Possible Pasteurella

[kwhigam]

Hello everyone, I'm new to this forum. Sorry that my first post is a question, I've been reading past threads but I just wanted to tell you what is going on.

First off, I have four chinchillas and one Netherland Dwarf rabbit. I just got my rabbit 4 months ago, his name is Effie, however I have had the chins for several years.

Effie was born on January 11th of this year (2010) and he weighs about .8 Kilos (almost 2 pounds).

Three weeks ago, I had noticed that Effie stopped eating completely. I took him to the vet and they gave him an X-ray and there was a small mass of hair in his intestinal tract. The vet said that it was only perhaps a day old and she was surprised I noticed so quickly, having chinchillas I learned very quickly the warning signs.

For 6 days I force fed him Critical Care, three times a day. Also gave him .25 ml of a laxative, as well as 1 cc of Bene-Bac daily. Once I saw that he was eating and pooping normally I stopped the forced feedings and everything was fine. That was about two weeks ago and all looked normal again.

However something kept bothering me that there was more going on here. I noticed that he started to lose his balance at times. At first I thought this was because he had his nails clipped and it appeared that he wasn't putting pressure on his front paws. I thought that perhaps they cut one of the nails too close to the quick. However, on Tuesday he sneezed and a big blob of white mucus came out of his nose.

So, back to the vet I went and they gave him an injection of Baytril and I am giving him oral syringe doses of Baytril twice daily at .30 ml each. When I woke up this morning he had not eaten anything the entire night so, once again, I force fed him Critical Care. I knew that there was a possibility that Baytril could decrease appetite, however I thought that he would have SOME appetite. The vet is closed today as it is a holiday in Quebec so I cannot call them.

Anyway, I just wanted your thoughts on this. I take EVERY precaution necessary and thought some reassuring thoughts from you guys would give me some more confidence because I'm beginning to wonder how long this will continue.

The vet took a swab and prepared a culture so I will know for sure within the next 4 or 5 days if it is, indeed, Pasteurella.

 

[ra7751]

Couple of thoughts here. First, laxatives and/or gut motility drugs are inappropriate for use in rabbits. It is not unusual for rabbits to have small "hairballs" (and rabbits don't generally get true hairballs). The best response to a GI slowdown is hydration and lots of hay.

As far as the culture, Pasteuralla is a faculative anaerobic bacteria. It is sometimes difficult to grow in a petri dish. If I have clinical presentations of a bacterial infection but no significant growth in the dish, I treat for Pasteurella. Baytril has been the traditional response to Pasteurella over the years but we are seeing it (and the sulfa class drugs) becoming obsolete as the bacteria are mutating and becoming more and more resistant to these drugs. We also know that we can use much more effective drugs that have traditionally been considered unsafe. My primary drugs I use against Pasteurella are Azithromycin or Convenia. The Azithromycin has to be dosed quite a bit higher in rabbits that is used in other species. Convenia is safe only as an injectable and should be dosed at least once a week....I do every three days.

The vertigo is concerning as that can be the first indicator of a middle and/or inner ear infection. Ear infections are very serious in rabbits and should be treated aggressively. I treat with my "big guns"....I treat with multiple drugs to get better coverage. Will be interested in what the culture shows.

Randy

 

[kwhigam]

ra7751 wrote:

Couple of thoughts here. First, laxatives and/or gut motility drugs are inappropriate for use in rabbits. It is not unusual for rabbits to have small "hairballs" (and rabbits don't generally get true hairballs). The best response to a GI slowdown is hydration and lots of hay."

The laxative was Lactulose, if that gives any further indication. I have Oxbow Timothy hay, with some Oxbow orchard grass, and some botanical hay for variety, however if he doesn't eat the hay it won't do any good. That is why I started force feeding the Critical Care again. Is it normal that Baytril would cause complete loss of appetite?

"As far as the culture, Pasteuralla is a faculative anaerobic bacteria. It is sometimes difficult to grow in a petri dish. If I have clinical presentations of a bacterial infection but no significant growth in the dish, I treat for Pasteurella. Baytril has been the traditional response to Pasteurella over the years but we are seeing it (and the sulfa class drugs) becoming obsolete as the bacteria are mutating and becoming more and more resistant to these drugs. We also know that we can use much more effective drugs that have traditionally been considered unsafe. My primary drugs I use against Pasteurella are Azithromycin or Convenia. The Azithromycin has to be dosed quite a bit higher in rabbits that is used in other species. Convenia is safe only as an injectable and should be dosed at least once a week....I do every three days."

I will bring this up with the vet when I call tomorrow. However she did say that in addition to the oral Baytril he may require weekly injections of another antibiotic, maybe she was referring to Convenia, I didn't ask which one it was but I will when I call.

"The vertigo is concerning as that can be the first indicator of a middle and/or inner ear infection. Ear infections are very serious in rabbits and should be treated aggressively. I treat with my "big guns"....I treat with multiple drugs to get better coverage. Will be interested in what the culture shows."

