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SMALL MAMMALS/
EXOTICS
Treatment of Bacterial Infectious Diseases
in Pet Rabbits and Other Small Mammals
Thomas Göbel, Dr med vet
Klinik und Poliklinik für kleine Haustiere, Freie Universität Berlin, Berlin, Germany

Bacterial infections are a common
cause of illness in small mammals.
Antibiotic therapy is clearly essential to
successfully treat these animals. Effec-
tive treatment requires accurate diagno-
sis of infection, identification of any
underlying problem, and appropriate
antibiotic selection based on the anti-
biotic susceptibility of the organism and
the ability of the antibiotic to reach the
site of infection.
The use of antibiotics in small mam-
mals presumes specific knowledge of the
biology and physiology of the patient and
the pharmacology of the antibiotic. As a
group, small mammals include diverse
species that differ in body weights and
sizes, especially in the physiology of the
digestive tract. Diseases of these animals
are influenced by nutrition, housing, and
other specific needs, as well as a variety of
stress factors. It is therefore important to
become familiar with husbandry practices
and anatomic and physiologic differences
among these species (Figure 1, Table 1).
Small mammalian patients include
three groups of animals:
■ The domestic rabbit (Oryctolagus
cuniculus), which belongs to the
order Lagomorpha, with different
breeds distinguished by a variety of
sizes, shapes, and colors.
■ The rodents, a large group of mam-
mals with one pair of upper incisors.
There are the hystricomorph rodents,
such as the guinea pig (Cavia aperea
porcellus), the chinchilla (Chinchilla
lanigera), and the degu (Octodon
degus), and the commonly kept
small mammalian rodents like the
golden hamster (Mesocricetus aura-
tus), the rat (Rattus norwegicus), the
gerbil (Meriones unguiculatus), the
mouse (Mus musculus), and many
newly introduced exotic species.
■ The ferret (Mustela putorius furo),
the only carnivorous small mammal
patient.
Bacterial Diseases
in Small Mammals
For more detailed information about
the diseases discussed in the following
sections, the reader is referred to
Antimicrobial Therapy in Exotics, a sup-
plement to Compendium on Continu-
ing Education for the Practicing Veteri-
narian®, (21[3], 1999), the proceedings
of a symposium held at the 1999 North
American Veterinary Conference.
Rabbits and Rodents
Bacterial infections are very common
in rabbits and rodents. Most infections
in small mammals are due to aerobic
gram-negative and gram-positive bac-
teria. An examination of specific bacte-

TABLE 1
Life Span of Common
Small Mammalian Pets

Mean
Species Life Span
Ferret Mustela putorius furo 5–7 years
Rabbit Oryctolagus cuniculus 5–8 years
Guinea pig Cavia aperea porcellus 5 years
Chinchilla Chinchilla lanigera 5–8 years
Degu Octodon degus 3–4 years
Gerbil Meriones unguiculatus 3–4 years
Mouse Mus musculus 2–3 years
Rat Rattus norwegicus 2–3 years
Golden hamster Mesocricetus auratus 1.5–2 years

Figure 1—Severely diseased degu (Octodon degus).

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TABLE 2
Some Bacterial Diseases of Rabbits and Rodents and Recommended Therapy
Disease Etiology Therapy

Colibacillosis Escherichia coli Enrofloxacin

Trimethoprim-sulfamethoxazole
Tyzzer’s disease Clostridium piliforme Tetracyclines
Metronidazole
Wet tail Lawsonia intracellularis Enrofloxacin
Tetracyclines
Trimethoprim-sulfamethoxazole
Pasteurellosis Pasteurella multocida Enrofloxacin (extended time)
Bordetellosis Bordetella bronchiseptica Enrofloxacin
Streptococcus pneumonia Streptococcus pneumoniae Trimethoprim-sulfamethoxazole
Chloramphenicol
Tetracyclines
Murine mycoplasmosis Mycoplasma pulmonis Enrofloxacin
Trimethoprim-sulfamethoxazole
Cystitis and nephritis E. coli, Klebsiella spp., Pseudomonas spp. Enrofloxacin
Trimethoprim-sulfamethoxazole
Endometritis/pyometra P. multocida, Staphylococcus aureus, Trimethoprim-sulfamethoxazole
Klebsiella spp., Pseudomonas spp. Enrofloxacin
Tetracyclines
Chloramphenicol
Venereal spirochetosis Treponema paraluiscuniculi Penicillin
Tetracyclines
Chloramphenicol
Mastitis S. aureus, Streptococcus spp., Enrofloxacin
P. multocida, E. coli, Klebsiella spp. Trimethoprim-sulfamethoxazole
Chloramphenicol
Orchitis/epididymitis Proteus spp., E. coli, Staphylococcus spp. Enrofloxacin
Trimethoprim-sulfamethoxazole
Chloramphenicol
Abscesses S. aureus, Streptococcus spp., Enrofloxacin (extended therapy)
P. multocida, Enterobacteriaceae,
Pseudomonas aeruginosa, Streptococcus
equi subsp. zooepidemicus
Ulcerative pododermatitis S. aureus Trimethoprim-sulfamethoxazole
Enrofloxacin
Conjunctivitis/epiphora P. multocida Enrofloxacin
Pseudotuberculosis Yersinia pseudotuberculosis Therapy not recommended because of public health risk

