Lower Respiratory Illness, Advice/Experiences?

[Rhea92]

Does anyone have any experience with a bunny dealing with a stubborn lower respiratory infection or any advice/suggestions to what I could do to help alongside vet treatment or what might be hindering it healing that I can change?

My senior bunny's right lung is foggy on xrays and both his lungs are scarred, I see my vet once or twice a month and have been treating his illness for 6 months now, his upper respiratory improves but then reverts, there is small improvement to his right lung over months of treatment. He is taking antibiotics and does a 30 minute nebulizer treatment twice daily.

Theres a lot of things I'm trying to do to keep any respiratory irritation to a minimum and keep the air clean (ie, fragrance free laundry detergent, no products with fragrances like perfume or air freshners, vinegar/water instead of chemicals/cleaners with fragrance, 2 air purifiers, shake off hay dust before feeding, etc) i also clean weekly and clean his litter daily with vinegar/water, he uses washable cushioned pee pads instead of bedding/paper litter now that he has arthritis (he wont enter the low entry litter box if it has bedding/paper litter) i switch out the washable pee pads twice a day so they dont stay pee soaked in the room for too long.

Any suggestions or advice, or does anyone have their own experience with a bunny with a lower respiratory problem they can share, even if its not optimistic? I have heard it is notoriously difficult treating a lower resporatiry illness in rabbits and his lungs are scarred so the odds are not in his favor, Im preparing for it never clearing up but I want to do whatever I can on my end to help his odds or even just get more of an idea of other bunny experiences

 

[JBun]

I've dealt with upper respiratory and was able to get a stubborn infection cleared up. But lower respiratory is different, and yes, difficult to treat. In fact it usually has a very high mortality rate in that first week of infection. So your rabbit hanging in there, that at least is a promising sign.

What antibiotics have been tried so far, and how long was each given? Are any meds nebulized, or is it just saline? Any mucolytics, anti inflammatory, or other meds that have or are being given? Is your vet a knowledgeable rabbit vet?

 

[Watermelons]

Id also be curious to know more about how/what is being done for these nebulizer treatments. Setup, meds, etc.
And the meds that were tried, what route they were given.

 

[Rhea92]

I've dealt with upper respiratory and was able to get a stubborn infection cleared up. But lower respiratory is different, and yes, difficult to treat. In fact it usually has a very high mortality rate in that first week of infection. So your rabbit hanging in there, that at least is a promising sign.

What antibiotics have been tried so far, and how long was each given? Are any meds nebulized, or is it just saline? Any mucolytics, anti inflammatory, or other meds that have or are being given? Is your vet a knowledgeable rabbit vet?

Yes my vet is an exotic specialist and rabbit savvy, a huge blessing! The first week mortality rate makes a lot of sense, I was sure I was going to lose him in March before I found this vet, he is so strong and a gentle fighter.

I'll give the whole treatment timeline best as I can remember:

At the beginning of treatment in April she prescribed him 2 weeks of Fenbendazone and Enrofloxacin after doing an Aerobic and Anaerobic cultures test.

She made sure to prescribe sulcrate (stomach lining protection) dioctyl (stool softner) cisapride (gi motility) gabapentin (pain relief) and benebac (probiotic) and Lafeber Herbivor intensive care (critical care substitute) to make sure he didnt go into GI Stasis.

His nebulizer medication was F10 sodium chloride and after 2 weeks he was also presribed Acetylcysteine for the nebulizer as well, so one in the morning one at night. She instructed I put him in his carrier, place the nebulizer mouth piece at the entrance of the carrier facing into it with the carrier door open, then I cover his crate with a towel so the vapor doesn't escape while I run it for 30 minutes. Sometimes when I uncover him after it's done he's turned around facing away from the mouthpiece.

He got another 3 week round of enrofloxacin in June, he continued the nebulizer and enrofloxacin with benebac and he was improving tremendously and he also started Ciloxan nose drops.

In August he was no longer showing any symptoms so he was finally off all oral medications but thats when she discovered scarring on his lungs via xray. She said to continue just the nebulizer and keep a close eye, and he started showing symptoms again after 2-3 weeks... there were also terrible forest fires that had my citys air quality at a critical health risk around when he started showing symptoms again (sneezing, a spec of gel-like white discharge from nostril, wet yellow discoloring around nose)

She did another Aerobic Culture test but his nose was pretty clear and the only thing detected was a "non-enteric gram neg rod" that was unable to speciate so it couldnt be identified. He was prescribed Gentamicin nebulizer medication to do at night and continue Acetylcysteine nebulizer medication in the morning.

The vet was concerned continuing Enrofloxacin longer might create antibiotic resistance, so instead she prescribed Ceftazidime injections under the skin once daily for 2 weeks. She explained to me it is used for reptiles and not yet officially acknowledged for Rabbits but she is constantly staying up to date with new research, break throughs and attending conferences and she assured me it is effective in her experience giving to rabbits, but it is very intense so his GI needs to be monitored carefully. If he shows any signs of changes in litter, eating and drinking habits I have the sulcrate, dioctyl, cisapride, gabapentin, benebac, herbivor emergency care (critical care) and pedialyt to use as needed until he is back to normal.

He seemed symptom free again almost right away after starting that and after the 2 weeks she did an xray and saw some improvement but his right lung is still pretty foggy. She prescribed another round of the Ceftazidime injections but this time once every other day for 2 weeks and to continue the nebulizer medications. His symptoms of sneezing and yellow discoloring showed up again during this round, im seeing her again next week

 

[JBun]

Ok, so after the last enrofloxacin course ended, it was 2-3 weeks before symptoms re-emerged? Is that correct? Were the enrofloxacin treatments continuous since April, or were there breaks being off of it in between each course?

