Rabbit Pasteurellosis (Snuffles): Signs and Treatment

Pasteurellosis (snuffles) is the most common bacterial disease of pet rabbits, caused by Pasteurella multocida, and produces a spectrum of illness from mild nasal discharge to life-threatening pneumonia, abscesses, and inner ear disease. It is rarely cured and almost always managed long-term — but early diagnosis and appropriate antibiotics substantially improve quality of life.

Last reviewed: June 2026

What Is Pasteurellosis (Snuffles) in Rabbits?

Pasteurella multocida is a gram-negative bacterium that colonises the nasal passages of a large proportion of pet rabbits, often without causing any signs. When the rabbit's immune system is stressed — by diet change, overcrowding, concurrent illness, pregnancy, or seasonal change — P. multocida can spread and cause active disease. The colloquial name "snuffles" refers specifically to the upper respiratory form, but the same bacterium causes a much broader range of disease including rhinitis, pneumonia, otitis media and interna, conjunctivitis, abscesses (particularly of the head and jaw), and uterine infection in entire does.

Pet rabbits frequently carry P. multocida subclinically from birth, having acquired the organism from their mother. In a multi-rabbit household, all rabbits should be assumed to be exposed once one is symptomatic. As described in Quesenberry & Carpenter's Ferrets, Rabbits & Rodents: Clinical Medicine and Surgery, P. multocida is the most common pathogen isolated from rabbit upper respiratory infections, and the chronic carrier state is the norm rather than the exception.

Signs of Pasteurellosis in Rabbits

Signs vary significantly by which body system is primarily involved.

Upper respiratory (snuffles) — most common presentation:

• Clear to white or yellow-green nasal discharge — starts watery, becomes mucopurulent as the infection becomes established
• Sneezing, often frequent and productive; the rabbit may sneeze sprays of discharge
• Matting of the inner surface of the forepaws — rabbits wipe their noses with their front feet, so bilateral paw fur matting is a classic and highly specific clue
• Noisy, congested-sounding breathing
• Reduced activity and appetite in more advanced cases

Ocular involvement:

• Conjunctivitis — red, watery, or mucoid eye discharge, often bilateral
• Dacryocystitis — infection of the nasolacrimal (tear) duct, which connects the eye to the nose; drainage of purulent material at the inner corner of the eye

Lower respiratory / pneumonia — more serious:

• Increased respiratory rate (normal rabbit respiratory rate: 30–60 breaths per minute)
• Labored breathing — abdominal component, flared nostrils
• Lethargy, anorexia, and rapid deterioration
• Rabbits hide respiratory compromise well; by the time breathing looks labored, the illness is often advanced

Otitis media and interna — inner ear involvement:

• Head tilt (torticollis) — sudden or progressive tilting to one side
• Rolling, falling, or inability to maintain balance
• Nystagmus (rapid eye movements)
• Often confused initially with Encephalitozoon cuniculi (a common differential)

Subcutaneous and dental abscesses:

• Firm, well-encapsulated lumps on the jaw, cheek, or face
• May grow slowly over weeks to months
• Rabbit abscesses typically contain thick, caseous (cheese-like) pus rather than the liquid pus typical of dog and cat abscesses — this makes them difficult to drain and often requires surgical removal rather than simple lancing

Systemic / reproductive:

• Pyometra (uterine infection) in entire does — vaginal discharge, lethargy, anorexia

Rougier et al., 2006, JVECC documented long-term antibiotic treatment outcomes for Pasteurella rhinitis in rabbits, confirming that while clinical signs improve with appropriate antibiotic therapy, bacterial eradication is rarely achieved and recurrence is common when treatment stops.

Diagnosing Pasteurellosis

Diagnosis combines clinical signs, culture, and imaging where needed.

Diagnostic approach:

1. Clinical history and physical exam — paw matting, nasal discharge, and sneeze history are highly suggestive; otoscope exam for ear canals; dental exam for jaw swelling
2. Nasal or ocular swab culture and sensitivity — identifies P. multocida and guides antibiotic choice; also identifies concurrent pathogens (Bordetella bronchiseptica is a common co-infector)
3. Complete blood count and chemistry — evaluates systemic inflammation; neutrophilia common in active infection
4. Skull radiographs or CT — essential for suspected otitis media, abscess evaluation, or dental root involvement; CT is far superior to X-rays for evaluating the tympanic bullae and tooth roots
5. Thoracic radiographs — for any rabbit with respiratory signs; consolidation, pleural effusion, or lung abscesses may be visible

The same presenting signs (head tilt, sneezing, nasal discharge) can be caused by E. cuniculi, dental disease, or other bacteria — culture is needed to confirm P. multocida and target treatment appropriately.

Treatment: What to Expect

Pasteurellosis management is almost always long-term; cure is the exception rather than the rule.