rial samples is often a useful tool for
obtaining specific information about
the pathogen and its sensitivity to spe-
cific antibiotics (Table 2).
Gastrointestinal Tract
Enteritis is very common in rabbits
and rodents. Usually the disease is
caused by an overgrowth of the normal
bacterial flora of the gut by pathogen-
ic bacteria. Factors favoring the occur-
rence of disease are tooth problems
(Figure 2), dietary changes, stress,
antibiotic use, and environmental
changes.
Bacterial enteritis in rabbits and
rodents can be caused by different bac-
teria, such as Escherichia coli, Salmo-
nella spp., Clostridium perfringens, and
Pseudomonas aeruginosa. Young ani-
mals are especially susceptible to dis-
ease (Figure 3); animals newly bought
at a pet shop are a typical anamnesis.
Diagnosis is by bacterial culture of fecal
samples.
Respiratory Tract
Pasteurellosis. Pasteurella multoci-
da is the major cause of respiratory dis-
ease in rabbits1,2 but can also affect
rodents. Pet rabbits from pet stores or
private breeders frequently are infected
with P. multocida. Often they show no
clinical signs of disease until they are
exposed to stress. After changes in
nutrition, climate, or especially their
social life, clinical signs develop, typi-
cally rhinitis and sinusitis. The animals
show first a serous and then a purulent
whitish nasal discharge (Figure 4);
severely diseased animals often sneeze.
The lacrimal duct can have a secondary
infection. The result is tearing because
the lacrimal duct is occluded by exu-
date (Figure 5). Clinical diagnosis can
be confirmed by a skull radiograph
showing the increased opacity of the
bullae as a result of the exudate in the
middle ear (Figure 6).
Microbiological diagnosis is often
difficult; P. multocida strains require a
bacteriologic medium containing blood
for growth, and the swabs should be
cultured within a short time (Figure 7).2,3
Bordetella bronchiseptica. Bor-
detella bronchiseptica is frequently
found in the respiratory tract of rabbits
without causing disease.4 B. bron-
chiseptica in guinea pigs causes a puru-
lent bronchopneumonia with consoli-

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Figure 2—Abscessed tooth in a rabbit. Figure 3—Abdominal radiograph of a young rabbit with E. coli
enteritis. Massive pertubation of the whole intestine, containing
large amounts of gas.

Figure 4—Rabbit with severe nasal discharge because of pas- Figure 5—Rabbit with conjunctivitis because of an occluded
teurellosis. lacrimal duct.

Figure 6—Radiograph of the skull of a rabbit with an abscessed Figure 7—Nasal swab of a rabbit with pasteurellosis.
right bulla tympanica because of an infection with Pasteurella mul-
tocida.

dation of lung lobes. The organism is a
gram-negative rod spread by aerosol
and direct contact. Subclinical infec-
tions are common and stress increases
the susceptibility to disease.
Streptococcus pneumoniae.
Streptococcus pneumoniae causes
pleuritis and pericarditis in guinea
pigs.5 Transmission is by aerosol or
direct contact. Clinical disease is precip-
itated by stressors such as shipping,
social stress, and dental disease. Clini-
cal signs are anorexia, coughing, and
ocular and nasal discharge (Figure 8).
Murine Mycoplasmosis. Myco-

