(RIP) Pasteurella?? (molar spurs)

[MILU]

Ah, one more detail: his urine has been dark, brown, for like a week.

 

[tonyshuman]

Yes, benzyl penicillin benzathine is the same thing as penicillin G benzathine!! If you combine that with penicillin G procaine, you'll have bicillin. They need to have the same number of units between the two drugs, and the dose should be 75,000 units every other day. You'll need to dilute it with the lactated ringer's or a sterile saline for injection.

http://www-unix.oit.umass.edu/~jwmoore/bicillin/bicillin.htm

Finally found it!!

 

[tonyshuman]

Dark brown, or orange? Brown could be a sign of kidney problems or dehydration.

 

[MILU]

Anything for chest painful pressure in humans? That's how I've felt the whole day today!

 

[Maureen Las]

Sorry that you are feeling bad yourself but rabbits's being sick is really a stressful siutation.

I know nothing about acetylcysteine for use in rabbits. It is also called Mucomist . I can't advise you as I know nothing of it's use in rabbits but will try to find out more. until you get an affirmativeI would not use it.

Claire is right that the 70 mg a day of azithromycin is too low and the 100 mg is right in the medium range for a 2.5 kg rabbits and would be better.5 days is too short a course of the drug and at least several weeks is better.
I am concerned about the dark urine... is there anyway that your vet could show you how to administer subqutaneous fluids for your rabbit.I would guess that he is probably dehydrated and may have other issues also but not getting enough fluids is going to have very negative effects on overall health.
If you can syringe him an electrolyte drink for children without problems you could also do that.I am concerned that because of the involvement of the chest that you may have difficulty syringing and that he may have issues swallowing ; you need to use your own judgement and evaluate him. if he likes the elctrolyte drink you may be able to have him drink out of the syringe (one of my bunnies does this) or even flavor his water bowl with a small amount of apple juice or an electrolytedrinkto get him drinking

He also needs to have labwork to check how his organs are functioning ; the dark urine could be reflective of possible liver , kidney or other organ dysfunction


benzetacil is benzathine penicillin.I believe that our administrator , sas, Pipp uses benzathine pencillin alone without the procaine.I would be somewhat concerned re. mixing the procaine with the benzathine unless the people doing this were very sure of what they were doing

Iam also not sure of dosing benzathine alone but am hoping that Pipp will help us out when she gets on-line.

Randy often comes on the forum on weekends and we ill hope that he does this weekend.; it is the beginning of heavy wildlife season so I am not sure we will see him here .
We are trying to help you , however , your rabbit sounds severely ill so will all just try to do our best and hope that he can get though this. :hug:

 

[MILU]

Well, actually, like the last time, his symptoms aren't good, but he's a fighter. He still plays, eats and drinks water. Should I add some vitamin in it?

I don't think syringing drinks would be a problem at all. He actually feels hungry and eats. Perhaps I should even syringe more water than what he drinks daily. If I can't find an electrolyte drink for children now, can I give him adult ones? Should I give lots daily?

Thanks for the input on mixing procaine and benzatine, People here do NOT know what they're doing and that's why I get SO stressed.

I won't give my bun acetylcysteine then. I respect your opinion and will do what you say.

 

[MILU]

 

[MILU]

And about azithromicin again, should I give it for about 14 days?

 

[MILU]

Ah, should I administer it everyday at the same time?

 

[Maureen Las]

hotmaildeal wrote:

Well, actually, like the last time, his symptoms aren't good, but he's a fighter. He still plays, eats and drinks water. Should I add some vitamin in it?

I don't think syringing drinks would be a problem at all. He actually feels hungry and eats. Perhaps I should even syringe more water than what he drinks daily. If I can't find an electrolyte drink for children now, can I give him adult ones? Should I give lots daily?

Thanks for the input on mixing procaine and benzatine, People here do NOT know what they're doing and that's why I get SO stressed.

I won't give my bun acetylcysteine then. I respect your opinion and will do what you say.

