HELP! Eye infection after treatment for pasteurella

[tonyshuman]

First, make sure the dosing is correct:
"Azythromycin, a modified erythromycin, that does not show the side effects of the later in rabbits, is very efficacious in the treatment of Bordetella sp. (and so is enrofloxacin). The azythromycin dosage used for rabbits (50mg/kg PO QD (SID), is much higher than that used for other small animals like cats and dogs (5-8mg/kg). Treatment lasts generally 7 days, after which an evaluation is done and eventual prolongation decided."

http://www.medirabbit.com/EN/Respiratory/Bacterial/URI.htm

I can't remember now, but I have heard of bunnies being on it for I think 2 months. I will look and see if I can find that.

 

[Al_Koenig]

We've tried a dosing of 40mg/kg a day. Twice. But she went into a terrible GI stasis, which was really hard to remedy with sub-q, benebac and force-feeding. Maybe it has to do with her age (6 years). and so therefore we lowered it to 30mg/kg a day.

Would it work on a lower dose but with a longer duration of the treatment?

And, please, it would be great if u could find more info on this. Thanks a lot!

 

[tonyshuman]

I can't find it. The reason to keep going after all the symptoms have gone is that even if there aren't outward signs of infection, a few bacteria can still be left, the stronger ones, and by taking away the antibiotic they can come back stronger.

 

[tonyshuman]

I'll try to get our expert on this.

 

[Al_Koenig]

That would be awesome! I have posted this on many forums, but couldn't get the answer to it:

• If our rabbit can't endure a regimen of azithromycin for 7 days on 50mg/kg, would we get similar results with a lower dose (let's say 30mg/kg) with a treatment duration of 30 days or more?

• Also, as was the case of Michelle's bunnies, our bunny also has swollen tear ducts after her acute sneezing subsided. Is that conjunctivitis? The Medirabbit document page says that conjunctivitis must be treated locally in addition to the main antibiotic. I think it was not the case with Michelle's bunnies. (Right Michelle?)

However, if that is a mandatory, I could look around for Gentamycin or Enrofloxacin. Could you give me some pointers on the right dosage. Does it have to be drops? Would nebulizing the bunny with a mixture of Saline Water + Gentamycin or Enrofloxacin help her tearducts too, or does it have to be drops directly applied to her eyes/tear-ducts?
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[michelle86]

My rabbit's eyes had discharge, but his eyes were not swollen or red. It was essentially just a buildup of the nasal discharge coming up through his tear ducts. His eyes and tear ducts were not infected. (if I had not treated it promptly, it could have turned into an eye/tear duct infection).

When I researched eye discharge in bunnies, I read about vets flushing the tear ducts to clear them because in those cases, the rabbits had eye discharge because their tear ducts were blocked - which may be the case in your rabbit.

 

[Al_Koenig]

Thank u again, Michelle! Bad thing is no vet in town will do a tear duct flush here. So, I'm looking for topical alternatives (if there are any).

 

[michelle86]

Does anyone more knowledgeable know what antibiotic eye drops are effective against pasteurella?

 

[ra7751]

Al....Zithromax does cause some GI upset initially in most rabbits but I just ride it out. I have dosed Zithromax both alone and with Penicillin for months. Didn't seem to have any long term effects. If you can find some injectable Penicillin to go with the Zithromax, I can probably work up a dosing protocol if I know precisely what it is. You can certainly dose the Zithromax at a lower dose. In my early days of using that drug, dosing was by "SWAG" method and I did have success at lower dosing...but I use the higher dose now.

As far as eye drops, Gentamicin is what I call a "big gun".....it is the best (in my non-professional opinion). As far as tear duct flushes....totally overdone. While I am sure it can happen, I have never actually had a rabbit with that condition. I did flush the ducts of a rabbit born with bilateral micorphthalmia just to make sure his damaged eyes were lubricated properly. In most cases a tear duct flush is not necessary and only leads to stress on the rabbit for no real benefit.

There is adrug you might find quite helpful.....it's rarely found in the US but is still commonly used in third world countries. That drug is Chloramphenicol. It is a very effective drug....especially against "walled off" infections such as abscesses or lower respiratory infections. It is very safe for the rabbit. One down side is that some humans are very sensitive to this drug and it can lead to a condition known as Aplastic Anemia.

 

[Al_Koenig]

Wow, that's a relief. I was worried that a tear duct flush would be a mandatory.

So, today I will be looking for Chloramphenicol or Gentamicin. If I can find both, with which one would u go? And could u advice me with the proper dosage on each of the two drops?

I'll also be on the lookout for injectable penicillin.

One last question on Zithromax: Does it harm the rabbit in any way if the dosage is not consistent? (i.e. higher dosage now, and then lowering it or vice versa?)

 

[ra7751]

Only use Gentamicin as an eye drop. You can get Chloramphenicol drops but you want the oral version. It is very gentle on the beneficial bacteria in the GI. If you find a vet that will use this drug, follow instructions for properly handling the drug. Just drops will usually not do much good unless it's for a corneal abrasion.

Drugs are always more effective if kept at a constant level.....I never vary dosing and try to administer drugs at the same time each day.

