Ear infection advice (not one of my rabbits)

[Dragonrain]

Hello,

Someone on another forum I mod came asking for advice for her rabbit. Her rabbit had white discharge from it's nose so she took it to the vet and the vet found pus in its ears. I guess the vet told them that the rabbit has some kind of "ear disease" and that the pus in the rabbits ears would eventually travel through bone and into the rabbits brain and kill it, unless the rabbit has some type of expensive surgery to open the ear canal and drain the pus. The vet also told her that the rabbit will need to be on antibiodics for life.

I'm a little concerned about the mention of that surgery. I know a vet here (who I had some very negative experiences with) who recommends that type of surgery to every patient that walks in with a bunny with an ear infection. I also know someone who went to another vet for a second opinion and their rabbit was cured with a course of antibiodics alone.

The good thing is that she did say that her vet took a culture of the pus and bloodwork and all that (results arn't in yet). But really is surgery necessary to drain pus? And if it's not drained, can it really eat into the brain? Also I can't see keeping a rabbit on antibiodics for life, wouldn't the bacteria just develope immunity after awhile?

If anyone has any advice I can pass on I would really appreciate it. I told her that if it where me I would take my rabbit in to another vet for at least a second opinion, since this vet pretty much told her that either the rabbit gets this expensive surgery or eventually dies from pus eating into it's brain. But if possable, I'd like some information to pass on and also just for my own knowledge - I've been lucky that none of my rabbits have ever had to deal with any ear problems.

 

[Maureen Las]

I think that the surgery that is being talked about is called an ear resection.

I only know about this in reference to someone who has an English lop with a very deep ear infection. In this breed of rabbit because of the pendulous ears and the anatomy of the ear it is almost impossible to clear up an infection because of the lack of air to the area and the moisture in the ear canal; it is a breeding ground for bacteria and/or funguses

The ideal would be to have this kind of surgery done. My friend is choosing to keep the rabbit on antibiotics for life as she cannot afford anything like an ear resection

Your friend could also have a vet who wants tomake as much $$ as possible and is going to this procedure initially without trying anything else.

I don't know the situation fullybut I think a STRONG combo of antibiotics ( much like Randy talks about) could be attemtped initally for a long period of time. Zithromax and bicillin or possibly chloramphenical or possibly Convenia

If a C&S was donethen the antibiotics that would be helpful are already identified.

Iwould suggest that your friend get a second opinion making sure that the next vet is rabbit saavy and trustworthy (possibly recommended by soemeone she knows)

here is a printout on medi-rabbit on ear resections

http://www.medirabbit.com/EN/Surgery/Ear/ear_resection.pdf

 

[ra7751]

Umm....how rabbit savvy is this vet? I may be wrong, but it almost sounds as if the vet is treating a symptom rather than the cause. While it is entirely possible that a vestibular infection could cause this.....I would really like a gander at the teeth. Like with people, the ear, nose and throat are all connected and a problem in one could present in another. I learned this very early in my rabbit years when one of my rabbits had a white nasal discharge that was diagnosed as "snuffles" (I now know there is no such condition and "snuffles" is a misused label). The problem was actually an overgrown molar root that had penetrated the roof of her mouth and invaded the nasal cavity.

An ear resection is something that should be performed only by a highly qualified surgeon. It is quite similar to the human baby surgery that most people call "putting tubes in the ears". In the hands of a qualified doctor, rabbit surgery isn't any more risky than other species. But I would want to make sure that the surgery is the only viable option.

I would see what the culture shows....that will tell a lot. I would also want some radiographs of the teeth looking closely at the tips of the lower arcade molars as well as the length and positioning (possible inpaction and abscessing of the upper arcade) to make sure we don't have a dental concern that is presenting as a vestibular issue.

It is not totally outside the possibility of this beinga serious vestibular infection....but I have treated many very bad infections and have never had to have a resection performed. I really think this puzzle is missing a few pieces. I would suggest deferring any decision on a resection until those diagnostic pieces are in place and a clear picture of the true problem can be considered.

Randy

 

[Dragonrain]

Thanks for the replies!

I don't know how rabbit savy the vet is - I only know she got the vet from the House rabbit society website. I'll suggest she gets the teeth looked at, and she is still waiting for culture results on the pus in the ears. Hopefully the rabbit responds well to antibiodics. So lifetime antibiodics isn't that unusual? With lifetime antibiodics is it still possable for the infection to go to the brain? Because I guess her vet told her that it would unless the surgery is preformed. Umm, I believe her rabbit is a mini lop if that makes any diffrence. I just feel bad for the owner, $1,200 is a lot to spend on the surgery and it's clear that she's really worried about her bunny.

Thanks again!

 

[Maureen Las]

Randy is absolutely right!!

A really thorough exam of the teeth should be done and any possible molar infections or tooth root infection be eliminated before the problem is solely blamed on an ear infection. Teethproblems can cause infections in the face and ears

No it is not usual for a rabbit to be on antibiotics for life but just a last ditch attempt for this girl to keep her rabbit going longer.

Not anything that would be recommended...

 

[tonyshuman]

I think a culture and strong antibiotics will hopefully do the trick.

 

[Dragonrain]

Okay well I just heard back from the girl and she said that "monocytes were high, he had a strong Pasturella Titre and the culture of the puss in the ears showed a light growth of Floucomonus"

I didn't hear anything back on if she had his teeth checked or not but I'll mention it again.

Any more thoughts about all this??

 

[tonyshuman]

Well, the ear infection is caused by pasturella, which seems to be infecting the blood as well. I can't figure out what the floucomonous is, but the high monocytes are indicative of an infection/generalized inflammation. I think at this point, injectible antibiotics are needed, like penicillin G procaine and penicillin G benzathine (aka bicillin) and perhaps zithromax (azithromyacin). It sounds like the infection is pretty strong and may have entered the blood stream. I think Bene-Bac would be a good thing to add to keep the GI system going.

If they can get the infection under control with antibiotics, then take a look at the teeth to see if they're abscessed in the roots (with an x-ray).

 

[tonyshuman]

An even better antibiotic would be Convenia.