# Cat Scratched Rabbit's eye



## MattTren (May 30, 2010)

I'm not 100% sure if this is the case, but I'm pretty sure Bucky went after the cat, and she swatted him. 

Yesterday morning I woke up and noticed he wasn't as active as he usually is. When I looked at him, his eye was closed. I pried it open a little and it didn't look good, I made calls to various vets, I found a vet that said they specialize in rabbits, and took him down there. He has a starched cornea. He said he was going to give us some gel that would make it better but turns out it wasn't in stock, so he gave us Neo-Poly-Gram and said put it in his eyes 4 to 6 times a day. As loyal, I put it in at 8 last night, 12 midnight. This morning I put it in at 9, 1, and 6. When I got home, around 10 I noticed, he was slowing down even more than he did before. As soon as we got out of the vet he was opening his eye a little bit more, then all day today it seemed to have gotten better. However when I got home at 10 he is keeping it almost shut completely, and when we looked at his eye, it seems to be getting cloudy or like some membrane is forming. Doctor said he was confident it was going to get better, and assured me he wasn't going to go blind.

I feel so bad for him, he is in a lot of pain and isn't eating like he usually does. 

I'm surprised he seemed to get better for a while and now he's doing worse. 

What can I do? Did the doctor lie? Is he going to go blind? What can I do to stop the pain? Should I continue with the Neo-Poly-Gram? what kind of gel was the doctor talking about, that he didn't have? 

Gosh I hate holidays cause I feel like I'm stuck until Tuesday.


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## MattTren (May 30, 2010)

why would it get better, as soon as we got back from the doctor and now he is keeping it almost completely shut?


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## MattTren (May 30, 2010)

Should i stop using the Neo-Poly-Gram could that be making it worse?

The doctor also put some kind of gel on his eye to see how bad the starch was.


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## Pipp (May 30, 2010)

Unfortunately cat scratches can be dangerous. He really needs to have an oral antibiotic as well as a different antibiotic for his eye, seeing as the one you have isn't working. 

And he's going to need pain relief. The vet didn't give you anything? 

If its serious, you may have to go to an emergency clinic.

A few questions... does there seem to be a lot of pus around it? Does he seem to be running a fever, where he seems hot? Can you take his temperature? I think a fever might indicate whether the scratch has an infection that is traveling through his body.

It could be the pain making him lethargic, and/or it could be the natural progress of the injury, they do often seem worse before they seem better. And/or that particular antibiotic can be useless against that bacteria. Eye medications are notoriously fickle. I've have to try three before finding one that works for my bunnies with minor infections. 

If you don't have Metacam or another rabbit pain relief med, do you have anything there like Baby Motrin? 


sas :clover:


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## pla725 (May 30, 2010)

I agree with Pipp. He needs pain meds and an antibiotic both topical and oral. 

I would take your bun to the nearest emergency clinic. I know there are two in Langhorne and The University of Penn in West Philly.


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## ra7751 (May 30, 2010)

A cat scratch (or bite) transfers a lot of bacteria. In baby wildlife, it usually causes death within 72 hours. In adult animals (including humans), it can cause some serious infections. In this case, I really think this should be treated more aggressively. NPG comes in either a drop or ointment and contains three different antibiotics. I don't like using the term "stronger" or "weaker" in talking about antibiotics since it is medically incorrect....but if I were to label NPG, it would be one of the weaker drugs. If a corneal abrasion isn't properly treated, it can ulcerate and that takes the problem to a much higher level. It normally takes up to 72 hours for most antibiotics to get to working levels. He was better after the vet visit because I suspect the vet flushed they eye.

I would continue with the NPG but would try to get into the vet (or another vet) in order to step up the treatment. I would suggest asking about either Tobramycin or Gentamicin drops. DO NOT use any drops/ointmentthat contain steroids. Very few vets know this one, but a human drug called Acetylcysteine can be used as an eye drop (in conjunction with the abx) to help heal any scratch or ulcer. Using a lubricant gel in-between abx drops would also be helpful. This condition is also quite painful and something like Metacam would also be appreciated. In this case, if your rabbit has never been given Baytril, this might be the rare time I would suggest it. If Baytril has been used before, I would suggest using Convenia (safe only as an injectable). And keep the light levels low.

