Pain and analgesia in pet rabbits within the veterinary environment: a review

Published:December 14, 2018DOI:



      To provide an overview of pain and analgesia in rabbits with the aim of developing a more accurate understanding of these topics. To illustrate and discuss the areas that have advanced in recent years and those that still require further research.

      Databases used

      Three key subject resources were used: Web of Science, Medline and CAB Abstracts. Search terms were rabbits, lagomorphs, laboratory animals, pet, pain, surgical procedures, ovariohysterectomy, orchiectomy, castration, analgesia, opioids, and non-steroidal anti-inflammatory drugs. References from books and articles relevant to the topics were also included.


      Rabbit medicine has improved over the last 20 years, but the literature suggests that pain management in this species is still inadequate and veterinary professionals believe their knowledge of pain and analgesia in this species is limited. Assessment and quantification of pain in rabbits can be challenging in a clinical environment not only because, as a prey species, rabbits tend to hide signs of pain but also because there are no validated methods to assess pain, except the Rabbit Grimace Scale, which is based on only one rabbit breed.
      Current consensus is that perioperative multimodal analgesia is the best practice. However, it is not widely used in rabbits. In rabbits, analgesia protocols and dosages reported in the literature are often poorly researched and do not result in complete pain amelioration with the return of normal. The present literature on rabbit pain and analgesia presents gaps either due to unexplored areas or insufficient findings. Further research should focus on these areas with the aim of improving the welfare of rabbits within a veterinary clinic.


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        • Adam V.N.
        • Markic A.
        • Sakic K.
        • et al.
        Local anaesthetic toxicity.
        Period Biol. 2011; 113: 141-146
        • Barter L.S.
        Rabbit analgesia.
        Vet Clin North Am Exot Anim Pract. 2011; 14: 93-104
        • Beswick A.
        • Dewey C.
        • Johnson R.
        • et al.
        Survey of Ontario veterinarians' knowledge and attitudes on pain in dogs and cats in 2012.
        Can Vet J. 2016; 57: 1274-1280
        • Bonnet F.
        • Marret E.
        Influence of anaesthetic and analgesic techniques on outcome after surgery.
        Br J Anaesth. 2005; 95: 52-58
        • Bradbury A.G.
        • Eddleston M.
        • Clutton R.E.
        Pain management in pigs undergoing experimental surgery; a literature review (2012-4).
        Br J Anaesth. 2016; 116: 37-45
        • Brodbelt D.
        Perioperative mortality in small animal anaesthesia.
        Vet J. 2009; 182: 152-161
        • Capner C.A.
        • Lascelles B.D.X.
        • Waterman-Pearson A.E.
        Current British veterinary attitudes to perioperative analgesia for dogs.
        Vet Rec. 1999; 145: 95-99
        • Carbone L.
        • Austin J.
        Pain and laboratory animals: publication practices for better data reproducibility and better animal welfare.
        PLoS One. 2016; 11
        • Carpenter J.
        Exotic animal formulary.
        3rd edn. Saunders, 2005
        • Carpenter J.W.
        • Pollock C.G.
        • Koch D.E.
        • et al.
        Single and multiple-dose pharmacokinetics of meloxicam after oral administration to the rabbit (Oryctolagus cuniculus).
        J Zoo Wildl Med. 2009; 40: 601-606
        • Cho H.J.
        • Lim S.C.
        • Kim S.G.
        • et al.
        Effect of low-level laser therapy on osteoarthropathy in rabbit.
        Vivo. 2004; 18: 585-591
        • Cooper C.S.
        • Metcalf-Pate K.A.
        • Barat C.E.
        • et al.
        Comparison of side effects between buprenorphine and meloxicam used postoperatively in Dutch Belted rabbits (Oryctolagus cuniculus).
        J Am Assoc Lab Anim Sci. 2009; 48: 279-285
        • Corti L.
        Nonpharmaceutical approaches to pain management.
        Top Companion Anim M. 2014; 29: 24-28
        • Coulter C.A.
        • Flecknell P.A.
        • Leach M.C.
        • et al.
        Reported analgesic administration to rabbits undergoing experimental surgical procedures.
        BMC Vet Res. 2011; 7: 6
        • Coulter C.A.
        • Flecknell P.A.
        • Richardson C.A.
        Reported analgesic administration to rabbits, pigs, sheep, dogs and non-human primates undergoing experimental surgical procedures.
        Lab Anim. 2009; 43: 232-238
        • Dalla Costa E.
        • Minero M.
        • Lebelt D.
        • et al.
        Development of the Horse Grimace Scale (HGS) as a pain assessment tool in horses undergoing routine castration.
        PLoS One. 2014; 9: 10
        • Deflers H.
        • Gandar F.
        • Bolen G.
        • et al.
        Influence of a single dose of buprenorphine on rabbit (Oryctolagus cuniculus) gastrointestinal motility.
        Vet Anaesth Analg. 2018; 45: 510-519
        • Delk K.W.
        • Carpenter J.W.
        • KuKanich B.
        • et al.
        Pharmacokinetics of meloxicam administered orally to rabbits (Oryctolagus cuniculus) for 29 days.
        Am J Vet Res. 2014; 75: 195-199
      1. Directive 2010/63/EU of the European Parliament and of the Council. Last access day: 16.01.2019.