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Figure 8—Guinea pig with exudate at the forepaws because of
nasal discharge.
Figure 10—Rabbit with soiled perineum caused by bacterial cys-
titis.
plasma pulmonis infections in pet rats
are very common. The typical age for
first clinical signs is 14 to 18 months.
Infected animals show sniffling, rough
hair coat, and sneezing (Figure 9). The
clinical onset is progressive; after weeks
or months the animals are presented
with severe dyspnea caused by a puru-
lent inflammation of the respiratory
tract. Secondary bacterial infections
can complicate the disease.5
Other Bacteria. Other bacterial
agents such as Staphylococcus aureus,
P. aeruginosa, different Pasteurella
spp., Chlamydia, and Mycoplasma can
be associated with respiratory disease
in rabbits and rodents. Antibiotic thera-
py is recommended in severely diseased
animals.
Urogenital Tract
Bacterial Cystitis or Nephritis.
Bacterial infections of the urinary tract
are a common problem in rabbits and
rodents. Often the disease becomes
chronic, with animals displaying no or
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Figure 9—Rat with murine mycoplasmosis.
Figure 11—Vaginal discharge of a rabbit with pyometra.
minimal clinical signs of disease. Clinical
signs of bacterial cystitis are depression,
anorexia, weight loss, hematuria, stran-
guria, and especially a perineum soiled
with urine (Figure 10). Common bacter-
ial pathogens are E. coli, Klebsiella spp.,
and Pseudomonas spp. Diagnosis is con-
firmed using urinalysis by cystocentesis
or free catch. Proteinuria, hematuria,
and numerous calcium oxalate crystals
are common in animals with cystitis.
Red urine is a common cause for pre-
sentation of a rabbit at the clinic. Uri-
nalysis or a urine dipstick can deter-
mine whether hematuria or pigmented
urine is present. The pigmentation of
the urine is probably caused by plant
pigments.
Endometritis or Pyometra. Endo-
metritis or pyometra can occur in
breeding rabbits. Clinical signs are vagi-
nal discharge, anorexia, and lethargy
(Figure 11). In most cases these signs
are subtle. Common bacterial patho-
gens are P. multocida, S. aureus, Kleb-
siella spp., and Pseudomonas spp.
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Radiography, ultrasonography, and a
complete blood count (CBC) are useful
for clinical diagnosis. Treatment is ovar-
iohysterectomy (Figure 12) or, in mild
cases, an antibiotic regimen.
M. pulmonis in rats causes a genital
infection with metritis and pyometra.
In female hamsters, especially in older
animals, metritis characterized by
creamy vaginal discharge is frequently
seen. Prognosis is poor; antibiotic treat-
ment or ovariohysterectomy can be
attempted.
Venereal Spirochetosis. The
causative agent is Treponema paraluis-
cuniculi, a spirochete transmitted by
direct or venereal contact between rab-
bits. Infection is often subclinical or
asymptomatic in pet rabbits. Typically
associated with the disease are skin
lesions at the perineum and the face
around chin, lips, and nose (Figure 13).
Diagnosis is confirmed by typical
lesions or skin scrapes to identify the
causative bacteria in dark-field
microscopy.
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Figure 12—Ovariohysterectomy in a rabbit with endometritis.
Figure 14—Mastitis in a rabbit; abscessed mammary glands.
Mastitis. Mastitis in pet rabbits
occurs most often during pseudocyesis
but seldom during lactation. Causative
agents are S. aureus, Streptococcus
spp., and P. multocida. Clinical signs
are swollen and hot mammary glands,
depression, fever, anorexia, and gener-
al weakness (Figure 14).
Orchitis or Epididymitis. Orchitis or
epididymitis can be diagnosed in rabbit
bucks. One or both testicles are swollen
and hot and can exhibit abscesses (Fig-
ure 15). The bucks show fever, weight
loss, and depression. Treatment consists
of antibiotic therapy and/or castration.
Dermatologic Diseases
Abscesses. Abscesses are a com-
mon problem in rabbits and rodents.
Causative bacteria are S. aureus, Strep-
tococcus spp., P. multocida, Enterobacte-
riaceae, and sometimes P. aeruginosa.6
Common causes for abscesses are dental
disease, bite wounds, or bacteremia fol-
lowing bacterial infection (Figure 16). In
guinea pigs cervical lymphadenitis with
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Figure 13—Skin lesions in a rabbit caused by Treponema par-
aluiscuniculi.
Figure 15—Abscessed testicle of a rabbit buck.
abscessation of the cervical lymph nodes
is seen with infections by Streptococcus
equi subsp. zooepidemicus.7
Ulcerative Pododermatitis. In pet
rabbits and rats, ulcerative pododer-
matitis is primarily seen in heavier ani-
mals often living in poor hygienic con-
ditions, for example, wet litter and
soiled bedding. The animals have very
small lesions that become secondarily
infected with S. aureus. Ulcers appear
at the footpad, and the lesion becomes
abscessed (Figure 17). The staphylococ-
ci disseminate to the bone and other
organs.
Neurologic Diseases
and Diseases of the
Ears and Eyes
Torticollis. Infections of the middle
ear cause torticollis and rolling move-
ments (Figure 18). Otitis media and oti-
tis interna are associated with respirato-
ry disease, including infections with P.
multocida. A radiograph of the skull is
used for diagnosis. In rabbits the same
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signs but no increase in opacity of the
bullae indicate infection by the parasite
Encephalitozoon cuniculi. Diagnosis is
possible using serology.8
Conjunctivitis and Epiphora.
Chronic conjunctivitis and epiphora can
be caused by P. multocida infections or
infections with other bacteria of the eye
and the lacrimal duct. The lacrimal duct is
clogged with exudate; the eyelids can
become swollen and red. Therapy
involves flushing of the lacrimal duct (Fig-
ure 19), antibiotic eye drops, and, in
severe cases, systemic antibiotic therapy.
Severe conjunctivitis with purulent
discharge is a common disease in geri-
atric hamsters.
Encephalitis. Encephalitis can
result from bacterial septicemia. Neuro-
logic signs are convulsions. Encephalitis
caused by Listeria monocytogenes has
been reported in chinchillas.9
Systemic Bacterial Diseases
Pseudotuberculosis. Infections
caused by the bacterium Yersinia
99
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Figure 16—Abscess in a guinea pig caused by a bite wound.
Figure 18—Rat showing torticollis caused by otitis media and oti-
tis interna.
pseudotuberculosis are reported in
many rodents.5 The signs are nonspe-
cific, such as weight loss and cachexia.
Because of the possible risk of trans-
mission to humans, therapy should not
be attempted.1 In pet animals such
infections are rare but should be con-
sidered in the diagnostic workup.
Listeriosis. L. monocytogenes can
cause a disease with nonspecific signs
in rabbits. The animals show depres-
sion, anorexia, and nervous disorders. It
is a disease of small rabbit colonies and
is not a problem in pet rabbits.
Ferrets
Domestic ferrets (M. putorius furo) are
the only carnivorous small mammalian
patients. Ferrets have the typical carnivo-
rous intestinal tract with a simple gut flora.
As with rabbits and rodents, an exami-
nation of specific bacterial samples is
often a useful tool for obtaining specif-
ic information about the pathogen and
its sensitivity to specific antibiotics
(Table 3).
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Figure 17—Abscessed footpad in a male rat.
Figure 19—Flushing of the lacrimal duct in a chinchilla.
Gastrointestinal Tract
Bacterial infections of the gastro-
intestinal tract of ferrets are caused by
different bacteria than those infecting
domestic rabbits and rodents. Infec-
tious causes of diarrhea include infec-
tions with Salmonella spp., Campylo-
bacter jejuni, and Mycobacterium spp.
As in humans, Helicobacter infection
seems to be a common cause of gas-
trointestinal problems.10,11
Proliferative Bowel Disease. In
younger ferrets proliferative bowel disease
(PBD) is seen, characterized by chronic
diarrhea with feces varying from dark liq-
uid to mucoid with bright red blood.12 The
causative agent is suspected to be Lawso-
nia intracellularis, an intracellular organ-
ism.13 The bowel of affected ferrets is
thickened, and the colon and ileum can be
affected. A prolapsed rectum and tenes-
mus are also typical (Figure 20).
Respiratory Tract
Bacterial infections of the respiratory
tract can be primary (caused by bacteria),
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secondary (following a canine distemper
virus infection or an influenza virus infec-
tion [Figure 21]), or a sequela of megae-
sophagus. Bacterial pathogens causing
pneumonia are S. pneumoniae and S. equi
subsp. zooepidemicus, Klebsiella pneumo-
niae, E. coli, B. bronchiseptica, and P.
aeruginosa. Signs of bacterial infection of
the respiratory tract are dyspnea, nasal dis-
charge, apathy, fever, increased lung
sounds, and cyanosis. The CBC reveals
leukocytosis, with pathologic changes of
the lung tissue visible on radiographs.
Urogenital Tract
Bacterial Cystitis and Nephritis.
Ferrets, like dogs and cats, can develop
urinary tract infection. Clinical signs of
lower urinary tract disease are dysuria,
pollakiuria, stranguria, hematuria,
cloudy urine, and foul-smelling urine;
signs of systemic illness are often pre-
sent as well. The cause of disease can
be a bacterial infection (e.g., Proteus
spp., E. coli, Staphylococcus spp., and
others) and/or urolithiasis. Diagnosis is
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TABLE 3
Some Bacterial Diseases of Ferrets and Recommended Therapy
Disease Etiology Therapy

