Yeast Infection of the Ear?

Question
QUESTION: My bunny came to me from a rather stressful situation with a pretty severe inner-ear infection caused by an overpopulation of staph. (Yes, it was cultured and I had a sensativity test done on it.) After 6 and a half weeks on oral Baytril twice daily, she seemed to have improved quite a lot, but not completely. So I took her back to the vet.

Turns out, we'd successfully eliminated the staph -no redness or signs of it under the microscope. (As opposed to being horribly red and pus-filled at first.) However, the elimination of the staph gave way for yeast to take over. What I'm told now is that she has a yeast infection.

They gave me some eardrops -Tresaderm- to give to her twice daily for a week. However, I'm concerned. First of all, I can't seem to find much information on ear yeast infections at all in the first place, and I've only seen Tresaderm mentioned casually once or twice. The main ingrediant I'm worried about in it is the corticosteriod Dexamethazone.

Now, it's obvious that I can't let her ingest it, but my main worry is whether or not it's safe to use in the ear. And also, will it even work? What is your experience with yeast in the ear?

I've also read about cases where they've previously used an antibiotic that cleared away too much of a certain bacteria in which they've used certain OTC medicines to boost the presence of the said bacteria to balance out the yeast. But my problem, of course, is that she had an ear infection due to having too much staph in the FIRST place, and I don't want to provide it with another opportunity.

So mainly, three questions:
-Is the Tresaderm I was given safe to use in her ears/ will it work?

-Would it be better to give her a medicine that would boost the presence of naturally-occuring bacteria like staph to counteract the yeast despite the fact that it was staph that caused the problem in the first place?

-Would it be a better option to just leave it alone and let the bacteria replenish on their own to a healthy level at which they will kill the yeast?

Thanks in advance!

ANSWER: Hi Sarah,

First, I am impressed by both you and your vet...props to both of you.  It is nice to hear good questions from a very well informed rabbit slave that has done the right things already.

Ear infections are one of my "things".  I do some very different treatments on ear infections....outside the box of what vets do. I do rescue "special needs" and they tend to be much sicker than what doctors normally see. I have some very effective protocols.  I would say that your vet has followed proper protocols based on your comments.  I don't use Baytril here for any front line treatment....and there is a reason for that.  Baytril has been very overused and misused over the years.  I have found that with serious infections, such as this rabbit's vestibular issue obviously has been, that the bacteria will become resistant after one or two rounds of Baytril.  Since ear infections are something that tend to visit regularly once they start, the Baytril may not work in the future.  I have had success in treating staph a sulfa drug.

Lops, particularly Holland Lops, are very prone to yeast infections in the ears especially with a bacterial infection and the long term use of antibiotics.  The ear canals are quite small and between the heat from a fever coupled with the use of antibiotics and low air flow will provide breeding ground for yeast.  Tresaderm is an excellent ear drop to use (and it's also effective against ear mites too).  You are very correct in being concerned about the steroidal component of this drug.  With any medical treatment in which drugs are used....there is always a trade off.  That trade off is having to make a decision of if the benefits of a drug outweigh the risks.  In this situation, I think your vet has made an excellent choice.  Tresaderm is a powerful and effective drug. It should be refrigerated and warmed slightly before using.  In this case, I would think the small negative regarding the steroid is outweighed by the huge benefit of this drug.

I don't really know of any OTC products that can stabilize the bacteria.  There are numerous holistic treatments that make certain claims.  While I have no problem with some of the holistic/herbal treatments, some of the things you can buy OTC may interfere with the way the antibiotics work.  I prefer not to take that risk since an ear infection is so close to the brain.  I just took in a beautiful lionhead that has suffered just that fate...she has some rather interesting neurological deficiencies due to an ear infection that was treated too conservatively.  I would stick strictly to the protocols prescribed by your doctor.  Sounds like a very rabbit savvy doctor.  While I do use other drugs for this concern, the treatment protocols your vet is using is the standard treatment method.

Randy

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

QUESTION: (Sorry I posted this in my thank you message spot. >< I'm new to this site and have yet to figure it out..hehe. Erm, I also added some more info to this follow up question here.)

Thank you so much for your insight! It's made me feel a lot better about where I'm going with her. Just out of curiosity though, what exactly -would- the negative  side effects of this drug be if they were to arise? And would they be based on overdose, etc or just an inherent reaction in the genes?

Anyway, I suppose we'll be starting her on Tresaderm tomorrow. I suppose I should mention that she's only about 8  or 9 weeks old right now. We estimate her birth to be late December.

Hehe...and as for my vet being rabbit-savvy, I'm a feel a bit awkward in saying that I've more or less made them that way. They are slowly BECOMING more rabbit-savvy since my bunnies have been clients there. =)

Aw, my sweet baby. She has the sweetest disposition -I definitely want to do everything within my power to prevent her from having serious long-term problems. She is some odd lionhead/ dwarf mix I believe. Weened far too early -she was probably only 2-3 weeks old when she came to us. (She was originally to be a foster, but..you know how that goes.)

Would you mind if I kept you as a contact? You seem VERY knowledgeable in bunnies. My email address is bipolarartist@yahoo.com

Oh! And one more question. I think I know the answer, but just to be sure -is this sort of thing contagious? I have another 4 year old, healthy bunny as well. The two are in seperate rooms right now until we can have the baby's issues taken proper care of and have her spayed.

Answer
There is only one negative of using this Tresaderm.  That is the steroid.  A steroid suppresses the immune system.  In a rabbit with such a fragile immune system and the constant threat of pasteurella and E Cuniculi looming all the time, it's really not a good idea to do anything to bring down the immune system.  But as I mentioned, medical treatments are always a trade off....do the benefits outweigh the risks.  And there are risks in any medical treatment on any species.  I do use steroids quite a bit with wildlife particularly with head or spinal trauma.  The use of steroids for this is a very hot topic in the veterinary circles.  But nobody can argue the effectiveness of preventing the body's immune system from attacking itself during a major crisis.  There have also been times when I have used all out steroids in certain conditions with rabbits....particularly with E Cuniculi issues.  But I always support the immune system by giving a broad spectrum antibiotic.

I fully understand about "training" vets.  I am fortunate to live near a major vet school.  My primary vet is a teaching professor there.  A huge benefit.  It's a thrill for me to be called in by a vet and have the doctor work as "my tech" in their practice.  It's actually quite an honor to work side by side with these talented doctors.  And I understand the "foster" part of that too....do I see a full fledged rescue coming here?  That is what happened here.

Contagious?  Depends on exactly what the pathogen is.  That is hard to call but I would say it most likely is contagious.

Randy