HELP! Eye infection after treatment for pasteurella

[michelle86]

I have two bunnies. They are both dwarf size. One is 9 months old (Bella) and the other is 6 years old (Ben). They were both recently treated for white nasal discharge. They were prescribed azithromycin oral suspension for 10 days. Treatment was over Feb 8th. It cost me $84 for the vet visit and another $130+ for medicine for both rabbits.

They have both stopped sneezing, and from what I've noticed haven't had any obvious nasal discharge.

I was caring for Ben today. He has longer hair than my other rabbit and the thick syrupy medicine had matted the hair around the corners of his mouth and the skin is scabbed and split between the scabs. It looks sore. this is a hard area to see because of his hair so I only noticed it today :/ So I was clipping the hair around his mouth and dampening the scabs and trying soften them before removing them and applied antibiotic ointment on the corners of his mouth.

After I did this he went to bathe himself because I got him all wet and he bent his head down to lick his chest, and I watched a drop of white discharge form at the corner of his eye! I looked at the other eye and he had some there too.

My other rabbit's eyes are fine.

So my question is... what do I do? Do you think it is a plugged tear duct? I read about having rabbit's tear ducts flushed out and being treated with eye drops and antibiotics. Do they have to be under anesthesia to have their tear ducts flushed? I want to be educated a bit more on what effective medications there are for buns for this problem and also have an idea of how much it will cost me for these treatments.

My rabbit was treated with baytril in the past, but this medication made him lose his appetite, and his droppings were much lighter and smaller in size. It made him a lot worse. He did not feel good at all when he was on it. And so at the recommendation of someone here, I asked the vet to put him on azithromycin. This was a little over a year ago. The medication worked awesome and he had no negative effects.

The vet knew he had been treated with azithromycin in the past and that it worked, so he prescribed it again. But I wonder if it didn't work because the bacteria had become resistant to it. My younger rabbit though seems fine and it worked perfect for her, even though she caught the bacteria from Ben.

I'm really confused because he has stopped sneezing but he seems to have the same pasteurella infection in his eyes.

I know that tear duct infections often result from overgrown molars, but the vet checked his mouth when he went in and he didn't notice anything wrong with his mouth, so I assume that his eye got infected when he'd clean his nose with his paws and then rubbing his paws over his eyes.

I already felt so bad for noticing his mouth sores this late, and now this! I'm very concerned for him.

 

[ra7751]

Couple of things here. First, if there was not a culture performed, do not assume Pasteurella. At one time we could assume but no longer. I have never actually seen a blocked tear duct but a skilled vet can flush tear ducts without sedation in most cases. Azithromycin is the current drug of choice against Pasteurella. But many vets underdose this drug quite a bit....dosing for a rabbit is much higher than for a dog. If you can provide your rabbit's weight and the concentration of the drug....I can calculate the dosing for you. Looking at the teeth doesn't cut it. If there is a root issue, that has to be seen on radiology.

A few things about drugs.....Azithromycin is the best available currently to treat Pasteurella (as well as several other pathogens). I also use Zeniquin sometimes as well as penicillin and Convenia. The latter two drugs are safe only as injectables. Zeniquin is a newer Floroquinolone that is in the same family of drugs as Baytril and Cipro. The newer version is not yet showing signs of resistance. I understand it is a very expensive drug. I do not generally use Baytril and never use Sulfa as they are ineffective in most cases and sulfa can severely damage the beneficial bacteria in the GI. Dosing protocols for these drugs are many times not available to vets. And Convenia is specifically labeled "not for use in rabbits" but when dosed properly is highly effective. I have used it in wild and domestic rabbits and squirrels....one of my vets has even used it in guinea pigs.

When using oral antibiotics, it is always beneficial to support the GI with an appropriate probiotic such as Bene Bac. The appetite can be stimulated with a B Comp (a vitamin) injection.

Randy

 

[michelle86]

I am pretty sure his weight is something like 5 lb 11oz. His dosing was 3.125 ml daily (200mg/5ml azithromycin suspension) x 10 days.

 

[ra7751]

The dosing is correct (in fact it's almost the high end dosing....props to your doctor)....I normally go 14 days or 5 days past the presentations of the infection. I would talk with your vet about either continuing the Zithromax or doing a culture to identify the bacteria and treat accordingly.

Randy

 

[michelle86]

I am going to give the vet a call tomorrow (couldn't do it this weekend) and see what he wants me to do.

