RIP GIZMO: WARNING: GRAPHIC PHOTOS!!!! (CLOSED)

[Bon]

Well my Gizmo has some bad news, the penecillin course and surgery hasn't helped at all apart from provide some relief of the puss buildup temporarilly.



So just need some advice on where to go here, the abscess is so deep into the jaw muscle that complete surgical removal is impossible and penecillin hasn't even slowed it (daily injections).

Its now also at the point where the pressure buildup is effecting her ability to eat, she cant actualy open her mouth properly, shes lost 2kg since been diagnosed with the abscess, and Im realy stuck now. If nothing else comes to mind its either go back to surgery which again is likely to be unsuccessful or have her put to sleep.



Any last help would be much appreciated

Bon

 

[tonyshuman]

Oh dear. That's very sad. I don't have any advice, but I hope you can help her the best you can.ray:

 

[pamnock]

Give this article to your vet . . .

http://www.vspn.org/VSPNSearch/VINLibrary/rabbit_abscess.htm

Nutri Cal will help her hold her weight.

Please keep us updated.

Pam

 

[ra7751]

Hi Bon,

I never do surgery on abscesses. My vets know better than to even suggest it. Which penicillin is being used? All penicillin is not created equally. I have treated quite a few mandibular absccesses with complete success using a combination of Pen G and Zithromax. There are several different versions of the penicillin concoction. Most vets carry only Procaine. I use a version that is generically called "Bicillin" (it hastwodifferent penicillins...hence the"Bi" term).There is also a drug that just became available that might be of some help....it's called Convenia. It is a cephalosporin and is chemically similar to penicillin....just with a bit different coverage.

There is something you said here that greatly concerns me for her prognosis. In severe abscess conditions, the bone structure itself is altered due to the damage from the infection. The bone will become soft. Even if you get the infection under control, there is a high liklihood of having some occlusion issues with the molars. It might be a good idea to consider extracting the offending molars. There is also a concern with fusing of the hinge of the jaw after a major abscess situation is resolved.

Is she on any pain meds? NSAIDs would help with the pressure of the swelling...but prolonged use may bring on additional collateral concerns. I generally use either Buprenex (Buprenorphine) or Tramadol. Both of these drugs can be used in conjunction with the NSAIDs. Many vets are unaware that Tramadol can be used in rabbits. A little bit of valium may help "take the edge off". And a shot of B Comp may help with her appetite. Supplemental fluids will also help her overall sitation.

Treating an abscess is much like working an advanced EC or even a paraplegic rabbit. It takes an entire package of medical and husbandry protocols to resolve the problem. It may take weeks to get major resolution. And I have treated an abscess for weeks and weeks. Hope this helps....and keep up posted.

Randy

 

[Maureen Las]

I'm really sorry Bon..as I remember you don't have access to bicillin.
Was your vet able to combine drugs for Gizmo? like pen G and ziithromax?
if you don't have the resources to do more you could continue with injections as many rabbits are on injections for lenghty period of time.

Also address dental issues if you are able to do that.

Really sorry!
Maueen

 

[Bon]

angieluv wrote:

I'm really sorry Bon..as I remember you don't have access to bicillin.
Was your vet able to combine drugs for Gizmo? like pen G and ziithromax?
if you don't have the resources to do more you could continue with injections as many rabbits are on injections for lenghty period of time.

Also address dental issues if you are able to do that.

Really sorry!
Maueen

We never got that far unforuntately. But im currently thinking all or nothing, gonna have to sell my paintball equipment to help pay for it, but gizmo is worth it.



Get her in for an xray, see how far this abscess actualy goes, and get best treatent process outlined

Get the surgery done to releif the pressure in her jaw so she can eat properly, lance, drain, posisbly use calcium hydroxide treatment

Start on Xithromax / Pen-G daily injections.

Hope for the best and contnue with treatment to elimite this bloody abscess.

 

[Offspring2099]

What about anti-biotic beads? After our Penny had the surgery to remove her jaw abscess, the pus came back and was oozing through the surgery cut/ stitches. So the vet went in for the 2nd time and put in the antibiotic bead, with that and bicillin shots every other day the abscess was suppressed.

 

[EileenH]

Randy and the others have a lot more experience than I, but when I first got my bunny he had an injured front paw. I had a lot of problems with an abscess. I ended up using 50% dextrose in the wound. We would flush it out, then flush in the dextrose. The theory behind using it was similar to using manuka honey for would treatment:
http://www.manukahoneywoundcare.com/
However, you can't use manuka honey as the rabbits will be attracted to it. My vet suggested the dextrose and it was helpful for us.

I hope you find something, you're working so hard with Gizmo...

 

[Bon]

Ok xray has been done and its good news for once, the abscess hasn't pushed any further so shes booked in for surgery next week.



Current planning is to have the side of her face opened up again, remove if possible or lance the abscess then use peroxide to clean it out as much as possible.

Fill the cavity with Calcium Hydroxide for a week.

