My Rabbit Vet Says She is at a Complete Loss Why Daisy is so Sick

Question
i just got back from my 6th visit to the vet's office, i've been seeing them for 3-4 weeks, now.  my vet is unsure why daisy is still sick after 20 days of baytril and 7 days of penicillin.  she has had x-rays, sonogram, blood tests and a urinalysis.  so far, there is no indication that she has stones, tumors, cancer or other obstructions of any kind.  the original urinalysis showed high levels of blood, calcium crystals and (i think) white blood cells.  there was also a very pungent smell of infection and greenish-grey sludge in her urine.  the blood test showed anemia and low protein.  

today i brought daisy in 2 days after completing the 7 day penicillin shots and the 2 bottles of baytril because she had stopped eating, was listless, was still passing small and irregularly shaped fecal pellets and her eyes suddenly became inflamed with hair loss around the eyes and white mucus seeping from them.  as of today, she is now on penicillin (.4mls daily/10ml bottle), buprenorphine (.25 1-4xs daily), cisapride (1ml 2xs daily), probiocin oral gel (1gram daily), and critical care.  this is the exact same medicine regimen as before minus the baytril.  i, myself, made an error with the penicillin the first time and stopped it at 7 days instead of continuing on for 10 or more days.

my vet is unsure whether she just has an incredibly resistant bladder infection (my words), an infection of the uterus or possibly cancer which was not detected through the tests.  i should also mention that the urine sample she took today showed a lot of sludge and a few small blood clots.  i have been expressing daisy's bladder from the first--with mixed results.  i believe her first symptoms could be a bout of diarrhea she had about a month before she started loosing her bladder on her bed.  that was when i first took her in to see a vet.  daisy may be unfixed--no one is sure, not even the vet.  because she was from the pound, we are also unsure of her age, but we think she is 6 1/2-7 yrs old.  i would so appreciate any help or advice you can provide.  i have read your websites diligently.  thank you, michele.

Answer
Dear Michele,

If Daisy is not spayed, there could well be a uterine problem.  But it's not great to try spaying her while she's suffering from what sounds like a severe infection.  Has a culture and sensitivity test been done on her urine?  This is really vital:

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

If no bacteria can be found, it's possible that there is a nasty anaerobe causing these problems, and some are very resistant to a wide variety of antibiotics.  If you've already tried Baytril and penicillin, I would suggest bringing out the Big Guns:  Amikacin.  This should be administered in subQ fluids to protect the kidneys. But because (1) amikacin is excreted primarily through the kidneys and (2) many bacteria resistant to fluoroquinolones and penicillins are still sensitive to the aminoglycosides, I think this might be a good option to try.  Perhaps combine with zeniquin to achieve maximum clout against resistant bacteria.

But again, if she's not spayed, this might not work.  If she has uterine adenocarcinoma, she needs to be spayed to save her life, though it sounds like she's not the greatest candidate for surgery at this moment.  :(  You're kind of caught between a rock and a hard place.  

You might also want to find another rabbit vet for a second opinion:

www.rabbit.org/vets

I hope this helps.

Dana