I found somewhere online about using boiled salt water (cooled) to clean the area around the eyes. Does anyone know the rationale behind this? Is it just soothing? I figured I'd do it because I couldn't take him to the vet this weekend and there was nothing else I could do for him.

 

[tonyshuman]

The salt water should be the same concentration as the eye fluid--it's less painful to get slightly salty water in your eye than to get pure water. I use sterile saline made for storing contact lenses--not contact lens solution, just sterile saline. If you've ever done a sinus rinse they also use boiled water with a low concentration salt solution.

The main reason is that the cells of the body prefer to be in a solution that has some salt there. It's based on osmosis. The eyes are particularly sensitive to the salt concentration because they're delicate and don't have a protecive barrier like skin. I think the best thing to do for him is rinse the eyes with sterile saline for contacts, artificial tears drops, or one of those sinus rinse products--they have sachets of salt you're supposed to add to a certain volume of pre-boiled and cooled water.

 

[michelle86]

I am taking Ben to the vet next week.

I've been watching him more closely. I haven't noticed as much eye drainage, but what I am noticing is that he still feels stuffy. He doesn't sneeze anymore, but he forces air out his nose to try and clear it. Also when he cleans his ears (you know tilting his head to the side) he makes a sound. like a *humphhh* as if it is harder for him to breath in that position.

Anyone recognize these as classic symptoms of anything?

He's already been treated 10 days with azithromycin. When I had taken him to the vet, he said his lungs were clear and that his infection was only in the upper respiratory tract.

 

[Pipp]

It can take a long time on antibiotics to completely clear an infection. My Vet can keep my guys on them for a month, (sometimes three months).

Does he sleep sitting up or rest with his nose slightly upwards?

I've had healthy bunnies make noise when they clean their ears. Is this a new behaviour?

I think he just needs more time.

How are the corners of his mouth?


sas :clover:

 

[Pipp]

PS: Can you put your location in your profile? Thanks!

 

[michelle86]

Well after he cleans himself he forcibly blows air out his nose to try and clear it. If he ever did this in the past, then he's doing it a lot more now, because I never noticed it.

The corners of his mouth healed up really nice. I was able to take a small pair of scissors and remove the scabby mats. I put some antibiotic ointment on the raw skin, and now he looks great, not 100% back to normal but tons better than he was.

 

[michelle86]

Oh and he has been sleeping as he always does. On his side.

 

[tonyshuman]

It sounds like he's doing better, but Pipp is right that he probably needs to be on the antibiotics for just a little longer. The absolute minimum course, from what I've read on bunny health, is 14 days, with 20 preferred.

 

[michelle86]

I called the vet, and asked to just speak with him, and he said that he would prescribe Ben for another round of antibiotics. So 10 more days.

 

[tonyshuman]

That sounds good!

 

[jamesedwardwaller]

michelle86 wrote:

I have two bunnies. They are both dwarf size. One is 9 months old (Bella) and the other is 6 years old (Ben). They were both recently treated for white nasal discharge. They were prescribed azithromycin oral suspension for 10 days. Treatment was over Feb 8th. It cost me $84 for the vet visit and another $130+ for medicine for both rabbits.

They have both stopped sneezing, and from what I've noticed haven't had any obvious nasal discharge.

I was caring for Ben today. He has longer hair than my other rabbit and the thick syrupy medicine had matted the hair around the corners of his mouth and the skin is scabbed and split between the scabs. It looks sore. this is a hard area to see because of his hair so I only noticed it today :/ So I was clipping the hair around his mouth and dampening the scabs and trying soften them before removing them and applied antibiotic ointment on the corners of his mouth.

After I did this he went to bathe himself because I got him all wet and he bent his head down to lick his chest, and I watched a drop of white discharge form at the corner of his eye! I looked at the other eye and he had some there too.

My other rabbit's eyes are fine.

So my question is... what do I do? Do you think it is a plugged tear duct? I read about having rabbit's tear ducts flushed out and being treated with eye drops and antibiotics. Do they have to be under anesthesia to have their tear ducts flushed? I want to be educated a bit more on what effective medications there are for buns for this problem and also have an idea of how much it will cost me for these treatments.

My rabbit was treated with baytril in the past, but this medication made him lose his appetite, and his droppings were much lighter and smaller in size. It made him a lot worse. He did not feel good at all when he was on it. And so at the recommendation of someone here, I asked the vet to put him on azithromycin. This was a little over a year ago. The medication worked awesome and he had no negative effects.