Randy


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## tonyshuman (May 30, 2010)

Agreed with above. The treatment of the cat scratch needs to be more aggressive, and a systemic (oral or injected) antibiotic should be used in addition to the one applied directly to the eye. The stuff the vet put on the eye to see if it's scratched was a dye to help diagnose what was going on, not a treatment. I would keep up the ointment but try to get him some systemic antibiotics and pain medication.


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## MattTren (May 30, 2010)

I just got back from University of Pennsylvania Vet hospital. I'll write out everything they gave us. Said it is not looking good, and the previous vet we went to was incompetent.


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## MattTren (May 30, 2010)

Okay so the vet prescription:

Ciprofloxacin (drops) every four to six hours.

Meloxicam in his mouth every 12 hours.

Atropine (drops) once a day.

Any objections?


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## ra7751 (May 30, 2010)

Umm.....OK, Cipro is the human version of Baytril. Usually dosed twice a day but ideally should be done once a day. This is one of those times that this drug might do the job. Meloxicam is the human version of Metacam. Dosing is interesting since it is usually dosed once a day for a max of 4 days. Great drug for moderate pain and as an NSAID will reduce swelling. Of the NSAIDs, it is the besttolerated in rabbits. Was there an explanation of why atropine is being used? Inquiring minds want to know.

Randy


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## MattTren (May 30, 2010)

I have no idea i read through the specific instructions and it gave us no reasoning to why Atropine was prescribed. Should I not use it, from what I read it looks like it is to dilate the pupils or something but I am not a doctor. What is it?


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## MattTren (May 30, 2010)

In your professional judgment should we cut back his Ciprofloxacin to maybe three times a day? a compromise from the doctors orders?


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## ra7751 (May 30, 2010)

Well....I am not a professional....just been doing advanced medical treatments for years. While I am not a vet, I do train vets on exotics and wildlife. I would follow your vet's instructions but it is always good for you to ask questions.

As far as the Cipro, I rarely use Flouroquinolones and when I do, it's Zeniquin. When I did use Baytril (same family)....I always injected it sub-q. Seems to be more effective and you lessen the risk of GI upset. I generally dose it once a day....no more than twice....depending on the situation. There may be a perfectly good explanation as far as your vet's protocol. Again, the more educated you are (by asking questions)....the better you can make things for your rabbit. Meloxicam is generally dosed once a day. We generally use a "loading" dose the first time (twice the normal dosing) and then normal dosing for the following three doses. We generally limit NSAIDs to a max of 4 days to protect the liver. I'm not really sure why your vet is using Atropine....again maybe he/she has good reason. Another question to ask. I use Acetylcysteine in eyes and most vets have absolutely no idea that this drug works in eyes....but it does.

My point in all of this is to encourage you to ask questions. I do the same thing with my personal doctors. I want to know the "whys" in everything. You will be amazed at what you learn by asking the proper questions. And a side benefit, most doctors appreciate someone that is willing to learn....makes their job easier.

Randy


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## MattTren (May 31, 2010)

what the heck is sub q?


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## pla725 (May 31, 2010)

It is injected under the skin.

Also most of the vets at the University of Penn ER are residents. They are trained to handle anything that walks, crawls or is carried into the clinic. Did they give you a phone number to call if you had any questions?


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## dazsgeo (May 31, 2010)

It sounds like the ciprofloxacin is ophthalmic drops, not oral medication. Is that correct? If so, I would follow the vet's recommendation. Here is some info on treating corneal ulcers in rabbits- http://www.medirabbit.com/EN/Eye_diseases/Disorder/Corneal_ulcers.pdf



Just wanted to add this article also mentions using atropine.


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## ra7751 (May 31, 2010)

Very possible that the Cipro is the eye drops. I don't use them because they are not that effective. Also the article mentioned is quite dated as we have learned quite a bit in the past couple of years regarding treating ulcers and abrasions. As I have mentioned, I use a very specific protocol in dealing with this type of issue. An appropriate eye drop....usually Tobramycin or Gentamicin. An appropriate systemic antbiotic....Zeniquin, Convenia or Penicillin would be possible choices. Instead of Atropine, I use Acetylcysteine. It's a human drug used to break up mucus in the lungs and protect the liver in certain drug overdoses....but used as an eye drop....it is an excellent healer for ulcers...although very few vets are aware of this. I have experienced no problems in healing abrasions/ulcers and have used it in both domestic and wild rabbits. Andappropriate pain meds. Just something I have had success with.

