URGENT! Pneumonia in rabbits and our current vets are not rabbit savvy

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vietanh

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Hi bun parents,


Despite my preparations, I couldn't help but feel almost crushed when my precious bun was diagnosed with pneumonia yesterday.

I would want to seek your advice, since I cannot trust our vet anymore, and it is very difficult to seek medical advice from a rabbit specialist in my country.


I will list my questions first, if the story below is too long, I hope you can at least answer (some of) these questions.

1. May I ask about your experience with pneumonia in rabbits? Can it be cured? I attached the file of yesterday's x-ray below.

2. I attached the vet's prescription, and would love to have some advice on its suitability and effectiveness (reasons for reconfirming are given below)

3. Do you have any suggestions for how I can make my rabbit comfortable and feel better, besides medication? I asked the vet about it, but he said nothing but the medication he prescribed could help.

4. What can/can't I do (disinfect, sanitize, ...) to avoid affecting her lungs?

5. Do you have any idea of the cause of her pneumonia? Is it due to an external cause? Or is it due to the dental abscess?

6. In your opinion, should I switch to another hospital? I'm really angry and frustrated with the current vets. If they had been diagnosed in the prior appointments, my little bun wouldn't have suffered as much pain and stress as now. It breaks my heart to see the little bun I love suffer, she is so loyal that she always sticks to me, and always tries to lick me even though every time she licks, she gasps. The reason why I hesitated to switch hospitals is because where I live (Hanoi, Vietnam) there are only 2 hospitals with veterinarians who can see rabbits, I want to repeat "can see rabbits" because rabbits are not common in my country so it's not easy to get a rabbit savvy vet to come here



I can't stop blaming myself for being too subjective, not doing enough research and not asking you guys sooner. So this is how it goes:

My rabbit is free roam, she sleeps with me and we are very close so I can notice her changes, and always carefully record them to inform the vet.

- December 2022 she has a dental procedure to file the overgrown lower molar and clean the upper molar abscess

- Late March 2023
, I noticed that my bun was breathing louder than before, and often breathing rapidly and shallowly. At the same time, she has blood in urine. April 1 at the hospital, she was diagnosed with UTI. Besides that, I emphasized how unusual her breathing was and asked the vet to check her teeth. The vet just palpated her lower jaw and said there was no problem with the teeth, and that the irregular breathing could be due to her stress at the time. (the first vet at the hospital)

- By mid-April, the respiratory abnormalities did not subside, and became even more severe. She sneezes many times, breathes hard, fast and shallow, and sometimes has to push her head forward to breathe. I shoot many videos as these symptoms unfold. April 27 I took her to vet. I repeated over and over that she had to push her head forward to breathe and her breathing loudly to the vet, as well as showing him the video I took. He examined her teeth with an otoscope and confirmed that they were coming from an abscess, specifically an abscess that had inserted itself into her airway. I was very concerned about her breathing because before this, despite having overgrown teeth and upper molar abscess, she didn't breathe like this. However, the vet ruled out a respiratory problem, and there was no mention of pneumonia in the record, although I was very worried and emphasized many times that I found her breathing abnormal. At that time, I was not aware of pneumonia, so I could only trust the vet. He prescribed Meloxicam (10 days) and Baytril (keep taking it until the dental procedure) (the second vet at the hospital - the vet in charge of dental care for my rabbit)

- Her symptoms subsided after taking the medication, and after about 10 days they gradually increased again. I quickly messaged to schedule a dental procedure because I was afraid of the abscess. The hospital message that the vet in charge is on a 3 week vacation, and they discourage us from choosing another vet, so we wait. After that, she sneezed more, wheezed, pushed her head forward to breathe, .... I should have taken her to another hospital, but trusting the vet, I kept texting the current hospital. They replied that they could not arrange another vet and said I should wait for the vet in charge to return. Because I was too worried, I posted post and videos on groups. At that time, I was informed by some owners about pneumonia. I asked the hospital about this and the vet answer was to continue using Meloxicam and Baytril because if there is any inflammation they can still help. At my appointment yesterday (finally), June 17, I mentioned it to the vet and asked for a chest X-ray. And we cried a lot when she was diagnosed with pneumonia, which they should have diagnosed from prior appointments when I said that I was very worried about her breathing. As far as I know, her symptoms are typical.


