Penecillin abscess treatment advice.

[Bon]

Well my pride and joy gizmo is starting a Penecillin treatment to treat a large (long but flat) abscess thats formed on her jaw, standard surgical removal was impossible due to the length that it extended so they lanced it instead, after giving it some quite agressive treatment it wasn't getting any better so I looked up treatment (how I found this site) with penecillin.

I gave her first injection yesterday and she is still eating and happy as ever (although a little disgruntled that Im poking her with sharp pointy objects!)

Today the injection didn't go as well, she wriggled at little as I started to inject in and a little of the Pencame down the side of her coat, although im pretty sure most of it went in.





Anyways, I was just wondering if anyones had this treatment before, being in the UK Bicillin is actualy not an authorised treatment so were just going with daily injections of Pen-G, so anyone got any idea of successfully beating the abscess with daily Pen-G rather than every other day with Bicillin?



Thanks

Bon

 

[Maureen Las]

I would think that the penicillin could be used instead but I am going to track down the expert on this ..

and hopefully he will post later

 

[Bon]

angieluv wrote:

I would think that the penicillin could be used instead but I am going to track down the expert on this ..

and hopefully he will post later

That would be great, from my understanding the Bicillin formulation baisicly just keeps the penecillin in it longer in the body, so by doing daily injections hopefully we can achieve the same effect.

 

[Maureen Las]

There are other injectable penicillins other than Pen G procaine and Penicllin G benzathine

I would like to find out if there are any differences in these 2 pencillinsother than that one is longer acting than the other. I am also wondering if there is a synergistic effect between the 2 that makes "bicillin" more effective than one or the other alone.
Working on that right now.

 

[Bon]

angieluv wrote:

There are other injectable penicillins other than Pen G procaine and Penicllin G benzathine

I would like to find out if there are any differences in these 2 pencillinsother than that one is longer acting than the other. I am also wondering if there is a synergistic effect between the 2 that makes "bicillin" more effective than one or the other alone.
Working on that right now.

Thankyou for taking the time.



Please note, aswell as looking for other treatments, in the UK the drugs must be approved by the VMD.



http://www.vmd.gov.uk/



As I previously said Bicillin I believe is Pen G procaine and Penicllin G benzathine
50/50 and the Penicllin G benzathine is metabalised into Pen G procaine which takes causes it to stay in the body for longer, however any info you could find would be great!

 

[Maureen Las]

Procaine Penicillin Gcreates higher serum levels for a short duration
Benzathine Penicillin G creates a lower serum level for a longer period of time
I think that you 're giving the procaine?

Someone else will have to go from here as I'm not a pharmacist ............

I do know that some individuals in the UK have have had success using azithromycin orally in the treatment of abscesses

 

[Bon]

Yep shes on an injection of Procaine a day.

 

[ra7751]

Hi Bon,

Gizmo already has a special place for me as we once had a very unique chinchilla named Gizmo and he was quite a character.

I don't know how things are in the UK...but here in the US there is a lot of confusion about "bicillin". As you already obviously known, the "bi" means two drugs in one. The problem in treating mandibular abscesses, or any other abscess in a rabbit, is for the drug to penetrate the thick pus and reach the core of the abscess. The core usually contains anaerobic bacteria that are difficult to treat. I have treated many abscesses non-surgically. I am not saying I would never do surgery on one, but I haven't up to this point. The confusion here in the US is over all the different concentrations and brand names. Regardless of what name is on the bottle, the version of drug that is most effective with rabbits contains 150K units of Procaine per mLand 150K units of Benzathine per mLfor a total concentration on 300K units per mL.This should be clearly noted on the labeling of the drug. The Procaine is a fast strike drug and the Benzathine is more of a "mop up" drug that takes longer to reach working levels but also stays in the system much longer. Most vets, still very leery of using penicillin in a rabbit, will only dose once a week. I have traditionally dosed every other day. But, I have been having great success in wild rabbits (and internally wild and domestic rabbits are the same) in dosing the Penicillin once a day for 3 days and then every other day after that. That seems to get the blood levels up to where they need to be quickly and the every other day will sustain them. A side effect from every day injections is that some rabbits will develop sterile skin abscesses near the injection points. If you want more "bang"....use Zithromax and Penicillin at the same time. This combination is awesome in dealing with abscesses....and it has never failed me. It is essential that proper dosing be followed on both drugs. If your vet is not familiar with this protocol, I can help them out with formulas and dosing.

There is also some tag along treatments that should be done. The fever caused by the infection can help dehydrate...so I offer fluids, usually LRS, to help with hydration and replace lost electrolytes. Pain meds, aggressive pain meds, should be the order of the day. I usually give up to 4 days of Metacam or some other anti-inflammatory (watch forand maintain proper hydration while on NSAIDs). Narcotics are good especially at first....I have excellent results from Buprenex (Burpenorphine) but Tramadol is acceptable.

Treating an abscess is a package deal...there are lots of side jobs to deal with other than directly with the abscess. Your rabbit's immune system will be stressed in dealing with the abscess....so work hard to provide a comfortable environment to support a strong immune system....but be on the watch for opportunistic infections especially in the ears and urinary tract.

