Jelly’s abscess – culture results negative

[jerseygirl]

It looks like Jelly is already presenting with some dental problems. I expected this at some point, but not this early on. He’s not yet a year old.

I took him to the vet last week and she suspects a tooth root abscess (Lower left side). I had him lined up for xrays the next day. He’d have to have general anaesthetic to do this and if she found abscess, she attempt to drain/clean it then. The next day though, all his symptoms seemed to be gone! He was all dry under the mouth and was no longer sneezing. It was odd but I put the appt off as I really didn’t want to stress him out 2 days in a row. Anyway, he’s slowly begun getting nasally again, and today the chin is wet on the problem side.

The vet told me if it was related to the tooth, that it would be taken out and gave me name of vet where I could have that done. I’m actually wondering if I’m better off just going there with him now? As a second opionon and to get moving on this.  If this vet would be performing the dental surgery, why not book him in for xray there, and if they discover the problem then, remove the tooth then and there. I’m just trying to figure out the best way to approach things.

I figure it would save me some dollars but also mean Jelly would only be put under anaesthetic once. Plus, I’m more likely to have better success clearing up the abscess if there is one, with the tooth gone. I’m told they remove it through the bottom of the jaw.

 I’d appreciate hearing the BB-ers opinions. : )

[Monkeybun]

I would just go to the specialist, to save you money and to save jelly another dose of anesthetic.

Vibes to Jelly!

[Sarita]

I agree with MB, just go straight to the specialist.

More vibes to Jelly.

[Kokaneeandkahlua]

{{Vibes}} Sounds like the specialist would be the way to go

[jerseygirl]

Thanks guys. It helps me when I sound things out here.

Thank you also for the vibes. I’m am worried about him.

[MimzMum]

JG, there was also just a thread this evening at RU about dental buns getting new procedures to stop frequent burrings…not sure if it might have relevance to your case, but perhaps you can find extra info to ask about.
http://forums.rabbitrehome.org.uk/showthread.php?328146-Possible-Hope-For-Rabbits-with-Molar-Spur-Problems
Hope Jelly will be okay. Give him some snuggles from us!

[jerseygirl]

Will do! Thanks for the link, I have the page open already. : )

One thing I just remembered… at the appt on wednesday, I asked if they take out a problem tooth if that meant the opposing tooth would also have to come out. The vet said that they are finding now that they don’t need to do this because of the way the molars occlude. The opposing tooth would still contact some of the lower molars. She showed me on a replica skull which was pretty cool.

The other thing I forgot to mention is Jelly seems to have a bump on the jaw bone. It is bone too and she thinks it is because his face is asymetrical. Thing is, I only discovered it 2 weeks ago. He usually sits in my lap and I pet his face and back so I thought I was pretty familiar with what was normal for him. It was a real shock to feel that protuberance. Kafrn tells me abscess can deform the bone as she saw with Stubob so I’m curious if that what is going on. An xray should provide some answers.

[Elrohwen]

Poor Jelly! I would definitely just take him to the specialist

[equalsign]

 I’m sorry you and your rabbit are having to go through this. Personally I would recommend you take him back in every 3-4 weeks until you are confident that the abscess is really gone. They can literally pop up overnight, so I would check him every couple days at least.

 

I would consider what you want the vet to do if they find it is worse than they thought. What I mean is I would discuss beforehand the maximum time that you want him under. I would discuss beforehand what they will do if it has spread to the other side of the mouth. Would you break it up into two sugeries? How quickly would he handle two sugeries so close together? Would two surgeries be more risky than one?

 

With my rabbit it had spread to the other side and so they kept her under for over an hour to try and get a third tooth. Upon pulling that third tooth her vitals dropped and she died. It’s impossible to know exactly what caused it and would have been impossible to know beforehand, but my vet told me that he knows if he hadn’t pulled that third tooth that she would have lived. With something like this it is very difficult to find that line between being safe/conservative and agressive enough to have that chance you get it.

 

I really hope this works out for both of you. I’m sorry if I’ve worried you.

[jerseygirl]

equalsign, that is a very valid concern.  His being under for a protracted length of time could very well be dangerous. I hadn’t even thought of that so thank you!   It will help if I can ask these sorts of things beforehand but as I haven’t dealt with this before, I wasn’t certain of the specifics.  

@MimzMum, that thread on RU was really interesting.  Could Mimzy be a candidate for this if your vet agreed to trial it?  Are his problem molars in the lower jaw?

I had a mini meltdown about Jelly this morning, I admit.
We have an appointment tomorrow now, but it will just be a consult. I’m relieved though as I feel I’m moving on things again.
 

[LittlePuffyTail]

Awww….what a great pic. ((((((Tooth Vibes)))))

[Sarita]

He’s cute.

Pepe who had terrible teeth had a bump on his lower jaw that the vet thought may be the root growing down (or something like that).

Bobby has had maybe 3 or 4 teeth removed but the vet just removed the infected or lose teeth.

I think the deal with bad teeth, is they will always need regular trims and maintenance on their teeth.

