Milky Eye Discharge Medication Options

[danakscully64]

My rabbit, Mason, has a reoccurring eye problem. He's about 7 or 8 and has milky discharge. He's been to a vet already, April 1st of this year, and was prescribed Gentamicin Sulfate Ophthalmic Solution USP, .3%. The instructions said 3-6 drops into the eye four times daily for 5-7 days. I did that and he seemed okay for a bit. I had extra drops so when I'd see the eye dripping again, I'd put some drops in. I'm completely out of drops and his eye is really acting up again.

The reason I'm posting is because I recently moved out of state and while some of the vets here say "Small Animal Vets" on the web, I honestly don't know how qualified they are. I plan on taking Mason in next week. I was wondering what medications are commonly prescribed to rabbits for this condition besides the Gentamicin. I would like a list to make sure I'm getting a safe medication for my little guy. Thank You!

Mason doesn't stay still, this is the best shot I could get with my macro setting (light sucks, that doesn't help):

You can see my dog in the top, right corner. Right after I took this shot, she ran in to lick Mason.:bunnydance: :run:

 

[Maureen Las]

Here is our list of Ca veterinarians ; I don't where Riverside is so maybe you can find someone here who is close to you.

http://www.rabbitsonline.net/view_topic.php?id=11590&forum_id=9


When you call the vet office and inquire ...ask them how many rabbits they see in a week. If they hesitate and say a couple this probably is not a true exotic vet.
Feel free to question them further .Remember that you are the client who is paying for their services . Most experienced rabbit vet office staff will be up front that they see many rabbits .
Sometimes there is one good rabbit vet in an office that is not all around rabbit saavy. As long as you are reassured that " Dr. so and so" is rabbit knowledeable and sees a lot of rabbits it should be worth a try.

Could this actually be conjunctivitis? A thought to consider

I am wondering if their is an issue with your rabbits tear ducts or even dental issues that are creating this on-going problems.
That is something that you could bring up to the new vet. Eye problems are often seen when dental issues are going on undetected so when you find the right vet it may be a good idea to have them check the teeth per x-ray ( usinga a scope visually tells vey little) and/or attempt a tear duct flush to see if their is blockage and infection in the ducts. Also check the eyeballs themselves for ulcers or scratches (this is done by placing fluorescent dye in the eyes)

I had a rabbit with an unresolved ulcer who was treated with many different opthalmic ointments and drops soI can name a few ...
Hopefully Randy can also tell us what he uses at the rescuefor eye infections.

I have used Gentacin Sulfate Opthalmic Drops

Tobramycin Opthalmic drops
Neo -poly-bac Opthalmic Ointment
Neomycin opthalmic drops
Chloramphenical1% veterinary opthalmic ointment

My rabbit responded only to the chloramphenical salve ( much to my relief.)

During the time he was not responding to treatment I cleansed his eyes with sterile eye wash which can be found in the contact lens sections of any pharmacy .

Good Luck and let us know

Maureen

 

[tonyshuman]

I would guess that it is conjunctivitis. I think it would be good to try an antibiotic from a different group or class of compounds. Gentamicin, neomycin, and tobramyacin that angieluv posted are all aminoglycoside antibiotics, meaning they pretty much all work on the same bacteria in the same way. I think a different type of antibiotic would be better to try.

Other classes of antibiotics include fluoroquinolones (ciprofloxacin (cipro), enrofloxacin (baytril)), penicillin-related ones (end in -cillin usually, cannot be given orally to rabbits--must be injected), tetracyclines, and chloramphenicol.

I would get a good vet off the list angieluv posted, ask those questions, and go to them. The vet should do a head/dental x-ray as well, and feel around the area for bumps. They may want to do a week or so of a stronger eye drop/one from a different class of antibiotics before going through the trouble of an x-ray as those require sedation.

