1. What is sedation versus anesthesia?
Sedation and anesthesia are important resources commonly used in veterinary
medicine, especially with small exotic animals. Whether they are used to assist with
diagnostic testing, procedures, or surgery, sedation or anesthesia is often required to
help minimize risks and maximize your pet’s safety.
Sedation is utilized more often than anesthesia and helps provide a state of
relaxation and reduced anxiety through the administration of injectable or oral
medications. Sedation is commonly used prior to anesthesia to help minimize stress
with anesthetic induction. Anesthesia, as the name implies, is the full loss of
consciousness or awareness through the use of injectable or constant rate infusions of
medications or inhalation of anesthetic gas.

2. What is the anesthetic risk in rabbits compared to dogs/cats?
A study that compared dogs, cats, and rabbits showed that anesthetic risks in
dogs and cats are significantly lower compared to rabbits (1) This demonstrates why
rabbit anesthesia monitoring is so important and why no sedation or anesthetic event is
ever benign and without risk. At our hospital, we have an amazing team of doctors and
technicians who work closely to care for your rabbit and ensure your pet receives the
highest level of care they require, as well as intervene quickly when complications arise.

3. What are the specific anesthetic risks with rabbits? Why is body temperature
important in rabbits?
Specific anesthetic risks in rabbits include stress during induction of anesthesia,
hypothermia, fewer accessible veins for catheterization, difficulties with endotracheal
intubation, GI hypomotility after anesthesia, and corneal ulceration. It is also important
to consider whether or not your pet has subclinical respiratory infections or other
illnesses that can further increase the risk of anesthetic complications and mortality.
Other anesthetic risks include decreased heart rate, decreased respiratory rate or
absence of breathing (apnea), and cardiac arrest.
Rabbits are obligate nasal breathers, which means they can only normally breathe through
their nose, unlike dogs and cats. Therefore, monitoring a rabbit’s breathing is very
important. Providing oxygen and anesthetic gas through an endotracheal tube or via a
tightly fitted nose mask are ways to ensure your pet gets adequate airflow.
For more information on intubation, please refer to the section below.

Hypothermia, or low body temperature, is one of our primary concerns in rabbits,
and this is a common effect of anesthesia. Heat loss occurs due to lowered blood
pressure and a high surface area to body weight ratio in rabbits (and other small exotic
mammals). This can lead to body temperature changes. Hypothermia can lead to a
slower recovery from anesthesia. Ways we address or prevent hypothermia include
heat pads, forced-air warming blankets, warm water bags, blankets, and covering
extremities during the procedure.
Anesthesia causes decreased GI motility, which is a side effect that can
significantly impact a rabbit. To prevent GI complications, we do not recommend fasting
rabbits before anesthesia. Once they are awake enough to swallow, we make sure we
offer them food and critical care assist feedings to help encourage the gut to move.
Depending on the case, we may recommend that clients continue to syringe or assist
feed at home until their pet has returned to eating normally.
Corneal ulcers can occur in any pet under anesthesia because they are unable to
close their eyelids. Therefore, their eyes stay open, increasing the risk of drying out or
becoming injured. To prevent corneal ulceration, rabbit eyes are lubricated with a
special eye lubricant. However, there is still the risk that a corneal ulcer can develop,
despite preventative measures. If a corneal ulcer (abrasion to the corneal surface) is
suspected after anesthesia, then we will recommend administering eye medications.

4. What is CPR, and how do I choose a CPR status for my rabbit?
CPR stands for cardiopulmonary resuscitation, which is an emergency procedure
to keep blood and oxygen flowing when the heart or breathing has stopped, or arrested.
Cardiopulmonary arrest can occur due to anesthesia, physiological stress, or an
underlying disease condition. CPR is the act of an intensive and rather aggressive
intervention with the goal of the patient having a heart rate and breathing on their own.
This includes chest compressions, delivery of oxygen, multiple injectable medications,
and more. If the rabbit has not been intubated prior to going into cardiac arrest, an
endotracheal tube should be placed to open an airway and directly deliver oxygen. An
intravenous or intraosseous catheter should be placed to administer medications and
fluids to help with blood pressure. Complications with CPR can include broken ribs and
bruised lungs, and intensive hospitalization is often recommended if CPR is successful
and the rabbit survives.
CPR is an individual choice and may vary from one pet to another, depending on
their age and the reason for the visit. It’s important to talk to your veterinarian about the
risks and complications of anesthesia, as well as the prognosis of the overall health of
your rabbit. This kind of discussion will help guide your choice of confirming CPR or not
for your pet.
It is important to know that whatever CPR status you choose, our veterinary team
fully understands the careful and informed decision of confirming or declining CPR
efforts for your pet.

5. Why is pre-anesthetic bloodwork important?
If you’ve ever had a conversation with a veterinarian before an anesthetic event
for your pet, you may have discussed the option of having pre-anesthetic bloodwork
performed. Having recent blood work performed is our standard of care because some
of the pre-anesthetic medications and anesthetic gases can affect the major body
systems. Sometimes it can result in changes to our pre-anesthetic plan, or may prompt
further discussion with you about the appropriateness or safety of the procedure for
your pet. Younger rabbits may be at less risk for liver or kidney issues compared to
older rabbits, but unfortunately, we won’t know without bloodwork. Performing
bloodwork on a healthy rabbit also determines their baseline normal values, which are
useful to compare to in the future.