        • DiVincenti L.
        • Meirelles L.A.D.
        • Westcott R.A.
        Safety and clinical effectiveness of a compounded sustained-release formulation of buprenorphine for postoperative analgesia in New Zealand White rabbits.
        J Am Vet Med Assoc. 2016; 248: 795-801
        • Egger C.M.
        • Souza M.J.
        • Greenacre C.B.
        • et al.
        Effect of intravenous administration of tramadol hydrochloride on the minimum alveolar concentration of isoflurane in rabbits.
        Am J Vet Res. 2009; 70: 945-949
        • Farnworth M.J.
        • Walker J.K.
        • Schweizer K.A.
        • et al.
        Potential behavioural indicators of post-operative pain in male laboratory rabbits following abdominal surgery.
        Anim Welf. 2011; 20: 225-237
        • Foley P.L.
        • Henderson A.L.
        • Bissonette E.A.
        • et al.
        Evaluation of fentanyl transdermal patches in rabbits: Blood concentrations and physiologic response.
        Comp Med. 2001; 51: 239-244
        • Fredholm D.V.
        • Carpenter J.W.
        • KuKanich B.
        • et al.
        Pharmacokinetics of meloxicam in rabbits after oral administration of single and multiple doses.
        Am J Vet Res. 2013; 74: 636-641
        • Freijs E.
        • Kannin H.
        Comparison of plasma levels and analgesic effect between oral transmucosal and subcutaneous administration of buprenorphine in rabbits.
        • Goldschlager G.B.
        • Gillespie V.L.
        • Palme R.
        • et al.
        Effects of multimodal analgesia with low-dose buprenorphine and meloxicam on fecal glucocorticoid metabolites after surgery in New Zealand White rabbits (Oryctolagus cuniculus).
        J Am Assoc Lab Anim Sci. 2013; 52: 571-576
        • Gozil R.
        • Kurt I.
        • Erdogan D.
        • et al.
        Long-term degeneration and regeneration of the rabbit facial nerve blocked with conventional lidocaine and bupivacaine solutions.
        Anat Histol Embryol. 2002; 31: 293-299
        • Grint N.
        in: Harcourt-Brown F. Chitty J. BSAVA Manual of rabbit surgery, dentistry and imaging. BSAVA, 2013: 1-25
        • Hager C.
        • Biernot S.
        • Buettner M.
        • et al.
        The Sheep Grimace Scale as an indicator of post-operative distress and pain in laboratory sheep.
        PLoS One. 2017; 12: 15
        • Hawkins P.
        Recognizing and assessing pain, suffering and distress in laboratory animals: a survey of current practice in the UK with recommendations.
        Lab Anim. 2002; 36: 378-395
        • Hedenqvist P.
        • Trbakovic A.
        • Thor A.
        • et al.
        Carprofen neither reduces postoperative facial expression scores in rabbits treated with buprenorphine nor alters long term bone formation after maxillary sinus grafting.
        Res Vet Sci. 2016; 107: 123-131
        • Hunt J.R.
        • Knowles T.G.
        • Lascelles B.D.
        • et al.
        Prescription of perioperative analgesics by UK small animal veterinary surgeons in 2013.
        Vet Rec. 2015; 176: 7
      2. International Association for the Study of Pain: ( Last access date: 16.01.2019.