 

[ra7751]

Umm....well, I usually use Tobramycin or Gentamicin....and would use Chloramphenicol if necessary. But a couple of thoughts here. Looks like from the pic that Mason isa Holland....I would certainly get some rads and look at those molar roots on the upper right arcade. Next, if it is a true bacterial infection, I have rarely had long term success using drops only. Conjunctivitis is quite common in wild finches and so many rehabbers have used drops only....appeared the condition had resolved...and released the bird only to have the eye close up again. So our experience has been drops and a systemic abx. I would also stain that eye to see if there is anything going on with the cornea. Sometimes some debris or even an eye lash can cause an abrasion. Left untreated, it can ulcerate. But I certainly think something is going on here that needs more than just drops.

And just for information.....Gentamicin is one of the drugs I consider "big gun". I don't want to call it "stronger" than other drugs because that would be an inaccurate statement but it does offer wider coverage then some of the others.

I would like to see your current vet, or your future vet, perform a bit more diagnostics here. Eyes and ears are nothing to play with ina rabbit. And a word of caution....until you find out exactly what is going on, make sure that you DO NOT use any drops or ointment thatcontins a steroid.

And a final thought....I would irrigate the eye in-between the drops. The best OTC product you can get is Refresh Gel. The gel stays in the eye better than artificial tears.

Randy

 

[danakscully64]

Thanks for the comments, everyone I went to the vet today and got a refill of the same medication I had before. Mason didn't have any issues with his teeth, they are in great shape. Last night he stopped eating and hasn't pooped since. The vet prescribed an oral medication and a injection to help with that problem. He got an injection at about 3pm (it's 9pm now) and we just gave him the oral meds, so far, no poop. He did have an appetite when he got home, he immediately ran to his food bowl, but only took a few bites.

If this medication doesn't work, I can call her and just pick another up. I'm definitely going to pick up some Refresh Gel

I do have a question... with the Gentamicin (3mg/ml) , how many drops per eye/per day? My first bottle said a few drops, this one says one. Thanks!


~Heather
PS: I think Mason is a Mini Lop

 

[ra7751]

I am almost scared to ask....but was the injection Reglan or Metaclopramide? I hope not. If so, I would find a rabbit savvy vet. And if it's not one of those, can you post what the injection was and what the oral drug is. With a few exceptions, the most effective antibiotics are injectables.

If radiographs were not performed of the jaw, there is no way anyone can say the teeth are in good shape...gotta look at those roots and the only way to do that is by radiology.

As far as the Gentamicin, I would put 3-4 drops in each eye every 4 hours or so if possible.

Randy

 

[danakscully64]

Oh no, why not those? It was Metoclopramide.

 

[Maureen Las]

metoclopromide is a gut stimulant drug which is used by some vets when a rabbit is in stasis. It makes the gut contract and supposedly help the system start moving

It is a controversial drug on this forum.

The important thing is .........How is Mason today?

 

[danakscully64]

angieluv wrote:

metoclopromide is a gut stimulant drug which is used by some vets when a rabbit is in stasis. It makes the gut contract and supposedly help the system start moving

It is a controversial drug on this forum.

The important thing is .........How is Mason today?

That part I didn't know.

Mason is still constipated He ate a baby carrot this morning, but stopped there. The only thing I could get him to eat after that was unsweetened, dried papaya and about 2 baby bites of shredded wheat. I can tell he doesn't feel good, he's staying in one spot in his cage, that's not normal for him, he flops around everywhere. If he's not feeling better in the next few hours, I'm going to take him in to the emergency vet. The problem is this vet charges an insane amount for a visit, they're known for being the most expensive in town. I have to do it, it's just a big blow to me because I'm unemployed.

On a good note, he's still drinking water and peeing.

