Chronic Ear Infection in Holland Lop... Need advice on how to proceed!!! please.

Hello bunny parents!

I have a 7.5 year old Holland Lop named Clarence. In mid-July he had a reoccurrence of an inner ear infection (it first popped up the summer of 2015. The vet thought it may have been an abscess and we treated him with penicillin injections every 48 hours for one month. This cleared it up for 11 months.)

This July he started exhibiting signs of an ear infection again. Slight head tilt, meatloafing, and he didn't want to come out and hang out with us. The vet wanted to try other antibiotics and leave the penicillin as our last option. He has since been on 2 courses of Baytril, 2 courses of SMZ-TMP and he tried doxycycline but it upset his stomach and caused GI stasis. As of last week we got him on metoclopramide for his tummy and started him on his penicillin injections.

At this point, he has had 5 shots of penicillin and I hate to say it, but it doesn't seem to be having the same effect as last year this far into it. I understand that once holland lops have an inner ear infection that it will never be cleared fully and that surgery is usually necessary. We have opted to forgo surgery up until this point because I heard its really stressful and painful and I worry about his age and what his chances are that he would recover or even make it through the anesthesia.

Does anyone have any experience with this? or can provide any advice on treating or making the difficult decision of taking a chance on the surgery? Please help!!! No other pet parents really understand and this has been so stressful on us! we love our bun and want him and his old playful self back! Thanks!

Hello,

no, it can be cleared. The problem is to find out where the problem comes from. Ear infections can have several causes, like an allergy, some kind of pasteurella, a tumor... Was a scanner done? A fiberscopy? Analysis to look for parasits and fungus?
I knew a rabbit who had a tumor in his inner ear and who was operated for it. He was about 8 and the vet said the survival rates to the operation were very good (9/10), it went just fine for him. The problem is that before thinking about operating, you need to know what you are fighting against... Like GP, vets have a tendency to treat with broad spectrum meds without making real attempts to know what the problem is ("it's an infection", "it's a virus"... feel enlightened...) - sometimes, it can work, but when it fails you need to do a battery of tests to find out what the problem really is. Then, you will be able to make a decision.

Thanks Aki,

My vet has said as much, the only problem is that the only way to obtain a culture for him is to get into the ear, which from what she has said, would require a surgery anyway. She basically said the surgery would consist of opening up the ear, cleaning out the pus and infection, providing an antibiotic and once the culture comes back, put him on an antibiotic for whichever bacteria the culture has shown.
She has also mentioned the fact that his breed usually has chronic ear issues and that over time, the ear canal changes shape and builds scar tissue, so she cautioned me that he will always have some level of ear scratching and head shaking.

I'm stressed from what appears to be "all the guessing games" of treatment. I don't like the idea of putting him through a surgery that is kinda diagnostic and treatment at the same time.

I had one rabbit who had an antibiotic resistant ear infection which ended up needing to go to surgery. He was 10 (maybe more, he was adopted as an adult) and lived another 3 years! In his case, since there was no way any antibiotic would work that wouldn't kill him, they removed his entire middle and inner ear and closed the ear canal (basically that pinna was decorative ). Because his infection was so extensive, he did have some facial nerve damage, but he didn't care that he was ugly.

Yes, I think the rabbit I knew went through the same thing (cleaning, exams under anesthesia). He was a lop too. In the end, they had to take away part of his ear as the tumor had 'eaten' his eardrum and that the other ear was beginning to fill up with blood and pus. He was just fine afterwards (part of his ear was missing, but it didn't show that much once the hair grew back) and the infection didn't come back. Of course, there is always a risk when you put a rabbit under anesthesia but, like I said, it's not a particularly risky operation. So if the vet is rabbit-savvy, I think your rabbit's chances are pretty good. If you can afford it, I would go for the cleaning under anesthesia without waiting as, the longer you wait, the more infected it will become - as you know, a good physical condition as a whole is the key for a successful surgery. It must be painful for your rabbit to stay with an infection, and it must be pretty awful for you not to know what the problem is (I had a rabbit with an 'unknow condition' for almost 2 months at the beginning of the year and it was terrible playing the guessing game). It sounds like you exhausted all you could do without doing more invasive tests so now is probably the time to go for a more agressive approach. It's true 7.5 year old is not young for a rabbit (my Aki is the same age) but it's not ancient either, he can still live 3 or 4 years in good conditions. So, I would go for it. Keep us updated on what you decide to do and how it goes! I hope your rabbit recovers quickly!

Thank you guys. We are meeting with the veterinary university tomorrow as a consult to see where we can go next. I will keep you updated.

