Five months of mystery disease issues in my bunny.

Question
Bear me with as this is a long story. Back in March my 9 year old Rex has a brown sludge come out his nose and mouth. We rushed him to his exotic specialist vet who detemined it was a respitory infection. They nebulized him, gave him O2 and loaded him up on all sorts of other drugs including pen shots, a bronchodilaror, Miloxicam, little noses, and so on. The next week he had another attack, but this time it was a trace amount of clear liquid.. Rush to the vet again. 16 days later he had another attack with a clear discharge. They did x-rays, a catscan, blood work, fecal float, MRIs and more and everything came back that he was perfectly healthy in every way. The vet finally determined he had allergies. So we bought an oxygen tank and a nebulizer of our own and made a little bin to stick him in when he had an attack. From that point on he had an attack once a month and that was that.

Come july 4th, he had a massive attack with his stomach gurgling and a lot of clear liquid coming out his mouth and nose. This lasted for an hour or two and the vet just watched him and was like, "There's nothing else you can do. His allergies are getting worse." It became apparent that even thought hey were an exotic vet clinic, they had no idea what was wrong with him and we had gone through 10,000 in tests and treatments. As well since the 4th, he developed severe anorexia and absolutely refuses to eat hay except on rare occasions, and then it's either Oxbox oat hay or alfalfa. So I brought him to Doctor Stahl (from NPR) and his rabbit doctor immediately diagnosed my bunny as having a rare condition called esophagitis brought on by a bad gastric ulcer.

Since being put on his new meds from the Stahl clinic, the bunny in question hasn't had any discharge from the mouth or nose. Now he just has a week of swallowing issues, followed by him being normal followed by another week of swallowing issues. What happens is he takes forever to eat and when he does, his head and ears shoot back in obvious pain as he tries to swallow. He can eat, it just hurts to while he's having a flare-up, but we need to get the food in him.

His most recent flare-up started late night on 8/18 as a raisin went down his throat wrong (one of the few things he will willingly eat) and he choked for a bit, causing the flare up. Now his throat is all swollen and raw.

He still won't eat hay although between the last few flare-ups he was eat a few mouthfuls of oat and alfalfa a day, once laced with half a packet of cammommile. He has an allergy to timothy hay (sneezing) and won't touch orchard grass at all. He will eat parsley, Bok Choy (baby and regular), cilantro, oats, nuts, and oddly enough hard things. We give him four sessions of critical care a day (7:30am, 12 noon, 5pm, 9pm), each 42 ml and each syringe holds 3 ml. This gives him a total of aroughly 168 ml a day, but he fights the critical care tooth and nail. He currently weights 5.8 lbs. His lowest after his first severe bout of anorexia dropped him to below 5 but his weight before all this was around 6.5 lbs, but he was a tad overweight. The hardest part is he WANTS to eat. He comes up whenever we have food and is very interested, but then he smells it and walks away. So it's not a lack of desire to eat like a G-I stasis bunny. It's just nothing seems to taste good to him anymore.In fact, he's a normal bunny in every other respect. He wants to play, snuggle, eat the walls, dig in boxes, destroying his nutty stick ball toys, hopping around in his house and everything. But when he's having an attack, the grinding is so loud that we just want to cry because he's in such pain. However, while grinding he's still grooming himself and acting normal. It's like he just accepts the pain and goes about his day.

His stools, both hard and soft are normal and he goes to the bathroom regularly. His urine is not sludgey at all. Occasionally his cecotropes can be a gooey stinky mess, but that happens once a day while the rest are fine, so we assume (and have been told), it's probably just a reaction to one of the meds.

He is currently on the following meds:

Children's benedril 1ml 1-2 times a day when having breathing or swallowing issues
Aminophilyne 25mg/ml .5ml 1-2 times a day when having trouble swallowing or breathing.
Propulsid 2mg/ml .6ml 2xday
Omeprazole 20mg tablet 1/4th of said table once a day ground up and given with water.
Sucralfate 1000mg tab - 1/4th of tablet twice a day dissolved in water
Meloxicam 1.5mg/ml .3 ml once a day
Tramadol 50mg/ml .12ml twice a day

Basically we're just at the end of our ropes with him. He hates the critical care (while the other rabbit is more than willing to eat his leftovers) and we're trying to figure out how else to get him his fiber and nutrients without battling him 4-8 hours a day over eating, which stresses him out and probably makes his ulcer worse. Any suggestions on food? I know the fact he has a severe timothy hay allergy makes things hard as that is tyhe defacto bunny food. Is there anything else we can give him to make him eat or want to eat? Is there anything else we can give him for his esophagitis or ulcer? Is there some weird side effect between any of these meds? Would upping his doses help at all? I just don't want him to be in pain or stressed by the simple act of eating. I'm sorry this is long and rambly. It's just he's physically and mentally perfect in every way according to every test on the planet and we just want him to be able to eat on his own again in terms of amount and frequently instead of stressing him out regularly.

Answer
Dear Alexander,

I apologize for the delay.  Household emergencies just waterfalled down on me, and I'm only now catching up with AllExperts.

So now I'm sorry to answer your question with another question.  Please let me know:

In all of this, I see no mention that anyone looked deep into his mouth with an otoscope to see if he has molar spurs or another dental problem. The signs you describe really sound as if they have their origina in dental disease.  I have known of rabbits with perfect incisors to have horrific spurs.  And some bunnies with small spurs are just more sensitive to them, and they drool and regurgitate because of them.

He might also have an abscess at a tooth root or in his throat.  We have seen that.  Have head radiographs been taken?

Please see:

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

and please feel free to refer your vet to this excellent article that can help detect cryptic dental disease:

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

I hope this helps get you on the right track.  But please write back if you have more questions, or can shed more light.  I'm on "vacation" at AllExperts, but please feel free to write to me directly at dana@miami.edu

I hope your boy will be fine soon.  Sending healing thoughts.

Dana