Relieving congestion

[MeggoWaffle]

Some may remember that Piper has been through two rounds of Baytril for presumed pasteurellosis. The vet never did a culture (said it was a waste of money because you can get false negatives, and most rabbits test positive for Pasteurella anyway… but obviously it’s something more than this since Baytril was ineffective). The first round of Baytril was two weeks in March, the second round was 20 days starting in mid-May. The symptoms went away after the first round, reappeared six weeks later. The symptoms NEVER went away during the second round (sneezing and snuffle noises) and about 10-12 days after we finished that round she had a bit of white nasal discharge.

So after I figured out that our usual vet messed up diagnosing my other rabbit Nona (didn’t see the spondylosis on her X-ray), I decided both buns are going to the veterinary teaching hospital from now on where there are exotic vets (for some reason my usual vet is listed on House Rabbit website but the teaching hospital isn’t) and where they will want to do a culture.

I called for an appointment the day I saw the white nasal discharge, but they didn’t have an appointment until today. After examining her, they recommended holding off on a culture and sensitivity test because the nasal discharge wasn’t white today, even though her nose is clearly congested. So now I’m waiting on blood test results and then if that indicates infection then we’ll do Xrays and culture and sensitivity at the same time. Good news is Piper has been happy and hungry as opposed to the last couple times where she lost her appetite (still unclear whether loss of appetite was related to her nasal congestion).

Questions:

Don’t C&S tests take a while to get results, so aren’t we putting off treatment even longer by not doing that test today?

How can I help her sneeze this crap out so her nose doesn’t get too plugged up while we wait to do more diagnostic tests? Any non-medicated nasal sprays that are safe? Should I look into a nebulizer?

[RabbitPam]

I would actually recommend a bit more patience since you are doing the right thing by taking her to this teaching hospital. It sounds like they have it in hand, being processed and will treat according to their findings and observations. If you introduce another action or treatment before they recommend what to do, you may change what she needs or have an interaction problem. (Even by using a nebulizer.) If she’s not in immanent danger, let’s see what they want the next step to be. If she suddenly gets into serious distress, call them with an emergency and take her in right away. I doubt putting it off a wee bit longer will adversely effect her severely right now.

[Beka27]

I don’t usually disagree with Pam, and I guess I don’t “disagree” with her advice here, but I would ask for the culture test, sooner rather than later, if I were in your position.

The baytril isn’t working, so regardless of what the issue is, they need to figure out what med will be effective against this infection. Just like with people, rabbits can develop resistance to a drug, and there are other options for treatment beyond baytril. Baytril is usually the “first line of defense”: they give a course of meds… if it works, awesome! and we all move on with our lives. If it doesn’t work, or the symptoms return shortly after, we need to find out what will work.

Doing the culture isn’t going to interfere with what they’ve already done. I find it a little odd that they opted for bloodwork prior to a culture, but I am not a vet so they may have reasons I don’t know of, or may suspect something else is the culprit.

[Sarita]

I would do a culture sooner rather than later as well – it can take about a week for the culture to “culture”.

You can certainly try a nebulizer – it won’t hurt not sure if it would help with the stuffed up nose. I’ve used it to administer medicine to rabbits with upper respiratory infections.

[Emandme]

When I first got Bunneh he was in bad shape. They ended up doing two rounds of baytril and after his neuter they told me he sneezed/coughed up a large amount of white discharge so they gave me chlor palm as a third round. Maybe chat to the vet about it? They never did a culture for Bunneh for the same reason – they said its in almost every bunny. Take with a grain of salt as I could be totally off. I’m no expert!

Hope Piper feels better soon.

