Cellulitis

• Cause: acute inflammatory syndrome of the skin. Can be a sequel to suboptimal husbandry or difficulty grooming due to another inciting cause, eg dental disease, obesity. Also reported secondary to respiratory infection.
• Signs: pain, alopecia, matted fur, purulent exudate, edema, anorexia, ileus, pyrexia, sepsis.
• Diagnosis: history, clinical signs, bacteriology, cytology, microscopy, histopathology.
• Treatment: clipping and cleaning of the area, topical and systemic antibiotics, cold compresses, management of predisposing cause (if known), severe cases may require surgical management.
• Prognosis: guarded to good.

Presenting signs

• Pain.
• Pruritis.
• Swelling of the affected skin and deeper tissues; this swelling can be severe.
• Malodorous, purulent discharge from the affected site.
• Lethargy.
• Depression.
• Pyrexia.
• Anorexia Anorexia.
• Ileus Gastrointestinal: ileus.
• Several types of cellulitis have been reported in rabbits:
  • Acute cellulitis of the head and neck.
  • Orbital cellulitis.
  • Mammary cellulitis.

Acute presentation

• Head and neck cellulitis:
  • Very rapid progression of clinical signs.
  • Swelling is confined to the head, neck, forelimbs and thorax.
  • Swellings are very painful to palpate.
  • Pyrexia of 40-42°C/104-107.6°F is present.
  • May have concurrent respiratory signs including sneezing, dyspnea Dyspnea and nasal discharge Nose: nasal discharge - overview: signs may develop after respiratory disease has presented.
  • May be rapidly fatal.
• Orbital cellulitis:
  • Often develops subsequent to dental disease, eg anorexia Anorexia, jaw abscessation.
  • Periorbital and facial swelling may be seen; most commonly unilateral.
  • Exophthalmos Eye: exophthalmos is progressive:
    • Pain may be noted on compression of the orbit.
    • Secondary exposure keratitis, corneal ulceration Eye: keratitis - overview and blepharitis Eyelid: blepharitis is common.
• Mammary cellulitis Mastitis:
  • Most often develops post-partum but may also be seen with false-pregnancy and milk retention. Nest building and hair pulling may be observed prior to other signs.
  • Affected teats are firm, edematous, erythematous and painful:
    • Purulent or hemorrhagic discharge may be expressed from the teat.
    • Concurrent abscessation Abscess of the teat may be present.
    • Can affect or one more gland.
  • Affected rabbits are frequently depressed and lethargic:
    • Pyrexia may develop if infection spreads systemically.
    • May progress to sepsis and can be fatal.
  • May cause rejection of offspring:
    • Failure to thrive in affected young.
    • Increased neonatal mortality.

Geographic incidence

• No geographical predilection.

Age predisposition

• Mammary cellulitis has been reported mainly in older breeding animals.

Breed/Species predisposition

• Brachycephalic breeds Brachycephalic syndrome such as dwarfs Netherland dwarf Dwarf lop and the Lionhead Lionhead are at increased risk of orbital cellulitis:
  • Dental malocclusion Dental malocclusion / overgrowth predisposes to tooth root abscessation.
  • Maxillary root abscesses Abscess can progress to involve the bony orbit.
  • Retrobulbar abscessation Eye: retrobulbar abscess frequently induces orbital inflammation and associated cellulitis.

Public health considerations

Cost considerations

• Prolonged antibiotic courses may be required to achieve clinical cure.
• Many affected rabbits present with severe clinical signs and require intensive management or hospitalization with supportive care.
• Severe cases may result in tissue sloughing and require surgical treatment in addition to ongoing antibiotics and supportive care.
• Cellulitis pathogens are highly infectious and can lead to multiple rabbits being affected, particularly with mammary disease.
• Treatment of concurrent and underlying causes

Special risks

• Rabbits are at risk of developing myiasis Fly strike, especially in hot weather:
  • Affected animals should be kept indoors and examined twice daily for the presence of larvae or eggs.
  • Pododermatitis Ulcerative pododermatitis (Bumble foot) can develop as a consequence of immobility from prolonged convalescence.