Thank you everyone, your replies helped and I was able to fully discuss things with the vet. We had a long chat.
I have mixed news about Bonnie. She was examined with an otoscope and the vet saw the spurs have indeed returned though they are not as long as they were before. She also has an ulcer on her tongue where one spur has been rubbing against it. She will be getting another dental under general anaesthetic today and the vet will file the teeth right down until they are level with the gums. Last time he filed the sharp points (spurs) off but left the teeth as normal.
Bonnie’s problems cannot be cured, she will always have squint teeth from now on and though we can explore other options they may not be fair on her. I discussed this extensively with the vet.
The main problem we have is time. Had Bonnie cleared the 6 week mark (no dental problems in the 6 weeks following her previous operation) then there would be less cause for concern. The fact that the spurs have returned so soon means she is prone and will always be beset by dental issues. The vet said that if she needs a dental operation every month or so we have to consider whether that is fair on Bonnie.
I also asked him about full tooth removal. He said full tooth removal would involve drilling a hole in the jaw (or under the eye socket) to extract the root and tooth. However taking out the unhealthy tooth means the opposing healthy tooth above or below will also have to be removed. If that is not done the healthy tooth will be left rubbing against the gum flesh causing excessive bleeding and pain. My vet does not perform that kind of surgery; he would have to refer us to the rabbit specialist Brigtte Reusch. She is the only specialist in Scotland and works and lectures at the **** Vet at Edinburgh University. While she would perform the operation she may question the ethics behind it as full tooth removal is such a dangerous and tricky operation.
For a start drilling around the eye socket is fraught with risks and injuries can occur as a result. The jaw can break, the eye socket pierced and even if successful there is a high risk of oral bacteria entering the hole where the tooth once was thus causing infection characterised by pus and bleeding. Furthermore Bonnie would never be able to eat hay or grass again if she did not have molars. She would have to live off a permanent soft diet which would probably cause permanent diarrhoea. This will cause her to lose essential nutrients as rabbits eat their own (solid) faeces to regain bacteria. She won’t be able to do that if her stool is soft or runny. Finally full tooth and root removal is not a guaranteed cure, teeth and roots can grow back and if that were to happen we’d encounter the same problems.
Bonnie’s problems are old age related and directly linked to the issue of calcium. Rabbits need calcium and fibre more than any other nutrient and this is absorbed through the diet. Some rabbits when they age start to lose calcium around their body or fail to absorb it properly so the body trys to derive from every source possible and apart from the bones the teeth are richest source of calcium. So as the calcium levels in the teeth are depleted they become softer and start to misalign causing the teeth to miss each other and fail to wear against each other which encourages the growth of spurs. The vet can give calcium injections but has said they often have little effect in older rabbits and the injections won’t cure the spurs.
Now that her jaw is misaligned she will she will always suffer from spurs. In humans a brace would be used to correct any misalignment but no such thing exists for rabbits and it may not be practical.
We face a hard decision with Bonnie and it all comes down to time. As I said the vet will operate today and grind the teeth down as low as possible, lower than last time in order to give Bonnie time. We need to see how long she can go without dental problems. The vet said if she were to clear three months then there is a chance we would not need to explore other options. If she develops problems before then we would have to take her back and discuss our options.
She will die one way or another because of this whether we put her to sleep or whether she fails to come round after an operation or sustains severe injuries and health problems
So for today at least I need her to come through this op and then we shall take it one day at a time and decide what is best for based on what happens next.
I can't believe this is happening in some ways. She has such a great diet and life as do all the buns and she is so sweet tempered and cuddly, she does not deserve this
