Tooth growing at an angle - malocclusion. Remove or trim?

[Zicheri]

I have a 6 year old Flemish Giant named Winston. He's neutered and generally healthy.

I brought him in for an eye infection, and the vet found that in addition to his eye problem, one of his top front incisors is growing at an angle. Because of this, Winston isn't able to keep it trimmed and it's overgrowing.

The vet has said that I have two options:
1) trim the tooth every few weeks for the rest of his life
2) remove the tooth/teeth? (I don't actually know if they remove one or all or what)

I don't really want to have to take off work every few weeks to get his teeth trimmed. I also don't really want to spend close to $1000 for bunny dental surgery.

What do you all recommend? Anyone else have experience with this?

I assume that surgery involves risks, but it sounds like there's also the risk of infection if you trim the teeth and they break in the process... Is there a good option here?

His teeth were fine for years. I'm so bummed that this showed up unexpectedly. The vet thinks he likely broke the tooth and this happened when it started to grow back.

 

[scottd]

My rabbit also had the same problem, in the end we decided to remove his front teeth, he's now 3 weeks post op and doing really well.
He's gained weight, eating well and seems much happier.
The vet I originally took my rabbit to wanted and obscene amount of money to remove his teeth but I phoned around and got the price cut in half so maybe worth phoning around for a few quotes also.

 

[Zicheri]

How much did you end up spending? I have a consultation next week (that alone is costing me $100) to determine how much they need to do and what it'll cost. If it's outrageous I'll call around to a few places. I just want to make sure that whoever does it is experienced with it and not just cheap.

You don't happen to live in the Boston area, do you?

 

[missyscove]

How are Winston's molars? Was your vet able to evaluate them pre-sedation?
Unfortunately older rabbits do often develop dental disease and treatment can be frustrating! On top of that, rabbit dentals are a bit of a unique procedure and many vets can't do them. Rabbit extractions are even more challenging, the molars in particular. If the opposing teeth aren't extracted they will continue to grow but extracting healthy incisors is very difficult. $1000 for a procedure that includes extractions in a rabbit sounds like an incredible value. These procedures should require anesthesia and at Winston's age (considering his breed) I'd recommend bloodwork first to check out his organ function.
I would not recommend trimming his teeth yourself at home. Some people do it, but the risks of breaking the teeth or causing other damage are too high.

 

[Aki]

I don't have any personal experience with malocclusion, but I read a lot of articles / testimonies about it and I decided that if one of my rabbits had an incisor malocclusion, I would have it removed. I've met several owners of rabbits who had it done to them and from what I was told the rabbits had no problem after the operation (you just have to cut the vegetables in smaller pieces) and you couldn't see the incisors had been removed at all while looking at them. Having to take your rabbit every 6 weeks or so to the vet is really taxing for your rabbit (his health and his stress levels) and for the owner. If your vet is knowledgeable about rabbits and that, after running tests he thinks it's a viable option, I would go for the extraction. I have no idea how much it would cost where you live, but in the long run filing is going to get expensive too especially since your rabbit is still quite young...

 

[Zicheri]

My vet didn't look at his molars. They recommended another vet that is doing the consultation next week. I assume they will look at all of his teeth and maybe take an xray, but I'll find out when I get there. I'll be sure to ask them about the molars. My vet thought it looked like he had broken the incisor and now it was growing back at an angle, so hopefully it's that and not a tooth disease.

I also realized that he hasn't been eating hay lately. He's never been a huge fan of it, but it doesn't seem like he's eating much at all anymore. Could that be related to the tooth? I'm going to pick up another kind and see if maybe he just doesn't like this batch.

 

[scottd]

Sorry I didn't realise you were from Ameica, I'm in the UK and paid £224 to have my rabbits front teeth removed plus anti biotics and pain relief.

 

[JBun]

You may actually want to try out at least a couple of trims. Considering that this may be something that happened due to an accident and not something he was born having an issue with, it's possible that trimming the teeth a few times could give the offending tooth a chance to grow back in correctly, as long as the underlying structure hasn't also been damaged. Though it's also possible that this may not make a difference and you may still be faced with the same decision of removal, but if it were me I would prefer to try trimming to see if it corrected the problem.

Also keep in mind that 6 is generally considered older for a flemish, and older rabbits teeth usually don't grow as fast and sometimes can stop growing much at all. So this could mean that if you do decide to try trimming instead, that it won't have to be done as often as it would need to be done in a young rabbit, and could even be several months before another trim would be needed, if at all. I just would be very reluctant to be doing an extraction on an older flemish. At that age I would feel that the surgery could be a bit rough and difficult for an older rabbit to recover from, and I would only consider it if the other options didn't work out.

Did the vet trim the bad tooth? If not, it could be it's causing pain to chew and that's why your bun isn't eating hay well. If that tooth wasn't trimmed, I would want to get that done right away, as well as the rest of the teeth checked and trimmed if needed, no matter what the ultimate decision is on surgery or not, as to avoid any chance of the overgrown tooth causing further lack of appetite and stasis inadvertently setting in.

