Jaw abscess - options?

[Bunny999]

Dear fellow bunny parents,

Recently, my 11 yo Pepper developed an abscess on his lower right jaw. Due to his age, my local vet recommended to let him hop into the rainbow to find happiness as he most likely won't survive anesthesia/surgery or the quality of life after won't be good. The second option is to go see a specialist for surgery.

She gave him Baytril and the size of the abscess stopped growing. Plus, my bun is still very happy and enjoying his life (eating, playing, sun bathing...)

Given his age, letting go is most likely the best thing to do but I am still wanting to try another way (requested another refill for Baytril).

Don't really know what to do next as this is the first time he got sick (except a diarrhea a few years ago). He was super healthy before this.

Please let me know your thoughts.

Many thanks!

 

[JBun]

If the baytril is working, I would ask the vet to just continue it long term to help keep the infection under control. Then if the baytril stops working, switch to a different antibiotic. Antibiotics may not completely resolve the issue on their own, but they may at least keep the infection at bay and help prolong your buns life by maintaining a good quality of life. As long as he continues eating well, maintaining a good weight, and is relatively happy with any pain under control, I don't see any reason to have to put to sleep at this point. Just my opinion.

Another option if the baytril stops being effective, is pen g injections. There is slightly more risk of this antibiotic leading to digestive problems, but it can also be a very effective non surgical treatment for jaw abscesses.

http://www.bio.miami.edu/hare/jawabscess.html

 

[BentleyBun]

My bunny has a abscess on this stomach region. We are going daily baytril and penicillin G procaine injections. Had an appointment this morning and vet said it looks less red/inflamed and was even a bit smaller. If baytril doesn’t work, I would definitely ask about the pen G injections

 

[Bunny999]

Update and additional questions.

My Pepper is a tough little bunny. His abscess sunk, dried up, and literately fell off, leaving a small hole. The abscess was the size of a big grape.

Unfortunately, his vet retired and I went to a new vet. This vet refused to give him Baytril because it won't help (?) and refused to give him daily Pen-G. She only offered to give Metacam for pain and Betadine to clean up the wound. After I pressed her hard, she offered weekly Pen-G. I took Metacam, Betadine and still on existing Baytril. Fortunately, I got more Baytril from a bird store so Pepper can be on daily Baytril.

For the wound, it filled up with pus daily and I tried to clean it really well with Betadine and packed it with triple antibiotic for the past 3 days. Pepper is happy and still enjoying his daily life. No problem with eating at all. Weight is well maintained.

I feel like these vet are trying to milk me out for $ rather than trying to treat Pepper. Unfortunately, I can't keep on switching vet and it is difficult to get an appointment (1-1.5 week for one).

Is there anything else I can do? Take the offer of weekly Pen-G ($200 per visit) and risking it stopped working? Increase Baytril dose to the max? Where can I get Pen-G myself in California/LA?

 

[JBun]

I did the same thing with my rabbits eye abscess. She had her eye removed and it abscessed after with the empty socket filling up with pus. I kept it cleaned out and used ointment in the cavity, in addition to the oral azithromycin she was on. The pus gradually lessened as the flesh and hole filed in and closed up. But I was squeezing and cleaning pus out of that hole for a while, even as it tried to close over, I had to keep it opened up as there was still pus in there. It took several weeks for my rabbit, but it was a deep hole. So just keep up with it and make sure that cavity doesn't close over until you are sure no more pus is coming out of it.

Medirabbit: abscess management

If the baytril is working and you can get that with no problem, I would just keep up with that. If you feel you need the pen g injections, it is possible to buy it online or at farm stores otc. Though this is the pen g procaine for daily injection and not the long acting pen g procaine/benzathine for giving every second or third day. I don't think you can get the long acting otc anymore though. Tractor supply usually has pen g procaine and is a national chain.

pen g procaine

pen g procaine/benzathine(combipen)

Though technically if you are insistent with your vet, you should be able to request they write you a prescription for the antibiotic or request they call the prescription in to an online pharmacy. Though it sounds like your vet isn't being very helpful, so I don't know that they will work with you on this.

If your vet is only wanting to give an injection once a week, that's not the protocol and not going to be very effective. So no use spending $200 a week for an ineffective treatment. Plus that price is outrageous. They shouldn't be charging you anymore than $25 for follow up injections, or they should be showing you how to do it yourself at home and sell you the medication. They definitely are trying to jack up costs and milk you in my opinion.

