Delilah's Abscess

[delusional]

Well, for a few reasons I haven't been very active on the forum of late. I won't go into them, but anyway...

I feel like I should seek out som opinions from our knowledgeable lot at this point.

Delilah has grown a huge abscess on her front leg / shoulder / neck. It sprung up over just a couple of days, really. There's a big ball, about the size of a golf ball, hanging from her left 'elbow', then smaller blobs which are kind of joined together up her side and onto her shoulder, then a very small (kidney bean?) sized one on the back of her neck.

We took her to the vets on Thursday last week, and they drew a small amount of puss so they said it was an abscess (though all parties are confused as to where it has come from - no visible injuries and I don't remember her having any cuts or scratches there for quite some time...)

They gave us some Baytril, which we have been giving her over the weekend, and the swellings have gone down a little - they felt like little rocks under her skin onThursday (yes I was in tears thinking it was a tumour), and now they're softer and there is loose skin around them, and they do feel slightly smaller.

We have another appointment in about an hour. The vet said that this one may be too large for just antibiotics to clear up, and that because the puss is 'cheesy', they can't just lance it with a needle. They might have to anaesthetise her to remove the larger bits.

So.. guess I just wondered if anyone had experience with this kind of thing? Obviously with the mention of anything more invasive than just meds has me concerned for her...

 

[tonyshuman]

Oh no! The vet is right that lancing the wound may not help--rabbit abscesses are notoriously hard to treat. However, the Baytril isn't going to do a great job at treating it. Many rabbit abscess bacteria are resistant to Baytril and that class of antibiotics, which also includes cipro.

Depending on her age (sorry, I couldn't tell that from your blog), I'd just go with a course of strong injectible antibiotics and oral antibiotics. If it continues to respond a little to the baytril, you could continue to give that orally, but our expert Randy and several others on here have had much more success with zithromax. The injectible antibiotic to use is called bicillin, and it's a combination of penicillin G procaine and penicillin G benzathine. I think both zithromax and bicillin are available in the UK, but I'm not 100% sure.

Here's a really good article on the bicillin protocol:
http://bellsouthpwp.net/m/o/morfz/pdf/bicillin.pdf

If she is a bit older and the abscesses are very well encapsulated (the borders of them are well defined), surgical removal may be better. I say this for older bunnies because sometimes having the abscess is much more of a strain on their bodies, although recovering from surgery is pretty difficult too in some cases.

I'd print out that article and mention that you've heard some good success from this treatment protocol. An even better option would be to get a sample of pus from one of the abscesses and have the vet do a culture and sensitivity test on it, which is expensive but can tell you exactly which antibiotics to use.

Good luck!

 

[aurora369]

I also believe that Flashy has used Convenia in the UK with good success before. That is another antibiotic to discuss with your vet.

Good luck!

--Dawn

 

[ra7751]

Only have a sec.....to treat an abscess, you have to get meds to the core. That core contains anaerobic bacteria that will laugh at Baytril. If this is a true abscess, there is no possibility of Baytril doing anything positive. You have to use drugs that can punch thru the encapsulation and get to the cell walls of the bacteria. A precise combination of Zithromax and Pen G (Procaine and Benzathine) have worked every time for my abscess patients. I do not open abscesses.....not saying I never will.....just never seen the need so far.

If you can get your vet to contact me directly, I will give them exact protocols to treat this.

Randy

 

[delusional]

Thanks for all the info guys.

I mentioned bicillin at the visit this evening, and my vet explained that it isn't licensed for use in the UK. She did say that we could try some other injectable penecillin, but I wasn't sure what was best so I said that we'd continue as we were, with the Baytril, for now.

Randy - would it be possible to give me an email address that I can pass on to my vet, to see if she would be willing to contact you?

She seems quite adamant that we're trying to shrink the abscess to make it more manageable to remove it surgically, and told us that surgery was really the only way to make sure that there was no abscess material left behind.

Personally I would like to at least look at every option before proceeding with surgery, so I would really like for her to have your opinions to consider.

