Ideas into what actually caused my Himalayan lop Milo's Death

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Cassie119300

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Hello,

This story may be very triggering for some so please read with caution, this story though is a part of what's causing me to lose peace. My bunny Milo who passed away on October 24th 2021 at 6.5 years old had a lot going on. At five years old he has developed what is known as snuffles, it started with his eyes looking reddish in the corners especially his right eye and then eventually a white mucus on the right side nostril just one nostril.

He was given baytril for 2 weeks. He did not sneeze a lot and I cleared his nose as needed usually every other day. He did have quite a snore when he slept though.

The baytril didn't do much but did reduce the eye redness to some degree. I also noted to the vet at the time his penis looked reddish and watery, just off to me.... I also had to give him butt baths a lot as he always had a problem with poopy butt it seemed no matter what I did or changed.

Penicillin G Procaine injections were given to him once a week for for 3 weeks for possible syphilis. Looking back I would have thought this would have been enough to clear his pasteurella but no. I noticed Milo was itching his ears a lot and flapping them around. I emailed the vet again explaining this and that he had some dry white flakes on his ears. She used a q tip to check his ear although I swear I remember her culturing under the microscope the discharge from his nose not his ear but whatever the case, the vet returned to the room two minutes later and said there was nothing. As for the ear flakes it didn't seem they wanted to be bothered with that.

Time goes on... I ask is there anything else we can do for the snuffles. Milo gets prescribed azithromycin twice. Again I want to say at most for two weeks. It still was not going away. Then came the antibiotic doxycycline. Still no improvement.

This is when the vet then basically told me that it now likely had become chronic and there is nothing that can completely rid rabbits of upper respiratory diseases or in his case pasteurella...which is weird for pasteurella never having been cultured, well I didn't know that at the time... She said he would most likely need to be treated every 3-4 months with antibiotics. That is not what happened though, I pretty much got ignored.

He developed a nystagmus of his eyes darting left to right in addition with his head swaying left to right rapidly, very fast until he would suddenly snap out of it. I understand some red eyed rabbits can do this, but this was pretty weird I thought, and the vet thought this was seizure activity??? He still continued to scratch at his ears. Now he did have some fleas but I had been using measures to help that, it can be difficult having two dogs and two cats in addition at the time. I was treating him with ovitrol as per a vets directions, unfortunately that very had retired long before all of this began. Leaving no exotic vet in my area. This other vet I was seeing regularly was a 40 minute drive.

I was even shockingly told by an assistant over the phone at this vets office most people opted to put their rabbits down due to it being " very distressing". I sought another opinion about 30 miles the opposite direction in the middle of winter, I do not drive unfortunately so my dad usually helped me with this on his days off, or my mother if the location wasn't too far, otherwise it was difficult with heavy traffic and unknown areas.

This other vet unfortunately had a pretty basic set up and prescribed baytril tablets which I had to crush up and liquify to give Milo orally. Thankfully Milo took medicines for me like a champ especially with applesauce on the syringe. She did a basic evaluation of his teeth and prescribed advantage for fleas as she was concerned he may be anemic, the ovitrol was not working like I thought... The advantage worked a bit better but still some fleas remained. I knew this place wasn't going to be much better.

I noticed he had developed what looked like facial paralysis... When he would eat his salad too his head would kind of rock side to side as well as he tried to eat the leafs. He was still eating as usual, he was also drinking a lot of water and peeing a lot too. The one side of his face seemed higher than the other. I emailed the usual vet about his face and the ear issue he had and asked about dental issues. I went in for a check up...she did a brief look at his teeth not even recommending checking his teeth better and wanted to start treatment with febendazole due to the " seizure activity".

Two rounds of this and more doxycycline I insisted on and nothing was getting better not worse, but just remaining the same. I was also instructed to groom him better whilst I was always taking care of his poopy butt, sometimes however he would arrive at the office this way but this vet didn't seem concerned with that?

We're now about a year and some months in later when June 2021 Milo developed pus in the right ear...again exactly where all other symptoms were occuring as well as some fur staining/fur loss and crusting of both eyes and some discharge in his other nostril now as well as some pus on his left ear but not as bad as his right ear.

The vet literally just kept insisting on e cuniculi and gave me tresaderm drops for his ear a steroid which I was hesitant to use but I was also just desperate to help him. She used an ear cleanser on his ear, looked at the pus...refused to culture it and that was that. Eventually she gave me the ear flush to use at home after saying " no" to me the first time when I asked if that's something I should use at home. It was virbac epiotic cleanser, and I'm even afraid she may have used a bottle that was just sitting out on her counter where it was probably used on many pets. This office was very clean and sanitized all the time, this concerned me though. I was also told to give him yogurt drops as a probiotic....no, I would not. She also liked giving rabbits plain Cheerios as treats?

I sought another vet after being charged an arm and a leg for literally nothing and getting no where. His right ear looked strictured, I used a pen light to assess it and clean it almost every other day as per instructions which I later read can just make the pus more virulent unfortunately. This other vet did a culture thankfully at least, looked in his ear with the right tool and said it looked very swollen, and full of pus. The culture he did and came back and said cocci bacteria. I was prescribed two weeks of tresaderm for the swelling much to my dismay, and Albon oral. He said at the next visit it was 50% cleared but the ear drum was not visible. The thing is his ear would always begin to clear up then it would just resurge with pus again. I was then given an ear cleanser for yeast called trizultra keto and it seemed to get some wax up out of his ears but not much else otherwise. My bunny seemed to be spending more time napping under my bed and randomly peed by my bed one day. I knew something was up bad. I thought I had just 5 more days to go until his next appointment... Then it happened. Milo began to lose balance using the side of my desk, walls and near by areas for support. He was wobbly and having trouble getting into his litter pan. I also couldn't tell if he had been drinking still or not and he did not want his salad. He was also beginning to go into GI stasis. It had been at least 4 weeks since the tresaderm. I wonder if the remodeling going on near by had stressed him out as well, Milo could not hear me anymore and had not been able to since late June. We are now in the beginning of October 2021. I could not get into this vet asap so I had to go back to the one I'd always seen.

