Looking for input....I have a 7 year old English Angora.  He has recently been cultured and heavy growth was observed.  He has had nasal discharge with a thick white mucus and has been on antibiotics (Enrofloxicam/Baytril).  Finally, a dental check revealed a tooth problem and his CT1 was removed (under anesthesia) and the socket was cleaned with Chlohexidine.  We added Metacam and Tramadol for pain on a daily basis.  While the nasal discharge discontinued for a week or so, there was no sign of improvement.  We closely monitored for stomach issues with regards to the meds (he did have a bit of gas and some stasis) but was eating, drinking and pooping regularly.   

We went to another vet (ours was on vacation) about a week ago, who under inspection, found and removed a tooth in the back part of his mouth that was actually jabbing towards the tounge.

After taking him back home our little guy has not shown great improvement and  the nasal discharge.  Our vet is now recommending adding amikacin to the mix in an attempt to go after this pesty pseudomonas that just will not clear up.

I also need to point out, our little guy recently (two months ago) lost his mate of 4 years whom he was closely bonded too.

With all os this stated - has anyone had experience using amikacin, thoughts on it in combo with Baytril....any/all input is welcome, just want to get my best buddy feeling better!

Gr8ful

Not familiar with that particular bug, but my pasteurella bun was on and off a variety of antibiotics over a 4 yr period.  We used amakacin in a nebulized solutiion but not orally.  After Baytril didn't do much, we had pretty good results with chloramphenicol and eventually with PenG injectable.

The thing I would recomment is to verify that the germ is responsive to the antibiotic in question, and do a good long course.  My vet also always had me sprinkle a probiotic on her pellets while this was going on, to keep her gut in balance.

I've definitely had combo antibiotics before, I think it's best to treat aggressively when there are lots of things going on. Looking on wikipedia it says that blood panels should be done when taking amikacin But that's all I can add as I've not had any experience with the drug -Sending {{{Vibes}}} Welcome and please keep us posted on your bunny's recovery!

Will do and thanks for the feedback! My concern is there was missed tooth problems, or his mouth needs to be cleaned more - he has been using salt lick and lots of water, but I think he may still have discharge in his mouth from the first tooth removal.

Hmmm yeah, I'm not sure; I've never gone through a tooth extraction (ok, I have, but not my bunnies) but I wonder what the aftercare would be-how to keep it clean or to watch for discharge.... I'm going to send an alert, one of our forum mods has had extensive experience with dental issues in her bunnies so I bet she'll have lots of advice!

They didn't do a sensitivity test with the culture?

Gentamycin is from same family of drugs as amakacin and is supposedly used for this species of bacteria. So another option maybe?
Nebulising is a good suggestion! That's a way you can bypass the gut.

If you get another culture done (with sensitivity test) make sure your bun is off antibiotics beforehand. Otherwise they can interfere with the result.

He's having a rough trot by the sounds. Healing {{{vibes}}} for your boy.

How long was he on Baytril and did he show any improvement in symptoms over that time period?

Amikacin is a common drug to use for Pseudomonal infections, but it can be hard on the kidneys...I agree with K&K in that a kidney function screen might be a good idea before going on amikacin, especially for an older bun. Also, I'm assuming that it will be given as an injection? It's a drug that doesn't absorb well orally, though nebulizing is interesting - I haven't heard of that before, very cool! Seems like nebulizing would be specific for respiratory infections though, as wendyzski had to deal with.

JG - I agree that gentamicin could be another option, and belongs to the same family..the difference is that amikacin is usually used as the "big gun" that is more potent against many of the strains that have become gentamicin-resistant. Could work though!

Thanks Peppy! Good to know!

I have used amakacin as well in a nebulizer. I had a rabbit that was also cultured and had the pseudomonas and pasturella as well. We also did baytril as well.

How are you administering the amakacin?

It would be a good idea to do bloodwork as well just to check the kidney values. I'm certain that your vet must know about the side effects of the drugs and is using them with caution.

Our vet has done all the tests and the cultures having been coming back with heavy growth still....here is my other concern, our vet didn't want to run a second culture report as it would have been about three weeks since the last and our little guy was still on Baytril....when he had his second tooth removed she was able to get a good sample from discharge from the first tooth removed which needed to be cleaned up. I am wondering if the abcess from the first tooth removal was not thorough enough and that is causing lingering issues.

Also, has anyone here ever heard of use of Gallium Maltolate on rabbits?

Many times with dental abscesses it can be difficult to eradicate right away so it's certainly possible...rabbit pus is very thick like toothpaste so sometimes it is more difficult to clean an infection site.

I have had success with pen-g shots for my dental problematic rabbits as well so you might discuss this with the vet to see if this pseduomonas is sensitive to that.

I am not familiar with the gallium maltolate.

Ok...the decision right now is to go with injectible amikacin along with continuing Baytrol. Based on the sensitivity results this seems to be the best one two punch and otherwise our little guy is in good health. We know we need to closely monitor for any type of kidney issues that might appear (and dehydration). Our vet is hoping two weeks of this course, but possibly 4 weeks - which would be about the max from what I understand a bunny should be on amikacin - I'm hoping for two....will keep you posted!

I'll be very interested to know how this works for you - please do keep us updated and some healing vibes for your rabbit too!

O.k., after a visit to the vet today - here is the rundown for the treatment for the next 2 to 4 weeks.
Enrofloxin twice a day 1.45ml
Gentamicin Opthal solution - 1 drop in each eye 3 to 4 times per day
Amikacin injectable - .4ml injected every 12 hours
Lactated Ringer Solution - 50cc by injection when giving the amikacin
Nebulizer - 2 ml F10 twice daily
Metoclopramide - 1 to 1.5ml twice daily as needed for digestive tract function

This is going to be very tedious, time consuming and stressful - but worth every bit of it to get my little guy feeling 100% again! Will update with progress reports!

Wow! You'll be busy.

So the nebulizing solution is non medicated? Just using the mist to loosen things?

Interesting about the opthalmalgic drops. I know a lady who has had good success with her snuffly bunnies by using chloramphenical eye drops. It's like another route to the nasal passages I suppose.

Yes the nebulizing solution is non medicated, while we don't have to do this it was agreed upon our suggestion to do to loosen everything up as you mentioned....I forgot to add the drops will also go up the nose (one drop per nostril twice daily).

Quick update...we have completed week 1 of the injectable Amacacin (with water),...baytril orally twice a day. We have cut back the pain meds...have seen a really good improvement UNTIL just today the sneezing and mucos discharge started (it had pretty much stopped). I do believe weather is a factor as a storm front has moved in and we have a noticeable change in pressure, humidity and temp. Also, he's an English Angora that has just started blowing his coat. We trimmed him last night, so I am hoping the combo is what may have sparked it....otherwise, he has definitely improved in activity, play time, and again there has been virtually no nasal discharge or sneezing until today. Thoughts on this? Am I way off?

Also, we did not do the nebulizing since it did not have medicine and didn't want to add any further stress to our little guy!

Well a little improvement is better than none! Thanks for the update