Helicobacter infections Helicobacter mustelae Amoxicillin-metronidazole

Proliferative bowel disease Lawsonia intracellularis Ampicillin
Amoxicillin
Trimethoprim-sulfamethoxazole
Chloramphenicol
Cephalexin
Enrofloxacin
Respiratory infections Streptococcus pneumoniae, Streptococcus equi subsp. Enrofloxacin
zooepidemicus, Klebsiella pneumoniae, Escherichia coli, Trimethoprim-sulfamethoxazole
Bordetella bronchiseptica, Pseudomonas aeruginosa
Bacterial cystitis/nephritis Proteus spp., E. coli, Staphylococcus spp. Enrofloxacin
Trimethoprim-sulfamethoxazole
Prostatitis Proteus spp., E. coli, Staphylococcus spp. Enrofloxacin
Trimethoprim
Clindamycin
Mastitis Staphylococcus aureus, E. coli, Proteus spp. Enrofloxacin
Chloramphenicol
Dermatitis/abscesses S. aureus, Pasteurella spp., E. coli Amoxicillin-clavulanate
Enrofloxacin
Cephalosporins

Figure 20—Soiled hindlegs in a female ferret with proliferative Figure 21—Purulent conjunctivitis in a ferret with secondary bac-
bowel disease (PBD) and hyperestrogenismus. terial pneumonia following a canine distemper infection.