I have seen this often and have worked hard to find an aggressive and effective treatment for these nasties. Don't hesitate to ask questions. Good luck.

Randy

 

[Maureen Las]

Hi Randy ,
Bon only has access to pen G and cannot get bicillin in the UK. Sheis treating with one injection a day of pen G procaine and wondered whether that would be effective.

 

[Bon]

ra7751 wrote:

Hi Bon,

Gizmo already has a special place for me as we once had a very unique chinchilla named Gizmo and he was quite a character.

I don't know how things are in the UK...but here in the US there is a lot of confusion about "bicillin". As you already obviously known, the "bi" means two drugs in one. The problem in treating mandibular abscesses, or any other abscess in a rabbit, is for the drug to penetrate the thick pus and reach the core of the abscess. The core usually contains anaerobic bacteria that are difficult to treat. I have treated many abscesses non-surgically. I am not saying I would never do surgery on one, but I haven't up to this point. The confusion here in the US is over all the different concentrations and brand names. Regardless of what name is on the bottle, the version of drug that is most effective with rabbits contains 150K units of Procaine per mLand 150K units of Benzathine per mLfor a total concentration on 300K units per mL.This should be clearly noted on the labeling of the drug. The Procaine is a fast strike drug and the Benzathine is more of a "mop up" drug that takes longer to reach working levels but also stays in the system much longer. Most vets, still very leery of using penicillin in a rabbit, will only dose once a week. I have traditionally dosed every other day. But, I have been having great success in wild rabbits (and internally wild and domestic rabbits are the same) in dosing the Penicillin once a day for 3 days and then every other day after that. That seems to get the blood levels up to where they need to be quickly and the every other day will sustain them. A side effect from every day injections is that some rabbits will develop sterile skin abscesses near the injection points. If you want more "bang"....use Zithromax and Penicillin at the same time. This combination is awesome in dealing with abscesses....and it has never failed me. It is essential that proper dosing be followed on both drugs. If your vet is not familiar with this protocol, I can help them out with formulas and dosing.

There is also some tag along treatments that should be done. The fever caused by the infection can help dehydrate...so I offer fluids, usually LRS, to help with hydration and replace lost electrolytes. Pain meds, aggressive pain meds, should be the order of the day. I usually give up to 4 days of Metacam or some other anti-inflammatory (watch forand maintain proper hydration while on NSAIDs). Narcotics are good especially at first....I have excellent results from Buprenex (Burpenorphine) but Tramadol is acceptable.

Treating an abscess is a package deal...there are lots of side jobs to deal with other than directly with the abscess. Your rabbit's immune system will be stressed in dealing with the abscess....so work hard to provide a comfortable environment to support a strong immune system....but be on the watch for opportunistic infections especially in the ears and urinary tract.

I have seen this often and have worked hard to find an aggressive and effective treatment for these nasties. Don't hesitate to ask questions. Good luck.

Randy

Hey there, thankyou for such a load of information, I will ask about using Zithromax when she goes for her check up.

Currently she is on 300k units of Pen-g procaine a day with probiotics in her water and an isotonic solution "force fed" (she willingly takes it from a syringe but doesnt seem to like the taste enough to have it on her own) every other day to keep her gut healthy.

She also has a lot of hay, food fresh and pellet available which she is eating willingly as well as whatever she eats in the day in the garden. She is drinking like normal and her droppings / toilet habbits haven't changed, as has her behaviour (apart from after the injections she likes to run into my room and throw stuff around and make a mess (a bit of a "screw you!" from her i guess )).

She isn't on any pain meds atm as she is in no obvious distress from all this and she hasn't showed any signs of distress at all durring her injections, and trust me when she don't like something she lets us know!!



Again thankyou for the info and if you could provide some calcuations for the Zithromax + Penecillin it would be great, her current weight is just over 5kg.



Many thanks

Bon

 

[ra7751]

I've been looking over the list of "authorised" drugs in the UK....I don't feel so bad about the US and the drugs here now. I think the Pen G you are using is probably the best option right now. Ask your vet about using the Zithromax...and if he.she is OK with it, I will PM you the dosing info (I am not a vet so giving dosing information is in a questionable area). A possible alternative is Convenia. It has just become available in the US but the effects of Cephalosporins are simiar to penicillin. There are a couple of other drugs on the list that can be used....with extreme caution and only under the close watch of your doctor. I will keep looking as I have time.

Randy

 

[Bon]

Well some good news, 4 days in and she seems to have picked up a bit, also the swelling on her face is obviously going down, hopefully this will keep going untill cured!

 

[Maureen Las]

that's great! hope it continues...

 

[Bon]

Bit of bad luck with todays injection, unknown to me when I put the needle in the skin had doubled upon the other side and the neddle was stuck in it (trust me when i say gizmo probably has enough skin to cover 3 rabbits!) so when I went to inject i got a nice facefull of penecillin myself! (doesnt taste too bad either )



Anyways second attempt went smoothly with 2 people helping to make sure the skin didnt double up again.



Most awkward rabbit ever i swear :biggrin2:Anyways looks like she'll be in for an earlier vet checkup this week as im now a needle short!