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Removing diseased/ infected incisors

M

Mad Bunster

Mama Doe
We've had trouble with Maddie and her jaw abscesses recently - she's had three capsules removed (under 2 GAs) in the last 10 weeks and I think I can feel another one starting to come up on the same site as her last one, even with antibiotic impregnated beads in there.

The last time she was under GA we had an xray taken which showed irregular tooth roots on her lower incisors - they appeared "lumpy" on the xray which vets took as sign of infection.

The advice they got from a specialist for removing her incisors was that it probably wouldn't make any difference to the prognosis because the infection was probably already in her jaw bone. I had decided to wait and see what happened next, but wasn't expecting this to happen so soon.

She isn't ready to give up just yet - neither am I - but am I being unrealistic in expecting that removing her teeth will help? If the teeth roots are infected is it feasible to take them out or is it more likely they'll break and we'll be in a worse position? If the infection is in the bone, then theres no point in taking teeth out either?

I'm hoping someone can offer some experience or opinions??
Thanks
 
Mad Bunster said:
We've had trouble with Maddie and her jaw abscesses recently - she's had three capsules removed (under 2 GAs) in the last 10 weeks and I think I can feel another one starting to come up on the same site as her last one, even with antibiotic impregnated beads in there.

The last time she was under GA we had an xray taken which showed irregular tooth roots on her lower incisors - they appeared "lumpy" on the xray which vets took as sign of infection.

The advice they got from a specialist for removing her incisors was that it probably wouldn't make any difference to the prognosis because the infection was probably already in her jaw bone. I had decided to wait and see what happened next, but wasn't expecting this to happen so soon.

She isn't ready to give up just yet - neither am I - but am I being unrealistic in expecting that removing her teeth will help? If the teeth roots are infected is it feasible to take them out or is it more likely they'll break and we'll be in a worse position? If the infection is in the bone, then theres no point in taking teeth out either?

I'm hoping someone can offer some experience or opinions??
Thanks
Click to expand...

No experience, just an opinion. I think it would depend on her general health otherwise and ability to withstand the GA and op, your feelings and whether or not your vet thinks it is worth a shot. I think removing the incisors will remove one source of pain - if the roots are infected then when bunny eats and grinds them this will of course give intense pain - so to be able to eat without aggravating site of infection I think would be a positive outcome. I also think that removing the roots/and tooth and killing stem cells below to prevent regrowth would perhaps allow any osteomyelitis in the root cavity and surrounding bone an opportunity to drain and heal, alongside antibiotic therapy, without constant aggravation from the tooth in the cavity. I would have thought there would also be less risk of any re-infection if the cavity is not being constantly moved around during grinding and allowing bacteria in, and maybe heal over completely if underlying infection treated at same time. Just my opinion - have no idea how clinically relevant it is:)
 
Last edited:
We opted not to remove our bunnies incisors when she was in a similar position. The bone was severely infected and it was thought that removing the incisors would not make a great deal of difference. There is also the posibility of the bone crumbling if it is badly infected as a lot of force is needed to extract the teeth.

I am certainly not saying don't do it, but we choose not to so I guess there is no right or wrong answer :)
 
Thanks for your inpur Hugo and Lupin - its true that theres no right or wrong answer.

At the moment, Maddie is very healthy, has a great appetite and is as bouncy as always - which I suppose makes making the decision a little harder as theres no clear cut answer, she appears healthy apart from the lumps. Last time I spoke to the vet he thought there wasn't much benefit to be had from removing the teeth - in terms of halting the infection any case. I'll ask him what he thinks of the pain aspect of that though, as I'd not considered that, and also what he thinks as to the integrity of the bone.

I think it is uncomfortable for her though as she constantly plucks fur from her dewlap (a longstanding problem though - may or may not be related?)

This last lump has returned despite antibiotic treatment, so I think that side of treatment can't be of any more benefit.

I'll see what the vet says tonight. Wish us luck!
 
How about a change in the type of antibiotic given? Or has your vet already tried a few?? Good luck with whatever decision you make. Bone infection is notoriously difficult to treat and rabbits are so fragile, it's a very difficult decison.
 
If any of the root is left they regrow and if they are already diseased/infected odds of bits breaking off are higher. On the other hand if it's an abcess it might give a hole to help drainage.
 
Well, slightly better news than I was expecting.... The abscess seems to not be connected to the bone this time, it seems to be formed around the antibiotic bead (ironic?). The Vet is happy to remove the capsule again and he asked what I wanted to do about her incisors.

He gave me a few options but I've decided to go for removing her incisors - this may or may not "cure" the abscesses, but its the best shot we have at it and it'll hopefully improve her quality of life as she won't have the discomfort from her teeth (once she is over this surgery). I would be annoyed with myself if, in another months time we are in the same situation, an abscess and still have dodgy teeth - at least I know we have tried our best for her. I couldn't keep putting her under GAs knowing it might not help, at least this way I know we're trying.

Her Culture results showed that the bacteria was resistant to Penicillins but the Vet is willing to try something else other than Baytril, so I've been scouring other peoples posts for antibiotics they've used in the past and I'll collate a list for him.
 
If it's cultured sensitive to tetracyclines then the doxycyline powder (ornicure) and intrasite gel mix we used for Mack might help, along with engemycin injections. I'm guessing if it's formed around an APIMMA bead that treatment won't be attempted again.
 
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