Although rabbits are often listed as the third most common pet in the UK, if you ask your vet about their medication, you’ll often find that it’s an off-license product – because there are very few licensed drugs for the species! But why is that, and what effect does it have on their medical care? RAMA Dawn Prime explores medication for this often forgotten species…
Veterinary medicines – a recap
Authorised veterinary medicines fall within the first four categories, which were established by the Veterinary Medicines Regulations. In the UK there are two classes of medicines available only on veterinary prescription, POM-V and POM-VPS. Only in the case of POM-V medicines does that veterinary prescription have to be issued by a qualified veterinary surgeon.
The act of prescribing is taken to be the decision made by the prescriber as to which product should be supplied taking account of:
• the circumstances of the animals being treated
• the available authorised veterinary medicinal products
• the need for responsible use of medicines and the requirement to prescribe the minimum amount of product necessary for the treatment (subject to the minimum pack size manufactured and any authority to break bulk in the Regulations).
• the abilities and competence of the person who will administer the product; and
• any available animal health plan.
What are the different veterinary medicines?
The veterinary classifications of POM-V, POM-VPS, NFA-VPS, AVM-GSL, and CD are all established and regulated by the VMD in the UK.
- POM-V (Prescription Only Medicine – Veterinarian): These are veterinary medicines that can only be prescribed by a veterinary surgeon. Examples of POM-V medicines are antibiotics and steroids.
- POM-VPS (Prescription Only Medicine – Veterinarian, Pharmacist, Suitably Qualified Person): These are veterinary medicines that can be prescribed by a veterinarian, pharmacist, or a suitably qualified person. Examples of POM-VPS medicines include flea and worm treatments for farm animals and horses.
- NFA-VPS (Non-Food Animal – Veterinarian, Pharmacist, Suitably Qualified Person): These are veterinary medicines that can be prescribed by a veterinarian, pharmacist, or a suitably qualified person for non-food animals, such as pets. Examples of NFA-VPS medicines include wormers and flea treatments.
- AVM-GSL (Authorised Veterinary Medicinal Product – General Sales List): These are veterinary medicines that can be sold directly to the public without the need for a prescription. Examples of AVM-GSL medicines include dietary supplements and grooming products.
- CD (Controlled Drugs): These are veterinary medicines that are subject to legal controls under certain legislation including the Misuse of Drugs Act 1971 & 2001. These medicines have the potential to be misused, and their use is strictly controlled to prevent harm to animals and humans. Examples of CD medicines include opioid painkillers and anti-seizure drugs.
While there are a few licensed products for bunnies, there aren’t that many – but it gets more complicated…
Exempt Medicines
However, did you know that there is an additional category of veterinary medicines in relation to veterinary products intended solely for use in small, non-food producing animals, not just rabbits, including:
- aquarium animals, including fish only kept in closed water systems.
- cage birds; birds kept in cages or aviaries.
- homing pigeons; pigeons kept for racing or exhibition.
- terrarium animals including reptiles, amphibians and arthropods kept in tanks and cages, including animals free-living in domestic gardens.
- small rodents
- ferrets
Chickens, ducks, and turkeys are classified as food producing animals and so medicines for these species are not, under any circumstances, covered by the exemption.
Any medicines for the small animals can have medication under the Small Animal Exemption Scheme (SAES) products. They are not authorised (so they have not been assessed for quality, safety, or efficacy) but may be legally marketed and administered according to the instructions on their labelling.
Although such products are exempt from the requirement to hold a Marketing Authorisation, these products are still legally classed as veterinary medicines. Therefore, they must meet all the requirements of the VMR (Veterinary Medicines Regulations) relating to the manufacture (GMP) of veterinary medicines. Exempt medicines can only contain active substances which have been approved for the purposes of this exemption by the Secretary of State.
What medicines not included in the exemption?
The following medicines are not covered by this exemption:
- antibiotics
- narcotic substances
- medicines that are intended to treat more serious conditions that require a veterinary diagnosis, or which have effects that may confuse future tests.
These medicines exist because for many products, it’s just not economically worthwhile for the manufacturers to pay for a full marketing authorisation for such a small population – or, sadly, for one where the majority of owners are unwilling to pay “full price” for a licensed medicine.
Fortunately, a lot of manufacturers do produce effective medicines for preventative health in species, including rabbits, under this exemption.
If it is a small animal product, will I get a label showing instructions?
