Pododermatitis in rabbits
Health and Wellness

Sore Hocks in Rabbits (Pododermatitis): Causes, Symptoms + Treatment

Sore hocks mean that the ‘heels’ of the rabbit’s feet have become inflamed. Vets tend to refer to this condition as ‘sore hocks’ or ‘bumblefoot’, though the medical term for this condition is pododermatitis.

The most common cause of sore hocks in rabbits is hopping about on hard, unnatural surfaces such as carpet, tiles, and wire mesh. These surfaces are much harder than sand, grass, and soil. Also, obesity and arthritis can further aggravate the condition.

Bumblefoot can range in severity from mild to very serious. The biggest concern is that pododermatitis could develop into ulcerative pododermatitis, and eventually, deep infection. So, if you suspect your rabbit has sore hocks, you’re doing the right thing by intervening.

How Do Rabbits Use Their Hocks?

As you’d imagine, the hocks are an important part of the rabbit’s anatomy. Without them, they’d struggle to hop and jump.

To appreciate why hocks are so important, just compare them to human ankles. In humans, the ankle joint acts like a hinge to the foot. This enables the foot and leg to move forward or backward.

Rabbits’ hocks work in a similar way. If you watch a rabbit hop, you’ll see that they sink back into their hocks and use this momentum to propel themselves forward.

Unsurprisingly, if the underside of the hocks is sore, it will be difficult for the rabbit to sink back into the ground and propel itself forward. Hopping will then become extremely painful for a rabbit.

are sore hocks common in rabbits?

What Causes Sore Hocks in Rabbits?

One of the main reasons rabbits get sore hocks is because their environment is not suitable for their delicate hocks/feet. Unlike most animals, rabbits don’t have paw pads.

As mentioned, rabbits sink back into their hocks to propel themselves forward. In the wild, rabbits would sink into sand, grass, or soil.

In contrast, most rabbits walk on rough carpet, lino, or hard-bottomed cages. Hard surfaces are thought to be one of the leading causes of pododermatitis, but there are other explanations.

Very Long Claws

If rabbit claws become too long, this can force them to sink too heavily into their heels when hopping. Over time, this can place too much pressure on the hocks, and lead to pressure ulcers.

Obesity

Unsurprisingly, research suggests that overweight rabbits are more likely to develop sore hocks than normal-weight rabbits. This is because more pressure is placed on the hocks when the rabbit attempts to hop.

In fact, if an obese rabbit lives in a cage with a wire-mesh floor, this will almost certainly lead to bumblefoot.

Pain Conditions

Pain conditions, like arthritis, can be the underlying cause of sore hocks.

This is primarily because rabbits with arthritis find it awkward to jump, and so they place an unnatural amount of pressure on one part of the foot. Over time, this wears away the fur and leads to a pressure ulcer.

Also, pain conditions can make rabbits immobile, so they may spend too long sitting on dirty bedding.

Wet and Dirty Bedding

Urine-soaked bedding can cause health problems. Rabbits who sit in dirty bedding will probably develop urine scalding.

If their hocks become scalded with urine, this will leave the skin sore, tender, and vulnerable to flystrike.

Also, when this urine-scalded skin presses against the floor, this may tear the skin, and leave the rabbit vulnerable to bacterial infections.  

Not Enough Fur

The fur on the bottom of your rabbit’s feet is its protection from the outside world. Unfortunately, several different factors can cause the fur on the feet to become sparse. Such as:  

  • Mange
  • Urine scalding
  • Contact allergies
  • Stress
  • Rough carpet
  • Certain breeds have sparse hair on their feet

The worst cases of pododermatitis usually occur when multiple risk factors occur at the same time.  

Are Sore Hocks Common in Rabbits?

Bumblefoot is one of the most commonly diagnosed conditions in rabbits.

According to a study on NCBI, 157 out of 168 rabbits showed signs of pododermatitis.

Most rabbits in the sample had a mild form of sore hocks, but this is still concerning. Mild soreness will almost certainly develop into ulcerative pododermatitis unless treated.

Is it More Common in Certain Breeds?

According to Biology and Medicine of Rabbits and Rodents, some breeds are more prone to sore hocks than others. Remember we said that overweight rabbits are more likely to suffer from this condition?

Well, the same goes for oversized breeds such as Flemish Giant Rabbits. As you might have guessed, this is due to the extra weight placed on the hocks.

Also, Angora and Rex rabbits tend to have sparse hair on their feet, so they’re more susceptible to sore hocks. These rabbits need particularly soft bedding and must be closely monitored for signs of pododermatitis.

Symptoms of Sore Hocks in Rabbits

Sore hocks can range in severity from mild to very severe. It’s best to think of this condition in 4 stages of severity. The progression of pododermatitis is described in detail below:  

Irritation

According to VetTimes, sore hocks almost always develop at the ‘heel’ end of the foot (and may travel towards the claws if left untreated).

