# What might cause these symptoms? (pneumonia)



## Flashy (Mar 13, 2010)

I'm having a Badger related nightmare.

He had a dental last week. We know he needs a dental when he starts to do this funny cough. After the dental the cough goes (we think its due to excess saliva).

However, before and after the dental he has been having breathing issues.

He breathes very hard and fast when he sits in certain positions (namely the meat loaf/duck/puff ball position with no legs). He has been caught with his chin right in the air clearly struggling to breathe. When he sleeps in that position he rocks pretty quickly as he breathes. He loses his nose wiggle when he is like this. You can also see the effort doing into breathing in his sides. 

As I write his is lying in a completely different position showing none of these problems at all (typical). 

No mouth breathing. No more coughing. No sneezing. He has had a damp nose but only slightly so, since we got him. Vets not shown any concern in that because he has no other symptoms of any problem- until now. He has also lost weight (1.7 kg down to 1.5kg) and we put that down to his teeth, but since his dental I can't push it up, no matter how much I try.

The next thing the vet said is x-rays, and Badger has a vets appointment on monday so I need a plan of action and questions to ask, by then.

He is 3 and a half. He has regular pellets and obviously hay, and has not lost his appetite at all (not even when his teeth were bad). No changes in anything in his life at all. No change in behaviour, very happy, alert and active chappy. He also looks excellent at the mo, which is always an indicator. He doesn't seem to feel bad in himself.

He's been on Metacam for his teeth for a week and is now coming off that (I've been reducing the dose over the past couple of days). 

When he was under GA for his teeth they had a good listen to his lungs and can't hear anything wrong, no sounds of infection or anything anywhere in him. I'm worried about his heart?

Any ideas? Thoughts? Questions I can ask?

I don't want to lose another. I couldn't fight Summer's chest cancer because we knew what it was. I couldn't investigate Tilly's non infection chest issue (which we suspect was also cancer) because of her head tilt and how ill a GA made her. I can't do anything at all about Cloud's issue because he's a stresshead. I HAVE to make Badger ok, or at least get him the treatment he needs. He's not stressy, he's young and otherwise fit and can take whatever we have to do. I just don't know what we have to do.


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## Maureen Las (Mar 13, 2010)

Strange that you are having a nightmare with Badger as I am in a nightmare at this moment with Beau. He went into stasis probably on Wed and I am still nursing him out of it. I am very frightened that it is due to his teeth which would make me have to syringe feed him until I can get the dentist and as you know the dentist is far away and the appointments have to be made weeks ahead of time. 

Anyway I reread your post several times and am wondering if they could do a recheck ofBadger's mouth post dental. What did they do? Was it simply molar spur grinding or was it something more. 
Is it possible that he has some sort of post nasal drip that is occluding his trachea when he is in that particular meatloaf position?

Beau is doing a really odd motion which Is related to his teeth. Evert time he takes a drink from the nozzle of the water bottle he has to raise his head and neck in an odd way. It doesn't look like it is a breathing problem but just one of those things that occurs probably when his teeth are bothering him. I cannot figure it out 


I guess the other possiblilty with Badger if not teeth related would be either chest or heart . Probably would be a good idea to get an x-ray of both .
Beau has often stretched his neck out oddly when his teeth are bothering him but it has never appeared to affect his breathing 

Hope that you get some answers.; it is so hard to be in these kind of bunny nightmares.:hug:

Maureen


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## tonyshuman (Mar 13, 2010)

I think an x-ray would be really good to rule out some serious stuff that could be going on with the heart and lungs. It's possible that his throat is also swollen from post-surgery irritation.


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## Pipp (Mar 14, 2010)

I'm going through the same thing with one of Bunny George's bunnies (the street bum paranoid schizophrenic guy with all the rabbits). His dutch boy was looking really sick, had a wet muzzle, very very thin and was sitting with his head up. 

I figured he'd need a dental but wouldn't make it through the surgery in the condition he was in so I brought over Critical Care, Nutri-Cal, parsley and some fruit and that got him eating again. But now he's perfectly normal so I can't convince George to get him into the Vet for the dental. 

Radar also started wheezing when he was around four, and the Vet couldn't find a reason for it, although I never did get a culture or a head x-ray. He put him on antibiotics for a suspected URI. Radar ultimately died I think because I didn't catch a problem with a penicillin shot that leaked onto his fur where he could lick it off, and I didn't have access to him to monitor him. He had been coping with it quite well before that happened. I wanted the necropsy to examine his head but I guess that was too difficult. 