Is he still on the nebulized gentamicin? And is he still currently being given the ceftazidime injections every 2 days? Did the vet say why every 2 days and not every day again, especially with symptoms now returning?

 

[New2RabbitsDonna63]

Oh my goodness. What a terrible struggle you have been having.
And Your poor dear rabbit.
I have nothing to offer except encouragement as I am a first time rabbit owner.
You are doing amazing, fighting so faithfully for your pet.
Huge hugs.

Does anyone have any experience with a bunny dealing with a stubborn lower respiratory infection or any advice/suggestions to what I could do to help alongside vet treatment or what might be hindering it healing that I can change?

My senior bunny's right lung is foggy on xrays and both his lungs are scarred, I see my vet once or twice a month and have been treating his illness for 6 months now, his upper respiratory improves but then reverts, there is small improvement to his right lung over months of treatment. He is taking antibiotics and does a 30 minute nebulizer treatment twice daily.

Theres a lot of things I'm trying to do to keep any respiratory irritation to a minimum and keep the air clean (ie, fragrance free laundry detergent, no products with fragrances like perfume or air freshners, vinegar/water instead of chemicals/cleaners with fragrance, 2 air purifiers, shake off hay dust before feeding, etc) i also clean weekly and clean his litter daily with vinegar/water, he uses washable cushioned pee pads instead of bedding/paper litter now that he has arthritis (he wont enter the low entry litter box if it has bedding/paper litter) i switch out the washable pee pads twice a day so they dont stay pee soaked in the room for too long.

Any suggestions or advice, or does anyone have their own experience with a bunny with a lower respiratory problem they can share, even if its not optimistic? I have heard it is notoriously difficult treating a lower resporatiry illness in rabbits and his lungs are scarred so the odds are not in his favor, Im preparing for it never clearing up but I want to do whatever I can on my end to help his odds or even just get more of an idea of other bunny experiences

 

[Rhea92]

Ok, so after the last enrofloxacin course ended, it was 2-3 weeks before symptoms re-emerged? Is that correct? Were the enrofloxacin treatments continuous since April, or were there breaks being off of it in between each course?

Is he still on the nebulized gentamicin? And is he still currently being given the ceftazidime injections every 2 days? Did the vet say why every 2 days and not every day again, especially with symptoms now returning?

Yes, it was within 2 weeks of no antibiotics since vet thought he was basically clear that he started showing symptoms again.

I forget the specific reason why she presribed every other day instead of daily for his current round of Ceftazidime injections, he did have a GI stasis scare after 7 days of the daily Ceftazidime injections which she warned me was a risk factor to watch out for closely, I caught it in time thankfully and he was back to normal in 2 days (treated with GI medications Sulcrate, Dioctyl, Cisapride, Gabapentin and the critical care substitute). I think she is concerned another daily round might be a bigger risk on his GI system if that was the cause

He does have a pattern of GI upsets when there is huge weather pressure fluctuations, that happened the day he had the GI stasis scare, his eating/littering/drinking was doing good on the injections right up until that day and doing good now on this round too

I looked at his health records I keep, here is his Enrofloxacin and Nebulizer timeline (not including other medications like the probiotics and nose drops etc):

April 14th 2024
First vet visit
Prescribed Enrofloxacin
Nebulizer F10 begins daily

April 16th - April 24th
Enrofloxacin, 12hrs, 10 days

April 23rd - April 30th
Recheck
Enrofloxacin, 12hrs, 7 days

May 1st
No Enrofloxacin

May 2nd - June 2nd
Enrofloxacin, 12hrs, 30 days

May 2nd - July 25th
Nebulizer F10 morning + Acetylcysteine evening daily (approx. 2 months)

June 3rd
No Enrofloxacin

June 4th - June 11th
Enrofloxacin, 12hrs, 7 days
Sample taken for lab testing

June 11th - July 2nd
No Enrofloxacin for 21 days
Lab results showed minimum amount of infection measurable, sample was taken June 4th, assumed the 7 days of Enrofloxacin since then had cleared it up
Symptoms gradually worsen over 21 days
Refill requested June 26th via email, need to wait until July 3rd for lab testing to be re-reviewed first

July 3rd - July 24th
Enrofloxacin, 12hrs, 21 days
Final Enrofloxacin as treatment

July 25th - August 18th
No antibiotics for 24 Days
Nebulizer F10 + Acetylcysteine daily treatment ends for 24 days

August 1st
Recheck after 7 days off Enrofloxacin
Seemed clear, if symptoms show book recheck

August 14th
Emailed symptoms worsening update

August 18th - September 1st
Recheck
Enrofloxacin NOT re-prescribed
Instead Ceftazidime injections, 24hrs, 14 Days
Nebulizer Gentamicin morning prescribed + Acetylcysteine evening re-prescribed, daily (ongoing)

September 3rd
Recheck
Ceftazidime injections, 48hrs, 14 days

September 17th
Next recheck

 

[Rhea92]

Oh my goodness. What a terrible struggle you have been having.
And Your poor dear rabbit.
I have nothing to offer except encouragement as I am a first time rabbit owner.
You are doing amazing, fighting so faithfully for your pet.
Huge hugs.

Thank you so much, that sincerely means a lot to hear, he is my first bunny too so I am with you on being a first time owner! Thank you for the encouragement