Rabbit insect stings: facial swelling, and the airway that has no backup

Quick answer

Gauze, a clean towel and a carrier that is already accessible. With a stung rabbit the useful work is assessment and transport, not treatment at home.

Most insect stings in rabbits cause local pain and swelling and nothing worse. What makes a sting dangerous in this species is location, not allergy.

A rabbit breathes through its nose and cannot switch to breathing through its mouth. Its larynx is held up inside the back of the nasal passage, so the mouth and the airway are effectively separate routes. Swelling anywhere along the nose, muzzle or throat closes the only road the air has.

• A sting on the face, lips, nose or inside the mouth is an emergency regardless of how the rabbit seems.
• A sting on a foot or the body is usually painful rather than dangerous, and the risk shifts to gut stasis if the rabbit stops eating.
• Open-mouth breathing in a rabbit is never normal and always urgent.
• Do not give human antihistamines, painkillers or creams. Get pain relief from a vet, who has rabbit-safe options.
• Multiple stings are a poisoning problem, not an allergy problem, and the danger is proportional to the number.

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A rabbit cannot breathe through its mouth.

The epiglottis sits above the soft palate and locks the larynx into the back of the nasal chamber, so air travels nose to windpipe and the mouth is not part of the route. Swelling of the nostrils, muzzle, tongue or throat can therefore close the airway completely while the rabbit is still standing and alert.

If the face is swollen, if the nostrils look narrowed, if there is noise on breathing, or if the rabbit is trying to breathe with its mouth open, this is an emergency now. Phone ahead and travel.
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Decide in 60 seconds

Why a rabbit is different

The airway.

In a rabbit the larynx is held up into the nasopharynx by the epiglottis, so the animal breathes through the nose almost obligately. This is efficient for a grazing prey species that needs to eat and breathe continuously and to smell constantly for predators.

It also means the rabbit has no backup route. A dog with a swollen muzzle pants through its mouth and buys itself time. A rabbit with a swollen muzzle cannot.

This is why facial stings in rabbits are treated far more urgently than the same sting on a dog, and why an open-mouthed rabbit is in serious trouble rather than merely uncomfortable.

No vomiting.

Rabbits cannot vomit. A stinging insect swallowed with grass, clover or fallen fruit cannot be brought back up, and the sting happens in the mouth or throat where you cannot see it and cannot reach it.

Pain and the gut.

A rabbit's digestive system depends on continuous eating and continuous movement of gut contents. Pain reduces appetite quickly. Reduced intake slows the gut, gas builds, that causes more pain, and appetite falls further.

This loop is the most common way a sting kills a rabbit, and it usually happens a day later, after everyone thought the crisis had passed.

Shock signs are quiet.

Rabbits are prey animals and do not make a fuss. A rabbit in shock sits still, hunched, with its ears cold and its eyes half closed. Owners describe it as "just resting". Learn to distinguish the loose, sprawled rest of a comfortable rabbit from the tight, tucked posture of a rabbit in trouble.

What a normal reaction looks like, and what it does not

Local reaction. Swelling at the site, heat, tenderness, the rabbit licking or scratching at it. It develops over minutes to an hour and then stabilises. The rabbit still eats, still moves normally, and still produces droppings.

This is expected, and it needs pain relief rather than panic.

Spreading local reaction. The swelling keeps enlarging over several hours, or spreads well beyond the site. Worth a same-day appointment, and urgent if it is moving toward the face or throat.

Systemic reaction. Weakness, wobbliness, rapid or laboured breathing, pale gums, cold ears, collapse. This is an emergency and is not something to manage at home.

Multiple stings. A rabbit that has disturbed a wasp nest in a shed or hutch, or that has been swarmed by ants, has a venom dose problem. Enough venom damages muscle and can injure the kidneys, and the effects continue developing over the following day or two. Treat any multiple-sting event as an emergency even if the rabbit seems bright.

Gum colour is the fastest circulation check you have. Healthy rabbit gums are pink and moist. Pale, white or grey gums mean go now, and a swollen tongue or lip means the same.

The first ten minutes

Move the rabbit away from the insects. Indoors, into a quiet room. If there is a nest, keep everyone away from it and deal with it later.

Look at the whole animal before you look at the sting. Breathing first, gums second, posture third. That order matters, because it stops you spending five minutes on a swollen toe while the muzzle swells.

Find the sting site. Part the fur systematically. Common sites are the feet from stepping on an insect in grass, the nose and lips from grazing, the ears, and the mouth.

Remove a honeybee sting if you can see it. A honeybee leaves the barbed sting and its venom sac in the skin, and the sac keeps pumping. Scrape it out sideways with a fingernail, a card edge or the back of a blunt knife. Do not grip it with tweezers or squeeze it, because squeezing the sac injects the rest of the venom.

Wasps, hornets and ants do not leave a sting behind, so there is nothing to remove.

Cool the site briefly. A cool damp cloth held on the area for a few minutes reduces swelling and pain. Do not use ice directly on skin, and do not keep a rabbit cold, because a shocked rabbit needs warmth.