If you do still need the help of a vet and you want to try and find a new one, you could always see if there is a farm vet around you that is knowledgeable about rabbits. Farm vets are often more helpful in working with you on getting your animals treated.

 

[BentleyBun]

Like JBun said you can probably just buy penicillin procaine or procaine/benzathine online but seeing that you are located in CA you might be required to get a prescription unfortunately.

If you do get it, injecting it subcutaneously is not super hard. It can be at first but after some practice it does get easier. Do you happen to know someone in a near by state that you can send it to and maybe pick it up from them? Penicillin does need to be refrigerated.

It doesn’t sound like your new vet is helpful at all. I’ve been doing rechecks once a week and not once did they charge me, only for meds if I need them.

 

[Bunny999]

Thanks for all the info. Tractor Supply has Pen G Procaine in stock in NV and AZ. I will see how it progress for the next few days and will drive to AZ/NV to get it for my bun. Everything for my bun, 8 hours drive is nothing

Bentleybun, you are very lucky to have a vet like that, treating animals with a heart, not $$$.

 

[BentleyBun]

I know, it can be really frustrating to be with a vet who doesn’t listen nor care and just want money

Keep us updated on how everything goes! I hope pepper gets better without the need of penicillin but if it comes down to it, hopefully penicillin does the trick. I know for my bun it definitely did.

Also make sure to bring a cooler with ice if you do end up making the trip! You definitely don’t want penicillin to warm up for too long. And don’t forget about the needles and syringes as you CANNOT give penicillin orally.

 

[TORY93]

Hi Bunny999

Sorry to hear about Pepper, at least he is still his usual self.

Sounds like your vet situation is a bit of a nightmare.

I hate to play the devils advocate but I follow an account on Instagram called "puffytails" and they have 4 rabbits, 3 of which are senior, with one of them being 12. When this rabbit was either 10 or 11 he had an abcess surgery on his face and actually made a full recovery. He had a drain in his cheek for several days which they had to flush and he was fully medicated but he pulled through.

I completely understand if you wouldn't want to go ahead with the procedure as it could lead to you losing your lovely bun prematurely and if he is okay im himself and eating at the moment then it may be best to leave him as he is with his antibiotics but I did want to put it out there just in case

I hope you manage to get the Baytril and penicillin sorted out. Good luck and send my love to little Pepper x

 

[Bunny999]

Hi Bunny999

Sorry to hear about Pepper, at least he is still his usual self.

Sounds like your vet situation is a bit of a nightmare.

I hate to play the devils advocate but I follow an account on Instagram called "puffytails" and they have 4 rabbits, 3 of which are senior, with one of them being 12. When this rabbit was either 10 or 11 he had an abcess surgery on his face and actually made a full recovery. He had a drain in his cheek for several days which they had to flush and he was fully medicated but he pulled through.

I completely understand if you wouldn't want to go ahead with the procedure as it could lead to you losing your lovely bun prematurely and if he is okay im himself and eating at the moment then it may be best to leave him as he is with his antibiotics but I did want to put it out there just in case

I hope you manage to get the Baytril and penicillin sorted out. Good luck and send my love to little Pepper x

Thanks for the kind words!

Technically, surgery is not needed anymore. His abscess was gone, leaving behind a small hole and pus coming out from inside (about 1/4in deep). It is very similar to other rabbits after surgery. I used a small ear wax remover tool to go in the "tunnel" to remove as much pus as possible. Hopefully, with penicillin, the pus will completely stop. Baytril is just a bandage at this point.

I feel this community offered me much more help and kind words than those greedy vets.

 

[Bunny999]

Quick update:
I am going out of state to get Penicillin G procaine. Also got bene-bac plus probiotic to prepare my bun for the injection.

Any other medications that I need to get?

 

[Bunny999]

I know, it can be really frustrating to be with a vet who doesn’t listen nor care and just want money

Keep us updated on how everything goes! I hope pepper gets better without the need of penicillin but if it comes down to it, hopefully penicillin does the trick. I know for my bun it definitely did.

Also make sure to bring a cooler with ice if you do end up making the trip! You definitely don’t want penicillin to warm up for too long. And don’t forget about the needles and syringes as you CANNOT give penicillin orally.

I have all the needles and syringes ready. What is the dosage and frequency you are using for your bun? I read it is around 6,000 IU/kg(drugs.com) to 20.000 – 60.000 IU/kg (medirabbit) to a flat 75,000 IU for rabbits weighing less than 2.5kg (Umass). Pepper is at 1.7kg.

