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More bad news for Mack: Another check-up tonight (04/03)

Sooz

Wise Old Thumper
Just back from his latest check-up after the removal of abcesses 2 & 3 and his culture and sensitivity results were back in. They showed the presence of Pasteurella which was completely expected and not a huge issue in the grand scheme of things as it registered susceptible to all antibiotics.

However it also showed a result of Pseudomonas, again, not unusual as it does tend to be a fairly widespread & opportunistic bacteria but what was unusual was it wasn't appearing as a surface infectant rather it was located inside a cross section of the abcess capsule itself which had been taken at the deepest point of the cavity (connecting with the mandible). It is also Penicillin resistant and resistant to all the other antibiotics (bacteriacidal) we have tried. The lab results showed it as susceptible to Baytril :? but given the poor tissue penetration of enrofloxacin it's not going to touch it.

So Mack is now on a Oxytetracycline injetion every third day as the lab indicated the use of a bacteriostatic antibiotic to make the abcess environment inhospitable might halt the growth of the bacteria. However the fact that Pseudomonas is showing a significant factor in Mack's issues has meant we are left with very few options for the long term and it looks like it is almost certainly now a case of control rather than cure.

Oh and to top it off, whilst waiting for our appointment, I noticed the poor little lad has started with a mite infestation.

Gutted :cry::cry::cry:
 
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Poor lad :cry:

What about putting Baytril into the abscess cavity itself aswell as giving systemic Oxytet' :?

I did this with the first one, but he has had an almight reaction to the Hibiscrub (now on saline only flushes since Saturday) and his skin is still going down, which is why I think it isn't recommended at the moment.

He is due back in a week for another check, but if his skin has improved markedly before then I will call and ask if it's OK.

Thanks for the suggestion. :)
 
I did this with the first one, but he has had an almight reaction to the Hibiscrub (now on saline only flushes since Saturday) and his skin is still going down, which is why I think it isn't recommended at the moment.

He is due back in a week for another check, but if his skin has improved markedly before then I will call and ask if it's OK.

Thanks for the suggestion. :)

Yes, I am really not sure about the direct application of Baytril given how some Buns react badly to Baytril injections (Baytril Burn)..:?


Arrrrrrrrrgh, bloody abscesses :evil:
 
I just found this previously written by Janice:

In humans if you have a wound which is infected with Pseudomonas it should not be cleaned with saline as this encourages the bacterial growth in it rather than actually cleaning it, sterile water is the cleaning agent of choice. Boiled cooled water being most people's nearest equivlent. I would assume that this is the same with animals.
__________________

What do I do? I can't flipping win! :censored:
 
Awwwwww Sooz I am sorry, :(

I know this isn't much help, but I had the problem with Nibbles, she had one after another and she couldn't have ga's, she did at first, but she was nearly 12 when we lost her and they became hard to do because of her age.

Anyway in the two years we have her she had a stack, infact I couldn't tell you how many. They were always in the same place and we did go through the motions each time, after a while they would even burst as soon as they come up, the area where they were must of been so weak from having them lanced (sp?) all the time. They didn't even bother her, they were just a pain for us to keep treating, and she would have ceporex injections and different things in the actual abcsess, but nothing got rid of it, it kept coming back.

Are the abscess's coming up in the same place?
 
Awwwwww Sooz I am sorry, :(

I know this isn't much help, but I had the problem with Nibbles, she had one after another and she couldn't have ga's, she did at first, but she was nearly 12 when we lost her and they became hard to do because of her age.

Anyway in the two years we have her she had a stack, infact I couldn't tell you how many. They were always in the same place and we did go through the motions each time, after a while they would even burst as soon as they come up, the area where they were must of been so weak from having them lanced (sp?) all the time. They didn't even bother her, they were just a pain for us to keep treating, and she would have ceporex injections and different things in the actual abcsess, but nothing got rid of it, it kept coming back.

Are the abscess's coming up in the same place?

No, they are all in his mandible but they are tracking backwards towards his throat now whereas the initial one was on his chin. 2&3 were walled off but communicating but had no relation to abcess 1.

How old was Nibbles when her abcesses first started?

Mack's only bother him when we interfere, he dosn't seem to notice them until we lance or excise them but the cleaning routine is so tough on him. :(
 
I am sorry, you must be in bits :(. I took Nibbles on when she was ten and she came with an abscess, it was like a golf ball, we kept having them done and they would always come back, she didn't suffer for it though.
 
I'm sorry you have had such bad news about Mack.

I don't know if you have already tried this or whether it will help his type of abscess but my vets have put tiacil daily into the cleaned out cavity before putting in the honey. Just a thought :D
 
I'm sorry you have had such bad news about Mack.

