Hi,
A true abscess is sometimes very challenging to resolve. As recently as a few years ago, most rabbits with a true abscess didn't survive thru both pain, infection, a combination of both or inadequate medical response. Then there was a procedure, that has since been pretty much abandoned by all the top doctors, that surgically implanted antibiotic laced beads directly into the abscess. Good idea on paper that was usually unsuccessful. Very painful and expensive. Many of the early beads contained an antibiotic known as Clindamycin....and if that drug ever gets to the GI....the fat lady sings because it is usually over as this drug absolutely devastates all the beneficial bacteria.
The first step in treating a true abscess is a proper diagnosis. An abscess will become "walled off" and will be encapsulated by a very thick wall of pus. The core will contain faculative and obligate anaerobic bacteria.....and that set up is very difficult to treat. There are some issues misdiagnosed (or maybe it would be more inaccurate terminology) asabscesses that are not true abscesses. A true abscess will not respond to drugs such as Baytril or Sulfa drugs (such as SMZ, Septrin, Septra, Bactrim, etc). True abscesses will have "tag along" bacteria that these drugs may be effective against the secondary infections but not the primary. Staph infections, which staph is the most common surface skin pathogen, is usually responsive to Sulfa drugs (noting that oral Sulfa has been linked to a serious GI issue called Tyzzer's Disease). We have also seen a bacteria called Peptostretococcus "free ride"on the surface ofan abscess (and this is usually sensitive to Doxycycline).
I have had perfect success in treating major abscessesusing a combination of Pen G (commonly called Bicillin and available under a variety ofbrand names in the US....not available in all countries with theUK being one of them). This drug contains a combination Procaine and Benzathine. In those countries this combo isn't available, the Procaine aspect usually is available and that results in a different dosing protocol as this is a short lived drug and is purged from the body quickly. I use it in conjunction withZithromax (again at one time a couple of years ago Zithromax was not available for vet use in the UK but I know it is being used now). This combo of drugs is capable of penetrating the encapsulation around the core....and the core is where the drugs need to be. And this drug combo is effective against nearly all the bacteria that can be found in the core of the abscess. I do not open an abscess.....not saying it is never appropriate since that would be determined by the location of the infecton and the involvement of surrounding tissues/bones.
The keys to treating an abscess are not much different than any other infection. Early detection, know what you are treating and what is effective against it and have a total support protocol in place. Radiographs are always useful to detect any collateral involvement of other tisses or bones (especially with jaw abscesses). And remember that these abscesses are very painful so aggressive pain management should be in place. And as you already know, have a plan in place and stick with it.
Randy
