rabbit w/ similar symptoms to cavy that just died

Question
QUESTION: Hi Dana, I hope you might have some ideas on this because my vet isn't having much luck. We just lost our guinea pig and are worried that this may be related. Both the guinea pig (Mo) and the bun (Aero) have been recieving antibiotics but nothing seems to work.

Aero is a Holland lop & is almost four. His medical history isn't great: many respiratory infections over the last 3 1/2 yrs. (altho Baytril always worked in the past) and tested positive for e. cuniculi and had neurological problems at the time (seizures). Treated for e. cuniculi (can't be more specific, don't quite remember what the vet did) and seemed to recover although has various odd behaviors that we assume are either the result of inbreeding (I'd never get another "fancy" breed again, he is so much less healthy than our plain ol' grey, stand-up-ears, 10-year-old bunny) or because of neurological damage from the e. cuniculi.

Now he is sneezing and has wheezy, rattly breathing which doesn't respond to Baytril (3 weeks) and doesn't seem to be clearing with doxycycline (4 days, no improvement whatsoever). He also seems somewhat less coordinated even than usual, although this is hard to judge. He is eating. We're very worried that he has whatever Mo had, because Mo had respiratory symptoms too. He also had Cheyletiella (sp?) mites which we treated a week ago with Revolution.

The vet has suggested testing to see if it's Pasturella or if it's viral. She says either way there will be little to do b/c Baytril is the only treatment for Pasturella, and there aren't treatments for viral problems. Is this correct? What would your next suggestion be, and how long do you think we should try the doxycycline? Do you think it could be somehow related to the e. cuniculi (since he seems weak-legged again)? Are there any other treatments we should try? Sorry this is so long, but I wanted to be thorough about his colorful medical history! Thank you,

Dora & Aero

ANSWER: Dear Dora,

I would recommend a culture and sensitivity test, as the vet suggests:

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

but I do NOT agree with him that Baytril is the only treatment for Pasteurella!  That is completely incorrect.

We have had *excellent* results treating Pasteurella (which may or may not be the pathogen causing Aero's problem; only the C&S will tell that) with injectible Penicillin-G Procaine or bicillin (Pen G with Benzathine).  Because penicillin is so infrequently used on rabbits, many of their pathogens are still sensitive to it.  Many a dog/cat vet will pooh-pooh the idea of using penicillin (Pen G injectible ONLY--no other safe penicillins for rabbits!), and this is a pity.  It really can save lives.

But even if the vet is unwilling to try Pen G, then there are other fluoroquinolones to which Aero's bacteria might not be resistant:  difloxacin (Dicural), and Zeniquin (marbofloxacin) to name only two.  We dose either at 20mg/kg for five loading doses (one every 24 hours) and then back down to 15mg/kg once a day for *at least* two weeks, and preferably three in the case of respiratory infections (which tend to recur if not treated for sufficient duration).

If this were my rabbit, I would seek the opinion of another rabbit-savvy vet:

www.rabbit.org/vets

since it sounds from your description as if your current vet may not be keeping up with rabbit medcine, and this is doing Aero no favors.

I hope this helps.

Dana

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

QUESTION: Thank you so very much for your input! I hate to take more of your time, but I just have one other question (I'd love to find a more rabbit-savvy vet, but we are in an isolated area-no listings anywhere near us on the rabbit.org list - I've checked!)...

I read your article on c & s tests, and I had asked the vet if we could do that, because what she wants is to do is a blood test. I was hoping to avoid drawing blood (to minimize stress on Aero), but when I asked the vet about it she said a culture wasn't a good option because of it being a respiratory infection--she said that there are too many other bacteria present in the nasal passages to do a very accurate culture. I think she also wants to do a blood test mostly to rule out an underlying problem such as kidney or liver. Would you suggest that we can test via culture, despite her argument against it?

Answer
Dear Dora,

What the vet wants to do is a blood titer for Pasteurella, and I'm not a huge fan of titers.  All they tell you is whether a rabbit has ever been exposed (antibodies to the bacterium will be present in the blood, if so), but not whether there is an active infection.

I agree that there are potential bacterial contaminants in the nose, but if you *carefully swab* the outside of the nose with chlorhexiderm flush and allow it to dry, then do a very careful sampling to touch *only* the mucosa inside the nose, you'll still get what I consider a better idea of what's up there than with a blood titer.  In most cases, you'll get *heavy* growth of whatever pathogen is causing the problem.

Nasal cultures are not as perfect as cultures from, say, the capsule of an abscess.  But I still think they are more informative than a blood titer.

That said, it's not a bad idea to have complete blood chemistry and blood cell count values for the bunny, as this can give a more accurate picture of overall health.  Taking blood need not be terribly stressful, especially if the vet is able to get it from the lateral saphenous vein running along the outside of the rear leg--which is our vein of preference.

This is something you'll have to decide.  But I would not rule out a C&S test.  If it is done in a very clean manner, it can still be informative.

But if the vet is adamant, and the Baytril is not working, then I would ask to switch to a "bigger gun," such as Zeniquin.

Dana