(RIP) Mr. Bun in Acapulco has a Jaw Abcess

[marnarojas]

Hello to All. I am new to the list and I am writing to you from Acapulco, Mexico. Mr. Bun came to me 2 years ago after having been abandoned on Christmas Eve on the steps of a local veterinary clinic. He is a beautiful, soft, VERY WELL-BEHAVED New Zealand White, and having known NOTHING about rabbits until he arrived in our home, I am now a hopeless bunny lover. Mr. Bun had been very healthy until about 2 weeks ago when I noticed he was eating less and "producing" less. We have no rabbit-savvy vets in Acapulco but I took him to someone that I trust with my other animals. He suggested we put him on .3ml of Shotopen (Bicillin?) every 48 hours with 3 drops of Metacam each day for the pain. He seemed to do well for the first 48 hours and then he tapered off. I have been syringe feeding him softened pellets and pureed greens. But he seems very uncomfortable today and the jaw bone feels very swollen to me. He weighed 2.67kg at the beginning of the treatment. He weighs 2.5kg now. I am confused as to whether I should go to the protocol of daily injections as I haven't seen any results with injections every 48 hours. Also, Shotopen is administered I.M. in dogs and cats here, so the vet prescribed I.M. injections for Mr. Bun, but I'm noticing Marcy Moore's protocol is for subcutaneous injections. Any words of help you can pass along would be greatly appreciated. I miss Bunny's binky dancing! : (

 

[tonyshuman]

I'm glad you've come here. Abscesses can be nasty and difficult to treat, but if you have a vet that is willing and open to suggestions, we have some people on here who have gotten good results dealing with stubborn abscesses. I personally don't have any experience with it, but I know Bicillin is often used in rabbits. I seem to remember it being used for upper respiratory infections caused by pasturella bacteria, but i think it can be used on abscesses as well. A member here named Randy is our resident (non-vet) expert, and I hope he gets hold of this thread.

If he is eating and eliminating less, you can force feed him Critical Care (if available) or a pellet slurry. You get pellets really wet (let them soak) and force feed them into his mouth with a syringe (no needle). You can also force-feed water this way. Another way to increase water intake is to add a drop of vanilla flavoring or offer pedialyte (children's medicine for rehydration). It's very important for any bunny to remain hydrated as it keeps the gut going. If the gut shuts down, everything shuts down.

It is also important to get this abscess early because many jaw abscesses can infect the bone, which can require major surgery. You should try to figure out what caused the abscess (teeth are usually the culprit) to treat that. Sometimes tooth roots grow improperly and the tooth must be removed.

In any case, good luck, kudos for taking Mr. Bun into your home, and I hope someone with more experience gets a hold of this thread. My knowledge comes only from what I've learned reading other posts on here.

:goodluck

 

[Maureen Las]

I am going to pm Randy so he will be able to explain this to you better than the rest of us. it It is true that we don't give bicillin IM but we do give it subqutaneously usually diluted with either lacted ringers, sodium chloride or another isotonic solution.

he will most likely be able to help you with the dosage and suggest a complementary drug in addition to the bicillin for the difficult treatment of absceses.
in the meantime I would not give the dosage on a daily basis.
your vet is far ahead of mine here as I had to go on-line to learn of bicillin and it's very postive effects on the treatment of abscesses
Please be patient as weWILL get this info to you................

 

[marnarojas]

Thank you for your reply. I am DESPERATE this evening as Mr. Bun has become quite lethargic and is not wanting to take food from the syringe. I'm offering papaya, banana, Gerber baby food(squash), ANYTHING to help him keep his little intestines moving. Shotapen is a milky white liquid. My vet has never administered it subcutaneously. That doesn't mean it can't be done? THANK YOU so much for responding.............I was just getting ready to give him .4ml of Shotapen via subcutaneous, the first time at a 24-hour interval instead of 48. I will wait for Randy's reply. I'm very worried we won't make it through the night. : ( : (

 

[marnarojas]

tonyshuman wrote:

I'm glad you've come here. Abscesses can be nasty and difficult to treat, but if you have a vet that is willing and open to suggestions, we have some people on here who have gotten good results dealing with stubborn abscesses. I personally don't have any experience with it, but I know Bicillin is often used in rabbits. I seem to remember it being used for upper respiratory infections caused by pasturella bacteria, but i think it can be used on abscesses as well. A member here named Randy is our resident (non-vet) expert, and I hope he gets hold of this thread.

