Another trip to the vet school with Philip

So after a recent check up we found out Philip had lost quite a bit of weight, the vet also found that his ear was bothering him when she was looking inside. He was treated for ear mites in the first instance and that seemed to help and he also put some weight back on. Then the vet thought he had an ear infection at his next check up as it was really bothering him when she checked it so he was to get antibiotics in his ears (you put in a drop but use a syringe, very tricky. Also Philip is tiny with fully lopped ears, his ear holes are barely visible) plus tramadol (he already gets loxicom). But then after a few days he kept falling over a lot one day, so back to the vet and she said the ear didn't seem to be improving and with the falling over she wanted to check the middle ear wasn't affected. So off to the vet school we went for a CT scan

Turns out it was just a build up of wax and his middle ear wasn't affected, so thats good! He was there before with this but it wasn't as bad this time.
The CT scan also showed that his spondylosis has gotten slightly worse but its progressive so thats no surprise. They also said he has pododermatitis on one food, but it probably looks worse than it is because he had poo stuck to his foot which my vet shaved off. The report also says "• Mild increased attenuation within the ventral right lung lobes consistent with atelectasis. " which google tells me has something to do with lungs so I will need to ask my vet about that, but theres no mention of it under the treatment section.

MJ also has a swelling at the base of one ear but doesn't seem to be bothering him at all, they weren't looking at MJ so thats all she said.

If anyone is interested this is the full report:

Clinical Investigation:
Complete Physical Examination:
• Body Weight 985gm
• Heart and respiratory rate within normal limits
o Thoracic auscultation normal with good chest compliance
o Mucous membrane colour pink/hydrated
• No lymph node enlargement
• Quiet gut sounds bilaterally
o Abdominal palpation normal
• Skin/fur in good condition
o Pododermatitis present on right foor (grade 3.5/5)
• Ocular exam - no abnormalities present
• Otoscopic oral exam - no abnormalities present
• Otoscopic ear exam-
o left ear stenotic with no erythema or purulent discharge
o right ear stenotic with no erythema present
 resents palpation of ear base and scratches with hind foot when examined
 used Otoclean to remove a small amount of normal ear debris from ear canal with resolution of scratching

Computed Tomography:
Philip had a conscious CT scan performed with IV contrast given. This involved Philip having small areas of his ears shaved for an IV cannula to be placed. Philip received a bolus of IV fluids after this procedure to help flush the contrast from his body. Complete results are as follows:
Head
• The dentition and nasal cavity are within normal limits.
• Both tympanic bullae are air-filled. Within the horizontal part of both external ear canals there is a similar of fluid-attenuating, non-contrast enhancing material, however is less compared to the previous CT.
• No regional lymphadenopathy detected.
Thorax/Abdomen
• Mild increased attenuation within the ventral right lung lobes consistent with atelectasis.
• No other significant findings
Musculoskeletal:
• Along the ventral aspect of multiple thoracic, lumbar, lumbosacral vertebrae there is ventral new bone formation and bridging consistent with spondylosis deformans. Compared to the previous study, these osseous changes are slightly more pronounced.
• The rest of the musculoskeletal structures are within normal limits.

Diagnosis:
• Bilateral otitis externa (improved compared to previous CT)
o Philip has ear wax material trapped within both of his external ear canals with his right a bit worse than his left clinically. This is commonly seen in lop eared rabbits as the kink in the cartilage prevents normal material from escaping. Similarly, in smaller breed rabbits, the ear canal may be too narrow (stenotic) to allow normal ear debris to come out. This can result in billowing of the ear canal often felt as an ear base swelling, become infected over time, or cause pressure on and rupture of the ear drum resulting in otitis media. Philip may require a suitable ear cleaning product to be used on a regular basis to prevent the otitis externa progressing to otitis media.
 Products such as Otoclean, CleanAural Sensitive, and CleanAural Cats are suitable. A few drops can be placed in each ear and the ear base massaged once weekly or every other week
 Overuse of ear cleaning products can cause irritation and inflammation and regular vet checks are recommended
o If medical management is not successful, surgery such as creating a stoma, may be required to help alleviate build up of material in the external ear canal.
 As the otitis externa is improved compared to the previous CT, your current managment may be adequate
• Slightly progressive thoracic, lumbar and lumbosacral spondylosis deformans.
o This may have been acquired over time after an injury or due to overuse.
o You may need to modify Philip's enclosure at home to make it easier for him to move about without needing to jump up or down too much. Keeping him in healthy lean body condition will also reduce the rate of progression of the arthritis in his spine.
o Philip may require long term pain relief. There are multiple options which should be discussed with a vet and a protocol tailored to his needs:
 Meloxicam
 Nonsteroidal anti-inflammatory pain relief
 If this is to be long term pain management, we would recommend a blood profile to ensure no anaemia is present and kidney function is adequate
 Paracetomol
 aniline analgesic; this is not licensed for use with rabbits but may be used in some cases
 Tramadol
 Opioid pain relief may be used in conjunction with other analgesics or on its own if kidney function is compromised
 Gabapentin
 targeted to pain related to nerve injury or dysfunction

Oh bless him!

I don’t envy you trying to get ear drops into him. Would be bad enough with an uppy wares rabbits but lifting the ears on a lop just feels so unnatural to them doesn’t it.

That’s strange they mentioned lungs but then nothing further.
You’ll need to let us know what your vet says!

Wow, that's comprehensive. But good to have, reassuring of your vets dedication and competence. I hope Philip responds well, they seem to be pleased with him.
I hated the long list of examinations/results that were done on Reboot. And the list of drugs was really upsetting. I refused to read it as I only actually received it after he was gone and I know I couldn't have faced it.

Hoping that he feels better soon

Thundercracker had the same ears issues before his op.

Xxx

Update: I asked the vet about the lung thing, she says its nothing to be concerned about and it is something that could easily have happened without us knowing.

She's not satisfied with the vet school report tho in terms in his ears so she's going to speak to them directly.