I am eagerly anticipating the results! The vertigo is very slight, he usually tilts slightly to the right, however there is no head tilt whatsoever. He just leans slightly to the right when he "telescopes" (gets up on two paws and stretches up to investigate something).

 

[ra7751]

Lactulose is basically a synthetic type of sugar....and sugar ina rabbit's gut isn't a really good idea. When you combine that with the Baytril, you should feel lucky that loss of appetite was the only symptom.

If your vet mentioned an injectable antibiotic, it is probably a type of Penicillin...which Pasteurella is usually sensitive to Penicillin. Convenia is a Cephalosporin which is generally used with Penicillin resistant bacteria....and very few vets are aware that it can be used safely in a rabbit.

Monitor his posturing closely as ear infections can escalate quickly...just in case it is an infection. And keep a watch on his eyes for nystagmus....the eyes will dart back and forth as he is searching for a focal point.

Randy

 

[kwhigam]

Lactulose is a sugar? Hmmm... well she told me not to give him the Lactulose with the Baytril, that was a few weeks ago.

I will be sure to ask these questions when I talk to her tomorrow, but please tell me is it normal for him to not want food while taking the Baytril? I just gave him another dose of Critical Care.

 

[kwhigam]

I just checked my receipt and the injection was Duplocilline.

 

[ra7751]

The Duplocillin is what many call either Pen G or Bicillin. It is a combination of two antibiotics...Procaine and Benzathine. It is safe only when injected...it should never be given orally. It is a very safe and effective drug.

Any oral antibiotic can cause loss of appetite. In the very rare times I use Baytril, I inject it and dose it differently than the standard protocols. Many times some supplemental fluids and a one time injection of B Comp (a vitamin) will help stimulate the appetite.

Randy

 

[kwhigam]

Thanks Randy, this has been an upsetting day for me. He was not eating, I force fed him Critical Care for 6 days, he was finally his old self until the vet injected him with the antibiotic yesterday afternoon, he immediately lost any appetite. This morning I saw he did not eat anything at all the entire night, I immediately started him back on the syringe feedings. It is so frustrating for me, and I tend to over analyze everything and worry to excess.

He has not pooped at all since this morning, but it had been about 15 hours from the time I put him in his cage last night and when I checked on him this morning.

I force fed him three times today with the Critical Care and I gave him 1 cc of Bene-Bac to keep his gut flora up. I am sure that I'll see some poos tomorrow morning in his cage, and I will feel a lot better too.

He doesn't want to do anything except sit in his straw hutch in his cage. I have read that in addition to loss of appetite it could cause stomach ache. He does not appear to be in any distress, I rubbed his belly. I took him out to sit on the couch with me and he actively looks around and wants to explore, however when I took him into his normal play room he looked around for 5 minutes and then just made himself comfy on the blanket in the corner.

I left a voicemail for the vet to call me and I will discuss this with her then. I've done all I can now, as long as I keep his gut moving he'll be fine.

I never thought I would look forward to seeing poop before this

 

[Maureen Las]

Is your bun any better today?.
In addition to the critical care you should either learn to give sq fluids or give your rabbit oral pedialyte or another electrolyte drink for children. Hydration is extremely important when a bun is ill.

 

[kwhigam]

Thanks to both of you for your concern. This morning, still no poop so I took him to the vet, yet again. During the belly palpation the vet said that there was no poop in there.

We took another X-ray and his system is clear except for a small air bubble, most likely from accidental swallowing of air during syringe feedings. He was not in any pain, however it may have been enough to make him slightly uncomfortable.

So, I am giving him (twice daily) .5 ml of liquid Simethicone, .17 Cisapride, and .3 ml Enrofloxacin (Baytril).

In addition I am force feeding Critical Care three times daily, and twice daily I have force fed pureed carrot baby food. Also I gave him 2 ml of apple flavored pedialyte (as much as he would swallow).

The vet said that he was only slightly dehydrated and my dedication was apparent. Indeed, when I walked in the office with him I just broke down in tears and embarrassed myself in front of an entire waiting room. I suppose I felt frustrated and powerless, and had, at that point, spent nearly $700 and nothing to show for it.

Just now I saw two very small dry poos that were not there 30 minutes ago, so it seems my efforts have started to pay off, hopefully within a couple of days he'll be eating on his own again.

 

[ra7751]

Umm...I would have an additional discussion with your vet. In my non-professional opinion based on many years of treating very sick rabbits, gut motility drugs such as Cisapride are totally inappropriate. They cause very painful contractions and we know how rabbits respond to pain. Additionally, during a GI event, gastric ulcers can form. The contractions can be strong enough to perforate those ulcers and there is only one outcome to that scenario. Many vets use antibiotics in a GI event to try to contain harmful bacteria. The bacteria that most often appears during these events is certain strains of Clostridium. It is an obligage anaerobic and is not sensitive to Baytril. The appropriate antibiotic to use in this situation would be Metronidazole. I also use a product called BioSponge which is a horse product...and a rabbit is just a very small horse as far as the gut is concerned. I would urge caution in using Critical Care at this time especially with any degree of dehydration as this product can induce additional dehydration. Rule of thumb is hydration before nutrition. Any animal will die from organ failure much faster from dehydration than from lack of food. And feeding a dehydrated animal will cause additional dehydration. Get the hydration up before pushing too much Critical Care....you have to get the gut hydrated and pliable before it can digest food. Keep in mind that leafy greens such as dandelions or romaine lettuce are primarily water and are a huge help with hydration. Push the hydration above all else. Also keep your guard up and pay close attention to everything as thiscondition is usually the secondary result of another issue.

