BINKYBUNNY FORUMS > HOUSE RABBIT Q & A > Tooth Root Abscess- to remove teeth, or lifelong antibiotic treatment??
Last Post by LittlePuffyTail at 11/08/2012 1:23 AM (29 Replies)
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User is Offline ThreeBuns
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10/06/2012 3:25 AM

Hmmm, it appears we have a tricky decision to make- our little boy bunny has a lump under his jaw, so we took him to a bunnies-and-piggies-only specialist in Melbourne the other day.

It's not an abscess attached to the jaw, thank god, just a lump of very hard pus. However, the verdict is that at least one if not two of his bottom teeth are problematic, and once the antibiotics have (hopefully) reduced the infection and shrunk the lump, we have to make a hard decision:

1. We have his teeth, one or two, removed.

2. We put him on lifelong antibiotics.

 

My worries are thus:

1. The 'matching' top tooth/ teeth will keep growing, and with no opposing tooth to grind against, will need to be filed down by the vet every...week? Few weeks? (I have no idea how fast they grow!) In any case, quite frequently I would think, and would mean much stress for the poor little guy. He also hates travel and being handled (apart from pats), so the long travels to and from the surgery (we live in the country, a few hours away) would also stress him a great deal. Not to mention the shock and pain post-surgery, the more teeth they remove.

Is it possible that we could have all the matching (top and bottom) teeth removed at the same time, to avoid regrowing-problems? Or would that much surgery stress him too much/ be too dangerous/ be too painful for him to recover from?

 

2. This seems the less-stressful option, but only so long as it actually works...

 

Has anybody here had to make this decision, and if so, what did you go with, and what were the pros and cons?

We want to do the right thing by him, but aren't quite sure which would be best, and we'll have to decide, two weeks from now...

 

Thanks!

 


User is Offline Sarita
(Dallas)
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10/06/2012 3:35 AM
My rabbit Bobby has no teeth on his lower left side due to abscess and he does have to do regular maintenance but it's not too bad to do that. I believe with dental problems you will ALWAYS have problems with teeth (in my experience) - even with the current abscess clearing up it will most likely cause the teeth to shift and malocclude.

Bobby initially had his teeth checked every 3 months but we are now able to go longer between treatments.

Bobby basically lost his teeth due to the abscess and eventually lost others. He manages very well without those teeth.

User is Offline jerseygirl
Australia
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10/06/2012 4:04 AM
Welcome ThreeBuns

You're fortunate in Vic to have quite a lot of rabbit savvy vets.

It's is hard to know which way to go with these and it really does vary case by case.

Did the Rabbit Clinic open the abscess to clean it out and culture the puss before he was put on the antibiotic?

Is the vet recommending one thing over another? Would they be willing to discuss your rabbits case with other vets? If so, I'd recommend Dr David Vella in Sydney.
Whoever says "It's only a rabbit" has obviously never loved a rabbit.

User is Offline Sarita
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10/06/2012 4:54 AM
I do question the lifelong use of antibiotics - what are you using for the abscess as an antibiotic now? And what does the vet mean by lifelong....

User is Offline tobyluv
South Carolina
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10/06/2012 8:44 AM
It seems that antibiotics are going to lose their effectiveness after a while, and there are only a few different ones to try that are available for rabbits. Also, the prolonged use of antibiotics can cause GI problems. Since your rabbit hates being handled, how would he react to be given an antibiotic once or twice a day (for his lifetime)? I don't really understand the lifelong comment the vet made. You didn't mention how old your bunny is.

There is a rabbit at the sanctuary where I volunteer who had such terrible maloclusion that all of his front teeth were removed a few years ago. He seems to have no trouble eating. He draws in the food with his lips, then chews it with his back teeth.

I hope that everything will work out well for your bunny.

User is Offline ThreeBuns
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10/06/2012 11:35 AM

Wow, so many replies, thanks! :-)

Hi Jerseygirl, a fellow Aussie!