Milo was given subcutaneous fluids, more dewormer for e cuniculi, doxycycline, metacam, and metoclopramide 3-4 times a day to stimulate his gut and prevent nausea as well as critical care. His head was tilted to the right, the original bad ear side. I also do think he may have had a slight bulge underneath this right ear that I could feel sometimes, it was hard for me to tell though.

His poops were very tiny and I was told his stomach was a bit doughy no blockages and he was dehydrated. He took the medicines for me, critical care...water though, was not very easy. It was falling out of the side of his mouth when he was trying to drink it, he could not drink water on his own but the critical care was easier for him to take.

The next day he lost all balance and began rolling, his right eye was also swollen and infected. We were back at the vet and he was given an ointment for his eye and in addition baytril just in case it was an ear infection when I'd been saying it was his ear all along. She just refused to ever acknowledge it for some strange reason, even though she could see the pus.even though she could never be bothered to do much as look in his ear with a light, do blood work, cts.... They had one of their assistants give him a shot of something to calm his dizzyness and I was quite pissed when I saw them roughly jab him with it and even saw some blood on his fur. It was just unbelievable everything and it all just felt so hopeless. Why did I have to be in a situation where it seemed no one knew what they were doing half the time or what was going on? Even deliberately? I felt so bad for him. They just told me to pretty much see how it goes over a few days and see if it's worth his suffering for, when I thought he'd have to be put down each time I went back there with him, I relived that torture about 6 times within this month.

The next appointment she told me she wanted to try acupuncture as she would " hate to see him go downhill" due to his paralysis. Well ... He could kick his little feet and if he was on his side he could groom his face with his front paws and even propel himself forward somewhat with his back legs but he was pretty much paralyzed. I agreed to try it and I wasnt too happy when he then rolled during the procedure with pins in him. The other vet doing it even said she would like to see him again some muscle before doing another session. I wasn't having it though, I knew I could do exercises for his feet at home and massages for his head tilt, I had to tell the vet repeatedly no. This one session alone was 300.00

She never cared to mention that he was losing muscle to me, maybe just a pound he had lost and commented yet again on how he was dehydrated ( according to the skin tent test) even though I was doing everything to get water in him with literally no guidance from this vet, just my own research. I would do it along with critical care, medicines, some baby food etc... I was doing my all but the water falling down was causing fur loss and some dermatitis to his chin and right front paw. I even mentioned he couldn't drink out of every different source I tried...not a water bottle, not a small nipple bottle, not a shallow dish and hardly with the syringe. She just responded sarcastically and snottily with yeah bunnies don't drink from straws. She rarely allowed you to ask questions she always dominated the conversation.

I had always given Milo echnichea supplements to keep his immunity in check and still was and even gave him a probiotic. He seemed to be lifting his body up for the water and trying to sit up on his own. His poop was sort of improving, he had passed these big prices of sticky poop with hair all in it followed by small tiny poops and kept having these weird big sticky poops in the morning, which I didn't understand. I saw no cecotrophs at all and I knew he couldn't be eating them. He was eating salad, just couldn't with water but he seemed to want to be able to he tried to bring his head close but just couldn't. He was eating hay on his own and some pellets and still critical care. He would put his face into my palm after my feedings and I always kept his favorite stuffed sheep animal near by. Let me also mentioned for a dehydrated bunny he was still peeing a lot. Bright yellow pee even. I changed out puppy pads frequently. His morning poops concerned me though. It seemed underneath them was somewhat of a liquid puddle. The only advice I was given was keep feeding more hay. I was so on full duty so much to the point where I did not sleep until about 3 am each night and my mother would help me with him in the morning or when I needed to shower, I shower her everything and she had cared for cats in the same ways before. I rarely ate and couldn't think about anything but saving his life.

Milo was very skinny feeling... How a rabbit goes from 4.80 pounds approximately right down to 3.03 oz is beyond me. Something was wrong and he was beginning to grow weaker again. Here's the thing though... And it doesn't make sense to this day. His rolling stopped, his eye began to clear up, and his nystagmus started to improve....but the rest of his body was moving even less...His snuffles had been the worst I'd ever seen them throughout the beginning of October and I was constantly clearing his nose putting hot steam in the air but at times...his mouth did seem to be going from slightly open to closed. This vet said there was nothing I could do for it which is a **** lie. Early on antibiotics could have been nebulized, I could do neb treatments, anything! She could have done x rays...no offer ever made and I had to find this all out on my own.

The last visit October 18th.. 2021, Milo was weak, but still eating some hay for me some pellets and still salad, taking meds as usual and critical care. My advice that day was " either he gains weight or... And putting him under for an ear flushing" I looked at him and did not see how he would even make it. I demanded a culture of his ear. She then told me most likely whatever came back would need to be treated orally and topically and kept saying it would be less risky to do an ear flushing than give him antibiotics.