 

[ra7751]

The gut motility drugs are something that are used often in dogs and cats....but those guts are quite different than a rabbit. Depending on the drug, it simulates harsh contractions in certain parts of the GI. Just like when we have gas cramps, they are very painful....and you know a rabbit's response to pain....not a good thing. In many GI events, the pH will change radically and that will allow the formation of gastric ulcers.....these ulcers will make an already thin GI wall even thinner. If there is a total impaction and the contractions are at the point of the ulcer, the ulcer can perforate and that is never a good thing. All of my vets are teaching vets and none of them will use motility drugs in a rabbit. In my non-professional opinion, if a vet even suggested using a motility drug, I would be out of there. The proper response for stasis is hydration....not stimulanting drugs. These drugs put the vet in a "can't lose" situation.....if the rabbit survives stasis, vet is a hero. If it doesn't, we got to it too late and the drug didn't have time to work. I am not a vet....but I have been treating very sick rabbits for decades. Motility drugs will never be used on any rabbit that I am dealing with. Too much risk and no potential benefit...again, in my non-professional opinion.

Hydration, hydration, hydration. To get the gut going, it has to have fluids. The first thing a rabbit savvy vet should do is adminster fluids sub-q or IV.

Randy

 

[Maureen Las]

You need to go out and get some electrolyte drink for children (pedialyte) and also a fresh pineapple. You can squeeze juice from the pineapple and give him a few cc's every 6 hrs or so. Also start syringing pedialyte . ..as much as your rabbit will take..many times they like the taste of it so will not resist.

You can also pick up some canned unflavored pumpkin. ( no seasoning). Some rabbits like pumpkin and will eat it on their own. You can syringe several cc's of pumpkin also every 6hrs or so.
it is very important to keep fluids and food ( particularly fluids) going into your rabbit; the longer the rabbit goes without eating and proper hydration the worse the stasis will become.
You should also be giving simethicone for gas ( 1ml about every hour X 3 doses) . When the Gi tract is not active there will be a build-up of gas which is uncomfortable and painful for the rabbit Simethicone can be bought overthe counter in the form of liquid gas drops for Infants. Some brands are Mylicon and gas X for infants but always read the back of the box to make sure that simethicone is the only active ingredient.

it would also help to get some benebac ( a probiotic) and give him a dose of that. You can buy this at petsmart or petco and get either the small syringes for small mammals or the powder form ( marketed for dogsand cats but still fine) which you can sprinkle on a piece of banana.

In a case like this you cannot wait for the rabbit to begin eating and drinking ; you need to tak an aggressive approach in trying to help him ..

if you should decide to go to the Emergency vet they may teach you to do sub q fluids on your rabbit which also would be very helpful.

 

[danakscully64]

Thank You for all the info!

Randy - I'll likely be calling the vet I got the meds from, talk to them about it so they don't administer/prescribe that again for rabbits.

Angie - If he pooped a bit, is it a good idea to still give him those items? Are they safe to give him if statis isn't his problem?

Yesterday he pooped, but not a lot. It was dry, I was expecting more.

Update for today: Mason is still accepting dried papaya, water, a few bites of shredded wheat, and he did eat 3 baby carrots. He still won't touch his pellets or kale. He's peeing a lot still.

I'm going to take him in, even if he starts eating normally. What is most likely the problem? Teeth, stomach, something else?

 

[ra7751]

If I were treating this rabbit....I would try to get a culture of the discharge. Most likely if it's a bacterial infection, it's Pasteurella. It looks like he has a relatively flat face which seems to lead some individuals to dental issues. I would like to see some radiology of the jaw on that side. I would be looking for points on the pre-molars or molars (spurs) or some type of root impaction in the upper arcade. It is also possible to have something likea piece of hay stuck between the teeth and infected the gum.....like popcorn does to us sometimes.

As far as drugs to discuss....Zithromax is my drug of choice now to battle Pasteurella. I used Zithromax for the first time many years ago (it was considered "unsafe" back then) after pleading my case to my vet. This rabbit was scheduled to have his eye removed due to infection that wasn't addressed by any other drug. Within 5 days, the discharge resolved and he remained healthy for the next 5 years until his death at nearly 10 years old. I would continue with the Gentamicin drops as well as flushing the eye several times per day. I would probably add a pain med....maybe be few days of Metacam (with caution) or maybe Tramadol since pain will decrease appetite.

