Hi 🐰 I have a question about a patient I saw today. 4yr old, intact male hermel

admin

Hi I have a question about a patient I saw today. 4yr old, intact male hermelin rabbit. Since this sunner he has had a mild eye infection that comes and goes, no other symptoms. Seems normal in every other way. In the last few days it has gotten worse.
Eye is normal on examination, no cornea wound but when i palpate in front of the medial canthus of the eye, pus comes from both nostril and eye. I suspect this is from the nasolacrimal duct. Possibly dental issues. I have tried to refer it to a more experienced exotics vet but the owner isnt motivated to spend too much money.
What is the most likely diagnosis and how could i best diagnose and treat it?
Advice is appreciated

admin

All of the above, but without owner compliance or economic ability, this rabbit might not do well. Snuffles is often multi factorial, chronic, often progresses relentlessly if the primary cause is not addressed early. Since pasteurella, staphylococcus and other commensals invade the inflamed tissue, it is impossible if not futile to treat with antibiotics, even after culture (if you get any growth, pasteurella must be put in blood agar without conservatives immediately to get any growth, so internal lab…)because these are part of the bunny’s flora.
The gold standard for dx is CT, because radiography will not tell you anything about the sinus and turbinates, tumors/polyps or foreign bodies…you should talk to the owners about this, because they might have unrealistic expectations of simple quick fixes…rabbits might initially respond to tear duct flushes, anti inflammatory meds, mucolytics and nebulization therapy (F10, saline, bromhexine). Environmental changes must be considered, since this is often a disease caused by stress, pollutants and other environmental factors.
Keep us posted!