His snuffles seemed to calm down at least he wasn't sneezing as much anymore and the snot was not non stop it was now back to what it was and we were now just in this standstill. I weighed Milo at home at he was 3.01 oz. His mental alertness became dull the last two days of his life on a weekend of course. He was not responsive to my touch as much, was not moving anything really except for occasionally flicking his ear when I cleaned it.... He still took the critical care for me and he still wanted lots of it but it was getting more difficult to give him water..the last night especially he didn't seem to want to swallow it really and I had worried he aspirated. His breathing was slow and sucked in looking and it looked like a cough after when I feared he aspirated but he did not make any sound. His ears became cold and he developed a very watery mushy type of stool his last night that was coming out non stop, he had also not peed since 6 pm, It was hopeless and I knew it and all I knew how to do was just hope and keep him comfortable. His ears were cold and when I wiped him he was shaking and his genital area looked a little red again. I knew nothing about expressing bladders at the time..

I kept him warm with a water bottle and put a light blanket on him after giving him his metoclopramide for his gut at this point just once a day his baytril and metacam just before bed at 3 am...I pet his fur. Any hay I tried this night and the last few he kinda chewed held in his mouth and ate it or let it drop out the same with his spring mix....but not the critical care. A few nights before this when I was cleaning his eye he made this sad sounding moan like noise for a few seconds and he sighed here and there. I will never be able to get it out of my head though.

I regret not staying near him just a little longer and not being at his side as not even 5 hours later my mom woke me up to tell me he was gone. I will always regret that. More than that though I feel absolutely rotten and terrible I never realized somehow humidity got to his hay satchel and there was some white mold on the bottom of the bag... I didn't know until it was too late. So as to what actually truly happened I don't know. His lips and teeth were slightly parted but he was still warm, his lips were slightly blue and when I moved him to make sure he was gone...normal yellow pee leaked out. So I don't understand that as well with his pee how none came out nearly half the night yet it did when he passed. There was also that watery poop as well. My poor little guy. I cleaned him off and only mad sure 50 times he was really gone, I was in utter shock and heartbroken. He was to be cremated the next day. I finally got the culture results the day he passed.... It was pseudomonas Areugenosa found in his ears...not cocci as the other vet said. The only antibiotics that would have worked would have been amikicin or gentamicin. The vet waited too long and knew all along what she should have done but she never did it. What a terrible awful senseless death she caused him. I was more than angry, I was shattered.

She had the fall to blame it on his snuffles and e cuniculi still and said it often claims the lives of rabbits then lied and said he had both upper and lower respiratory diseases. When shed only ever told me it was upper in the past. She said all treatments he had been given in the past provided reasonable responses but that he didn't respond over the last episode. She then also said I was never receptive to ending his decline to make it even worse. And that it was my responsibility to ask her to refer him so he could have had better care when she never told me to begin with she did not do sensitivity cultures there they had to be sent out, x rays, blood work etc...and yet they can spay rabbits there? Flush their ears? She later went in when I asked for his records and changed it so it would look like she found a rare bacteria in his ear an entire year prior.

I don't know what truly happened to him, if it was multiple things even, I can only assume..encephalitis took hold or sepsis and sadly his ear infection went past the bone in his ear, the bulla, and spread to his brain. It is so awful though...how hard it was to get him the care and relief he so desperately needed. Milo passed on just before my birthday as well, it was awful.

I've never ever in my life had to deal with such a terrible human being. So yeah that's Milo's story and it's a hard one to swallow. He was the sweetest thing I could have ever asked for, him and I went through a lot together. <3 If anyone has any thoughts into what may have happened it is much appreciated.FB_IMG_1655435869009.jpg





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LadyGrey

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What a long and heartbreaking story, I can tell you really loved and took care of this little guy with all your heart. Hopefully I can put you to ease in understanding what happen to your bunny.

When rabbits hit about 6-7 years old their considered seniors and their immune systems just don't work as well. It sounded like he started with snuffles (upper respitory infection). Because dwarf breeds have small faces, infections that start in the sinus cavity can easily spread to eye socket, and ear canals. Hence you started to see the eye issues along with the itchy ear symptoms. Once the ear started to itch that was a sign that there was now an inner ear infection, the pus proved the presence of an inner ear infection. When left untreated the the bacteria and pus can literally dissolve bone, making its way into the brain. Ay this point its super difficult to treat with just antibiotics.

Since EC is an opportunistic pathogen it likely became worse as your buns immune system became compromised. Ec can manifest in nearly every oragn of the body, but it often starts in the bladder and spreads to other proximal organs. Excessive drinking is often a sign of an EC out break, and chronic poopy bottom/runny stools could have been from the damage EC did to the intestinal tract. Many rabbits who have untreated EC tend to have compromised digestive tracts.

Hard to say if the EC or inner ear infection caused the head tilt/rolling over as both can do it. It was good the vets started the fendizbole.

It seems your small clinic lacked the tools to see exactly how severe the problem was. Many clinics try to save their clients money by just throwing wave after wave of antibiotics at problems because the alternative is to get an x-ray , culture test, or possible ct scan and even a surgery to remove the infected tissue and bone and that would easily have run you $4000+ without pet insurance. It didnt seem like they were the type of clinic who could do that. So they tried to help with the only tools they had, a microscope, antibiotics and acupuncture. Treating advanced inner ear infections is very difficult, I've known people who had to have their rabbits on 2 or 3 antiobitoics for half a year to finally get it under control. But it often goes better with surgery and the infected tissue and bone is removed.

Because of disease control only special labs are allowed to cultivate bacteria. First they take a sample of the bacteria then they grow it, then they test differnt antibiotics on it to see which therapy would work. It takes a while to get results but its definitely the best way to deal with stubborn infections. Sometimes bacteria grow resistant to antibiotics as well.

