Ear infection follow-up

Question
QUESTION: Hi Dana! Last week, I noticed my rabbit scratching and shaking his ears every now and then. I got worried it might be ear mites so I took him to the vet three days ago. His vet took a sample but there were no mites found. Instead, he found out he has an inner ear infection. Because it was too deep, he wasn't able to get a sample but he gave him a shot of Enrofloxacin, cleaned his ears and then squirted an ointment called Oribiotic into his affected (left) ear. He gave me the ointment and asked me to apply it twice a day for one week.

I don't know if it was the ointment or Baytril (it's his first time to get such) but my rabbit has changed so much. I'll try to describe what happened in bullet form to make it clearer for you.

Days before vet visit:
* Very active and has good appetite
* Likes pellets and greens more than hay but eats hay too
* Always in a flopped or stretched out position when resting
* Doing binkies and playing with his toys
* Scratching and shaking ears sometimes (like 5 - 10 times during daytime)
* No sign of ear infection or any sickness aside from the scratching and shaking
* No head tilt

Vet visit day (after the treatment)
* Both ears flopped to the back and not active in observing
* Shaking ears so much
* Always in a hunched/defensive position when resting
* Eyes round and wide, looking really scared
* Sitting with a blank stare
* Ignoring favorite treat and pellets but eating hay and greens
* Losing balance when shaking body
* Moving very slowly but prefers not to move at all
* Making breathing or teeth chattering sounds when resting (not very loud but louder than purring type)
* Ignoring toys

Day after vet visit
* Right ear moving and observing
* Left affected ear flopped to the back and not moving
* Shaking ears A LOT
* Eating A LOT of hay always
* Eating greens and fresh fruit
* Not eating pellets
* Exploring but in a slow pace
* Grooming
* Sometimes flopping to his side when resting but most of the time hunched or sphinx position
* Still making the breathing / teeth chattering sounds but very quietly
* Still sitting with a blank stare


2 days after vet visit
* Same as the day before except he is eating pellets now and moving in a faster pace
* Seemingly more active

3 days after vet visit (this morning)
* Right ear is still the active ear, left ear still not moving
* Shaking ears a lot still, sometimes scratching
* Eating his proper diet with near normal appetite (but more hay and less pellets than before)
* Active and exploring with normal pace (but no binkies or running yet)
* Grooming
* Flopping when resting (looking really relaxed with head on the floor too), but still sitting with blank stare sometimes


I want to ask the following:

1. Is my rabbit's behavior change normal reaction to the ear infection treatment? Will his left ear move again like before?

I am confused so much because he seemed so healthy and active before the treatment. I am scared about how he isn't moving his left ear.

2. Should I use the Oribiotic ointment as his vet advised?

I have never encountered Oribiotic in my rabbit care readings so I was really hesitant to use it. I did a little research and found out it is for cats and dogs. Because of this, I have yet to give it to him. I decided to wait for your opinion before putting it.

3. If it is not the correct treatment, what is the correct treatment for rabbits with ear infection?

4. How can I make my rabbit's discomfort less?

It's really so painful seeing him like this. I cannot go to the animal hospital until Monday as they are closed due to holidays. I really hope you can help me and my bun again. I'm so sorry about this being so long. Thank you so much for your time. Thank you so much!!! <3

ANSWER: Dear Yumi,

I wasn't with you at the vet to see what happened, but it's possible that the vet was too rough in sampling the ear, and may even have pushed matter too deep into the ear canal.  If what you describe is accurate, I would NOT go back to that vet.  One shot of antibiotic is not only ineffective, but it's asking for trouble:  it could promote the selection of resistance in your bacterial population.

Please go here to find a rabbit-savvy vet:

www.rabbit.org/vets

and get bun there ASAP.  She may need an ear flush to clear the canals, and that must be done with care by someone who really knows what to do.  The Oribiotic won't hurt, but is not likely to cure a deep ear infection.  Systemic antibiotics might be necessary.

Your bunny may also need pain medication such as metacam and/or tramadol, and the vet can advise you about that.  In the meantime, try warm compresses against the base of the ear to try and soften any wax or buildup that might be in there. This might make it easier for bun to get it out on his own.  But get bun to a different vet ASAP.

Dana




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

QUESTION: Thank you Dana for your immediate reply. I live in Asia and the vet I went to is already considered as the best in my area (I think even in my entire country). He is highly experienced with rabbits and many other exotic pets which is why my family is wondering why I am doubting the treatment. It's embarrassing to say this, but it's really the only animal hospital I can go to. The rest are just small clinics x pet shops that cater to dogs and cats and are inexperienced with rabbits.

It did seem like the sampling and cleaning was not done very gently. My rabbit jerked once and looked very distressed the entire time. It seemed so painful! I was just trusting the vet thinking how experienced he is so I thought it was normal.

I will go see him next week and ask that what you suggest (ear flushing) be done. What systemic antibiotic should he be on?

The vet also saw mild molar spurs and suggested we do the filing next week. Is that safe (seeing how my rabbit is now)? I guess he was thinking that my rabbit's ear infection would be better in a week. It's our first time to do the surgery too so I don't know if it's a simple surgery or not. He did say that he will be put under light anesthesia. Will it be fine? My rabbit is over a year old and eats well (though his eating and drinking habits change every now and then). He is very active today but still shaking his ears and not using his left affected ear.

I'll start the warm compresses now. I'm so sorry for asking too many questions and thank you so much for your time! My rabbit and I really appreciate it so much! Thank you for helping us and everyone else, Dana. <3

Answer
Dear Yumi,

It's good that you have an experienced rabbit vet.  If your bunny requires systemic antibiotics for this problem, the right one will depend on the species and strain of bacteria causing the problem.  Please see:

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

You and your vet will have to decide whether bun is ready for a molar filing, depending on how he's feeling by then.  I hope he will be completely well soon.

Take care,

Dana