of the source. If you have a rabbit in pain, that isn’t eating, then you will begin to roll down the deadly cascade of gastrointestinal stasis, negative energy balance, and eventually death.

So what can we do about it?

Prevent or at the very least reduce any pain in our rabbit and guinea pig patients!

But what are the signs of pain in rabbits? As a prey species they may not broadcast their pain to the world, and so these signs can be quite subtle. The most common sign of pain in rabbits is reduced appetite, which is often when they are presented to the clinic.

Pain in rabbits may present as:

  • Hunched posture and reluctance to move
  • Reduced activity, interest and appetite (OR Increased appetite!)
  • Increased drinking, urination and over grooming painful areas
  • Reduced production of faeces
  • Twitching, wincing and piloerection (raised hairs!)

Now you’ve refreshed your knowledge about what rabbit pain looks like? What will you do?

1. Address the problem!
2. Provide analgesia!

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Your options when providing analgesia for rabbits and guinea pigs, begin with (but aren’t limited to!);

  • NSAIDs – Non steroidal anti-inflammatory drugs
  • Opioids
  • Local analgesics – eg EMLA or xylocaine cream


NSAIDS, especially meloxicam, have a very well earned reputation in rabbits and guinea pigs. Meloxicam especially, is used as a safe pain relief medication for mild to moderate pain. Most commonly meloxicam is chosen due to the knowledge of meloxicam as a safe choice, and also for ease of oral administration via syringe. Other options, such as carprieve and ketoprofen, are not as easy to administer to outpatients and so are less favoured.

WARNING! Make sure to assess kidney function and hydration prior to any non steroidal anti-inflammatory use, as rabbits, like cats and dogs can experience nephrotoxicity following NSAID usage.


Commonly used opioids in exotics include,
  • Fentanyl – moderate sedation, moderate analgesia
  • Buprenorphine – mild sedation, moderate analgesia
  • Butorphanol – moderate sedation, mild analgesia
  • Tramadol – controversial, can be used for mild acute or chronic pain relief in rabbits

Opioids are a mainstay of pain relief and anaesthesia in rabbits and guinea pigs, often used as premedications in anaesthetics. Depending on your choice of opioid, they can be useful for mild pain (butorphanol, tramadol) to severe pain (buprenorphine, fentanyl).

However, respiratory depression is a risk, so use them wisely. Alternatively, pain can result in gastrointestinal stasis and death, so choose wisely and use your best judgement.


Currently controversial as they can lead to hepatic lipidosis, and hepatic abscesses. Currently best avoided, use NSAIDs instead. Will this view change with time? Maybe, watch this space!

Local analgesia

I think this may be my favourite option here, as it is frequently overlooked. Local analgesia can be topical, or injectable.

Topical analgesia is available in the form of EMLA cream or xylocaine gel. Just as in dogs and cats, if you can control a problem topically, why reach for systemic medications?
This is something i want to incorporate daily where possible in all aspects of my veterinary work. Using topical analgesia could really assist in some tricky catheterisation circumstances, by applying the gel 10-15 minutes before attempting catheterisation, you can really minimize pain on catheterisation and venepuncture – which i sure would appreciate if i was getting catheterized!

In rabbits local analgesia can be KEY to reducing pain and stress of catheterisation of the lateral ear veins, increasing your quality of patient care, whilst also making your job EASIER as your patient wont hop around! Nerve blocks are another useful tool, epidurals, dental blocks, line blocks and testicular blocks can be used to provide analgesia and limit pain receptor stimulation. Depending on your source of information, this may include lignocaine, bupivicaine and buprenorphine to extend analgesia.

Remember the importance of analgesia in your rabbit and guinea pig patients!

Take home options

  • NSAIDs
  • Opioids
  • Local analgesia

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Keep your rabbits bouncing, and your guinea pigs popcorning!

Hop to it!

  • Melbourne Rabbit Clinic. Rabbit & Guinea Pig Emergency Manual. Melbourne Rabbit Clinic, Ferntree Gully, 2014.
  • Lichtenberger, M, Ko, J. Anesthesia and Analgesia for Small  Mammals and Birds. Vet Clin North Am Exot Anim Pract 10 (2007), pp 293-315.
  • Wenger, S. Anesthesia and analgesia in rabbits and rodents. Journal of Exotic Pet Medicine 21 (2012), pp 7–16.