 

[tonyshuman]

Well, technically I think the use of bicillin in rabbits here is off-label, but I'm not sure. We usually can get it at a farm supply store in a formulation for livestock. Convenia might be a better oral option, since that seems to be available.

 

[aurora369]

From what I recall, Bicillin is not available at all in the UK. For whatever reason, people just can't get it. I do know that someone has ordered it online and had it delivered from out of country.

I believe that others in the UK have used the available penicillin in conjunction with another antibiotic.

I also believe that Flashy has used Convenia successfully for head tilt (ear infection).

--Dawn

 

[ra7751]

Couple of quick notes just for everyone's benefit.

>The version of Pen G (Bicillin) we use in the US is a cattle drug and contains two drugs....Procaine and Benzathine. The Procaine is a fast in-fast out drug and hits like a blitz....but doesn't stay in the system long. The Benzathine takes longer to get to working levels but it stays in the body at working levels longer. It is possible to use different penicillins by manipulating the dosing.

>Baytril and many other commonly used antibiotics are not effecitive against most anaerobic bacteria. You may have faculative or obligate anerobes in this type of infection. Faculative can live with or without the presence of oxygen. Obligate lives only in an oxygen free environment and will quickly die when they come in contact with oxygen. Most of the commonly used antibiotics are effective against aerobic (which requires oxygen to live) bacteria only.

>Convenia is a Cephalosporin and is basically a derivitive of Penicillin, therefore it is safe only as an injectable drug. Cephalosporins are used when Pencillin resistant bacteria is encountered. DO NOT ALLOW ORAL ADMINISTRATION OF ANY PENICILLIN OR CEPHALOSPORIN. Now, there are some rabbits....rare individuals....that can tolerate oral penicillins but they are certainly the exception and not the rule. The reason these drugs are so devastating is that they are very effective against Gram Positive bacteria and GP bacteria is the primary type of bacteria responsible for digesting food. And the good bacteria controls the bad bacteria...and if you lose that control....that allows for potentially fatal bacteria and toxins to grow in the GI.

>All drugs used in rabbits (and most exotics and wildlife) are all used "off label" which means they have not been legally certified for use in a particular species. Baytril, for example, is labeled only for use in dogs. Off label use is always at the user's (the vet) risk.

>The idea that surgery is required on abscesses is totally wrong. While there may be certain cases that surgery is indicated, I have treated some very nasty abscesses and they have resolved and remain resolved to this day without surgery. A shining example is JoJo...and one of our forum members arranged his transfer to be treated here.....and he had a rather involved abscess when he came here. Well, he has been here for quite some time now and is perfectly healthy.....and the abscess has not returned and I treated by drugs only.

Randy

 

[tonyshuman]

OOPS big mistake there--I didn't know Convenia was only injectible! So sorry.

 

[delusional]

Thanks for the PM Randy - I contacted my vet and she said she's 'not comfortable taking advice from someone off a forum'... =/

Do you have any web references about this kind of treatment, or would you be able to give me detailed info that I can print out and take with me? I just want to get her to look at it, and consider it.

As I said she's already stated that we can start using injectible penecillin if we'd like. Would you recommend we go with that if she disagrees with the other info here, or would it be better to just go with what she says and maybe end up going with surgery in the end?

I don't know what to do at this point. I don't want to damage the relationship we have with our vets, because I like them and they've been really great for everything else. But I want to do what's right for Lilah and make sure she doesn't have to go through anything unnecessary.

 

[ra7751]

There is no printed protocol on this treatment....mainly due to the fact that I am the one that started using it. I do have some vets using this protocol so maybe she can talk with them. I can send you the protocol by PM if you would like along with an explanation of why this treatment works.

Randy

 

[delusional]

That'd be great Randy, if you could. Just so I have something to leave with her, which explains everything. And she can decide from there if she's willing to try it or not...

 

[FLFLEMISH]

ra7751 I sent you a PM, very interested in your protocol as lancing/pen g/silvadine is such an ordeal to put my rabbits through in comparison.