Hope this helps you understand a bit about what happen. If you have any other questions im happy to help.
 

Cassie119300

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Yes I did the best I could, My partner and I easily spent over 8k trying to cure Milo. He was a Himalayan Holland Lop, whether he was a regular lop or a mini lop I'm not sure but I'm thinking just a regular lop. I was aiming to give him a lifespan of at least 10 years or more, I did everything to try and do that. The vet told me at the time he wasn't super senior but was getting there, I read it's like 57 years in human years when I looked it up, that seemed a short time for his life. I know lops are more predisposed to ear infections and tooth problems though. It was because of him that I learned everything I know now. I think the tresaderm certainly weakened his immune system as well, he was given two weeks worth roughly 4 weeks before this all happened. The issue is that, she saw for 4 months straight the pus coming out of his ears... literally leaking out and I could not convince her to do a culture for me, or to recognize it as an ear infection, it was pure ignorance. Those four months were critical to saving him with the right antibiotic. For a clinic that claimed to do a bit of everything, that routinely did surgical procedures for dogs, cats, and even x-rayed dogs and cats, I would think they at the very least did blood work before putting them under? And if they are to do ear flushing on a rabbit or a spay surgery... then most certainly they would need to be equipped to do such things. However, I was never informed they could not... until the very last moment. I was never told they didn't have anything like that. I was given the impression all was under control a very false impression. Yes I definitely agree it ended up traveling to his brain, no doubt about that. I feel like he had those weird stools all along though and these stools coming out were huge... huge piles. It was the last night he developed a very bad watery type poop.

So I ask myself...

1. How could he be dehydrated still if he was still peeing a lot? Why was he rapidly losing muscle and weight severely within weeks...?

2. Why the last night at 6 pm he no longer urinated and yet the next day when he passed on... it leaked out when I moved him... with no sign of blood or anything weird. His urine was not dark.

3. What prevented him from being able to drink water properly and why was the critcal care and hay easier? or spring mix or pellets?

4. Did the moldy hay have a role to play?


5. His rolling stopped and his nystagmus was clearing up.... yet suddenly he went downhill without these symptoms coming back?

6. I wonder if the infection when it spread to his brain.... stopped functioning of his bladder or something was very wrong in his cecum...

This vet was not very good that much is for sure, as I as a human being could never look at something helpless with pus in its ear and refuse to do anything about it. She proved it later on by saying we most likely will need to treat it topically and orally that she knew the whole while... it should have been treated with a culture then the right antibiotic. I could never see an animal dehydrated and not want to find out what's going on with him not being able to swallow water properly, the vet may have offered to help clip his fur in the affected pseudomonas area and where water kept getting despite me drying it and drying it, and more importantly they were capable of giving him intravenous fluids or more subcutaneous I was probably better off learning how to do it and doing it myself.


I've read Snuffles is more likely to be treated early on by using a heavy duty antibiotic through nebulization, putting the rabbit in a kennel with a towel over with the nebulizer, and nebulizing gentamycin early on, this antibiotic as well as amikacin is effective at even getting rid of pseudomonas early on and will go through the nasal ducts where an oral antibiotic cannot reach. However more commonly, it is confused to be only Pasteurella that causes snuffles, which is not the case it's a multitude of bacteria that can do it. So Milo did not have Pasteurella, but he had most likely pseudomonas the entire time.... which could have been treated early on. Also, the vet probably could have put him on baytril to begin with for a month. If anything all these antibiotics for two weeks at a time made him resistant to all of them. Not good.

A good vet would offer every option available and let the patient decide what they can and cannot pay, they should never assume... this was never offered and no referral or recommendations, it was entirely selfish. I probably could have afforded that surgery early on.... I would say the clinic lacked more than the tools, they lacked the want to even use any tools that they did have available. I've not known a vet that will not look into a rabbits ear properly with a flash light. That was them though. Not even once did they do that. If they had the equipment for cats and dogs, then that's rather suspicious to me they wouldn't use it for a rabbit?

Thank you for your insight into what may have happened, I appreciate it.
 

LadyGrey

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1) When the functioning of the intestines are comprised they dont extract water properly. When you start to see any sort of moisture in the stools the large intestine is not doing its job properly and dehydration will happen.

2) When you pass away the autonomic nervous system stops holding the bladder shut.

3) Once rabbits have an inner ear infection they often experience vertigo. Many rabbit savey vets are aware of this and prescribe anti nausea mediction along with anti inflamotories. Hard to eat when you feel sick and queasy.

4) Unsure. Rabbits are pretty good at avoiding moldy hay but if he had a uri his ability to smell the mold may have been compromised.

5) Sounds like he was responding well to the antibiotics but there was still an issue going on with his bowels. Dehydration was probably the other secret enemy. The withering of the muscle mass was definitely an indication that his body wasnt able to utilize the nutrients it was getting from the crital care.

6) It's possible but not likely, but he was showing so many signs of advanced EC.

Sometimes we put to much faith in our doctors. My cousin lost his life because his doctors kept telling him he was only having heartburn, by the time he got sick he found out it was cancer and by then it was too late. I learned if something feels wrong you need to get that second or third opinion.

I don't want to sound like a anti vet person but I always tell people. Vetinary practice is a business, making money comes first. I've probably worked with 5 clinics and 8 rabbit savvy vets none of them have ever referred me to another clinic. I went to 3 clinics to deal with my buns cherry eye. #1 said leave it alone as long as its not bothering her, #2 wanted to remove the eye for $1900, #3 wanted to try and use a tissue adhesive to keep the gland from popping out for $2200. Each had a wildly different approach.
 