 

[JBun]

Just what I would do, but I would stick with around 40,000IU/kg, based on the published dosage recommendations in the references I've seen. That's the standard dosing for other pen g treatments, like for rabbit syphilis. Keep in mind that the protocol used in the abscess study, is with the long acting pen g. So the short acting procaine is a daily injection.

http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
Medirabbit: safe antibiotics

Usually pen g injections won't mess with the gut bacteria, provided any possible injection site leakage is thoroughly cleaned off so none is accidentally ingested while grooming. But because of the potential for pen g to upset the gut, I would make sure to stop all high sugar/carb treats/foods and make sure a lot of good quality grass hay is being consumed. Grass hay is the best regulator for a rabbits gut microflora and digestive tract, so will help keep things in balance as much as possible.

Then keep a really close eye out for lack of appetite and changes in poop, particularly for any signs of watery or pudding like fecal poop(not just mushy cecotropes), which is an immediate emergency(antibiotic induced enterotoxemia). Also, benebac needs to be given at least 2-3 hours from antibiotic administration so it will not be counteracted by the antibiotic, especially the oral baytril.

 

[Bunny999]

Just what I would do, but I would stick with around 40,000IU/kg, based on the published dosage recommendations in the references I've seen. That's the standard dosing for other pen g treatments, like for rabbit syphilis. Keep in mind that the protocol used in the abscess study, is with the long acting pen g. So the short acting procaine is a daily injection.

http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits
Medirabbit: safe antibiotics

Usually pen g injections won't mess with the gut bacteria, provided any possible injection site leakage is thoroughly cleaned off so none is accidentally ingested while grooming. But because of the potential for pen g to upset the gut, I would make sure to stop all high sugar/carb treats/foods and make sure a lot of good quality grass hay is being consumed. Grass hay is the best regulator for a rabbits gut microflora and digestive tract, so will help keep things in balance as much as possible.

Then keep a really close eye out for lack of appetite and changes in poop, particularly for any signs of watery or pudding like fecal poop(not just mushy cecotropes), which is an immediate emergency(antibiotic induced enterotoxemia). Also, benebac needs to be given at least 2-3 hours from antibiotic administration so it will not be counteracted by the antibiotic, especially the oral baytril.

Unfortunately, he hates hay since 3-4 years ago. He would rather quit eating than eating hay (tried several types of hay and several ways to reintroduce hay).

I'm going to get some critical care, just in case .

How should I transition from baytril to Pen G? Baytril is keeping everything under control right now. I plan to go on Pen G for at least 2 weeks or until all the pus stopped + 5 days.

 

[BentleyBun]

Unfortunately, he hates hay since 3-4 years ago. He would rather quit eating than eating hay (tried several types of hay and several ways to reintroduce hay).

I'm going to get some critical care, just in case .

How should I transition from baytril to Pen G? Baytril is keeping everything under control right now. I plan to go on Pen G for at least 2 weeks or until all the pus stopped + 5 days.

We were given baytril as well In the beginning. We gave it along with injections for about a week and since it didn’t do anything for us, vet told us to stop using it.

My bun is 2.75 lbs and the dose given to us was 0.2ml for the concentration 300k units/ml so I’m not too sure sure what the dosage is exactly. Our vet told me to do every 48 hours, but I insisted we did everyday because it was just procaine and not the long lasting one. It has been about 18 days since we started on daily injections and just this week we started to do it every other day until the end of the week because I only have a couple of needles left and he’s all healed up (waiting for his scab to fall off). So hopefully his last injection will be this Sunday.

 

[Bunny999]

We were given baytril as well In the beginning. We gave it along with injections for about a week and since it didn’t do anything for us, vet told us to stop using it.

My bun is 2.75 lbs and the dose given to us was 0.2ml for the concentration 300k units/ml so I’m not too sure sure what the dosage is exactly. Our vet told me to do every 48 hours, but I insisted we did everyday because it was just procaine and not the long lasting one. It has been about 18 days since we started on daily injections and just this week we started to do it every other day until the end of the week because I only have a couple of needles left and he’s all healed up (waiting for his scab to fall off). So hopefully his last injection will be this Sunday.

Based on my calculation, your bun is getting around 48,000 IU/kg. I think you should consider it for a few more days until the scab is off and his skin completely ”sealed". Some pharmacy will give you a few syringes for free/small charge if you can provide a prescription (according to a friend, working for Walgreens).

