Stubborn earn infection?

[Lise Patterson]

My senior boy Ollie (2 years, 2 1/2 months) was diagnosed with an ear infection about two weeks back. I took him to the vet due to his frequent head shaking and balance problems, and the vet found he had pus in both ears. He was prescribed a baytil/doxy combo for two weeks, and this treatment seemed to resolve all symptoms... initially. But after 12 days of meds the head shaking is back.
I've read that ear infections can be quite stubborn in rats. Has anyone had experience using alternative meds for this problem?
The vet & I are also a bit worried that an internal blockage might be causing the infection, e.g. from a growth or cyst of some kind. In any event, I guess Ollie needs another trip to the vet.

 

[SQ]

I have had rats with inner ear infections that had to be treated for months ... and I always had to treat for 6 weeks.
I have also used other antibiotics for treating ear infections (baytril + zithro, clavamox, clorpalm)
Have you seen this information from the ratguide.com ?
http://ratguide.com/health/auricle_ear/otitis_media_otitis_interna_labyrinthitis.php

 

[Lise Patterson]

Thanks SQ - you've helped verify that this is indeed a stubborn condition. I love the rat guide but sometimes struggle with its many suggested options. I was thinking of asking the vet about using zithro; have you found the baytril/zithro combo especially effective? And have you had experience with topical meds for this condition?
I see the rat guide suggests possible addition of prednisolone....but I'm a bit leery of the immune-suppressing effects. I'll see what my vet thinks on this.

 

[Dena]

You should be able to use prednisone for a short time. I did 5 days on baby. Being the rat is already on a combo of meds, I wouldn't worry so much about the suppressed immune system. You just need swelling to go down, and give the antibiotics a better chance to do their job.

 

[lilspaz68]

I really find Baytril/Zithro is a good combo for inner ear infections that aren't really responding. I had culture and sensitivity tests done for a persistent ear infection and zithro was good for all the bacterias we found. It finally cleared up a long standing infection. Make sure your baytril is at 15 mg/kg BID and your zithro is 20 mg/kg once a day. If there's no tilt I wouldn't bother with steroids. Both ears having an infection IS odd though.

 

[SQ]

Thanks SQ - you've helped verify that this is indeed a stubborn condition. I love the rat guide but sometimes struggle with its many suggested options. I was thinking of asking the vet about using zithro; have you found the baytril/zithro combo especially effective? And have you had experience with topical meds for this condition?
I see the rat guide suggests possible addition of prednisolone....but I'm a bit leery of the immune-suppressing effects. I'll see what my vet thinks on this.

You are welcome Lise
I have never used zithro unless it was in combo with baytril as it is not very effective unless given with baytril (except for babies, it is effective with babies)
I have never used topical medication for inner ear infections.
If you are unsure you could see about having the infection tested to see what it is sensitive to.
Metacam is often used to try to prevent further damage but I have given pred short term as it is stronger - I have only used this when there was a head tilt as my rats have always had a head tilt
all the best

 

[Lise Patterson]

Thanks to all. I saw my vet today and she sent me home with zithro as well as prednisone, though she instructed that I wait at least three days before using the latter. Immune suppression is a concern with poor old Ollie so we'll first see what the revised antibiotic regime can deliver. As for dosages, the zithro dose is as recommended by lilspaz68; I've been using a lower dose of baytril than suggested though, and I recall that my vet was deliberate in setting a dose on the low side. She's an excellent vet and does all things for a reason...I'll try to confirm her thoughts on this.

 

[Lise Patterson]

Update - despite high-strength zithro/baytril and addition of prednisone (0.24 mls/day) Ollie's neurological symptoms are growing worse. Has anyone heard of simultaneous ear infections AND PTs in rats? Ollie has no head tilt, but he is dragging himself around in circles. His front and back feet are knuckling under, and he seems to have lost contol of his mouth - syringe feeding is necessary. Significantly, his front legs now seem a bit stiff. His upper respiratory symptoms have improved a bit but he now seems to be using more diaphragm effort to breathe...yet no audible signs of lower respiratory infection. The ear pus found earlier confirmed the presence of ear infection...but I'm beginning to wonder if something more is involved. I just started the steriods yesterday morning, so I'll continue with these + other meds and cross fingers. I've also been using steam therapy, as suggested by vet. He struggles to accept the current load of meds, so I dare not introduce bromocriptine or cabergoline right now.

 

[lilspaz68]

Rats can have multiple issues and its sooo difficult dealing with them. Maybe syringe feed him until the prednisone kicks in and helps reduce his symptoms?

 

[Lise Patterson]

Multiple issues indeed. Right now I'm most worried about the heaving in his chest. Might Ollie have contracted aspiration pneumonia, what with the syringe feeding and the neurological problems that seem to affect his mouth functions (perhaps swallowing too)? Or has the upper respiratory infection migrated to his lungs? Or has all this health stress taken a toll on his beautiful old heart? If his chest/diaphragm action gets much worse I'll take him to the nearest emergency hospital - don't know whether that would lead to better treatment, but at least he'd have access to oxygen. For now I don't want to move or stress him any more; I just hope he can rest and let the meds work.

 

[lilspaz68]

Just do your best. Poor lad, so many issues

 

[Lise Patterson]

Very grateful for your support.
In a few hours it will be time for Ollie's antibiotics, but I fear trying to force the meds down his gullet while his breathing is so laboured - it was tough even in calmer times. If I went to emergency I think they might adminster the bayril by injection. I know that there is an injectable form of zithro as well...do you know if it is used on rats?

 

[Lise Patterson]

One other thing...I noticed this under the "Considerations" section of the Rat Guide file on azithromycin: http://ratguide.com/meds/antimicrobial_agents/azithromycin.php
Note:some reports have indicated a limited response in older rats with more chronic or advanced problems. The drug is reported to be more effective when used in young rats.
I now wonder whether zithro is not the best antibiotic for Ollie at this point. Best alternatives?

 

[lilspaz68]

i have used zithro and baytril to beat pneumonia, its my big gun combo BUT if you cannot get anything in orally you may have to turn to nebulizing antibiotics/medications or sub-cutaneous injections. I have never heard of an injectable form of zithro used with rats.

 

[SQ]

I believe they are referring to using zithro by itself. I have found that using zitro 10mg/Ib in combo with baytril to be very effective for breathing issues with rats of all ages.
If you think he still has an ear infection clorpalm might be effective
I would be afraid of injecting baytril although but maybe it is ok if diluted enough - lilspaz68 would know

I am very sorry that Ollie having so many health issues
I hope the pred soon makes a difference with his breathing and with his pt