middle ear infection / kidney damage

Hi all

Firstly – I just want to say thanks for all the advice you’ve given me over the last few weeks – it’s really been such a comfort during this difficult period.

Secondly – I wonder whether you might be able to give me some more advice / opinions on the below (and apologies if I ramble on):

So in terms of what is wrong with him: he had the e cuniculi parasite which has done irreversible damage to his kidneys. He also has a middle ear infection. When we first took him to our new vet he was very underweight at 1.6kg - the vet pointed out that his teeth were really worn down – almost flat to the gums and that could be a contributing factor to how underweight he was – the vet said his teeth would almost certainly not grow back. A month ago at this first visit (after blood tests) the vet gave him a two week course of septrin antibiotics for the middle ear infection, a steroid injection, a vitamin B injection and a four week course of lapizole.

We took him back for a check-up this week (we thought he was doing quite well) and our vet has suggested that we have him put to sleep. Although discharge has stopped from one ear, the other ear still has it – so the septrin hasn’t got rid of the middle ear infection. He’s put on a little weight – 10g, but he’s still very underweight. The vet doesn’t want to continue to treat the middle ear infection. They feel that he’s got two major things wrong with him and that it’s not worth putting him through treatment. On the positive side, his teeth have begun to grow back (even though they said they wouldn’t!)

I feel really anti putting him to sleep and not just because I’d be devastated to lose him. When he’s at the vets he just sits really still and won’t move at all – there he’s willing to be picked up and handled – just not bothered about anything. This is not what he’s like at home… at home if we try and pick him up he’ll run off, and although he is much quieter than he used to be he is still alert. My family came to visit yesterday and he came out of his own accord to say hello and he’s still spending loads of time cleaning himself. We’ve been at home a lot during the Christmas period and during this time he’s almost stopped eating by himself. This isn’t to say he’s stopped wanting to eat – he comes out every hour to ask for a syringe of food (recovery and ground up excel pellets) and he’ll eat as much parsley, basil and coriander as we’ll give him. We mentioned this to the vet and I think perhaps they took this to mean that we’re having to force feed him. I’m back at work today and have been watching my bun on a webcam I set up to make sure he’s ok (I know I’m sad!) and he’s been eating pellets from him bowl and hay from the bale – so I think that it’s just his preference to be hand fed – I think he enjoys the interaction with us that comes with it too. So yes, basically I don’t think he’s at the stage yet where he should be put down.

I am hoping to pop in to speak to my vet over the next couple of days as I was so shocked that she wanted to put him to sleep I didn’t ask all the things I wanted to. I don’t want the vet to feel like I’m telling her how to do her job, as she comes highly recommended and I respect her opinion and advice – I just feel unhappy about some of it and would really appreciate your opinion before I go blurting it all out to her!

1. I feel that the middle ear infection is what’s really making him not himself and I don’t think we’ve tried hard enough to get rid of it. I think that the ear infection is also what had put him off eating so much hay/pellets (because of the pain?) The vet has said the only way to get rid of this would be to surgically scrape the infection from the middle ear. I’ve read that there are antibiotics that can be effective – this article was particularly good – http://www.bio.miami.edu/hare/tilt.html Our vet hasn’t even taken a swab of the ear to find out what antibiotics would be best to use. Do you think I should insist that we do that? Do you think there could be another reason she doesn’t want to treat it?
3. I’ve also read that giving a rabbit steroids at the same time as antibiotics can be counter-productive and that non-steroidal anti-inflammatories should be given instead – does anyone have any experience of this? My bunny has had two steroid injections – the first one at the same time we were giving him antibiotics.
5. I’ve read that although kidney damage is irreversible, bunnies can still lead a happy life with kidney damage – does anyone have any experience of that?

I’m really sorry to have rambled on so much! This is just such a critical time and I’ve got two huge opposing sides – part of me feels totally anti putting him to sleep, but the other part of me doesn’t want him to suffer – and I want to make sure that we’ve done everything we possibly can…

Thanks so much

I can't really offer any advice, but just wanted to say that if i were you i would definitely not have him put to sleep at this stage. I would definitely want a culture and sensitivity test for the ear infection too. I think Jacks Jane would be able to advise you better, hopefully she will see this. Good luck x

Is your Vet a Rabbit Specialist as such ? Could you request a referral for a second opinion. From what you have said about how he is coping I think trying different antibiotics would certainly be an option. A swab to culture for microscopy, culture and sensitivity testing could be useful to identify the exact bacteria involved and the most suitable antibiotic to use. In my experience Septrin seldom proves to be useful for ear infections.

A non steroidal anti-inflammatory is generally the best option rather than a steroid. Metacam is the drug most Vets prescribe. It is a palatable oral preparation.