If he is eating and eliminating less, you can force feed him Critical Care (if available) or a pellet slurry. You get pellets really wet (let them soak) and force feed them into his mouth with a syringe (no needle). You can also force-feed water this way. Another way to increase water intake is to add a drop of vanilla flavoring or offer pedialyte (children's medicine for rehydration). It's very important for any bunny to remain hydrated as it keeps the gut going. If the gut shuts down, everything shuts down.

It is also important to get this abscess early because many jaw abscesses can infect the bone, which can require major surgery. You should try to figure out what caused the abscess (teeth are usually the culprit) to treat that. Sometimes tooth roots grow improperly and the tooth must be removed.

In any case, good luck, kudos for taking Mr. Bun into your home, and I hope someone with more experience gets a hold of this thread. My knowledge comes only from what I've learned reading other posts on here.

:goodluck

Thank you to Tony's Human! I have been syringe feeding Mr. Bun for the last 2 1/2 weeks and he seems to have enjoyed the extra attention until today. He seems very sad and out of sorts and tonight would not even open his mouth for Critical Care.............I am VERY WORRIED!!! But he is allowing me to hold him close which is a first for him.............He has known throughout this whole ordeal that he is VERY LOVED!

 

[Maureen Las]

Randy may not post tonight but probably in the morning.

he is a wild life rehabber who specializes in rabbits and has extensive medical knowledge on medications and treatment and his own rabbit rescue in NC

it's possible that Mr Bun needs Subqutaneous fluids (which I know are not available) to help him tonight .

I am really sorry that no one got back to you sooner today . We re usually quicker than this.

I'm so sorry that he's not doing well and You're right ) he may not make it tonight but then again he may and you have to think that you are doing everything in your power to help him.
it's possible that he needs another medication with the bicillin to treat the abscess. Usually Randy will recommend a combo of bicillin and either Zithromax (azithromycin) or chloramphenical

was your vet able to culture the bacteria??
if notI totally understand ...the vets where I live just grab an antibiotic and tell me to use it without a culture (wrong)

Anyway right now I am going to attempt to figure out if he's getting the correct dosage of bicillin.(according to medi -rabbit ) as I'm not a vet just a rabbit owner and lover who is interested

 

[marnarojas]

This post is for Randy: a link to Shotapen manufactured by Virbac to view the formula.
http://www.virbac.com.mx/produc/shotapenLA.asp

 

[marnarojas]

Thank you Angieluv.................Mr Bun and I will be here for a little while longer this evening.

 

[Maureen Las]

Did your vet give you a bottle of pencillin "if so look at the back and see if it says
150,000 u procaine pencillin G

150,000 u benzathine pecillin


and Mr Bun weights 2.5 kg??

 

[Maureen Las]

I hope that Randy is pming you asI think the dose is too low.................

 

[marnarojas]

The bottle says:
Penecilin G Procaine................100,000 UI
Penecilin G Benzathine............100,000 UI
Dihidroestreptomicina base...........200 mg
Vehiculo c.b.p.....................................1 ml

It is a milky white liquid............not oily.

 

[Pipp]

angieluv wrote:

I hope that Randy is pming you as I think the dose is too low.................

.4 sounds right to me, I think my little guys (3 and 5 lbs) were on .25. My vet didnt' seem to think it was an exact science.

I honestly wouldn't worry about feeding him at all, just do what you can to get warm liquids in him, that will keep the gut going and help with infection issues.

ER protocol I think for bunnies with infection that may be going systemic is warmth, fluids, heavy doses of antibiotics and low stress.

An ER vet would probably put him in an incubator and give him sub q fluids, ETA and some kind of heavy duty antibiotics, although I'm not sure what kind..

Even with the Metacam, he needs lots of fluids. What measurement does three drops work out to? He could be reacting to the pain.

PS: Apologies for the late responses, the forum is having serious tech difficulties, it shut down for awhile today more than once, I didn't scroll back far enough I guess when I finally got online. We're working on trying to get it fixed. So sorry!

sas ray:

 

[marnarojas]

Pipp wrote:

angieluv wrote:

I hope that Randy is pming you as I think the dose is too low.................

.4 sounds right to me, I think my little guys (3 and 5 lbs) were on .25. My vet didnt' seem to think it was an exact science.

I honestly wouldn't worry about feeding him at all, just do what you can to get warm liquids in him, that will keep the gut going and help with infection issues.

ER protocol I think for bunnies with infection that may be going systemic is warmth, fluids, heavy doses of antibiotics and low stress.

