Bunny dental/gut issues. Advice needed.

[Louisexx]

Hey everyone

I'm completely new here but I joined as I'm in desperate need of some advice. I have been a rabbit mum to little Bluebell for just over four years now. She is a house rabbit, with a big garden and has always been very healthy with absolutely no issues at all.

In July this all changed. I went on holiday for two weeks and Blue was left in the care of my parents (still in the same house/environment she was normally in). I came back from holiday and she seemed absolutely fine but I noticed she seemed to be off her hay...about four or five days later she was off her pellets, then slowly but surely stopped eating most other foods. She still picked at things here and there but wasn't her normal self.

After a trip to the vet it was decided she might need a dental and a few weeks later when they could fit her in she had one. This made next to no difference, and we were then referred to a specialist exotic vet (about 5 weeks after she initially stopped eating). Again, she was still eating bits and pieces and her energy levels were still high. Good days and bad really.


She was diagnosed with arthritis and put on paracetamol and metacam which made some difference but not a lot. She was then given tramadol. Again not much difference - still energetic enough but eating very little food. Especially when compared to what she used to. I'd like to note as well her blood was taken which came back pretty perfect. This was around the end of August. Blue still didn't improve and her eating became more pickier, she hardly drank water and her mouth was really annoying her.

10 days ago she was taken to the exotic vet for yet another dental and xrays. They found three abcesses under her tongue and infection in the root of her tooth. Arthritis was also confirmed. As well as the three painkillers blue is now on metronidazole and endocare (antibiotics) twice daily.

I feel like she still isn't getting much better. Her mouth is really annoying her although I do know it takes time for the antibiotics to kick in. Out of the last week she has had two good days in terms of eating - yesterday she was interested in everything (except her hay and pellets) but everything else she wanted to try. She is still somewhat energetic but slowly losing weight. I'm still syringe feeding her sporadically but I'm not sure how beneficial this is in making her better. I have some gut stimulant she gets as well. She's still passing urine, and feaces although these are all different shapes and sizes and pretty wet. Today she ate quite a bit of basil, a blackberry and some banana on her own.


She doesn't look in pain as such, just uncomfortable in terms of her mouth and I think her stomach must be hurting too with how poor her diet has been.


Does anyone have any advice? She seems so happy and energetic one minute and a little bit down and lethargic the next. I'm trying so hard to fight this out with her but I'm so worried. I can't actually believe she is still here after all of this, she's such a good girl and I'd do anything for her to get better.

Any help would be appreciated!

 

[JBun]

Has it been determined if the infection has spread to the jaw bone or not? Was surgery done to remove the abscesses and the infected tooth? Or if not, does the vet recommend surgery and removal of the tooth?

If she's not eating well, syringe feeding needs to be consistent every 4-6 hours or she'll continue to lose weight and could develop GI stasis. I would recommend keeping up regular syringe feeds, or if she'll eat it on her own offer her the syringe feeding mix in a bowl, or a pellet mush may also be an option to try.

https://rabbitwelfare.co.uk/rabbit-health/medical/syringe-feeding-guide/
If it's been about 10 days on this antibiotic and you aren't seeing at least some noticeable improvement, your rabbit may need to be on a different antibiotic or have another antibiotic added, as the current ones may not be effective enough by themselves against the bacteria involved. The two that seem to be the most effective for head abscesses, from what I've read of treatment and other owner accounts, are penicillin g procaine/benzathine and azithromycin, though this of course will vary depending on the bacteria present and what antibiotics that bacteria(s) is sensitive to.

I haven't done pen g injections, but I have used azithromycin with some of my rabbits, which cleared up a retrobulbar abscess completely with one elderly rabbit that had to have her eye removed because of this infection, and two others that had stubborn respiratory infections. I saw significant improvement quickly, in about 3-4 days of my rabbits starting it, though they did need to have the dosage increased to the higher dose(50mg/kg) and for an extended period of 4 weeks, as originally 2 weeks at a lower dose was tried and the infection started to come back after the antibiotic was stopped.

All rabbits infections cleared up completely, two for the remainder of their lives until they died from old age about 2 years later, and the other rabbit was symptom free for those two years before developing another respiratory infection the last few months of his life before he passed from old age. So it worked really well for my rabbits, though it did cause some initial stomach cramping for two of them, but that cleared up after a few hours after the dose was given. But it does need careful consideration, as in some rare instances, some rabbits can have severe and dangerous digestive upset from this med.

Medirabbit: facial abscesses in rabbits

https://wabbitwiki.com/wiki/Abscesses
https://www.vetlexicon.com/treat/lapis/generics/azithromycin
Your rabbit is on enough pain meds that it should be helping better than it is, I would think. If you don't feel it is doing enough, it would be good to discuss with your vet if the dosages can be increased at all. Often vets that aren't terribly experienced with rabbits(generally, not necessarily your vet), will prescribe pain meds at the dog dose, which is far too low for rabbits. So that's something I always would suggest to check and make sure of.

https://rabbit.org/the-importance-of-analgesia-pain-control-for-pet-rabbits/
https://rabbitwelfare.co.uk/rabbit-health/medical/drug-focus-meloxicam/
Medirabbit: safe analgesics

If you don't already have a vet you feel is very experienced with rabbits, or feel you need a specialist, if you're at all near Edinburgh(and haven't gone to this place yet), you may want to try The Royal Dick Veterinary College. Though do keep in mind that if you don't have pet insurance on your rabbit, the treatment(and scans) could be expensive.

https://www.ed.ac.uk/vet/services/small-animals/rabbit-exotic-practice
https://rabbitwelfare.co.uk/rabbit-...abbit-friendly-vets/rabbit-friendly-vet-list/

 

[Louisexx]

Hi everyone, thank you so much I just wanted to pop on and give a little update on Bluebell.

She was back at the exotic vet yesterday and they kept her in all day for tests and just to give her some proper vet tlc. The vet we spoke to yesterday was absolutely amazing with her and me - as at this point I'm a complete emotional wreck.

Unfortunately along with her abscesses and confirmed arthritis she said Blue may also have Megacolon. I had heard of this before but only briefly.

I already had Blue on painkillers and gut stimulants (although the Emeprid was sporadic). She was started yesterday on more medication at the moment it takes her to eight syringes twice a day. 4 painkillers, two gut stimulants and 2 antibiotics. Today she probably had the best day she has had in a very long time although I'm not going to get my hopes up or hold my breath. A good deal of her appetite came back in terms of the amount of different veg she was trying. For the last two months almost she would only eat one type of veg for a week, then go off that and I would have to try another the next week etc.

Today she had banana, celery,a cabbage leaf, kale and some carrot. I understand with megacolon their diet should be quite specific but we spoke yesterday and she said at the moment the best thing we can do for Blue is just get her eating again. So if she wants it she can have it just now. She also seems to actually be eating the food out of the end of the syringe rather than me having to fight with her and she had a little nibble on a hay stick earlier.


Again, I won't get my hopes up but I can be thankful that she has a good day today. Her tummy does seem to be making noises and she does seem to be quite uncomfortable with them at times, her stools are also very soft but they vet is still quite happy with the fact she is still passing stools etc.

Thanks again for your comments and if anyone has any further advice it would be appreciated.