The antibiotic he's being trialled on is called 'Chloramphenicol Oral 200mg/ml (ml) x 20)'

It's fake-banana flavoured/smelling, so at least not horribly bitter like Baytril, our 'usual' small-critter antibiotic. (She said this one treats internal infections, so ones not exposed to air, as opposed to what Baytril does)

I'm reading this off his extensive medical records now- We've been given two options: 'Control', or 'Cure':

 

Control: He'd be on meds to keep further abscesses from developing, for the rest of his life. Once a week, a penicillin injection we would learn to administer, nowhere near as stressful as twice-daily (every 12 hrs at the moment) syringe of stuff into the mouth!

 

Cure: remove the infected tooth. success rate is 95% with one tooth, 80% with two, etc. Also, some 'suspect' teeth (he has one on the other side, yay...) may after surgery themselves develop into abscesses. Often at this point the infection is classed as 'non surgical' and control is the only option.


User is Offline ThreeBuns
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10/06/2012 11:39 AM

Whoops, it cut off the comments so I thought there was only one line to reply to, argh. Bit new to all this.

Hang on, I'll keep replying...

 

Yep Jerseygirl, this is a specialist clinic, NOTHING but rabbits and piggies! :-)

Melbourne Rabbit Clinic

 

The opening and taking a sample for analysis will happen once they see how he's responded to the antibiotics, two weeks from now.

I'm not sure how they'd feel about me recommending they speak to other vets, since they're all bunny specialists here... But I could mention him, they may know him. The next appointment is with the vet who owns the clinic.

 

 


User is Offline ThreeBuns
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10/06/2012 11:42 AM

Hi Tobyluv,

 

They tell me "long term antibiotics can control tooth root abscesses sometimes for years", so it seems a good option....

He's about 2 1/2 years old, but being a dwarf, I imagine he has a slightly shorter lifespan than a normal-sized bunny? He's in fine health otherwise though, so may yet outlive us all. ;-)

If it were his incisors, I would go ahead and have all removed, but these are back teeth, much trickier...

 

 


User is Offline Sarita
(Dallas)
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10/06/2012 12:25 PM
Bobby is a Netherland as well and he's about 4 now.

Chloramphenicol is good stuff so hopefully that will help.

I do pen-g injections alot for my rabbit Toffee who is about 10 years old and has continual dental decay problems and it really helps.

Please keep us updated and let us now what you decide.

User is Offline Sarita
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10/06/2012 12:31 PM
Oh and the pen-g shots and removing some of his teeth is what eradicated Bobby's dental abscess eventually.

So don't think it's not curable - it is. Yes, Bobby will have to have lifetime dental checkups but it's not a big deal really. He goes under frequently for dental trims and he bounces right back.

User is Offline ThreeBuns
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10/06/2012 1:11 PM

Thanks, will keep y'all informed. :-)

The only problem with lifetime dental checkups/ tooth-grinding by the vet, even 'every few months' is that we just can't get to the city that easily, as we live rurally. It's a very long drive, and not something I could do on my own if I had to- and taking him on public transport would be possible, but would add a few hours I suspect, and increase his stress (and mine) even more...and we're about to expand by one small human, so I doubt I'd be up for much travel by train in the next few months!

Injections are the much easier option for us therefore, so we'll keep considering...

 

I'm also still worried about how much pain tooth-removal would put him through, especially if it's two or more teeth- how will he be able to eat for weeks afterwards, and keep his mouth clean, and....yeah.

You mention that Bobby 'goes under' frequently...frequent anaesthesia is not something I like the sound of, as we've lost guinea pigs to post-anaesthetic stress twice now, and he's such a small bunny, I'd never forgive myself if he didn't 'bounce right back' and instead stressed and died after a tooth trim...