Ask the vet about buprenex, metacam and reglan to use after each dental trim or procedure – you can do burenex (buprenorphine) orally so you don’t have to do an injection (it’s the same formula for both oral and injectible).

[jerseygirl]

A belated update. I’ve been taking some time to absorb things…

So its confirmed Jelly has an abscess. The diagnosis reads “extensive tooth root abscess”.   He had xrays done by the referred vet and he’s not keen on surgery. He said it’s possible but not good outcome and likely ongoing problems…

So the approach we’re taking is hitting it with an antibiotic Fortum (Ceftazidime) in the hopes it will deal with the abscess and the bone in his jaw can stabalise.  He already has some bone thinning occuring under some teeth on the other side too.  Jelly doesn’t do things by halves. :/

The vet I’ve been seeing at my own clinic has suggested we get the opinion of a very rabbit experience vet interstate. There is also another here I could ask the opinion of. For now though, I’m hoping the antibiotic will help. It’s supposed to be good and it’s not cheap! Jelly is off for the 3rd shot tomorrow. He’s actually handling the car trips well and is quite bright after the appointments. He’s surprised me!

Here are the xrays.  This is on his left side.    Basically, the bone is to soft and thinning in areas and the tooth roots (at least 3) have overgrown causing abscess. 

You can see the abscess in the soft tissue are where I’ve put the red arrow.

Below is same xray image with more contrast to hopefully show tooth and bone more clearly.

My red arrow shows area of bone that has deterioated. And left of that you can see the teeth roots.

[Sarita]

Poor Jelly. I’m not familiar with that medication so I will be very curious to see if it works.

Have you found Jelly’s diet has changed due to his tooth abscess? The radiologist saw some abscesses in Toffee’s x-rays but they weren’t as severe as Jelly’s but they certainly changed her eating habits. The vet put her on baytril and she is now eating her greens again so I hope that you will have success with Jelly’s treatments.

Do you think that you would be able to do the injections at home by yourself? How many is he going to need?

[RabbitPam]

Thanks for posting the xrays. That’s so interesting.
Gosh, JG, you have a lot going on with bunnies today. I am hoping the treatment for Jelly will be effective.
It may not help but it couldn’t hurt: {{{{{{{{{Healing vibes, Jelly}}}}}}}}}}}}}}

[bunnyfriend]

Awhhh poor Jelly! I hope the antibiotic heals him. Did the vet say how long it might take for it to start working?

[BinkyBunny]

Rucy had thinning bone on one side — so much so that it easily got a hairline fracture during a nasty little fight between her and Bailey. It healed okay and I think it was then that I discontinued trying to bond them indefinitely. I am also not familiar with the antibiotic you named (but found it on the House Rabbit Society as one of ones that are given to rabbits (http://www.rabbit.org/health/antibiotics.html). Rucy had tried so many different kinds, I can’t be sure anymore what they were or what worked better than the other. I do remember trying one after some of the other common ones didn’t work or stopped working. It was called chloramphenicol and if I remember right, a bit more pricey.

Sending out healing vibes for Jelly!!

[jerseygirl]

Posted By Sarita on 02/01/2012 06:19 AM
Poor Jelly. I’m not familiar with that medication so I will be very curious to see if it works.

Have you found Jelly’s diet has changed due to his tooth abscess? The radiologist saw some abscesses in Toffee’s x-rays but they weren’t as severe as Jelly’s but they certainly changed her eating habits. The vet put her on baytril and she is now eating her greens again so I hope that you will have success with Jelly’s treatments.

Do you think that you would be able to do the injections at home by yourself? How many is he going to need?

 

Sarita, I’ve noticed he’s not eating as much hay. I do feed a hay only pellet also so he’s still getting fibre.  He’s a little slower with some greens and doesn’t eat celery pieces now.  Generally though, he is bright and appetite seems good. The lump on his face is large and not reducing… : (  I’m concerned as my vet said the body walls off the abscess so I wonder how much antibiotic is getting to it.

The med is one of the cephalosporin family. I think i read read sometimes more effective if something has not responded to a penecillin??  Thankfully it wasn’t as expensive as I feared. Turns out I paid for it all up front and its not that cost per shot.   The injection has to be given intra muscular and even the nurses required assistance when giving it.  I wouldn’t be confident to give it myself at home.  Jelly is coping really well with the trip to the vet so I’ll stick to them administering it.

 

 

[jerseygirl]

BB, the bone thinning was referred to as lysis. Were you able to recognise it on Rucys xrays? I find xrays confusing…

[BinkyBunny]

This was a long time ago so if I am remembering right I don’t think it was obvious to me. I do remember though that my vet at the time attributed it to previous nasty abscesses and the fact that part of her jaw bone was scraped (not sure of right term), since the abscess she had was a deep infection. I dont know much about that as the most serious abscess she had was before I adopted her. She had a few after but I usually was on top of it right away with meds and then surgery when needed. This was almost 10 years ago and a completely different vet so nowadays I would have known more and paid closer attention and asked more questions with the xrays. I’m sorry I am not too enlightening here.