That is, neither of the veterinarians at the hospital we visited could diagnose pneumonia with such obvious symptoms. It makes me feel so unfair because my bun could have been treated sooner, she shouldn't have suffered for this much longer, she shouldn't have had to take such high doses of medicine. Watching her struggle made me unable to hold back my tears. If only I were a better owner. If only we could get a rabbit savvy vet, or at least he/she has a better diagnostic ability than our vets. They did not suspect pneumonia even though they directly examined my rabbit, and although I always take the video very carefully, take note of the date to inform them as accurately as possible. Only when my bun's illness was suspected by other owners.


Thank you all so much for taking your time to read and give me advice!
 

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I'm so sorry your bunny is unwell 😔I haven't got any experience with pneumonia but I can tell you Enrofloxacin is an antibiotic, tramadol is a pain relief and meloxicam is an anti inflammatory, which are all common meds given to rabbits here in the UK.
I'm not sure what TMPS tablets are though, sorry!
A bowl of steaming water near your bunny (but out of reach!) may help to clear any mucus.
Best of luck! 🤞❤️
 
I've only had a rabbit with an upper respiratory infection, which was successfully treated with the oral antibiotic azithromycin. I can say that pneumonia in rabbits is extremely serious, and that if not treated promptly and aggressively, there is a very poor chance of recovery or survival.

Medirabbit: pneumonia in rabbits

If the two antibiotics your rabbit is currently on, aren't proving effective and your rabbits condition is steadily getting worse, you likely need to get the antibiotic changed to a more aggressive antibiotic. Azithromycin has been the most effective for my rabbits, and it acts quickly. I saw a significant improvement in a reduction of bacterial discharge and improved breathing, within a couple of days. The dose was 50mg/kg for 3-4 weeks I think. 2 weeks was initially tried, but the infection returned after the antibiotic was stopped.

Just be aware that some rabbits have a very negative digestive reaction to azithromycin, so it's very important to monitor for it causing lack of appetite and/or mushy poop or diarrhea. If this occurs the antibiotic has to be stopped and the new problems dealt with immediately. But my rabbits only had minor stomach cramping for a few hours after administration, then were back to normal and eating again. A good high fiber diet with lots of high quality grass hay (not moldy) or medium coarse fresh grass, can help minimize the digestive upset that may occur.

In really severe cases of pneumonia, nebulizing the rabbit can be a helpful addition to the treatment plan as well. In very severe cases the rabbit may need hospitalization in an oxygen chamber. If your rabbit is struggling to breath, nebulizing and oxygen are things that I would recommend asking your vet about starting immediately.

Link has videos showing nebulizing a rabbit.
https://wabbitwiki.com/wiki/Medicating_your_rabbit
Your rabbit is on meloxicam, which is a common anti inflammatory for rabbits, so that's good. The tramadol is a narcotic pain medication, that you do need to be cautious with, as a dose that's too high can not only cause sedation, but will affect the respiratory function, which is something you really don't want happening with a rabbit already struggling to breath.

The pneumonia may have been caused by the dental abscess spreading, but it's impossible to say for sure. It may not even be pneumonia, but could be edema and fluid in the lungs causing the respiratory difficulty, which could be related to heart problems. And if this is the case, antibiotics aren't going to make any difference, and your rabbit would need to be on diuretics and heart meds to manage the condition.

Because your rabbit has had this condition for so many months, I'm inclined to believe that pneumonia isn't the most likely cause of the respiratory difficulties, as pneumonia is usually fatal inside a week if not treated aggressively, and even then it's sometimes fatal very quickly no matter the treatment. The fact that your rabbit is still alive more than 2 months after you noticed increased respiratory effort with pretty improper treatments from the vet occurring, points to this probability.

A heart issue or possibly thymoma, would be what I would suspect as possible causes. Both can produce similar symptoms to pneumonia, of sneezing and increased respiratory rate and labored breathing. So I would be considering these as possibilities as well. I had an older rabbit that showed increased respiratory effort and rate. He also had protruding third eyelids, so I suspected it was a heart issue or thymoma. Vet concluded likely thymoma. So the symptoms can definitely be very similar, though a good vet should be able to determine by xray and possibly an ultrasound, whether it's pneumonia, a heart problem, or thymoma.

https://wabbitwiki.com/wiki/Cardiovascular_disease
https://wabbitwiki.com/wiki/Thymoma
If you can find a better vet, yes I would recommend changing vets. But if you can't, maybe your vet could consult with a rabbit specialist in another country. There are several in the UK that do consultations.

I know you're limited with the quality of care that's available to you, so just try your best with what you can manage. Most importantly, always ensure the medications prescribed are rabbit safe, as some antibiotics in particular, can be fatal if a rabbit is given them.

https://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
Medirabbit: drugs safe for rabbits

Medirabbit: antibiotics dangerous for rabbits
 

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