achieved through urinalysis, including a
urine culture, after a complete physical
examination.
Prostatitis. Bacterial prostatitis is
relatively uncommon in ferrets because
most male ferrets are neutered. Bacter-
ial prostatitis is caused by the same
bacteria that cause urinary tract infec-
tions. Clinical signs include fever,
anorexia, urethral discharge, and
dysuria (Figure 22). Diagnosis is
obtained using urinalysis, radiography,
and ultrasonography.
Endometritis and Pyometra. Endo-
metritis and pyometra can occur in intact
females. Affected ferrets show vaginal
discharge and signs of systemic disease,
such as anorexia and lethargy. Ovario-
hysterectomy is the therapy of choice.
Mastitis. Mastitis can be acute or
chronic. Acute mastitis can be dramat-
ic, with the ferret becoming gravely ill.
The glands are swollen and red; they
often become gangrenous. The disease
is very painful for the jill and immediate
therapy is necessary.
Dermatologic Diseases
Bacterial dermatitis and abscesses
are normally the result of trauma. Male
ferrets bite the females during mating
and the wounds can become infected.
The animals develop deep pyoderma or
abscesses. Bacteria involved in skin dis-
eases include S. aureus, Pasteurella
spp., and E. coli. Abscesses are
removed surgically; for therapy of deep
pyoderma, local and systemic anti-
biotics is recommended.
Antibacterial Treatment
in Small Mammals
Rabbits and rodents are herbivorous
animals. Their intestinal microflora con-
sists mainly of gram-positive and
anaerobic bacteria1,14,15 and remains
constant only if feeding and keeping

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TABLE 4
Factors to Consider in Selecting
an Antimicrobial Agent for
Use in Small Mammals
■ The species of animal affected and its physiologic
intestinal flora
■ The pathogens that usually cause disease in the
species
■ The organ system involved
■ The antimicrobial most likely to be effective against
the suspected pathogen
■ The dose and route of administration of the
Figure 22—Urethral discharge in a ferret with bacterial prostati- antimicrobial
■ The possible side effects or toxicity of the drug
tis.

are unchanged. The diversity of body
weights, sizes, and metabolic rates
results in differences in drug distribu-
tion and metabolic elimination.
Information regarding the use of
antibiotics in small mammals is lacking.
Very few antibiotics are evaluated for
their therapeutic effectiveness in small
mammals, and only very few drug
dosages are approved through stan-
dard drug trials.16
Because of this lack of research, the
use of antibiotics in small mammals is
largely dependent on empiric data;
there is no definitive information about
dosage or frequency and length of
administration. Clinical use of certain
antibiotics in small mammals can be
dangerous in some species or thera-
peutically ineffective in others.
Selection of an
Antibiotic for Use in
Small Mammals
When selecting an antimicrobial
agent for use in small mammals, the
veterinarian should consider the fol-
lowing factors (Table 4):
■ The species of animal affected and its
physiologic intestinal flora. It is impor-
tant to distinguish among ferrets, rab-
bits, and different species of rodents.
Ferrets can be treated much the same
as dogs and cats and they are not sen-
sitive to gastrointestinal disorders
resulting from antimicrobial use. Rab-
bits may develop mild gastrointestinal
disturbances through parenteral use of
amoxicillin, while rodents may develop
a fatal enterotoxemia with enteritis,
cecitis, and often death within 3 to 6
days following treatment.16
■ The pathogens that usually cause
disease in the species. Major bacte-
rial pathogens in rodents are Borde-
tella, Klebsiella, Streptococcus,
Staphylococcus, and different Enter-
obacteriaceae. In rabbits many dis-
eases are caused by P. multocida.
■ The organ system involved. It is
important to identify the organ sys-
tem affected by the infection. This
will aid in antibiotic selection. An
infection of the central nervous sys-
tem is best treated with an antiin-
fective that penetrates the cere-
brospinal fluid well, such as
chloramphenicol or enrofloxacin.
The concentration of antibiotic
needed at the infection site is diffi-
cult to determine. The serum con-
centrations of a certain antibiotic in
small mammals are unknown
because of the lack of pharmaco-
kinetic studies in most of these ani-
mals. Bacterial infections in rabbits
and rodents typically cause walled-
off abscesses with caseous pus,
which most antibiotics cannot pen-
etrate.
Very few
antibiotics are
evaluated
for their
therapeutic
effectiveness in
small mammals.
■ The antimicrobial most likely to be
effective against the suspected
pathogen. It is important to select
the best antibiotic for the pathogen.
Various factors must be considered.
The best method is to use sensitivity
information from a culture of the
site of infection. However, often a
culture cannot be obtained or
antibiotic treatment must be initiat-
ed without culture results. Empiric
antibiotic treatment in small mam-
mals is complicated by the lack of
information about the sensitivity of
bacterial pathogens from small
mammals and the few or nearly
nonexistent pharmacokinetic stud-
ies performed on the selected
species of small mammal.
■ The dose and route of administra-
tion of the antimicrobial (Table 5).
There have been almost no pharma-
cokinetic studies regarding anti-
biotics in small mammals. Very few
antibiotics are evaluated for their
therapeutic effectiveness in small
mammals, and only very few drug
dosages are approved by standard
drug trials, as with intravenous and
intramuscular administration of
enrofloxacin in rabbits.17 The dose
for most antibiotics in small mam-
mals is based on clinical experience.
The administration of an anti-
microbial agent depends on the
species and age of the animal affect-
ed, the site of infection, the severity
of disease, and the choice of drug.18
For commercially kept large popula-
tions of small mammals, prepared
foods or additives to the drinking
water are a common route of drug
administration. This method, howev-