At stage 1, you will be able to see initial signs of soreness and irritation. However, it is easy to miss stage 1 pododermatitis. Symptoms include: 

  • Sparse hair on the feet, particularly around the heels
  • Hardened calluses on one or both hocks
  • The calluses may look slightly red and sore
  • There will probably be no visible signs of pain. Your rabbit might be slightly less active than usual, but equally, it may not

Inflammation

Rabbit feet become sore and inflamed. Most owners will spot the signs of stage 2 pododermatitis, even if they are not regularly monitoring the hocks. Symptoms include:

  • The calluses will be sore, red, and inflamed
  • There may be some bleeding
  • Scabbing and peeling skin
  • Your rabbit will be less active than usual

Pyoderma

Deeper cells and connective tissues become inflamed. There may also be a superficial skin infection at this point. Symptoms include:

  • Ulcer/ blister
  • A discharge that may or may not smell  
  • Bleeding and scabbing
  • The rabbit will not move around much
  • Whining or whimpering
  • Your rabbit may refuse food and water

Deep Infection

The infection goes deeper and may swell the joint tissues and start to infect the bone marrow. This will cut off blood supply to the bones. There will be:

  • Severe pain and immobility, probably accompanied by teeth grinding
  • Bleeding
  • Smelly discharge coming from the wound

This is a very serious and life-threatening stage of pododermatitis.

Can Rabbits Die from Sore Hocks?

Bumblefoot not usually fatal, but it must be diagnosed and treated early.  If you wait until your rabbit is at “stage 3” or “stage 4” of this illness, then it becomes much harder to treat.

This is because, at these stages, the infection starts to set in. Rabbits are small and delicate creatures and, even with the use of antibiotics, infections can be very hard to treat.

If you suspect your rabbit has sore hocks, an early diagnosis is vital. 

How to Diagnose Pododermatitis In Rabbits

Every rabbit owner should be able to spot the signs of sore hocks. Moreover, they should know when it’s necessary to take a rabbit to the vet. We’ll guide you through the four stages of diagnosis below.

what causes sore hocks in rabbits?

Inspect your Rabbit’s Hocks

Whether you suspect your rabbit has this condition or not, get into the habit of inspecting her feet at least once per week.

As mentioned, the first signs of sock hocks are usually visible towards the ‘heel’ so pay close attention to this region.

Although you might be very concerned, try not to stress your rabbit out during the examination process. For example, don’t pull at her legs. Instead, set some time aside to carry out the examination.

Ideally, patiently wait for your rabbit to approach you, and spend some time playing/petting her as you normally would. Then, when it is feeling relaxed, gently lift it and ask another family member to inspect the hocks.

If you do notice any wounded or ulcerated skin be sure to wash your hands thoroughly afterward.

Know What You Are Looking For

Inspecting your rabbit’s hocks is important, but you need to know what you are looking for. We’ve already discussed the four stages of pododermatitis, so keep this in mind when looking at your rabbit’s feet.

The hocks should be covered in a good amount of fur. The fur should be dry and clean. Fur staining is normal in rabbits, however, damp, urine-soaked fur is not.

It is quite common for rabbits to have calluses on their hocks. These are not necessarily anything to be concerned about. However, you should keep a close eye on them, as they may become sore and aggravated over time.

If you see any signs of redness, irritation, bleeding, wounds/ulceration, then you must consult a vet.  

Monitor your Rabbit’s Behavior

When hocks become sore, it’s only natural that a rabbit’s behavior would change. Keeping a close eye on your rabbit’s behavior is a good way of monitoring its health. As the condition progresses, you may notice it: 

  • Not hopping around as much as usual (or hopping around differently)
  • Placing more pressure on the forefoot when jumping
  • Becoming anti-social and avoiding all contact
  • Refusing food and/or water
  • Whimpering, whining, or teeth grinding

All of the above indicate a potential health problem, so they should be followed up by a vet’s visit.

Visit the Vet

Your vet will take a look at the hocks to see if they are damaged and/or infected. It’s not always possible to see the extent of the infection with the naked eye so your vet may also perform radiography.

If your rabbit has a mild case of sore hocks, it’s still a good idea to see your vet. They will be able to advise on the best type of treatment. On the other hand, if you try to treat the condition at home, you might end up making things worse.

How to Treat Sore Hocks in Rabbits

Sore hocks are a serious condition so you should not attempt to treat them on your own. Having said that, owners can often take an active part in the rabbit’s treatment (under the supervision of their vet).

To give you an idea of what to expect, here are the most common forms of treatment for pododermatitis in rabbits.

Cleaning the Wounds

If the skin has become ulcerated or broken, your vet will need to clean the wounds. This is not something that should be attempted at home unless your vet has given you the go-ahead.

