Pus infection / Swollen Toe (merged)

[tofuhead]

Hello I'm new to this forum. I searched themessageboard if anyone has previously posted about this issue and itappears it hasnt been discussed. If it has I do apologize for repeatingit.

My dearest chechi who is an opal mini rex(2 years old) has a swollentoe that is infected with pus. Vet says it might be broken.She was rough housing with the new bunny over territorial status. I'mpretty sure thats what happened. Due to my limited student funds Icouldn't afford the full assessment at the clinic which is an xray andculture test to find out whats up. So she recommended to take the nailout and flush the infected area for an extra $100. I thoughtgreat okay. Vet says they couldn't pull out the entire toenail and sheisn't sure if the remaining piece left is her actual toe bone or thebottom part of her nail(doesn't know because we didn't take thexray). Chechi is without a toe nail and is on antibiotics(bactrim) and pain meds. She expresses her pain (i dont knowwhat level of pain) by grunting a lot if i approach her. she still eatsbut prefers to be alone hidden somewhere in the house. Nowi'm really concerned because the vet has said she can lose her toenow. To amputate her toe will cost me $1000. WhichI can't afford. I was hoping to hear some advice fromexperienced rabbit owners as to what I can do for the time being sinceI don't have the money (i can obtain a $1000 in a month and a half fromworking). And what do you think of the way chechi was treatedat the clinic because I have no clue. My plan is once I getmy paycheck in two weeks I'm going to see the vet again. For now Idread every day that I'm making this worse with my inability to pay andsometimes i fear that she might die which may or may not be thecase. Rabbits seem to be fickle delicate creatures in termsof care compared to dogs and cats so I feel helpless andlost. Any thoughts, opinions?

 

[bbgrl20]

Did you ask if they had a payment plan? They mayallow you to pay for treatment in installments? I know at my animalhospital we offer something called care credit, maybe they havesomething similar.

Hope chechi is doing better, he'll be in our prayers

ray:ray:

 

[naturestee]

If there's pus I'd be worried about an abscess,which would need immediate treatment. They tend to spread,although hopefully the oral antibiotic will prevent that.Sometimes that's all they need, but surgery or injected penicillin isusually prefered because they work more directly on the infection.

Can you use Care Credit? It's a credit card for vetexpenses. If you pay it back on their plan they don't chargeyou any interest.
http://www.carecredit.com/

Some vets will also allow you to pay them back in installments so itwould be a good idea to call the vet and ask. Also, checkhere for more ideas on paying vet bills:
http://rabbitsonline.net/view_topic.php?id=12684&forum_id=10

 

[tofuhead]

Has anybody had any experience with infectionswith pus in it? Does the pus ever go away with the help withantibiotics or is the only way to remove it successfully is to performsurgery? can a pus infected area spread? my chechi is on bactrim liquidand has a swollen toe with semi hard pus. it has not softened within 2weeks.

 

[Pipp]

So sorry I didn't see this sooner. (Only just now saw your other post as well).

There's a tonof info on abscesses here in the RO ResourceCenter, it really would be a better bet just to read through it,there's a lot to explain.

http://rabbitsonline.net/view_topic.php?id=11791&forum_id=10

As I'm sure you know by now,rabbit pus is thick and hard,like cottage cheese, and wounds sometimes can bedrained andwashed (sometimes with beads implanted), but just as often the entireabscess must be surgically removed. The problem withabscesses is they can have tentacles that reach beyond the infectedarea, so sometimes even this is a problem.

I'm surprised the prices quoted by the vet are as high as theyare. Just to make sure you have a vet that really knows aboutrabbits and abscesses and is reasonably priced, I'd check with theOntario Rabbit Education Organization, one of the best articles is ontheirsite, written by a vet in Scarborough.

http://www.ontariorabbits.org/health/healthinfo1.1.htm

However, also check with any other bunny rescue places tomake sure you're dealing with a good price as well as a good vet --second opinions are always worthwhile. Unfortunately I seeour vet listings for Ontario haven't been done yet, although there aresome member recomendations here:

http://rabbitsonline.net/view_topic.php?id=12548&forum_id=9

There's also a ton of listings on the OREO site, here:

http://www.ontariorabbits.org/health/healthvets.htm

Continuous drainings and washings and the culture and sensitivitytesting to determine the best antibiotic may end up costing the same asthe surgery.

Abcesses in rabbits are really serious, if the current course oftreatment isn't working by now, best to move on to the next step asap.

Hope she's okay. Please let us know how she'sdoing.


sas

 

[tofuhead]

It looks like I have no choice but to agree tothe surgery. Thank you for replying to my post it seriously gave mesome idea about the reality of chechi's situation which iscomforting. Now I know what to do. It will take me two monthsto come up with the money. But i am trying alternatives topayment. I'm a student and I live alone. But I am determinedto be resourceful about this and not give up on my Chechi!

