UPDATE TECA-BO

[Bunny House]

Okay so Penelope, my lop has had chronic ear infections for the past year or so. We do different meds, cultures, CT, blood work, the whole 9 yards. She’s been on meds for the past 4 months, to treat fungus and bacteria in her ears. All the tests show up negative for anything concerning. Itl work and then stop 2 weeks later. You can ask details about the steps we’ve done in the last 6 months. She can barely hear from her ear canals from being so swollen. 3 weeks ago ear canals were almost all the way open, then she goes back and her canals are swollen shut, and the ear stains show only fungi and no debris. So now that I have basically already paid the amount of the surgery in the last 4 months with all this treatment that won’t work, I want to do the lateral ear resection. I know I read one thread on here that talked about it a while back. I just didn’t know if anyone lately has gotten it done and has it eradicated all ear infections or do your lops still get infections? I know there’s mixed results with the surgery. I’m just so frustrated with how my buns have been so sick in the last year and I can’t help her. I just want to get it done before there is too much damage to the ear canal and a full ablasion will need to be done. I’ll be getting her on immune supplement stuff shortly, but it’s still not gonna help her with how bad it is.

[LBJ10]

I know someone who had this done. I can ask her.

[jerseygirl]

If it’s just fungal infection that is showing up, then this procedure should be successful in getting on top of that. I don’t recall any recent threads about this, unfortunately. I have heard they do help. And it’s so much less invasive then TECA-BO surgery, obviously!
You’ve probably seen this info on medirabbit? http://www.medirabbit.com/EN/Surgery/Ear/ear_resection.htm (warning for anyone squemish; contains surgery images).

Ive been having to deal with some gunk in lop ears more and more now that the buns are older. Rumball, (now passed) never had much of an issue most his life and had good control of his ears. I think that helped with air flow. But he did start to get some pus in the past year or so.
Gooseman has more typical lop ears sitting flat against his head and he’s had more issues. He is younger then Rumball was also.

I know LPT had issues with Bindi’s ears for years also. Just an uphill battle.

So if your vet thinks Penelope is a good candidate for this procedure, it may just be a way to prevent further problems when you have chronic infection there all the time. Great job on keeping on top of it so far! You mentioned in another thread what you had been using to get the swelling down but Ive forgotten what that was.

[Bunny House]

Thank you LBJ10!
And Jerseygirl, I just would hate to spend the money and get it done and then it didn’t change her ear infections. She got staph in her ear last culture we did 2 months ago so now it’s gone but the fungi has been a constant battle. I know my other buns have their ears up so they never have issue so I would think the surgery would almost act as if she were to have the same air flow but then again her ears are still laying against her head, so would it still have good airflow in there to dry them out?

And yes I saw it! It looks like a simple, less invasive surgery, I was trying to feel where she would have her ear cut down to and it’s not a very long path, since she is just so small, but I’m afraid dealing with these infections will cause so much damage that we will need to do the TECA-BO instead. The weird thing is, is that there’s no gunk… so it’s just the fungi. But the culture is still in the works but preliminary says fungi Malassezia, which has very little case studies since it’s rare in buns.

So did Rumball have the resection or he was just good at airing out his ears? And Gooseman didn’t have it done right?

We recently were using AEK packing? I think and then pen-g shots every week. Now we are using a flush- Triz something and then she prescibed her Synotic which looking up today is a corricoidsteroid, which I don’t know why she would do that, so I’m stopping that today because I don’t want her to have her liver get damaged.
Thank you for your input!

[jerseygirl]

No, Rumball had gentimycin injected into lump at base of ear and it actually ended up helping my get a lot of stuff out through his ear. Then I was just treating with ear drops. He was 11 and I wouldn’t have had him have that surgery at his age. His ears where generally good the majority of his life.

Goose is another story. He’s developed abscess below the ear and had surgery to have that removed. The vet went in through his cheek. It all healed and has been okay for 2 years. He was left with facial nerve damage. But now I am removing some pus from the ear on that side. And he has a lump forming on cheek on the other side.   I don’t know if this is deep in the ear or something to do with a molar root.

[jerseygirl]

Are they letting the culture develop more? I do remember reading something about needing time to allow certain things to grow with a culture. Trouble is, I never remember where I read these things.
There was a discussion one time about acidifying the environment, as that discouraged yeast and fungal growth. However, I don’t know what the normal pH for rabbit ear canal should be. Acidifying could lead to other problems if its not normally acidic.

Silly idea…..but, would she tolerate having her ears sat up with a hair tie? 

[Bunny House]

I’ve never thought about injecting the ear before. Poor thing! I would say it’s either and infection in the jaw or infection in the ear that spread, either way that has to be painful and annoying for you. Too bad we can’t just make bunnies a healthier species :/.

Yeah, I don’t want to get to the point to where her canals are so damaged or she gets an abscess or even gets a head tilt because I fell like a head tilt has to screw with motor capability in them.