Randy

 

[DeniseJP]

I am sorry to hear about what the rabbit is going through but this has been a worthwhile thread for me to learn on.

Best wishes for a resolution to the rabbit's troubles...

Denise

 

[kwhigam]

Well, the bunny is happily playing which he hasn't done in three days. He even did a little binky for me!

The exercise will do him good, and keep everything moving.

I have been forcing at least 10 cc's of pedialyte and baby apple juice three times daily. In addition I either mix the critical care with pureed carrots (baby formula) or orange juice (which he likes better).

Today there are about 15 tiny poos in the room, and they are getting bigger by the hour. I would never believe I would be happily picking up poos during a course of a day and lining them up by hour to monitor the size!

He ate several basil leaves from the basil plant I have for him (on his own) and a bit of timothy hay.

He is much more alert and the slight imbalance and tilting to the side seems to be gone.

I wonder if there is a way to cram as many calories into the force feedings as possible. I don't know how many are in the critical care. I do have Nutrical (bought if for chinchilla emergencies) but I have read past threads about this contributing to dehydration, so I am cautious on it.

 

[kwhigam]

Poos are bigger and more numerous today, at least 25 to 30. Also he ate more basil and a big leaf of book choy just now!

 

[tonyshuman]

Glad he's improving. I'll be hoping for further improvement.

An important thing to remember in bunnies is that GI stasis is almost always a symptom of something else wrong. In this case, I think that the upper respiratory/ear infection caused him to stop eating as much, which led to gut slowdown and then stasis. It is however also possible that shedding led to hair blockage of the intestines, and then the blockage and pain related was stressful leading to the URI because stress weakens the immune system that normally keeps all these things in check. So it is kind of a chicken and the egg scenario here, but at least with more antibiotic treatment both of the issues should go away.

I have a question about lactulose, more for Randy--I thought it worked as a laxative by pulling water into the GI tract from the surrounding tissue--which would be just what a stasis bunny needed, provided it had enough water there to be pulled in. Is this not the case?

 

[kwhigam]

Ok, sorry for no postings in a while, I went to New York City for four days and had to board the bunny at the vet.

He did not have Pasteurella, but another bacteria (can't remember the name), however he is back to normal eating and pooping more than ever.

Thanks for all the support during this time.

 

[ra7751]

As far as a laxative like Lactulose.....using it in a stasis situation just adds to the rolling snowball. By the time you notice the slowdown problem, the gut has already been pulling fluids from surrounding tissues...including other vital organs. You would basically be robbing Peter to pay Paul. I am sure everyone has heard my steadfast rule...hydration before nutrition. Any animal will die from dehydration much quicker than from starvation. And a dehydrated gut can't digest food and itpulls fluids from other tissues/organs to try to digest the food and that is when youget acute organ failure. The body is already dehydrated and is in survival mode. My thought is not so much to move the limited fluids left but to bring the body's hydration back into balance.

Randy

 

[kwhigam]

Here we go again! He was eating normally for the last four days however he just started losing interest in food again. My guess is that the Baytril is eliminating the good bacteria in his digestive tract, this literally started this morning. Therefore I am giving him Bene-Bac to keep the flora count up until I stop giving him the Baytril.

I should have anticipated that this might happen and given the Bene-Bac as a preemptive strike, however hindsight is 20/20.

Other than his decreased appetite he is fine, and he doesn't appear to be dehydrated in the least, he is peeing normally and the skin pull test for hydration was fine.

His poos are slightly smaller today, so until the gut bacteria build back up I will supplement him with additional forced feedings when necessary.

 

[ra7751]

Couple of things...first, can you find out what bacteria was identified in the culture. Baytril doesn't work well against much of anything and with most bacteria, there are much more effective drugs that can be used. And to stimulate him a bit, see if your vet will do a one time injection of B Comp (a vitamin).

Randy

 

[kwhigam]

Thanks for the tip! I will talk with her tomorrow and ask her which bacteria it was and also about the B comp shot. Question: What does the B comp actually do?

I have him out of the cage now and he's playing, pooping and peeing normally. Anyone else would look at him and say he is fine, but I have grown so accustomed to monitoring his eating habits that I can tell if there is even the slightest difference from day to day. Perhaps, though, I am blowing it a bit out of proportion. I figure better safe than sorry. I'd rather force feed now and find that he didn't need it, than to wait even one day longer and have to go through that long agonizing (and very emotional) 6 times a day feeding schedule again!