Rabbit choking, 'Heimlich maneuver', Centrifugal Swing, Thoracic compressions, Back slaps & Regurgitation information. [Updated on: 11/17/17 06:04]
The following information is provided for reference only. Ask your rabbit savvy vet about this subject before you need to use it! They can show you the correct technique for your rabbit! There can be very serious negative consequences using the techniques below!
Very Dangerous: Rabbits can not vomit and therefore choking is a very extream issue with them. Stephan Flores (The Bunny Guy) wanted to express how very serious using the "Heimlich maneuver" is! It is possible to break a rabbits neck or become severely injured. Anything from fractured vertebrae to even death. Ask your rabbit savvy vet about this subject before you need to use it!!! Most all choking information for rabbits (on the web) is based on "The Bunny Guy" or Dana Krempels's posted information.
Choking = Vet ASAP: Even after a choking event the rabbit should see a rabbit savvy vet as soon as possible. If the rabbit
dislodges the food/blockage itself (or with help) most likely the rabbit has aspirated. Many vets will put the rabbit on antibiotics to prevent...
Prevent respiratory tract infections
Some vets will also give a few days of an nonsteroidal anti-Inflammatory such as Metacam (Meloxicam).
Other Choking Issues:
There are also other issues that can cause a rabbit to choke that a rabbit savvy vet can help and identify.
Mega Esophagus - Mega esophagus is very rare in rabbits but does happen. If your rabbit has a lot of choking/regurgitation events you should ask your rabbit savvy vet amount this!
"Emily, a checkered giant, was 2 years old when she began to have choking episodes. On oral examination nothing abnormal was seen, but endoscopy revealed an elongated soft palate, which may have interfered with her ability to regulate swallowing and breathing." - by Barbara Deeb, DVM; HRS
Dental issues. "Hay, etc can get caught on molar spurs" - by Sandi Ackerman; House Rabbit Journal Winter 2009: Volume V, Number 4; HRS
This page is dedicated to
August 2009 - March 2017
Rest in peace Lady Star
Things to look for if a rabbit is choking
Rabbit lifting its head and pointing its nose to the air - this is them trying to breathe, it is also seen in rabbits with heart issues.
Making gurgling or whistling sounds.
Laboured breathing, panting and gasping type breaths (like you'd see in a human choking)
Turning blue - their gums that is, not fur! This is lack of oxygen, and again something you might see in a human.
Rabbit pawing at its mouth and moving around whilst chewing
One of the things to look for if a rabbit is choking is when they lift their head and point their nose to the air. Above is a good example of this.
CharlotteM. was giving her pair Luna and Ollie a few tiny bits of dehydrated papaya and taking a few pictures. Ollie lifted his head as he started to choke on a small bit of papaya, he may have not chewed it. Ollie was able to clear it right away and is perfectly fine now, giving Charlotte a big scare. Info and pics used with direct permission from CharlotteM.
Methods & Techniques
"Centrifugal Swing" Dr. Dana Krempels & Stephan Flores (The Bunny Guy)
Many refer to this technique as the "Bunnny Heimlich," when in fact swinging the rabbit tries to take advantage of centrifugal force. This force will hopefully push the bunny's internal organs forward and in turn force air out of the lungs, and with luck, it will clear the rabbit's trachea. The "Bunnny Heimlich" method below more closely resembles the real human Heimlich maneuver.
There are two methods to preforming this technique. The first is preformed by Stephan Flores (The Bunny Guy) as seen in the video animation to the left. Support here comes mainly from the top and bottom, but also supplies good support to the sides.
The second provides main support for the rabbit from the sides. Dana Krempels's & Joy Gioia explains and demonstrates this technique in the House Rabbit Rabbit Society's HRS Rabbit Center Master Seminar Series. Thanks to Margo & Elizabeth for the video use.
Stephan Flores (The Bunny Guy): "Hold the rabbit firmly, providing ample support for head and neck. With their nose pointing downward, firmly and gently apply pressure upwards against the diaphragm. Make a smooth movement that starts mid abdomen and sweeps upward toward their ribcage. This will apply pressure against the lungs, and by using the force of that air trying to get out, dislodge the item in the trachea. Having the buns's head pointed down will help it not fall right back into place again."
Dana Krempels's explains and demonstrates the 'Bunny Heimlich.' The video clips used are from the House Rabbit Rabbit Society's HRS Rabbit Center Master Seminar Series. They are copyrighted by the HRS and used with direct permission. Thank you to Margo for the use and Elizabeth for making it happen! Video below....