Typically, the rabbit’s feet will be soaked in a rabbit-safe antibacterial solution. Epsom salts are sometimes recommended as a good natural treatment but only perform this if suggested by your vet.

Wound cleaning can cause more harm than good if it is done incorrectly, or if it is performed unnecessarily.

how do you treat sore hocks in rabbits?

Protecting the Wounds

The next stage of the process is to protect the wounds with a cream or lotion. An antiseptic cream like Bepanthen or Neosporin cream may be applied to the wound.

If the wound is severe enough, your vet may dress/bandage it. If the cream is not being covered by a bandage, the rabbit will be monitored to ensure they do not lick it off.

Fighting Infections

If your rabbit has developed an infection, oral antibiotics will be given via a syringe. Antibiotics aren’t good for rabbits and should only be used as a last resort. Sometimes, vets will prescribe probiotics to try and alleviate the negative effects of the antibiotics.

Depending on the type of treatment your rabbit receives, your vet may ask you to repeat some of the stages at home. You should practice proper hygiene and clean up thoroughly after touching your rabbit’s hocks.

Throw used dressings away immediately and use disposable gloves when applying any cream. Also, when applying the cream, don’t apply it straight from the container as this will contaminate the container.

How to Prevent Sore Hocks in Rabbits

Treating sore hocks can be time- consuming, expensive, and lead to further health problems. So, try your best to prevent this condition in the first place. Here are eight tips to consider.

Change Cages

If you currently have a wire/mesh-bottomed cage, try an alternative. Although mesh-bottomed cages are easy to clean, they are not the ideal choice for rabbits because this material is very hard on their feet.

A wooden (splinter-free) or plastic-bottomed cage is a better choice. But remember, rabbits like to burrow. So, no matter what the base of their cage is made from, provide them with somewhere they can safely burrow.

Different Bedding

Rabbits need bedding to stay warm, comfortable, and to express their natural behavior. Unfortunately, some bedding can be harsh on rabbit hocks. Bad bedding choices include Rough Carpet, Cardboard, Lino, Woodchips, and Cat Litter.

So, what are the best bedding options? Well, you should choose:

  • Grass Hay
  • Shredded Paper

Even if your rabbit lives indoors, you could put some loose bedding in part of its enclosure. This will allow her to burrow and take the weight off its feet. Indeed, it’s a good idea to provide your rabbit with at least two types of ‘flooring’ so it can choose where to go depending on its mood.

Trim your Rabbit’s Claws

Remember we said that having very long claws can force a rabbit to put too much pressure on its heels? Well, trimming the claws back to a sensible length can stop your rabbit from putting too much pressure on its heels.

But this is a fine balancing act – be careful not to over-clip the claws! Ask your vet for guidance before you attempt to clip your rabbit’s claws.

Never Trim the Fur

Although trimming the nails is sometimes necessary, trimming the fur on your rabbit’s feet is an absolute no-no. Cutting the nails/claws is important if you want to avoid broken nails.

According to Rabbit Welfare, the fur on the feet should never be trimmed because it acts as a protective barrier and prevents sore hocks.

So, even if the fur looks unruly, don’t be tempted to trim it.

Check your Rabbit’s Weight

Overweight rabbits are prone to sore hocks due to the extra pressure they exert when hopping about. Your vet will be able to tell you if your rabbit is overweight, and they’ll advise on weight loss interventions if appropriate.

Often, when putting a rabbit on a diet, it’s less about withdrawing food and more about changing the type of food you give your rabbit.

Usually, this means cutting back on pellets and treats but providing plenty of grass hay and water.  

Keep Everything Clean

Urine-soaked fur leaves rabbits vulnerable to sore hocks, as well as flystrike. That’s why it’s important to keep your rabbit’s enclosure clean.

Change the bedding regularly and replace it with a fresh substrate. Don’t try to reuse soiled hay. You should compost it in the garden instead.

Let Your Rabbit Outdoors

In an ideal world, all pet rabbits should go outdoors sometimes. In most cases, it will be safest to let your rabbit outdoors in a run.

This run should be placed on the lawn or soil, rather than on a concrete surface. This will allow your rabbit to come into contact with the ground it’d encounter in the wild, and allow it to hop about as naturally as possible.

Check for Other Conditions

Sore hocks in older rabbits are often caused by arthritis. However, other health problems like mange and allergies can also cause sore hocks.

It’s clear that sore hocks are very common amongst pet rabbits. However, don’t confuse “common” with “normal”. While it might be normal for rabbits to have some calluses on their hocks, it is not normal for the hocks to become red, inflamed, ulcerated or wounded.

Pododermatitis often leads to severe pain and infection, so the sooner it is treated the better. In most cases, you should not try to treat this condition at home because rabbits are very delicate creatures.

However, you should improve your rabbit’s environment to ensure that this problem doesn’t happen again. Above all, make sure your rabbit has soft and comfortable bedding to burrow in.