Should I quit giving her Orbax?

[RattusNorvegicus]

To make a long story short, Emily has been on antibiotics since December for an inner ear infection. She firstly went to a vet I no longer go to, so I took her to another vet which wants her on Orbax for the rest of her life since the infection could be deeper than she can see. Emily has not adjusted to her head tilt very well, and sometimes possibly seems worse. I'm not very good with judgment though, so I may be wrong. Orbax is expensive, and I always wonder if the infection is gone and I am treating nothing. What would you recommend?

 

[mamarat]

I don't know what Orbax is but for an ear infection my vet gives me Baytril and sometimes Pred but after a couple months of treatment if the rat seems healthy otherwise we will stop treatment but sometimes the rat has a permanent head tilt but copes well.

 

[jorats]

Orbax is a newer drug, similar to Baytril. But for an inner ear infection, I usually do a couple of weeks of Baytril and that's it. If you feel Orbax didn't help, it might be wise to ask for another drug like Clavamox. Do a couple of weeks of Clavamox and that should be it.
Rats usually adjust quite well with head tilts. The infection may be gone but the tilt may always remain.

 

[RattusNorvegicus]

I do understand her tilt is permanent, but some days she seems more clumsy. To begin with she was on Baytril except the vet I took her to first had her on such a low dose that after she finished the course she got worse. I then got more Baytril and got a proper dose from lilspaz. She was on Baytril from the beginning of December to *I think* the ending of January.

I ran out of my fourth refill of Baytril and gave up. This vet knew nothing; He tried to make me believe rats menstruate. I took Emily to the vet I go to now, and she looked in her ears (which the other vet did not do with an Otoscope) and said they looked clear but since she still rolls when I hold her, the infection could still be there but deeper something about in the bone? Anyway, so she wants her on Orbax forever. Is it normal for rats with a tilt to still roll with the infection gone?

And mamarat as jorats said it's like Baytril: http://ratguide.com/meds/antimicrobial_ ... oxacin.php
My vet prefers it over Baytril.

 

[jorats]

Yes she could still roll, the head tilt is usually due to her feeling off balance. Not knowing the ceiling from the floor. Giving her narrow boxes like cereal boxes will help her feel more secure because she can feel the "ceiling" over top. How long have you been doing the Orbax now? It is possible that it's very deep. Did the vet see anything when she looked in the ear? You could do the Orbax for a couple of months.

 

[RattusNorvegicus]

Let me find her invoice to figure out the exact amount of time she has been on Orbax..

Okay, since February 10th. So from December 7th? she was on Baytril until Feb 9th. Then Feb 10th to today she has been on Orbax.

My vet said her ears looked clear.

 

[jorats]

Oh boy. That's a long time. I'd probably stop it. If she gets worse, start her back up.

 

[RattusNorvegicus]

Okay. So taking her off, and if she gets worse, putting her back on will not cause resistance?

 

[jorats]

Okay. So taking her off, and if she gets worse, putting her back on will not cause resistance?

I don't think it would cause a resistance but it could cause a set back. But honestly, if the ear was clear, I'm betting the infection is done and her tilt has remained.

 

[lilspaz68]

Severe head tilt will often remain, after the infection is gone. Is she bright, alert, active and capable? The rolling is only when she's stressed right? When you hold her? She feels even more unbalanced being picked up, so if you aren't already you will need to modify how to pick up your tilty girl. The best way I have found was grasp rat quickly with 2 hands and pull her into your chest with her tucked under your chin (there's her "roof") and if she rolls let her, restraining her will make her worse. Shade still rolls sometimes, but once you keep doing this, they learn slowly to trust you and will relax and the rolling will be less...always make sure ALL feet are supported when picking up or handling them.

I would stop as well. If the infection is in the bone, its progressive and if all the antibiotics haven't knocked it out over the past 4-5 months then keeping her on abs for life probably won't either.

 

[RattusNorvegicus]

I would stop as well. If the infection is in the bone, its progressive and if all the antibiotics haven't knocked it out over the past 4-5 months then keeping her on abs for life probably won't either.

That is a very good point but I think my vet wanted to keep her on it not to see if the infection would clear up, but to prevent it from getting worse. I stopped the Orbax, and now a few days later, she seems like she is getting worse. She has been very moody as if she is hurting and more clumsy. Just now she was having a hard time climbing to the next level. I think I will give her a dose of Metacam and start the Orbax again tomorrow. *Sigh.

 

[mamarat]

Have you tried Pred or Dex for her along with Orbax? Poor baby.

 

[RattusNorvegicus]

I have not tried those, no.

I still have not started the Orbax again, because I am not sure if she is worse. She has been sneezing a lot now that she isn't on it though. She has been very active lately as well.

 

[jorats]

It's a hard call if and when to start up again. How is she now? Maybe time to switch meds.

 

[RattusNorvegicus]

She is still the same. Currently on no meds. I haven't noticed her tilt and balance worse.

 

[EDK]

I'm no expert on these things, but I do know when i used Orbax to try and save one of my boys from phemonia, it did absolutely nothing. I've been using baytril for my boys ever since, any sneeze ups or injuries my vet has recommend baytril and it really does work from what i've seen. But i hope she recovers without meds, if not I'd still recommend baytril, just a opinion

 

[RattusNorvegicus]

EDK thank you for the suggestion. Emily was on Baytril before the Orbax. The vet she went to first had her on it, but that vet really was not a good vet, so I took her to the vet I go to now and she says she's noticed more improvement with Orbax.

 

[RattusNorvegicus]

I decided to start the Orbax again. I emailed my vet asking about pulse dosing, and she said this:

"Pulse dosing is generally fine for chronic soft-tissue infections (one of my cats has kidney stones and I am pulse-dosing her), but is pretty risky when there is bone involvement, which is always the case with middle/inner ear infections. Infections in bone are so deep-seated that continuous antibiotic therapy is generally recommended. I think I'd prefer an every other day dosing if that keeps clinical signs in check over a true pulse dosing regimen."

Would every other day be okay? I am just confused about resistance.

 

[RattusNorvegicus]

???

 

[mamarat]

My vet doesn't like the pulse treatment, she says there's no benefit in it.