"Thoracic Compressions" Mark Burgess DVM [Text used with direct permission from Dr. Burgess]
"Choking episodes fortunately are rare, but if they occurred, I'd probably recommend thoracic compressions (slap both sides of the chest simultaneously, causing exhalation of air rapidly, like a cough). Bunny thorax expands side to side, not front to back, so side compressions are best, and relatively safe. Hope this helps." - Mark Burgess DVM, Southwest Animal Hospital - Thanks to I.Klimczuk for this information.
"Personally not fond of this even though I have done it on a choking bunny. I do think there is danger of doing more harm than good with this method." Centrifugal Swing. "I have had more success with back "pounding" with a cupped palm, while bunny is held with head lower than torso, to dislodge food. Where the real problem lays is not in the stuck piece of pellet or hay or whatever but in the instant and copious amount of mucus produced by the choking rabbit. This needs to be suctioned out fast and the only way to do that is with your mouth. I have saved three buns now by alternating "pounding" with suction." [Text used with direct permission from Lisa.B]
DonnaK. recounts her choking event with her bun Little Girl using a different technique. "A couple years ago I had read that they (choking rabbits) run around in a panic which is not what she did. At that time I practiced the manuver on a stuffed toy rabbit so I would know how to do it if I needed to."
"Within a minute after giving her the broken up Oxbow support (she can't chew it on her own and has tooth issues) I thought that she was sneezing (which she does on occasion). Whn I checked on her she was pawing at her mouth, she was gasping for air, had her nose pointing up in the air and mucas all over her face which are the symptoms in the link you have provided. I called Delia (a friend from Disabled Rabbits group on FB) because I know she just went throught this with her rabbit a few days ago."
"This went on for at least 5 minutes while I tried the manouver over and over. I also had her face pointed down and was shaking her when she wouldn't respond to the manuever. A little food came out, but she was still gasping and starting to lose conscienceness which is when Delia told me to put my finger down her throat, and that didn't work either. She told me to syringe some water which finally worked. She stopped gasping for air and appeared to be breathing normally so I let her go and she ran about 5 feet from me and began grooming herself. Maybe the finger down the throat isn't a good idea, but after 5 minutes it was the last resort." - Thanks Donna, text & picture used with permission. Donna is with the Rabbit & Small Animal Rescue.
TracyRM shares her choking story with her girl Suzie from The Bossy Bunny: "Tuesday morning started out like any other day. Mom came downstairs, I got excited and jumped off my kitty condo, ran through my tunnel, and rushed to the top level of my Cottontail Cottage. This is where mom gives me about a teaspoon of my pellets. She saves the rest for my playtime at night. She sprinkles them in my ball pit and litter box of hay. As usual, I started inhaling my pellets like I hadn't eaten in weeks.
Mom went to get my salad and then everything got scary. I started sneezing and ran to the downstairs of my cottage. Mom thought I stuck my nose in my water bowl at first, but I kept sneezing, so she ran to check on me. I had tried to eat so fast that I got choked on my pellets. I was starting to drool everywhere and shaking my head. Mom pulled me out of my kingdom (aka my pen), put me on her arm and held me tight with her other hand (supporting my head, neck, and back) and started swinging me downward towards the floor. That's the last thing I remember. She said my eyes rolled back in my head, I was drooling everywhere, my mouth was wide open, and I went limp. She thought I died. Next thing I remember, dad is there wiping my face and looking worried. Mom remembered reading about the bunny Heimlich Manuever at some point. She said she didn't remember all of it, but remembered enough.
After mom posted a video of me talking about my bad day, she said so many other people commented on how they lost their bunny due to choking, or was able to save their bunny because they had seen the instructional video on the bunny Heimlich, or they had no idea it could happen. So mom asked me to share my experience in hopes it would help other people save more bunnies. It is a terrifying experience for everyone involved. Mom said she's only going to give me pellets in my ball pit or hay from now on. You can also use a treat ball if your bunny is a pig, too.
After your bunny has a choking experience, you need to take your bunny to the vet. There are many things that can happen, including pneumonia and antibiotics will be needed. In my case, it caused some sinus issues, so I'm taking antibiotics for that. I'm not happy about it and I am making mom work hard to get it in me, but I am taking it.
Please watch and/or read the information attached. And please share this story far and wide, not so I can become a bigger celebrity, but to save other bunnies. http://www.vgr1.com/choking/" - Thanks TracyRM, text & picture used with permission.
/u/Okcool81 shares their choking story about Cadbury.
