Slow recovery after ear infection - should I worry?

[Imma]

Our geriatric (10 y.o.) bun had her first serious health scare 10 days ago. She lost her balance completely because of a sever inner ear infection and could only lay on her side when supported with towels, her eyes were rolling and I wasn't even sure she would make it. She's been on antibiotics since and making very slow recovery. She's able to stand up and wobbles as she slowly hops, still very unsteady and with a head tilt. I've fed her critical care in the first few days and now she'll only eat leafy greens if I hand feed her, refuses hey and pellets. I've returned to supplementing with critical care but she hates the syringe feeds and I feels it really stresses her. Her poo is ok in number but very very tiny which shows she's not getting enough in. The vet says we have to get her weight up.
How long did you go after a bad ear infection before real improvement? Can she make it on greens alone?
I'm worried that because of her age she wont be able to pull through...
Any advice is welcome

 

[InspectorMorse]

How was the diagnosis of a middle ear infection made, ie what diagnostics? Has the possibility of Encephalitizoon (EC) been ruled out ?

Encephalitozoon cuniculi in rabbits

Encephalitozoon cuniculi is a small pathogen that is spread in urine and mainly affects the nervous system (brain and spinal cord) and kidneys. The disease is very common in the pet rabbit population and can be carried by other animals including wild rabbits.

www.rvc.ac.uk

Encephalitozoon cuniculi in pet rabbits: diagnosis and optimal managem | VMRR

Encephalitozoon cuniculi in pet rabbits: diagnosis and optimal management La'Toya V Latney,1 Charles W Bradley,2 Nicole R Wyre1 1Departments of Clinical Studies, 2Departments of Pathobiology, Matthew J Ryan Veterinary Hospital of the University of Pennsylvania, Philadelphia, PA, USA Abstract...

www.dovepress.com

Is she on a nonsteroidal anti inflammatory such as meloxicam as well as the antibiotics ? The clinical symptoms are a result of inflammation within the CNS, so an anti-inflammatory drug is needed to minimise the inflammation.

Recovery from both middle ear infections or EC can take weeks and weeks of ongoing treatment. The fact that she is showing signs of improvement already is encouraging.


What is her poo output like ? If her gut motility is reduced she would also need prokinetic drugs, metoclopramide and cisapride.

 

[Imma]

It's highly unlikely to be the result of CNS involvement because there was a diagnosis of outer ear infection which despite treatment probably pushed through the eardrum and got to the part of the ear that regulates balance. She got anti-inflamatory antibiotic ear drops which cleared the outer ear infection which I stopped giving her after a week. I was told one of the antibiotics by mouth should also have an anti-inflammatory effect and she still has about a week to go with that one.
I'm worried about her poo - quite a good number but they are tiny in size and I know that's not a good sign. She's refusing hey and pellets and I constantly have to coax her to eat greens - cilantro, dill, basil, celery leaves. I've given her a bit of the celery bulb because I read it has more calories, and a few bits of carrot, to get her calory intake up. She started this at 1.9 Kg and she's 1.72 Kg now, I can feel she lost weight.

 

[InspectorMorse]

If she has head tilt and had a period of the inability to stand and was rolling then that is indicative of the fact that there is CNS involvement. Either due to EC or otitis media.

What is the name of the antibiotic she is on ?

AFAIK there isn’t an oral antibiotic that has anti-inflammatory properties.

Ear infections are painful, so she needs to be on some sort of anti inflammatory analgesic. A Rabbit in pain will not want to eat and not eating causes gut stasis.

Personally I would want to speak with the Vet again to discuss pain relief and prokinetic medication ASAP.

 

[Orenoko]

I had a bunny who had long-term complications very similar to yours from an ear infection, additional pain relief is extremely important, please speak to your vet about this. My boy had the infection just before I adopted him and it wasn't treated properly so he had a relapse which left him with permanent issues which gradually declined. I don't say this to scare you just to caution you that it could be a long road. Refusal of hay may potentially be an indicator of pain given it is "easier" for a bun to chew veg so would definitely speak to the vet about trying additional pain relief to see if that makes a difference. Without eating hay you are likely to end up with dental problems sooner or later so really important to try and motivate her. I did also supplement with alfalfa hay, which usually is only recommended for young buns but it helped with weight gain, and some dry porridge oats in very small amounts. It isn't a recommended part of a rabbit's normal diet so I wouldn't feed it every day but it may help give her a boost in weight while she recovers.

 

[Imma]

Thanks for all the information and advice. I texted the vet re the possibility of stronger pain meds, hopefully will get a reply soon.
I understand this will be a long recovery and I want to be as smooth as it possibly could with as few complications as possible. I really hope we don't develop dental problems as a result of the ear infection.

 

[bunny momma]

I agree with what others posted. If you need to give syringe feeds, take it slow and try to keep the bunny stable since moving the bunny around can make symptoms worse.

You saw improvement which is a positive. Pain meds/anti inflammatory will make bunny more comfortable and more likely to eat. Pellets and hay may be uncomfortable to eat due to ear pain. Sending vibes..