Antibiotics:

• Enrofloxacin (fluoroquinolone) — the most commonly used first-line antibiotic for rabbit pasteurellosis; as described in Plumb's Veterinary Drug Handbook, the dose and route (oral, injectable) depend on disease severity; it is bactericidal and reaches therapeutic concentrations in the upper respiratory tract
• Azithromycin — useful as an alternative or combination agent; particularly for deep tissue or abscess infections
• Penicillin (injectable) — effective against P. multocida in rabbits but must never be given orally in rabbits, as oral penicillins cause fatal enterotoxemia; injectable benzathine/procaine penicillin G is the safest form
• Chloramphenicol — used in refractory cases; effective but requires monitoring for bone marrow toxicity
• Duration: typically 6–8 weeks for active upper respiratory disease; longer for abscesses or otitis; often lifelong for carriers with recurrent flares

Abscesses:

• Surgical excision under general anaesthesia is preferred over drainage alone — the caseous pus does not drain completely
• Marsupialization (creating an open pocket to allow delayed healing) is used for some jaw abscesses
• Long-term antibiotics after surgery to reduce recurrence

Supportive care:

• Nebulization with saline helps loosen nasal secretions and can be done at home once the vet demonstrates the technique
• Nutritional support — a rabbit that stops eating is at high risk of GI stasis, which becomes a secondary emergency; assisted feeding with a syringe diet (e.g., Critical Care formula) is often needed during flares
• Environmental optimization — reduce stress, prevent temperature extremes, and ensure dust-free bedding

Otitis / head tilt:

• Treatment of otitis media typically requires prolonged systemic antibiotics (months) and sometimes bulla osteotomy (surgical opening of the tympanic bulla) to drain infected material
• Vestibular signs (head tilt, rolling) can improve substantially but may not fully resolve

Benato et al. confirmed in a rabbit pain and welfare study that prolonged untreated infectious disease significantly diminishes quality of life metrics (Benato et al., 2019, JSAP), underscoring the importance of prompt treatment even when cure is unlikely. The AEMV Pet Care Guides, 2024 outline husbandry-based prevention as a cornerstone of reducing P. multocida disease burden in domestic rabbits — minimising overcrowding, stress, and concurrent illness that activate the carrier state.

Prognosis

Prognosis depends heavily on which systems are involved.

Form of pasteurellosis	Prognosis
Mild rhinitis (snuffles) with prompt treatment	Good for symptom control; low cure rate
Pneumonia	Guarded; requires aggressive treatment
Otitis media/interna with head tilt	Fair; many rabbits adapt to permanent tilt
Facial/jaw abscesses	Fair with surgery; frequent recurrence
Pyometra	Good with spay; recurrence eliminated

Long-term management is the realistic goal for most affected rabbits. Many live comfortably for years with periodic antibiotic courses during flares and attentive husbandry.

When to See a Vet

Call your vet today if:

• Your rabbit has been sneezing for more than 2–3 days or has nasal discharge of any color
• You notice matting of the fur on your rabbit's front paws (a sign of chronic nose wiping)
• Your rabbit has a new head tilt, circling, or loss of balance — even if it seems mild
• You notice any firm lump on your rabbit's face, jaw, or head

Go to the ER immediately if:

• Your rabbit is breathing rapidly at rest or appears to be working hard to breathe
• Your rabbit has suddenly developed a severe head tilt and is rolling uncontrollably
• Your rabbit has stopped eating for more than 12–18 hours alongside any other sign of illness — rabbits develop fatal GI stasis rapidly

Frequently Asked Questions

Is snuffles contagious to other pets or people? P. multocida is highly contagious between rabbits — direct contact, shared feeding bowls, litter boxes, and bedding all spread the organism. It is not contagious to cats or dogs in normal circumstances, and zoonotic infection of humans is rare and typically only occurs through bites or deep scratches from infected rabbits. Basic hygiene is adequate protection for rabbit owners.

Can snuffles in rabbits be cured permanently? Permanent bacterial eradication is uncommon. Most rabbits respond to antibiotics with marked clinical improvement, then relapse when treatment stops. The goal is long-term clinical control — keeping the rabbit comfortable, reducing flares, and maintaining quality of life — rather than a one-time cure. Some rabbits require intermittent or lifelong antibiotic courses.

How much does treating rabbit snuffles cost? An exotic vet exam typically runs $80–180. Culture and sensitivity testing adds $60–150. A course of enrofloxacin (6–8 weeks) typically costs $30–80. Skull CT for otitis or abscess evaluation adds $500–1,200. Abscess surgery, including anesthesia, runs $600–1,800 depending on complexity. Expect higher costs than for cats and dogs given the specialist nature of rabbit medicine.

Can I give my rabbit over-the-counter antibiotics or human medications? No. Many antibiotics that are safe for other species are fatal to rabbits — oral penicillin, ampicillin, clindamycin, and lincomycin all cause fatal dysbiosis of the rabbit cecum. Only a vet experienced with rabbits should prescribe antibiotics; dosing errors can be lethal.

How do I prevent pasteurellosis in my rabbit? There is no licensed vaccine against P. multocida for pet rabbits. Prevention centers on reducing stress, providing a clean and low-dust environment, quarantining new rabbits for at least 4 weeks before introducing them to established rabbits, and using rabbit-experienced veterinary care to address health problems early. Entire does should be spayed to eliminate uterine pasteurellosis risk.

What is the difference between pasteurellosis and E. cuniculi in rabbits with head tilt? Both cause head tilt and vestibular signs. Pasteurellosis is bacterial and shows purulent nasal/ear discharge on exam; CT may reveal fluid in the tympanic bulla. E. cuniculi is a microsporidian parasite causing neurological disease without ear purulence; serology (antibody titer) and response to fenbendazole help confirm it. Some rabbits have both conditions simultaneously.

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