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TABLE 5
Recommended Dosages of Antimicrobial Drugs for Small Mammalsa

Drug Route of Dose Interval Comments

Administration (mg/kg) (hours)

Rabbits
Amikacin IM, IV 8–16 24 Nephrotoxic; administer fluids
Amoxicillin SC 15 24 Induces dysbiosis; only Treponema infection
Chloramphenicol SC, PO 20–40 12 Potential human toxicity
Clindamycin SC 7.5 12 Osteomyelitis under strict monitoring
Doxycycline IM, PO 5–10 24
Enrofloxacin SC, PO 5–20 24 Drug of choice against Pasteurella and gram-
negative infections
Trimethoprim-sulfamethoxazole SC, PO 8 (TMP)/40 (SMX) 12 Animal must remain hydrated; drug of choice
in many infections
Metronidazole PO 20 12–24 Anaerobic infections
Penicillin SC, IM 40,000–80,000 IU 24 Treponema infection
Tetracycline SC, PO 10–20 12

Rodents
Amikacin SC, IM, IV 10–20 24 Nephrotoxic; administer fluids
Chloramphenicol SC, PO 30–50 12 Potential human toxicity
Doxycycline IM, PO 5–10 24
Enrofloxacin SC, PO 5–20 24 Drug of choice in rodents
Trimethoprim-sulfamethoxazole SC, PO 8 (TMP)/40 (SMX) 12 Animals must remain hydrated
Metronidazole PO 10–40 12–24 Anaerobic infections
Tetracycline SC, PO 10–20 12

Ferrets
Amikacin SC, IM, IV 8–16 24 Nephrotoxic; administer fluids
Amoxicillin SC, PO, IV 10–20 12 Oral administration possible
Ampicillin SC, PO, IV 15–30 12
Cephalexin SC, PO 15–25 12 Most gram-negatives
Chloramphenicol SC, PO 50 12 Potential human toxicity
Doxycycline SC, PO 5–10 24
Enrofloxacin SC, PO 5–15 24 Drug of choice in many bacterial infections
Gentamicin SC, IM, IV 4–8 24 Nephrotoxic; administer fluids
Metronidazole PO 10–20 12 Anaerobic infections; Helicobacter mustelae
Penicillin G SC, IM 20,000–40,000 IU 12 Gram-positive bacteria
Trimethoprim-sulfamethoxazole SC, PO 8 (TMP)/40 (SMX) 12 Animals must remain hydrated
Tetracycline SC, PO 20–25 12–24

aThe dosages given in this table are derived from published literature. They are based on clinical experience or are empiric.

er, has many disadvantages. The
food or the water often develops an
undesirable taste after addition of
the antiinfective, causing the patient
to stop eating or drinking. The anti-
biotic may be inactivated by expo-
sure to light or by contact with the
environment. In addition, sick ani-
mals frequently are anorectic and do
not drink or eat.
Direct oral administration is a pre-
ferred method of medicating small
mammals, especially if therapy is
continued at home. Liquid veterinary
preparations or human pediatric
preparations given by syringe are
advantageous. This route generally is
not suitable using antiinfectives that
can induce dysbiosis because the
antiinfective may alter the gastro-
intestinal microbial population and
the animal can develop enterocolitis.
The subcutaneous route of
administration is the preferred par-