Yeah they let it grow three days and no bacteria so they had some fungi grow and so they are now waiting for that to grow. Yeah I thought about that, but then again, like you said there could be consequences. And I would hate to do that and then they become resistant to being treated with acid.

I actually tried that before! She got that hair tie off sooner than I put it on her haha.

[LBJ10]

OK, so she said that it has helped but the vet told her it wasn’t a cure-all. And her bun has had some staph. The lateral ear resection works by opening up the vertical portion of the ear canal and allowing the rest of the ear canal to air out. It’s the warm moist conditions that fungus and bacteria like. It also makes it easier to clean the remaining portion of the ear canal.

On a side note, have you tried any ear washes that are designed to dry things up? I have used Oti-Clens in the past for Wooly. His situation is a bit different since facial paralysis has caused his one ear to not drain properly… but it might help your bun.

[Bunny House]

That’s what I thought. I knew it was probably not gonna cure it but help it. But her ears lay flat against her head so do you even think it would air her ears out? She’s a holland lop and her ears don’t really have a gap between them and the head.

As of right now, we are doing a flush as mentioned above and it’s so painful that she will not eat or drink today so I have to force feed her and I put her on meloxicam until the vet gets back next week. So I had to stop flushing until tomorrow for her and my sake to get her to eat again. Poor thing is in so much pain.

I think I will try and get some oti-clens once the final culture results come back, since we’ll need to kill the fungi there, and then probably do the lateral resection and then daily ear flushes for life to try and keep her darn infections from coming back. Because if we keep her ears dry with the clens then it should prevent infection and the resection should allow her to easily get in her ear and clean them herself right?

[LBJ10]

Her bun is a lop as well. Even with the lop ear, I think air would be able to get in there. After all, they do this surgery with floppy eared dogs all the time. The Oti-Clens would be like a maintenance thing… so after the infection is cleared up. It would help keep things dry in the ear so stuff doesn’t grow. You have to be careful not to get it in their eyes because it stings. That, of course, is hard when the bunny shakes their head after you put some in their ear. It’s helpful to put it in something that you can control the amount of liquid coming out, like a syringe, rather than using the bottle it comes in.

[LittlePuffyTail]

I know all too well about ear infections. My poor little Bindi got chronic infections for years. It was so frustrating because it wasn’t always the same bacteria causing it so we had to do so many cultures and different meds. The problem, once they start getting frequent infections, is that it’s an uphill battle. The ear canal narrows due to the frequent inflammation and the ear ends up making more gunk to try to protect itself. The ear gunk and the narrow canal is the perfect habitat for infections. But the more you try to clean out the ear gunk, the more the ear produces. I tried many different vet prescribed washes and flushes until the vet said to stop trying to clean them. His ears got so full of exudate (mix of wax and pus….gross, I know) that to administer drops, I would need to take several Qtips full of gunk out of his ears just to make room for the applicator. It was really awful fighting the infections for so many years, and I was always scared, during really stubborn ones, that it would migrate to the middle or inner ear. Thankfully, that never happened.

So a lot of my story but nothing much very helpful to you, except to say that, had it been an option, after the first couple of years of chronic infections, I would have def had the surgery done, providing blood work showed him up for it. My vet did not do this procedure and didn’t know any vets who did.

One of my FB friends, who was dealing with infections and ear abscesses in her lop, recently had this done. Unfortunately, the abscesses are recurring. From my observations, the procedure is much more effective for ear infections than for abscesses.

Now we are using a flush- Triz something

Triz-EDTA? We used that one for the last year or so. Did seem to help somewhat.

[Bunny House]

Poor Bindi. That must have been such a frustrating thing dealing with that. I couldn’t imagine her having pus in her ears like Bindi, did but who knows since it’s so swollen, anything could be behind the closed canal. Penelope doesn’t have any gunk which is weird to me but I think it’s because her canals are so swollen the debri can’t get the to vertical canal so it’s all stuck behind the swelling. If it was one bacteria or fungi causing it, it would be so much easier to control but since it does change, it’s like roulette, and you can’t do too many meds or it can become resistant.

I think I am going to see if the vet will do it, if not the vet school and itl be after finals so she’ll just have to be on painmeds for the time being so I can monitor her if anything goes wrong.

I also think she is getting a uti with her pee smelling weird within the last 2 days.

Did you ever use it Oti-clens like LJB10 has? Did you get some good results with it? She needs a dry ear environment but nothing to dry it out too much.

