Belle referred to vet school

So despite daily nebilising and bisolvon Belles sneezing/snottiness hasn't improved so I've had her referred to the vet school, appointment is on weds AM. Could be doing without the vet bill but its clearly causing her some discomfort when it gets bad and nothing else has helped.
Fingers crossed its an easy fix!

Fingers crossed for Belle!

Yes, fingers crossed. Get well, little girl.

How did she get on?

Sorry for the delayed update, I only heard back from the vet a few hours ago

Basically she has a really quite severe sinus infection that has caused some destruction of her nose cartilage and has spread to her ears so she also has a bad middle ear infection.

The next step is to have her admitted for a middle ear flush under general anaesthetic, this will hopefully help clear everything else up but due to the damaged cartilage that can complicate things and make them prone to recurrance of infection so if that doesn't help with the snottiness the next step is surgery to drain her sinuses. Expecting a all from them between xmas and new yr to arrange an app for the ear flush.

I'm annoyed at delaying referring her, but honestly I didn't think it would be that bad :/

Here is the full discharge note if anyone is interested:

Diagnosis:  Upper respiratory tract and middle ear infection, most likely from Pasteurellosis
Clinical Findings:  Belle was a little nervous for her visit with us, but was very well behaved. A summary of her physical examination findings were:
- Small amount of discharge at the right eye from the tear duct.
- Normal ears
- Normal jaw palpation, lateral jaw movement and oral examination of cheek teeth and incisors
- Bilateral nasal discharge with most prominence on the right side
- Increased 'bubbly' wet sounds in the upper airways
- Normal lung and heart sounds
- Normal chest compliance
- Normal abdominal palpation
- Well muscled and excellent coat condition
- Weight - 1.6kg, body condition score 2/5 (ideal 2.5/5)
- Small area of pododermatitis to both hocks (very mild hock sores, which is commonly seen in pet rabbits).  Please monitor this and if worsening ensure that there is extra soft bedding provided, as the point of the hock is a pressure point for the weight of the rabbit when sitting at rest.
Investigation:  Belle underwent a conscious computed tomography scan to investigate the reason for her chronic upper respiratory tract discharge.  She had an intravenous catheter placed in her ear to allow us to administer an intravenous contrast agent.  Belle sat beautifully still for us and we were able to get good quality images.
A summary of the main computed tomography scan results were:

- Infection within the right side of the nasal passage affecting the lower nose and sinuses. There is mild destruction of the cartilage within part of the nasal passage. (This condition is also known as a mildly destructive rhinosinusitis)
- Infection and distension of the right tear duct. (This condition is known as dacrocystitis)
- Middle ear disease affecting both sides with infection within the tympanic bulla (middle chamber) of the middle ear. (This condition is known as a bilateral grade III Otitis Media)
- Small artefactual lung changes, considered not significant and an incidental finding
- Mild abnormality of upper cheek tooth roots, with slight elongation - no action currently required, please just continue to promote good hay eating, as you have been.
Based on the CT findings, we can be sure that infection has started in the right nasal passageway, however we have signs of secondary ascending infection to both middle ears via the Eustachian tubes.  To try and treat this condition we would recommend a bilateral middle ear flush under general anaesthetic.  This would also allow for some flushing of the nasal passage and a tear duct flush.  In some cases, where the infection within the sinuses is severe, we drill a hole through the skull into the sinus to facilitate more aggressive flushing.  If our initial treatments are not successful at improving Belle's signs, we may need to consider this type of treatment.
While Belle is anaesthetised, we would also recommend taking a deep nasal swab for culture and sensitivity testing.
Often with destructive upper airway disease, complete resolution of the problem can be difficult to achieve.  For these reasons we often consider these cases as management cases i.e. we try to keep on top of the condition, knowing a complete cure may be unlikely.

Poor Belle. Having sinus/ear probs myself I can sympathise with her. Is her balance affected?
Give her lots of cuddles from me... I have no bun to cuddle now so I've got lots going spare.

Oh, same! Its actually fine, I did mention that to the vet that I would have thought there would be more symptoms with how bad the infection is but she said that her symptoms are typical, you only really start seeing balance problems etc with inner ear infections.

She's not one for affection but I will give her an extra biscuit from you!

The vet school called this morning and Belle is booked in for her procedure tomorrow morning, dropping her off at 9.30am!

