Long term management of abscesses - Advice and opinions please.

Hey all,

Dallas has had recurrent abscesses around his jowls and under his right eye for the last 3 months.

It started with one under the right jaw and a swollen eye. He has been on Depocillin since the first one plus eye meds to keep the eye healthy and lubricated. Metacam given when abscesses form. Manuka honey in the areas I can reach.

He has had xrays done twice to check his tear ducts, jaw and tooth roots. None have penetrated the bone yet and his teeth and roots seem fine based on the 2 lot's of xrays.

He is happy in himself in terms of still being the same active rabbit, eats everything, enjoys exploring etc etc.

The abscesses just keep coming though, it's a cycle of infecting new parts or previous parts of his dewlap, jowls, under his right eye. I don't think it's going to change, I think this is the beginning of the end.

I'm out of touch with the current situation with recurring abscesses so would really appreciate your experiences and if there are any other avenues I should try.

I won't let him suffer, if it comes to a point where he is even slightly unhappy (I know he must be uncomfy and at times in some pain) and the prognosis is that it will get worse, I won't hesitate to pts for his sake but whilst he still has such a zest for life, I want to make him as comfy as possible.

Have you had a culture taken to confirm that the Depocillin is the best abx?

Also, what UMF Manka do you use?

Did a culture at the start, but maybe another one is worth doing?

They start deep tissue so it's difficult to treat them and they are in areas where it's not easy to remove the whole capsule, if that makes sense. So it's just managing as they come to the surface at present.

Manuka honey is the active 16 +

:wave:

What Kermit said, and also, is he on daily Metacam all the time or just at selective times?

Selective at present as I don't want his system to become used to the metacam dosage quickly. So I am playing it by ear with the metacam.

ETa; When I lance an abscess he has metacam for 3 days. Then it's play by ear the rest of the time. If one is brewing and it's too deep he will be given metacam until it is safe to be lanced.

If you go for a culture + sensitivities then he will need to be off all abx for at least 7 days prior to testing, otherwise results will be corrupted

You could just opt for changing abx and/or adding Metronidazole, an abx that specifically targets anaerobic bacteria

From a person's point of view, I don't know if you've had an abscess or not but they are absolutely excrutiating and unbearable. Thumps informs me that bunnies abscesses are even more painful because their teeth are growing continuously. I know of a bunny who has had ongoing abscesses from at least two and a half years now (she arrived at the rescue with them) and her treatment from day one has been Metacam all the time, and also various antibiotics. They try to keep her on the lowest possible dose so that she has scope to go upwards of necessary and so they aren't battering her body unnecessarily. It's very clear when she is and isn't on pain relief though. It's also clear, when they gave it to her every 24 hours, that she didn't cope when it wore off, so now they give a split dose of half every 12 hours and it's worked a treat.

Like you, I'm one for quality over quantity, but knowing how horrificly painful it is to have an abscess, my 'quality' would always include pain relief, even if the bunny wasn't showing pain. Obviously the anti inflammatory effect is beneficial too.

Sky-O said:

From a person's point of view, I don't know if you've had an abscess or not but they are absolutely excrutiating and unbearable. Thumps informs me that bunnies abscesses are even more painful because their teeth are growing continuously. I know of a bunny who has had ongoing abscesses from at least two and a half years now (she arrived at the rescue with them) and her treatment from day one has been Metacam all the time, and also various antibiotics. They try to keep her on the lowest possible dose so that she has scope to go upwards of necessary and so they aren't battering her body unnecessarily. It's very clear when she is and isn't on pain relief though. It's also clear, when they gave it to her every 24 hours, that she didn't cope when it wore off, so now they give a split dose of half every 12 hours and it's worked a treat.

Like you, I'm one for quality over quantity, but knowing how horrificly painful it is to have an abscess, my 'quality' would always include pain relief, even if the bunny wasn't showing pain. Obviously the anti inflammatory effect is beneficial too.

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Yes that's my concern, I don't want to reach the limit too quick(i'm thinking in terms of months not days though), I would say now thinking about it, he is on metacam 5 out of 7 days a week on average, the 'break' happens after day 3 of lancing and then one tends to start up again so back on it.

I really am in 2 minds at the moment as buns hide their pain so well that I worry if I am doing the right thing, even though on the outside he is acting the same as he always has I don't want him to suffer and half of me feels he is because to have abscesses all the time but be painful, albeit at varying levels during the cycle, and I need opinions so I can make the right decision for him.

Jack's-Jane said:

If you go for a culture + sensitivities then he will need to be off all abx for at least 7 days prior to testing, otherwise results will be corrupted

You could just opt for changing abx and/or adding Metronidazole, an abx that specifically targets anaerobic bacteria

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I'm taking him back tomorrow so I will def ask about changing him over. He was on metronizadole for a while, I will ask about re-instating it.

I have always used Manuka with a 25+ UMF for treating abscesses, this would maybe worth changing to as the higher UMF does have better antibacterial properties.

I would also go for daily Metacam. If there is even a remote chance that this could help then I would go for it.

My Inca has been on daily Metacam for nearly a year now (for a number of issues), I have just increased her dose recently, but she has coped really well with it so far. I don't know what it is doing to her insides by taking it, but I feel that I would rather just give her it and make her feel better for now and deal with any fall out later.

When you drain/lance the abscess do you flush it with anything before packing with honey? I found that flushing with dilute iodine really helped abscesses to clear up quickly.

Inca has always had Ceporex Injections when she has had abscesses and I have found they work well.

Good luck x

Thank you Kermit (and Tracy and Jane!), I will speak to my vet tomorrow about all the alternatives advised.

I flush with either dilute hibiscrub or iodine every time I clean (daily minimum) and pack with fresh honey.
I did have a 25+ ages ago, but used it all up and haven't replaced it yet due to cash flow, but I do have a new credit card! It worked a treat on my horses wounds. The 16 + was half price so I bought 3 of them at the time!

I will go for daily metacam constantly then, thank you ladies.

How you getting on with Dallas' abscess?

Sorry Kermit, I have been totally snowed under with animals and work for the last few weeks!

Thanks for asking after Dallas

Well he had another operation to remove as much of the capsules as possible and most of his dewlap removed - the infection kept tracking back and forth between capsules in his dewlap and his jaw and eye.

It was a lengthy and risky op but we felt it was his last chance of a comfortable outcome.
It went well although one of the capsules had fused close to his thyroid gland :? but successfully removed.

He came home that night and thankfully was eating straight away, I was giving him a high dose of pain relief as it was such a nasty op.

I am happy to say, but don't want to jinx his recovery, that 3 weeks on and he only has a very minor infection at present that I am able to easily keep open, clean and packed with manuka. It's not increased so I am hopeful it might work. He is still on depo injections and I'm just hoping that he can eventually make a full recovery.

Sounds a promising update . Good that things are now at a more manageable state, which with poorly buns is often the best we can aim for.

Really hope he continues to do well x

Thank you yes it is a hundred times improved at the mo. Just got to keep fighting!