In Dec 7 2008, a rabbit that had not been eating for 2 days  and had crusty ears and paws was presented to me. It was a bright sunshine Sunday. This was one of those cases of instant diagnosis - Sarcoptes in the rabbit.   

"Get a skin scraping to show the mites," I told my assistant Mr Saw. "It is best for owners to see the scabies mites under the microscope."

"I can take your word for it," the mother said. "I was told by my family members that the rabbit has mange."

Mr Saw left the consultation room promptly to get a scalpel blade to scrape the skin to get the mites buried in the skin and to put them onto the microscope's slide.

"No need to do that," I stopped Mr Saw. There are some raw skin areas with blood in the right ear. Mites would be found in the bleeding spot (see picture). He got the skin scraping onto the slide and put on some oil. Actually there was no need to use oil. Water would do but since he had done it, I did not comment.    

The two willowy daughters aged around 7 years and 5 years looked so much like their mother who was tall as well as being willowy. The mother lifted each child onto the chair to see the scabies mite under the microscope.

Mum had seen the mite first. My microscope was on a higher level on the cabinet as my consultation room was small.  I showed the children the drawing of a Sarcoptes mite in a Hills' veterinary book too. Pet health education is important for children especially when they are inquisitive and intelligent.

"How did the rabbit get infected?" Mum asked. After all the rabbit had no crusts for many months.

"Contact with another infected rabbit," I said.

"He is the only rabbit at home and has been running and hopping around happily in the garden."

"Did he meet another rabbit a few weeks ago?" I enquired.

"Yes," the elder sister recalled. "A friend had brought her rabbit to visit us."

"When?"

"After the visit of grandparents," the elder sister remembered. That was some 4 months ago. 

This case seemed to be a standard case of giving an anti-mite injection and sending the rabbit home.

"The rabbit has a high fever of 40.7 deg C," I said. "That is why he is not eating and not active. I will not advise giving him an anti-mite injection today as he is not in good health. Some rabbits do die after the injection some days later because they were not in good health to receive the injection.

"I have had encountered such cases when the owner wanted treatment for the Sarcoptes despite the fact that the rabbit was in poor health. Not all cases die but some will die. I need to inform you of the risk and consequences to avoid misunderstanding in the event of death."

The younger sister took her mum's hands suddenly. Mum looked at her. I turned my attention to her too. She rubbed her eyes. Her  eyes were red with tears. She had heard the word "die".

I did not know she was paying close attention and understood  death. Many 5-year-old children do not comprehend the finality of death nor pay much attention to veterinarian-parental discussions.

"The rabbit is not going to die," Mum comforted the young one and hugged her. The elder sister had an excellent command of English as spoken in Singapore and understood what I said. She did not cry. She was 2 years older. 

I should use the euphemism "passed away" next time when little ones are around. Now, what will be the management of this case at least cost for the owner?

1. Treat the fever by antibiotic injection for 3 days.
2. Give the anti-mite injection when the rabbit has recovered from fever fully in 3 days' time.

"You can bring the rabbit daily for injections, to save cost," I said to Mum. "Or let the rabbit remain in the surgery for 3 days for antibiotic injections. An anti-mite injection would be given on the 4th day when the rabbit is free from bacterial infections."

Mum had to decide. Elder sister intervened, "It is best to ward the rabbit so that the vet can monitor him daily." It seemed that the elder daughter had made the decision. The rabbit was warded.

His fever subsided to 40.1 degree C after 24 hours. He was eating and passing stools 3-4 hours after the first antibiotic injection.

DAY 2.
The mum and two daughters visited the rabbit on Day 2. It was raining cats and dogs on this Monday, a Hari Raya Haji public holiday in Singapore. They brought him his food. Mum had also driven by yesterday to give the bunny his own pink cage and accessories.

I could not talk to them as I was spaying a stray cat - one of 2 females and 1 male strays adopted by a young girl studying in the polytechnic.

DAY 3.
The rabbit ate more during the next 2 days at the Surgery. More and more faecal pellets blanketed the wood shavings. Mr Saw had to remove them and change the litter.

The mother brought the children to visit. "Good news," I said. "The rabbit's temperature is normal at 39 degrees C."  The elder sister's friend held the rabbit on her lap. The mother now had 2 daughters, one son and a friend of the elder sister to take care of.

In reply, the rabbit suddenly flicked his front paws trying to dislodge or scratch away the crusts. The elder sister was surprised at this action. "Probably his left paw was very itchy," I commented.

The little sister wanted to see the warded dogs at the Animal Holding Area. There was some barking.  I took her to see them.

This 5-year-old asked about the reasons for the nine dogs being warded. There was a Jack Russell with a swollen right eyelids. "He vomits every day for many weeks," I said. "He has rubbed his eye suddenly and now wears a collar."

"Will he die?" the little sister asked me suddenly. This was the second time she spoke on the subject of death. The mother looked at me in surprise too. I said, "No, this dog will not die." 

It was time to go home. There must be a lot of things the mother of 3 children had to do. A veterinary intern, a 18-year-old Ms Tan phoned for a taxi as this time, the mother did not drive. Father had the car. A blue Comfort Taxi arrived outside the Surgery. I went out to say goodbye to this nice family. 

"Doctor, thank you for taking care of my rabbit," the elder sister said in the Queen's English as the mother ushered her into the taxi.

A 7-year-old girl thanking me was uncommonly encountered in my 3 decades of practice in Singapore. This was no ordinary willowy 7-year-old girl. She was a girl with good manners. An inner beauty.  She was also good looking. This girl will be a smasher and a heart breaker in a few years. The upbringing was excellent.

DAY 4
The rabbit's temperature went up to 40.1 degrees in the morning check. The bacterial infection had returned. I could see more faecal pellets on the wood shavings. The rabbit was active, standing on his hind limbs and eating. It was now or never. I gave the rabbit the ivomec injection SC and the father brought him home.

At home, he would be hopping around in the garden under the supervision of the children. Born free. Fresh carrots and plenty of love.

I only hope that the stalking cat would not get him. "We live on a higher ground," the mum soothed my worries. "Therefore the cat would be unlikely to catch the rabbit."  Maybe. Cats are predators by nature. I hope the rabbit enjoys his freedom without being killed.