There are two options for rabbits with a deep inner ear (middle ear) infection (Otis media). One is surgical and one is medical management with minor surgery using just a local anaesthetic. Of the two major surgical options, one is more invasive and risky than the other.

Two surgical options for middle ear infection in rabbits:

Lower risk and less invasive = lateral ear canal resection

Higher risk and more invasive = total ear canal ablation and lateral bulla osteotomy

Dr JJ Racecourse Road Veterinary Hospital Ballina NSW

At The Rabbit Sanctuary we currently have two mini lop rabbits who have received veterinary treatment for this condition in the first few months of 2021. They are Chocolate Charlie and Snoopy. In September another of our rescue bunnies, Smokey presented with symptoms. This article discusses the three cases and their treatment.

Snoopy had a history of treatment for deep inner ear infection prior to being surrendered to The Rabbit Sanctuary.

His quality of life was poor and he suffered pain. In consultation with The Rabbit Sanctuary’s Dr Sam it was decided that Snoopy’s best hope was the more invasive surgical option of total ear canal ablation and lateral bulla osteotomy.

After surgery Snoopy stayed in hospital for a week. A drain was inserted to allow fluid to drain from the wound. The ear you see in the photo was sadly removed. As a complication of surgery the lower tip of the ear began to die.

You can see in the photo that Snoopy’s eye is quite small and appears squinted. This could be from nerve damage to this area from the deep inner ear infection. This was evident prior to surgery.

Medical management
Chocolate Charlie is having medical management. Every month or two he has a clean out of the pus in the upper area of his ear canal. That involves a local anaesthetic. The side of his head under the ear is cut and Dr Sam cleans out the pus and sews it up.

Penicillin of no use
Chocolate Charlie used to be on daily penicillin but we decided to stop. That made zero difference to either rabbit. The reason is the penicillin doesn’t get to the place it’s meant to due to the thick pus and the bloodstream can’t carry it to the spot it is needed in. So it is useless. It is for this reason that we chose surgical options for Snoopy and Smokey whose quality of life had deteriorated.

What is needed to cure the infection
Surgery is necessary – Total ear canal ablation and lateral bulla osteotomy is the ultimate cure.

This is an invasive surgery and super risky. The risk is mainly that the area has facial nerves and others that if damaged can cause paralysis of face or even unbearable head and neck paralysis which would look like a dreadful case of head tilt and would mean a sorrowful quality of life for the surviving rabbit. (Dr JJ Racecourse Road Veterinary Hospital Ballina)

For Snoopy a riskier surgical option was chosen…

Snoopy underwent surgery to totally remove all infection performed by The Rabbit Sanctuary vet Dr Sam. This was successful. No nerve damage was detected and Snoopy is now a well bunny. The reason that the surgical option was chosen for Snoopy was that his quality of life was poor.

There was however a down side. Over the next week or two of recovery Snoopy’s ear pinna began to ‘die’. This was caused either by the blood supply to the pinna being cut off due to the ear having lost it’s structure or it could have been nerve damage. Dr Sam sadly had to remove Snoopy’s ear. This is now healed and Snoopy is living a happy life at The Rabbit Sanctuary.

Surgery or medical management of deep inner ear infection in rabbits?

The bunny owner is faced with a difficult choice of treatments for their bunny suffering from deep inner ear infection.

Medical management with periodic minor surgery to remove pus combined with antibiotics

Lateral ear canal resection:

Total ear canal ablation and lateral bulla osteotomy:
involves complete removal of the infection from deep within the ear involving removal of the canal, ear drum and bulla but with a high risk of nerve damage.

Doing nothing or medical management:
Ultimately the disease is worse than the cure…

What needs to be known is that ultimately not performing infection removal surgery on the rabbit’s inner ear can also result in facial paralysis and other problems caused by the infection itself.

For more information contact The Rabbit Sanctuary or Dr Sam at Riverbank Animal Hospital on 02 6642 3083 and book a phone consult.

Click here to find a Rabbit Sanctuary vet in your area.

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