Osteomyelitis ??? Facial Abscess

[Pugish]

Perky ...a black female Flemish... 1 yr old..not sure on weight but certainly not under or over...

Poo's and pee ...normal
eating very well anything and everything offered..greens...carrots...pellets ...no signs of tooth problems...at last vet check 4mths ago her teeth were great.

Moves around just fine ... runs and jumps and looks very happy

Just wanted your opinion about a lump I noticed last night on our rabbit Perky's upper right side of her jaw... it's hard like bone and doesn't move and I missed it's growth till now since she's not a cuddly girl..and it's the size of a large marble now!! I've done a google and only thing I've come across that sounds like it is Osteomyelitis ... if it is what should I expect when I take her to the Vets??

Thanks so much,
Sharon

 

[Maureen Las]

It sounds like an abscess which could have attached to the jaw and may or may not be the result of gum or dental issues. These are very common in rabbits.

Before you go to a vet make sure that you seek out a vet who is very rabbit knowledgeable ; jaw abscesses can be treated successfully if the vet knowwhat to do

Probably one of the first things a good vet will do is take dental x-rays , making sure to examine all the teeth and roots of the teeth to see if there is any abscessed teeth. he will also want to know if the abscess has actually attached to the jaw
One of our mods, Randy, has guided us through his protocol for abscesses ..as he has treated many of them both as a rehabber and the owner of a rabbit rescue . he works closely with cutting edge exotics vets.

Randy believes that if you get the right combination of antibiotics that you can treat an abscess without surgery. usually he will use a combination of stronger antibiotics ;. he will use bicillin injections and an oral med like zithromax for an extended period of time .

Many vets do not treat this way and will want to do surgery and use an over used drug like baytril; in these cases the bacteria are not really attacked and even if there is some initial improvement the abscess will often return with a vengenace.

usually there are anareobic bacteria deep within the core of the abscess that are difficult for mostantibiotics to reach . rabbits wall off infections and because of thatinfections are more difficult to treat. That is why it is so important to treat with the right drugs.

Hopefully Randy will add more to this ; he often is available to talk to the vets of forum members if the vet is willing.

If you give us your location we can give you a list of rabbit savvy vets

 

[tonyshuman]

I would hope it is an abscess as angieluv said instead of osteomyelitis. Once the infection is in the bone, there is no other option but to remove the bone. Check our library article on how to treat abscesses with bicillin
http://rabbitsonline.net/view_topic.php?id=11791&forum_id=10

Rabbit abscesses can be very hard so it may just be an abscess. I agree that x-rays need to be taken and an injectible antibiotic treatment is best if there is no tooth decay.

 

[Pugish]

Thanks guys...my fingers are crossed for her as she really is a huge part of our family.
We are in Auckland, New Zealand and good rabbit vets are hard to come by! But will defiantly have a look for a vet with Rabbit knowledge esp since our usual vet isn't that keen on rabbits esp ones that don't like being forced to sit still while being examined LOL
I will also request that she get the bicillin... ))

Thanks again guys... you put a little ease to the mind...esp after reading most people on the net saying it's almost fruitless to try and treat abscesses and slimmer hope treating the osteomyelits!

Sharon

 

[Maureen Las]

http://www.rabbitsonline.net/view_topic.php?id=15530&forum_id=9


If you cannot get bicillin which is a combination of procaine G penicillin and benzathine G penicillin

you probably can get procaine g penicillin and give it daily rather than every other day because it is the short acting kind. It HAS to be given by subqutaneous injection and not by mouth. if it is given by mouth it will kill the rabbit.

believe it or not in the US we can buy this kind of penicillin in farm stores over the counter because it is sold to farmers for livestock but is exactly the type that rabbits need.

See what you can find in the vet section and keep us up-dated

 

[Pugish]

I will... I'm going to spend this morning finding a vet and booking her in today... she's not showing any outward signs of being ill yet so I think we have that on our side.

It's all a bit scary as our last bunny Bubbles had a abscess down near his balls.. his was nice and open so was fairly easy to deal with and healed up beautifully but it was a long road with syringe feeding and watering. He died about 4 months later when his teeth went very bad...

Sharon

 

[Pugish]

Well found a vet through another topic on here ... he was close and had an opening this morning... took her in and it's where she is for the day as he needs to put her under to examine the lump better...told him if it was a tooth to pull at the same time and hopefully he'll lance and clean that abscess as well while he's at it... I think it would be better to do it all while she's already under than have to take her back and get it done later???

 

[Maureen Las]

We'll hope for the best ray:
be sure to stress to him the need for strong antibiotics to keep the abscess from reoccuring if he does take it out.

 

[tonyshuman]

Yes. I hope they do a dental x-ray while she's under. Lancing and flushing the abscess is not always the best route, as a systemic antibiotic is better at treating the infection. If your vet thinks it's best to do, of course listen to them, but make sure a strong systemic antibiotic (not baytril) is prescribed.

 

[Pugish]

Thank you I will... when I asked him this morning he said it would have to be removed... Hoping he actually know what he's doing... the ph is with me where ever I go waiting for the ph call!

 

[Pugish]

Okay we just got her home... she's still very groggy but I'm sure she is happy to be home! The cut is huge he has removed all the nasty stuff and said he had difficulties removing the sack but thinks he got it all... said it was very close to the nasal bone but not on it.. he's stitched and put in a drain ... he has given baytril which is to administered orally ... I did ask him about the bicillin but didn't say much .. I'm a little worried as you guys have said not to get baytril unfortunately I didn't have a great deal of choice and I couldn't argue the fact as I don't know what the difference is between the two drugs... so I guess I should ask and should have asked before but was so worried and not really thinking!!