[longhairmike]

they have a procedure now whereby they implant little balls with long-term antibiotics in them right into the abscessed area.
one of the buns we sponsor at TTAS just had this done jan 24th.

[BinkyBunny]

LHM – This is what they did for Rucy with her first two abscesses. Though some do say the beads may not help, Rucy was abscess free for two years

[jerseygirl]

Oh yeah, I’d forgotten about antibiotic beads! I’ll ask vet on Monday.

I had heard we can’t get them here though don’t know how accurate that is. Or maybe it’s bicillin that’s not available… From what I’ve read though, these can be made with other antibiotics. Could even made in the clinic.

[LittlePuffyTail]

((((((Jelly)))))) More vibes to your little guy.

It was interesting to see that X-Ray.

[jerseygirl]

Thanks LPT.

Well, we’ve gone ahead and opened up the abscess to clean it out. So now poor Bub has a shaved face and hole in his jaw. And I get to poke him daily with a saline syringe. Poor thing! I’m glad to have taken this step though. I was getting so concerned because the antibiotics had not changed the abscess at all and it was only getting bigger.

Should be getting results from a culture in a few days and have a better idea what med to use. The vet said there were 3 areas she had to excavate, like the abscess had separate capsules.
I was really pleased she likes using manuka honey in the site as I’ve read about it and was keen to use. Glad we are on the same page with that. So will probably start to pack the wound with it soon.

Thanks for being my sound board here. : )
Jelly is coping so well with all of this! I just hope we can get things under control.

ETA: The antibiotic beads are not an option unfortunately. I asked and she told me she’s tried several times to get them here but cannot. Can’t import and can’t get compounding pharmacists here to make them either.

[MimzMum]

Sorry I haven’t been back here lately, lots of updates to go over! Poor Jelly! I’m so sorry you’ve both had to go through so much. But you’re getting quite the veterinary education aren’t you? You’ll be helping in surgery next!
To answer your earlier question, I’m not sure the ‘root canal’ approach would work for Mimzy. I’ll have to wait to see his vet, she was helping on the Yukon Quest sled dog race again this year so she may not be returned from Whitehorse yet.

I agree that the antibiotic chloramphenicol is a penetrating one that extends to hard to reach cavities. Now that the capsules are opened, if it’s necessary to bring healing to the underlying tissues it could be a good drug to try. I think my vet said it can even reach to bone, but don’t quote me. It is a tricky med for humans to dose because if your skin absorbs it you can contract a fatal anemic condition. I had Mimzy on it for two weeks and had to wear gloves to handle the meds and clean up after. It was nerve wracking, but I think it helped him for a brief while.

Vibes to you and Jelly…I hope he improves soon and something can be done to help his teeth and jaws. ((((((((((Vibes)))))))))

[equalsign]

 Glad to hear things are going alright. If you see repeated scabbing over the next few weeks I would take him back in. In my case it was actually dried puss because the abscess had returned.

[LittlePuffyTail]

I’m glad Jelly is making out okay. ((((((Continued healing vibes))))))

[longhairmike]

Strider at TTAS just lost his battle with his abscesses today. :*(  februarys suck
http://www.facebook.com/photo.php?fbid=10150667112101620&set=pu.124193741619&type=1&theater

binky free strider
 

[jerseygirl]

: ( *binky free Strider!* that’s sad news. 4 surgeries in 1 1/2 years. Wow

[LittlePuffyTail]

Aw….

[jerseygirl]

Another “belated” update. I got the culture results back last week. Nothing grown after 48 hours…. The vets think because he was already on antibiotics this is why got this result. Which means the med was probably working. In hindsight, should have really got culture done when he went under GA for the xrays. Least then have more clue of what bacteria is present. Ironically, had I done this thru my own vet, they would have done cleaned out the abscess at the time and sent of for culture… Oh well.

So we decided to try Jelly on Pen G Procaine now for 6wks. Still regarded as a “medium risk” antibiotic as the fortum but can be given subQ and only needed once a week. After this course we’ll assess again and if any growth, stop abx and xray & do another culture.

[Sarita]

I hope the pen-g works. That’s what the vet but Bobby on when he first came in with dental abscesses and it really cleared up his abscess – of course he lost about 3 teeth. I’m pretty sure they never did a culture on Bobby either.

Let us know how the pen-g does.

[LittlePuffyTail]

That’s frustrating about the culture. The same thing happened to me several times when we tried to culture Bindi’s ears.

**Crossing my fingers he does well on the medication.**

[Kokaneeandkahlua]

Oh that’s too bad-you’d be curious to know what was growing in there.

X-rays were neat-thank you for sharing. I’m with you though x-rays totally confuse me. If you hadn’t put the arrows I wouldn’t have seen the bulge. (In fact I can’t make hide nor hair of ultrasounds either!)

Vibes Vibes and more Vibes!! Sounds like Jelly is such a trooper. I know how stressful and hard it is to have an ongoing illness -you just aren’t sure what to expect, , and there is so much to think about, hear about from the vet, game planning, researching…so stressful. Take a nice bath and find a nice book and kick back-you deserve it and Jelly is so lucky to have someone driving him back and forth and caring for this for him!

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