Supplement to Compendium on Continuing Education for the Practicing Veterinarian, Vol. 21, No. 12(M), 1999 103
Home Search All Publications
Figure 23—Intramuscular injection in a ferret.
enteral route in small mammals
because it is easy to accomplish with
minimal stress. Appropriately soluble
formulations such as enrofloxacin
are absorbed very rapidly from the
subcutaneous site and attain suffi-
cient plasma concentrations.18–20
The intramuscular route is limited
by the relatively small muscle mass in
small mammals (Figure 23). Only the
large muscle groups of the hind-
limbs should be used for injections,
and the sites should be alternated.
In hospitalized animals the intra-
venous route of antibiotic adminis-
tration is preferred after placement
of an indwelling catheter. The
antibiotic can be administered sus-
pended in the daily fluid require-
ment. Maximum plasma concentra-
tions are reached instantly through
the intravenous route; disadvan-
tages include inconvenience and
increased potential for adverse reac-
tions.18
The intraperitoneal route can be
used with antibiotics that cause no
tissue irritation suspended in an
appropriate diluent.
Topical antibiotic administration
is used for eye, ear, or superficial
infections in small mammals. With
topical administration, the antibiotic
can be deposited near the site of
infection and high local tissue con-
centrations can be achieved.18 Anti-
infectives with minimal ability to
induce dysbiosis are preferred for
topical therapy because animals
may eat or lick the preparation. Dur-
ing topical therapy, animals should
be housed on towels or newspaper
to prevent pasting with bedding
material (Figure 24).
104 Third International Veterinary Symposium on Fluoroquinolones Proceedings
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Figure 24—Rat housed on newspaper during topical therapy.
Multiple daily dosing of an anti-
infective can be very stressful for
small mammals. Antiinfectives such
as penicillins that are effective at
steady-state concentrations should
be administered so that continuous
effective tissue concentrations are
reached, requiring multiple dosing.
With fluoroquinolones and amino-
glycosides, “pulse therapy” is possi-
ble; the drugs are effective even
after their concentration has
decreased. These agents have a
postantibiotic effect and are con-
centration dependent, making once
daily administration possible,18 an
advantage in drug administration to
easily stressed small mammals.21
■ The possible side effects or toxicity
of the drug. The main complication
in herbivorous small mammals such
as rabbits and guinea pigs is antibiotic-
associated enterotoxemia. These ani-
mals possess a predominantly gram-
positive anaerobic gastrointestinal
The
intraperitoneal
route can be
used with
antibiotics that
cause no tissue
irritation
suspended in an
appropriate
diluent.
> < Page Page > Print Quit
flora.1,14,15 The common entero-
pathogens are E. coli, Clostridium
spiroforme, and Clostridium diffi-
cile.5,16,22–24 These organisms are not
infective in small numbers. The use
of therapeutic antibiotics can
change the intestinal bacterial flora
and disrupt its natural balance,
however; the reduced competitive
protection of the indigenous intesti-
nal flora permits overgrowth of E.
coli and clostridia and proliferation
of their toxins. The result is a fatal
enteritis and diarrhea caused by
mucosal dysfunction and necrosis in
the intestine. Affected animals be-
come clinically anorectic and dehy-
drated, develop diarrhea, and die
within 3 to 6 days after treatment.25
Ferrets, which are carnivorous,
are not as sensitive to serious gas-
trointestinal disorders resulting from
antimicrobial use. Therapy can be
administered as with dogs and cats,
but there is no information from
clinical trials regarding the use of
antiinfectives in this species.21
With these factors in mind, success-
ful antibacterial therapy should be pos-
sible in many cases of bacterial diseases
in small mammals. Nevertheless, anti-
microbial therapy can be effective only
in combination with additional support-
ive care such as fluids, nutritional sup-
port, and intensive care (Figure 25).
Seriously ill animals, especially small ani-
mals with a high metabolic rate, need
immediate and aggressive therapy.
Antibiotics for Small
Mammals
Aminoglycosides. Aminoglyco-
sides have a low lipid solubility; they are
Home Search All Publications
Figure 25—Nasogastric feeding tube in a guinea pig.
rapidly and exclusively eliminated by
glomerular filtration. They are bacterici-
dal and achieve low concentrations in
cerebrospinal fluid and in the eye. They
are poorly absorbed from the gastro-
intestinal tract and should be given
intramuscularly. Aminoglycosides are
potentially ototoxic and nephrotoxic
and should not be used in dehydrated
small mammals or those with impaired
renal function. They are effective
against many gram-negative aerobic
pathogens and staphylococci but have
poor activity against most streptococci,
anaerobes, and sites with low oxygen
tension, such as abscesses in rabbits
and rodents. Their use in small mam-
mals is especially recommended for
Pseudomonas infections. Amikacin is
considered to be the least toxic amino-
glycoside, making it the aminoglycoside
of choice.
Cephalosporins. Many pharmaco-
kinetic characteristics of the cephalo-
sporins and their antibacterial action are
comparable to penicillins.18 These drugs
are resistant to many beta-lactamase
enzymes, are excreted mostly unchanged
in the urine, and have short elimination
half-lives. Third-generation cephalosporins
include ceftriaxone, ceftizoxime, ceftazi-
dime, cefsulodin, cefotaxime, cefopera-
zone, cefmenoxime, and moxalactam
and are active against most gram-negative
bacteria such as Enterobacteriaceae and
Pseudomonas. Only cefotaxime achieves
