Leg Abscess - the healing process

[stevesmum]

Looks like there's some good granulation (pink) tissue there, but a lot of what looks like exudate. The vet is debriding all of that white stuff whenever you go in, is that right? That wound is going to take a long time to heal. I'm not a vet or vet tech or anything but I am an RN. So I guess it depends on how much your bunny is suffering with this, how long you can continue on with your dressing changes, and if you are seeing progress each week. Might be time also to bribe your helper with dinner or something
You're doing a fantastic job.

 

[Rayen]

They're not taking the white tissue off all that often, actually. They just removed a bunch of excess tissue this week, should I be trying to remove more of it when I clean it myself?

I don't feel like he's suffering at all. The vet kind of made it sound like we were at the end point last time I talked to her, that if he wasn't making any real progress that we'd have to take the leg off or put him to sleep. Obviously I don't want to be changing bandages for the rest of his life, but I really don't want to give up on him yet either. I just don't think he'll do well without his leg, plus it'll be another $1000 operation. I know it sounds horrible, but I'm not sure I can put another $1000 into this thing especially when I don't think it'll help.

 

[stevesmum]

Not forcefully, but just by cleaning, remove what will come off. But it depends what it is, if it's exudate or slough or what. I wouldn't try to debride it myself. If you don't think he is suffering then I would plod along for now, I've been following this thread and you report seeing slow but steady progress. I can't remember, did they change antibiotics? Did they send a culture of the wound? Another good thing to check might be the trend in wbc count in his bloodwork. But I know the costs are just piling up.

 

[stevesmum]

are you still using the honey?

 

[Rayen]

The vet did change the antibiotic this time around. It says sulfatrim suspension 1ml every 12 hours on the label. As far as I know, they didn't send out a culture. I didn't pay for one and they never suggested it. I really miss my regular cat/dog vet! They can do cultures right there so they always just do them.

I'm not using honey right now, the vet mentioned a weird smell coming from the wound and I wanted to see if it was from the honey or not. So far I'm pretty sure it was just a honey smell, I know what smell she was talking about and it hasn't come back since I've stopped using it.

 

[Rayen]

I'm so mad. I don't know what I'm doing wrong but the last two bandage changes I've done have slipped and ripped some tissue off and now it looks worse again. I just feel like nothing I'm doing even matters anymore. I'm sure that the vet is going to see it and tell me that there's nothing else we can do to heal it. I don't get why I've been able to do them fine for the last few weeks but suddenly when it really does matter I'm apparently useless.

 

[MessiTheLop]

I don't speak English well . So I can't tell my story about Messi's abscess on his chin . But I recommend you to search about bicillin treatment . In here , Antalya / Turkey , is so hard to find a vet familiar to pet rabbits . Mine on the other hand worked on some rabbits before , so he is okay . When Messi had abscess vet gave him some medicine and it didn't work . His abscess got bigger in a short time . I went to a different vet , my vet's teacher from university , and Messi had a surgery . I literally had to push his food into his mouth to feed him . I wrapped him with a towel so he couldn't resist , move and it was taking more than an hour to feed him .. It went okay and the wound healed ....than in a month i found a lump on his chin , again . Then I began to search, with my poor English, everything about the abscesses on rabbits and then I've discovered bicillin treatment . I talked to my vet and insisted on that treatment . He agreed to that in the end and we're on treatment now . Here are some pages ..
http://people.umass.edu/~jwmoore/bicillin/bicillin.htm
http://www.bio.miami.edu/hare/jawabscess.html
I hope you'll get thorough this .

 

[pani]

Oh my gosh, that looks so sore - poor Quinn. I'm not a vet and have no medical training so I'm afraid I can't really provide any assistance, but I just wanted to say how dedicated you are to him and you've done such a great job. :rainbow:

 

[JBun]

Honestly, that looks completely different than I expected. I really don't have experience dealing with a wound that is affected to this extent in rabbits, but I do in horses. And I know that in horses when the granulation tissue starts to overgrow past where it would be even with the normal skin layer like your rabbits has, steps need to be taken to fix any overgrowth of tissue, before the layer of skin can start to grow over it and the wound completely heal. In horses, a steroid cream can help prevent the overgrowth of granulation tissue. But before that, any overgrown tissue needs to be cut back to be even with the skin layer. You can google 'granulation tissue and proud flesh in horses' and that will give you a better idea of what is going on with your rabbits wound and how it is treated when it occurs with horses.

