molar spurs vs respritory infection

Question
QUESTION: My 6yr old minirex starts sneezing (a bunch) I immediately check rabbit.org and plan a visit to my vet after reading about white discharge being a concern and that the simple sneezing can be nothing to worry about.

My vet explains this could be a physical irritation, allergy, or, of course, pasteurella. I decided to do as she suggested, wait & watch, and not to put her on any meds until necessary (Im aware of stress(physical, in the case of meds) being an activation of all things.. yucky.)

So, a month goes by and Im wiping her nose relatively often (its clearly coming from one nostril, btw) and she just stops sneezing one day. Well the occasional, but no discharge. A few more months go by and I noticed a strange reaction in her left(same as nostril) side of her face, lip smacking, and some pawing. The eye and the ear seem to be dropped and she is showing some discomfort.

Back to the vet....during the interim I soon noticed her left eye also appeared to have some redness. Now Im thinking could this be dental?

temp good..weight good..diet good. bathroom habits good (I did notice she peed on my bed a few times..NOT normal for her)But mostly all things being equal she seems good.

An exam of the teeth was conducted and she saw small molar spurs, then explained that the roots could be effecting the eye duct. She then could determine if the eye duct was flowing but explained that the treatment (of terramycin) would be needed for this as well as for some other concerns.

Let's skip the eye probe!!

Now we are in treatment and I still see this pulling back of the face and pawing..especially, when I put out the parsley, it seems as though the act of smelling is traumatic? However, the eye redness is starting to go away.

My question to you is: Does this sound like molar or respiratory or a combo...(the molar effecting the entire area)..OR a viral/bacterial illness in need of antibiotics? Why would the treatment stop a tooth from effecting the eye? And finally, how can I get those molar roots to stop bugging her if this is indeed the problem?

ANSWER: Dear Carina,

This definitely sounds like a problem with the molar roots contributing to an upper respiratory infection.

I'm not sure why the vet is so certain that the proper treatment will be terramycin without doing a culture and sensitivity test, though.  The bacteria causing an abscess (which is possible, given that the eye is getting swollen, too) may not be Pasteurella, and they may not be sensitive to terramycin!  The only way to know for sure is with a culture and sensitivity test:

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

Please also read this:

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

And you might just want to find another rabbit-savvy vet for a second opinion:

www.rabbit.org/vets

and maybe a more thorough molar exam and filing of spurs.  

I hope this helps.

Dana

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QUESTION: Dana, Thank you for your reply. My vet is a recomended vet from rabbit.org.
I brought my doe back to her after 3 days of the terramycin feeling that there was definitely more to this..her eye was seen to be not blinking now and there seems to be more swelling. We are now taking baytril and Im lubing her eye to ensure no drying.
My vet suggested we do this for 3 days (we also did an xray, not seeing anything without a more thorough xray was what I was told)
I am to watch for any improvement and if none to return for the beginning of injectable penicillin.

Her appetite is good and she hasnt had any weight loss. I have shifted the ratio in her diet to less pellets and more hay to increase the grinding down of molars.

I am so sad. I have had such determination to be on the lookout for ANY disturbances during her life in order to get early treatment, knowing how these illnesses move so quickly.

Any thoughts on blinking, injectable penicillin, and/or baytril responsive signs to lookout for?

All the Best,
Carina

ANSWER: Dear Carina,

I'm glad you have a good vet who's on top of the problem.  This does sound like a developing retrobulbar abscess, and antibiotics are probably going to be the way to go.

If there is no pus to culture (i.e., the abscess is encapsulated), then all anyone can do is "best guess" antibiotics that will kill the bacteria causing it, since a culture and sensitivity test can't be done:

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

We have had good success treating retrobulbar abscesses with injectible bicillin (Pen-G Procaine plus benzathine; not available in the UK, if that's where you are), as well as with a cousin of Baytril, *Zeniquin* (marbofloxacin).  This fluoroquinolone is given once a day, and appears to have very good abscess penetration.  It often works when Baytril doesn't, so you might want to ask about a combination of penicillin and zeniquin, which has worked very well for us.

The only sign to look for is reduction of the swelling of the eye at this point.  But it can take time, so hang in there.

I hope she'll be well soon!

Dana

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

QUESTION: Dana, For the sake of anyone else's searching for answers, I wanted to post again another follow up.
Having had a 2nd opinion, where we stand now is yes, determining the retrobular abscess(by ultrasound methods) and a case of glaucoma the dryness of the eye from blinking being arrested has caused extremely painful cornial ulcers on the eye itself(my poor dear) I have now had it explained to me that in no way should this have been seen as conjuctivitis, as the under lid shows no sign of redness just the upper. The pain issue is heartbreaking for me to not have known the signs of real pain in a bun. The drooling was a sign of this.

Im told the glaucoma is in albeit uncomfortable but early stage and we have a good chance of saving the eye, glaucoma drops are being administered until an ultrasound can be performed, weds, its labor day for crying out loud!!If it is determined that there is indeed an abscess behind the eye I think the removal of the eye and cleaning out the infected yuck might be our path.

Perhaps I should try the bicillin? I will speak to my vet again about this once we know conclusively where we stand.

As for now thanks for your interest and help...SO glad to know you guys are here!!

Carina  

Answer
Dear Carina,

Wow, you and your bunny are really being put through the wringer by this problem!  :(

Our Maggie had a retrobulbar abscess that occurred before the days of bicillin, and she did have the eye enucleated.  Unfortunately, the abscess was fingered all the way back into her sinuses.  Our vet tried a very aggressive procedure, packing the eye socket with wet 50% dextrose dressings, and changing the dressing (and debriding the socket) twice a day under anesthesia!  It was wrenching!
But after a week of this drastic treament, the abscess began to resolve, and Maggie was able to go on with just antibiotics.  

This happened when Maggie was about seven years old, and she lived to be nearly 14...so it did turn out to be worth it in the end.

I would ask about the bicillin and zeniquin, just to see if the vet thinks this might be worth a try.  Tramadol has proven *great* for pain relief in our bunnies with severe pain, especially when combined with an NSAID (metacam if the pain isn't too bad; Banamine for the really heavy stuff).

Also, though most rabbits have atropinase (an enzyme that breaks down atropine), not all have it at high levels.  We have found that atropine drops can really relieve the pain caused by muscle cramps inside the eye in response to corneal or other damage.  It may need to be administered more often than with other species, but it *does* work for a while.

I hope your little gal will be on the mend soon!

Dana