Rabbit UTI Treatment and Antibiotic Issues

[bunmomof2]

Hi everyone, this is my first post here and it is regarding my almost 7 year old spayed-female rabbit named Bailey. Bailey is a megacolon rescue bun and twice daily she takes colon rescue, Cisapride, metoclopramide, and Meloxicam. She has been on these medications for About three years now. She is also bonded to, and has been for 6 years, to my 10 year old neutered male named Reggie. Unfortunately on 10/12/2024 she began to have blood in her urine. She was seen by the vet that same day and was sent home with Bactrim and a probiotic to take for 2 weeks. However, her symptoms began to worsen on 10/14 and she began dribbling urine, heavily straining, and going in small amounts frequently. She was seen at the same clinic on 10/15 where she was X-Rayed, had an ultrasound, and had her urine examined under a microscope to confirm the presence of blood and lots of bacteria. She was sent home with enrofloxacin and given fluids and her symptoms dissipated. By Friday morning (10/18) all symptoms were gone. I was of course continuing to give her the enrofloxacin and probiotics. However, on Sunday night (10/20) she began urinating blood again. I immediately contacted her vet and she advised to continue giving the enrofloxican and if this continues or symptoms worsen by Tuesday, she can have her antibiotics changed. Well Tuesday came and she was still occasionally urinating blood and had a few accidents/dribbles outside of the litterbox. Our vet prescribed her azithromycin which I was very worried about giving her. She had her first dose this morning (10/25) and began experiencing discomfort within an hour of taking it. She has been receiving critical care throughout the day with the dosage/amount her vet recommended based on her weight. Tonight she started to eat a bit on her own, pooped, urinated a few times, and appears to be more comfortable. After discussing with our vet, we will not be giving her the azithromycin again. I was just curious if anyone could give any advice om a different antibiotic or treatment that I can try that won’t upset her already sensitive stomach. Or if anyone has dealt with difficult to treat UTI. I can’t even figure how she contracted this as I clean her litterbox twice daily and her free-roaming room is always kept very clean. To make matters even worse, her and Reggie have been separated by an x-pen since 10/14 as Bailey was being very territorial and aggressive of their 2 litterboxes and one of their hidey houses. She actually got so upset that she scratched his eye and he needed to be treated with 2 different types of eye drops. I tried putting them together again on 10/19 but she was still protective over the litterboxes and was very demanding in wanting him to groom her. I feel bad having them separated but cannot risk them injuring each other and I can better monitor Bailey’s urine, droppings, and food intake. Any advice on the matter would be  much appreciated!

[LBJ10]

These things just happen when they get older. Their immune system weakens as they age, creating opportunity for infections to creep in. The same is true for people. So your bunny having a difficult to treat UTI at her age is not unusual, especially if she has other health problems.

Bactrim and enrofloxican are often go-to antibiotics that vets will try first. Keep in mind that sometimes bunnies have to stay on antibiotics for longer courses than other animals and there may be setbacks along the way. It looks like she wasn’t on the enrofloxican for a long time. Perhaps she just needed to take it for an extended period of time to make sure all the bacteria was gone.

Azithromycin is more for difficult to treat infections. I had a lot of luck with it in the past with stubborn URIs, but it didn’t seem to bother my bunny. He just REALLY hated the taste and there was no disguising it.

Depending on the type of bacteria, you could try something like Doxycycline. It is used for UTIs in people and is listed as safe to use in rabbits. There is no note about potentially reducing appetite. But you have to remember that any antibiotic can cause digestive upset, so sometimes it’s just a matter of finding the right one (that will also be effective against whatever bacteria is causing the infection).

Is your vet able to do a culture?

[bunmomof2]

Thank you so much for your reply. My vet is about an hour and half away from us and round trip, the buns are typically in the car for over 3 hours. She is the best and most experienced vet I have been to which is why I continue taking them there.  She just prescribed metronidazole to begin taking along with the enrofloxacin and I am picking it up from a compounding pharmacy tomorrow. She advised if this does not resolve the UTI then she we can do a culture. The only reason we have not does this yet is because the car rides really stress her out and if reducing and eliminating them as much as possible is an option, that is what we lean towards.

[LBJ10]

You can combine enrofloxacin and metronidazole. They work in different ways. Is the vet recommending taking the enrofloxacin for an extended period? It is safe to give for longer periods. Metronidazole, however, is only supposed to be given for a short period of time. I’m sorry the vet is so far away. My bunny freaks out going to the vet as well, but at least they aren’t too far (about 10 minutes or so). Hopefully this will take care of things and you won’t need to traumatize her any further.

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