An ER vet would probably put him in an incubator and give him sub q fluids, ETA and some kind of heavy duty antibiotics, although I'm not sure what kind..

Even with the Medacam, he needs lots of fluids. What measurement does three drops work out to? He could be reacting to the pain.

PS: Apologies for the late responses, the forum is having serious tech difficulties, it shut down for awhile today more than once, I didn't scroll back far enough I guess when I finally got online. We're working on trying to get it fixed. So sorry!

sas ray:

Thank you..........just having someone "out there" at this hour of the night is a big help. I will give Mr. Bun warm liquids now. I've been giving him water and pureed veggies with a syringe but pretty much at room termperature, and maybe even cooler than that. I'm not sure how much I should be giving him though? I think 3 drops of Metacam works out to be about .1 ml. Iwas thinking maybe he had developed some ulcers from that? I hope not

 

[Maureen Las]

If you are having trouble posting just click on the REPLY button at the top of the post instead of the QUOTE button

How is he doing????/

 

[Pipp]

At Maureen's suggestion, I just checked my penicillin and I was given a stronger suspension than yours by about half as much again -- mine is 150,000.

I'm going to see if I can roust somebody on Etherbun for some ER antibiotics feedback. I'm not sure what the protocol is on a possible systemic infection -- which unfortunately may be the problem here, the abscess infection is spreading through his system.

How is he?


sas ray:

 

[Pipp]

PS: You can increase the Metacam I'm sure. Don't know the suspension you have vs what I had, but my dosages vary a lot with each vet, anyway. My little guys can get anywhere from .18 to .5 (for a 'kick start' dose) depending on the vet. Any kidney or stomach issues can be dealt with by giving it with water and a little food.

sas

 

[marnarojas]

Ooooooooooooo, I HOPE AND PRAY we don't have a systemic infection starting. The jawbone has been very swollen for the last 2 1/2 weeks. In the last couple of days I have seen the cheek on that side and under his neck puff out like maybe they are filled with fluid. THIS IS DIFFICULT. HE'S SO YOUNG. HE'S BEEN SO HEALTHY. I just gave him about 15 ml of warm water with a drop of vanilla. Then he ate a tiny bit of Gerber squash which he seems to love, and a few licks on his pellets. I'm going to give him some Metacam now so that he will be pain-free the rest of the night. We have our paws and fingers crossed that we will get through the rest of the night without incident. I have an animal welfare association here in Acapulco...............wish I would have studied Vet. Medicine to know what to do in the middle of the night. I want to thank you.............all of you in the Infirmary are GREAT! Marna

 

[Pipp]

BTW, my guys were give the penicillin sub q for mouth abscesses, and it was in conjunction with a daily oral med, Chlor Palm.

When I ran out of Chlor Palm, my vet said NOT to increase the dose of the penicillin to compensate.

It's a good sign if he's showing any interest at all in food, really glad to hear that.

If he's 'shocky', you don't want to force feed him, but if he's showing interest, by all encourage him and give him a gentle hand.

Did he have an x-ray? A culture done on the abscess?

I also think you need stronger antibiotics, maybe an oral med as well. Also, some vets will inject antibiotics right into the cavity. And there are antibiotic beads, and a variety of drugs. He's not out of options.

sas ray:

 

[marnarojas]

Unfortunately we have no Rabbit-Savvy vets here in Acapulco. Neither of the 2 that I consulted wanted to stress him with an x-ray!!!! I'm sure they don't have a clue how to handle bunnies. So I didn't even go into having a culture done...........also because much of what I have read says it is hard to get a conclusive diagnosis from the abscess. Yes, Mr. Bun is still showing a little bit of interest in food, not much though, and what interest he has comes in spurts at very strange hours. But I am happy if he laps up even a half teaspoonful of something. Will check back here first thing in the morning. Right now I want to give Mr. Bun some good warm hugs..............

 

[Pipp]

Nope, they did okay, actually. It's standard procedure at my vet's to just start on antibiotics and not do x-rays and cultures until after the drugs have had a chance to work and there's been no improvement.

The x-rays take anesthetic or at least sedation (I think my vet uses Domitor, a sedative that knocks them out for 20 or 30 minutes and another shot to bring them out of it) and the majority of abscesses respond to the injection/oral combo he always uses, so the culture isn't the first thing on the 'spend' list (unless he needs an extension on his patio and is looking to pad the bill).

Give Mr. Bun a cuddle for me, too.

PS: If you get conflicting info from me and Randy and/or Maureen, they know a lot more than me.


sas :clover: