Please help! Pneumonia

[shannibutterfly]

Hello! I am just looking for advice, I am at the end of my rope....

My bun Keiji, he has pneumonia. I took him to the vet, spent over 800$ so far, he is going on his fourth week of antibiotics, but I don't see any improvement! After the first week of antibiotics, he seemed to bounce back and he gained weight...but it didn't last long, maybe 2 days...
Now, he barely eats anything, he is so skinny. He will nibble at his food a bit, eat a couple of bites, he will eat more if I sit down with him and hand feed him, but he will only eat Kale. He doesn't have any mucus in his nose or anything else, just barely eating. His poop is fine, just very tiny because of not eating...
Also, giving him the meds stresses him out a lot, after I give it to him, he will run and hide and breathes a little heavily and that is why I think the pneumonia is still there (they said it was pretty bad). Unless it's just the extreme humidity we've been getting here...
I tried everything I could! I even bought an air purifier and a dehumidifier for my room. But I don't have over 1,000$ for surgery.

I did not go to the vet for follow-up ex-rays though, because I see that he's still not 100%...I don't know if I should keep with the antibiotics or just stop them!?? I am also waiting for a response from the vet on what to do now, but any suggestions will be greatly appreciated!

Oh! I also have some critical care food to give him, but he won't take it...he just lets it drip down.

 

[JBun]

What antibiotics has he been on so far, and how long for each one? Has the vet had you try nebulizing? Has he been on or is he on, anti inflammatories or any other meds? Is he still showing signs of respiratory illness and that's why you think he is still unwell(and if so, what signs is he having), or is it just because he isn't eating well and is losing weight that you feel he is still sick? Have you tried a period without the antibiotics and other meds to see if they could be causing the lack of appetite?

One thing to consider that could be affecting his eating, is if he's developed dental issues. That could make it painful for him to chew and eat. If he's not accepting syringe feeds, you really need to find a feeding solution very quickly. Have you tried other kinds of syringe feeding mixes, or a pellet mush?

 

[shannibutterfly]

What antibiotics has he been on so far, and how long for each one? Has the vet had you try nebulizing? Has he been on or is he on, anti inflammatories or any other meds? Is he still showing signs of respiratory illness and that's why you think he is still unwell(and if so, what signs is he having), or is it just because he isn't eating well and is losing weight that you feel he is still sick? Have you tried a period without the antibiotics and other meds to see if they could be causing the lack of appetite?

One thing to consider that could be affecting his eating, is if he's developed dental issues. That could make it painful for him to chew and eat. If he's not accepting syringe feeds, you really need to find a feeding solution very quickly. Have you tried other kinds of syringe feeding mixes, or a pellet mush?

Hi!

He's been on Doxycycline and Enrofloxacin, both for almost 4 weeks now. I just gave him his dose and let him go, I noticed he was breathing a little heavy again, I can see his sides moving and it looks a little labored, but it goes away quickly as opposed to a few weeks ago. Now he's eating some watercress and last night he actually ate some pellets!

He is not on any anti-inflammatories or any other meds. She did notice his teeth were a little crooked I think, but the x-rays showed fluid in his lungs. I feel like it's just dragging? Is it true pneumonia can take between 4-12 weeks to go away?!

I tried the critical care food again, mixed with water. I wrapped him up like a burrito this time lol, but he still refuses to swallow it. I'm scared to stop giving him the antibiotics....

Update!:: He's eating one of those sticks right now...you know the honey or fruit flavored things? It's hard to describe lol, but he's eating it! So I'm guessing it really isn't his teeth.

 

[JBun]

I think if it's not getting better, a different antibiotic is probably needed at this point. Enrofloxacin isn't always the most effective antibiotic in rabbits. Though a rabbit breathing heavy after getting meds, wouldn't be unusual. If he's not breathing heavy the rest of the time, it makes me wonder how much of a respiratory infection there is left.

If you definitely feel that your rabbit is still sick, I think it might be worth finding a more knowledgeable rabbit vet for a second opinion. I feel like your vet may not be very knowledgeable about rabbits. A good rabbit vet would have wanted to change antibiotics if a rabbit wasn't significantly improving after 2 weeks, and would have also certainly put your rabbit on an anti inflammatory pain med(meloxicam). They likely would have suggested recommended nebulizing as well. I could be wrong about your vet, but it's something I would be thinking about.

https://rabbit.org/veterinarians/
You may need to try some other types of recovery food. Your rabbit needs to be getting enough food each day. And if this is something your vet is aware of, they should have been suggesting ways on how to get your rabbit eating as well. I would try different flavors of critical care. Or if you get sherwood or Supreme recovery food there. Or try making your own pellet mush. I would be trying just about anything that gets your rabbit accepting food at this point.

Rabbits can still have dental issues when they'll eat certain foods but not others. Reason is that certain foods can hurt to chew, more than another food. It has to do with the chewing motion. Not that your rabbit has a dental issue. It's just a possibility for a rabbit not eating well.

 

[shannibutterfly]

I think if it's not getting better, a different antibiotic is probably needed at this point. Enrofloxacin isn't always the most effective antibiotic in rabbits. Though a rabbit breathing heavy after getting meds, wouldn't be unusual. If he's not breathing heavy the rest of the time, it makes me wonder how much of a respiratory infection there is left.

If you definitely feel that your rabbit is still sick, I think it might be worth finding a more knowledgeable rabbit vet for a second opinion. I feel like your vet may not be very knowledgeable about rabbits. A good rabbit vet would have wanted to change antibiotics if a rabbit wasn't significantly improving after 2 weeks, and would have also certainly put your rabbit on an anti inflammatory pain med(meloxicam). They likely would have suggested recommended nebulizing as well. I could be wrong about your vet, but it's something I would be thinking about.

https://rabbit.org/veterinarians/
You may need to try some other types of recovery food. Your rabbit needs to be getting enough food each day. And if this is something your vet is aware of, they should have been suggesting ways on how to get your rabbit eating as well. I would try different flavors of critical care. Or if you get sherwood or Supreme recovery food there. Or try making your own pellet mush. I would be trying just about anything that gets your rabbit accepting food at this point.

Rabbits can still have dental issues when they'll eat certain foods but not others. Reason is that certain foods can hurt to chew, more than another food. It has to do with the chewing motion. Not that your rabbit has a dental issue. It's just a possibility for a rabbit not eating well.

Thanks for the reply and for that link!

I actually just got the call back from the vet, she told me it could take a long time for the pneumonia to go away because his was pretty bad, and to keep up with those antibiotics. You're right about her not being very knowledgeable though! The other vet is on maternity leave... and there is a shortage of vets here. I remember calling the Emergency Animal Hospital 4 weeks ago and she told me they were full! I was like....WHAT?? But then my vet squeezed me in for an appointment.

There is an improvement, so maybe I am overreacting a bit...most of the time his breathing is fine. He's just not eating enough...I heard that I can give baby food??? Is that true?? I'm going to try giving him the critical care food again but with a smaller syringe, it'll take more time because I'll have to load it often, but that's ok. I will look into the pellet mush as well...
I will book another appointment soon for x-rays and I will ask for a different type of antibiotic and different flavored critical care food.
I'm very tired from waiting on him day and night but there's no way I'm giving up on him!

 

[shannibutterfly]

Do you think I should stop the antibiotics and see?? Maybe he doesn't need them anymore...

 

[JBun]

I can't say if you should stop antibiotics or not. But I certainly wouldn't stop them until my rabbit had first been rechecked by the vet with possible xrays, to verify the pneumonia had cleared up.

The eating thing would be a very big concern, as that alone could prove critical for a rabbit. Lack of eating could cause serious secondary illness, whether or not the pneumonia is still present. One thing I would do is request a prescription for meloxicam suspension from your vet(cheapest option is buying online and them verifying the prescription with your vet). The added pain relief and reducing any inflammation, may be enough to help getting your rabbit eating more normally again. If your rabbit does still have pneumonia, reducing inflammation and pain could only help. Usual recommended dosage for rabbits is 0.3-0.6mg/kg, twice a day. Being that your vet might not be that experienced, it's important to make sure an adequate dose is prescribed, as less experienced vets often under dose at the dog dose, which would be ineffective with rabbits that need much higher doses.

https://rabbit.org/the-importance-of-analgesia-pain-control-for-pet-rabbits/
https://rabbitwelfare.co.uk/rabbit-health/medical/pain-management-rabbits/
https://rabbitwelfare.co.uk/rabbit-health/medical/drug-focus-meloxicam/
https://www.vgr1.com/metacam/
Baby food could be mixed in with the critical care to try and improve the taste, if you know of one your rabbit actually likes. The main thing to be careful with is adding too many sugars or new foods that could result in further digestive upset. But you also are needing to try almost anything at this stage, just to get your rabbit eating. I would be inclined to try all sorts of feeding ideas to see if anything works, though within reason and not overdoing any food changes. A little bit of baby food mixed in, different feeding mixes, a pellet mush. If he'll eat more greens and pellets on his own, I would feed more of those, which would also be less stressful than trying to syringe feed.

The main thing is trying to prevent GI stasis from setting in or fatty liver disease, from lack of eating. Here are some feeding suggestions. The main thing I'm very careful with when syringe feeding, is giving small amounts, allowing the rabbit time to chew and swallow, as you don't want to be risking aspiration, which would further seriously complicate the pneumonia. I will squirt a tiny bit in the side of the mouth, wait for my rabbit to chew and swallow, before giving more. And not continuing trying to syringe feed and contacting your vet if your rabbit won't swallow at all and isn't eating enough on his own.

https://wabbitwiki.com/wiki/Medicating_your_rabbit

 

[shannibutterfly]

I can't say if you should stop antibiotics or not. But I certainly wouldn't stop them until my rabbit had first been rechecked by the vet with possible xrays, to verify the pneumonia had cleared up.

The eating thing would be a very big concern, as that alone could prove critical for a rabbit. Lack of eating could cause serious secondary illness, whether or not the pneumonia is still present. One thing I would do is request a prescription for meloxicam suspension from your vet(cheapest option is buying online and them verifying the prescription with your vet). The added pain relief and reducing any inflammation, may be enough to help getting your rabbit eating more normally again. If your rabbit does still have pneumonia, reducing inflammation and pain could only help. Usual recommended dosage for rabbits is 0.3-0.6mg/kg, twice a day. Being that your vet might not be that experienced, it's important to make sure an adequate dose is prescribed, as less experienced vets often under dose at the dog dose, which would be ineffective with rabbits that need much higher doses.

https://rabbit.org/the-importance-of-analgesia-pain-control-for-pet-rabbits/
https://rabbitwelfare.co.uk/rabbit-health/medical/pain-management-rabbits/
https://rabbitwelfare.co.uk/rabbit-health/medical/drug-focus-meloxicam/
https://www.vgr1.com/metacam/
Baby food could be mixed in with the critical care to try and improve the taste, if you know of one your rabbit actually likes. The main thing to be careful with is adding too many sugars or new foods that could result in further digestive upset. But you also are needing to try almost anything at this stage, just to get your rabbit eating. I would be inclined to try all sorts of feeding ideas to see if anything works, though within reason and not overdoing any food changes. A little bit of baby food mixed in, different feeding mixes, a pellet mush. If he'll eat more greens and pellets on his own, I would feed more of those, which would also be less stressful than trying to syringe feed.

The main thing is trying to prevent GI stasis from setting in or fatty liver disease, from lack of eating. Here are some feeding suggestions. The main thing I'm very careful with when syringe feeding, is giving small amounts, allowing the rabbit time to chew and swallow, as you don't want to be risking aspiration, which would further seriously complicate the pneumonia. I will squirt a tiny bit in the side of the mouth, wait for my rabbit to chew and swallow, before giving more. And not continuing trying to syringe feed and contacting your vet if your rabbit won't swallow at all and isn't eating enough on his own.

https://wabbitwiki.com/wiki/Medicating_your_rabbit

Thank you so much for all this, it's really helpful!

I booked an appointment and I will definitely ask for pain meds.
Last night I placed a full bowl of lettuce/kale and he ate most of it during the night so I'm happy about that. I will try mixing some baby food with the critical care food today.

 

[shannibutterfly]

Can too much antibiotics make him unwell??

 

[JBun]

Too high a dose can, a long course of antibiotics could lead to upset of the gut microflora, certain antibiotics can upset the gut microflora(some fatally), some can cause some nausea, some can cause stomach cramping, or some rabbits can be sensitive to a certain antibiotic.

Doxycycline and enrofloxacin are both considered rabbit safe oral antibiotics, though a rabbit could be sensitive to either antibiotic even when considered rabbit safe. But it will also depend on the dose prescribed to your rabbit. Too high of a dose can lead to problems regardless of a sensitivity.

Medirabbit: safe antibiotics for rabbits

If you want to try giving your rabbit a probiotic to try and help balance the antibiotics, it could possibly be helpful. Benebac plus is the one I've used. One that I haven't used but seems to be for rabbits is Equa Holistics healthy gut. UK brands that you might have there in Canada are Vetark pro c for rabbits, or Protexin biolapis, fibreplex, or pro fibre for rabbits. Probiotics do need to be given several hours before or after having given the antibiotics. So like 3 or 4 hours after the antibiotic dose. I think I would try the Healthy Gut one for rabbits as they guarantee the probiotic count(supposedly), if you can get it. Amazon and Chewy have it here in the US, not sure about Canada though.

Medirabbit: use of probiotics in rabbits

https://www.petag.com/products/bene-bac-plus-pet-powder
https://equaholistics.com/products/healthygutprobioticsrabbit
https://www.vetark.co.uk/products/rabbit-other-small-mammal/pro-c-probiotic
https://www.protexinvet.com/products/rabbits/c26