 

[naturestee]

Did you have a chance to look through myresponse to your other thread? I included some links on waysto afford vet care. You might be able to find a program thatcan help you. And I definately agree with contacting OREO tomake sure the vet is rabbit-savvy and to see if they have any other vetrecommendations in your area.
http://rabbitsonline.net/view_topic.php?id=15780&forum_id=16

Just so you know, I did take care of one rabbit (temporarily) whodeveloped a large abscess on her neck. My vet wanted toremove it surgically but I only had her for two weeks and then she wascontinuing on her cross-country trip to a new owner so surgery was abad idea. He drained it and prescribed oralantibiotics. It healed nicely and never came back.However, she had been rescued from a horrible place that had probablyworn down her immune system and her improved care might have had a lotto do with helping her heal.

 

[Pipp]

I'd still get a second opinion (and a cheapervet). I haven't been able to find out much about toe surgeryand foot abscesses.



sas et al

 

[tofuhead]

Thank you for the replies.



Yes i'm going to get a second opinion next Friday. I tookthenecessary attempts to try and make thepayments.I called the local shelter which is the TorontoHumane society and my current vet for payment alternatives. There isnone. Just payment in full and that's it. So for now I'm selling thegoods that I have. Like electronics. And I'm searching for a job thatpays more per hour. I hope for the best.

 

[Pipp]

Please let us know how the appointment goes.

I wish I could be more help.



sas

 

[m.e.]

I'm so sorry you(and your bunny) are going through this. Best of luck, and lots ofprayers for the both of you ray:

:hug2

 

[Pipp]

Okay,I've been askingaround,I didn't get any feedback about infected toes, so Istarted asking around a few different placesabout the priceestimate and finally got some replies.

The first one is aresponsefrom Pamela Alley, who'sa veteranbreeder, respected association head,etc... These are excerpts from severalemails:

"Depending on where the infection is on the toe, $1000 is a bitsteep! The free portion of the toe is easily removed (underanaesthesia, of course!) by retracting healthy skin and simply nippingthe bone at the base of thephalange, either at the joint ormid-shaft. The skin is then glued or sutured over the area and healingis very fast.

If you're talking further into the foot, then it becomes somewhat more
complicated, and the extent of infection makes a huge difference.

But considering that a full leg amputation isn't that expensive, it makes me think that someone is padding their pockets.


"Keep in mind that prices are going to vary considerably from placeto place, but a thousand bucks for a toe? Still seems awfullyhigh, even if you did histopath and C&S on it."

Rabbit infections, especially in the foot, aresome of the very most difficult things to fix and KEEPfixed.... (Note the discussion before this sentencewas about sore hocks)

Back to anatomy...fungus is often the cause ofchronically scaled, swollen nailbeds...it doesn't often become infectedper se. But when it does, the nail can loosen and actuallypull out complete with bone. Really gross, but with goodwound cleaning and treatment heals pretty quickly.

Further down the foot, abscesses tend to occuralong the side of the pads and between the toes (front feet,mostly). The callus areas can often have some quitesignificant 'zits'--hardened oil plugs which can lead into abscessesdeeper in the foot--removal of these plugs can release quite a bit ofpus without having to lance greater areas of the foot, and systemicantibiotics can do the rest...


Here's someof the other responses I got mostly relating toprices: (Again, all these responses are US pricing, althoughnot much difference in the dollar these days)...

"Our rabbit had an abscess in his shoulder that got into his muscles
and tendons and we were told it was a complicated surgery. It cost
about $600. She did well after the surgery with a lot of TLC "

And...

I have never had rabbits with abscesses, so can't speak directly to
this situation. BUT one of my rabbits had an eye enucleation (removal) and
that cost about $300.

Hope she's okay. And I hope this helps.



sas

 

[Pipp]

PS: I just merged the previous topic with this one, hope that's okay.

 

[pamnock]

tofuhead wrote:

Has anybody had any experience with infections with pus init? Does the pus ever go away with the help with antibioticsor is the only way to remove it successfully is to perform surgery? cana pus infected area spread? my chechi is on bactrim liquid and has aswollen toe with semi hard pus. it has not softened within 2weeks.

Has the vet lanced it open? Rabbit abscesses have a tendencyto encapsulate and become hard. I had a buck with a largeabscess - we lanced it, flushed it with Penn G, and it completelyhealed. I do recommend the oral antibiotics also though.

Pam

 

[Pipp]

How's Chechi?

I've got a lot more info for you, just haven't had a chance to post it. Stay tooned!!

(Sent you a PM too)

sas

 

[tofuhead]

Pipp wrote:

Okay,I've been asking around,I didn'tget any feedback about infected toes, so I started asking around a fewdifferent placesabout the price estimate and finally got somereplies.

The first one is aresponsefrom Pamela Alley, who'sa veteranbreeder, respected association head,etc... These are excerpts from severalemails:

"Depending on where the infection is on the toe, $1000 is a bitsteep! The free portion of the toe is easily removed (underanaesthesia, of course!) by retracting healthy skin and simply nippingthe bone at the base of thephalange, either at the joint ormid-shaft. The skin is then glued or sutured over the area and healingis very fast.

