chronic nasal pseudomonas

Question
I work in rabbit rescue and adopted what appears to be an older 4-5 lb
rabbit, white with blue eyes, no definite breed, had him neutered.  He was
emaciated when we got him and has a very healthy appetite.  Unfortunately
for over a year he has had chronic pseudomonas in his nasal passages.  I
never really see drainage but when I pick him up or startle him he makes a
snotty snort.  This goes away when he is on antibiotics and for a short time
afterward but it always comes back. I get advice from our House rabbit group
and from a local rabbit vet.  He has been treated with cipro, levaquin and
zithromax, in that order.  Two nasal cultures have been positive for
pseudomonas.  Do you have experience with long term antibiotics for this?
Perhaps Baytril- or someone had suggested Orbax? Thanks!

Answer
Dear Sherry,

Pseudomonas is an opportunistic pathogen.  That means its primary mode of living isn't inside a host, but it will take up residence and grow there if the immune system doesn't object too strongly.  And unfortunately, that's what's going on with bunnies who have chronic Pseudomonas.

Often, there's an anatomical reason:  a foreign object up the nose, a tooth root intruding into the nasal cavity, or just plain immunosuppression from some other source (molar spurs?  other health problem?)

Giving the bunny antibiotics will usually keep the snot at bay, but it will almost never completely kill off a population of bacteria as tenacious as Pseudomonas.  Those little bugs are everywhere, from soil to your kitchen sponge.  And even if bun clears the ones in his nose, he will be constantly exposed.  It is only by boosting his immune response that you might hope to make headway here, since several bouts of powerful antibiotics don't seem to be making much difference.

If he's really snotty and you're desperate, you could try *combining* something like zeniquin with amikacin for a real one-two punch that can make a very big difference.  This is the ONLY way we finally beat pneumonia in two of our jackrabbits with Pseudomonas.  But you always do risk recurrence if the problem is just a bunny with a less-than-optimum immune response.

If this were my bunny, I'd get him off the abios and not use them unless his symptoms get really bad.  Give his immune system a chance to fight the bugs, and maybe boost with a bit of echniacea extract (7 days on, 7 days off).

If his symptoms *are* bad, then you have little choice but to keep him on antibiotics, if they help.  But you always run the risk of breeding resistant strains of bacteria that won't respond to the abio you're using, and then you'll have to keep switching.

I hope it doesn't come to that.

And I hope this helps a bit.

Dana