[Beka27]

Meggo and Emandme: This is a really good article about culture and sensitivity tests. As you’ll read, the test has two purposes…
http://www.bio.miami.edu/hare/culture.html

Here is an excerpt from the article regarding Pasteurella and why you STILL want to test for it:

Why Bother with a Culture and Sensitivity Test?
One cautionary note. Some veterinarians who are not as experienced with rabbits as they are with cats and dogs will take one look at a rabbit with “snuffles” or other infection and proclaim that the problem is caused by Pasteruella multocida. Although this bacterial species is not uncommonly carried by rabbits, please do not let anyone convince you that your rabbit’s problem is caused by Pasteurella unless that diagnosis is confirmed via culture and sensitivity test! Not only are some strains of Pasteurella resistant to commonly prescribed antibiotics such as Trimethoprim sulfa, Baytril (enrofloxacin) and even ciprofloxacin, but infections in rabbits also can be caused by even more resilient strains of bacteria, such as Pseudomonas aeruginosa, Bordetella bronchiseptica, Staphylococcus aureus, and others. Without a culture and sensitivity test to positively I.D. the pathogen, you could not only delay your rabbit’s return to good health, but also be throwing good money after bad by treating with an antibiotic that is not effective against the particular strain of bacteria your bunny has.

[Emandme]

Beka:

An excellent article. I love reading things like this. So it makes sense to get a culture, for sure. My only thought is that since it takes a while to get it done (looks like a week or so perhaps?) treat it in the meantime so bunny isn’t getting sicker? Idk – just thoughts.

Perhaps Bunneh was just lucky, or my vet was playing the odds. I’m thinking the latter.

I guess each bunny’s case is different. Piper’s vet said to wait for the bloodwork since the discharge is clear. Is that often done? Is clear discharge considered ‘normal’?

[Beka27]

It really depends. There isn’t really a right or wrong way, and vets do things differently. My purpose in posting the article was that you both said something along the lines of there being no point in testing for it because of “false negatives” and that “most rabbits have it”. I wanted to provide more info to clear up the diagnosis process.

Not everyone will get their rabbit cultured, and in your situation, Emandme, everything did work out fine. If your rabbit was still sick after the meds, you would have definitely wanted to follow up and try something different. In Meggo’s case, two full rounds of baytril and the bunny is not better. That means it is not working.

Like I said, everyone does things differently, but in my mind the schedule the vet would be most likely to follow is:
1) sick bunny vet visit: exam, no additional testing, rx sent home
2) full course of meds
3) is bunny better? (Yes? Good! No? Back to the vet!)
4) 2nd sick bunny vet visit: exam, *culture*, MAYBE another round of meds while waiting for results?
5) results come in, change rx if necessary, or pursue further testing, bloodwork, etc…

This is just a rough outline, of course. Also, some vets will do a culture at the FIRST sick bunny visit, and send the first round of meds home while waiting for the results. You’re not wasting as much time in this second scenario, but the culture might end up being “unnecessary” if the meds fix the problem right away.

In Meggo’s situation, my concern is that after two full courses of baytril, the vet is still hesitant to culture. The bunny should have been cultured after the first round did not work.

I don’t know if this helped answer your question or just muddied the waters further… lol

[MeggoWaffle]

Just to clarify, I never said cultures were pointless, my original vet did. I had originally asked for a culture the first time she said it was pasteurellosis and that’s what she told me, and I stupidly believed her. I came across this article before Piper’s purulent discharge came back a third time, and that helped me decide to go to the teaching hospital from now on.

I was just surprised that this new vet, while not saying it was pointless, wanted to put it off. I feel really frustrated with myself for agreeing to put it off, I should have insisted they do one while I was there yesterday. Of course I get home and Piper has some wet sneezes with a bit of white snot. I called the vet as soon as I saw this but of course they are booked until next week.

I am just scared this will take a turn over the weekend and her appetite will go away again. I’m also scared it will turn into pneumonia or something.

[Emandme]

Beka,

It did clarify things quite a bit. Thanks! My vet didn’t say anything about cultures even after the neuter and I got the chlorpalm. She was definitely playing the odds.

