One problem with using hedgehogs for garden pest control is the use of chemical insecticide. While the hedgehog is immune to most poisons, it is not immune to them when ingesting insects full of the poison. This causes many hedgehog deaths where pet hedgehogs eat contaminated bugs within the house.
In areas where hedgehogs have been introduced, such as New Zealand and the islands of Scotland, the hedgehog itself has become a pest. In New Zealand it causes immense damage to native species including insects, snails and ground-nesting birds, particularly shore birds. As with many introduced animals, it lacks natural predators. With overpopulation, it kills off more insects than initially intended and expands its diet to include things such as snails, worms, and the eggs of wading birds. Attempts to eliminate hedgehogs from bird colonies on the Scottish islands of North Uist and Benbecula in the Outer Hebrides have met with considerable opposition.
There are many diseases common to hedgehogs, mostly fatal. These include cancer, fatty liver disease, cardiovascular disease, and wobbly hedgehog syndrome.
Cancer is very common in hedgehogs. The most common is squamous cell carcinoma. Squamous cell spreads quickly from the bone to the organs in hedgehogs, unlike in humans. Surgery to remove the tumors is rare because it would result in removing too much bone structure.
Fatty liver disease is believed by many to be caused by bad diet. Hedgehogs will eagerly eat foods that are high in fat and sugar. Having a metabolism designed for low-fat, protein-rich insects, this leads to common problems of obesity. Fatty liver disease is one sign, heart disease is another.
Wobbly hedgehog syndrome is very similar to multiple sclerosis in humans. The hedgehog slowly loses muscle control. Initially, it wobbles when attempting to stand still. Given time, the hedgehog loses all muscle control, including control of the lungs and heart. Vitamin E has been shown to delay the deterioration, but it is very temporary as a higher and higher dose is required.
As with most small mammals living around humans, cars pose a great threat to hedgehogs. Many are run over as they attempt to cross roadways.
Another common human-related fatality is pesticides. Hedgehogs that eat insects filled with pesticides will often form digestive problems and eventually die.
In 2006, McDonald's changed the design of their McFlurry containers to be more hedgehog-friendly. Previously, hedgehogs would get their head stuck in the container as they tried to lick the remaining food from inside the cup. Then, being unable to get out, they would starve to death. Domesticated hedgehogs display this behavior by getting their head stuck in tubes (commonly, toilet paper tubes) and walking around with the tube on their head. Hedgehog owners often refer to this as "tubing" and promote the behavior by supplying clean tubes.