        • Johnson-Delaney C.A.
        • Harcourt-Brown F.
        Analgesia and postoperative care.
        in: Harcourt-Brown F. Chitty J. BSAVA manual of rabbit surgery, dentistry and imaging. BSAVA, UK2013: 26-38
        • Johnston M.S.
        Clinical approaches to analgesia in ferrets and rabbits.
        Semin Avian Exot Pet Med. 2005; 14: 229-235
        • Keating S.C.J.
        • Thomas A.A.
        • Flecknell P.A.
        • et al.
        Evaluation of EMLA cream for preventing pain during tattooing of rabbits: changes in physiological, behavioural and facial expression responses.
        PLoS One. 2012; 7: 11
        • Keown A.J.
        • Farnworth M.J.
        • Adams N.J.
        Attitudes towards perception and management of pain in rabbits and guinea pigs by a sample of veterinarians in New Zealand.
        N Z Vet J. 2011; 59: 305-310
        • Kohn D.F.
        • Martin T.E.
        • Foley P.L.
        • et al.
        Guidelines for the assessment and management of pain in rodents and rabbits.
        J Am Assoc Lab Anim Sci. 2007; 46: 97-108
        • KuKanich B.
        Outpatient oral analgesics in dogs and cats beyond nonsteroidal antiinflammatory drugs: an evidence-based approach.
        Vet Clin North Am Small Anim Pract. 2013; 43: 1109-1125
        • Lascelles B.D.X.
        • Capner C.A.
        • Waterman-Pearson A.E.
        Current British veterinary attitudes to perioperative analgesia for cats and small mammals.
        Vet Rec. 1999; 145: 601-604
        • Leach M.C.
        • Allweiler S.
        • Richardson C.
        • et al.
        Behavioural effects of ovariohysterectomy and oral administration of meloxicam in laboratory housed rabbits.
        Res Vet Sci. 2009; 87: 336-347
        • Leach M.C.
        • Klaus K.
        • Miller A.L.
        • et al.
        The assessment of post-vasectomy pain in mice using behaviour and the Mouse Grimace Scale.
        PLoS One. 2012; 7: e35656
        • Lindhardt K.
        • Bagger M.
        • Andreasen K.H.
        • et al.
        Intranasal bioavailability of buprenorphine in rabbit correlated to sheep and man.
        Int J Pharm. 2001; 217: 121-126
        • Longley L.
        Anaesthesia and analgesia in rabbits and rodents.
        Practice. 2008; 30: 92-97
        • Mayer J.
        Use of behaviour analysis to recognize pain in small mammals.
        Lab Anim. 2007; 36: 43-48
        • Mathews K.
        • Kronen P.W.
        • Lascelles D.
        • et al.
        Guidelines for recognition, assessment and treatment of pain.
        J Small Anim Pract. 2014; 55: E10-E68
        • Meredith A.
        Bsava Small Animal Formulary. Part B: Exotic pets.
        9th edn. BSAVA, UK2015
        • Morton D.B.
        • Griffiths P.H.M.
        guidelines on the recognition of pain, distress and discomfort in experimental-animals and an hypothesis for assessment.
        Vet Rec. 1985; 116: 431-436
        • Parmen V.
        • Pestean C.
        • Ober C.
        • et al.
        Paraclinical investigations of electroacupuncture analgesia in a rabbit ovariohysterectomy.
        J Acupunct Meridian Stud. 2015; 8: 44-47
        • PAW-Report
        PDSA Animal Wellbeing Report - PDSA.
        • Ramsey I.
        BSAVA Small Animal Formulary, Part A: Canine and Feline.
        9th edn. BSAVA, UK2014
        • Rooney N.
        • EJ B.
        • SM M.
        • et al.
        The current state of welfare, housing and husbandry of the English pet rabbit population.
        BMC Res Notes. 2014; : 942-955
        • Sotocinal S.G.
        • Sorge R.E.
        • Zaloum A.
        • et al.
        The Rat Grimace Scale: A partially automated method for quantifying pain in the laboratory rat via facial expressions.
        Mol Pain. 2011; 7: 55
        • Souza M.J.
        • Greenacre C.B.
        • Cox S.K.
        Pharmacokinetics of orally administered tramadol in domestic rabbits (Oryctolagus cuniculus).
        Am J Vet Res. 2008; 69: 979-982
        • Turner P.V.
        • Chen H.C.
        • Taylor W.M.
        Pharmacokinetics of meloxicam in rabbits after single and repeat oral dosing.
        Comp Med. 2006; 56: 63-67
        • Varga M.
        Textbook of rabbit medicine.
        2nd edn. Butterworth Heinemann, 2014
        • Weaver L.A.
        • Blaze C.A.
        • Linder D.E.
        • et al.
        A model for clinical evaluation of perioperative analgesia in rabbits (Oryctolagus cuniculus).
        J Am Assoc Lab Anim Sci. 2010; 49: 845-851
        • Weber G.H.
        • Morton J.M.
        • Keates H.
        Postoperative pain and perioperative analgesic administration in dogs: practices, attitudes and beliefs of Queensland veterinarians.
        Aust Vet J. 2012; 90: 186-193
        • Wenger S.
        anesthesia and analgesia in rabbits and rodents.
        J Exot Pet Med. 2012; 21: 7-16