Exempt products must be clearly labelled to show that they are exempt from having a marketing authorisation, for example, by including the following statement on the outer packaging:
- name of the product
- the authorisation number of the manufacturer*
- name and strength of each active substance
- route of administration
- batch number
- expiry date
- the words, For animal treatment only
- contents by weight, volume, or the number of unit doses
- name and address of the manufacturer or distributor
- target species
- the words, Keep out of reach of children.
- storage instructions
- the shelf life after the immediate packaging has been opened for the first time.
- disposal advice
- full indications, including:
- therapeutic indications
- contra-indications
- interaction with other medicines and other forms of interaction
- dosage instructions
What pack size can I purchase?
Exempt products must only be sold in pack sizes suitable for a single course of treatment. The VMD (the medicines regulator) considers this condition should be met by ensuring that packs contain only sufficient product to treat the following numbers of animals until symptoms are sorted or, for preventative treatments, up to six months.
Examples include:
Aquarium: a single course of treatment should be no more than seven administrations to an aquarium of up to 25,000 litres.
Cage birds and homing pigeons: to treat no more than fifty birds.
Terrarium animals: to treat no more than five animals.
Small rodents: to treat no more than five animals.
Ferrets: to treat no more than five animals
Rabbits: to treat no more than five animals.
What if I notice adverse effects?
Manufacturers and importers must report any serious adverse event within 15 days of becoming aware of it; and must keep records of all adverse events for 3 years, which they must make available on request. If you notice any adverse effects from a product on your small animals, then you must contact your vet, the supplier, or directly get in touch with the VMD.
What if my pet is unwell?
If you have any concerns about your pet, it is good practice to seek veterinary advice where a vet can treat and prescribe the correct product for your pet.
What can I do to keep my rabbit healthy?
To stay happy and healthy, rabbits need:
The Right Food
Rabbits require a diet that primarily consists of hay and/or grass. This is essential for maintaining their dental and digestive health. It is important to monitor your rabbits’ eating habits daily and ensure they pass plenty of dry droppings. Any changes in their eating or drinking behaviour, or a reduction or cessation in droppings, should be taken seriously. If this occurs, you must ask your vet immediately, as your rabbit could be seriously unwell.
Companionship and Socialisation
Rabbits are social animals and thrive in the company of other rabbits. Where possible, keep your rabbit with at least one other friendly rabbit, unless your vet advises otherwise.
Daily Health Checks
Check your rabbit daily for signs of illness or injury, including when you are away from home. If you suspect any problems, speak to your vet promptly.
Cleanliness
Inspect your rabbit’s bottom and tail areas every day to ensure they remain clean.
Teeth and Nail Care
Check your rabbit’s front teeth and nails at least weekly, as they grow quickly. Only a vet should correct overgrown or misaligned teeth.
Veterinary Check-Ups
Arrange for annual veterinary check-ups. These should include treatment for external and internal parasites such as fleas and worms.
Vaccinations
Vaccinate your rabbits against myxomatosis and Viral Haemorrhagic Disease (VHD), following your vet’s advice.
Avoiding Wild Rabbits
Keep your rabbits away from wild rabbits and areas where wild rabbits live, as they can carry diseases.
Grooming
Maintain your rabbits’ coats by grooming them regularly to remove dirty or matted fur.
Identification
Your rabbits should be identifiable and ideally microchipped, so they can be quickly treated if injured or returned if lost.
And most will benefit from Neutering
Unneutered female rabbits are at a significant risk of developing tumours. The incidence of tumours in females older than three years may approach 80 percent, and these are usually fatal. In addition, unneutered rabbits are more likely to fight and exhibit territorial aggression, such as urine spraying. You should therefore neuter your rabbits unless you intend to breed them and have made proper arrangements for the care of both parents and offspring.
So WHY are there few licensed medicines?
To put it simply – cost. It can cost hundreds of thousands – or millions – of pounds to obtain a full marketing authorisation for a “licensed” veterinary medicine. And unfortunately, the drug companies believe there isn’t enough of a market for rabbit-licensed drugs to justify more than a few products (usually those which are also lciensed for another species, as it’s cheaper to add a rabbit onto another license application than to start from scratch). Fortunately, here int he UK we have the Cascade that make it legal for vets to prescribe off-license products; as well as the ESPA (Exemption for Small pet Animal) scheme for routine preventative treatments.
Further Information
Exemption from authorisation for medicines for small pet animals – VMD
Discussion