Randy


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## MattTren (May 31, 2010)

Let's just be honest, chances are Bucky is going to go blind right? After a severe eye injure?


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## Pipp (May 31, 2010)

*MattTren wrote: *


> Let's just be honest, chances are Bucky is going to go blind right? After a severe eye injure?


How did they classify the injury as severe? Is it the infection? The depth of the scratch? 

Some nasty looking injuries clear up just fine once the infection is gone, but some deep lacerations can cause permanent damage, but I think its more common to have the eye removed completely than to have it recover and be sightless. 

The usual down sides in my experience with rabbits and other animals have been the eye at some point collapsing (or expected to collapse) warranting removal, infected tissue going 'necrotic' (dying), or the the infection getting into the blood stream.

Most of the time with the rabbits I've heard about, a cornea scratch hasn't affected vision. 

Are they sure the cause of the eye issue was a cat scratch btw? There are many other ways this can happen. I've seen it occur from a piece of hay, a genetic eyelid issue and other things. (Unrelated to this, but I think my cat ended up with a corneal ulcer as a secondary effect from high blood pressure). My rabbits have had the cats take a swipe at them (in self-defense) but the only injuries have been to the third eyelid, not the cornea. They're usually pretty quick to protect their eyes. 

PS: My vet prescribes ChlorPalm for eye injuries. 


sas :clover:


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## pla725 (May 31, 2010)

Don't give up hope. I really think you need to be agressive with this situation. Make calls. 

I'm not sure how close you are to the Wayne/Radnor area but there is an excellent vet at Radnor Vet Hospital. 

Dr. Len Donato
Radnor Veterinary Hospital
610-687-1550
112 N. Aberdeen Ave.
Wayne, PA 19087

You can also go back to Penn through the clinic. They have a special species department run by Dr. Karen Rosenthal one of the top exotic specialists in the US. They also have eye specialists on staff.


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## MattTren (May 31, 2010)

"On physical exam today, Bucky was bright and alert. There was significant corneal edema and a large ulcer on his left eye with evidence of white blood cell infiltration. It appears that the corneal ulcer may be deeper than just the surface of the cornea

We are unable to predict whether Bucky's ulcer will progress or heal normally. We are, however, switching him to a stronger topical antibiotic, ciprofloxacin, with the hopes of stopping any serious infection from progressing. We are also starting him on an anti-inflammatory and pain medication (Metacam) which should make Bucky feel more comfortable and help the anterior uveitis (inflammation of the uveal tract of the eye)."

That sounds really bad doesn't it? But then again the doctor said she is not sure, since she is not an eye specialist. She suggestion an ophthalmology consult in a few days.


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## pla725 (May 31, 2010)

I would schedule that appointment with the specialist.


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## Pipp (Jun 1, 2010)

:yeahthat:

This is somewhat off-topic because this article is for dogs and cats, but it seems to say something I've suspected for awhile -- there is a problem with most topical eye meds. 

The article, geared for vets, discusses ways to self-manufacture (if that's the right phrase) antibiotic treatments.

http://cal.vet.upenn.edu/projects/ophthalmology/ophthalmo_files/Tools/ComplicatedUlcers.pdf


Here's an excerpt: 

_MEDICAL THERAPY SPECIFICS

Typically infected (septic) corneal ulcers can have either cocci or rods, or both; septic ulcers are usually of an aerobic variety. _ _*Because the infected cornea can melt down to a full thickness perforation rapidly; one can not wait for culture and a sensitivity result to return before an antimicrobial decision is made. With this in mind, the antimicrobial choice needs to have a great likelihood of being effective. Many of the traditional commercially available drugs (neomycin, bacitracin, gramicidin, and polymyxin b) are not as likely to be effective.* Therefore one needs to choose drugs that have a greater potential for efficacy; unfortunately, many of these drugs are not commercially available as an ophthalmic preparation. Therefore special topical preparations of antimicrobials that have greater efficacy must be prepared.

