rabbit sneezing etc, vet not helping

Question
Dear Dr.Dana,
We are having a problem with our 3 1/2 year old male dwarf rabbit, Pepper. It began with his right eye running a couple of years ago, it became infected, he was prescribed fucidic acid eye drops and it went away. His eye would run on and off by itself since then, just on the right side. At the time we thought it might be a blocked eye duct, but it went away for a year and didn't come back until recently. Several months ago he came into contact with some wild rabbits and mice outside. When I brought him inside he was covered in fleas, which I carefully removed with a flea comb. Within a day or two of this event, Pepper began sneezing. Within the last month his sneezing became sneezing "fits" and his eyes and nose have been running, sometimes with a whitish discharge. Sometimes he shakes his head and wipes at his nose with his paws, trying to remove the discharge. We took him to a vet who specializes in "pocket pets".  The vet thought the problem was either bordetella or pasturella; but she did not culture his discharge. She prescribed 0.90cc strawberry flavoured novo-trimel liquid (240/40 per 5ml) orally twice a day (every 12 hours) which we gave to him for ten days, to no avail. A few weeks later we went back to the vet. Pepper was x-rayed under sedation and his x-rays showed clear lungs and no problems with his teeth or nasal/eye passages. The vet injected him with penicillin (300 000iu/kg) on Feb.13, which she prescribed for us to give him 0.20cc injections once/week. We have kept the penicillin in the fridge, shaking it daily and we gave him one injection on the 19th of February. He is still on the novo-trimel, (but this time banana flavoured since he didn't seem to like the strawberry flavour). We thought he was getting better for a couple of days after the first injection of penicillin, his sneezing was milder and his eyes and nose were running much less. But by the time we gave him his second injection, he was back where we started. He is having sneezing fits, and his eyes/nose are running with a whitish discharge. He doesn't seem to be getting better. What do you think? Is there a different antibiotic that would work better or can we increase his dosage of penicillin or decrease the intervals of injections? Is it possible either of these medications can have an effect on his digestive system? (He seems to be eating less). Any advice would be helpful. Please give us your thoughts, you've very helpful with Pepper in the past. Thank you, Kimberley

Answer
Dear Kimberly,

Please read:

http://www.bio.miami.edu/hare/sneezing.html

http://www.bio.miami.edu/hare/weepy.pdf

and

http://www.bio.miami.edu/hare/dental.html

The doses of penicillin are far too infrequent, in my opinion.  You're doing no more than killing off the most susceptible ones and then giving the bacterial population to recover with the more resistant ones doing all the reproduction.  Good way to breed resistance!

Our vets usually prescribe dual-acting Penicillin-G Procaine/Benzathine at 50,000IU/kg once every 48 hours.  

But the main problem may be a blocked maxillary sinus due to dental disorders, which are very common in dwarf rabbits.  I hope the articles above will help you understand the complex nature of that problem, and know that antibiotics may only be palliative, not curative, in a case like his.

I hope this helps.

Dana