Duration of injectable penicillin for inner ear infection

Question
QUESTION: Hello Dana

We treated our 3 yr old male bunny for head tilt with both Panacur and Injectable Penicillin recently. I has been 6 weeks since initial tilt and we completed a month of Panacur and a then month of Pen a week ago. He was quite bad with a 90 degree tilt and falling and spinning constantly.

We really saw an improvement after the third dose of penicillin and again with the fourth and final dose. We see a good bunny vet who felt the month was enough in terms of  duration..

It has now been about 10 days since his final dose and she seems to be becoming tiltier and quieter than normal again. He is still eating and eliminating well and not falling but behaviour is different this last 2 days. This makes me nervous he is going to go downhill again.

We have him booked for acupuncture this weekend hoping to improve the tilt more.

What are your thoughts on duration of penicillin? My gut tells me it is an ear infection not EC. We bought a bottle of penicillin in case we needed to recommence it.

Thank you for your advice

Natalie

ANSWER: Dear Natalie,

Personally, I disagree with your vet that a mere 8-10 day course of dual-acting penicillin is long enough to really get a handle on a well-established middle or inner ear infection.  We have had to keep some bunnies on it for *weeks* before our vets are confident that the infection is really under control.  If your bunny is getting worse now that the Pen-G has been stopped...well...case in point.

If your current vet is adamant about not continuing the bicillin, then please find another rabbit-savvy vet here:

www.rabbit.org/vets

for a second opinion.  Your bunny's health is at stake here, and I think it's really important to give an adequate course of antibiotics, lest you risk selecting truly resistant ones that will no longer respond to treatment.

Hope this helps.

Dana

---------- FOLLOW-UP ----------

QUESTION: Thank you Dana fpr your reply but I may have been unclear in my email- we treated for 4 full weeks with Penicillin not 10 days. It's just I have read they may need to treated for months and was unsure if we had stopped too early.

He has his good and bad days and of course as soon as I sent you the first email he rallied and has had a really good few days, bright and happy, binkying around even. Our vet explained he may fluctuate like this for some time but was happy that we had treated for as long as we needed to with Penicillin. She told me to keep the bottle in case we needed to recommence if he was to deteriorate and in this case we would treat for much longer than the inital month I'm sure.

We took him for acupuncture Sat and after one session his head was less tilted. Truly amazing. We have 3 more sessions to go and the veterinary acupuncturist believes that due to his quick response to the initial session he will do well.

Thank you Dana for responding to my question. This is an excellent forum.

Natalie

Answer
Dear Natalie,

Well, if bun is continuing to improve, it might be okay to stop now.  But I'm glad the vet agrees that the Penicillin might need to be re-started if signs start to recur.  You'll just have to wait and see and hope for the best.  We all have to go through that with head tilt bunnies.  :(

Hope he continues to improve!

Take care,

Dana