And the most important rule....hydration before nutrition. An animal will die of dehydration long before starvation. A dehydrated animal can't digest food. We lose a lot of rescued wildlife because well meaning but untrained people (illegally) offer food to a dehydrated animal. The first thing a rabbit savvy vet should do is administer fluids. A hind gut isn't going to work at all if it's dehydrated. DO NOT use gel type hair ball meds made for cats or the high calorie supplement gel as these products will add to the dehydration and any impaction.

And I would really drop the shredded wheat.And again, just my non-professional opinion....but those gut motility drugs just make me cringe.

The gut problems is secondary, as they usually are, to the eye/dental/URI issue. Proper diagnositics should be utilized to pinpoint the root cause of this concern and address it.

Randy

 

[Maureen Las]

danakscully64 wrote:

Thank You for all the info!

Randy - I'll likely be calling the vet I got the meds from, talk to them about it so they don't administer/prescribe that again for rabbits.

Angie - If he pooped a bit, is it a good idea to still give him those items? Are they safe to give him if statis isn't his problem?

Yesterday he pooped, but not a lot. It was dry, I was expecting more.

Update for today: Mason is still accepting dried papaya, water, a few bites of shredded wheat, and he did eat 3 baby carrots. He still won't touch his pellets or kale. He's peeing a lot still.

I'm going to take him in, even if he starts eating normally. What is most likely the problem? Teeth, stomach, something else?

You've got a lot of good info to bring to your vet Thanks to Randy



...to answer your question to me I would still get all the items thatI suggested in the above post. If his poops are dry and he is eating and drinking only small amounts he will still eventually get dehydrated

if he needs any kind of procedure when you go to the vet you want him to be in good conditionand keeping him hydrated with pedialyte, water and pineapple juice will keep him hydrated. If you do not want to syringe fluids you can try some apple juice in his water bowl to see if he will drink a lot on his own; this would also be fine. I would also give him some fresh wet greens

Ithink everyone should keep canned pumpkin , benebac and simethicone in their home all the time. Countless times I have used simethicone at 11:30 at night when i really would not want to be going out to a store.

I would still give him some simthicone and benebac today

You want to PREVENT a stasis stuation from developing and blowing up.

Even if a rabbit has a dental issue and/or an eye issue or any other issue stasis can still develop as a secondary problem to the primary problem.

For ex. if I have a terrible tooth pain chnances arethat Iam not going to eat or drink until I get to a dentist because of pain. The same with a rabbit except that not eating or drinking compromises the gut situation faster in a rabbit.

 

[danakscully64]

I just took notes of everything you two have said, I'm taking Mason to the emergency vet now. I will report in when I find out what's wrong.

 

[danakscully64]

Change of plans, long story... his appointment is now at 1:30 tomorrow. He accepted pumpkin puree, he ate a spoonful. He's still drinking a lot of water and peeing regularly. He wasn't sleeping on his side for a few days, now he is. I'm really starting to believe his stomach is fine, it's just his teeth that are giving him problems.

 

[Maureen Las]

I didn't see this until now.
Try the best that you can to keep him hydrated and at least a,little more food until tomorrow.
I wish that you had some critical care... thatwould very helful with dental problems.

let us know how things go..

 

[danakscully64]

He loved your apple juice/water idea, he's probably drinking too much water now He seems to be much happier now, like he's getting better. My boyfriend saw him eating pellets last night, but he didn't have a ton. He nibbles on baby carrots and will eat papaya pieces.

His appointment is in 2 1/2 hours

 

[Maureen Las]

danakscully64 wrote:

He loved your apple juice/water idea, he's probably drinking too much water now He seems to be much happier now, like he's getting better. My boyfriend saw him eating pellets last night, but he didn't have a ton. He nibbles on baby carrots and will eat papaya pieces.

His appointment is in 2 1/2 hours

not such a thing as too much water...

let us know what happens at the appointment

 

[danakscully64]

$558. $558. $558! That's the estimate for his treatment for the next 2 days. They're going to do blood work and X-Ray his whole body. He's staying there, they're going to call me as soon as they know anything.