Rabbit with head tilt and seizures

Question
QUESTION: Dear Dana
i have a rabbit with tilt head, the veterinary diagnosed it with otitis media an i begin treatening it with oral cloranphenicol one week ago, but now my pet dont like it i changed to enrofloxacine 2 days ago. An study I made in a lab detected some Klebsiella sp. in their oral fluids (nose). The problem is getting worse is that from time to time it jumps and do a 360 drawing on the air and after it, my pet puts like a fetus and begins to tremble. I think is like a seizure. Any suggest how to deal with it? with the infection and the seizures?

ANSWER: Dear Julio,

Please read these two articles for more complete information on the condition your bunny is suffering, and for treatment possibilities:

www.rabbit.org/health/tilt.html

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

Ear infections are difficult, and may require antibiotics that have better abscess penetration than enrofloxacin.  Please ask the vet about the culture and sensitivity test:

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

and whether bicillin is a viable option. This can give excellent results, if the bacteria are sensitive to it.  Combined with a powerful, long-acting fluoroquinolone such as zeniquin (marbofloxacin), it can make a huge difference, if the meds now being used are not working well.

If you're not sure your present vet is experienced enough with rabbits, find another one for a second opinion here:

www.rabbit.org/vets

I hope this helps.

Dana

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

QUESTION: Dear Dana,
thanks for your response,i have read your links, and all the symptoms match with an inner middle-ear infection (HEAD TILT, LOSS OF  BALANCE)

I think enrofloxacin is doing its job because my pet doesn't get worse, but it is still with head tilt. Yesterday night I have not seen any seizure or epilepsy like than the day before.

I have read about bicillin, a rabbit-safe combination of injectable Penicillin-G Procaine and Benzathine, that drug isn't known here (in Lima-Peru) buy my vet asked about the percentages of that combination.
I have some doubts:
Do you recommend cleaning its ear? I have bought a liquid for cleaning its ears with a cotton tipped swab wetted with that liquid every other day. What's the best way of cleaning it? my vet said I should place a drop into each ear, just clean the ears (outside).

My rabbit refused chloranphenicol, my vet suspect about damage to liver and that the reason of the
refuse. Or maybe of the flavor??

What doses do you recommend about taking enrofloxacin

Blanch (my rabbit) is taking half of a 50mg pill each 8 hours intervals. I have bought yesterday in suspension of 20% of enrofloxacin, but still don't know the equivalent of  how much my pet should take.

And about the culture Klebsiella was the result... (taken from nose drops) although we think it's rare that Klebsiella produce that symptoms, my vet suspected previously from pasteurella.

About sensitivity test of that bacteria, is sensible to enrofloxacin and other antibiotics.  Not sensible to penicillin.
Many thanks.


ANSWER: Dear Julio,

I'm glad your buny is slowing getting better!

Ear cleaning:  VERY carefully.  If you can get Zymox, it will help a LOT:

http://www.heartlandvetsupply.com/cart/product_info.php?products_id=338

You can probably order it to be shipped to you, since it does not require a prescription, but ask your vet.  It has apparently produced fantastic results for people I know who have used it, but I have not yet had the opportunity to try it.

Chloramphenicol tastes horrible, and few rabbits will take it readily.  If you can suspend it in a dilute solution of molasses, that helps mask the taste.  But given orally, it can upset the tummy.

We use 20mg/kg enrofloxacin twice a day. But ask the vet about zeniquin (marbofloxacin), which is given at the same dose only once a day.  It has very good abscess penetration.

Klebsiella isn't all that uncommon in rabbits.  We have cultured that, too.  Don't bother with the bicillin or penicillin if the culture said that won't help.  But do ask about the zeniquin, and possibly combining it with amikacin injections and subQ fluids for 14 days.

I hope Blanch continues to improve!

Dana


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

QUESTION: Dear Dana,

thank your for your guide, my rabbit is getting a little better, here in Peru most of the medicine you mention are not well known or doesn't exist. I continue injecting blanch with subcutaneous enrofloxacin (Baytril 5%) (I use 20mg /day injection, thats the doses recommended by my vet because more medicine could stress the animal and affect the digestive system) blanch's weight is 1.7kg , it seems better but continue with a little head tilt... my vet said it could last for a month...
Im worried also for its defecation is not as solid as it used to be before the illness, sometimes is smelly and uncomfortable like the cecal dysbiosis description. What should i do for that? My vet said something about probiotic yogurt should help. Anything else recommended?

Many thanks.

Julio.

Answer
Dear Julio,

More effective than yogurt for the mushy poop would be pain relief.  Please ask the vet about getting your bunny some metacam and tramadol, since it may well be the stress of treatment and the pain of the infection that are causing the slowing of the GI tract and the soft stool.  Please read:

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

For a safe way to keep him clean, please read:

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

I hope he continues to improve!

Dana