If there is some degree of renal insufficiency then the dose of Metacam would need to be carefully monitored. Alternatively a different category of analgesia could be prescribed.

Could you take a video of him at home to show the Vet how he behaves there and that his subdued demeanor at the consultation is not how he is in his home environment ?

Jack's-Jane said:

Is your Vet a Rabbit Specialist as such ? Could you request a referral for a second opinion. From what you have said about how he is coping I think trying different antibiotics would certainly be an option. A swab to culture for microscopy, culture and sensitivity testing could be useful to identify the exact bacteria involved and the most suitable antibiotic to use. In my experience Septrin seldom proves to be useful for ear infections.

A non steroidal anti-inflammatory is generally the best option rather than a steroid. Metacam is the drug most Vets prescribe. It is a palatable oral preparation.

If there is some degree of renal insufficiency then the dose of Metacam would need to be carefully monitored. Alternatively a different category of analgesia could be prescribed.

Could you take a video of him at home to show the Vet how he behaves there and that his subdued demeanor at the consultation is not how he is in his home environment ?

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this!! it is essential that the correct abx are given otherwise you are wasting time and money and the bunnys health.

My new vet is a rabbit specialist (I think) - we recently changed vets as we'd be taking my bunny to another vet and they just kep on sending us home saying they didn't know what was wrong and couldn't do anything to help.

I will give my new vet a ring tomorrow - they're only in on certain days so I'll try and catch her when she's in.

I have considered taking a video in to try and convince her - I have described to her how he behaves, but I feel like she thinks I just don't want to let him go - which is true, but if I thought he was really suffering I would have him put to sleep. I always think that you put an animal down (we had so many pets growing up that I'm sort of used to it) when they have given up themselves - so you're just easing their passing. At the moment when I look at my bunny I just see him as poorly, not dying.

what area do you live in,maybe someone can recommend a exotic vet. my bun had middle ear infection which 3 vets thought was e c and wanted to pts but I refused and finally found a good vet who treated her, one other thing be careful with steroid injections as they lower the immune system,but good luck with your runny.

Agree with Jack's Jane's advice and would recommend pushing for culture & sensitivity testing to find out what strain of infection is in there and then getting the right antibiotic to treat it. My bunny had a middle ear abscess and the infection that was in there was a very particular type that required an unusual type of antibiotic. We got this done via a referral to a specialist. I think your instincts are right that the bunny will not be eating so well if he is in pain from this. I think if you wanted a second opinion or more specialised advice, your vet would have to respect your request and really, considering what she sees as the gravity of the situation, ought to be happy to do so.

You know your rabbit the best of anyone, your instincts are almost definitely spot-on and you should trust them. I agree with you that as long as the bunnies quality of life is still there - which is demonstrated by his behaviour as you observed it - then I think you have everything to fight for.

I would suggest getting to the bottom of his ear troubles first and foremost and then it might also be worth asking to look into the extent of his kidney damage - unless you already know? And make sure your bunny always has plenty of water available to drink from as they self-regulate kidney damage to a degree by constant drinking.

Good luck x

minky said:

1. I feel that the middle ear infection is what’s really making him not himself and I don’t think we’ve tried hard enough to get rid of it. I think that the ear infection is also what had put him off eating so much hay/pellets (because of the pain?) The vet has said the only way to get rid of this would be to surgically scrape the infection from the middle ear. I’ve read that there are antibiotics that can be effective – this article was particularly good – http://www.bio.miami.edu/hare/tilt.html Our vet hasn’t even taken a swab of the ear to find out what antibiotics would be best to use. Do you think I should insist that we do that? Do you think there could be another reason she doesn’t want to treat it?
3. I’ve also read that giving a rabbit steroids at the same time as antibiotics can be counter-productive and that non-steroidal anti-inflammatories should be given instead – does anyone have any experience of this? My bunny has had two steroid injections – the first one at the same time we were giving him antibiotics.
5. I’ve read that although kidney damage is irreversible, bunnies can still lead a happy life with kidney damage – does anyone have any experience of that?

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1) the middle ear infection could possibly be the reason he isn't eating when Finley had his bulla abscess it was
Impossible to get him to eat hay as the side to side movement was incredibly painful. Middle ear infections are difficult to get rid off even if on correct antibiotics and given for a lengthy period sometimes a ear op is the only definite way to solve the problem (i wouldn't go down this route until all other aspects have been examined I did it for Finley and its invasive surgery
2) steroids shouldn't really be given at the same time as antibiotics usually if on them they have a steroid then 48 hrs later a long acting antibiotic. a non-steriodal will be heavily contraindicated in your bunny due to the renal impairment many vets won't prescribe it and instead use steroids or opiates for painrelief in animals with kidney disease.


You know your bunny best and if you feel its not time then trust your instincts x