 

 


User is Offline Sarita
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10/06/2012 2:02 PM
Here's my take, take it for what's it worth - guinea pigs are not rabbits and they seem to be more fragile than rabbits. I have to consider what the quality of life is for my rabbits - having a tooth abscess is not a good quality and if I have to put my rabbit under anesteshia more than normal, then I have to do this and so far so good - it's ALWAYS a risk, but I've been lucky that the benefits outweigh the risks. What choice do you make? I know if my rabbits goes under anesthesia for a procedure that makes them have a pain free better quality of life and they don't make it, it's pain free and worth the risk. I'd rather my rabbit be pain free and go to the bridge pain free than be in pain. It's a risk that I make because it just has to be done. I'd rather my rabbit live pain free and die pain free - life is full of risks and you just take them.

User is Offline TBpony414
Washington, DC
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10/06/2012 2:28 PM
^ Very well stated, Sarita. OP, for what it's worth, my when my bridge bunny was still alive he had a myriad of dental problems which stemmed from having a misaligned jaw and therefore uneven growing teeth. He ending up having a few molars pulled due to infections and he did just fine. (Un)Fortunately he needed to have his molars trimmed every 6 weeks for the last several years of his life so was under isoflo anesthesia quite often and we were able to monitor the teeth closely. He recovered from all of his surgeries just fine.

I would never consider using IV sedation in a rabbit, only gas. I have a friend who fosters guinea pigs for a local rescue and it is my understanding that they are more sensitive to medications and anesthesia than rabbits.

My current rabbit also has dental problems and gets his molars trimmed under isoflo anesthesia every 9 weeks. No issues whatsoever. If you are unsure about having your bunny's teeth pulled then give the Penn G a try and see how it works out. It may buy you some time but I think down the road the teeth will need to be removed. Good luck and keep us posted

User is Offline BB
San Francisco Area
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10/06/2012 7:09 PM

My bunny Rucy had ongoing tooth issues. She had an incisor removed before I adopted her, and she had several molars throughout the years removed (to the point where she too did not have much on one side of her mouth. She did have to have tooth spurs trimmed a few times a year. (amazingly though her incisors rarely needed to be messed with). 

 We also tried to keep the tooth infections at bay with meds first -- She had beads inserted after her first surgery, then two years later when another tooth started acting up, we did all sorts of meds, including 'Chloramphenicol, and it did help keep things at bay for quite a while. But over time, it kept coming back, so we chose surgery for another tooth removal, AND my vet was able to get a culture deep in the gum at the time. From that she was able to identify some of the resistant strains and recommended antibiotics that would not only help with healing, but would help prevent these reoccurring infections over the years.


Luckily all of the antibiotics that Rucy had over the years did not upset her digestive tract, but that is something to discuss with your vet as well.  Each bunny is different. 


User is Offline jerseygirl
Australia
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10/06/2012 9:44 PM
I know of the clinic though I'm in SA. Even though they only see rabbits and guineapigs I still think its good for vets to consult with others. These days they can chat to vets around the world. But it might be early days yet and the antibiotics do the trick. Fingers crossed.

My rabbit got a fast growing abscess earlier this year. It involved 3 lower teeth and there suspicion about the bone around his opposing teeth too. Bit of a nightmare.

I had a few false starts in his treatment which was frustrating and expensive. His first culture came back sterile. I had a second one done when he was off antibiotics (important! IMO) and this gave 2 antibiotic options. Even then, with amount of puss and his abscess walling off, the antibiotic didn't seem to be getting thru. It took the abscess growing big and bursting open (sorry!) to be the blessing in disguise. I was able to clean it out thoroughly and the antibiotic became more effective. So far so good...

With this experience i can see how important it is to get onto the right antibiotic as early as possible. You do not want the abscess starting to infect the bone. If the vet is going to clean the abscess and take a sample, ask if your rabbit is to be off the chloramphenicol before this is done. It might be a given but it never hurts to ask.

The PenG... it seems to be med of choice to add to the mix. apparently rabbits do well on long term low(?) doses. So ive heard.

Have you had X-rays done?

Regarding tooth trims, does your rabbit currently have molar spurs or a malocclusion? Or is this something the vet thinks could arise?
Perhaps they could recommend a vet closer to you for any maintenance molar trims if required?


Whoever says "It's only a rabbit" has obviously never loved a rabbit.