ClarBun said:

Thank you guys. We are meeting with the veterinary university tomorrow as a consult to see where we can go next. I will keep you updated.

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Hopefully you can find a good treatment plan :goodluck

Hi Guy -

So we went to the vet yesterday and Clarence got the whole workup.
We are opting to move forward with the CT scan where they will be able to see whats going on inside his ears and skull. They will also be able to give him a deep inner ear flush and get a culture. His teeth will be trimmed while he is under as well.

Yesterday Clar did some bloodwork to see if he is healthy enough to go under the anesthesia and we opted to do testing for e. cuniculi (since he once had neurological symptoms after a bout of GI stasis a few years ago and to see why his immune system may be suppressed).

They did an eye duct flush on his to give him some relief from his weepy eye and we left with anti-inflammatory eye drops as one of his ducts was blocked.

We were also given meclizine for his balance issues (which are very minor) and meloxicam for discomfort pending the results of his bloodwork (to show his kidneys and liver are healthy.)

Needless to say this cost close to $600 and this is prior to the CT scan! I got a price range for the CT and the ear surgery. For all you bunny parents out there curious about costs... the CT can range anywhere from $450-900 and the ear surgery $1800-2900. :cry1:

Yes, unfortunately, vets are really money pits and it sounds a lot worse in the US than it is in France. I'm quite horrified everytime someone from this forum mentions the costs of treating an animal over there -_-'
I hope your vet accepts to be paid in installments and that you'll find the root of the problem quickly...
The tests concerning e cuniculi aren't really reliable. You can only detect that the rabbit was in contact with it at some point. The treatment for it is pretty long (around 30 days, if my memory serves me right), but the good news is that it's really safe.

If you're not having success after changing antibiotics that many times I'd say it's certainly time to move on to further diagnostics. I wouldn't add in other antibiotics before a culture or you could really be dealing with resistance. CT is definitely the way to go for middle ear disease! That pricing sounds reasonable to me, especially in a specialty facility.
I hope you can get to the bottom of this.

Hello everyone,

Clarence got the CT which proved there was a lot going on within his ears. The infection appeared really bad so the vets at Tufts recommended we move forward with the TECA-BO surgery. Naturally I was a nervous wreck. Clarence is almost 8 and I was terrified he wouldn't make it through surgery...

His surgery was this past Thursday and he did very well! The ear wasn't as terribly infected as originally shown in the CT and therefore only a partial ear canal ablation and bulla osteotomy was needed instead of a total.

Three days post surgery and he is doing okay. We have him on critical care, meloxicam and metoclapramide for the time being. He will get antibiotics once the culture comes back. We are mostly focused on keeping him eating at this point. He is pretty uncomfortable at times and his eating habits are sporadic, although his poops are normal. He is more interested in eating treats and yummy sweet medicines rather than his hay and pellets.

His wound looks great though, no redness, swelling or discharge.

Hopefully this will all be worth it in the end. Poor baby has a funny haircut with his shaved ear and legs (for the IV).

If anyone has any advice on keeping him interested in eating or making the recovery process easier please let me know! Thanks!
I will keep everyone updated!

ClarBun said:

Hello everyone,

Clarence got the CT which proved there was a lot going on within his ears. The infection appeared really bad so the vets at Tufts recommended we move forward with the TECA-BO surgery. Naturally I was a nervous wreck. Clarence is almost 8 and I was terrified he wouldn't make it through surgery...

His surgery was this past Thursday and he did very well! The ear wasn't as terribly infected as originally shown in the CT and therefore only a partial ear canal ablation and bulla osteotomy was needed instead of a total.

Three days post surgery and he is doing okay. We have him on critical care, meloxicam and metoclapramide for the time being. He will get antibiotics once the culture comes back. We are mostly focused on keeping him eating at this point. He is pretty uncomfortable at times and his eating habits are sporadic, although his poops are normal. He is more interested in eating treats and yummy sweet medicines rather than his hay and pellets.

His wound looks great though, no redness, swelling or discharge.

Hopefully this will all be worth it in the end. Poor baby has a funny haircut with his shaved ear and legs (for the IV).

If anyone has any advice on keeping him interested in eating or making the recovery process easier please let me know! Thanks!
I will keep everyone updated!

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Hello, I know this was posted years ago but I’m wondering how your bun did after ear cleaning surgery. My older Holland lop is having similar issues.

Ollie’sMom said:

Hello, I know this was posted years ago but I’m wondering how your bun did after ear cleaning surgery. My older Holland lop is having similar issues.

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If you scroll over the the name of ClarBun next to her post, a window pops up. It shows that she has not been on the forum since Feb of 2017. If you have a new question, please post in a new thread.