Info/Advice on Antibotic Resistant Bacteria (URI)

[tanlover14]

The odd breathing noises Simba was making turned out to be right – he developed mucuous and began sneezing hard a little over a week ago… So we took him to the vet who put him on Baytril.  He began to get better – no mucous, sneezing was gone.  But yesterday morning he was sneezing a lot and the mucous was back.  He’s still on the Baytril (2-week dose). 

Does this typically mean the bacteria is resistant to the bacteria?  I’m confused about it as he was doing so well again and then overnight went right back to where he was at the beginning.  I also heard pencillin has about a 50/50 chance of the bacteria being resistant which is why he was put on Baytril (I heard it has less chance of the bacteria being risistant).  What do they do if the bacteria continues to have resistance to the meds? 

I have e-mailed my vet as she told us to let her know if he wasn’t showing signs of being better in a week (yesterday was the week mark from when we brought him in).  I haven’t heard a response yet so I’m not sure her take on it yet but was hoping to get more info from those of you who have dealt with this before or had info/tips to offer!

[Sarita]

I can’t remember did the vet ever do a culture and sensitivity test?

[tanlover14]

No, he hasn’t had one done.

I’m not really sure why – but most of the vets in our area don’t do cultures (at least not right away). Nora never had a culture done either when she was having her respiratory issues (and she was seen by the most trusted vet in our area). I wonder if the vet may suggest one now?

[Sarita]

I think you should suggest it – perhaps it’s the bacteria is just not sensitive to the baytril and that is why you are not seeing results.

The way I always approach these things is by saying “what is your opinion on doing a culture and sensitivity test since the baytril does not seem to be working”? I find that my vet will tell me exactly why or why not and then I am satisfied (usually).

There is nothing wrong with you bringing up possible tests since he is your rabbit.

Many time vets don’t bring them up because of the cost and they don’t think the owners are willing to fork out the money…not saying this is the case with your vets but that may be it.

[longhairmike]

my vet said that Pen-G shots combined with baytril will compliment each other,, unfortunately i just found this out too late.
dont let the infection get up into the head.

[LittlePuffyTail]

I just want to send some ((((((Simba Recovery Vibes))))))))

I would also do a culture if you can. When Bindi has particularly stubborn ear infections, we usually do a culture. I’m curious why your vet would not suggest it.

[mia]

How do you know there’s bacteria?

My bun has lots of snot and sneezing sometimes. First gave him Baytril and it was “gone.” Then it came back and gave him more Baytril and it didn’t get better. Then we tried some really strong meds and it made him really sick; it “worked” for a week. Then it was on to other meds and we did cultures and flushed out nasal cavity. Found a couple things in the culture and got meds that were supposed to work but didn’t. Did another culture and didn’t find anything of importance. Then x-rays, CT, etc. Oh, all this with a few different expert bunny vets, just in case, who of course got his chart from the other vets. Basically it comes and goes and I’ve noticed it comes with the seasons.
Now we’ve decided he’s perfectly fine even though he has lots of snot and can sneeze up a storm at times. No other close bun has issues nor has any bun who has played with him have issues.

Basically, there’s a lot of paths you can take, a lot of meds, a lot of analysis, and YMMV.

[jerseygirl]

I think trying dual antibiotics and more then one mode of delivery would be worth a try.
Say, oral+nose drops or injection + nebuliser etc.

It’s possible you’re dealing with more then one type of bacteria.

[tanlover14]

I’ved talked to the vet – we are going to wait a few days to see if it was just a “small bump in the road”…. hopefully.

It seemed last night he wasn’t sneezing much. Unlike yesterday morning. So I’m not sure… but we are going to wait it out a few times and continue the Baytril. If he’s showing any more symptoms today or tomorrow, my BF is going to take him in on Friday. Since we can’t take him ’til Friday anyways, it’s not really much of a difference when deciding to wait since we woud be waiting until Friday anyways.

Miaeih – He’s never had an issue like this (with me or when he was in rescue for a year – he was a foster so he was closely watched). If it was seasonal, I’m sure I would’ve noticed before. One of my buns has been prone to sneezing since we rescued her from a horrible pet store. She never has mucous so I’m pretty sure hers is an allergy (or rather hypersensitivity to stuff). But I don’t think that’s the case with Simba. He was obvoiusly doing much better on the meds… until yesterday. He was pretty Blah, all last week and then on Sunday night he was binkying everywhere (it’s very unlike him to be so full of energy!). LOL.

[tanlover14]

Jersey – when we were googling things to try I saw that it’s pretty common to piggy-back the meds also. So I imagine my vet may try that if it doesn’t clear up in the next day or two (or show improvement rather).

