Dealing with URI's

[Bunnsworth]

Our first and eldest bun (female, mini-rex, 5 years) came down with an upper respiratory infection last week. We've taken her to the vet, once for the initial sneezing/wheezing symptoms, and again 4 days later because her sinuses became clogged, she couldn't breathe, and she started freaking out to the point where she was bouncing off the walls of her cage and I was afraid she was going to break a leg by catching it on one of the bars. After I grabbed her and was able to calm her down a bit, she went almost completely limp, so we rushed her to the vet (thank god there are tons of rabbit savvy clinics in my area! especially considering it happened around 6am on a sunday) The vet said the infection has remained in the upper respiratory tract and hasn't gone further into the lungs so we need to keep her on the Baytrill and just hope that things start to clear up. It's been a week since she started and we haven't seen too much improvement. They never did, or offered to do a culture- so I'm not sure if I should

She had a few more no-breathing incidents yesterday after we had taken her to the vet. Both times she started frantically looking back and forth and looked as if a dog had her cornered or something. I'd have to gently place my hand on her chest and lift her neck up a bit until the she could breathe again and fit stopped. It usually resulted in her going a little limp, pooping herself, then laying down and resting for the next hour. After that she'd get up and run around the room for 20 min as if to say "look, I swearsies I'm not sick" then go back to wheezing and sneezing in the corner. Every time she's done this I've thought she was dieing. One of our previous buns had gotten a mouth infection and passed in my arms while doing similar convulsions earlier this year- so it's really getting to me.

We've set her up in the bathroom away from her companion because he just seems to stress her out by his constant want to play/cuddle/groom. We leave her in there while we shower (under the vet's recommendation) in hopes that the steam will help loosen some of the mucus and set up warm water bottles around where she relaxes in order to keep her temperature up. It's been in a normal range when we've checked, but she's been a bit cold to the touch.

She was eating fine up until yesterday. She'll eat leafy greens, but won't touch her pellets or fruit so I've been supplementing with oxbow critical care. The vets say that I'm doing pretty much all I can for her- but I just wanted to know if there was anything else that I might be able to do (my vets can be surprisingly uninformative on home care), how long these usually last- and, well... if it is a big of a rabbit killer as every forum I've read seems to make it out to be. I'm just worried for her-

 

[tonyshuman]

Does she have ocular or nasal discharge? I wonder if it is not an upper respiratory infection, but a lower one--like pneumonia, or some other thing causing her to have difficulty breathing. One thing that can happen and I think happens a lot more often than people realize is that bunnies can get cancerous masses in their chest that put pressure on the heart and lungs, making them work harder and have less room in the chest. Our bunny Ben had this, and he lived about 6 months after he was diagnosed, leaving us too soon at the age of 3.5. I have read several other stories where this happened, and others where I suspect it happened but no necropsy was done to confirm it.

Cancer of the thymus (an immune/hormonal organ) is one of the more common ones in rabbits, and this is what our guy had. The thymus is located right next to the heart. If she is having difficulty breathing like you describe, without nasal discharge, elevated body temp, or some things you might be able to see on a complete blood count (signs of infection like elevated white cell count), I would ask for an x-ray to be taken of her chest. If it is thymoma, there are things you can do, depending on what is available where you live and what you can spend (sadly this has to play a role in the decision), weighed against how much extra time the treatments will give you and what her quality of life will be. Not many places will do radiation treatment on bunnies, but I have heard of it extending the lives of thymoma bunnies a few months to years. The breathing issue you're describing sounds a lot like what our Ben went through at the very end. It is definitely terrifying. I'm sorry you have to go through that. Here's some info on thymoma, although our bunny did not have lots of dandruff like the ones in the article.
http://www.medirabbit.com/EN/Cancer/Thym/Thymoma_rab.htm

If it is indeed an infection, Baytril probably isn't going to cut it. You should have seen some improvement in 3-4 days if it was going to work. A different antibiotic is a good idea in this case. Oral ones that might help are azithromycin, chloramphenicol, tetracycline or sulfa drugs. The sulfa drugs are older and can cause GI issues, but they do work sometimes. Azithromycin also has GI issues sometimes. Sub-Q or IV antibiotics might be good too. I do not know what antibiotics they give IV in rabbits, but penicillin is good sub-Q. Convenia is also injected, but it is just a newer form of Baytril, and it's really expensive, so if you haven't had success with Baytril at all, it's probably not worth it. In her case, you want to treat this quickly so she doesn't have these attacks. Of course you know they are serious for her health, and the stress of the attacks too is not helping.

