URGENT: Side effects of medications?

Question
Our bunny, Scissors, is a 3 year old dwarf hotot. I had to
leave my pets in the care of a neighbor when work called me
out of town for two months. I left detailed instructions but
he was not properly cared for and I returned to find him
extremely sick. So we rushed him to the vet (focuses on
exotics) and she diagnosed a bacterial skin infection,
respiratory infection, and of course eye ear and nose
infection, all thanks to horrific untreated mites. An x-ray
showed no pneumonia, no bloat, and full intestines but as of
my return, he had been eating, drinking and passing fairly
normal pellets. She advised his illness may have caused his gi
to slow, administered Ivermectin and Cipro shots to get him
started, and proscribed eye drops, oral cipro drops and
metacam at my request and follow-up Iver shots scheduled.

We brought him home, cleaned and sterilized his environment
and we've been administering all the medication according to
the instructions but he appears to have developed possibly
serious side effects. We're guessing ataxia, every so often he
suddenly just seems to fall apart. His head slowly lolls to
the side, then his body starts leaning and he usually either
snaps out of it with a startled hop, or falls over completely
on his side and then snaps out of it with a startled hop. He
responds to petting while this is happening, so he's aware
while it's going on. His eye function seems normal aside from
the infection and it doesn't seem to hurt him. Once he
appeared to be stuck like that (seizure-like) but he recovered  
quickly. He's also developed gas bubbles and the ataxia (?)
seems to happen often right after audible gas bubble movement
(I stopped holding him for abdominal massage because I'm
afraid he'll collapse and be hurt so I am trying to rub him as
he'll allow with him in the cage.) I suspect he may have been
pushed him into stasis, as he's only passed two pellets since
four this morning (it's noon, yes we've been up all night :(
). He also appears severely constipated - I've never seen a
bunny strain, but he seems to struggle to pass (no luck) -
quaking with effort, his eyes squint, hindquarters tucking in,
lips twitching with strain. This seems to cause the ataxia
too.

I read that ataxia and GI distress are side effects of both
the infections and the treatments.

I've continued all the medications on schedule, but I'm afraid
he might be having a severe reaction? He is scheduled to see
the vet again in a week. I understand it's likely we'll have
to deal with unpleasant side effects considering how sick he
is and how strong the treatments are, and I don't want to risk
shocking him any more if it's not necessary I will take him
back to the emergency vet if these symptoms / side effects
merit it? Am I right, is it nasty but bearable or should I
take him back to the vet?

Thank you very much,
Lee & Scissors

Answer
Dear Lee,

It's difficult to say exactly what is happening with poor Scissors, but I would be more suspicious that this is an effect of his poor health condition than a side effect of any of the medications.  In rare cases, ivermectin can cause neurological complications, but this is really only if the blood/brain barrier is somehow compromised by severe ear infection or other problem.  This would likely show up within a few hours of ivermectin administration, so if this happened much later than that, it is less likely to be the ivermectin.

Pain can cause signs like this, as can hypothermia from shock.  Please use the instructions here to take his temperature, which is a very critical piece of information right now:

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

Getting his body temperature in the normal range will go a long way towards helping him get through this in one piece.

Gas can be painful enough to cause shock and seizures, too, and the single most effective treatment I've found for reversing GI stasis/slowdown is an enema.  Instructions can be found here:

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

In short, use a pediatric ear syringe filled with lukewarm water.  Lubricate the tip with KY jelly (or other similar product), and insert very gently into the anus (it's the one that should "wink" at you when you touch it, and it's closer to the tail than the genital opening).  DO NOT insert more than about a centimeter, and then gently express the liquid into the rectum.  If you feel any resistance, don't force it.  Just gently reposition the tip until the liquid flows in easily.

Hold bunny on his back for a few minutes, and even rock him a bit so the liquid starts moving.

You will be amazed that in a few minutes after the enema, a completely silent gut will begin burbling away.  You can repeat this in a few hours, as necessary.

I hope this helps get your little guy through the night until you can see the vet in the morning.

Dana