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Willys eyes weeping-had tear duct flush...

22 10:49:23

Question
Medical diagnosis by vet:  Epiphora - bilateral plugged tear duct., Not clouded and only slight swelling around eyelids. Tear duct flushes, are they safe and or commonplace for the treatment care of Epiphora.
Allergies., could this be an explanation?  If so, how do vets find this out, is a blood titer taken to find out?  The vet recommends Willy bunny to have this procedure every 3-6 months.  Is this safe and necessary?  New vet for us, our regular of over 15 years experience in caring and treating bunnies,Is there a way I can verify this? The vet stated Willy could have this condition for life? It is a condition, not a virus or infection, right?  I asked the vet this, about possible antibiotics orally., Because I read this is the first things vets with his experience usually recommend. Vet stating sensitivity to the intestinal flora is the reason for not prescribing.  I said could a bacterial infection cause this condition?  No he said and I discovered no culture was taken., I flush his eyes with a safe solution to remove any possible foreign matter, under both yes material has cause hair to bunch up and get hard, daily care will hopefully fix this., Daily care routine., Given pre and post flush by vet, eye wash, following flush using the neo-poly-dex 1-2 drops 2 x daily in each eye and neobacimyx ointment around eyes to aid in preventing tear scalding., He has developed wicking under each eye, with daily care trying soften and loosen up.  Is there another way to loosen up this material around his delicate eye area in addition to the treatment he is receiving daily?  Would you have recommended another source of treatment {presented with mild tearing in March., went to a vet of whom he indicated he had experience in treating bunnies, I come to find out he has only treated a few in his many years as a vet, unfortunately 1st vet was inexperienced in treating bunnies., 2nd vet with 15 years experience gave Willys initial exam & post exam shows a healthy and sound body., teeth and dental check shows normal., normal as well as bone structure around head, jaws, was no need for trimming his teeth., His diagnosis was Epiphora plugged tear ducts, recommended tear duct flush using 33 gauge to flush.  He had his lower belly shaved a little and under his legs. Little home consists of an area with a 3' high dog fence, as those in dog shows, has a tiny desk fan 4-6" around and 4-6" ht, and tall fan circulating the air in the kitchen and Hepa air cleaners in each room of the house. His home in an open top 6'long by 4' wide area, has rubber mats completely covering the floor with place mats put under food, mats wiped every other day due to food, and or water spilled, all rubber mats and place mats are safe for use in and all around pet area., area swept daily to pick up accidental feaces pulled out of litter box as he jumps out.,litter box is 18" x15" about and 7" deep, litter box taken out and cleaned 1 time weekly., non-tip plastic food and water bowls changed every other day and 3 little plastic stools 9" high to jump as to encourage jumping and excercise, and a small recreational plastic dome house, similar to the dogloo house., though top of this dome is flat, sleeping quarters & inside and on top little hiding place inside for privacy and sleeping.,  18"ht, 18" around. The cushion attached on the top has velcro under the cushion to keep in place with a slight lip on top so the bed will stay safe and secure.  I use only safe cleaning products in his area on while cleaning is cotton/soft denim bedding:  Eating habits: went from a piece of fresh banana to 1 freeze organic freeze dried banana chip am & pm coinciding with daily flush, drops and ointment -  1/2 tim-1/2 alfalfa to 2/3 timothy hay, 1/3 alfalfa hay, a mixture of rabbit pellets {Kaytee} , now plain pellets just sifted out all material instead of putting him on a new pellet 1/8th cup daily, amount of pellets consumed remains the same, fresh wheat grass from the grocers produce section 1 x wkly. He takes about 3 days to nibble it away, occasional meadow grass, as well as 1/4 cup shredded carrots am &pm., timothy and alfalfa hard squares to chew as well as fruitwood twigs , and mineral wheel., litterbox material is newspaper., Normal weight 5lbs.9oz male holland lop 1 year of age., his bathroom habits with the white stuff has nearly discontinued due to the vet recommended changed diet. We found him in our side yard eating grass Sept 1 2006, he was 3-6 months of age thin, a bit malnourished and no energy, post 3 months later a new bun-bun., Willy continues to put on weight nicely and a regular basis.,has reached normal weight, @ has soft healthy fur and skin all over body.,We are new as companions to our little bun-bun., Willy checked out by vet post 1 wk. tear duct flush both eyes, both still weeping around the same rate., only right eye minimally improved. Vet did a simple test to diagnose Epiphora by placing this yellow solution in his eyes to see if it drains well out of his nose, Nothing dripping out of nose on initial exam, using the yellow drops, turning off light and using a black light and using an instrument for examing eyes checking for amount of liquid draining pre duct flush., Nothing dripping out of nose., Post flush minimal improvement rt eye., left eye unchanged, Why is his condition not improved? Procedure was successful as the vet indicated., I am near UC Davis Vet hospital., should I seek 2nd opinion., or is this commonplace post tear duct flush., Could other health problems be causing this condition & can new health concerns spur from this condition in the future? Should he have undergone a blood chem. panel and CBC first prior to flush to rule out infection in body? Shouldn't a culture had been done to rule this out as well? What & how would you have treated this condition? I do hope I gave a pretty good picture of Willys situation.  Is it common for bunnies to have this and will it or can it pose any future discomfort and or health concerns, I hope I gave a proper indication as to what is going on with Willys health, hygiene, environment and daily care.  We are anxiously awaiting to hear your expert reply., any info. I learn ., the better it will be for Willys health and happiness., his happiness is our happiness of course., we feel priviledged to have been found by this little Cadbury bunny, he is near cinnamon brown with black tipping on fur over entire body with a little black muzzle, un-neutered.  Advice will be graciously received and appreciated.  Thank you so much.
Willy & I await responses.

Answer
Dear Kathy,

Wow, that's a long description!  (If you need to ask a follow-up question, please be so kind as to write in shorter paragraphs in which I can more easily find the main questions you need answered.)

The problem you describe is very common in lops, and particularly in Holland Lops with their very short faces.  The condition is very often caused by congenital malformation of the bony tear ducts that travel just above the molar roots from the corner of the eye to the internal nares (nostrils), where tears normally drain.  

In some rabbits with congenitally narrow ducts (such as Holland Lops), only a slight additional problem can cause permanent occlusion/blockage of the ducts.  Such problems can include (1) bacterial infection clogging the narrowed ducts, (2) cellular debris (normal) clogging the ducts, (3) molar root intrusion into the skull (due to osteoporosis, which may come on with age) pinching off the already narrowed ducts.

Any of these cases is a permanent problem, and will need regular treatment.  Unfortunately, this is going to be a chronic problem for your little guy.  We've found that in *some* cases epiphora is improved with systemic antibiotics, but only if the problem is due to molar root infection and/or bacterial overgrowth in the tear ducts.  

The following articles may be of some help to you:

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

and

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

Please also see:

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

The vet hospital at UC Davis is a good one, but unless there is an exotics specialist there, you might be better off checking the list linked here:

www.rabbit.org/vets

for a vet who is very experienced with rabbits.  There are *many* excellent ones in the Bay Area.

I hope this helps.

Dana