[tanlover14]

Sigh…. The infection is back. He had a sneezing fit so I checked his nose and sure enough, full of mucous. Will be trying to get a vet appt on Saturday.

[longhairmike]

is it white or clear?

usako has been on pen-g batril for 3 weeks now still having occasional dizzy spells. and the white mucous also started coming out of her eye this morning so now we have to it it with anti-bac eyedrops on top of the other two. this thing keeps movign all around her head and it’s a total beotch to fight.

[Sarita]

Do a culture.

[tanlover14]

It is white, Mike.

Sarita – we will be. She asked me if I just wanted to start him on another antibotic or if we wanted to bring him in for tests so we opted to bring him in for tests. We’ll be taking him in tomorrow morning.

I had read that cultures sometimes can be useless because rabbits can have different bacterias in their noses and it can be common to end up fighting the one that isn’t causing the problem. Hace you know this to be true at all? Someone had also mentioned concerns to me about just switching meds because you don’t want him to build up a resistance to any of them. This went hand-in-hand with mention of x-rays for long roots. Thoughts?

[mia]

Posted By tanlover14 on 09/13/2013 12:10 PM

I had read that cultures sometimes can be useless because rabbits can have different bacterias in their noses and it can be common to end up fighting the one that isn’t causing the problem. Hace you know this to be true at all? Someone had also mentioned concerns to me about just switching meds because you don’t want him to build up a resistance to any of them. This went hand-in-hand with mention of x-rays for long roots. Thoughts?

All vets I went to must have the same into as your vet; it’s like hearing the same story!

Yes, I was told all those too. Exact thing happened with the culture and meds to cure those specific bacteria. Exact thing went  into switching up the meds and moving on to x-rays. And snot still drips…

[Sarita]

Here are some good links from Dana Krempels I think you will find helpful:

en.allexperts.com/q/Rabbits-703/200…urable.htm

en.allexperts.com/q/Rabbits-703/200…gested.htm

en.allexperts.com/q/Rabbits-703/200…estion.htm

[jerseygirl]

It’s true there are some bacteria naturally in the nasal passages. Maybe ask your vet if cultures also indicate when there is a larger presence then ususual.
A culture *may* show up something that the current antibiotic is not targeting. Also, some that would normally be present *may* be absent or in low numbers due to the current antibiotic. So hopefully your left with getting a culture of problematic bacteria and finding out what med it is sensitive to.

Tooth roots can cause a physical problem in the flow. The ducts not draining well causing build up, then infection resulting. Even if that was the case, you still will want to identify an effective antibiotic to help treat. So culture is good next step.

@miaeih, is your buns discharge clear? Have you tried different litter materials? I found my rabbits nose got more wet with some wood litters.

@Mike, not sure if you’re doing this for Usako but you can get a fair amount if the gunk out of the eye by applying mild pressure under the eye.

[longhairmike]

it actually seemed to be coming from above the eye,, the whole top of the lid was swollen.
but good news the gentimicon & new tobramicin drops we just got have made a huge improvement in 48 hours.

this is what she looked like 2 nites ago, it was really scary, i thought her eye was going to pop

[LittlePuffyTail]

Awww…..poor Usako. They look so sad when they have weeping eyes. Glad she’s improving.

Good luck at the vet with Simba.

[tanlover14]

We are back from the vet.

We opted not to do the culture and sensitivity test – my vet just does not think they’re useful. And she looked up and showed me articles with newer research that they really don’t do enough in showing you what the problem could be. So instead we opted for blood work. The results come back Monday or Tuesday and I have opted not to put him on a newer antibotic until the results come back (as I’m concerned about the little man developing resistance to them if that is not actually the problem and solution.) She consulted and used info put out by one of her old professors, Karen Rosenthal. She was named 2012 Oxbow Exotic Mammal Health Award of the Year and “Dr. Karen Rosenthal was named the 2010 Exotic DVM of the Year at a presentation held during the recent annual conference of the Association of Avian Veterinarians (AAV) in San Diego.” So I really do trust her judgement.

If nothing comes back abnormal, we will be discussing heading to Ohio to get a CT Scan done on him to help figure out where the problem is coming from exactly.

[tanlover14]

Also, thank you Sarita for those articles! I read them all and discussed some of that info that I pulled out of her articles and research with my vet so I could help understand my options and possibilities! So definitely thank you for those…

[tanlover14]

Mike – I really hope Usako keeps moving forward and no going backward! These bunnies are enough to make all your hair turn gray.

[mia]

Posted By jerseygirl on 09/13/2013 09:54 PM

@miaeih, is your buns discharge clear? Have you tried different litter materials? I found my rabbits nose got more wet with some wood litters.

