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Background
Rectal sacculation or dilatation caused by weakness and separation of the pelvic diaphragm is known as perineal hernia (PH) ( Niles and others 2005 , Aronson and others 2012 ). Protrusions of abdominal organs through weak pelvic muscular layers can occur. A bladder protrusion is linked to classic sequelae such as azotaemia, hyperphosphatemia and changes in urine constitution ( Quesenberry and Carpenter 2011 ). Diverse patient-dependent factors contributing to degenerative tissue in the pelvic diaphragm were reported in previous literature. So far, the most finding were made in dogs. Persistent tenesmus ( Aronson and others 2012 ), hormone influence ( Smeak and SLATTER 2003 ) and muscle atrophy due to neuropathy or cachexia ( Niebauer and others 2005 ) are mostly discussed features in all domestic species. However, tissue atrophy can also be caused by metabolic imbalances, for instance hyperadrenocorticism or diabetes mellitus ( Wang and others 2010 ).
Acquired herniation, defined as abnormal protrusion of organs or other body structures through a defect, is normally prevented by fat ( Mehler and others 2006 ). Hypothetically, progressive muscular atrophy and fat breakdown due to persistent cachexia can facilitate viscera herniation ( Wu and others 2016 ). Previous publication that only reviewed cases of herniation in rabbits includes inguinal urinary bladder hernia in male ( Petritz and others 2012 , Thas and Harcourt-Brown 2013 ) as well as in intact female domestic rabbits ( Grunkemeyer and others 2010 ). To the authors' knowledge, only one case of PH in domestic rabbits has been reported previously ( Dziwok 2006 ). Accordingly, it is important to emphasise this as a very rare condition and differential diagnosis to inguinal hernia in rabbits.
Case presentation
A six-year-old intact female domestic dwarf rabbit (Oryctolagus cuniculus) was presented at the Tierklinik am Sandpfad in Wiesloch in Germany with a five-day history of persistent lethargy, inappetence, decreased urination and loss of weight. A soft fluctuating swelling in the perineal area was noticed one day before presentation. Since birth the rabbit was raised by the present owners. It was fed with a varied commercial diet. No traumatic event was known before presentation. Due to loss of weight, haematuria and inappetence, the rabbit was presented five days before at another veterinary practice...