I'm convinced there is something about their anatomy or general health that we're not understanding. Can rhinitis or sinusitis be related to tooth issues? Do the tooth roots play a part in this? I see this in too many rabbits around the same age having the same thing, and nobody seems to know what it is. 

I'm thinking its not all that horrible just because of the number of rabbits that seem to live with it or recover from it, but I'd certainly like to see x-rays.


sas :?


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## Flashy (Mar 14, 2010)

Ok, you all sound relatively confused like me.

angieluv, I'm so sorry you are having a struggle with Beau. I sure hope that he comes out of it and it's NOT dental because I know how much of a nightmare that is for you.

I guess we will get an x-ray and then see where to go from there.

His tooth roots are completely fine, he's had that x-ray in November, so we would be looking at the chest area.


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## Pipp (Mar 14, 2010)

I think we're confused because there can be so many causes. 

Here's the article I was trying to find earlier: 


http://www.petmd.com/rabbit/conditions/nose/c_rb_rhinitis_sinusitis


*Sinus Infections in Rabbits


Rhinitis And Sinusitis*

Rhinitis in rabbits is an inflammation of the nasal mucous membrane. Sinusitis is quite similar; it is an inflammation of the air-filled spaces surrounding the rabbit's sinus or nasal cavity. Both of these conditions can cause respiratory problems and are often noticed because of the rabbit's excessive sneezing and nasal discharge.

*Symptoms and Types*
There are both acute and chronic forms of rhinitis and sinusitis in rabbits. These can either be contagious, non-infectious, associated with allergies or other conditions, or due to an abnormal or deformed facial bone structure. Some common symptoms for sinusitis and rhinitis include: 

Sneezing
Runny nose (or nasal discharge)
Reduced airflow
Lack of appetite
Slobbering or excessive saliva
Dental disease
Discharge from the eyes or other orifices
Bleeding nose, which may suggest a bacterial infection in the teeth or mouth

*Causes*
There are many causes for sinusitis and rhinitis in rabbits, and they often are dependent on the type of condition (i.e., infectious or non-infectious form). The more common causes for the non-infectious forms of sinusitis and rhinitis include dental disease, trauma or injury to the face or nose, inhalation of foreign bodies including grass or seeds, allergies, and invasion of the nose by abnormal growth of cells, usually cancerous cells. The infectious forms of these two conditions may be due to bacterial, fungal or viral infections.

*Diagnosis*
To diagnose sinusitis or rhinitis, a veterinarian will typically perform blood tests and imaging examinations (e.g., X-rays, ultrasounds) to detect pneumonia, as this is a common condition in rabbits for these two cases. Occasionally, bacterial rhinitis will show up in imaging studies.

Swabs and cultures are done from time to time, but may be hard to discern, as some of the organisms in the samples may not be directly responsible for the condition (or opportunistic). Your veterinarian may also make a diagnosis by identifying any bone structure abnormalities or deformities in the rabbit's face or mouth, the latter being a common sign of dental disease.

*Treatment*
The type of treatment is dependent on the underlying cause for the symptoms. Oxygen is sometimes necessary if the rabbit has trouble breathing; using a humidifier can also help open airways. Other ways to improve respiratory function include washing the affecting area and removing any environmental irritants, especially known allergic items.

Antibiotics may help with cases of rhinitis or sinusitis due to bacterial infections. Often, secondary bacterial infections cause many of the clinical signs associated with these two conditions. And because certain topical nasal decongestants cause some symptoms to worsen, they are not commonly recommended. In these cases, your veterinarian may prescribe antihistamines.

*Living and Management*
Animals should be provided with a proper, well-balanced diet including a wide selection of fresh greens such as cilantro, romaine lettuce, parsley, dandelion greens and spinach. Recovering rabbits need plenty of fluids at this time, in addition to regular follow-up appointments. This will ensure that the long-term treatment is successful.

Rabbits with the chronic bacterial form of sinusitis are less likely to completely eliminate all symptoms. However, it is possible to control the disease's clinical symptoms with proper care and education.


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## pamnock (Mar 14, 2010)

Heart problems can also cause respiratory symptoms.


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## Pipp (Mar 21, 2010)

How is Badger? 

Did he end up going to the Vet? 


sas :?


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## Flashy (Mar 21, 2010)

Yes, I did keep the appointment and take him to the vet- couldn't leave him suffering. No thanks.

Looks like a LRI. Slight sounds on lungs, but not as bad as before the dental. No signs of it being URI at all. He's been on Septrin for a week. His breathing looks a bit better but since I opened (and then speedily closed) the window in my room on Friday he has been coughing again. I think I'm going to have to take him back. My vet is comfortable using Convenia now, but not Zithromax (because he's never heard of it) or a Penicillin (I'm hoping to change this too). Not sure what med I should be looking at or asking for but I'm not comfortable having him just on Septrin when it doesn't seem to be doing much of anything. He's also on Metacam.


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## Pipp (Mar 21, 2010)

Aw, too bad, I was hoping it was just a dental byproduct and would just go away. 

If it's a lower respiratory thing, I would think it needs aggressive treatment to make sure it doesn't develop into something worse. 

This page addresses bacterial infections, the most relevant info about a LRI is down the page. 

http://www.medirabbit.com/EN/Respiratory/Bacterial/URI.htm

I'm pretty sure Septrim is trimethoprim sulfadiazine, and MediRabbit really doesn't like that drug. Note the following paragraph: 

_Trimethoprim sulfadiazine is a bactericidal antibiotic used in GI tract, respiratory and urinary infections, among others. It is efficacious against a range of bacteria that affect rabbits, including Pasteurella sp., Clostridia spp., Staphylococcus sp., Bordetella sp., etc. It can be used long term, low dose. This antibiotic often shows poor results in rabbits, and often the disease comes back worse once the treatment is stopped. This could relate to the fact that half-life of trimethoprim in a rabbit last only 40 min. _

Too bad the Vet isn't familiar with Zithromax. The next paragraph after the one I posted mentions it (azythromycin). It doesn't say it here, but I believe one of the its stronger points is its ability to fight stubborn URIs and LRIs. But of course it has to be the kind of bacteria its designed to fight. 

I'd go for a culture or an x-ray next, probably a culture. Even if an x-ray showed another issue, an infection could still be accompanying it I guess. (But I am just guessing). 

It doesn't specifically recommend it for a LRI here, but I've seen quite a bit of data suggesting that the best treatment is a combo with a nebulizer delivering an antibiotic deep into the respiratory system. A lot of people on the board have had good luck with nebulizers.

BTW, if you print the MediRabbit page out for the Vet, which is the best idea, make sure you also print the linked page about safe antibiotics. I see they mention Gentamycin in this article without comment, but on the 'safe' page, they don't recommend it. 

Good luck! 


sas :clover:


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## Flashy (Mar 21, 2010)

Thank you.

Having read that article, it says 

'Cephalosporins are bactericidal broad-spectrum antibiotics used to treat skeletal, genital/urinary, skin and soft tissue bacterial and respiratory (associated with Pasteurella sp.) infections, among others. There are several generations of cephalosporin, each aiming a more or less specific group of bacteria. Although quite safe when used in injected form, this drug is potentially nephrotoxic.'

Convenia is a Cephalosporin, so I would take it that it could potentially be of use?

Also, not sure of the risks of an x-ray on a rabbit with a compromised respiratory system?


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## Flashy (Mar 21, 2010)

Off to emergency vets. Badger just woke up and started to mouth breathe :|

Just printing off the article to take.


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## Pipp (Mar 21, 2010)

Ugh, so sorry.  

I hope they give him an x-ray. (ETA: Its quicker than a culture).

Doubt you'll see this in time, but with one Convenia shot active for such a long time frame, you may not have a chance to switch if it doesn't work, so I'd say no go without a culture. (ETA: Not sure if there's a problem with other antibiotics given on top of that or not, just guessing on this). 

Hope he's okay. 



sas ray:


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## Flashy (Mar 21, 2010)

It has now progressed to full grown pneumonia. Jolly.

I didn't see it in time and he has had Convenia, but the other option today was Baytril :| So I had to make an on the spot decision given she thinks the next 24-48 hours will be critical. She is willing to use Zithromax but it has to be ordered in (otherwise he would have had that). At the end of the day, probably getting him through today is more key than anything, so if he does survive longer then he can change to something else once the Convenia has worn off. He will stay on the Septrin and Metacam throughout.

I've just spent an hour frantically locating a nebuliser, which I have now done, and she told me what stuff to use for it (quicker for me to buy it myself than for them to order it in).

He is pretty much fine in himself generally (eating, maintaining weight, looks good, very, very perky), the problem occurs when he is asleep because it sort of congeals (I suppose) in his chest. Obviously stress plays a part too. She said his left side is more congested than his right. 

I'm off to try and work out how to use this nebuliser.


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## Pipp (Mar 21, 2010)

Convenia doesn't last that long in rabbits, I think six days has been the max with the people who have used it here. And doubt there's a problem with high doses of multiple antibiotics in this case regardless, so agreed that without a culture to know for sure, it was the best choice to get him through the short term. Its a good drug.

Pets for Badger, hugs for Flashy. 


sas ray:


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## tonyshuman (Mar 21, 2010)

Zithromax can usually be found at a human pharmacy too, just in case that helps. Convenia for rabbits should be dosed every 5 days, I think. This might be a good situation to nebulize with acetycysteine--it makes the mucus less thick.


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## Flashy (Mar 22, 2010)

Thanks Claire. I'd be reluctant to do that, to be honest, unless I had used it before. I'd rather do it under the supervision of a vet in case it goes wrong.

I've been told to nebulise with something called F10SC, but until they get that, it has to be water.

How long may a nebuliser take to show that it is making an improvement or difference to him?

He's nice and bright today  and currently stuffing pellets.


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## Pipp (Mar 22, 2010)

Here's a story you may have already seen from the House Rabbit Network...

http://www.rabbitnetwork.org/articles/nebulizer.shtml


sas ray:


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## MPHF (Mar 22, 2010)

Hope Badger hurry ups and gets better. 
Hugs to you all. x


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## tonyshuman (Mar 22, 2010)

Here's info on the F10SC:http://www.f10biocare.co.uk/VETDISINFECTANT.pdf

It's mostly to kill bacteria and fungus. It sounds like an interesting approach, and it should work. I'd like to hear about how that goes.

It's not going to decrease the viscosity of his mucus, though. I don't know how long these things should take, especially since it probably depends on how many treatments per day, how long each treatment is, and what's being used. Nebulizing with water will soothe any dry nasal/bronchial passages.

This article from Dana Krempels suggests using acetylcysteine (to break up the mucus), amikacin (an antibiotic), and aminophylline (a bronchodialator--to open up airways) in the nebulizer. 

http://en.allexperts.com/q/Rabbits-703/2009/12/Bunny-trouble-breathing-2.htm

I do think that this disinfectant the vet is ordering will probably work, as long as it's not too harsh on the airways, but the other compounds might help it get to where it needs to be--the mucus may be too thick and the airways too constricted to get the disinfectant where it needs to go. It is, of course, up to your vet to decide that!

I mentioned that azithromycin is found at human pharmacies because it's a place your vet could write a prescription for it and have it filled. You can't get it without a prescription at all, but it's just an option of a place where you could get the prescription written by your vet filled. You'd want to call ahead to the pharmacies to see if they will fill veterinary prescriptions. You'll probably have better luck with a smaller, compounding pharmacy for filling a vet prescription than a larger chain, but I've never done it so I'm not sure. Our Walgreens (huge drugstore chain) had a sign up once that they filled pet prescriptions, so you never know.


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## Pipp (Mar 23, 2010)

:hug1


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## Flashy (Mar 23, 2010)

Badger has made it all the way through his third gotcha day, THANKFULLY!

He's pottering on. I think the nebulising has really helped. Got the proper stuff today so will try that tomorrow. Going to also get Bisolvon I think too to help. He's doing ok, currently. I'm hoping the anti bios are doing some good.

Thanks all for your help.


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## Pipp (Mar 25, 2010)

How is Badger today? Did the meds in the nebulizer make a difference? 

BTW, did you discuss the length of time for the Convenia injection btw? It wears off in as little as five days in rabbits, a much shorter time span than dogs and cats. 

If it seems to be working, maybe a second shot?


sas :clover:


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## Flashy (Mar 25, 2010)

He's poddling on. 

Yeh, I know Convenia wears off faster because we used it with TIlly and have also been closely involved in MPHFs Minnie's Convenia journey. They both had them redone at different times so I definitely know it can vary. He's going back tomorrow to discuss stuff further.


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## MPHF (Mar 26, 2010)

Hope Badger gets on ok. Tilly will always be remembered especially for making Minnie so happy and comfortable.


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## Flashy (Mar 26, 2010)

Thanks Clare. Sorry I haven't replied or updated my journal, we have had a hard week. Sky is perfect thank you  Bounced back fine and quickly.

Right, back from the vets Badger has had another Convenia. The vet said he is going to look into Zithromax today to see if we can get a supply in. I said I Don't want to start it just before the Easter weekend (I don't need an Easter emergency again this year), so it will either be the start of this coming week, or the start of the next, after Easter.