I will drop baytril off two days after Pen G injections.

 

[BentleyBun]

Based on my calculation, your bun is getting around 48,000 IU/kg. I think you should consider it for a few more days until the scab is off and his skin completely ”sealed". Some pharmacy will give you a few syringes for free/small charge if you can provide a prescription (according to a friend, working for Walgreens).

I will drop baytril off two days after Pen G injections.

I live in CT and I believe the law is that I can only get up to 10 needles without a prescription which my vet will not give me unfortunately, she was very insistant on the every 48 hours and so I was able to do them once a day for the past weeks is beacuse they gave me extras at our first appoinment. I was only given 6 (3 of each size, which would last me 3 days) for this week, which is why I was gonna do it every other day. I not sure if I am legally allowed to purchase needles online unfortunately.

 

[Cinn-a-bun]

Update and additional questions.

My Pepper is a tough little bunny. His abscess sunk, dried up, and literately fell off, leaving a small hole. The abscess was the size of a big grape.

Unfortunately, his vet retired and I went to a new vet. This vet refused to give him Baytril because it won't help (?) and refused to give him daily Pen-G. She only offered to give Metacam for pain and Betadine to clean up the wound. After I pressed her hard, she offered weekly Pen-G. I took Metacam, Betadine and still on existing Baytril. Fortunately, I got more Baytril from a bird store so Pepper can be on daily Baytril.

For the wound, it filled up with pus daily and I tried to clean it really well with Betadine and packed it with triple antibiotic for the past 3 days. Pepper is happy and still enjoying his daily life. No problem with eating at all. Weight is well maintained.

I feel like these vet are trying to milk me out for $ rather than trying to treat Pepper. Unfortunately, I can't keep on switching vet and it is difficult to get an appointment (1-1.5 week for one).

Is there anything else I can do? Take the offer of weekly Pen-G ($200 per visit) and risking it stopped working? Increase Baytril dose to the max? Where can I get Pen-G myself in California/LA?

You can try what I used for my cat.
Boric Acid powder,
1 part powder, 5 part warm water.
Soak cotton ball and hold on abscess 1-2 minutes. Repeat.
Do this 3-4 times a day.
This will draw the infection out. Do not allow abscess to scab over.
If it does. Use above to soften it and gently remove scab.
It must be kept open and allowed to drain.
When redness is gone and no more pus, then let it scab over and heal.
I have used this on many cat fight infections.

 

[Cinn-a-bun]

I understand that abscess is gone. But this will work for the pus.

 

[JBun]

Based on my calculation, your bun is getting around 48,000 IU/kg. I think you should consider it for a few more days until the scab is off and his skin completely ”sealed". Some pharmacy will give you a few syringes for free/small charge if you can provide a prescription (according to a friend, working for Walgreens).

I will drop baytril off two days after Pen G injections.

You may want to consider just keeping the baytril going along with the pen g, at least until you are out of the baytril or have finished the antibiotic treatment, which ever comes first. Reason is, there can be different bacteria involved in an infection, and it can be that some of the bacteria will be sensitive to the pen g, and some that isn't sensitive to it but is to the baytril. So you are just covering a wider range of bacteria by doing both. Especially since you did see improvement while your rabbit has been on the baytil. In the link, they briefly talk about combining two similar antibiotics for treatment of a facial abscess.

Medirabbit: facial abscesses

Unfortunately, he hates hay since 3-4 years ago. He would rather quit eating than eating hay (tried several types of hay and several ways to reintroduce hay).

I'm going to get some critical care, just in case .

How should I transition from baytril to Pen G? Baytril is keeping everything under control right now. I plan to go on Pen G for at least 2 weeks or until all the pus stopped + 5 days.

Not sure what your rabbits diet is then, but if you feel like adding hay to the diet would be good or helpful and you haven't tried hay pellets, I've used plain hay pellets(no other added ingredients) to supplement a rabbits diet who wouldn't touch hay. The pellets are a larger size, but didn't pose a problem for my rabbit to eat. Though if there is any difficulty eating them, they could be soaked in warm water to soften them up(made up fresh and not left out too long for bacteria to grow). I used the timothy pellets, but there are orchard grass ones, though they may need to be special ordered if your local feed store doesn't carry them.

https://standleeforage.com/products/certified-timothy-grass-pellets
I also found these hay pellets on amazon, in orchard or timothy. Though I can't say anything as to their quality, and they are more expensive than if you can get the standlee pellets at a feed store.
Viking orchard hay pellets