"As for the story: I heard a weird noise, saw she had mucus or something coming from her nose and mouth and noticed she didn't finish her food so something was definitely up. She was panicking. I picked her up and swayed her, tapped her lightly on her back and sides. She ran off and started cleaning herself. Watched her for a while and she seemed back to normal." - Thanks /u/Okcool81, text & picture used with permission.
ShannonD. shares her choking story about Pancake and how she used a modified version of the "Thoracic Compressions" technique.
"Very scary this morning! My Pancake was choking when I was in the middle of preparing his and Polly's pellets - He was having a very loud, panicked "sneezing fit", while sticking out his tongue constantly and rubbing his mouth and nose (no mucous present). Polly was frightened also because he was hopping around the cage, trying to stop.
I knew he was choking because a girl posted a video of her bun doing the exact things same as mine and people here told her there was something lodged in its nose/throat! I was scared, but I grabbed Pancake and tried tapping his back and rubbing my hand up and down it, like the way you would wind a baby and I tried squeezing his sides as gently as possible, when (I think) a lump of hay came out, he ate it again, drank looooads of water and then ate some pellets, as if nothing happened." - Thanks ShannonD., text & picture used with permission.
LynneL. shares her choking story about Ollie and how she used a "reverse version of CPR" as a technique.
"I would do anything to save my bunnies, so when my Ollie was choking on something this was the first thing that came to mind. I came home from work one night to find Ollie making a very loud gasping and wheezing sound. Every now and then, he would make a choking sound and then something like clearing your throat. Don't know if bunnies are capable of clearing their own throats. Ollie is a very calm and cooperative bun, so he was willing to let me try to help him. I Looked in his mouth and didn't see anything, so I basically just placed my whole mouth over his nose and mouth and sucked in quickly and forcefully. I did this maybe 2 or 3 times. Nothing came out into my mouth, but the vet thinks that I might have dislodged some hay that might have become lodged into the side of his throat. I did take him to see Dr. Harvey the following morning after a sleepless night. She squeezed him in before all her other appts 😍. Ollie still made the strange sounds while the vet was checking his throat. She noticed his throat was inflamed and irritated, thus the theory of the hay and me dislodging the discomfort. We went home with anti-inflammatory meds and made another appt for the following day in case the issue wasn't resolved and the Dr needed to sedate Ollie to check further down his throat.
Luckily by the next morning Ollie was at least 75% better. He still was making a very audible sound, not like his usual "buzzing" sound which he has made since a young bun. I brought him in for the follow up and the Dr agreed that he was in fact better because neither of us wanted to go down the sedation route. A few more days on the meds and he was back to normal." - Thanks LynneL., text & picture used with permission.
Anne Martin with HRS shares her choking story about Jedi a 8.5 year old bunny at the HRS HQ.
"We had an 8.5yr old bunny at HRS headquarters, Jedi, who choked on pellets and survived. We rushed him right to the vet, and they put him in oxygen & on IV antibiotics (food in the lungs often causes pneumonia). He has been on long-term PenG injections twice a week and daily nebulizing with Gentocin, and his breathing is no longer noisy, but his chest x-rays two years later still show hazy lung fields - likely scarring in his lungs. He's doing really well now and has a new senior bunny friend."
Updated information: In 2011 The Bunny Guy blogged about how to use the centrifugal swing and the "heimlich maneuver" on a rabbit. This included some info and pictures and these were posted at a few sites around the web. Some of this information was incorrect and showed the incorrect way to hold and support the rabbit. Very serious.
He updated the info & pics and this was published in one of his 2014 newsletters. Unfortunately this new information was not seen and the old dangerous info was not updated. I directly contacted The Bunny Guy and ask permission to use his new pictures.
He let me know that the first set of pictures (that are all over the internet from BunSpace) shows the incorrect way to hold the rabbit and could injure the rabbit's back or neck. See the updated pictures and information below courtesy of The Bunny Guy. This time the pictures are staring Ricky.
Update Information and Pictures
"Notice that my thumb and forefinger are in front of his front legs supporting his head underneath his chin. Then my other hand is supporting his head and whole spinal column so that the violent maneuver does not injure his back or neck." Click on picture for bigger view.
"Each year thousands of rabbits choke to death. If you know this simple maneuver, you can possibly save your rabbit if you can get to him in time." Click on picture for bigger view."
"It is the violent centripetal force that forces whatever is choking your rabbit out of their throat, but you must be sure not to break his neck or back in the process."
