Persistent respiratory infection

[Adam]

Our bunny seems to have had a respiratory infection for months now. The X-rays show he had bronchitis. In the last months, he was treated with enrofloxacin, then marbofloxacin, then azithromycin combined with a nebulization with Gentamicin. All these antibiotic treatments generally made him better, but he would relapse after each treatment with the symptom of an intermittent crackling breathing sound. I wonder why he wouldn’t get well after such a wide spectrum of antibiotics? Also, I wonder why the crackling sound is intermittent?

Our exotic animal clinic vet gave up on him. After the last visit, she said she would think about what’s next and call us, but she never did. Would anyone have any advice? I know that bacteria culture is one option, but then I heard that the results are not necessarily helpful. I wonder if anyone had a similar experience with their bunny.

[Wick & Fable]

How long were each of the treatments? Also, how long did symptoms stop showing before medication was stopped? There are times medication is stopped prematurely, so symptoms subside but there’s enough infectious bacteria left to multiply and lapse symptoms.

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[LBJ10]

I agree, we need more information.

[Adam]

Each treatment was about 10 days long, although at least one was double that.  For one or two of the most successful treatments the symptoms would disappear max 2-3 days before the end of treatment. I know that’s not optimal and the infection bacteria might have developed antibiotic resistance by now. There were also gaps between because our vet liked to check on our bun when out of treatment.

[Wick & Fable]

I think it would be worth revisiting antibiotic treatment with a longer course. 10 days is very short, and having only 2-3 days of symptom relief before the end of treatment is pretty small for what many owners experience as persistent URIs.

My Wick, who was treated for a very persistent URI, had a week-in check-in for each med we tried, with the expectation that if there were improvements, we would continue it (so 7 days for the check-in, with no expectation of discontinuing soon unless the medication was clearly not working, in which case, we switched to a new med). 2 weeks is a more typical full treatment course, from my experience. When we found the right medication combo (through trial and error, 1 to 2 week courses as I mentioned), the course was started on 3/2/17 and we didn’t stop meds until 5/16/17. Sneezing was “almost gone” at 4/5/17, so you can see we continued for a good time longer. Notably, the vet did mention this did seem like a very persistent URI, abnormally so (you mentioned no symptoms 7-8 days into treatment, while Wick needed at least a month to see that, so clearly different cases!), but it gives you an idea that longer antibiotic treatment may be what’s needed. Fast forward to now, and Wick has been sneeze and discharge free since then.

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[LBJ10]

I agree that 10 days probably wasn’t enough. If it’s a very stubborn infection, then you need to do what Wick described. Monitor progress to make sure the antibiotic is working (if not, then you can switch) and then continue treatment for an extended period of time.

Also, the nebulizer wasn’t a bad idea. I think that probably should have been longer though too.

[Adam]

Many thanks for all your comments! Cookie is on oral Azithromycin, 1ml/day since March 6 (15 days now) and on Gentamicin nebulization, .5ml/day for 8 days now, (he weighs 3lb) and he still exhibits the same symptoms as before: quick breathing with some crackling sounds suggesting a blockage in his nasal pathways. I don’t see an improvement. Since he will visit the vet in 2 days and, an inevitable question arises: should we keep the course or  is it the time to change the antibiotics.  (As I wrote earlier, he was treated with enrofloxacin, marbofloxacin,  azithromycin and nebulized with Gentamicin in the past, so it is possible that some resistance has developed to these antibiotics.)

[Wick & Fable]

If no symptom improvement has occurred, I would suggest trying a different antibiotic.  I wouldn’t get too hung up on antibiotic resistance — if bacteria could adapt that quickly in every circumstance of treatment, we’d have a much more difficult time treating infections across the board.

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[Ellie from The Netherlands]

Sorry that I can’t add more to this topic, but I’m happy to see that you have gotten so much good advice already! Wishing Cookie a speedy recovery ^_^

[Author]

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