Upper Respiratory Tract Infection?

Question
I have a 9 year old mini-rex who was in excellent health until about 3 weeks ago when she started experiencing signs of either an Upper Respiratory Tract Infection (URTI) or a dental problem. She had a full dental exam and x-rays under sedation which showed no dental issues so we began treating it as an URTI with oral Baytril twice per day. The symptoms have gradually gotten worse from sniffles to white nasal discharge, sneezing, coughing and inability to eat without choking and gagging. The vet worries that it is pasteurella but she has never had any eye discharge and her lungs are clear. We have not obtained a culture and sensitivity on the nasal discharge because the vet feels the procedure is too invasive and that the results will be inconclusive due to high rate of contamination. She has been on oral Baytril twice per day for three weeks with no signs of improvement. I am also nedulizing her twice per day with .25cc mucomyst, .5cc amminophylline, 1cc Baytril and normal saline. The nebulizaton helps to clear the congestion and then she can eat a little which is good. However, she is loosing weight and has so much trouble breathing that I am desperate for help. She is a house rabbit but before getting sick she spent time every day playing outside in the back yard and does not have contact with other rabbits. Could we be missing something in the diagnosis and/or treatment?

Thank you for any advice you may have, Julie

Answer
Dear Julie,

Even though there is a good chance of contamination in taking a nasal snot sample, I think with overgrowth this severe you need to take action and have that C&S test done.  It could be Pasteurella, or it could be something else.  Only a culture will really help you know.  And Pasteurella isn't as big a deal as many people seem to think.  It's certainly treatable.

Despite any obvious, external signs of dental problems, the signs you describe suggest to me that your bunny may have a molar root abscess or even a tooth root protruding into the sinus cavity.  Endoscopic exam and head radiographs will help elucidate what might be going on in her skull with respect to her tooth roots.

When we nebulize, we use amikacin, which is very effective when used along with a fluoroquinolone, such as Baytril.  Unfortuantely, we've also found that more and more bacteria are resistant to Baytril, so we've been switching to Zeniquin (marbofloxacin) or Dicural (difloxacin) with good results.  These are longer-acting fluoroquinolones that are given only once a day (same dose as Baytril).

It may also help to get a pediatric ear syringe like this:

http://www.imed.com/shop/detail.cfm?sku=K3092&rfr=FRG&zmam=1000941&zmas=21&zmac=...

(available at any local pharmacy/drug store) and gently suction the snot out of her nose with it.  You'd be *amazed* at the relief this provides!  Have a bowl of water nearby, and rinse the bulb with the water between syringes so you can see what comes out.  (gross! but helpful)

Once the nose is clear, you may be able to give her additional relief with pediatric Benadryl nose drops, which will help shrink inflammation in the mucous membranes.  Ask your vet about this, and don't try anything without running it by your vet first.

I hope this helps.

Dana