No, it’s not clear; it’s thick and white/milky (and sometimes with hay ). I’m stalking this thread to see it there’s anything unique to try; otherwise, we’ve given up since it doesn’t bother him except for the fact that he scares himself sneezing with such force and frequency.

[tanlover14]

Miaeih – I would be concerned about it becoming a lower resp. infection. Everything I’ve read says if uppers are left untreated they eventually become lower resp. infections which unless treated very quickly is fatal. If I get any other info – I will definitely pass it along for your sake. Have you attempted messaging Dana Krempels on the allexperts website? I would try and give her his results and the things tried and see what her opinion the situation is.

[Sarita]

If it’s a lower respiratory it’s critical – I’ve only had one elderly rabbit I believe had this as he was holding his nose in the air and stretching his neck and he had other problems so I let him go to the bridge – he was 11 years old though.

[mia]

He’s under the care of a HRS headquarter vet and we’ve been to other well known / highly recommended vets in the SF Bay Area. I have his papers from a couple vets we’ve seen and it’s over 30 pages. Don’t mind requesting his more current health history but is it really appropriate to send 40 pages of health history (he’s had other issues) to allexperts for review? We actually stopped short of taking a CT scan. Given his history, it was suggested it might be too much for him and also the cost vs results.

It was suggested by a friend to try UC Davis Vet Clinic but I don’t know if it’s that serious. it’s been over two years since I’ve had him / it started. His charts from SaveABunny says he didn’t have discharge or it was clear before. Now that I’m reading his history though, I think it’s possible they may have missed it. One of my first vet visits, they thought I was making it up because his nose was completely dry and they couldn’t obtain a sample, I guess he cleaned up well for them instead of being lazy like he is at home =).

[tanlover14]

Simbas amount of discharge (and sneezing) seems very sporadic also. My vet actually could only tell because of the stains the mucous was leaving under his nose. He cleaned up very well also. We actually don’t notice it a whole lot. We haven’t heard his sneeze or seen more discharge since Thursday. So as I said, it’s becoming very sporadic with him. He was off the antibiotics for about 10 days before we noticed the sneezing and discharge again.

Has your vet ever posted on VIN? That’s where my vet actually got a lot of info on how to proceed going forward with Simba and to make sure there were no new advances when it comes to resp. issues in buns over the past year. If it comes to that, we have already decided to do the CT scan on Simba. Granted, again… if it becomes that much of an issue. BUT the CT scan on the rabbit my vet just sent over for one showed a jaw tumor which they ended up being able to remove. But I understand your hesitance to do more tests, put him under for the scan with what seems (to you) a definite possibility that it will show nothing. I feel your pain – that’s how I felt with my own medical issue. I eventually just gave up because all their tests and everything were leading nowhere so believe me, I do understand what you mean when it comes to that. As for sending to AllExperts, I don’t think it can really hurt. It’s free, she’s extremely rabbit-savvy, and who knows… maybe, just maybe, you’ll get a different opinion or answer on something you’ve tried?

[Sarita]

Miealh you probably are working with some of the most knowledgeable vets for rabbits in the US. I think Dana could answer a general question and she probably would also tell you that you are working with some very knowledgeable vets as well. Possibly there isn’t anything to find if he feels fine.

[jerseygirl]

Very odd there’s sometimes hay in discharge. Maybe gets stuck in the gunk from his surrounds??

But if not, i’d wonder about a cleft palate or some other way food is going up into nasal passage.

[tanlover14]

Well, we got back everything but the actual Pastuerella blood test last night. Everything seems normal with his blood counts. I should find out the Pastuerella test today. I’m not sure how to take that his blood cell counts all came back good – BECAUSE if his white blood cell count IS normal… could this mean whatever bacteria he is fighting is probably a nasty one? Since his immune system isn’t compromised so that’s not what’s causing the outbreak?

Will let you know the results on Pastuerella as soon as I hear back from the vet.

[jerseygirl]

Maybe normal white cell count indicates this is more allergy???
Have you ever tried Benadryl with him?

I know you said he initially did better on the abx but possibly there was something that came on secondary to allergy and thats what cleared up. idk

What’s he like at the moment?

[tanlover14]

See, it’s really weird… it just keeps coming and going. Randomly. One day he’s sneezing with mucous all over his nose and the next day he looks perfectly fine. Even when he’s not on the meds. No one (rescue included) has ever known him to have allergies – they had him for about a year and we’ve had him since Feb so it seems he would’ve shown signs before if it was seasonal or something. Nothing has changed though in his area except for hay. But that was changed after all this started… It randomly came about when we were still on Oxbow. We have since switched to local but his recurrence doesn’t match up to when we began using the local either.