Sports drink for adults are more potent and sugary than the electrolyte drink for children. Some of the sports drink for adults would be OK but You should be able to findchildrens' electrolyte drink over there. it is called pedialyte here and I am sure they have it over there; it is used for kids who are vomiting / diarrhea to replace the electrolytes lost.

you can find it in the infant area of any pharmacy or dept store. Porbably never noticed it before.

Iam no expert on the acetylcysteine for rabbits :?

Azithromycin should be given for at least 14 days ( maybe longer) and you can give it at approx the same time every day.
Can you get probiotics over there.?
I will give you an example of what I mean


http://www.jefferspet.com/ssc/product.asp?cid=0&pf_id=4157

it is good to administer a probiotic when administering an antibiotic which could dis rupt normal gut microorganisms

This type of probiotic is sold in pets store for small mammals and also dogs and cats. If you have any farm stores there it is always sold for large animals like horses and young farm animals who are being weaned off milk. Many times it comes in a tube and small amounts can be fed to a rabbit daily .

http://www.probios.com/

 

[tonyshuman]

Acetylcysteine is used to make mucus less thick. It is also naturally occurring in the body and is used by the liver to metabolize things so that they can be excreted in the urine. However, I think its benefits have been highly exaggerated in functions other than mucus reduction. If he's having trouble breathing due to lots of mucus, it's probably fine. I don't think it will hurt him, however you never can be too sure. From what I've read, I would not apply it to the eye.

It is used when bunnies are in extreme respiratory distress and have so much mucus they can't breathe.
http://en.allexperts.com/q/Rabbits-703/2009/12/Bunny-trouble-breathing-2.htm

 

[MILU]

His urine is brownish.He has done it this color before, but I guess not too many times in a row, or maybe I was the one who's never paid attention to it before. He also made a whitish one today.

We don't have probiotics for pets. Hardly I found it for humans. What we have in powder has Lactobacillus Casei + bifidobacterium breve (and contains lactosis as I remember). My bunny took it and was ok, but he hadn't taken antibiotics, only anesthesia.

There's also a drink version (with milk) with acidophilus. This is easy to get.
Is there any food to cut the horrible bitter taste of the medicine? My tongue feels all cut and hurts, and I've tried as much as the size of this "O"!!!!! I wonder if my bun will stand this for 14 days!!
:tears2:

A very curious thing is the noise from inside him. He's switched positions and it came from like, the "belly" (?!?) area behind (inside? Aw my English!) his leg. It's like a honk from inside him. Sometimes it also sounds like coming from the chest, or throat. It's not the sound of bloating, which I know well. Weird!!!!! That's actually what made me worried at first, as I've never heard such a thing!

 

[MILU]

Claire

No, my bun is not in such distress. He can breathe. No acetylcysteine. Good suggestion the bathroom steam on the link!

 

[Maureen Las]

The powder with lactobacillus casei is fine to give him

The sound is understandable if it was from his chest and I do believe that it is a sound that seems to be coming from different areas of his body but I don't know what it is ....

I had heard one of my rabbits make a sound when she had a respiratory /tracheal infection. It sounded like a man clearing his throat and it seemed impossible that that big sound was coming from my little bunny.
keep us updated

 

[MILU]

I heard that noise you're talking about twice or so. That sure was respiratory - and loud. But the other noise is weird, and it comes with some sort of spasm or "hiccup" (?), like, my bunny wants to lay down on his side and can't, that "noise thing" with a spasm makes him jump back on his feet again. Really weird. Comes mostly (not always) when he switches positions, when he eats, when I carry him or randomly.

 

[Pipp]

I'd be curious re: the procedure the Vets did on his teeth. I often here about rabbits having post-op problems, here's an excerpt from an Vet's article explaining some of it:

http://www.theveterinarian.com.au/clinicalreview/article500.asp


from: Common problems in rabbits and ferrets

Working with unusual pets brings with it a new set of challenges and opportunities for professional satisfaction.