Cassie119300

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It is literally as if, despite how much water I gave him... it wasn't doing him any good, and I thought the skin tenting in part was also due to the weight and muscle loss. It was very confusing to see him peeing so well and have pee so light and judge his hydration and to think he could still be dehydrated. If only I'd known there was no way to reverse it, I thought the vet would have told me if it was hopeless or not, and I just feel awful for that and any suffering because I had the hardest time judging it all, it really wasn't until the last two days when his alertness just vanished, a week before... he was eating everything, he never stopped eating the critical care for me... lifting himself up so things looked good... It was only afterwards, after he passed on, the vet said there was no hope in reversing his decline...…and in addition, they went the extra mile to cover up the fact that the bacteria had been found only way later on... and made it look like a year prior.

Yes, he was on metoclopramide 4 times a day to start with to keep his gut moving as well as Metacam to keep inflammation down. He was on 1 ml of it for about a month once a day. The confusing bit was all those weird poops in combination with small rounded looking normal poops. Yes, I think he had been nutrient deficient for a while... and that is another thing that I could not seem to reverse.

Yes it's hard to know, he also ate some of my hair too... it must have been on the floor somewhere but there was a lot of it in his first initial poops. After that, I did not see anymore hair....

The doxycycline he was on may have been working as far as the baytril the culture showed he was totally resistant. I think it would always work to some degree, then just kind of halt. So maybe the EC itself... stopped him from being able to pee when his renal system got impaired. I wish I had known about expressing the bladder though, then. To make him a little more comfortable.

I hear you and am sorry that happened, unfortunately something very similar happened with my grandfather and he ended up having stage 4 stomach cancer, sometimes they don't always listen and you have to persist or go somewhere else. That mistake almost cost my life as well when my doctor told me to take ibuprofen when I was having acute pancreatitis. No amount of ibuprofen or a stomach acid pill is going to cure that.

Yes, and that I did... I saw two other vets in addition, many places were not taking patients further away... because of the pandemic and all. It was a shitty situation.

It is true, it's a gamble... you just hope you find one that knows what they are doing and doesn't want to take advantage or recommend unnecessary things for profit. You never know. I guess sometimes we just have to use our best judgement and decide which is better.

Not to be morbid but... this bothered me greatly, when Milo passed on... he never became... stiff? Not even the following day when I was bringing him for his cremation had he been stiff.... He was still very much warm when he passed... apart from his ears. I think I did read somewhere though where this is a lot of muscle loss.... rigamortis may not be present. A lot of it was me being in shock too and being terrified he could have still been alive...
 

JBun

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Your rabbit likely had what started out as an upper respiratory infection, that was never treated long and effectively enough with the multiple courses of antibiotics tried, to get it at least under control, and/or possibly completely cleared up. It sounds like it spread and developed into an inner/middle ear infection that abscessed, then eventually ruptured into the external ear canal.

Red eyed rabbits will sometimes exhibit normal scanning behavior, but horizontal nystagmus is something different, and certainly should have been investigated thoroughly by your vet, as it's a pretty good indicator of there being an inner/middle ear infection. Even a semi knowledgeable rabbit vet would have known this. When the horizontal nystagmus presented, your rabbit really should have received a thorough ear exam and xrays, to check for infection spread, and then put on a longer antibiotic course along with an adequate dose of meloxicam as an anti inflammatory.

Medirabbit: ear infection clinical signs and treatment

That's what was causing the excessive ear scratching and head shaking, the horizontal nystagmus, the facial paralysis, the loss of balance, head tilt, rolling. Combined, all are symptoms of an inner/middle ear infection. And with a current respiratory infection occurring, infection spreading to the inner/middle ear should have been the first suspicion, not e. cuniculi at all.

The main problem was that the courses of antibiotics were entirely too short. Rarely will a two week course make a dent in a respiratory infection in rabbits. Usually 4-6 weeks is the minimum with rabbits. With the penicillin, once a week wouldn't be enough to adequately affect a respiratory infection. It would take daily injections of the short acting pen g(procaine), or every 2-3 days of the long acting pen g(procaine/benzathine). And the course would have needed to be done for 4 weeks minimum, certainly at least 2 weeks or longer past the last of the symptoms clearing up.

If you saw improvement on the azithromycin, it's a good antibiotic for respiratory and head infections. It has good tissue and bone penetration and works quickly, but the higher recommended dose is usually needed, and for longer than 2 weeks. My rabbit that had an abscess in her eye socket(after eye having been removed), was on two antibiotics previously, for only a few weeks and it wasn't long enough. She was then put on azithromycin for 2-3 weeks at a lower dose. The infection cleared up, but then came back soon after the antibiotic was stopped. I wanted her on the highest recommended dose and for longer this time. So she was put on almost double the previous dose and for 4 weeks. This finally got rid of it completely. She lived symptom free for a year before her death from old age.

So it's about rabbit infections being difficult to completely clear up, especially if inadequate antibiotic treatment is given. It needs to be long and sometimes a higher doses, to truly be effective. 4-6 weeks is usually the minimum recommendation. Your rabbit should have been on a much longer course from the start. Rarely is 2 weeks ever long enough to clear an infection in rabbits, especially a respiratory or inner ear infection. Certainly by the second antibiotic failing, much more aggressive antibiotic treatment should have been started.