I don't know if you have already tried this or whether it will help his type of abscess but my vets have put tiacil daily into the cleaned out cavity before putting in the honey. Just a thought :D

Thanks for the suggestion....I will have to get them to see if Gentamicin is showing as effective against the pseudomonas on the lab report as it's a bactericidal antibiotic (though supposedly effective against pseudomonas aeruginosa).

We need to be careful because apparently the pseudomonas can often linger in the background behind a more prominant infection such as pasteurella, only to come into it's own when antibiotic treatment has eradicated the more susceptible bacteria...leaving it free to take over entirely.

Did any of the rabbits you have used Tiacil topically in experience any skin reactions at all?
 
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Thanks for the suggestion....I will have to get them to see if Gentamicin is showing as effective against the pseudomona on the lab report as it's a bactericidal antibiotic (though supposedly effective against pseudomonas aeruginosa).

We need to be careful because apparently the pseudomona can often linger in the background behind a more prominant infection such as pasteurella, only to come into it's own when antibiotic treatment has eradicated the more susceptible bacteria...leaving it free to take over entirely.

Did any of the rabbits you have used Tiacil topically in experience any skin reactions at all?

No we didn't have a skin reaction to the tiacil, but we washed it out first with diluted hibiscrub which they also diodn't have a problem with. :)
 
No we didn't have a skin reaction to the tiacil, but we washed it out first with diluted hibiscrub which they also diodn't have a problem with. :)

Ok, thats another option for us to consider then.

In the meantime I'll continue with the flushing & Manuka and can raise the use of Baytril & Tiacil next Wednesday to see what the vets think.
 
This is a mad suggestion (so feel free to treat it as such, but I just thought I'd throw it out there! ;)), but have you looked into things like Citricidal (grapefruit seed extract)? It's a potent broad spectrum antibacterial. It tastes really really bitter, unfortunately.

My guinea pigs have a long term infection problem with a resistant bacteria, and the only thing that really seems to help them is Citricidal. I've no knowledge of use with bunnies though.
 
Sorry to hear about Mack Sooz :(

A friend of mine has been researching abscess treatments recently for one of her buns. This web article seems to list all the treatments she mentioned to me....

http://veterinarycalendar.dvm360.co...meyelit/ArticleStandard/Article/detail/562358

Quote:

Simple single surgical opening of the abscess capsule and flushing is anecdotally associated with high failure rate, as this technique does not include removal of the capsule and diseased teeth and debridement of infected bone and soft tissues. Improved success rates have been reported utilizing a number of more advanced techniques including:

1. Aggressive surgical debridement with removal of affected teeth and bone, followed by marsupialization, and repeated flushing and gentle debridement, plus instillation of antibiotic gel and/or granulation-stimulating products until the wound heals by second intention;

2. Aggressive surgical debridement with removal of affected teeth and bone, followed by insertion of AIPMMA beads and primary closure, +/- repeated surgical debridement until healed;

3. More conservative debridement followed by packing of the wound with antibiotic soaked gauze until the wound heals by second intention;

4. Varying degrees of surgical debridement with or without marsupialization, and packing of the wound with honey or sugar solutions until the wound heals by second intention.

It is impossible to compare the merits of these approaches without an understanding of the variability of severity of periapical abscesses in rabbits. While less aggressive surgical techniques may be adequate for simple periapical abscesses of one or just a few teeth, the success rate in cases of widespread osteomyelitis is expected to be lower.

The author prefers technique (1) above, which is described in detail: Removal of the entire capsule is facilitated by incising the skin over the abscess and then carefully dissecting the intact capsule from surrounding tissues, taking care not to enter the abscess cavity. Once the capsule has been isolated up to the point where the abscess connects with bone, the capsule is incised and removed along with the purulent material. A specimen for culture and sensitivity can be collected from the capsule wall at this point. Any remaining debris or material is removed, and the infected or necrotic cortical bone debrided to the point of bleeding with a bone curette or rongeurs. Any affected tooth fragments are removed at this point, and the site thoroughly flushed. Marsupialization is performed with 3-0 or smaller non-absorbable suture material. Marsupialization produces a less appealing cosmetic outcome, but allows daily debridement, flushing and packing with antibiotic ointments. Most owners can be taught how to assume most of the care, with frequent veterinary rechecks to evaluate progress. Sutures are often removed 10-12 days post-surgery, and the wound allowed to granulate by second intention.
 
Well Mack has had a combination of technique 1 & 4 so far, repeat flushing 3 times a day followed by the packing of the wound with Manuka and sealing with gauze until the next flush.

Sarah, interestingly an acid environment will stop the bacteria producing and something that is very effective for this is actually white wine vinegar but we just can't pour this in an open wound, as it would be absolutely excruciating for him.

I'm waiting for Rob to call me Re: Tiacil and the use of Saline.
 
Poor little lad he has been through so much:cry:
Can't add to the recommendations for treatment but wishing him well xx
 
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