"That is the reason I am reproducing these pictures again to better demonstrate the need for support of the rabbits head, neck and spine during the procedure."
THE OLD & OUTDATED "The Bunny Guy" INFORMATION
The OLD PAGE SECTION is linked here so you can see what not to use and for reference. THE PAGE CONTAINS THE ORGINAL PICTURES & INFORMATION THAT SHOW THE INCORRECT WAY TO HOLD THE RABBIT. THEY ARE ONLINE ONLY TO SHOW WHAT IMAGES ARE FLOATING AROUND ON THE INTERNET.
Dana Krempels, Ph.D. (Houserabbit Adoption, Rescue, and Education, Inc. [H.A.R.E., Inc.] president & National House Rabbit Society Board member) answered a question on choking in rabbits back in September 2007 (on allexperts.com). Here are her (2007) steps for the "rabbit Heimlich maneuver."
From a 2007 Post
You must take the rabbit and firmly align him between your forearms so that his neck and spine are absolutely immobilized.
Swing your arms upward (rabbit nose pointing to the sky), and then smoothly (not *too* fast) swing them down, being extremely careful not to allow the bunny to hit the floor!
Again, it is *vital* to have the neck and back completely immobilized so that the force of the swing doesn't break the delicate back!
The centripetal force of the swing will push the bunny's internal organs forward, forcing air out of the lungs, and (hopefully) clearing the rabbit's trachea. We have had to do this only a couple of times, and it is very traumatic, sometimes requiring 2-3 swings before the bunny can breathe again.
Once the bunny can breathe, it's important to schedule a veterinary appointment as soon as possible, since aspiration pneumonia can result from an episode like this.
From a 2009 Post: "In extreme cases, when it's life or death"
I have actually stabilized a bunny very firmly between my forearms so that the back and neck are absolutely immobile
and then *swung* the bunny from a horizontal position to one where the bunny's nose is pointing downward
The shifting weight of the internal organs that results from this rapid motion pushes hard against the diaphragm, and can force air out of the lungs to dislodge a stuck particle
"Did you know that rabbits can't vomit? They have a very tight sphincter in their oesophagus (the food pipe leading to the stomach) and the position of their stomach means it is impossible for them to vomit. However in very, very rare cases they can regurgitate (which is not the same as vomiting) and bring back fluid or partially ingested material - see the photo for what this looks like! Rabbits can regurgitate if they have something stuck in their oesophagus acutely, or if they have a malformation of the oesophagus. A positive side to not being able to vomit is that they can't do this under anaesthetic, which makes things safer - and they should not be starved before a GA."
"... vomiting is not the same as regurgitation - i should have explained more - vomiting is an "active" movement requiring nausea and the active contraction of the stomach forcing material out of the oesophageal sphincter, rabbits physically cannot do this - whilst regurgitation is a passive act - its a reflux of fluid."
What color? "depends what they eat, it can often be brown"
The following regurgitation information is from LafeberVet.
"Gastrointestinal obstruction and acute gastric dilation"
Date: July 28, 2010
By: Susan Kelleher, DVM
Reviewed by: Peter Fisher, DVM; Pet Care Veterinary Hospital Virginia Beach, VA
"Rabbits have a very tight esophageal sphincter and cannot vomit or eructate. Rabbits also normally produce large amounts of saliva and gastric secretions. As a result, obstruction of gastric outflow quickly leads to distension of the stomach. The distended stomach compresses the acute angle of the pyloric outflow tract in the rabbit creating a self-perpetuating cycle of further distension and obstruction. The distended stomach may place excess pressure on the diaphragm, which compromises the rabbit’s already small lung volume." - Dr. Kelleher
The following regurgitation information is from Rabbit Meadows - Offical HRS chapter for Seattle, Washington.
By Sandi Ackerman - Washington House Rabbit Society chapter manager
"I have personally observed 3 different rabbits in the process of vomiting. The first time involved one of my foster rabbits who is just a pig and always claimed that he hadn't eaten in weeks. And so he gobbles, or literally inhales his food. I had just placed his and his mates pellet bowl on the floor when he dashed over, stuck his head in the bowl and started chewing. After only a couple of seconds he started vomiting and then just as suddenly got up on his back feet with his front feet stretched high above him on the wall. It then appeared as though he were "dancing" on his back legs and it took me several seconds to realize that he couldn’t breathe. By the time I reacted and had picked him up he had apparently cleared the obstruction and was beginning to calm down. In only another few seconds he wanted to get down, shock himself and started eating again. There was no additional signs that anything had been amiss."