so unsure:chronic runny eye and nose

Question
QUESTION: Hi, Dr. I am back again with some questions for you; Fritz, my dutch has been having a stuffy right sinus and leaky right eye. So far he has been on baytril, and then zithro, no change. I have been giving him baby benedryl, no change. Vaporizer in room always on, no change. He has only seen the vet for molar trimming for the last 3 years, no other problems till this. He is active and eats, less grass, but more greens.He used to slobber alot with his greens, and that stopped when this problem started. Vaporizer always on near him, no change. Sneezes and mucus block is getting worse. Had chest checked, sounded clear, only in the sinus'. Question is this; is a culture necessary after no change with antibiotics? Would the molar root be seen in his mouth by now? or if impinging on sinus, would require xray or mri? We don't want to put him through all kinds of tests, and to us personally, feel it is his teeth due to no reaction to antibiotics, the other rabbits are not sick, and I thought it might be allergy to grass dust, but the benedryl doesn't help at all. Advice before making doctor's appmnt. would be much appreciated. Thank you Doctor. Robin

ANSWER: Dear Robin,

A chronically blocked maxillary sinus can have this type of manifestation, and the only way to fix it would be via radical surgery involving removal of the facial bones to access and "core out" the sinus.  Removing the offending tooth might not work, since scarring around the tooth root might still remain even after the tooth is removed.  

Has the vet tried ophthalmic antibiotic/corticosteroid drops, or a tear duct flush?  These can at least give temporary relief, and sometimes the blockage will stay away for a long time.

I'm not sure how useful a culture would be, since nasal cultures are full of contaminant, non-pathogenic bacteria.  But you could try to see if there is "heavy" growth of anything.  

Still, that would only be a symptom, not the ultimate cause of the problem, which is likely a sinus and/or tear duct blockage.  Unless the physical problems are addressed, this will likely be a chronic problem that can be dealt with via palliative care (warm compresses, face washes, a couple of Craisins afterwards).

Wish I had better news.  But this is usually the case with chronic runny eye and nose.

Dana

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

QUESTION: Yes, he did have his eyes flushed twice, and only the left eye flushed through, the right did not. And we were given the fluro "something" for eyedrops, and that didn't help either. So, I bought some artificial tears, and am now using a warm compress and holding him above the steam of the vaporizer. All his left molars are taken out, leaving him only with right molars, which last time, about a month ago, the vet said she did see some tiny spurs on them, but nothing to be concerned with at the time. Do you think it necessary to schedule an appointment for his teeth trimmings for the right now/ he is still eating his kibbles, which he did not eat when he needed a dental done, and the extra slobbering was always our sign he was due for a dental. I am still worried about him going under anthesia with the chronic nose blockage on the right nostril.... also, the mucus coming out is clear, the only concern is this affecting his brain in any way, or causing pnemonia? I wish I knew if there are rabbits out there that have lived alright with a stuffy nose like this...

ANSWER: Dear Robin,

Take heart in knowing that there are LOTS of rabbits who live with chronic runny/stuffy nose.  I have lived with many, and their schnucky noses were never the cause of their ultimate demise.  :(

I think you need to just keep doing what you're doing, keep him as comfortable as you can, and hope for the best.

Might ask the vet about using ophthalmic antibiotic drops in the *nose*, too.  We've done that with good results.  Gentocin is very good, broad-spectrum for this.  But you need to do it at least 2-3 times a day.

Dana

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

QUESTION: Hi Dr., I just set an appointment for Fritz for a dental trimming the 26th of Feb. I was wondering if it is safe for a bun with a stuffed  up nose to go under anathestic for his teeth trimming? He just started his slobbering again, but is still very stuffy. So I know he does need a dental, but am worried of him being alright going under like he is.

Answer
Dear Robin,

It's not ideal, since rabbits are obligate nasal breathers.  You might want to ask the vet whether it would be safe to give him a bit of pediatric Benadryl (antihistamine), or even something like Afrin nose drops (pediatric) to temporarily shrink the membranes in his sinuses and allow him to breathe freely, if he can't.

The vet will be the best to judge what is needed for Fritz's particular situation.

Hope all will go well!

Dana