He seems fine at the moment but I wouldn’t say he’s really seemed off at all except for the first day we noticed. He wasn’t very active but that was the only time we visuably noticed he may not be feeling well. The next day he was binkying around and back to normal though. I know the vet was a little worried because he had so much staining around his nose that she thought it seemed like he was having a significant amount of mucous.

[jerseygirl]

What did your vet say about the current blood results?

Im reading if no pathogen can be identified, then consider allergy.

I think with allergy in animals, it would be much the same as people. Something you tolerated in the past can become a problem later in life. Reading old threads on allergy (in people), it’s mentioned they’re often culmulative. So exposure to one or more allergens might cause only mild irritation initially but builds up to more full-blown symptoms.

Some environmental allergens: Pollen on hay. Even if not purchased in “hay fever” season, the hay might have been bagged then.
Wood litters, household cleaning products, carpet. And the common ones, dust & mold.
I have a friend whose allergic to her rabbits urine! I guess it’s possible a rabbit could be too.

[tanlover14]

It’s not that a pathogen hasn’t been identified yet – since his blood results wouldn’t have produced much except to tell us something was wrong with his immune system. The vet called me today – the results of the Pasturella will take 7-10 days to come back so it probably won’t be back until next week sometime. We are just going to go ahead and start him on Zithromax.

She doesn’t use cultures since they’ve never been proven to do much of anything. She explained it to me thoroughly today during our phone conversation and I see now why she doesn’t use them. There is no way to know if the bacteria you are cultivating in the culture IS the bacteria causing the problem. It’s just a pick and choose, guess, and hope you’re right type of thing. She said she could do one if we wanted but she personally didn’t encourage them because there’s never been evidence to prove they are useful. So I opted not to as I trust her and her decisions after her explaining her thoughts on them so well to me.

It seems – if he doesn’t respond to the Zithromax – we will most likely be heading to Ohio for a CT scan on him. There’s just too many other possibilities besides allergens that could be dangerous if left untreated. Tumors, abscesses, nasal cavity deteriorating, ect. that could all be causing the same problem. My poor little lion man… I just want him better. Sigh.

[tanlover14]

Well, Simba shocked us all. His pasteurella blood work came back negative.

We have started him on the Zithromax to see if the possibility of another bacteria is causing his problems. I’m so stressed out about him… It’s so confusing about whether the meds are working or not because whatever is causing the nasal discharge and sneezing is so back and forth. I’m so confused about where to turn or go if the Zithromax doesn’t work. I’m hesitant to try anymore antibiotics because I really worry about him developing a resistance to them…. and I really don’t want to have to truck him on a long car ride and put him under for a CT scan… it’s not the money, I just worry about the stress of it all… but when I talked to my vet, it may make the next logical option if he’s not improving from the Zithromax either…

Sigh…

[jerseygirl]

I hate to say it but….could it be a false negative? Did vet suggest doing a 2nd test?

Though if the result is correct, being negative for pasteurella is great! I know it still leaves question mark around what’s effecting him but the list of suspects would be shorter.

How about a flush like Nora had?

I encouraging asking if an antihistamine can be trialled while in antibiotics. If it helped, it could help establish if hyper sensitivities are in play or not.
I know you had the apartment painted after the fire but did you have carpets replaced also?
So many textiles are treated with formaldehyde now and I wonder how it could affect pets, kids or sensitive adults.

[tanlover14]

Ahh, we only had one spot in the condo painted which was right next to the door. Carpets were able to be salvaged so we didn’t need to change up the carpets. Although we did actually buy a big carpet to put down on the floor when we switched them to x-pens.

Can bloodtests really have false negatives if it’s to find out there’s the antibody in the blood? I’m not sure just wondering – because all the blood tests my doctors do, they never redo unless they think levels of something or another could have changed within the time they last did them. I guess I’ve always assumed blood tests are incredibly accurate. It definitely is a happy, yet sad feeling. Haha. I’ve heard pasteurella can really damage their nasal passages though over time so I AM happy if it is negative… but am confused about whether to be happy BECAUSE it’s easier to treat or deal with something when you know what that something IS than if you have no clue.

We actually had discussed a flush. But she seemed like she didn’t think you’d get anything there because he’s not sneezing like constantly like Nora was… it just seems to be a back and forth. Although, I do have to admit I’m worrying a little more about Nora and her constant sneezing.

I’ll message my vet about the antihistamine, thanks Jersey! I feel so lost with both of them… I can’t help but wonder if whatever is causing Noras could be causing this odd issue with Simba… which also makes me pray to god that I didn’t stick Nora with him and expose him to something else. She did have that infection when we first got her but it cleared up and we haven’t seen discharge since the first week we had her. Everyone just says she’s a sneezy bunny and that some have more sensitive noses. I just hope that’s all it is with her… Ugh.

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