Driver recognized the signs of gastrointestinal stasis, a life-threatening illness in rabbits. She took Twix to her veterinarian who determined that spurs on the three-year-old rabbit's molars were causing the discomfort.
Dr. Miranda Sadar, an assistant professor of the zoological, exotics, and wildlife service at the Western College of Veterinary Medicine (WCVM), says owners often know there is something wrong with their rabbit but don't always link it to their pet's teeth.
"Usually we see a premolar-molar problem which is inside their mouth," says Sadar. "Owners can't check that area very easily because their [rabbit's] mouth just doesn't open very wide."
Sadar says owners need to monitor their rabbits for many secondary signs of dental disease. The first hints of trouble may be found in the rabbit's fecal pellets — owners may notice a decrease in size, number and/or moisture.
Other signs of dental disease include discharge from the eyes and nose, or drooling from the mouth. Since rabbits clean their faces with their front feet, owners should regularly check the inside of their pets' front legs for excess discharge, crusting of the hair or saliva.
"As they get more and more painful, they will typically stop eating hard foods first," says Sadar. "So if they are fed hay, hay will go first, then typically pellets [and] then they will stop eating their greens — just based on how much effort they have to put in to chewing different food items."
Sadar notes that almost all cases of dental disease in rabbits that she has seen are in client-owned animals; dental disease in wild rabbits is rare.
She adds that some of the popular breeds — such as dwarf rabbits and lops — have been bred to have a short, "smooshed" face — not big and long like a jackrabbit's facial features.
"Lops tend to have what we call ‘skull syndrome.' They tend to have problems with their teeth, their eyes, their nose, their ears — pretty much anything that is there, they have troubles with," says Sadar. "It's tough because they are the cutest of the rabbit breeds, but those are the ones we will often see over-represented."
While breed predisposition and genetics both play a part in dental malocclusion problems, diet is often the main contributor to dental issues. Wild rabbits eat nutritionally poor, tough, fibrous grasses with high silica content; a very abrasive diet helps to keep their constantly-growing teeth in check.
"Take that and apply that to a captive situation. The most abrasive thing we have that also provides them with some nutritional content is going to be our hay products," says Sadar.
For an adult rabbit, grass hay is the most appropriate feed because it wears down their teeth and doesn't provide them with too many nutrients. For young rabbits, lactating females or pregnant rabbits, alfalfa is a more appropriate feed because it has higher calcium and protein content.
"It [alfalfa] is more nutritionally dense but will still provide them with the fibre that they need."
Before Driver rescued her two rabbits, Twix and Bonsai, their diet consisted of only pellets. After she took over their care, she gave them hay as well as pellets.
"I spent a huge amount of money on different types of hay, and at the time of the dental [procedure], I still hadn't found a type of hay that the bunnies would eat," says Driver, who finally found a suitable grass hay a month after Twix's dental procedure.
"[Twix] is a real diva and does things like thump if she doesn't get her own way."
Twix quickly returned to normal after the dental procedure, but proper nutrition is critical to keeping her healthy. Driver also takes Twix back to her veterinarian every three months to ensure that there are no changes. Veterinarians often need to do multiple procedures before dental malocclusions are permanently corrected.
Dedicated owners are key to the success of rabbit dentistry, says Sadar. Owners also need to be vigilant for signs of dental disease through every stage of a rabbit's life since it's a problem for all ages.
She recommends that owners of new rabbits visit a veterinarian to collect some baseline data on their pets and to get the latest health information.
As Sadar points out, veterinary research in the past decade has led to significant changes in what veterinarians now know about nutrition and husbandry for rabbits and other exotic pets.
"A lot of people are demanding higher levels of care for our [exotic] patients now."
Gwen Roy of Edmonton, Alta., is a third-year veterinary student at the Western College of Veterinary Medicine (WCVM) and a wildlife biologist.