If that tooth was trimmed but the molars weren't checked, there could also be sharp points on the molars affecting your buns eating. You'll want to keep a close eye on the amounts your bun eats and get your bun seen right away if appetite decreases too much, because once stasis gets started it can be difficult to get turned around. In the meantime you could try cutting up the hay into shorter strands to see if that helps at all. Or buying some hay cakes or plain hay pellets might work to replace the longstem hay until you get the teeth issues sorted.

 

[Zicheri]

Thanks for all the info! I've been wondering if a trim or two might do the trick. Hoping. My vet isn't an expert on teeth which is why she's sending me to another one for a consultation on Wednesday. I'll ask all of these questions and make sure that they check the molars.

I would love to do a few trims and find that the tooth grows back straight, but I definitely don't want to be taking time off work every 6-8 weeks to get it trimmed. I guess we'll see what they say on Wednesday and go from there.

What is the average life expectancy for a healthy flemish giant? He's always been inside, isn't confined to a cage, and eats well. He's also not too large - weighing in around 15.5 pounds at the moment.

I've heard 5-10 years, but I feel like that includes bunnies kept outside in hutches and probably is skewed a little low.

 

[Zicheri]

Our appointment is tomorrow, but Winston is hardly eating anything at this point. He still runs over to eat some apple or a dried cranberry (treats for taking his eye drops), but he's hardly eating any pellets, greens, or hay since Monday.

I don't want to just give him sugar, but right now it seems to be the only thing he'll eat. Could I try something like sunflower seeds or something to get a little more substance in him?

Our appointment is tomorrow so he'll get relief soon, but I'm a worried mama.

 

[JBun]

You really need to get him eating something or GI stasis can set in, then you have a whole other set of problems to deal with, which may also delay being able to sort out any dental issues, but you don't want him to just be eating a bunch of sugars and carbs which can cause serious disruption to a rabbits GI flora(which can lead to serious digestive issues).

You could try softening his pellets in warm water and see if he will eat the pellet mush. If he won't, you are either going to need to call the vet and move up the appt. to today, telling them it's an emergency(which it is any time a rabbit stops eating), or you will need to start syringe feeding to keep food in him and keep his digestion moving until your appt. tomorrow. You may be able to syringe feed the pellet mush if you have a syringe with a large enough opening at the tip(or it may clog). If that doesn't work, you should be able to pick up some Oxbow critical care food mix from your vet. You will need to syringe feed every 4 hours until your appt. tomorrow.

 

[Zicheri]

I called my local vet yesterday, and they told me to make sure he was eating even if it was mostly sugar. They thought forcing him mushed up pellets would be too stressful.

Today I went to a more bunny-savvy vet who is doing the dental work, and they said the opposite! I should have force fed him. He really needed fiber and the sugar, while giving him something to process, wasn't the best thing for him. Now we know... (and we know that I'll stop bothering with my local vet).

The new vet examined his teeth and confirmed the same thing - his front bottom tooth had broken, which caused the front top tooth to overgrow and shift off to the side. This was contacting his lower gum. The vet then looked into the back of his mouth with an instrument to see how his molars looked. He had suspicions that Winston (who doesn't love his hay) wasn't grinding his back teeth well enough, and that he might have some sharp edges forming that might be hitting him in the cheek and causing pain.

Unfortunately Winston's mouth was just too big for him to see all the molars while he was awake (I guess vet instruments are made for flemmies).

He recommended that they put him under and trim both the front and back teeth. The procedure went well, and they found that Winston clearly had some pain with one of his far back molars (his heart rate went up when they worked on that one, even while sedated). They trimmed/smoothed all the teeth even though it looked like only a few were an issue.

We got home and Winston was a little out of it, but within ten minutes he WENT TO TOWN on his greens! He didn't eat a ton at a time, but has since been back to his food a few times to munch. This is HUGE since just this morning he was refusing any greens or pellets. He's now lying at my feet happy to be home and feeling better.

The vet recommended that we trim the front teeth a few more times before we try an extraction, in case they start growing back normally. Even if they don't, he was hesitant to recommend the extraction of Winston's incisors. As a Flemish Giant, his teeth are very long and it's difficult to get all the way into the cavity. He said that there's more of a chance that another tooth will grow in, which would most likely have to be removed as well. Something to do with the base of the tooth and getting everything out of there. So we'll go back in 4-6 weeks (probably 4 this first time) to get a trim and see how things are doing.

In the mean time, I was given CriticalCare to help with his nutrition, a pain killer to give once a day, and something to help keep things moving through his GI tract. Lots of meds to give orally (which Winston hates), but hopefully he'll only need it for a few days.

Moral of the story? YOUR BUNNY NEEDS HAY! Winston isn't a huge hay eater, and that definitely contributed to how his molars were shaping up. We'll be trying a few different kinds after he's back to normal to find one that he likes more.

Oh - and go to the most bunny-savvy vet the first time!