abscess..... help asap please!

[tinfoilxtouch]

So today I took my baby Kaluha to the vet after discovering a red lump under her chin yesterday. They diagnosed it as an abcess, and indeed it even managed to pop while they were examining her (not a clean process at all).

The doctor has lots of experience with rabbits and is fairly certain it's a tooth that's causing the problem. She basically told me the only "cure" would be to totally remove the abcess, along with the tooth that had pushed into the area.

Now mind you, this is a fairly high-end vet. They are running bloodwork on her prior to the surgery, keeping her two nights for care, and giving her regular pain and antibiotic shots during this time. However, it adds up to over $900. Needless to say, this isn't easy to swallow. Nonetheless, she is having it done on Saturday unless I find a certain cure somewhere else.

Is this totally unreasonable? Has anyone else had a like situation?

 

[AngelnSnuffy]

I'm sure someone will be along on soon about this. I just want to post this from the Library for you to read for now.

Best of luck to you and your Kaluha!


http://www.rabbitsonline.net/view_topic.php?id=11791&forum_id=10

 

[Pipp]

AngelnSnuffy's links will answer many questions.

How old is she? What breed? Where are you located?

I have one vet who opens up and cleans abscesses and wants to surgically remove them whenever possible and another who only wants to do aggressive injectable and oral antibiotics regime.

Did they take x-rays and are they certain the tooth root is involved? It is common, especially in older rabbits, but if it is, it's major surgery. Its good to ask about alternatives.

You can try the injectable antibiotics for a few months and it may work, but it also could be back if it's tooth root and you may need to spend the $900 anyway.

You can bring the bill down if they let you take care of her at home, too. They'll have to show you how to do a lot of the procedures, but they really should. .

I'd like to hear what Randy has to say about this first.

Hope it all works out for you and Kaluha.


sas

 

[Maureen Las]

The person that started this thread never responded to my last postbut a lot of the info here would be similar to what you have described ...

http://www.rabbitsonline.net/view_topic.php?id=44875&forum_id=16

 

[tinfoilxtouch]

Pipp wrote:

AngelnSnuffy's links will answer many questions.

How old is she? What breed? Where are you located?

I have one vet who opens up and cleans abscesses and wants to surgically remove them whenever possible and another who only wants to do aggressive injectable and oral antibiotics regime.

Did they take x-rays and are they certain the tooth root is involved? It is common, especially in older rabbits, but if it is, it's major surgery. Its good to ask about alternatives.

You can try the injectable antibiotics for a few months and it may work, but it also could be back if it's tooth root and you may need to spend the $900 anyway.

You can bring the bill down if they let you take care of her at home, too. They'll have to show you how to do a lot of the procedures, but they really should. .

I'd like to hear what Randy has to say about this first.

Hope it all works out for you and Kaluha.


sas

Thanks for the responses...

She is a 2 1/2 year-old Netherland Dwarf. We live in Newport Beach, but the vet is in Westminster.

I think part of the reason they aren't going to just treat it with antibiotics is the fact it's now already an open wound, and the fact it's growing so fast- literally it went from not being noticed, to red and swollen, to bursting in three days.

They haven't done X-rays yet.

In terms of care, the plan is to have her there overnight Saturday and take her home sunday- the boarding cost is very small (something like $25).

 

[Maureen Las]

they should do x-rays of her mouth first to determine whether the toothroot is involved.It would be a shame to put her through all that with out evidence /

It is primary knowledge that abscesses are difficult to treat in rabbits and need antibiotics....they often reoccur or spread.
Nothing at all like in cats and dogs

 

[tonyshuman]

Agreed. First make sure there is no underlying tooth problem causing this, and then make sure very aggressive antibiotic treatment is going on. As to whether or not to remove what remains of the abscess, that should be determined (I think) by looking at the wound and seeing how damaged the remaining tissue is, and seeing if it will close on its own.