The vet knew he had been treated with azithromycin in the past and that it worked, so he prescribed it again. But I wonder if it didn't work because the bacteria had become resistant to it. My younger rabbit though seems fine and it worked perfect for her, even though she caught the bacteria from Ben.

I'm really confused because he has stopped sneezing but he seems to have the same pasteurella infection in his eyes.

I know that tear duct infections often result from overgrown molars, but the vet checked his mouth when he went in and he didn't notice anything wrong with his mouth, so I assume that his eye got infected when he'd clean his nose with his paws and then rubbing his paws over his eyes.

I already felt so bad for noticing his mouth sores this late, and now this! I'm very concerned for him.

awesome..!.>lots of support,,people who care>!!.now,my take on this is as follows,,,a proper exam w/facial radiogragh would rule out teeth and tear ducts.//.pasturella is contagious,,one rabbit close enough,drinking,,eating,,pooping-will get it...the key here is a strong immune sytem/proper diet-70% hay/water,,some quality lowfat pellets,,and a couple treats-(never free hand pellets)-big mistake,,teeth are constantly growing requiring proper maintenance-chewing on-(hay)- fruit tree branches/twigs are great for trhe gi-tract too..//.if the culture comes back positive for pasturella--once it is treated--the rabbit will have to be monitored for signs of a flareup.//.need to eliminate alot of stress,,build the immune system up,,and when giving oral antibiotics,,always give a probiotic-(benebac)-found at farm supply stores,,32grams for $8.00-one gram a day for up to 10 # rabbit..,,please let me know if this helps.??..sincerely james waller -god speed:wave::rose:ink iris:inkbouce::bunnydance::biggrin2:

 

[Al_Koenig]

Dear Guys,

You guys won't believe how happy I am to stumble upon this post. We live in Indonesia right now, and unfortunately there are no rabbit savvy vets in the whole country.

Our 6 year old Lionhead, Luna, has had an outbreak of Pasteurella. We used Zithromax on her and after a (rather lengthy) 20 days, her snuffling and nose discharge stopped.

However, we have now the same problem as with Michelle's bunny. Her eyes seem swollen and the eye-lids are a bit reddish. From time to time you can see whitish discharge coming out of her tear duct.

Michelle, I was wondering how it went with your bunnies. I understand the vet gave them ten more days on zithromax? But what about the white discharge? Did it go away after the second regimen of zithromax? Or did the vet do something else?

We'd really appreciate if anybody could give us hints on how we can finally help our little baby. As I mentioned before, there are no rabbit savvy vets at all in Indonesia (you can check it out on house rabbit society, it's amazing - there are simply NONE), and we are left on our own with medicating our bunny. But having no expertise as a vet myself, we just can't do stuff like flushing tear-ducts etc.

Kind Regards,

Al

 

[michelle86]

I just replied to your PM

 

[tonyshuman]

Al: I think it would be worth it to continue with the zithromax for 10 more days. It did work on her earlier, so the bacteria are at least susceptible to it (not resistant). I have heard of needing a 30 day course, or even more, of zithromax (or other drugs) to completely clear up a persistent URI. There are other antibiotics that can be used, but they're a bit trickier and might not be available. I am thinking in particular of Convenia, which is a dog and cat antibiotic that's administered by injection every 5 days in rabbits, and a penicillin G formulation that can be hard to find outside of the US--it's typically used for livestock. But since the infection first did respond to zithromax, it's best to try that for a bit longer. If it doesn't work this time, you may have to switch antibiotics.

 

[Al_Koenig]

Dear Michelle and Randy, many thanks for your input. I'll do just that. I'll continue to give her Zithromax for 10 more days. If her condition IS getting better after 10 days, but not perfectly goes away, should I simply continue with the drug? Are there any long-term side-effects?

 

[Al_Koenig]

@tonyshuman: With the bacteria being susceptible to zithromax, do you think it has a good chance that in time, it will kill off / suppress a major part of the bacteria when the antibiotic is sustained for a longer period of time?

If yes, are there any known side-effects of long-term zithromax use (beyond 30 days)?

I'm really sorry, I really seem to give my bunny a trial-and-error approach to medication. But for us down here, there are simply no vets nor to speak labs that can perform a proper C&S test. So, u gotta do, what u gotta do

Thanks in advance for your help,

Al