[Bunny House]

Update
So culture came back negative for everything. So now I suspect abcsess in both ears since that could be the only thing causing the random swelling after they were completely open 3 weeks prior. I’m hoping the vet will be able to read the reports and decide what to do from here but an X-ray is probably first to happen

[Bunny House]

Sorry this is long

Penelope had her CT yesterday and the results, this is the vet school I used to go to but the doctors left and now I don’t like the new one so I am going to a different vet.
:
Moderate bilateral otitis media. There is a moderate volume of soft tissue attenuating material within
the bilateral tympanic cavities, the material in the right tympanic cavity appears gravity
dependent, however the material in the left tympanic cavity is associated with the lateral
and dorsal aspects of the tympanic cavity. Additionally, there is a moderate volume of
soft tissue attenuating material within the bilateral external ear canals, mildly decreased
compared to the most recent study.

The treatment they say to do:
1) A myringotomy to obtain a sample of the contents of her middle ears to submit for
culture and sensitivity testing. We recommend that Penelope be kept on antibiotic
therapy for at least 4-6 weeks, or 2 weeks past resolution of otitis media on CT.
2) A myringotomy with flushing of the middle ear canals; this is often necessary due to
the caseous pus that rabbits develop, making it difficult for antibiotics to penetrate into
the middle ear. Sometimes this can resolve the infection; however, sometimes the
material builds back up and the procedure will need to be repeated.
3) TECA-BO surgery, which removes the entire external ear canal and middle ear. This
surgery is typically performed as a last resort option, as it is the most invasive.

I know we haven’t cultured the middle ear and flushed it but it is so freaking swollen we wouldn’t be able to. she still doesn’t want to eat on her own and she’s on painmeds.
Does anyone have suggestions? I know I want to do the TECA-BO and I think my vet wants to but I am waiting to get a call from her. I am just so scared for surgery since Patch didnt wake up after his, but he had cecum surgery, high mortality rate but it still scares me

[Bunny House]

I thought I would update for anyone in the future reading this.

The vet put Penelope under and we decided initially to just do a flush in both ears to try and save the ears. Ended up that when she went in, both canals were full of pus and there was no way to just do a flush and save the ears, they were too bad. Even if you flush the middle ear, infection will come back since that environment is perfect for infection, at least for lops. So she had to end up doing TECA-BO ( total ear canal ablation, bulla osteomy). We were worried that she could have facial paralysis and have vertigo and also loose blood supply to her ears. I brought her home yesterday, same day. She ended up having no issues at all, she acts like nothing happened besides just being drugged up. The vet was so amazing at how well she was doing after surgery. Even though she will now be deaf, she will be in no pain so it does break my heart she can’t hear the treat bag, hopefully she will start to look to my other buns for food cues and I’ll be teaching her new cues for sounds she used to hear. She will finally be a normal bun after 2 years of ear infections.

I was so worried the surgery would be too much and she would die right after surgery like my other did but she made it though it and I am so happy and amazed my baby girl can be a happy bun soon.

[jerseygirl]

Oh wow! Im very behind on where things are at with Penelope. The vet really went in with the double TECA-BO but it sounds like it was needed for Penelope. So great she came through it well. She must be feeling a lot of relief of pressure and pain.

How is she doing since you last posted? {{{Penelope}}}

[Bunny House]

It was so bad, I wish I coulda have seen the Surgery since I love stuff like that, maybe next animal I have haha (since all of mine have Health issues).
She is feeling so good, so relieved of pain. And turns out she can still hear me sneeze so not all hearing is lost. She always freaked when I sneezed.

She started to itch her ears last night so I put her in a cone in a pack n play I got. Worst decision ever. I woke up and cecetropes were everywhere… on everything, even on a part of the non washable mattress haha, so that was fun to clean this morning.

But she will make a full recovery and is undergoing laser therapy to help speed up healing and hopefully we’ll hear about the culture results this week. And I’m still force feeding, which is a bummer but hopefully within the week she’ll eat a full meal on her own without having to supplement it. Thank you for checking in jerseygirl!

[Bam]

This is so very interesting, Bunny House, thank you for sharing! It’s lovely to know she’s free of pain! The TECA_BO seems to have been the absolute best option for her. I dont think you had much choice about the cone. Even if you did have to clean cecals from everything, it would have been worse if shed hurt her ears scratching them. Although I feel for you, I know how cecals stick to stuff. It must be one of the stickiest compounds known to man.

[LittlePuffyTail]

That must have been kind of a relief to have the decision made so “spur of the moment” so you didn’t have to spend days worrying about the procedure. I’m happy to hear it went well and she is recovering.

Don’t feel bad about her being deaf. Bunnies are so much better than we are at adapting to things like that. I think Bindi was deaf for at least the last few years.

[Bunny House]

Sorry for not posting in so long, the holidays and showing have been so busy for me. Penelope is still doing great! She has adapted very well and looks at the other buns for food cues. She lets me cuddle her now. She had ripped out a suture when she itched too far into her ear which caused some of the skin to become necrotic but not too much of it died off. The vet is very pleased with how she is recovering.

[LBJ10]

So glad to hear she is doing well! I know it was a tough decision, but it sounds like everything has worked out.

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