[Beka27]

And I understand that, MeggoWaffle :o)

The good thing about these threads is that they are informative for other people as well, who may not be dealing with this right now, but could be in the near future. I know you wanted the culture, but for other people just reading, that’s why I wanted to clear that up. It is a common misconception that it is “pointless” to culture a bunny.

I’m really hoping that you can get answers. When do you go back?

[MeggoWaffle]

We’re going back today for head X-rays and a nasal culture. She is still sneezing but I haven’t seen any purulent discharge today or yesterday; I’m hoping they can still find something on the culture, infections don’t just take care of themselves, right? Other than that she is still happy, hungry, active, etc.

I should have also mentioned that she has always been a sneezer her whole life; I just never thought that was a problem. I wonder if she has had white nasal discharge in the past with her sneezing and I just never noticed it.

[MeggoWaffle]

Well, the Xrays look fine, but they only rule out teeth problems. They wanted to do a CT scan but that’s $700 I don’t have. Will have to wait about a week to hear about the culture.

They flushed her tear ducts yesterday as well. Has anyone ever had this done?

They told me she would be congested from the flush and groggy from the sedatives, but she is REALLY miserable. We came home and she just hid for the rest of the night and wouldn’t touch treats or anything (except had a bit of water). She nibbled a small bit of parsley while I was asleep but I am pretty sure she hasn’t touched anything else, including hay. Maybe I shouldn’t have but I did force feed some critical care this morning. Extends her stress but at least her stomach isn’t completely empty…. so effing stressful when she doesn’t eat =(

[jerseygirl]

Did they do any force feed at the vet?
It might take a day before her appetite comes good. I’m glad to read you had X-ray done and teeth were ruled out as contributing factor. Overgrown roots can cause sinus issues. One less thing to deal with for you.

Now that culture is done are you able to start on another abx before results? There are some are usually thought effective. You’d be a week or 2 into a new med and might be lucky it’s one of the suggested abx given in the results.

I think the mode of medicating can be important. Nebulising or administering drops in the nose along with an oral or injectable med.

I’ve read that buns with this sort of infection often get flare ups in the warmer weather. Do you find that with Piper?

For clearing gunk you can try a pediatric nasal syringe/bulb or nebulising with saline. My friend had a rabbit that got congested and she could clear quite a bit by placing fingers each side of the nose and applying pressure in a downward stroke.
When I looked after this rabbit for a time I cleared stuff out via the eye applying gently pressure just under it. Her infection was quite bad.

I was told that part of the
loss of appetite is because it’s difficult to eat & breath at same time when congested. So if you are able to clear away discharge hopefully that would improve her appetite during the flare ups.

(((Piper & Nona)))

[MeggoWaffle]

They did not force feed at the vet, but she is nibbling stuff now. More greens than hay, but I’ll take what I can get.

They didn’t start her on an antibiotic before getting results, because she wasn’t showing symptoms when I brought her back in. I don’t even think her nose was wet yesterday, which just makes me wonder when exactly I’m supposed to worry, if she is able to tamp down the nasal symptoms on her own. But I do think I’ll buy a nebulizer ahead of time, just so if it is needed I can start that treatment right away.

I don’t think it has to do with the weather. The first flare-up was in March…

I will try those different methods when the congestion comes back. She loves face rubs but probably wouldn’t go for a syringe…

[MeggoWaffle]

Hi everyone, sorry to bump this but I have a follow up question.

Piper’s culture and sensitivity test still isn’t back, but I know they found Pasteurella and possibly a couple other things. HOWEVER, her congestion is nonexistent right now, and her appetite and activity level are perfect.

I know some bacteria like Pasteurella never goes away, you are just supposed to beat it back with antibiotics when symptoms present. But since her symptoms are gone right now (she occasionally sneezes as she has her entire life, but no discharge), should I treat her with whatever they find on the sensitivity test or should we shelve those results and break out those antibiotics if/when her symptoms return?

[Beka27]

That would be a question for the vet. You don’t want to treat unnecessarily, but I could also understand you wanting to try whatever the sensitivity test says will be effective.

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