Cardiac/respiratory issues - transdermal medicine? Advice?

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pippinchip

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Hi everyone. I'm new to the forums and am posting because I have searched here and elsewhere on the internet but found nothing that encompasses the full situation!

My almost-5-year-old rabbit, Bang, has been having respiratory troubles. It started some months ago with a rattly breathing sound and sneezing - vet gave sulfatrim antibiotic, which seemed to help. A few months later I suspected breathing troubles when he started occasionally tipping his head back and/or flaring his nostrils a bit. Took him to a different vet who suspected asthma or an infection and put him on a different antibiotic, enrofloxacin, for 14 days. I couldn't really tell if it made a difference, so a week or 2 after finishing that first round of enro they gave him another 10 days of it and did an x-ray.

The vet says he has an enlarged heart and some fluid in his lungs and put him on 3 meds: furosemide, enalapril and pimobendan. All are in the form of creams that I rub onto the inside of Bang's ears where there's no fur so they can be absorbed through the skin. Vet said that the oral form of at least 1 of the meds needs to be taken on an empty stomach, but because rabbits need to eat around the clock so their digestive systems are constantly working, you can't really give it on an empty stomach and therefore wouldn't get full absorption of the meds. I don't remember if he was saying that about all of those meds or just 1 of the 3. So he said they'd be absorbed better through the skin and therefore more effective that way.

But they don't seem to be working! Bang seems to be getting worse: often tipping his head upwards, flaring his nostrils all the time, and just looking like he's working hard to breathe. Still seems happy and playful sometimes, but not as energetic as he used to be. I continue to be very worried. Vet says we're unfortunately at the limit of his rabbit knowledge and recommends looking for a vet with more rabbit expertise, which I'm still looking for.

Anyone have any advice or similar experiences to share? I can't find anything on the internet about those meds being given to rabbits in a transdermal form. Was that a mistake by the vet? Could some of the moisture in the lungs be caused by an infection like pneumonia that also should be treated with a longer course of antibiotics?? Bang isn't as sniffly as he was this all started, but I still hear that or a sneeze on occasion and the fur around his nostrils looks a little wet (not a ton of nasal discharge, but maybe a little?)


I didn't intend for this to be so long... thanks in advance. It's hard to find a vet near me who specializes in rabbits. I've left a message for one and am waiting to hear back, but they don't have openings until next week anyway. Next closest one is an hour away from me, which I'm open to trying but also nervous about the stress of such a long car ride to a new vet for this bun who is already struggling.
 
With CHF and an enlarged heart, I would presume that the fluid in the lungs is primarily from that. But it's also always possible for an infection to start as well. The fact that he doesn't sound as sniffly, and if his breathing isn't as noisy, that is an indication that the meds are working to some extent. But if you are concerned that an infection could be present, maybe ask the vet to start another course of antibiotics to be safe.

I would also ask the vet to at least try the heart meds orally. From what I can tell, that is usually how the meds are given to rabbits. The references I looked up mostly said given PO. I think at this stage, until you can find another vet, if transdermal doesn't appear to be effective, it's critical to try a different course of treatment since your rabbit is obviously still struggling.

http://www.medirabbit.com/EN/Cardiology/Failure/Cong_heart_en.pdf (congestive heart failure in rabbits, contains graphic medical related photos)

http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
 

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