If you're talking further into the foot, then it becomes somewhat more
complicated, and the extent of infection makes a huge difference.

But considering that a full leg amputation isn't that expensive, it makes me think that someone is padding their pockets.


"Keep in mind that prices are going to vary considerably from placeto place, but a thousand bucks for a toe? Still seems awfullyhigh, even if you did histopath and C&S on it."

Rabbit infections, especially in the foot, aresome of the very most difficult things to fix and KEEPfixed.... (Note the discussion before this sentencewas about sore hocks)

Back to anatomy...fungus is often the cause ofchronically scaled, swollen nailbeds...it doesn't often become infectedper se. But when it does, the nail can loosen and actuallypull out complete with bone. Really gross, but with goodwound cleaning and treatment heals pretty quickly.

Further down the foot, abscesses tend to occuralong the side of the pads and between the toes (front feet,mostly). The callus areas can often have some quitesignificant 'zits'--hardened oil plugs which can lead into abscessesdeeper in the foot--removal of these plugs can release quite a bit ofpus without having to lance greater areas of the foot, and systemicantibiotics can do the rest...


Here's someof the other responses I got mostly relating toprices: (Again, all these responses are US pricing, althoughnot much difference in the dollar these days)...

"Our rabbit had an abscess in his shoulder that got into his muscles
and tendons and we were told it was a complicated surgery. It cost
about $600. She did well after the surgery with a lot of TLC "

And...

I have never had rabbits with abscesses, so can't speak directly to
this situation. BUT one of my rabbits had an eye enucleation (removal) and
that cost about $300.

Hope she's okay. And I hope this helps.



sas

Pipp your help on this is amazing! I'm blown away by your kindness. Truely!

I thought it to be quite expensive. I am guessing the clinic needs themoney or Canadian vet clinics operate differently from American. Idon't know. I really don't know.

I suppose she was trying to initially cut off the nail from the boneand flush the infected area out but she said she couldn't because itwould seem too painful to pull the nail out completely. Soall she has is a clipped nail at the root and still a swollen toe whichcost me $240. She is still on bactrim liquid(antibiotics) and herappointment is on this Friday with another vet. We will see what thenew vet says and what we are going to do.

 

[Pipp]

Here's a further response from Pamela Alley, amajor breeder,after I sent her the original post...(I think she was talking about oral PennG, notflushing it, as per Pam Nock)

......

Well...in the past I've seen toes like what isdescribed taken off with something as simple as a local anaesthetic anda pair of sterilized nail clippers, with no illeffects.

Frankly, were this my rabbit, that's probablywhat I'd do. If, of course, a round of antibiotics (bicillin,not Pen G) didn't do the trick.

As for removing the nail and not being sure whatwas left--not unusual. But if the nail was removable, what'sleft is often just the nailbed. Losing the toe is not a majorproblem; they have more. The key is keeping the infectionout of the rest of the foot!

The grunting may be just that the rabbit is madas aitch-ee-double toothpicks rather than pain...or just that she hasan opinion and wants to share!

Broken toes are not unusual and may be easilydetected by turning the rabbit over and pressing gently on the pad andtoes. If the foot/toes resist, they're usuallyintact. Broken ones can easily be moved out of line and movemuch more freely than the others. They do not need to beremoved unless the break is compound or infected.
.
I'd say switch vets. A thousand bucks? Not hardly.



I also got an email from somebody in Florida whohad their bunny's whole leg amputated for $300.

Hopefully the oral antibiotics is keeping theinfection at bay, but I think at this point what has to be done ratherthan saving up for a potenial surgery is to get enough togetherASAP for another exam, and/or a C&Stestand/or an xray -- whatever it takes to determine thespread of the infection. It may be easier to deal with thanyou think!

Please let us know how she's doing! .

sas

 

[Pipp]

I'm in Vancouver,and that price iscertainly not the norm. I think my vet bill for a full set ofxrays, C&S test, amputating the nail bed (if not the toe),cleaning out the wound, giving her a shot and the meds would have beenin the $250, $275 range.

sas

 

[tofuhead]

I see I see. Maybe it's how the vets in downtownToronto operate.I will keep you guys posted on this after theappointment on Friday.

 

[naturestee]

I suppose she was trying to initially cut offthe nail from the bone and flush the infected area out but she said shecouldn't because it would seem too painful to pull the nail outcompletely. So all she has is a clipped nail at the root andstill a swollen toe which cost me $240. She is still on bactrimliquid(antibiotics) and her appointment is on this Friday with anothervet. We will see what the new vet says and what we are going to do.

Did this include xrays or anything? If not, I'd say thisvet is taking you for a ride! I hope the other vet isbetter. Have you checked out any of these vets?
http://rabbitsonline.net/view_topic.php?id=12548&forum_id=9