Bunny having massive sneezing fits with nasal discharge, medication making it worse? Please help!

Question
Dear Dr. Krempels,

I am the proud owner of an approx. 4 yr. old New Zealand white indoor house bunny.  She has been having sneezing fits which are becoming increasingly worse, until she can barely breathe.  We took her to a House Rabbit Society recommended vet, who said her nasal passages looked clear and her teeth looked good, and prescribed a round of Baytril.  Her sneezing decreased for a time, although it never fully abated, and then it came back with a vengence.  She now also has a nasal discharge and the sneeze sounds deeper and harsher, her sneezing fits are also longer and more frequent.  The vet prescibed another round of baytril and gentocin opthalmic solution admistered as a nasal drop. She tried to get a culture but couldn't, and said she couldn't get a culture or do a full exam of her nasal passages without sedating her, and that if we sedated her that there was a good chance that she might not wake up.  After adminstering the second dose of both meds today, she launched into a sneezing fit so violent, I thought she was going to die.  It lasted for almost ten minutes.  She is eating and drinking normally, urinating and pooping normally, and is still playful and loving, although is slightly more subdued, due to her incessant sneezing. The only other new behavior I have seen is that she rubs her chin on things a lot, especially after sneezing.  

My question is: could the medication be making it worse?  Could I have administered it in a way that exacerbated her sneezing?  Or is the increased sneezing after receiving nose drops part of the infection clearing out? Does this treatment seem like a proper regimen for the symptoms we are seeing?

Also, is there anything else that we can do to make her more comfortable and help calm her sneezing?  I have read about using children's benadryl for bunnies, is this something that might help her sneezing?  Someone else reccommended putting a dab of vasoline or vapor rub on her nose.  I would do anything to make her better, at the way we are progressing, I am afraid that she won't live long enough to see the end of her treatment.

A little about her care: We do not use pine bedding, we vaccuum and clean her cage and litter box every single day and give her fresh food, water, hay and litter daily.  We give her unlimited amounts of timothy hay and feed her a moderate amount of oxbow pellets. We give her carrots and leafy greens as weekly treats. She is allowed to roam freely as long as we are home to supervise and gets several hours of play per day.  We keep our house clean and use non-allergenic products in the home so as not to irritate her little nose.

Please, any advice you can give would be greatly appreciated.  I know she is suffering and it is breaking my heart!

Thank you,
Shandra

Answer
Dear Shandra,

It might be time to get her to a vet who can look up the nasal passages with an endoscope to see if there is a foreign body, such as a tooth root or even a bit of hay, stuck in her sinuses.  This can be the cause of such violent, prolonged sneezing fits.

Please also see:

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

Some rabbits have chronic runny nose because of a partial or full blockage of the maxillary sinus. This prevents proper air flow, and sets up a hospitable environment for opportunistic bacteria.

You might want another vet for a second opinion:

www.rabbit.org/vets

And yes, it's possible that the antibiotic could make things worse if it's knocking out one species/strain of bacteria and removing the competition for a different, more aggressive strain.  Or even moreso, if the problem is being caused by yeast (which are not killed by antibiotics).  

It really would be better to try to get a clean culture via deep nasal swab.  A meticulous vet will swab all areas around the external nares with disinfectant before going in, to reduce the chance of outside contamination.  Nasal cultures are notorious for contaminants, since just about everything goes up those nostrils!  But it might be better than nothing, just to see what you're fighting.

Many pathogens (or opportunists) that set up shop in the nasal passages in rabbits are sensitive to penicillin.  So if the Baytril and Gentocin really are not working, as the vet about trying injectable (NOT oral!) dual-acting Penicillin G.  This might help get the situation under control.

Hope this helps.

Dana