Same time start on an intensive course of depocillin and Azithromycin (Pen-G Procaine and Zithromax) pain meds and probiotic course.

A week later have the Calcium Hydroxide removed and cavity inspected, re-fill with Calcium hydroxide if needed still continuing with Antibiotics/Pain meds.





this is the current plan of action, however my vet hasnt used zithromax before in rabbits so if someone would be able to help with dosing information, thats would be much apreciated.

As for the plan of action, if anyone has any suggestions to aid gizmo's recovery or help with treatment, my ears are open.



Also to add, our vet cant get Calcium Hydroxide directly, so we are going to the dentist to get it. So just for my info, this is made into a paste then put into the abscess cavity and allowed to solidify right?

 

[Maureen Las]

I have used zithromax alone but don't know if the dosage is the same when combined with other meds. I'll try to get randy

 

[Haley]

I had a vet dentist use calcium hydroxide in Max when he had a tooth root abscess and I wasnt happy with it. I think it ate away at the tissue and made things worse. Ask about a possible antibiotic flush instead. We used some type of saline mixed with Baytril and flushed the wound 2x a day. Silvadine on the outer area of the wound works wonders as well.

Were you able to check out our section on abscesses in the Library? Theres a lot of great info there (inlcuding Max's thread). He wouldnt be alive today if not for the advice I gained from this forum and its members.

Dont give up hope. She will fight as long as she can. Hopefully once you get that area cleaned out and keep with the injections she will feel better. Is she on pain meds? If not, she needs to be.

Are you in the UK? I read an article how you can get your vet to be approved for Bicillin under certain conditions. Its much better than PenG Procaine alone because it stays in the bloodstream for longer periods.

I'll be praying for your little one.

Haley

 

[Bon]

Haley wrote:

I had a vet dentist use calcium hydroxide in Max when he had a tooth root abscess and I wasnt happy with it. I think it ate away at the tissue and made things worse. Ask about a possible antibiotic flush instead. We used some type of saline mixed with Baytril and flushed the wound 2x a day. Silvadine on the outer area of the wound works wonders as well.

Were you able to check out our section on abscesses in the Library? Theres a lot of great info there (inlcuding Max's thread). He wouldnt be alive today if not for the advice I gained from this forum and its members.

Dont give up hope. She will fight as long as she can. Hopefully once you get that area cleaned out and keep with the injections she will feel better. Is she on pain meds? If not, she needs to be.

Are you in the UK? I read an article how you can get your vet to be approved for Bicillin under certain conditions. Its much better than PenG Procaine alone because it stays in the bloodstream for longer periods.

I'll be praying for your little one.

Haley

Thanks for the info, unfortunately it has been a rollercoaster with giz, yes she is currently on light pain medication. As for getting Bicillin approved for use on her, its going to be hard, as any drug use not authorised by the VMD is illegal, and as such Bicillin isnt exactly available at the snap of some fingers.

Like is aid, final treatment plans will be made tomrow, so anything i can gather before then will be used in outlining her treatment.


If you could find out that info if its still relevent, would be awesome.

 

[dquesnel]

I have not had experience with jaw abscess but I do know people who have had their buns recover from severe ones that affected even the bone. One bun in particular had the abscess lanced, and then it was kept open to heal from inside out and so it could drain and to reduce pressure build up. I believe it remained open for almost 10 days, before they closed it again and deemed the process with an antibiotic flush to work.

I would warn against using peroxide to flush any abscess. Here is a comment from a member on a rabbit list:

" I just wrote recently about
what happened to me when I used hydrogen peroxide to flush out my
rabbit's jaw abscess wound. She gave a little jolt as I was
irrigating the wound, and it almost felt to me as if I had broken
through something, she twisted, had a seizure and died in my
arms. It was one of the most awful rabbit experiences I have ever
had, and I will never ever ever use peroxide in that setting
again. I have a feeling that if I'd been irrigating with sterile
normal saline, my rabbit would not have died. My vet doesn't like
peroxide and believes it can push bacteria further into a
wound."

Unfortunalty I have heard simillar stories from more than one person. It is believed that peroxide can also cause toxins to enter the body. I figured this information could be important to anyone who might be using/considering peroxide to flush abscesses.

 

[ra7751]

Just to add a bit to the abscess theme here....I never open an abscess. I have dealt with many. In my non-professional opinion, the only thing that is being done by lancingis to allow an encapsulated infection to spread quicker. If we do have one to open on it's own....or any open injury that needs flushing....I use saline. But I would suspect that having an abscess flushed would be very painful.

And for those of you that don't know what calcium hydroxide is....if I remember correctly, it's pickling lime. I don't think that is something I would use with my rabbit. I can only imagine the pain. And I don't see how that could possibly be of any benefit whatsoever.

