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cold laser treatments

22 9:39:46

Question
Hi Dana,
my bunny has ridiculous upper respiratory issues ie: she percolates, gags and sneezes without discharge, sounds congested all the time. She has been  cultured 100 times and nothing cultures. We have used antibiotics "just in case", done many courses of nebulizing, used allergy meds. i bought a $1500 sealed hepa vacuum, air purifiers.. etc etc. after many tests, exams, my vet is convinced that she has some malfunction n her sinuses which causes congestion and a post nasal drip, etc.  a friend suggested cold laser treatments as it helped her bunny. My vet {who is very rabbit savvy} said "no way! too close to her eyes". Now,  my friend said at her vet they put goggles on her bunny. heres my question, Since cold laser therapy is new and very new for bunnies, i'm not sure if there is any real info that the eyes are not affected down the road by the mere use of goggles. i want to help my bunny! but i certaintly would do nothing to harm her. do you have an opinion/advice on this subject?
thanks so much,
Jeanine

Answer
Dear Jeanine,

Unfortunately (?) I have no experience with this procedure, so really can't comment in its efficacy.  But if your rabbit-savvy vet does not feel comfortable with it, then that should tell us all we need to know.  :(

The most likely reason for your bunny's chronic URI is chronic dental disease.  Molars can gradually intrude into the skull as a bunny ages, and eventually enter the sinuses and pinch off the tear ducts.  Head radiographs might reveal the extent of damage, and whether there is a tooth actually *in* her sinus cavities (endoscopy might be even better here).  If that's the case, removing the offending tooth might help the problem, unless--like many bunnies with dental disease--she is walling off the area with bone.  If that's the case, then there might still be scarring and obstruction in the nasal passages even if the tooth is removed.

A drastic procedure--rhinotomy--is being done in some places to completely open the sinuses and remove obstructions of the maxillary sinus, thus removing the hospitable environment (very little air flow) that promotes bacterial growth.  But the procedure is very costly if done correctly:  the vet needs equipment for irrigating the sinuses during surgery, must be able to intubate, and have a lot of very fancy tools to do it right.  I would NOT recommend this surgery unless the vet can demonstrate to you that s/he has all the right equipment and has performed this surgery successfully several times.

I hope some of this helps.  But chronic nasal obstruction is a really common problem that sometimes is not amenable to anything but palliative care.

Dana