Randy

 

[Maureen Las]

I once had a rabbit who required tear duct flushes/

The presenting symptom was always a runny eye with clear fluid but when flushed the vet would get pus discharge from the duct

The vet did the procedure without anesthesia and I too had trouble finding someone who would do it. The treatment was an antibiotic eyedrop ( some neosporin drop combo??) and an oral antibiotic At thattimeI was prescribed baytril.
Looking back (this was awhile ago)I would think that if the oral antibiotic had been a more effective drug and the drug had been given long enough that the eye problem would not have kept reoccuring.

I had a rabbit (lost him today ) who had a horrendous eye infection and corneal abrasion several years ago;. it was unresponsive to everything I tried . it was so bad thatI was going to have the bun PTS if he did not get some help. A new vet pulled out a tube of Chloramphenical 1% opthalmic salve and it noticeably worked within the 1st 24 hrs of treatment and saved my little guys life.

In terms of the Zithromax dose why don't you try it at 40 mg/kg; right in the mid range???
I also had been looking into getting oral Chlorampenical;I was looking on-line and it is apparent that it is easier to get in foreign pharmacies than here, however the problem would be getting it compounded so that you wouldn't have to handle it yourself.

You might find that your vet would order it.

 

[Al_Koenig]

@Randy: I could only find Gentamycin eye-drops and Chloramphenicol - but in eye-drops form, too. So I guess, that means, we're going to give Gentamycin a try. I've heard of a dose of 2 times a day? Is that right? How long should I continue giving her the drops?

Also, should we expect any GI complications or any other side-effects during the treatment. Will it be painful for her, should we prepare some painkillers? If yes, what kind of painkillers are rabbit-safe?

Her sneezing and nasal discharge have completely gone away. But she'll be still on zithro for 7 more days.

many thanks,
Al

 

[Al_Koenig]

@Angieluv: I'm sorry to hear about your loss. I'm sure she had a happy with with such a caring and knowledgeable rabbit-mum.

We've tried 40mg/kg on our rabbit. Maybe it was her condition that was already far from top-notch or her age (6 years), anyhow, she stooped to eat and poop for almost 2 days. We had to give her sub-q (also ONLY available at a vet down here) and also probiotics, which are quite rare here. However, the lower-dose zithro seemed to work, albeit slower than people reported with higher dosages. She's stopped sneezing and no nasal discharge for 3 days already. However we'll keep the zithro for 7 more days.

I'd really wish someone knowledgeable about rabbits would open shop down here in Indonesia. He/she could save so many lives. From my experience the few "exotics"-vets who are here, are only good for surgeries and spays.

Now, let's just hope Gentamycin can fix her eye-infection.

 

[Al_Koenig]

Gentamycin just arrived. It says:

GARAMYCIN - Gentamycin Sulfate - Drops for eyes and ears. 5mL 0.3%
Produced by Schering-Plough Labo N.V., Belgium.

That is the right drug is it? Please could someone give me the right dosage? 2 times or 3 times a day for how long?

Our bunny is still on Zithromax; Gentamicin won't interact strangely with Zithromax, will it? Should we brace for GI trouble ahead? Please advice...


Thanks a bunch people,
Al

 

[tonyshuman]

It shouldn't be used in the ears for rabbits, although I guess that's not an issue here. Anyway, Medirabbit says the dose is 1-2 drops per eye, 3 times a day (that's what tid means in prescription-speak).

http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm

I looked at the interactions for azithromycin, and gentamycin is not on that list. I am having a hard time finding what concentration of gentamycin sulfate is used on rabbit eyes.

I would not worry about interactions anyway because the gentamycin will only be on the eye, and thus won't go to the GI tract which is where most issues are for antibiotics in rabbits.

 

[tonyshuman]

I did find a study where 0.3% gentamycin sulfate was applied hourly for 24 hours, and that didn't hurt the eye.

Here it was given 4 times daily but the dose wasn't specified.
http://www.mohrs.org/hrswebpg24.html

 

[Al_Koenig]

Dear Guys,
Just wanted to update you on Luna's condition. We've stopped her Zithromax after 30 days. She has stopped her sneezing completely, however her eyes-lids are still a bit reddish. The Gentamycin we planned to give her was a year beyond its expiry date. good thing we noticed it beforehand.

Today we found an eye-doc that was kind enough to give us "fresh" Gentamycin. So, we're starting to try to treat her eye-infection today.

Thank you all very much for your kind help so far! We will keep you posted on how it goes!

 

[tonyshuman]

That's good to hear! I hope the gentamycin takes care of the remaining redness.

 

[Al_Koenig]

Dear Guys,

Many thanks for your kind a replies. It helped us a lot in helping our bunny make her recovery. The Gentamycin finally cleared up her reddish eyes.

However, after last week or so, we could see our bunny sometimes sneezing randomly (mostly in the morning) two to three times consecutively. But it is really random, not the semi-continuous sneezing that we had before her treatment. I reckon, there is still something left of the bacteria in her body, and it has not been suppressed completely.

What would u guys do? Should we put her on another course of antibiotics (zithromax) to prevent it getting worse (having in mind that she already had a long term course behind her not so long ago), or should we wait and see first?

Kind Regards,
Al