Cefazolin Eye Drops?

[Goldberry]

Hi, I will try to keep it brief, as It’s kind of a complicated story.

My little Netherland dwarf has an eye ulcer in her left eye. Our vet is not particularly rabbit-savvy (tried his best with research and talking to other vets), but there are few options in a small rural town. He used a stain and other procedures to confirm she has an eye ulcer and we have been treating her for about three weeks with Ciloxan eye drops and Metacam for pain–both of which are bunny safe. She seems to have developed a whitish patch over the cornea that has now decreased slightly in size, but the ulcer is very slow to clear and she appears to be almost blind. It’s very important to clear the ulcer and save the eye, but also try to save some vision in the left eye, if possible, as she has some limited vision only in her right eye.

Our vet sent us yesterday for an emergency appointment with a veterinary ophthalmologist who was supposed to have some experience with rabbits. That was quite the ordeal for all, but a stressful, long journey (at least 4 hours each way) for a little bunny who gets very nervous and stressed in the car. The ophthalmologist did what seemed to be a thorough but fast (since we paid as an emergency, they had to squeeze us in between surgeries) exam with a stain and lots of specialized instruments. The good news is that our bunny does have some vision in the right eye (there doesn’t seem to be an explainable cause for some of the vision loss in the right eye, other than age), the pressure in both eyes is normal, and the blood vessels seem to be slowly regrowing in the cornea of the left eye. The bad news is that the ulcer is slow to heal, the white patch on the cornea is an inflammatory response fighting some kind of infection and the eye and surrounding area are very sore and inflammed. It seems, right now, that our bunny is also blind in the left eye. We’re really upset and hoping to heal her, as much as possible, and she must be so uncomfortable.

Anyway, the opthalmologist prescribed a continuation of the Metacam and Ciloxin. She also added in plasma to help healing, and Cefazolin eye drops as additional antibiotic. We did question if the Cefazolin was rabbit safe, but…the ophthalmologist didn’t seem to want to be questioned. We are going for a re-check in three weeks and had to leave in order to make it home.

Once home, we have researched online about Cefazolin, which is in the class of Cephalosporins and have seen nothing but advice definitely NOT to use in rabbits as anything other than an injectable, because it is toxic (e.g., http://www.rabbit.org/health/antibiotics.html and http://www.merckvetmanual.com/exotic-and-laboratory-animals/rabbits/management-of-rabbits Under “Therapeutics”). Today, we also contacted a rabbit rescue and the nearest chapter of the House Rabbit Society who said that they had never used Cefazolin. They gave us the contact information of a veterinary practice with rabbit specialists and those specialists said never to use Cefazolin!

We were pretty worried and tried to contact our local vet, who was not able to talk to us today (though, his nurse seemed to think we should just respect the ophthalmologist!). We did also get ahold of the ophthalmologist who seemed to think Cefazolin was safe, but could not remember if she had ever used it successfully in rabbits and finally decided that she understood if we didn’t want to use the Cefazolin, but that the Ciloxin may not clear the ulcer on its own. We are currently not using the Cefazolin.

So, my questions are:

1. By your knowledge, is Cefazolin safe for rabbits as an eye drop (considering they groom their faces and ingest a bit of the med. and she has a bonded mate who will groom her)?

2. What alternative antibiotic eye drops have you used for rabbits with eye ulcers?

3. Should we seek another vet locally? (A vet who, perhaps not a rabbit specialist, but has an interest in rabbits/ greater knowledge than our current vet in the past and seems to research thoroughly has very recently returned to our town after several years away and opened his own hospital)

[jerseygirl]

Im sorry you’re dealing with all this. It sounds stressful. From what I understand, eye ulcers can take quite a long time to completely heal up. Binky Bunny had a rabbit (Vivian) that developed gluacoma in her later years and she also got a corneal ulcer that took ages to heal. She wrote about it in this thread. (The second page details what they did to finally help it heal).
https://binkybunny.com/FORUM/tabid/54/aft/124334/afpg/2/Default.aspx

As to your questions:

1. Off the top of my head (muddled head!) I don’t know of cefazolin being used or rabbit safe. I think it is great you followed your instincts and looked into it. It sounds very similar to antibiotics that have been used for eye ulcers (cefalonium). That one is mentioned in textbook of rabbit medicine. Its also of the cephalosporin family.

2.My friend was given fusidic acid for her rabbits eye when he has some changes happen in them. Ive also heard of chloramphenicol being used for eye infections for rabbits.

3. It certainly wouldn’t hurt! It would be a good opportunity to see if he’s a vet you could take the buns to in the future too.

[Goldberry]

Hi,

Thanks so much for your response. The situation is very stressful! We’ve since talked to our local vet who seemed apologetic about the referral and who is currently trying to contact rabbit specialists he knows about Cefazolin, but has agreed we should not use it for now. We’ve also reduced the Metacam to once a day, until he does more research, as she seems to be off-balance, not very hungry (so we supplement her with syringe-feeding of Critical Care) and stressed (breathing more heavily, kind of hunching up) after she has it.

It’s helpful to know that eye ulcers can take time to heal–we must persevere! Thanks for the link to the other thread–the lubricating eye drops and contact lenses sound promising (but don’t necessarily seem to be on offer here). I wonder if the debridment might be the next step, though I guess it depends on what that white patch is.

I will look up those other options, thanks.

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