(CONTAINS GRAPHIC MEDICAL RELATED PHOTOS)
Medirabbit: abscesses in rabbits

You may have seen an improvement in some symptoms and worsening of others, because the infection or 'abscess' burst, relieving pressure and causing some symptoms to improve, but then other symptoms remaining bad.

With the poopy butt, when there is still normal fecal balls, it's usually from mushy cecotropes due to too many pellets and treats in the diet, and/or not enough fiber from hay. There are other possible causes like dental problems, arthritis, obesity, heart issues, cancer, and liver/kidney disease. Occasionally a food sensitivity can be the cause, or if this developed after the start of the URI and the ear infection, this stress could have contributed, along with the antibiotics.

Your problem was having the incredible misfortune of going to absolutely incompetent and inexperienced rabbit vets(if they can even really be called rabbit vets). I'm really sorry for your loss and for the truly inadequate vet support you received. If you feel that any medical malpractice occurred, you may want to consider submitting a formal written complaint to the office manager of the vets and clinics involved.

You can also submit a complaint to the NYSVMS. You want to keep any evidence of what occurred, particularly any written info, records, texts, emails, voice recordings, etc. It may be that nothing comes of it, but it may help you feel some sort of closure to at least try to hold them to account. Certainly any veterinary malpractice and failure to provide appropriate care should be investigated and the vet put on notice. Especially if they at all acted inappropriately and without due care, or acted out of their scope of knowledge and experience.

How to file a complaint with the NYSVMS
 

Cassie119300

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I agree 100%.... His eye that got infected infact...was rolling everywhere, it was so awful but it was just about healed when he passed on. His right ear, did definately have something abscess feeling at the base... All of the pus had begun around late June/July 21 so that's about 2-3 months of external ear pus coming out, to the point where I absolutely have to clean it off everyday. I did not know it was pseudomonas until the tail end, literally the day after he passed on the vet emails me the results finally. I say vet, but they were never a vet in my eyes, just a cold hearted person who didn't so much as flinch even leaving the room to go and put someone's pet down and said " it's just their time". Ok...


I have no idea how to explain what his poop became but it was like massive sized looking sticky poop...more so than I found with his poopy butt, I'd never seen anything like this. I can't honestly remember a time when he didn't have poopy butt, Milo was so used to needing butt baths he would lift his butt for me so I could help him, never thought that would ever happen but it was just routine for us, He was a very mild mannered rabbit though, very calm and relaxed.

Milo could no longer hear me as of July..... It broke my heart even then and even more not knowing how he must have been feeling all along. It was not until October he ever had pain medicine, but he carried on as normal until he could no more. I find it amazing...truly amazing, he was able to act normal as usual up until... eating, flopping, etc... I recall even asking quite a few times if they were going to keep Milo on the antibiotic longer and of course I'd get no all of the time...Ironically it was the last week of his life I was told I could do another two weeks and get a refill if it still wasn't clearing up. There never was any blood or anything like that from his ears either.... It was yellow and white. In the end the pseudomonas had changed his fur color to a greenish color, I actually thought it had been from the towel I had placed near him, but there was no way as it had been washed many times and I could not get the stuff out of his fur, the vet loved reprimanding me for that.

I would call there crying half the time asking the assistants what to do...and I was told to just keep trying just keep waiting... I didn't just lost Milo once but in my heart and mind I lost him 5 times over. Each trip to that awful vet... Was never knowing what to expect.

It hurt me so bad to see him go through such uncessary illness that could have been prevented early on, when this vet clearly could not and did not want to be bothered and quickly rushed to assume that he was just going to have it lifelong, and that was that. She even said he had seizure activity....no he would move his head back and forth fast about 10-12 times then stop... All I can say is every visit and every email I ever had with that vet was me basically saying I'm pretty sure it's an ear infection and it always getting brushed under.


I did complain to the OPD and absolutely nothing came of it. Within about four months it was decided. There was no hearing just the vets attorney and another vet of her type...the investigator himself...and despite a mountain hill of emails and evidence, my emails even proving she had altered his medical record disproving her lies of finding the bacteria a year prior... Everything was unfounded.

The reasons why? 1. Pandemic. 2. Cornell wasn't accepting any referrals as she told me after the fact after he was gone even telling me it was my responsibility not just hers to ask for that referral...which would have been great if I knew she never had the equipment to help him in the first place which honestly I think she did, she just didn't give a ****.

3. Due to very good email correspondence between me and the vet

4. That she... " Provided the minimum acceptable standard of care" no matter how low that minimum was. Just because they prescribed him medications.


Those were literally the reasons I was given by the investigator as to why she was not at fault. I also was not allowed to know anything she said or her attorney as well. Infact they seemed more happy to see a case with a rabbit as they don't get them very often but I'm told don't worry though it's not like it's just a rabbit, I assure you all the stuff was reviewed... except they never reviewed the video I supplied or Milo's head going side to side rapidly...

I continue to watch in horror as one dog almost died and another dog passed on from going to their office for spay procedures... I knew their reviews would plummet again, people were leaving really good ones really just based on the fact they were willing to take new patients in, rare around here, rarer yet to find someone who even sees rabbits.

I even wrote a blog about everything that happened just to make sure my story was out there, of course excluding names and places ... I have a good feeling they saw what I wrote though as not even a day later Facebook took it down...suddenly. it's been crazy.

Ever since though I try to warn everyone else I can when they have these symptoms in their rabbit, to not take no or lack of concern or treatment for an answer. I wait for the day this person finally gets it handed back to her for what she did to him and continues to do. Anytime I hear the office name I immediately tell people no... Unfortunately they are using the fact other practices are not taking patients to their advantage right now...it's only a matter of time until people realize..