User is Offline ThreeBuns
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10/06/2012 10:18 PM

Hmm, well his abscess is a little odd really...the vet was expecting it to be attached to the jaw on the xray, but nope, it's not at all, which I suppose is a good thing, meaning it's not so bad, we caught it early enough?

Here's one of his xrays, clearly showing it not being boney...phew! (it's the pale grey shadow under his jaw there)

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I think the scraping/ lancing of the abscess will be done depending on what the next vet thinks is best- he'll be on the Chlorowhatsit from now until then, so we won't take him off it since they didn't say we should- we also have to give it time to work, since I think it can take a few days before it really kicks in...

The xrays (he had lots done) had these results:

"3rd tooth on lower LH side = cause of the tooth root abscess, possibility the 4th tooth is also involved.

There is also changes to the RH lower 2nd tooth and the RH upper 1st tooth, but no abscesses. Potentialy in the future abscesses could develop"

All occlusion is normal, but yeah, there's 'root elongation' on those suspect teeth, so may have probs in the future.

 

Sadly, our local vets said this kind of dental surgery they weren't equipped for as it's so specialised, so sent me straight to the experts. (I'd rather that, than had they pretended they could, and made a botch-job of it, really.)

They might be okay with maintenance trims though, I will ask tomorrow when we bring a piggle in for his checkup.

 


User is Offline jerseygirl
Australia
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10/06/2012 10:48 PM
Oh yes,I definitely wasn't suggesting you take him off it.

Thanks for posting the X-rays. I always find them interesting but confusing too! I'll have take a better look on my pc.
Whoever says "It's only a rabbit" has obviously never loved a rabbit.

User is Offline LittlePuffyTail
New Brunswick, Canada
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10/07/2012 2:17 AM
I don't have much dental experience and, therefore, can't offer much advice, but it seems like you are getting lots of great advice from the other members. I just want to add that I'm sorry your bunny is having these problems and I hope whatever you decide helps him feel better. We are all here to offer support during your difficulties.

(((((Bunny Health Vibes)))))))
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User is Offline ThreeBuns
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10/07/2012 4:04 PM
Thanks for all the help so far, guys. Nice to find a supportive community.

Young chap is hating the evening meds which we give to him via syringe, but looooves the morning dose- perhaps because mummy is sneaky and mashes it into a small slice of banana, and puts it onto a spoon. He eats it right off, licking his lips and nudging the spoon for more. :-D

User is Offline ThreeBuns
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10/21/2012 10:54 PM
So, update!
Took him back to the Rabbit Clinic on Monday the 15th, after it was obvious that his lump was growing despite the antibiotics.
They lanced it and took a scraping, and showed us how to flush it twice a day...so, that's been happening, much to the poor little guy's horror. Not at all nice for us to have to do, or for him to have to sit through!
The culture&sensitivity test results from the scraping came back on Saturday, and showed that he should have been responding to the antibiotics he was on, so they suspect a second bug as well, which was being masked...or, because it wasn't yet lances and drained, the antibiotics couldn't get a good hold. 
So today, we picked up his new meds. Oh joy, TWO lots. He'll be so thrilled. Flagyl and Enrotril. In total, over 2ml of meds, twice daily. He was hating us enough with .45ml of the Chloramphenicol, but now with 4 times as much yummy meds each time, mmmm....Disapproval will be great. ;-)
His lump hasn't grown since the lancing, and nasty as it is to have to keep soaking and opening it to flush it out, we're getting very very little pus out now...a few teensy specks, if we're lucky. I hope this means he's nearly all good? Not sure how long to keep persisting with the 'flushing', since practically nothing is coming out. Or is this to keep the site open and let air in, to help kill off bacteria? It's getting harder and harder to open up, as he's doing his best to heal!
He'll be on these new meds for 14 days, and then we phone the Clinic to see what happens next...

Luckily he still loves us despite all this torture, and quickly forgives and comes looking for treats and nosepats a short time later.

