House rabbit - recurrent infections, loss of appetite, perforated ear drum

Question
Dear Expert,

I hope you can help!  Our poor little 6 month old dwarf lop, Bob is having recurrent problems with his ears.  
He's had 1 week of canural ear drops (in Feb#, followed by 10 days of Aurizon ear drops #in March#.  Each time we took him in for a follow up, and the vet said his ears looked clear, and to continue with 10 days of ear cleaning drops #called Ottoclean# to remove residual plaques of pus.


4 weeks ago Bob took a turn for the worse.  Our vet started him on 1 month of oral bayril plus the ear cleaning drops.  After a week he was still worsening, and refusing to eat or drink, even treats.  We saw a different vet #ours was on holiday# who said his ears looked absolutely fine, and thought maybe he had gastric trouble caused by all the different antibiotics, and gave him 5 days of pain relief #metacam#.
During this period he also developed an eye infection, so he had 7 days of antibiotic eye cream.

Following the pain medication #and dedicated hourly syringe feeding for 3 days# Bob improved alot.  He gained weight and perked right up.

However, just this week #this is after 3 weeks of baytril# he has stopped eating again, although his is still drinking and taking treats.  His eye infection has come back in both eyes.

We went to the vet #our original vet# this morning, who says there's a strong possibility that his right ear drum has perforated #although she couldn't see it clearly).  She has started him on 3 days of pain medication and a two week course of Aurizon ear drops.  She also said that if this doesn't work, the future doesn't look too bright.

We're so worried about him!  We don't see how his ears can have looked fine two weeks ago, and then 10 days later he has a perforated ear drum.  We've also been told that Bob should have had at least a month of antibiotics for his first infection, and that his current problems have probably been caused by stopping treatment prematurely.  I'm starting to lose a bit of faith in our vet.

I'd be grateful for your advice - are there any tests we should be asking for?  Is one additional week of oral baytril plus two weeks of aurizon drops sufficient, or should we continue the baytril longer?  Is he at risk of head tilt, and is there anything more we could do to prevent this? Is there anything else we can do for him?

Thanks in advance.

Bob's mum.

Answer
Dear Emma,

Poor Bob was born with a malformation of his ears--the lop condition--that predisposes rabbits to chronic infection. He's started a bit earlier than most lops. But this is very common in lop-eared rabbits, and very difficult to treat effectively.

In a case like Bob's, some of our rabbit-savvy vets would recommend a surgical procedure called marsupialization.  It's essentially cutting open the ear canal almost down to the jawline, so that there is more air circulation and less chance for bacteria to build up.

In very severe cases, an ear canal ablation can be done. But this is very drastic, and certainly not to be performed by a vet who is not experienced with this procedure.  

You might want to ask the vets about combining the fluoroquinolone antibiotics with injectable, long-acting Penicillin-G Procaine/Benzathine.  If the bacteria causing the problem are sensitive to this drug, it can be very effective.  But it might be wise to have a culture and sensitivity test done first:

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

We've also had excellent success in treating ear infections with a product called Zymox (**without** cortisone).  I'm sure you can order it online:

http://www.google.com/products?q=zymox+without+hydrocortisone&hl=en&aq=f

We've actually had this stuff cure ear infections *without* antibiotics!  So it might be worth a try.

If your vets are members of any online veterinary listserves--especially those about exotics--they might want to ask other vets about the ear marsupialization procedure.  I hope it doesn't come to an ablation.  That's really nasty.  :(

But I hope some of this will help for now.

Dana