Please help with any info on middle/inner ear infection treatment and care

[Anka]

Hi everyone.
I am a first time poster. My 2-year old male guinea pig Kevin has succumed to what I am 85% sure is a middle/inner ear infection. He developed a head tilt on a Friday the 8th of May, started severely wobbling and falling down, and his weight went down from 1100 to 1030. I rushed him for an emergency vet appointment where he was given a shot of antibiotics and pain killers. This perked him up a little bit. Then I took him to a regular vet appointment the next morning on Saturday where he was prescribed oral antibiotics and some kind of digestion medication, plus something to treat a possible e. cuniculi infection. We were also given critical care and I was feeding this to him round the clock, probably getting 60 ml into him a day. Another vet visit on Monday showed that he was progressing well. By Thursday mornind when he took the last dose of antibiotics he was much better, running around, eating a bit by himself, but still had a noticeable head tilt. From this point onward, however, he started losing weight - about 10 grams a day. So I took him back to the vet the following Monday where he was prescribed more antibiotics. I also keep giving him critical care. He is also eating by himself, but not as much as he normally would. His weight stabilised for a couple of days, but now he is losing it again and was at 980 grams this morning. I also started giving him probiotics. What else can I do?

Could anyone share any stories of deep ear infection treatment/recovery? I am really worried about my poor Kevin. Thank you!

 

[Wiebke]

Hi and welcome

Firstly, do you have rabbits as well?

 

[Anka]

Hi and welcome

Firstly, do you have rabbits as well?

No, no rabbits. Kevin has a mate (another male guinea pig). They are in their cage together now as I could really not keep Kevin in a separate box for over a week. However, the other guinea pig is competely fine. He is also not a bully, so does not bother Kevin at all. They get on well and don't fight.

 

[Ramia]

My boy had one and relapsed so he took doxycycline and baytril for two and a half months and it was cleared.

An X-ray also showed he had CBS

 

[Anka]

My boy had one and relapsed so he took doxycycline and baytril for two and a half months and it was cleared.

An X-ray also showed he had CBS

Gosh, that is a long course of antibiotics! I am glad the infection has cleared. How did the process affect his weight and eating?

 

[Ramia]

Gosh, that is a long course of antibiotics! I am glad the infection has cleared. How did the process affect his weight and eating?

He had soft stools for quite a while until I gave poo soup.

I offered critical care when he was paralyzed (he was temporarily paralyzed with his ear infection) until he was eating again.

After I saw him eating I offered critical care in a little dish which he ate all by himself. I probably did it for too long.

It took five months to put back on the weight.

 

[Wiebke]

No, no rabbits. Kevin has a mate (another male guinea pig). They are in their cage together now as I could really not keep Kevin in a separate box for over a week. However, the other guinea pig is competely fine. He is also not a bully, so does not bother Kevin at all. They get on well and don't fight.

HUGS

OK, so you can exclude e.cuniculi, which would have required different medication. It can be overlooked as a potential cause. Transmission can happen indirectly via soiled rabbit dishes coming into contact with clean guinea pig ones.
Rabbits and guinea pigs in the same household are much more common than in America, so with a UK based member, e.cuniculi needs to be ruled out first.

If you are dealing with a walled-in middle ear infection (otitis media), then treatment can be difficult.

If the middle ear capsule is calcifying at a younger age (it is a fairly normal gradual ageing process so many piggies over 4 years will show up), accompanied by other progressing symptoms, only then you can look at CBS syndrome, which is very rare in the UK but more wide-spread in the USA and Canada due to untreated respiratory pet shop infections and the continued sale of diseased stock with lower trading barriers. Unfortunately, a calcified bulla/middle ear capsule is not curable.

Please also keep an open mind that the cause could be something entirely different.

Here is more information:
Neurological Issues (Seizures, Strokes, E.cuniculi etc.) - Symptoms and Care
CBS Syndrome (Calcified Bulla Syndrome/Walled-in Otitis Media - Symptoms and Care

 

[Anka]

He had soft stools for quite a while until I gave poo soup.

I offered critical care when he was paralyzed (he was temporarily paralyzed with his ear infection) until he was eating again.

After I saw him eating I offered critical care in a little dish which he ate all by himself. I probably did it for too long.

It took five months to put back on the weight.

Thank you so much for your story. It gives me hope that my piggie will recover too despite all the difficulties. I do keep wondering if I am giving him critical care unnecessarily as he is eating a bit by himself, but he seems to have dropped particularly a lot of weight when I had to go to work for a day and was not there to feed him. Thank you!

 

[Anka]

HUGS

OK, so you can exclude e.cuniculi, which would have required different medication. It can be overlooked as a potential cause. Transmission can happen indirectly via soiled rabbit dishes coming into contact with clean guinea pig ones.
Rabbits and guinea pigs in the same household are much more common than in America, so with a UK based member, e.cuniculi needs to be ruled out first.

If you are dealing with a walled-in middle ear infection (otitis media), then treatment can be difficult.

If the middle ear capsule is calcifying at a younger age (it is a fairly normal gradual ageing process so many piggies over 4 years will show up), accompanied by other progressing symptoms, only then you can look at CBS syndrome, which is very rare in the UK but more wide-spread in the USA and Canada due to untreated respiratory pet shop infections and the continued sale of diseased stock with lower trading barriers. Unfortunately, a calcified bulla/middle ear capsule is not curable.

Please also keep an open mind that the cause could be something entirely different.

