Rabbit Pyometra: Uterine Infection Signs & Emergency Care

Rabbit pyometra — bacterial infection and pus accumulation in the uterus — is a life-threatening condition in intact female rabbits, causing lethargy, abdominal swelling, and vaginal discharge. It is nearly always fatal without emergency surgery. Any unspayed doe over 2 years old with abdominal swelling or vaginal discharge should be seen by a vet same day.

Last reviewed: June 2026

What Is Pyometra in Rabbits?

Pyometra (literally "pus in the uterus") is a severe uterine infection most commonly seen in middle-aged to older intact (unspayed) female rabbits. It results from bacterial invasion of a uterus already compromised by endometrial changes — cystic endometrial hyperplasia, adenomyosis, or endometritis — which are common in unspayed rabbits as they age.

Common organisms include Pasteurella multocida, Staphylococcus aureus, and E. coli. The infected uterus fills with pus, distending the abdomen and releasing toxins systemically.

Two clinical forms:

• Open pyometra: The cervix is patent; vaginal discharge (creamy, yellow, or bloody) is visible. This form is often caught earlier because the discharge is apparent.
• Closed pyometra: The cervix is closed; pus cannot drain, the uterus distends rapidly, and the risk of uterine rupture and septic peritonitis is high. This form is more dangerous and may not be recognized until the rabbit is critically ill.

As described in Quesenberry & Carpenter's Ferrets, Rabbits & Rodents, rabbit pyometra progresses more rapidly to sepsis than in dogs and cats, due to the rabbit's high metabolic rate and tendency toward closed-cervix disease.

Signs of Pyometra in Rabbits

Classic signs:

• Vaginal discharge — creamy, white, yellow, or reddish-brown; often noticed as staining on the fur around the vulva or on bedding
• Abdominal distension — the abdomen feels enlarged or doughy on gentle palpation
• Lethargy — the doe becomes progressively less active, spends more time lying down
• Reduced appetite — may stop eating hay and pellets, leading to GI stasis
• Hunched posture — sign of abdominal discomfort Advanced/systemic signs:
• Rapid weight loss
• Fever (>104°F / 40°C) or hypothermia in septic shock
• Pale or white gums (anemia, shock)
• Abdominal pain — grinding teeth, reluctance to be touched on the abdomen
• Collapse and inability to maintain sternal position

Differentiation: Uterine adenocarcinoma (the most common rabbit uterine tumor) presents similarly but progresses more slowly. Hydrometra is sterile uterine fluid with less acute signs. Small amounts of clear mucus can be normal at ovulation; purulent or bloody discharge never is.

Diagnosis and Treatment

Diagnosis:

• Abdominal radiographs: Identify uterine enlargement; free abdominal fluid suggests rupture
• Ultrasound: Confirms fluid-filled uterine horns, identifies uterine wall changes, and evaluates ovaries
• Blood work: Complete blood count typically shows leukocytosis (elevated white cells); chemistry assesses organ function and guides anesthetic risk

Treatment — ovariohysterectomy (spay) is the only definitive treatment:

• Emergency surgical removal of the infected uterus and ovaries is the standard of care
• Surgical risk is elevated in systemically ill rabbits; stabilization with IV fluids, antibiotics (penicillin G, enrofloxacin, or trimethoprim-sulfa based on culture), and pain management before surgery improves outcomes
• Antibiotic-only treatment is not curative and typically only delays deterioration while the uterus continues to distend

Post-operative care: IV fluids, warmth, syringe-feeding with Critical Care formula if not eating within 4–6 hours, meloxicam for pain, and monitoring for GI stasis.

An AEMV Pet Care Guide, 2024 notes that the risk of uterine disease in unspayed rabbits over age 4 exceeds 50–80% (including adenocarcinoma, polyps, and pyometra), making elective spay before age 2 the most effective prevention strategy.

When to See a Vet

Call your vet today if:

• Your intact female rabbit has any discharge from the vulva — creamy, yellow, bloody, or brown
• Your rabbit's abdomen looks or feels distended compared to normal
• Your rabbit is lethargic, hunched, and eating less than usual
• Your doe is over 3 years old and you have noticed any of the above

Go to the ER immediately if:

• Your rabbit has collapsed or is unable to sit upright
• The abdomen is severely distended and the rabbit is in obvious pain
• Gums appear pale, white, or gray
• Your rabbit is grinding teeth, breathing rapidly, or feels cold to the touch

Frequently Asked Questions

How much does rabbit pyometra treatment cost? An exotic vet emergency visit runs $100–200. Radiographs and ultrasound add $200–400. Pre-surgical bloodwork costs $80–200. Emergency ovariohysterectomy runs $700–2,000. Exotic vet rates are 1.5–2 times standard. Elective spay in a healthy rabbit costs $250–500 — a fraction of emergency treatment.

Can rabbit pyometra be treated with antibiotics alone? Antibiotics may temporarily reduce bacterial load and stabilize a critically ill rabbit for surgery, but they cannot drain or eliminate the infected uterus. Without surgical removal, the infection returns and worsens. Antibiotic-only management is considered a bridge to surgery, not a standalone treatment.

How common is pyometra in unspayed rabbits? Uterine disease — including pyometra, adenocarcinoma, and endometrial hyperplasia — is extremely common. By age 4–5, the majority of unspayed does show some uterine pathology. Pyometra is among the most acute presentations.

How do I prevent pyometra in my rabbit? Spay (ovariohysterectomy) before age 2 eliminates the risk of all uterine disease. Discuss timing and technique with an exotic vet experienced in rabbit anesthesia and surgery, as rabbit spay carries higher risk than in cats and dogs and should be performed by a specialist.

Still Not Sure if Your Rabbit Needs a Vet?

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