MARK SIMPSON

Of all the gastroenteric problems we see in rabbits, dental disease is the most common. And while dental problems are occasionally due to congenital (possibly inherited) malocclusion, the vast majority of cases are a result of a progressive syndrome caused by poor diet.

Inappropriate levels of dietary protein, calcium, and vitamin D, coupled with inadequate dental wear are strongly implicated in the aetiology. The syndrome of acquired dental disease is characterised by an alteration in the orientation, then shape, and possibly structure of the teeth and the consequent development of malocclusion. It is my opinion that the altered wear (leading to altered pressure at the tooth roots) and generous supply of protein and calcium in inappropriate diets, permitting ready remodelling of the bones of the jaw, are causative factors in the majority of rabbit dental disease.

As a result of this re-orientation, sharp spurs can develop on the cheek teeth that penetrate surrounding soft tissues of the cheek or tongue. In particular I find lacerations and ulcerations of the tongue are intensely painful and affected rabbits do not eat or groom effectively.

Though the incisors are most commonly treated dental problem in rabbits, I believe they constitute only a small proportion of problems - most rabbit teeth problems are associated with the cheek teeth. I have seen several rabbits with bilateral, medially directed spurs of the cheek teeth of the lower jaw literally trapping or skewering the tongue in an immobile position.

Rabbits with spurs are often salivating, which gives rise to the lay term slobbers. Gut stasis is, for multiple reasons, a common sequelae. In some cases the appearance of the teeth in the mouth is normal, and the roots are the site of the pathology. In cases where the clinical sign indicate dental problem but oral examination is within normal limits, radiographs of the head, to assess the tooth roots, are indicated.

The tooth roots are significant as they are frequently the site of abscessation, which may be the first clinical sign the owners identify as a problem. These abscesses will lead to severe osteomyelitis, with draining sinuses on the face, and are an absolute disaster. While occasional anecdotal stories of resolution are told, the vast majority of these abscesses require intense and complicated debridement and the use specialised treatments such as antibiotic-impregnated methyl methacrylate pellets or Consilâ to have even a hope of remission.

There is a constant risk of recurrence with these abscesses, and anything that can be done to avoid them is preferable to trying to treat them. One of the factors that we associate with these abscesses is the use of nail clippers to effect trimming, predominantly of the incisors. This technique has been associated with longitudinal microfractures of the tooth, which provides an excellent avenue of access for bacteria of the mouth to enter the tooth apices and begin a problem. For this reason we strongly recommend avoiding the use of nail clippers to trim the teeth.

Once there are spurs affecting the mucosa of the oral cavity the only successful treatment is removal of the spurs under general anaesthesia. It must be emphasised however that this is a temporary measure, and that trimming the teeth will need to be repeated once every six to 16 weeks for the rest of the rabbits life.

To anaesthetise these patients I use the protocol developed by Dr Ron Rees-Davies that I call rabbit DTK: Domitorâ (medetomidine 1mg/mL) at 30ug/kg, Torbugesicâ (butorphanol 10mg/mL) at 0.10mg/kg, and ketamine (100mg/mL) at 1mg/kg, which gives about 0.10mL Domitorâ, 0.03mL Torbugesicâ and 0.03mL ketamine for a 3kg rabbit, which I inject intravenously as a single bolus. This usually allows enough anaesthesia for cheek tooth examination and burring.

I then intubate the rabbit and provide supply oxygen, and then I am in a position to provide additional gaseous anaesthesia if the need arises

My experience with local anaesthetic blocks in rabbits has not been as good as those used in cats and dogs. This is not totally surprising, as the sites, especially that for mandibular blocks, are much more difficult to access than in other species. I no longer attempt regional blocks for this purpose in rabbits.

Some specialised equipment is necessary to trim the cheek teeth of rabbits. There are many rabbit mouth gags, and some of these may be viewed at Dr David Clarke’s web page at http://www.k9gums.com.au/page7.html. I find the concept of two-way action to be critical so that the jaws are opened and then the cheeks are effectively “dilated” one side at a time. I therefore have the jaws held open with a standard small animal gag.