therapeutic concentrations in the central
nervous system. Cephalosporins are rec-
ommended in ferrets; in rabbits and
rodents, however, these agents can
induce dysbiosis.
Supplement to Compendium on Continuing Education for the Practicing Veterinarian, Vol. 21, No. 12(M), 1999
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Chloramphenicol. Chlorampheni-
col, a broad-spectrum bactericidal
antibiotic, is highly lipid soluble and has
a large volume of distribution. It
inhibits bacterial protein synthesis and
penetrates the cerebrospinal fluid and
the eye well. It is metabolized mainly by
the liver after glucuronide conjugation;
inactive metabolites are excreted by the
kidneys. Chloramphenicol is well
absorbed orally, with chloramphenicol
palmitate preferred for oral administra-
tion because it is tasteless. Its use is
restricted because a non–dose depen-
dent and irreversible bone marrow
depression has been reported in
humans.
Fluoroquinolones. Fluoroquino-
lones are bactericidal antibiotics (based
on the 4-quinolone ring) that interfere
with bacterial topoisomerases.26 The
first agents to be introduced in this
group were nalidixic acid and oxolinic
acid, which are active only against
some gram-negative bacteria and have
limited in vivo distribution.27 Research
has led to the discovery of a family of
6-fluoro-7-piperazinyl-4-quinolones
that are active against gram-negative
and gram-positive bacteria, intracellu-
lar pathogens, trimethoprim-sulfa-
methoxazole–resistant microbes, and
mycoplasmas.19
Enrofloxacin (Baytril®) is the fluoro-
quinolone commonly used in small
mammals. It is the drug of choice
against most gram-negative bacteria
because of its efficacy. In Pasteurella
infections in rabbits, no drug offers
better clinical results. No toxic side
effects have been reported in small
> < Page Page > Print Quit
mammals at recommended doses. Dif-
ferent formulations of enrofloxacin
(i.e., for parenteral and oral use) allow
administration of the drug to be tai-
lored to the individual needs of the
small mammalian patient.
Advantages of these fluoro-
quinolones are their great oral bioavail-
ability in all monogastric species, excel-
lent tissue distribution, and low
binding to plasma proteins, allowing
them to cross membranes and reach
most body tissues at concentrations
above the MICs of many pathogens.
Fluoroquinolones are concentration-
dependent antibiotics. Their ability to
reach maximum concentrations is more
important than sustaining lower con-
centrations throughout the dosage
interval. Within a short time they have
become the most commonly used
antibiotic in small mammals because of
their efficacy against Pasteurella infec-
tions and infections with other gram-
negative bacteria.21,26,28 Fluoroquino-
lones are safe and do not induce
dysbiosis in herbivorous small mam-
mals. They can be given orally with
excellent oral bioavailability in mono-
gastric species.
Macrolides and Lincosamides.
Macrolides and lincosamides are bacte-
riostatic antibiotics that share many
characteristics. These drugs are active
mainly against gram-positive bacteria,
anaerobic bacteria, and some gram-
negative bacteria. Their main side
effects are gastrointestinal disorders in
rabbits and rodents22,23 ; thus these
agents are recommended for use in fer-
rets only.
At our clinic we use clindamycin for
jaw abscesses in rabbits because of the
drug’s excellent activity against gram-
positive and anaerobic bacteria. The
affected animal is given a dose of 7.5
mg/kg SC twice a day and is strictly
monitored.
Metronidazole. Metronidazole is a
nitroimidazole and is well absorbed
orally. It is used for anaerobic infections
and in combination with amoxicillin in
the therapy of Helicobacter gastritis in
ferrets.
Penicillins. The beta-lactam ring is
essential for the antibacterial activity of
penicillins. The beta-lactam antibiotics
can be classified into generations with
different antibacterial activities. The
natural penicillins, such as penicillin G
and penicillin V, are bactericidal against
gram-positive bacteria. The broad-
105
Home Search All Publications
spectrum penicillins, including ampi-
cillin and amoxicillin, are more lipid sol-
uble and achieve better tissue pene-
tration, as does penicillin G. These
drugs have a higher bioavailability and
can be given orally to ferrets. They are
eliminated by renal excretion and have
short elimination half-lives. They induce
gastrointestinal disorders in rabbits and
particularly in rodents.5,22 Only parenter-
al use is recommended for treatment of
venereal spirochetosis in rabbits.5
Sulfonamides. The sulfonamides
are weak organic acids that act by com-
peting with paraaminobenzoic acid.
They are well absorbed and widely dis-
tributed throughout the body. Their
effect can be potentiated by combina-
tion with diaminopyrimidines, such as
trimethoprim, which inhibit dihydro-
folate reductase. The combination of
these effects creates a highly effective
bactericidal action with a wide antibac-
terial spectrum against most gram-
negative and gram-positive bacteria.
Side effects such as crystalluria caused
by precipitation of the sulfonamides can
be avoided by optimal dosing and con-
trolling the hydration of the small mam-
malian patient. Sulfonamides can be
used safely in all small mammalian
patients and can be administered orally.
Tetracyclines. Tetracyclines have an
antibacterial activity against a wide
range of organisms. They are bacterio-
static and offer sufficient lipid solubility.
They are well distributed and are elimi-
nated by renal or hepatic mechanisms,
with the exception of doxycycline,
which is almost exclusively excreted in
the bile. Tetracyclines can be used in fer-
rets, rabbits, and rodents, but they can
induce mild gastrointestinal distur-
bances in these animals.22,23
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