I got pretty ticked when I was also told by the investigator this vet got off scott free as well because my rabbit was a senior and even though she changed his medical chart to suit her, it wasn't considered altering documents, oh and just because a vets word over mine. It's a load of crap. I said what about the pain he was probably in? How do they know how he felt?, how can they assess that.....

It did not matter....

So I get very upset whenever I hear a bunny is treated any less than any other animal...I saw this vet blame deaths on animals just being prey animals and hiding symptoms as well. Despite whatever factor they throw. That's exactly the game being played here....


Thank you for your insight, I truly appreciate it and it makes me feel a lot less alone in what I had been fighting for, for his life all along.
 
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I agree 100%.... His eye that got infected infact...was rolling everywhere, it was so awful but it was just about healed when he passed on. His right ear, did definately have something abscess feeling at the base... All of the pus had begun around late June/July 21 so that's about 2-3 months of external ear pus coming out, to the point where I absolutely have to clean it off everyday. I did not know it was pseudomonas until the tail end, literally the day after he passed on the vet emails me the results finally. I say vet, but they were never a vet in my eyes, just a cold hearted person who didn't so much as flinch even leaving the room to go and put someone's pet down and said " it's just their time". Ok...


I have no idea how to explain what his poop became but it was like massive sized looking sticky poop...more so than I found with his poopy butt, I'd never seen anything like this. I can't honestly remember a time when he didn't have poopy butt, Milo was so used to needing butt baths he would lift his butt for me so I could help him, never thought that would ever happen but it was just routine for us, He was a very mild mannered rabbit though, very calm and relaxed.

Milo could no longer hear me as of July..... It broke my heart even then and even more not knowing how he must have been feeling all along. It was not until October he ever had pain medicine, but he carried on as normal until he could no more. I find it amazing...truly amazing, he was able to act normal as usual up until... eating, flopping, etc... I recall even asking quite a few times if they were going to keep Milo on the antibiotic longer and of course I'd get no all of the time...Ironically it was the last week of his life I was told I could do another two weeks and get a refill if it still wasn't clearing up. There never was any blood or anything like that from his ears either.... It was yellow and white. In the end the pseudomonas had changed his fur color to a greenish color, I actually thought it had been from the towel I had placed near him, but there was no way as it had been washed many times and I could not get the stuff out of his fur, the vet loved reprimanding me for that.

I would call there crying half the time asking the assistants what to do...and I was told to just keep trying just keep waiting... I didn't just lost Milo once but in my heart and mind I lost him 5 times over. Each trip to that awful vet... Was never knowing what to expect.

It hurt me so bad to see him go through such uncessary illness that could have been prevented early on, when this vet clearly could not and did not want to be bothered and quickly rushed to assume that he was just going to have it lifelong, and that was that. She even said he had seizure activity....no he would move his head back and forth fast about 10-12 times then stop... All I can say is every visit and every email I ever had with that vet was me basically saying I'm pretty sure it's an ear infection and it always getting brushed under.


I did complain to the OPD and absolutely nothing came of it. Within about four months it was decided. There was no hearing just the vets attorney and another vet of her type...the investigator himself...and despite a mountain hill of emails and evidence, my emails even proving she had altered his medical record disproving her lies of finding the bacteria a year prior... Everything was unfounded.

The reasons why? 1. Pandemic. 2. Cornell wasn't accepting any referrals as she told me after the fact after he was gone even telling me it was my responsibility not just hers to ask for that referral...which would have been great if I knew she never had the equipment to help him in the first place which honestly I think she did, she just didn't give a ****.

3. Due to very good email correspondence between me and the vet

4. That she... " Provided the minimum acceptable standard of care" no matter how low that minimum was. Just because they prescribed him medications.


Those were literally the reasons I was given by the investigator as to why she was not at fault. I also was not allowed to know anything she said or her attorney as well. Infact they seemed more happy to see a case with a rabbit as they don't get them very often but I'm told don't worry though it's not like it's just a rabbit, I assure you all the stuff was reviewed... except they never reviewed the video I supplied or Milo's head going side to side rapidly...

I continue to watch in horror as one dog almost died and another dog passed on from going to their office for spay procedures... I knew their reviews would plummet again, people were leaving really good ones really just based on the fact they were willing to take new patients in, rare around here, rarer yet to find someone who even sees rabbits.

I even wrote a blog about everything that happened just to make sure my story was out there, of course excluding names and places ... I have a good feeling they saw what I wrote though as not even a day later Facebook took it down...suddenly. it's been crazy.

Ever since though I try to warn everyone else I can when they have these symptoms in their rabbit, to not take no or lack of concern or treatment for an answer. I wait for the day this person finally gets it handed back to her for what she did to him and continues to do. Anytime I hear the office name I immediately tell people no... Unfortunately they are using the fact other practices are not taking patients to their advantage right now...it's only a matter of time until people realize..

I got pretty ticked when I was also told by the investigator this vet got off scott free as well because my rabbit was a senior and even though she changed his medical chart to suit her, it wasn't considered altering documents, oh and just because a vets word over mine. It's a load of crap. I said what about the pain he was probably in? How do they know how he felt?, how can they assess that.....

It did not matter....

So I get very upset whenever I hear a bunny is treated any less than any other animal...I saw this vet blame deaths on animals just being prey animals and hiding symptoms as well. Despite whatever factor they throw. That's exactly the game being played here....


Thank you for your insight, I truly appreciate it and it makes me feel a lot less alone in what I had been fighting for, for his life all along.