6. Why do we recommend intravenous catheters? Why are surgical fluids
important?
An intravenous catheter can be placed in your rabbit’s vein to help deliver fluids
and medications. This is also useful in the event of cardiopulmonary arrest to administer
medications immediately into the vascular system, rather than into the muscle, where
the effect is slower. At our hospital, owners have the option of choosing to have an IV
catheter placed for elective and routine procedures, but it may be standard of care for
more intensive or invasive procedures.
During a procedure or surgery, we will provide fluids to help with blood pressure,
peri-operative hydration, and replace fluids due to blood loss. We will administer fluids
using the IV catheter if one was placed. Otherwise, we will give fluids under the skin in
the subcutaneous space, which are absorbed over several hours.

7. What is intubation, and why is it important in rabbits?
Intubation is the act of placing a flexible tube (called an endotracheal tube, or ET
tube) through the mouth into the trachea (windpipe). Placing an ET tube allows for direct
administration of oxygen and anesthetic gas to your pet. Not only does an ET tube
ensure a clear airway, but it also prevents complications like respiratory depression and
aspiration during anesthesia, and is crucial during CPR efforts.
Placing an ET tube in a rabbit can be challenging due to their anatomy and the
inability to open their mouth wide, like in dogs and cats, for visualization and
accessibility. Intubation sometimes requires an endoscope to assist in placement, which
is an instrument used to view internal body parts. Risks with intubation are low and
rarely occur. However, intubation can cause inflammation or damage to their small
trachea. This is why it is important to have knowledge of rabbit anatomy and be
comfortable with the technique of intubating. Our veterinary team is quite skilled at
intubating rabbits to ensure the best care for your pet!
If a rabbit cannot be intubated, such as if a rabbit is too small, there are other
methods of ensuring proper anesthesia and oxygen delivery. A V-gel is an advanced
supraglottic airway device that we can use in place of an ET tube (5)
. Designed to sit over the opening of the trachea, there is less risk of causing damage to the trachea.
However, the risk of using a V-gel is that the delivery of anesthetic gas and oxygen may
not be as direct since the tube is not positioned within the trachea like an ET tube.
The other alternative is providing a tight-fitting face mask over their nose with or without covering the
mouth. While placing an ET tube or V-gel is preferred, this method is also successful for
anesthetic and oxygen delivery due to the rabbit’s unique respiratory anatomy. This can
be used for short procedures, like dental trimming and wound care, as well as surgeries.

8. What is involved with anesthetic monitoring in rabbits?
When your rabbit is under anesthesia, our team diligently monitors the following:
- Temperature
- Heart rate and rhythm
- Breathing rate and patterns
- Lung sounds
- Oxygen perfusion and gas exchange
- Pain status
- Depth of anesthetic-induced unconsciousness
Since rabbit anesthesia is so involved and inherently has its own risks, compared
to dogs and cats, our anesthesia team is fully knowledgeable and intervenes when
complications arise. This skill applies to all of our companion exotic species as well. Our
hospital is involved in many anesthetized diagnostics, procedures, and surgeries, and
our veterinary team excels with anesthetic monitoring and intervention. Our team will
also make sure your pet is comfortable and recovering appropriately after anesthesia.

9. What post-operative care is provided at the hospital?
Anesthetic monitoring doesn’t end after the surgery is complete and the
anesthetic gas is turned off. Our team will continue to monitor your rabbit afterwards
and make sure they are recovering appropriately. We monitor their temperature, return
to consciousness, oxygen perfusion, and more. We will keep rabbits in an incubator and
provide additional heat support if needed to help increase their temperature, as they are
often hypothermic after surgery. If they are slower to recover, we can reverse some of
their pre-anesthetic sedation medications. Once they are alert and moving around, we
make sure they start eating right away. We will offer hay and assisted syringe feedings
to promote a return to normal GI motility and function.

10. What post-operative care is necessary to provide at home?
Recovery doesn’t necessarily end when your pet is discharged from the hospital.
If the anesthetic event happened that day, your rabbit may be tired for the rest of the
afternoon or evening. It will be important for you to watch them closely to make sure
they are not acting more lethargically or unresponsive to stimuli. While they may not eat
their normal amount right after anesthesia and surgery, they should return to eating their
normal amount of hay within 24-48 hours. You may need to provide assisted syringe
feedings to your rabbit if their appetite is not improving. Appetite recovery can be
patient-dependent, so if you have any questions, it’s important to reach out to your
veterinarian for advice.
Specific discharge instructions will be sent home with you and your rabbit. Our
veterinarians provide important information regarding any medications and the care
needed for your rabbit after anesthesia and/or any procedure. Therefore, it is very
important to read and follow those discharge instructions to help ensure the best
possible outcome for your pet!

References
1. Lee, H.W. et al. 2018. Peri-anaesthetic mortality and nonfatal gastrointestinal complications in pet
rabbits: a retrospective study on 210 cases. Vet of Anes and Analg 45 (4), 520-528.
2. Baileya K, Brileya J, Duffee L, Duke-Novakovskic T, Grubb T, Kruse-Elliotte K, Loves L,
Martin-Flores M, McKuneg C, Odah A, Pang DS, Posner LP, Reed R, Sagerk J, Sakai DM,
Schultz AW, Tenenbaum-Shih S. 2025. The American College of Veterinary Anesthesia and
Analgesia Small Animal Anesthesia and Sedation Monitoring Guidelines. Assoc of Vet Anaes and
Am Col of Vet Anes and Analg 52, 377-385.
3. Buckley GJ, DeCubellis J, Sharp CR, Rozanski EA. 2011. Cardiopulmonary Resuscitation in
Hospitalized Rabbits: 15 cases. Jour of Ex Pet Med, 20 (1), 46 –50.
4. Wenger S. 2012. Anesthesia and analgesia in rabbits and rodents. Jour of Ex Pet Med 21, 7–16
5. https://jorvet.com/product/v-gel-advanced-supraglottic-airway-device-rabbit