From your description it sounds like your rabbit is doing just fine, and the wound has actually filled in and is healing and may not even have any infection present anymore, but is just 'overhealing' with granulation tissue which needs to be stopped. I see no reason that your rabbit would need to be pts or even need an amputation, if the wound is dealt with properly by your vet. Your vet just needs to get a handle on the overgrowth of granulation tissue is all, and that may be easily accomplished with trimming away the overgrown tissue while your bun is sedated, and keeping a steroid cream on it to keep it from overgrowing again. Though your vet will need to make sure that using a steroid cream is the right treatment to use on a rabbit with this issue.

It may help for you to have your vet consult with a rabbit specialist in order to get the best info on how to proceed next with this type of wound problem. I don't know if you have any really good specialists in Canada or not. I don't even really know who are specialists here in the US. But I do know that the UK has some excellent rabbit specialists. Frances Harcourt Brown, Molly Varga, Iain Cope, John Chitty, Mark Rowland, just to name a few. If you can get a consult with FHB, she is one of the best rabbit specialists there are. But she is semi retired so you would need to find out if she is available for consult or not. It will cost you a consult fee, but if it means this doesn't keep dragging out and you get the needed info to get this wound healed, it will probably be worth it. You will need to have your vet contact the specialist though.
http://www.crablanevets.co.uk/

 

[Rayen]

From your description it sounds like your rabbit is doing just fine, and the wound has actually filled in and is healing and may not even have any infection present anymore, but is just 'overhealing' with granulation tissue which needs to be stopped. I see no reason that your rabbit would need to be pts or even need an amputation, if the wound is dealt with properly by your vet. Your vet just needs to get a handle on the overgrowth of granulation tissue is all, and that may be easily accomplished with trimming away the overgrown tissue while your bun is sedated, and keeping a steroid cream on it to keep it from overgrowing again. Though your vet will need to make sure that using a steroid cream is the right treatment to use on a rabbit with this issue.

I'm really glad you keep responding to this because I was honestly at the point where I was just ready for the bad news when I go back to the vet.

I really haven't seen anything infection-y since I started cleaning it, it's just that tissue that constantly keeps coming back. Even now, especially because of my stupid mistakes with bandaging, a lot of tissue has grown again.

I really wish vets would tell me more about this stuff. I really didn't know that I needed to have that stuff scraped off more often or that there was some special kind of treatment to try and stop it or how often I really needed to change this bandage. I'll admit it did seem weird that they were keeping it on that long, but I mean, they were a vet! I figured they knew what they were talking about.

This is my first time dealing with this extent of a wound, especially in rabbits. Quinn and Briar are my first rabbits and they have been almost perfectly healthy until just recently (thankfully Briar is still pretty healthy, despite being in desperate need of a diet. Quinn just eats so much better with her around, but she eats like 10 times more than him! Ugh). Cats and dogs are so easy to deal with wounds. I've never had to deal with a wound for over two months before!

I'll ask about the steroids when I go back. I hope they can be used for his wound. I feel like a monster, he's so alert and active that putting him to sleep feels like I'm just killing him for no good reason. It's so hard when a vet is telling me that the only thing they can do is amputation when I just see him having so much trouble when he tries to support himself with one leg bandaged already.

 

[squidpop]

I know manuka honey was mentioned earlier. I think it would be really good to use the medical grade manuka honey that diabetics use on wounds that won't heal, I know its expensive but I've read really good things about it.

 

[Rayen]

This will probably be my last post in this thread unless something dramatic happens in the next little while.

I talked it over with the vet and she just does not think this is going to heal. I asked about the steroids and she said that she had never heard of them being used for rabbits and that the way she had always dealt with the proud flesh in horses was to just keep scraping it away until the wound healed. She said that because of how much tissue they had already scraped off that that wasn't feasible for Quinn since there wasn't much left.

I'm not sure how much longer I'm going to keep at this. In all honesty, I really need to get my own life back and force feeding and medicating and cleaning the bandage has left me with little of my own time for the last few months. I love Quinn and I hate that this is how it all went but I think I will have to have him put to sleep soon.

For sure I'm going to give him at least two more weeks. My birthday is next week and I don't really want to kill my pet then and he's just so alert that it's killing me to even think about it in the first place. I hope I can at least give him a few more good weeks.

Thanks to everyone who chimed in with helpful advice. I'm sorry that this wasn't a happy ending, but I did try my best.