I really feel for you. Sounds like a devastating experience.

We lost my brother-in-law in a similar way. He lived in a rural part of a different country and passed away, probably unnecessarily soon, after receiving questionable medical care.

I can only say that I find it helpful to remind myself that while medical resources were imperfect, he lived exactly the life he wanted to live in exactly the place he wanted to live it.

You probably can't change that your vet wasn't fully competent or that there wasn't a better vet available. But it might be possible to nudge your vet and the governing agency toward responding more constructively to cases like these where there's a medical failure and where the practitioner tried to treat a patient with an illness that was beyond their skill set.

There's a report called "To error is human" on how to reduce systemic failures in medicine that you might find helpful.
To Err Is Human: Building a Safer Health System
 

Cassie119300

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It was for sure, there was no worse feeling than feeling utterly helpless to help him and wishing I could. I'm sorry for the loss of your brother in law and the circumstances of his passing. I do find comfort in the fact that he was happy and I gave him a good life and knowing he was so loved. If anything, I think I gave both that vet and governing agency some pause for thought, but there is a lot of change that has to be done to the system unfortunately and the way our pets are viewed when it comes to matters like these, not to say it doesn't happen with humans as well, but I've always wondered why our pets are even treated with a price tag, when for us it's absolutely mandatory we receive care, money or not, It should be the same.. absolutely. I'm not sure what more I can do other than all I have... I do however share his story in hopes it may never happen again and to try and prevent anyone else and their pet from ever having to go through it too. Unfortunately sometimes we just get dealt a crappy hand and no matter how much you try and change someone's view, it doesn't happen and nothing is done before it's too late, even when the answers are right in front of them.

Giving someone false hope and the impression everything is under control is quite cruel if said person knows the pet isn't going to make it however and is continuing to act as if there is still a treatment protocol to make the condition better. Only to then reverse it and blame you for not "ending the decline". There honestly was no way of knowing he wasn't going to make it.. until things took a turn for the worse. I understand us humans make errors, sometimes though, humans can also be exceptionally ignorant and let arrogance get the best of them, rather than treating the actual problem even when it's visible, and that is exactly what happened in Milo's case. I understand there was some things going on beyond this vet's control or that maybe they didn't have the equipment or knowledge to deal with that, fine and good, but let me know so I can quickly get him the help he needs. However, I'm not sure even a regular joe could have missed the fact he had an ear infection here... so to let it be ignored for 4 months, or not try and treat an upper respiratory with a different antibiotic or for a little while longer, is literally negligence.

I was once in this similar scenario myself, almost 4-5 days had passed and my condition was getting worse, the doctor wasn't really all that sure why it was continuing to get worse or why I was developing more serious complications. The doctor promised however, if he was not sure... he would put my care in better hands, and that... is exactly what ended up happening and because of that... my life was saved. I nearly died on the 5th and 6th day. I won't forget seeing that doctor years later on smiling to see me doing well. I miraculously survived a pulmonary embolism, DVT, Acute Necrotizing Severe Pancreatitis, a pseudocyst, and Pneumonia. In the end, I got to come home and once again be with my little guy after 3 long weeks when it could have been so much worse.... and so much longer.


I will check that out, thank you.
 
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Wow, that's quite a story. Thank God your doctor had the guts and competence to refer you to someone else!

It's been a million years since I read that report, but my recollection is that some of the key recommendations involve creating an environment in which healthcare professionals are encouraged to admit errors.

But none of that would be enough with a vet that just seems to be throwing random treatments at the wall to see what sticks!

I'm so sorry again for what you've gone through.
 

Cassie119300

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I have a video showing the scanning behavior Milo had been exhibiting.... which is what the vet and I had got into a debate over.... They said it was neurological due to "e cuniculi" or just in general.... It wasn't until Milo got very ill you could see the really bad nystagmus... I may have mistaken these videos at the time for "nystagmus" as I thought at the time nystagmus was the head movement I was seeing rather than of the eyeball itself, but I do still believe he had both of those present for a while.... here is the video I could not seem to upload it on here so I had to go through youtube....
 
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Cassie119300

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I just wanted you guys to all know what this 'vet' had said in regards to the above video I posted at that time.....

They said "
the video is showing neurological problem (most likely inflammation in the brain). E. cuniculi can
infect the brain. Pasteurellosis of facial sinuses/ears wouldn't show neurological symptoms like his
"seizure" activity. This movement is not nystagmus because only the eyes move w/ that condition.
If you have enough fenbendazole left for 3-4 more weeks, then somehow you are not giving the
correct dosage (the meds sent home would have maybe a week extra not a month). if we cannot get
clearance w/ fenbendazole for 28 days (+/- another round of Doxycycline) then we will likely be
unable to "cure" him. " They then also added before this
"
video showing repetitive head movement (motor or neuro seizure atypy). suggest we change tx to E
cuniculi because that often involves brain and ears."

1. Since when does E cuniculi involve the ears?
2. Since when does pasteurellosis of the ears not show neurological symptoms if it has spread into an ear infection?

This is just to show you guys how resistant this vet was on not calling it what it actually was, an ear infection.

7/21/21 - 7/22/21 is the dates on which the vet had input these statements. The first statement was never said to me, I only found out in his medical charts which I believe was changed to suit them after his death occurred as it took two weeks to get this medical record sent to me.

In the notes one of the receptionists also stated "Owner thinks ears are the main problem.... as well as Owner asked if she needs to continue the rx (in other words a longer duration"

3 months later Milo passed away.....
 
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