Another good way to improve breathing and deliver antibiotics more effectively to the area they are needed is using a nebulizer. We found one off Craigslist for about $40, but your vet may have one you could borrow for a week, or maybe you have one/know someone who has one. They are prohibitively expensive to buy new and you need a human prescription. They can be used with distilled water, an isotonic saline solution, or antibiotics in one of those things. Just the saline improved our little guy's breathing when he had non-bacterial pneumonia caused by the tumor. I think an antibiotic like tetracycline or a sulfa drug might be good to use with the nebulizer. This has some helpful links, including info on nebulizing:
http://www.medirabbit.com/EN/Respiratory/respira_main.htm

Here are safe antibiotics: http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm
*note there is an icky picture on the top part of the page. not recommended for sensitive viewers.*

I don't think you have time for a bacterial culture.

Edit: I would think the best thing for this bunny is to be in an incubator with increased oxygen in the air and a nebulizer going non-stop at a low level to increase humidity. The incubator could also keep the bunny warmer (most have a heating function). She should get sub-q antibiotics at the very least, perhaps continual infusion of IV fluids with antibiotics added to that. Home care is possible but you'd want to restrict her movement so she can't wear herself out like that (could cause cardiac arrest), and the nebulizing and oxygen-rich environment would be very helpful. Plus, the other diagnostics could be done (x-rays of the chest cavity), and she'd be near a vet that could help in case she did go into arrest. Depending on your vet, they might even be able to put her on mechanical ventillation (ie an endotracheal tube and breathing machine) while her body fights off the infection.

I know you are taking it seriously already, but this really sounds like an ICU-type case. Rabbits that have breathing problems like that do freak out, which could lead to physical injury or heart attack. She could also go into seizures for lack of oxygen (Ben did this at the end), and those are very dangerous in bunnies due to their fragile bones. Best thoughts for you and your little girl.

 

[Bunnsworth]

I'm so sorry to hear about your bun. Ivy's previous companion was around that age when he passed and, like you, I felt it was much too soon. I still miss him like crazy.

There isn't really any noticeable discharge from the eyes or nose. Her mouth on the other hand does look a bit crusty, which I've assumed was from all of the coughing/sneezing/medications/feedings. She sounds a bit like a stuffy infant, but from what I can tell- and from what the vet told me- the rasping is coming from the sinuses and not her lungs. Since this developed over the period of 24 hours, I'm hoping it's not cancerous. 2 different vets have seen her during this time (and I consulted with one over the phone the night we started noticing the wheezing) and they've all pretty much agreed that it was a URI and that they'd hold off on doing an x-ray unless her condition got worse.

There has been some slight improvement since she started taking Baytrill- as far as the congestion goes at least. Sunday was pretty bad with the blockages- but she still didn't sound as congested as she had a few days prior and we haven't had any recurrences of those issues since. Personality wise though it's a night and day change, which I did expect a bit. She still won't let her companion near her though- and I know it's killing him not to be with her because he's been sitting by the bathroom door scratching at it since we separated them. Thankfully she is more than willing to take her meds, and eat the oxbow mixture- even if she has been a bit more lethargic since the Sunday incidents.

Thanks for your response by the way. It has been very helpful. Depending on how she is doing when we get home I'll probably take her back to the vet and get some better tests done so we can really determine if it's more than the URI and possibly see if there would be an antibiotic that might have a better effect on the bacteria.

 

[tonyshuman]

It's good that the Baytril did help. If there is crustiness it probably is a URI then, but definitely it's serious. If possible, at home could you let her bonded buddy see her, or would that be too stressful? It can be helpful for them to be together or at least know the other one is ok. You don't want to induce an attack at all of course. When we got a bunny that had been in intensive care for a few days back from the vet, he couldn't be with his bonded buddy, but we put him in a pen where they could see each other at least.

I do want to say that there weren't any big signs of problems with Ben until it was too much for him to handle. We only knew he had a problem because we were really observant of a small cough and didn't give up when none of the antibiotics worked. Most bunnies with the cancer he had don't show it until it's way too late.

It's good that she's taking the meds.

 

[Bunnsworth]

We took her back to the vet and found out that she had developed some stasis- which the vet says is the most likely cause of some of her odd behavior. They gave her some sub-q fluids and injections for stasis, antibiotics, and pain. They gave us, I believe it was regelan and propulsid then we have some symethicone from her last bout of stasis to help with the gas (sorry about the horrid spelling on all of these- i don't quite remember what they were all called). They said if we don't see improvement in the next day or two we should consider hospitalizing her for a day or two.

She sounded better this morning- and wasn't as anxious about everything. She still gladly accepts her medication and oxbow, a bit more lethargic than yesterday but stasis does that. She seems like she was in a bit of pain so I gave her some tummy rubs and heard that she had a little gas in there. Her stomach wasn't as loose and wiggly as yesterday so I'm hoping the meds have kicked in.

I've brought Hubert in to see her a few times- but he's such a fiesty little thing and Ivy would just run when he'd start getting close. She was doing that with my fiancee as well the last few days- but cuddled up next to him this morning when we were in the bathroom so I'd like to take that as a good sign.