Badger still sounds 'dull' on the left side. We talked about what to do next if this doesn't work and it will be x-rays and a culture (although it sounds like they have never done a deep culture on a bunny before. His words were 'not for the faint hearted') but obviously that's risky with him compromised respiratory system.

What I have found is that since I started nebulising I have not heard a proper cough. Not one, and he was coughing once every hour and a half or so. So I think the nebuliser had instant effects and I'm going to keep doing that.

I asked for, and have been given, Bisolvon which can be given orally and I know people who have nebulised with it too. My vet has never done it through nebuliser so I've got the task of researching that myself to work out what to do. I'm doubting anyone here will have used it, but if you have, any ideas of how much to add to saline?


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## tonyshuman (Mar 26, 2010)

I'm so glad the nebulizing is working! I don't know much about Bisolvon, sorry.


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## Flashy (Mar 30, 2010)

Just thought I'd update. Today his lungs are clearer (wahoo) so the 6 meds he are on are working (or some of them are). Unfortunately she can now hear his heart isn't right (not so wahoo) so he's going in for an x-ray on Thursday.


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## Maureen Las (Mar 30, 2010)

Could the heart issues just be stress related; it has occured before on this forum .
I am so glad that his lungs are better.; you are doing such a great job Tracy. If I was a sick rabbit I would want to be owned by you.

you are so diligent and thorough .


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## tonyshuman (Mar 30, 2010)

I'm so glad his lungs are improving. I hope things with his heart improve as well!


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## Flashy (Mar 30, 2010)

Yes, I would guess that the heart issue COULD be stress related, however, if his lungs are clearer then why is he not appearing better overall. We must be missing something here somewhere (this is like thoughts outloud, not directed at you Maureen). He is breathing in a laboured way and he rocks when he breathes. He has like an old man, deep chesty cough every so often. If his lungs are clearer and less crackly and it is due to an infection, then he would be starting to show improvement, which he isn't. Either way, hopefully the x-ray will show something relevant.

Never again am I going to lose a bun and think 'if only'. If I lose Badger then I will know we both put up one hell of a fight and did everything and anything we could. I don't ever want to carry anymore guilt for letting down rabbits. I'm not going to let him down, and for as long as he wants to fight, we fight; tooth and nail.


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## Flashy (Mar 30, 2010)

I'm very, very scared for my most dearest Sky. He was making a similar noise to Badger was, but no sign of chest problems could be found (and other than the cough was showing no particular symptoms), but when the vet checked his mouth he found spurs at the back, so felt the noise was created by excess saliva.

Now Sky is recovered and has been making the same noise today. I can't see any evidence of any other issue (his breathing looks normal- no idea what it sounds like). I'm so, so scared I'm going to lose him. He's my world. He will go to the vets but I have no idea what I should be doing now.

All my specials are getting ill. I'm going to lose them all.


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## tonyshuman (Mar 30, 2010)

Positive vibes sent...


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## Flashy (Mar 30, 2010)

Thank you. I'm going to get Sky to the vets tomorrow and on Convenia straight away. The routine starts for Sky tomorrow too. He HAS to be ok.


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## MPHF (Mar 31, 2010)

Hope Sky gets on ok at the vets and Badgers x-ray goes ok. We all know you will do all you can for your Buns.


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## Pipp (Apr 6, 2010)

How are the bunnies? What happened at the Vet's? 


sas :?


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## Flashy (Apr 6, 2010)

Sky is good. No more problems with Sky.

Cloud is failing (not that Cloud has been talked about on this thread).

Badger is being complicated. No tests have revealed anything wrong with him at all. His chest is now clearer than it was, x-rays show no signs of infection in his chest, his heart looks ok, something else she was checking looks normal too. That vet reckons that there is nothing obviously wrong and he is not in any immediate danger. She said if I want to go further then its time to consult with a specialist (which are veyr few and far between here).

I disagree about him not being in any immediate danger because we've had mouth breathing, his nose is as far in the air as it can go, he's not comfortable at all. So tonight we are going back to the vets, to see a different vet. My regular vet is on holiday for another 2 weeks, and right now I'm very much missing him!

I have to keep fighting for him for as long as he wants to fight for himself. Its what he deserves.


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## Flashy (Apr 7, 2010)

Looks like Badger has a laryngeal (spelling?) issue. Not pneumonia, although he may have had that previously because it is a known secondary issue.


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