Belle had her procedure yesterday and it went fine, they kept her in overnight for observation and they're now home. She's got 5 days worth of drugs, and swabs were taken from her ears and nose and sent off to a lab. Belle is happy to be home and is in her litter tray munching away, Ben is not happy and is sulking in his castle lol

Great she's home and OK. And ben should get over himself!

Getting the loxicom and emiprid in Belle isn't a bother as she happily takes it mixed with crumble pellets, same with the bisolvon.

She still has to be nebulised twice a day which she's decided she hates again, she also has to get 1ml of stuff in *each* ear once a day which she HATES and she fights like a bear, today it took my holding her tightly in my arms and my OH trying to get the stuff in and we really struggled. I might try a burrito tomorrow but I've never had much success with those in the past.

Can sympathise with ear meds. I scream if I get water in my R. ear, it hurts like hell. Poor wee luv, twice a day in each ear, she must think you're torturing her. How long does that go on?
I never had any luck with burritos either. My buns always wriggled too much to get it wrapped round properly.
Hope all continues to go well...

Just once a day in each ear fortunately, they discharge note says 5 days but the bottle of ear stuff they've given is is really big and definitely looks like more than 5 days worth :/

Belle is really snotty today, I can hear her breathing because its so rattley at times. Its not any worse than it was before but I was expecting after a bit of a sinus flush her breathing would be clear. The D1ck vet is now emergencies only until the 5th, not sure when my own vet own opens but will give them a call when they open and ask if this is normal :/

Guessing you have central heating? (I don't) Do you use a humidifier? With sinus issues it might help to have one running all the time.

I do have gas central heating, I asked the vet at the D!ck vet about a humidifier but he didn't think it would be of benefit while she's being nebulised.

He also said her still being snotty after the ear flush is expected, I thought they were doing a bit of a sinus flush as well but maybe not. The results of the swab came back and she's now now on baytril once a day.

Apparently we've just to keep going with the ear flushes, the bottle isn't even half done!
I've been burrito'ing her but not very successfully, she struggles constantly so I can't get her wrapped very well although it does restrict her a bit. She's just getting the baytril at the same time as doing her ears, get all the stress out the way in one go!

Poor little girl. Ear probs are awful. And those meds when she's not feeling her best must be the pits. Hope she's soon better.

Poor Belle isn’t having the best of times is she? How has her week been?
I used to laugh when people on fb used to say “just put them in a bunny burrito” whenever I was struggling to handle molly and junior. Good one, you come try ’

I actually managed a good burrito 2 days in a row, and I was so impressed with myself but I think it was just luck as I've not managed again since and last night she nearly completely freed herself!

She's happy enough within herself, no improvement on the snottiness tho we are only day 10 of 28 for the antibiotics so hopefully she'll start to improve soon.

Just when you think you’ve nailed it Blimmin wabbits!

Glad to hear she’s happy enough.

Takes a while for ab's to show an improvement. I just hope hers don't give her an horrid taste in her mouth like the one I'm on at the moment. Keep pluggin' in Belle!

Oh no poor belle
Hope she has a speedy recovery.

How's she doing? I remember trying to get Henry into a burrito... never knew rabbits could ooze until then! He just went limp and lid out the end. Reboot was similar only he went stiff and sort of catapulted through. Never tried putting Lil Loll into a burrito, I was too aware of what his vet said... "TBB!"

Today is her last day of antibiotics, unfortunately she hasn't improved much if at all. She's sneezing less but she's still very snotty/rattley sounding. I spoke with my vet a few days ago and they're waiting to hear back from the D!ck vet about what we do next. Fortunately, she's otherwise fine within herself.

Sorry I missed this.... been having ear probs and they don't help when online.
How is she now?

Oh no, I hope your ears are feeling better.

She's ok, antibiotics are finished and the snottiness hasn't improved at all. She's got a check up appointment at the D!ck vet on 9th March at which point they'll decide if surgery is necessary. We've to keep nebulising mean time. We're away for a week from 12th march and couldn't get boarding for them so we have a pet sitter coming out so it would be better if she could live without nebulising that week as the pet sitter has medicated our buns in the past but they've all been pretty well behaved whereas Belle is not at all and she won't go in the box without a fight. I'm not sure how well the pet sitter will be able to handle chasing a rabbit round that does not want to be caught to be put in a box she doesn't want to go in.

Oh dear. You never know... she might behave for the pet sitter, like they behave for vets/nurses better than for us.
The chasing so reminds me of Reboot and the furniture barricades that never worked.