Here is more information:
Neurological Issues (Seizures, Strokes, E.cuniculi etc.) - Symptoms and Care
CBS Syndrome (Calcified Bulla Syndrome/Walled-in Otitis Media - Symptoms and Care

Thanks very much! Kevin is on a 28-day course of "just in case" e.cuniculi medication. The vet did not mention CBS at all. And Kevin is a rescue pig. He was rescued when he was quite young (maybe 2-3 month old). I got him when he ws 5 months old. But I have no idea what environment he comes from. And up until now he was very healthy.

 

[Wiebke]

Thanks very much! Kevin is on a 28-day course of "just in case" e.cuniculi medication. The vet did not mention CBS at all. And Kevin is a rescue pig. He was rescued when he was quite young (maybe 2-3 month old). I got him when he ws 5 months old. But I have no idea what environment he comes from. And up until now he was very healthy.

CBS is not an acknowledged condition by the veterinary profession; even more so over here in the UK. It is a recent phenomenon in North America resulting from a widespread infection of their commercially mass produced pet stock, which is not medically treated and which has been identified, described and named by Saskia from Los Angeles Guinea Pig Rescue in connection with her vet. This is a feat in itself in order to draw medical attention to a widespread US problem which is manifesting in a wide range of seemingly disparate symptoms.

An un- or undertreated low level respiratory infection can occasional spread into the middle ear capsule and can cause the symptoms that you are describing but we are seeing perhaps one case a year in the UK on here compared to the hundreds or even thousands in the USA where a considerable percentage of all sold piggies is infected and where this issue has become endemic? I mainly affects guinea pigs around 1-2 years old. 3 years seems to be the upper age.
This is the reason why I would not speak of CBS syndrome in Europe but of a walled-in otitis media. They are two very different kettles of fish.

Bacterial URI was ripe in the UK in pets @ home piggies in the UK around the time I joined the forum but some years later the chain obviously started all over with fresh breeding stock because we didn't get much of that problem with newly bought UK piggies. Most of it boiled down to a sensitivity to industrially produced dust extracted hay which seems to have been mostly sorted as well. However, this was obviously a different strain of bacteria which didn't so much impact the middle ear. Most head tilts were simple straight forward ear infections, or if they were going into the head, turned out to be e.cuniculi and not bacterial URI.

The same goes for a calcified bulla. It can be a medical clincher for piggies who present with at least 3 symptoms and are younger than 4 years old but in itself it doesn't constitute a middle ear infection, especially not in piggies over 4 years old.

I hope that this helps to clarify some issues and misconceptions around CBS syndrome?

Anyway, I sincerely hope that you can get to the bottom of what is the problem with your Kevin, though.

 

[Anka]

CBS is not an acknowledged condition by the veterinary profession; even more so over here in the UK. It is a recent phenomenon in North America resulting from a widespread infection of their commercially mass produced pet stock, which is not medically treated and which has been identified, described and named by Saskia from Los Angeles Guinea Pig Rescue in connection with her vet. This is a feat in itself in order to draw medical attention to a widespread US problem which is manifesting in a wide range of seemingly disparate symptoms.

An un- or undertreated low level respiratory infection can occasional spread into the middle ear capsule and can cause the symptoms that you are describing but we are seeing perhaps one case a year in the UK on here compared to the hundreds or even thousands in the USA where a considerable percentage of all sold piggies is infected and where this issue has become endemic? I mainly affects guinea pigs around 1-2 years old. 3 years seems to be the upper age.
This is the reason why I would not speak of CBS syndrome in Europe but of a walled-in otitis media. They are two very different kettles of fish.

Bacterial URI was ripe in the UK in pets @ home piggies in the UK around the time I joined the forum but some years later the chain obviously started all over with fresh breeding stock because we didn't get much of that problem with newly bought UK piggies. Most of it boiled down to a sensitivity to industrially produced dust extracted hay which seems to have been mostly sorted as well. However, this was obviously a different strain of bacteria which didn't so much impact the middle ear. Most head tilts were simple straight forward ear infections, or if they were going into the head, turned out to be e.cuniculi and not bacterial URI.

The same goes for a calcified bulla. It can be a medical clincher for piggies who present with at least 3 symptoms and are younger than 4 years old but in itself it doesn't constitute a middle ear infection, especially not in piggies over 4 years old.

I hope that this helps to clarify some issues and misconceptions around CBS syndrome?

Anyway, I sincerely hope that you can get to the bottom of what is the problem with your Kevin, though.

Thank you very much for this very detailed explanation! I had no idea such complexities existed.

 

[Wiebke]

Thank you very much for this very detailed explanation! I had no idea such complexities existed.

Why should you? I just would like to spare you jumping to conclusions or putting misplaced expectations onto your vet. You may still deal with a walled-in middle ear infection but the ear capsule takes some time to calcify; it doesn't happen instantly.

We have seen the odd UK case that compares with CBS but these are rather random and isolated cases since UK piggies are not exposed widely to a respiratory bacteria that is obviously much more prone to tracking into the inner ear and setting up home there over time than other strains. They are also not sold un- or undertreated to customers in large numbers over a long time. Trading standards are higher here in the UK.

You may also find this guide here helpful, which deals with looking after piggies with mobility issues, which can include balance problems and increased lying in the same spot.
Looking After Guinea Pigs With Limited or No Mobility

Please keep your boy comfy and as cool as possible in the coming heatwave: Hot Weather Management, Heat Strokes and Fly Strike

We continue to be here for you for any questions, practical care tips and for moral support. What we legally cannot do is diagnose without access (nor do we have the training).