Rabbit has chronic Pseudomonas need advice

Question
Hi there,

I have a 3 year old dwarf rabbit named Brownie. He's a happy bunny eats,
drinks, and plays a lot. Brownie was diagnosed with "snuffles" back in april of
2010 when the vet prescribed enrofloxacin for 30 days which didn't stop the
sneezing but helped with the caked yellow discharge he had and his sneezing
wasn't as loud and frequent. Then he was off meds for about 1 1/2 months
and the sneezing started again and this time it was more snorting in sound
and the discharge was white and runny. We are now seeing a different vet who
is a exotic rabbit specialist. She did a culture sensitivity test and Brownie is
resistant to a lot of antibiotics. We've tried ciprofloxacin and trimethroptim
and a nebulizer treatment for about 2 1/2 months with a combination of
aminophylline, amikacin and acetylcysteine. After all of this I'm discouraged
and he's made very little progress, still sneezing a lot and there is still white,
thick discharge. The vet is speaking of trying a dosage of the nebulizer mix in
a needle injection form to try and get more antibiotic into his system... but
there are risks of his kidneys shutting down because of dehydration but the
vet says its a very low risk. I'm not sure what to do or what my next steps
should be. Is this something better out there? Should I continue trying to find
something to help with his sneezing fits? He's also on a herbal med called Yin
Qiao San to help keep his GI regulated and boost his immune system. What
else is there to do? Help!

Thank you
Carrie

Answer
Dear Carrie,

With a chronic URI like this, sometimes the problem is not the bacteria, which are just opportunists, but the physical structure of the bunny's sinuses.  A common cause for chronic URI is a blocked maxillary sinus, the only permanent cure for which is a drastic surgery (rhinotomy) in which some of the rostral bones are actually removed so the sinus can be cleaned out and permanently opened.  The skin is sutured back over the boneless area, and the bunny looks normal, but the sinuses stay open.

The equipment required for thsi surgery is sophisticated and expensive, and few veterinary hospitals are equipped to do this procedure.  It's also (no surprise) expensive. But this is really the only permanent fix for the problem.

We have several bunnies like this, and the only thing we can do is temporarily put them on antibiotics when things get really bad, just to knock back the bacteria making a home in the poorly-ventilated sinuses.  This, of course, can breed resistance. And Pseudomonas is notorious for developing resistance to antibiotics.  Taking the bunny off the antibiotics can sometimes re-balance the nasal flora, and we've actually seen improvement when we took big Vash off the meds entirely.  (Had his sinuses been colonized by yeast after all those antibiotics?  I don't know.  But he got better for *months* and only yesterday did we have to put him back on to see if the antibiotics will stop his nasty discharge.

Not very heartening, I know.

Warm compresses on your bunny's rostrum (the long, muzzle part of his face) can help soften and loosen mucus, and if he's really bad you might ask your vet about showing you how to do a shallow nasal flush with warm, sterile saline solution.  That can wash things out with the bunny sneezing away the goo.

Wish I had a better solution for you, but what's here is what's known at the moment.

I hope you can find solution that will work for your bunny.

Dana