 

[tinfoilxtouch]

tonyshuman wrote:

Agreed. First make sure there is no underlying tooth problem causing this, and then make sure very aggressive antibiotic treatment is going on. As to whether or not to remove what remains of the abscess, that should be determined (I think) by looking at the wound and seeing how damaged the remaining tissue is, and seeing if it will close on its own.

It sounds like they did indeed intend on continuing antibiotic treatment.

The cost I was quoted includes the assumed removal of a bad tooth. Is this really that risky of procedure?

 

[Haley]

If you read through the library threads on abscesses you will see my experiences I went through with my rabbit, Max, who had a horrible tooth root abscess that almost cost him his life. If I hadnt done a lot of research and been very vigilant about finding the right vet to treat this, Max definitely would not be here today.

Which tooth is involved? Is it one of the front teeth? You need to make sure your vet is experiences with rabbit dental work. If they remove a bottom tooth they will need to remove the opposing top tooth, otherwise the top tooth will keep growing when it doesnt have another tooth to rub against. This happened to Max after his first surgery (when the vet only removed one tooth). He eventually had all his front teeth removed and he does just fine.

In addition to removing the abscess and the tooth (or teeth) you will need to insist on very aggressive antibiotics. They might tell you that you dont need it if the abscess is removed but this is rarely the case. Baytril alone will not be sufficient. Ask about Bicillin, which is given via injection. Your vet can show you how to do this at home every other day for at least a few months after the surgery. Max would not be here today if not for surgery and Bicillin. You will also need some pain medicine to take home. No matter what they say, the shot they give during the surgery will not be enough. Abscesses are horribly painful as is dental surgery.

I'll say a prayer for your little one. Please let me know if you need any help.

Haley

PS. It would be good to buy some canned pumpkin to mix with a pellet slurry (pellets soaked in water) because she will probably have trouble eating right after surgery. You might even have to givefeed her via syringe.

 

[ra7751]

Hi,

I deal with rabbit abscesses all the time....probably more than most vets. They are quite difficult to treat for many reasons. I have never opened an abscess. That is not to say I wouldn't, but even with the really nasty ones I have seen, I have not needed to open them. I am concerned if your vet did indeedstate "the only cure" would be surgical. Again, I have treated many abscesses without surgery and really nasty ones so I consider that, in my non-professional opinion, to be inaccurate. And you never remove "a tooth" with open rooted teeth. If you extract a lower arcade tooth, you also have to extract the opposing tooth. If you don't, the opposing tooth will grow unchecked since it is the tooth to tooth contact that actually wears the teeth down. So I would discuss that with your vet before any extractions.....it has to be a double extraction and that means more pain. If the abscess has been active fora while, it can damage the structure of the jaw bone itself. Depending on location of the compromise, it can lead to additional malocclusion issues (misalignment of the teeth which results in overgrowth) or even to a fusing of the hinge. In my early treatments, I resolved to abscesses too quickly and when the bone regenerated, it fused making it impossible for the rabbit to eat.

My normal drug protocols involve a very aggressive combination of Penicillin (a specific version of two drugs) and a high end dosing of Zithromax. Penicillin (or any derivitives including cephalosporins) are safe only when injected. This combination of drugs is highly effective at penetrating the very thick pus that encapsulates the core of the abscess. And the core is where you need to be. It usually contains very stubborn anaerobic bacteria.....most drugs that vets will use have no chance of resolving these bugs. Very aggreesive pain control and husbandry support will be required. The use of both NSAIDs (keeping in mind the side effects to the liver and kidneys) as well as a narcotic aspect should be implemented. I prefer Buprenorphine (Buprenex) but Tramadol is acceptable. I use Lactated Ringers to maintain hydration and control any fever that might be present. An appropriate B Comp injection is also beneficial. Modifications to the diet will be necessary to up the calories to provide the necessary energy for fight this infection and maintain weight.

Surgical intervention in abscesses is expensive, painful and many times does not properly resolve the issue. Again not saying I would never intervene surgically....it all depends on what radiographs show is happening to the jaw itself. But keep in mind that if surgery if performed.....the debridement is very painful and removes a lot of tissue and that if you remove the tooth in the abscess....the opposing tooth must be extracted...and that means more pain and more chance of collateral infections.