Offer food. This is not trivial. Put the rabbit's favourite green in front of it and see whether it eats. Whether it eats is the single most useful piece of information you will collect, and it is what the vet will ask.

Then call. For anything on the face, in the mouth, involving breathing, or involving several stings, call first and travel immediately. For a foot or flank sting in a bright, eating rabbit, call for a same-day appointment for pain relief.

Getting there

Use a hard carrier with a towel in it. Add a handful of hay and a few favourite greens.

Keep the carrier flat, level and quiet. Cover it partially so the rabbit feels enclosed but can still get air.

Take a bonded partner along if you have one and the journey allows it. Rabbits handle veterinary visits far better with their partner present, and separating a bonded pair adds a stress load you do not need. It also prevents the pair rejecting each other afterwards on the basis of unfamiliar clinic smell.

Keep the temperature moderate. A rabbit in shock loses heat, but a hot car is its own emergency.

Do not stop to give anything by mouth on the way, especially not to a rabbit that is struggling to breathe.

Assemble this before you need it, and know where it is. In an emergency the time you lose is spent looking for the carrier, not treating the rabbit.

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Never put a dog or cat flea product on a rabbit, and never use one to treat "bites".

Products containing fipronil are lethal to rabbits. They are sold in almost every pet shop, they look harmless, and rabbits die from them every year because an owner reached for what was in the cupboard. Permethrin-based products are also dangerous to rabbits.

If your rabbit needs parasite treatment, it needs a product licensed for rabbits, from a vet who knows what else the rabbit is receiving.
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What the vet will do

Understanding this makes the phone call faster and the decision to travel easier.

Assess and secure the airway. In a facial or oral case this comes first. Oxygen, and in a severe case sedation and an airway secured by a vet, because a rabbit fighting for breath deteriorates rapidly when handled.

Pain relief. Rabbits have safe, effective analgesic options, and pain relief is what keeps them eating. This is the single most valuable thing the appointment delivers in a straightforward sting.

Anti-inflammatory or antihistamine treatment, judged case by case.

Fluids, usually under the skin, for a rabbit that has been off food and water.

Gut support. Motility drugs and often assisted feeding, because getting food moving again is the difference between a rabbit that recovers and one that does not.

A look in the mouth. This usually needs sedation or specialist instruments, because the back of a rabbit's mouth cannot be seen properly otherwise, and an oral sting hides there.

Monitoring. For a multiple-sting case, expect a conversation about staying in for observation and possibly kidney monitoring over the following days.

Afterwards, and preventing the next one

The 24 hours after a sting matter more than most owners expect.

Prevention that actually works.

Check hutches, sheds, garden furniture and the underside of run covers for nests in spring, before they get large.

Fine mesh over runs and hutch fronts keeps out wasps as well as mosquitoes and flies, which matters twice over in regions where mosquitoes carry myxomatosis.

Do not leave sweet food, fallen fruit or sugary treats in the run, because that is what draws wasps in late summer.

In regions with fire ants or aggressive ant species, keep hutches off the ground, keep spilled food cleared, and check the base of the hutch legs, since an animal that cannot leave the enclosure cannot escape a swarm.

Never spray insecticide in or near a rabbit's enclosure. Remove the rabbit, treat, ventilate thoroughly, and clean surfaces before it returns.

What never to do

Do not give human antihistamines, paracetamol, ibuprofen or aspirin. Doses are not scaled versions of human doses, several human formulations contain additional drugs that are dangerous, and the wrong choice makes an already compromised rabbit worse.

Do not apply human creams, antiseptics or ointments. Rabbits groom, so whatever you apply is eaten.

Do not squeeze a bee sting out with tweezers.

Do not use ice directly on skin, and do not chill a rabbit that is in shock.

Do not assume a rabbit that looks fine an hour later is fine. Check the appetite and the droppings.

Do not use fipronil or permethrin products, ever.

Do not delay for a facial sting because the rabbit "seems calm". Rabbits seem calm right up until they cannot breathe.

When to get help

Go immediately, without phoning first if that is faster, for:

• Swelling anywhere on the face, nose, lips or throat
• Any noise on breathing, or breathing with the mouth open
• Collapse, weakness, or pale or grey gums
• Drooling or pawing at the mouth after outdoor time
• Multiple stings or a disturbed nest
• A rabbit that is cold, still and unresponsive

Go the same day for:

• Any sting site with a rabbit that has stopped eating
• A swelling that keeps spreading after the first hour
• Reduced or absent droppings

The state you are checking for in the days afterwards: loose, stretched out, breathing quietly, and back on food.

Bring these:

• Where and when it happened, and what the insect was if you saw it
• Whether it was one sting or several
• Whether the rabbit has eaten since, and when it last ate
• What the droppings have looked like
• Any medication the rabbit is already on
• The bonded partner, if you have one

Find out now, before you need it, which local practices see rabbits and which of them cover out of hours. Rabbit medicine is a specialism, general practices vary widely in how much of it they do, and the reason to know this in advance is that the emergencies in this article are measured in minutes, not hours.