Has anyone ever used a nebulizer for pasteurella?

[marissalb]

Hi Everyone,
My 1yr old Holland Lop Bailey has been sick for a few weeks with pasteurella. He has NO discharge, but is sneezing and having difficulty breathing (wheezing). We had him at the vet right away and they prescribed Baytril, which gave him diarrhea. He was then switched to Sulfa, which he showed no improvement with. We went to another vet for a second opinion, and we were prescribed an injection of Penicillin as well as an antihistimine, and were taken off the Sulfa. We know that it can take some time for the new antibiotic to work, and he has only had three shots so far, but he doesn't seem to be getting any better. We are feeding him 8 tubes of critical care a day, as he is no longer interested in pellets. He is eating his salad every night though, but very little hay. We called the vet again today and were prescribed an anti-inflammatory (Meloxicam), for any possible inflammation, and he's been taken off the anti-histamine. We are also giving him Benebac and Nutri-Cal. We are really at our wits end, as his breathing is still labored, and we're very concerned that our food crazy bunny is no longer interested in eating and losing weight. Has anyone had experience with nebulizer treatments? What did your vet use as the meds in them? Any other suggestions for a tough case of pasteurella? We're willing to try anything for our little guy.

Thanks!

 

[ra7751]

Yes...a nebulizer can be used but unless there is more to the story, there has only been guessing by your vets and not much diagnosis. Baytril is pretty much ineffective. If it is used, it works better as an injectable. I haven't used Baytril in years and even most dog vets don't use it now. Any vet that uses any of the sulfa drugs (which are also pretty much ineffective) is way behind the times. Penicillin is usually effective against most pasteurella. Depending on the exact composition of the Pencillin, most vets misdose this drug. Many will dose only once a week but, again, depending on the exact form....it could require daily injections. But the drugs of choice are either Azithromycin or Convenia. Azithromycin can cause some GI upset in the first few days but the effectiveness of this drug outweighs the GI issue. It does have to be dosed quite a bit higher in rabbits than in other species. Convenia is an injectable Cephalosporin and we use this when we have penicillin resistant bacteria. The dosing amount is the same as other species but it must be dosed more often than with other species.

Since the problem appears to be becoming chronic, I would suggest finding a vet that will do a nasal swab. And since we are talking about a Holland, dental concerns (especially molar issues) can result in a misdiagnosis. Overgrown lower arcade pre-molars and molars and/or excessively long upper arcade roots can lead to what you are describing. One of my first Hollands experienced exactly what you are describing and it was caused by spurs on the lower arcade penetrating the roof of her mouth....and she was eating normally. At the time, she was just over a year old. Regardless, a full PE by a highly qualified vet is in order to get to the root cause of this issue.

Randy

 

[tonyshuman]

I agree that the antibiotic treatment course has not been sufficient yet. Zithromax, Convenia, and/or chloramphenicol should be tried too--and since the bacteria has already proven to be difficult to treat, I would get a nasal culture done. This will grow the bacteria to 1) make sure there are bacteria there, like Randy said, as sometimes tooth root issues can cause runny nose, sneezing, wheezing, and 2) determine what antibiotic will kill the bacteria.

Since he's not eating at all, I would really look into the tooth issues. Usually when a bunny has a respiratory infection, they don't stop eating totally.

 

[marissalb]

I knew Baytril and Sulfa weren't effective, but the vet wanted to at least try before we got more aggressive. We switched to an injectible Penicillin, I think it's Pen B (I don't have the bottle with me) and he is given a shot every other day. We had xrays done of his molars, which our first vet found some spurs on. The vet said they didn't seem to be giving him a problem yet, but that in six months we would probably need to get them checked again. We disagreed and removed the spurs. The spurs were on his upper molars and when we saw the xrays we only saw xrays of his upper molars, NOT his lower. I think it's strange too that he has progressively stopped eating. He was eating salad (the leaves of everything but not the stems which is not typical of him), up until last night. He barely touched anything last night, and his breathing seems more labored. When the two vets we've gone to listened to his lungs they both said that they sounded good, and that it was all upper respiratory. I've been researching a lot lately and it is possible that even though his lungs may sound great with a stethoscope, an xray could tell a different story. My husband is bringing him to the vet today for lung xrays, to get a nasal culture taken, and for a full, complete dental exam. I'm very concerned as he hasn't shown any improvement with three different antibiotics. Both vets we have seen are very educated in rabbit medicine and endorsed by the house rabbit society, but I agree that there's been a lot of guessing and not a lot of diagnosing. I also think it's strange that he has had no nasal discharge. Everything I've read regarding pasteurella suggests one of the main symptoms as being discharge. It seems that he is so clogged up he can't get anything out, causing his labored breathing. I'm hoping a nebulizer treatment would help unclog him. The vet said that rabbit mucus is practically toothpaste and very immovable. We've also been keeping a humidifier on hoping it will ease his labored breathing.

Any more information anyone can provide would be fantastic. Hopefully we have some more answers after today's vet appointment.

Thank you everyone.