I then have an assistant use wooden tongue depressors to expose each part of the cheek teeth. A Dremelâ tool with a long bit is then used to burr all the cheek teeth to about a millimetre above the gum line. I find that if I slide off the tooth I do not damage the mucosa, (nor any expensive gags), but simply the wooden tongue depressor.

There is some controversy about how much to remove from the teeth. Some practitioners remove only the offending spur. It is not my aim to restore normal occlusion. By the time these procedures are required any return to normal occlusion is impossible as there have been irreversible changes to the tooth roots and dental disease will be permanent.

Some reports suggest burring will lead to heat necrosis of the tooth roots but I have seen no evidence in the many cases I deal with to support that contention. However there is good evidence to suggest that occlusive pressure will drive affected teeth back into their sockets, and this disrupts the normal anatomy of the tooth apex. The gingival attachment and the periosteum are damaged.

Once again, as in the case of microfractures of the incisors, bacteria of the oral cavity can reach the tooth root and surrounding bone.

By burring to within a millimetre of the gingival margin some of this occlusal pressure is relieved, and the likelihood of tooth root abscesses and associated osteomyelitis decreased. My clinical impression has been that rabbits that have their teeth shortened this way also return to eating more quickly, possibly because the root elongation has been painful.

Gastrointestinal hypomotility (also know variously as gut stasis, ileus, trichobezoars, or hairballs) is a secondary condition. It occurs frequently in rabbits in response to pain or stress and it is critical to identify and treat the underlying cause.

 

[Pipp]

ETA: We don't have Benzetacil here, sorry. My Vet prescribes Depocillin, which is Procaine Penicillin G.

To be exact - "Depocillin is a sterile aqueous suspension for injection, containing per mL, procaine penicillin G (BP) 300,000 IU (300 mg) and, as preservative, methylparahydroxybenzoate 1.1 mg."

The dosage for my smaller (4lb) but critically ill rabbit was .5 ml.

This stuff is not to be used casually, ditto with all antibiotics, particularly the injected ones. I've come to the conclusion that this ultimately killed Radar. The stuff was pretty thick, I had needles explode more than once and at one point it went through the 'tent' to the other side and was injected onto the surface. I believe that during one of these incidents (or both) he licked the area, developed gastric ulcers and died.


sas :clover:

 

[MILU]

Oh my, that's pretty sad!
I couldn't yet find injectable penicillin and still hope azithromycin solves the problem itself.

Soon my bun will take the 2nd dose and I hope he can stand 12 more days. He's ok, even eats, but his droppings aren't the same (size varies), and I hope his tummy isn't being hurt too bad. Even my tongue got hurt just by trying a tiny, irrelevant wee bit! He seems to have become more active though, which is a good sign.
He seems not to be comfortable laying down on his side.

*** The pharmacist didn't know well what he sold me. He thought it was packed as liquid but it's a powder to be mixed in the purified water that came in the package. I mixed it all (as I couldn't close the water pack or know how to fraction the powder and water to mix) and kept the closed "bottle" (that came in the package to shake the mix) in the fridge. I don't think it ran bad from last night to tonight, but there's content enough for 6 days and I wonder if I can still use it or if it will run bad. It seems like there's no better option than this sort of mix. If you think it will run bad, I'll throw it away and buy a new one tomorrow, but if you think I can keep it in the fridge for 4 more days, let me know. The thing is: this mix is supposed to be 1 single dose for children.. not supposed to be 6.. but I'm in Brazil....

 

[Pipp]

Storage

When diluted according to the instructions (1.0 mg/mL to 2.0 mg/mL), ZITHROMAX (azithromycin for injection) is stable for 24 hours at or below room temperature (30°C or 86°F), or for 7 days if stored under refrigeration (5°C or 41°F).

 

[MILU]

wow, you know everything! Thanks!