In my non-professional opinion based on my years of experience....I would opt for a very aggressive drug protocol. It has never failed me. Good luck.

Randy

 

[tinfoilxtouch]

*Update*

I went to the vet this morning to see Kaluha before her surgery. She was so sweet... she started licking my neck and chin while I held her. I was so sad to give her back and wonder how the surgery would go...

The surgery was supposed to go from 2:30-4:00. The vet closes at 4:00. I haven't heard from anyone by 4:15 so I called. The machine is on. At this point I'm really getting knots in my stomach.

I get a call from the doc at 5:15. The surgery took 2+ hours because of the size of the abscess. And, belive it or not, it had nothing to do with her teeth. There was a foreign metal object that had broken the skin and become stuck. Thankfully, the surgery went fine and she is doing well. They have her on a number of antibiotics and pain meds that she will continue for a couple of weeks or more. I get to take her home tomorrow if she's doing well. I'm very relieved.

I have no idea where the object came from. I haven't given everyone the full backstory on Kuku- my ex and I got her from a pet store when she was just a month or two old. When we broke up last October, she insisted on keeping her. I just happened to stop by the Orange County animal shelter when I drove by three weeks ago- and guess who was there. It must have been fate working. Whatever it was, it seems to have happened before she was given up to the shelter.

I'll post pics when she's doing a little better. We're not 100% out of the woods yet, but since there was no dental work involved and the entire abscess was removed, the outlook seems good.

 

[Haley]

Im so glad shes doing ok. Make sure you ask about antibiotics and pain medicine. She needs to have metacam at the very least, hopefully something stronger. You shuold probably print out some info on Bicllin and ask about it. Oral antibiotics will not be strong enough.
Keep us posted!

 

[Maureen Las]

I'm glad that she is doing well
but have absolutely no idea why they did not do an x-ray and had this knowledge proir to the surgery

As Haley has stressed there is nothing now more important now than strong antibotics (bicillin usually given SubQ) and a strong oral med in addition to a pain meds that will control the extent of pain that surgery as invasive as this will create
Abscesses like this (head) although opened and cleaned out often reoccur without the back up of antibiotics

She will also need to be syringe fed an with adequate hydration to maintain her strength until she feels better

If you need to print out an article

http://www-unix.oit.umass.edu/~jwmoore/bicillin/bicillin.htm
here is more info on absceses from the library including forum membersaccounts of dealing with them



http://rabbitsonline.net/view_topic.php?id=11791&forum_id=10

 

[Maureen Las]

there is a very good article on why rabbits need sufficient pain meds presented here ,,,,,



http://www.bunnybunch.org/rabbitcare2.html#success

 

[Flash]

Flash has had 2 absesses one on his jaw they found a piece of black plastic in there and removed it with surgery, that was $900. The other was tooth related and he was treated with injections and antibiotics. No x-rays were taken which would've helped later on with his ongoing teeth problems.

 

[tonyshuman]

Good points already made. Now your girl (she's had a rough few months I see, poor thing!) needs water, pain meds (ask for buprenorphine or tramadol in addition to metacam), and a strong injectible antibiotic (bicillin). Metacam can help with inflammation, but isn't as good as the other two I mentioned for pain. It seems that a lot of bunnies have a hard time recovering from mouth/tooth surgeries because it can be hard to get them to eat and get the GI tract going again, a very important part of post-op recovery for bunnies. Narcotic medicines are almost always necessary for surgeries like this. Also, make sure she's adequately hydrated as metacam can cause kidney damage in underhydrated animals.

Syringe feed her water, critical care or a pellet slurry (that has been rehydrated VERY well), perhaps some baby food, canned pumpkin, or veggie puree, until she starts eating on her own again.

Poor girlie and poor you. I'm so glad she has been reunited with you and is getting her medical needs taken care of. It may be good in the future to make sure there are no other problems with her teeth by doing a dental x-ray. Did they remove any teeth in the end, or just the metal piece?

[[hugs]]