Pasteurellosis is the most common bacterial infection in domestic rabbits, caused by the gram-negative bacterium Pasteurella multocida. The disease is colloquially known as “snuffles” when it manifests as upper respiratory infection with nasal discharge and sneezing. However, P. multocida can cause a wide range of clinical syndromes in rabbits including pneumonia, abscesses, middle and inner ear infection (otitis media/interna with head tilt), conjunctivitis, genital infections, and septicemia. A large percentage of apparently healthy rabbits carry P. multocida asymptomatically in their nasal passages — studies suggest carriage rates of 30 to 70% or more in pet rabbit populations. Clinical disease typically develops when the rabbit is stressed or immunocompromised.
Overview
P. multocida colonizes the nasal passages and can spread to other body sites through the Eustachian tubes (to the middle ear), through the nasolacrimal duct (to the eyes), down the respiratory tract (to the lungs), and hematogenously (through the bloodstream to virtually any organ). Rabbits can also develop abscesses from bite wounds contaminated with P. multocida.
Risk factors for clinical pasteurellosis include:
- Stress (overcrowding, poor ventilation, temperature extremes, transport)
- Concurrent illness (dental disease, GI stasis)
- Immunosuppression
- Poor husbandry (ammonia buildup from soiled bedding)
- Introduction of a carrier rabbit to a naive population
- Young age
Symptoms
Pasteurellosis can present in several forms:
Upper respiratory (“snuffles”):
- Sneezing and nasal discharge (serous to mucopurulent)
- Matted fur on the inside of the front paws (from wiping the nose)
- Audible breathing sounds (snoring, wheezing)
- Conjunctivitis (red, watery, or discharge-producing eyes)
Lower respiratory (pneumonia):
- Labored or rapid breathing
- Lethargy and decreased appetite
- Cyanosis (bluish tinge to ears and mucous membranes)
- Sudden death in acute cases
Middle/inner ear infection (otitis media/interna):
- Head tilt (torticollis) — the head is held persistently to one side
- Circling or rolling toward the affected side
- Nystagmus (rapid involuntary eye movement)
- Loss of balance and ataxia
- Facial nerve paralysis (drooping ear or lip on one side)
Abscesses:
- Firm, well-encapsulated lumps anywhere on the body (commonly the jaw, face, or limbs)
- Rabbit abscesses contain thick, caseous (cheese-like) pus that does not drain like liquid pus in dogs or cats
Reproductive tract:
- Pyometra (uterine infection) or orchitis (testicular infection)
- Infertility
Septicemia:
- Acute systemic illness with high fever, lethargy, and rapid death
Diagnosis
- Culture and sensitivity — The gold standard. Nasal or deep nasal swabs, abscess material, or respiratory samples cultured for P. multocida with antibiotic sensitivity testing to guide treatment.
- PCR — More sensitive than culture for detecting P. multocida in nasal swabs.
- Skull radiographs or CT scan — Essential for evaluating otitis media (bulla involvement) and dental abscesses. CT is significantly more sensitive than radiographs for detecting middle ear disease.
- Thoracic radiographs — For suspected pneumonia.
- Blood work — Elevated white blood cell count and acute-phase proteins in active infection.
- Cytology — Gram stain of nasal discharge or abscess material showing gram-negative coccobacilli.
Treatment & Medications
CRITICAL SAFETY REMINDER: Many common antibiotics are FATAL to rabbits when given orally. Never give oral amoxicillin, amoxicillin-clavulanate, cephalosporins, clindamycin, lincomycin, erythromycin, or oral penicillin to a rabbit. These destroy the essential cecal flora and cause fatal enterotoxemia.
Rabbit-Safe Antibiotics
| Medication | Route | Key Notes |
|---|---|---|
| Enrofloxacin (Baytril) | Oral or injectable | First-line antibiotic for most pasteurellosis presentations. Oral dosing at 10-20 mg/kg once to twice daily. Treatment courses of 2 to 6 weeks are typical; longer for chronic infections. |
| Trimethoprim-Sulfa | Oral | Second-line oral antibiotic. Broad-spectrum and gut-flora safe. |
| Penicillin G (injectable only) | Subcutaneous or intramuscular | Safe and highly effective when given by injection (bypasses the GI tract). Procaine penicillin G 42,000-84,000 IU/kg SC every 48 hours is a standard protocol. Often used for abscesses. Oral penicillin is FATAL. |
| Chloramphenicol | Oral | Reserved for resistant infections due to human health precautions (aplastic anemia risk to human handlers). Effective and gut-safe in rabbits. |
| Azithromycin | Oral | Gut-safe macrolide; emerging evidence in rabbit medicine. |
| Meloxicam | Oral or injectable | NSAID for pain and inflammation alongside antibiotic therapy. |
Abscess Treatment
Rabbit abscesses require surgical treatment in addition to antibiotics:
- Complete surgical excision of the abscess capsule when possible
- Marsupialisation (opening the abscess, debriding, and packing with antibiotic-impregnated material) when excision is not feasible
- Prolonged antibiotic therapy (weeks to months)
- Dental extraction if the abscess is tooth-root related
Otitis Media/Interna Treatment
- Prolonged antibiotics (minimum 4 to 8 weeks) based on culture and sensitivity
- Meloxicam for pain
- Anti-nausea medication (maropitant) for vestibular signs
- Physical therapy and support during recovery (padded enclosure to prevent injury from rolling)
- Some rabbits require bulla osteotomy (surgical opening of the tympanic bulla to remove infected material)
Prognosis
- Upper respiratory pasteurellosis (snuffles) — Fair to good prognosis with prolonged antibiotic therapy. Many rabbits improve significantly but may relapse during stress. Complete eradication of P. multocida from carrier rabbits is often not achievable.
- Otitis media/interna (head tilt) — Fair prognosis. Many rabbits improve with prolonged antibiotics, though some residual head tilt may persist. Early treatment improves outcomes.
- Abscesses — Variable prognosis. Superficial abscesses have a fair prognosis with complete surgical excision. Jaw abscesses associated with dental disease are more challenging and may recur.
- Pneumonia — Guarded prognosis, particularly if diagnosed late. Early, aggressive treatment improves outcomes.
- Septicemia — Poor prognosis.
Frequently Asked Questions
Can pasteurellosis be cured? Clinical signs can often be resolved with appropriate treatment, but complete elimination of P. multocida from a carrier rabbit is very difficult. Many rabbits carry the bacteria asymptomatically in their nasal passages for life. Relapses during periods of stress are common.
Is snuffles contagious to other rabbits? Yes. P. multocida is transmitted through nasal discharge, direct contact, and aerosol. Isolate clinically ill rabbits from healthy ones. However, since many “healthy” rabbits are also carriers, the practical impact depends on the population.
Can I give amoxicillin to my rabbit? NEVER give oral amoxicillin, amoxicillin-clavulanate, or any oral penicillin-type antibiotic to a rabbit. These drugs destroy the essential cecal flora and cause fatal dysbiosis within days. Injectable penicillin G is safe because it bypasses the GI tract.
My rabbit has a head tilt — will it recover? Many rabbits with head tilt from pasteurella otitis improve with prolonged antibiotic therapy (4 to 8 weeks or longer). Some rabbits retain a mild residual tilt but adapt well and maintain good quality of life. Early treatment is important for the best outcome. Note: head tilt in rabbits can also be caused by E. cuniculi, so diagnosis is important.
Should I treat my asymptomatic rabbit for pasteurella? Generally, no. Treating asymptomatic carriers rarely eliminates carriage and may promote antibiotic resistance. Treatment is indicated when clinical signs develop.