Abscesses are a complex event...and they require a complex response. It's not enough just to treat the infection, there is a laundry list of support therapies that should be implemented in order to get a successful resolution. Again speaking based on my non-professional opinion.....I think most vets treat ear infections and abscesses in rabbitsfar too conservatively.Rabbits do not have the margin of error that maybe a cat or dog would. I attack from multiple fronts with the big guns firing. I not only use multiple antibiotics, but I use all sorts of support protocols including hydration support, inflammation and pain management and nutritional support. It takes a full package to successfully treat an abscess....and I treat them non-surgically. Even some of my vets are using my methods now. So far, we have been successful in containing and resolving the infection. One of the major concerns with mandibular abscesses is the damage to the fundamental structure of the bone....and that is why it is so important to attack aggressively. A damaged jaw bone is a major concern in animals with open rooted teeth. Insist on aggressive treatments for abscesses.

Randy

 

[pamnock]

ra7751 wrote:

And for those of you that don't know what calcium hydroxide is....if I remember correctly, it's pickling lime. I don't think that is something I would use with my rabbit. I can only imagine the pain. And I don't see how that could possibly be of any benefit whatsoever.


Randy

No pain (and I'm assuming the rabbit is anesthetized anyhow). Calcium hydroxide-based compounds are used in dental applications for humans as root canal fillings because they are superior in inhibiting infection.

Would you believe that calcium hydroxide is also an ingredient in baby forumula?
http://www.babyorganic.com/cart.php?target=product&product_id=16182&category_id=249

It's also usedfor pickling (I used it when I canned veggies) and it'san ingredient in hundreds of foods that we consume.
Pam

 

[cmh9023]

My girl Sherry had what sounds like a very similar problem- an abcess in her lower jaw.This forum was so helpful when I was completely panicing. I honestly didn't think she'd make it and it was touch and go for a while. Based on what he saw in her little mouth, he was surprised she coud eat at all and that she was/is in stage 4 of 5 dental disease.

But...she did make it. And she's doing really well 1 year later. She is only 2 lbs but she was such a tough little girl. Now I call her my Rock Star. So, basically, I just wanted to encourage you to keep up hope. It's a serious problem, but there is hope for a good result.

Initially, she had to go to the emergency hospital because the golf ball sized thing on her jaw, that seemingly appeared overnight, exploded. They did what I guess you would call triage. Then, she saw the vet dentist when he came to our city. Do you have a vet dentist in your area? I don't think they are that common. We only have two in the whole state, but he was extremely helpful. Maybe you could check into that?

I'm no medical person like some of the others who have replied, but in my files I found the letter the vet dentist sent to my own vet about what he did for her and what was needed for follow up. Anyway...I was wondering if it would be of any help to write some of what his letter says about what exactly was wrongand what he did. It's not so much about medication. It's about the surgery, the molar removal, etc.

I guess I'm asking the people like Pam and Randy, who know a lot about this, if it would be helpful, or if every case is so different that it wouldn't be applicable at all. I was wondering if it might spark some ideas? I'm asking because, if not, I don't want to type it all out..haha.

Following the major procedures I gave her injections of PenG every other day for several months. It seemed to be extremely helpful.

Cara

 

[pamnock]

Cara,

It would be very helpful to post the information. More info both good and bad can help Bon to make an educated decision in dealing with this very difficult medical condition.

Pam

 

[Bon]

Well the drugs have been ordered fortomrow, as the Calcium hydrxide and zithromax are special orders, and the surgery is also tomrow morning.



Current outline for treatment is

Surgery Tomrow, have the abscess removed as much as possible it all cleaned and a small ball of calcium hydroxide injected into the main puss causing cavity. This is a sort termsolution for the few days after surgery to stop it re-filling while the levels of antibiotics in her body rise up.

While this is going on, cultures will be taken for sensitivity tests.

Begin daily courses of Zithromax and Pen G Procaine.

Daily rinse outs of the whole other areas with saline solution to help keep things clean.

Tuesday or wednesday have the Calcium hydroxide ball removed and inspect the cavity, rinse out and start packing with dextrose gauses to be changed twice daily durring saline washing.

Continue untill the wound starts healing too much for the gause to be viable.

Continue with antibiotics long term untill cured.



Along side this ill be keeping her with fresh food and probiotics as well as painkillers to keep things happy.

As said, all this starts tomrow, so prayers for gizmo that she'll pull through.

I sent a PM to ra7751regarding the zithromax dosing to send it to my vets email. So if someone knows him and could prod him into getitng that sorted asap that would be awesome!



Thanks for your support guys, and ill keep you posted.

 

[seniorcats]

Here is a medication dosage calculator - don't know if this will help. Good luck with your bunny's surgey.

http://homepage.mac.com/mattocks/morfz/rx/drugcalc.html

 

[Bon]

seniorcats wrote:

Here is a medication dosage calculator - don't know if this will help. Good luck with your bunny's surgey.

http://homepage.mac.com/mattocks/morfz/rx/drugcalc.html

Thanks for the info, unfortunately it doesnt provide the info for combining the 2 drugs.