User is Offline Roberta
Wanneroo, Western Australia
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10/22/2012 12:17 AM
So glad he is doing better. I have never had to flush a bunny tooth abscess but I have had to do it with a cat and essentially once the region stopped being easy to open and the puss was not recurring it was OK to stop (usually two or three days) you can always give the vet a call and continue to monitor it for any signs of it returning.
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User is Offline ThreeBuns
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10/22/2012 12:31 AM

Two or three days? Oh lordy, we've been doing it twice a day for a whole week now!

Will definitely contact the Clinic tomorrow then- much happier patient if we can stop the torture, and be down to only two oral medicines a day- and these, much easier to administer than the chalky thick previous one!


User is Offline Sarita
(Dallas)
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10/22/2012 2:41 AM
Continued vibes - I hope this works.

User is Offline LittlePuffyTail
New Brunswick, Canada
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10/23/2012 12:57 AM
Luckily he still loves us despite all this torture, and quickly forgives and comes looking for treats and nosepats a short time later.
Bunnies are great like that. You do medical stuff to them and think they will hate you, but they are so sweet and forgiving.

((((((Healing Vibes)))))))
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User is Offline ThreeBuns
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10/23/2012 1:10 AM
Yay! We can stop the abscess-torture. :-D
Only the two runny medicines twice daily for 14 days, no more poking and soaking and terrifying him.
He flicked away as soon as he was put down after his meds tonight, then came right back and sat on his little spot on the carpet, grooming himself and waiting expectantly for his slice of banana. Oh dear, now we have to keep doing that despite no more real drama, just easy meds? Oh I suppose so...can't say no to the little hopeful face.

User is Offline jerseygirl
Australia
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10/23/2012 2:02 AM
Haha! Well he should be loving the flagyl. My Jelly loooves it. I'm not sure what enrotril is. Sounds like a form of baytril (enrofloxacin).

The abscess site heals up super fast so your having flushed it twice per day was spot on. At least, according to what I was advised to do for Jelly.
I know you feel awful doing the flushes but I'm told they dont feel much pain with it. Maybe just the pressure from the solution. And you relieve some pressure getting that puss out too.

Good luck on the new antibiotics. {{{vibes}}}
Whoever says "It's only a rabbit" has obviously never loved a rabbit.

User is Offline ThreeBuns
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10/25/2012 2:22 PM

Yep, he likes the Flagyl, licks that up happily enough...but the Enrotril, eeh, he makes faces and tries to kill the syringe, or let it dribble out of his mouth. I can see why- I tried a tiny bit that spilt onto my  hand, and yuck, it's just like Baytril- nasty bitter!

I've made him a little happier by alternating the sweet and bitter meds, so we start with the Flagyl, and end with it, less traumatic.

 

Still happy with how the abscess is going- no growing, just the scab healing now slowly...looking good for a better result than we'd dared hope.


User is Offline ThreeBuns
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11/08/2012 12:21 AM
So, almost all cleared up now! :-)

Been back to the vet this week, and she got one last little lot of pus out of his now very small lump (since the scab came off easily), and we're now learning how to give him a penicillin injection once a week. The one they gave at the vet to demonstrate didn't seem to phase him at all, so with luck we'll be as quick and painless when we do it, and he'll barely have reason to fear us. ;-)
We're to do this for a few months, and then check back in...hopefully it should get rid of the last of the abscess, and stop it reforming.
He's back to normal now, happily eating all his hard foods, and getting more trusting and snuggly with us again. You'd barely know we'd been through so much in the past few weeks.

User is Offline jerseygirl
Australia
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11/08/2012 12:30 AM
Fantastic!

Good luck with the penicillin injections. Stuff is a pain in the butt.
Whoever says "It's only a rabbit" has obviously never loved a rabbit.

User is Offline LittlePuffyTail
New Brunswick, Canada
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11/08/2012 1:23 AM
Great news!!!!
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BINKYBUNNY FORUMS > HOUSE RABBIT Q & A > Tooth Root Abscess- to remove teeth, or lifelong antibiotic treatment??

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