Not all antibiotic preparations can be used topically. The list and recipes that follow cover a wide range of antimicrobials. Formulations below were taken from the UW VMTH Pharmacy; Don Michalski, RPh._ _

Special Antimicrobials:_ _

Amikacin_ _
Add 500 mg / 2 ml of Amikacin [Amicacina solution 25% IV solution] to 13 ml of Artificial Tears to make concentration of 33 mg/ml. Do not use Tears Naturale (precipitates). Expiration = 1 month

Cefazolin_ _
Add 500 mg / 1.5 ml of Cefazolin (330 mg/ml) to 13.5 ml of Artificial Tears. Exp. = 7 days. Refrigerate. Shake well. The final concentration is 33 mg/ml.

Gentamicin_ _
To make 9 mg/ml final concentration, add 35 mg (0.35 ml of the 100 mg/ml injectable) to 5 ml of gentamicin ophthalmic solution. Exp.: 1 month.

Insulin_ _
Remove 2 ml from Artificial Tears bottle. Add 200 units (U100 - 2 ml) regular insulin. Final concentration = 13.5 units / ml. Exp. = 1 month Refrigerate

Penicillin GK (Penicilina G)_ _
Remove 5 ml from 15 ml Artificial Tears bottle. Add 12 ml sterile water to 20 million unit vial of Penicillin GK (concentration = 1 million units per ml), add 5 ml Penicillin GK to 10 ml Artificial Tears. Final concentration of Penicillin is 333,333 units/ml. Exp. = 7 days. Refrigerate. Shake well.

Tobramycin_ _
To make 9 mg / ml, add 40 mg / ml of Tobramycin injectable to 5 cc of Tobramycin
ophthalmic solution. Exp. = 1 month. [Use Methylcellulose 1% for Artificial Tears Unless Otherwise Indicated]_

etc.... 





A lot of what I've read says that it can take a week to see results so there is still a very good chance he'll be fine, but I'd still take him in to the specialist to make sure he's getting the right meds. 


sas :clover:


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## tonyshuman (Jun 1, 2010)

I agree, it may be serious enough that the scratch is not just on the surface of the cornea and has actually gone through one of the layers of the eye. A specialist would be a really good choice.


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## MattTren (Jun 1, 2010)

I am going to the eye specialist tomorrow at 2 at university of Pennsylvania.


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## Pipp (Jun 1, 2010)

How is Bucky now? 



sas :?


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## MattTren (Jun 1, 2010)

he is keeping his eye closed, my dad says the white patch is getting smaller but I'm too skirmish to look, he is running around the house a little bit.


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## Pipp (Jun 1, 2010)

Yay! Sounds like its working. (Don't cancel the appt tho!)


sas :clover:


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## pla725 (Jun 1, 2010)

Let's us know how the appointment went. I was very happy with the treatment my rabbits received there. Unfortunately the vet I liked there left. 

At least with Penn you can make payment arrangements. Most vets won't even consider it.


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## MattTren (Jun 9, 2010)

I must admit Penn was an excellent hospital. Long story short we took Bucky to the Vet three times, he did better for a while. But he still wont' open his eye all the way. Yesterday he was running around acting a nut as he always did, eating really well and everything. But today he is just sitting in a corner not saying much, he has always been picky about his straw even before the eye problem, sometimes he'd eat it, sometimes he doesn't eat it, but his carrots are his addiction, but now he won't even eat a carrot. He isn't' doing well at all. It might be a passing thing, but I know how important it is for rabbits to eat all the time. I'm getting scared here. Maybe the infection spread. I am thinking i should give it a day or two, then Friday if he isn't doing better, take him to the vet and might possible consider putting him down. I know it sounds bad but I rather him die quickly than deal with pain and starvation. I really love him, but want the best for him. Maybe I'm just being overly paranoid though.


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## MattTren (Jun 9, 2010)

Mr. Nut job is back!!! My dad gave him some Gornola, and he wolfed it down, and now he is running around acting a nut, I don't remember him being like this for weeks. It was just strange how quiet he was.

I'm heading off to class. Report back tonight.


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## MattTren (Jun 9, 2010)

He is sticking his nose up to Carrots though which is very very odd for him.


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## Pipp (Jun 9, 2010)

Is he still on antibiotics? 


sas :?


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## MattTren (Jun 10, 2010)

Mr. Nut job is back! An hour after I posted this he got back to normal. It really really scared me when he got as quiet as he did.


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