Sharon

 

[tonyshuman]

Well, baytril is a common "catch-all" antibiotic that they give to animals. The problem is that most bacteria are resistant to it. Also, it is administered orally, which means that it has to be absorbed through the GI tract, which really cuts down on its potency. Bicillin is a combination of penicillin G benzathine and penicillin G procaine that is ONLY administed via injection. This antibiotic itself is stronger and can kill more bacteria than Baytril, and the fact that it's injected makes it more potent in the body (rather than GI absorption).

Here is our article on Abscesses from the library. Bicillin is really good and can frequently be found at farm stores (at least in the US) so it's popular around here.

I'll pm our member who's very experienced in abscess care to call his attention to this thread. He won't be terribly happy that the vet opened the abscess, but that was not something you could change--the vet is the vet and you couldn't argue about that.

Did she get a dental x-ray to make sure there is no underlying tooth or tooth root problem?

 

[Maureen Las]

If it comes to this you can buy , learn to and give bicillin to him yourself..

 

[Pugish]

I don't think he did get an xray ... sounds like he just did an examination while under and said the abscess wasn't from the teeth...He also said he'd treated a few abscesses in rabbits and they have healed up wonderfully but he usually removes a good chunk around the abscess to make sure he has everything ...but seeing how Perky's abscess was under her nostril (right side of upper jaw front) he couldn't remove the chunk he would have liked too... I'm not sure what kind of vet he is but I guess time will tell!

Sharon

 

[Pugish]

Oh thanks too for the explanation on the differences between those too drugs... I'm not sure if we get the bicillin here as when I mentioned it nothing was said...

 

[Flashy]

I hope Perky makes a speedy recovery

If you can put at least your country in your profile it will enable people to give you more location specific advice because things vary from country to country.

Please keep us updated

 

[tonyshuman]

Oh ok. It sounds like the vet probably got the whole thing, plus some tissue around it. This is probably better than what most vets do here, which is cut open the abscess, wash it out, and drain it, but leave the tissue there. Removing the whole abscess is probably much better than just lancing it open. It probably also allowed him to be more sure it wasn't due to tooth issues.

 

[ra7751]

Hi,

Wow....I really wish these vets would get some updated education on treating abscesses in rabbits. Way too quick to cut. Not always the best treatment option. I have never opened an abscess and would be horrified if a "drain" were installed. With the viscosity of pus in a rabbit....I doubt there will be much draining....much more of a new orifice for infection to enter. There are much more modern methods that are much less invasive and generally more effective. Having said that.....I am not totally dismissing the possibility of opening an abscess if the situation warranted....I just haven't been there with the numerous abscesses I have treated.

But now that you are in this position....Baytril should not be a drug that is considered in this situation. It does not have the punch to deal with this type of infection. And when given orally, it can lead to other concerns. Baytril has fallen from favor from most vets....even for use in it's intended species....dogs. Not a one of my vets use Baytril any longer. Old school and ineffective in today's world. While I understand the terminology, antibiotics aren't "stronger" or whatever....they are "targeted". And if I were to label Baytril with a strength level....it would be "weak".

I generally treat abscesses with a combination of Penicillin and Zithromax. I don't know if this version of Pen is available there....I use a specific combination of Procaine (150K units)and Benzathine (150K units). Zithromax is a human drug that is very effective when used in combination with the Pen.

I hope I overlooked this....but is this rabbit on NARCOTICS? In this case, I would have no problem combining a narcotic and NSAID together. And there is a huge amount of husbandry protocol to support this type of invasive surgery. And were any teeth removed? Many vets are so inexperienced at working rabbit dentals that they don't fully understand the impact of those long roots and how those that are impacted can result in an abscessorthey "forget" that if a tooth is removed, the opposing tooth should be extracted also. If it isn't, there will be more surgery in about a month or so.

Based on my non-professional experience, it seems you are at the point ofhaving to make the best out of an undesirable situation. I would suggest getting much more aggressive with the antibiotics (which I want to make sure this is clear....penicillin and related drugs such as cephalosporins are safe only as injectables)and make sure your rabbit is on mega pain meds. Be prepared for a long recovery with lots of extra hands on work. I would have this rabbit on supplemental (SQ or IV) fluids as well as a very nutritional feeding program.

Rabbits have recovered from situations like this and I hope this has a happy resolution. But in the real world....there are much less invasive methods of treatment. I hope Perky does well...we have several Flemish including a black female named Beyonce.

Randy

 

[Pugish]

Sorry Flashy... it's in there now ))

 

[Pugish]

Yes thats what our other vet did with our last bunny... and was basicly left to us to clean it out several times a day.
It is nice knowing that the abscess in Perky has been removed completly ..fingers crossed it heals nicely and quickly I think with her being only a year thats on her side as well as we got it dealt with before she showed signs of sickness.

Yes Randy I wish we did have as many options as you guys over there have when it comes to bunnies and certainly having non surgical options would have been nicer ...I certainly don't like seeing her with that huge cut and being mopey! I'm not sure about those or other drugs as this vet wasn't very forthcoming with any info about them. She didn't have any teeth removed ... I have to ask what you meant by "is she on any NARCOTICS" she's only on that baytril at 0.25mls x 2 a day.

She is only nibbling at her food today but thats understandable and she drinking well... has had some bursts of energy and is quite happy to ignore us as we are the bad people at present!

I would put up a pic but am unsure of how to on here! I will have a play and see if I can figure it out ...