Abscess treatment

Hi,
I have a 6 year old house rabbit called jasper. I noticed a large lump under his chin yesterday. From reading online, i realised this was an abscess and was upset to see the prognosis.
I took him to the vets this morning and the vet told me that the abscess was large and the infection had most probably spread to his jaw bone. She told me the options were not good. He could either be operated on, have the wound cleaned and infection site x-rayed to see how bad it is or be put to sleep.
She told me the operation is major surgery and due to his age it would be unlikely he would recover. He would be left with a open wound that i would have to clean twice daily by putting a cotton bud inside and scraping the puss out. He is very headstrong and hates being messed around with.
She also said it would be unlikely he would fully recover, would need to return to the vets regularly (which stresses him out massively) and would have re-occurring abscesses.
She basically made out that putting him to sleep would be the kindest option.
I really don't know what to do. I love my bunny to bits and dont want to be without him. He seems fine in himself but i was told this will only be the case for around 1 week. I dont want him to suffer and just want to do the best by him.
i have read studies about bicillin being injected directly into the abscess and how affective this treatment is. It appears to only be in usa and canada though. Has anyone heard of this in the uk? Can anyone offer any advice about what i should do??
Many thanks
J

I can't offer any advice sorry.. But just want to send a virtual hug, what a worry for you!

Really hope someone on here comes back with some help for your little man xx

Thank you for your message. I really hope so too. He's brilliant. i'm definitely not ready to let him go but may be left with no other option. The surgery and aftercare sounds horrendous and dont want to put him through all that just for another abscess to develop. There must be an alternative :-( xx

jjasper2 said:

Hi,
I have a 6 year old house rabbit called jasper. I noticed a large lump under his chin yesterday. From reading online, i realised this was an abscess and was upset to see the prognosis.
I took him to the vets this morning and the vet told me that the abscess was large and the infection had most probably spread to his jaw bone. She told me the options were not good. He could either be operated on, have the wound cleaned and infection site x-rayed to see how bad it is or be put to sleep.
She told me the operation is major surgery and due to his age it would be unlikely he would recover. He would be left with a open wound that i would have to clean twice daily by putting a cotton bud inside and scraping the puss out. He is very headstrong and hates being messed around with.
She also said it would be unlikely he would fully recover, would need to return to the vets regularly (which stresses him out massively) and would have re-occurring abscesses.
She basically made out that putting him to sleep would be the kindest option.
I really don't know what to do. I love my bunny to bits and dont want to be without him. He seems fine in himself but i was told this will only be the case for around 1 week. I dont want him to suffer and just want to do the best by him.
i have read studies about bicillin being injected directly into the abscess and how affective this treatment is. It appears to only be in usa and canada though. Has anyone heard of this in the uk? Can anyone offer any advice about what i should do??
Many thanks
J

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Your vet is partly right but is painting you a very negative picture. There is never 'one size fits all" with rabbit abscesses. In the past - when bicillin was briefly used here in the uk - abscesses were very bad news indeed. I have had many rabbits with abscesses and the care has got so much better since the early 2000's.

There are several options you can choose from. Your rabbit can have surgery (plus x-rays if you like), and perhaps have antibiotic beads sewn into the wound site. Then what often happens is they take a long course of antibiotics. Possibly a long acting penicillin - this is the only legal version here in the UK. Bicillin is only possible on a 'named patient' version. By the time you get the permit to give a rabbit Bicillin, it may be too late ...

One option I have tried several times recently is the 'lance and drain' technique. It's light sedation for the rabbit as opposed to a GA and big operation. Your rabbit is 6 years old which your vet thinks is old, but I don't! (perhaps that's because one of mine is just turning 13 this year). The abscess can be lanced under light sedation, and drained. You as the owner will then have to clean this out, and perhaps pack the cavity with high grade Manuka Honey to keep it clean and promote healing. This would have to be done for up to two weeks in order to let the wound heal from the inside out. Injectable penicillin can also be given every day to begin with - you can do these yourself. The injections may become every other day and continue for several months.

Some people are against this 'lance and drain' method, and say that it doesn't work, but my rabbits are living proof that it *does* work. My rabbits using this method have not had a recurrence of the abscess many years later. It does however involve a lot of 'hands on work' for you and your rabbit may not like it either.

This is a long essay - sorry Please PM me if I can help further ...... I hope it gives you a bit more perspective on something that is very common in rabbits and is no longer necessarily a death sentence.

Welcome to the Forum by the way :wave:

Hi mighty max. Thank you very much for your response and advice. I am unsure how to pm with being new to this.
With regards to the antiseptic beads..would this prevent the daily cleaning or will that still be required? I'm just worried that jasper wont allow this. We have a nightmare trying to cut his nails and i would imagine probing his open wound would prove impossible. I would be willing to try though if this would not be too distressing for him.
The vet said that the surgery would be major due to the extent of his infection. The swelling is the size of a golf ball (if not bigger) and his jaw bone is deformed due to the infection so that would need to be addressed.
Its a shame that bicillin isnt an option. The reports sounds very positive and alot less evasive than surgery but im not sure if jaspers abscess would be too bad for this anyway.
I would agree that 6 is not very old and was hoping to have him around for alot longer.
I wonder if the vet appeared to be swaying towards putting him to sleep due to the severity of his swelling. I should of asked more questions at the time but i was too upset

jjasper2 said:

Hi mighty max. Thank you very much for your response and advice. I am unsure how to pm with being new to this.
With regards to the antiseptic beads..would this prevent the daily cleaning or will that still be required? I'm just worried that jasper wont allow this. We have a nightmare trying to cut his nails and i would imagine probing his open wound would prove impossible. I would be willing to try though if this would not be too distressing for him.
The vet said that the surgery would be major due to the extent of his infection. The swelling is the size of a golf ball (if not bigger) and his jaw bone is deformed due to the infection so that would need to be addressed.
Its a shame that bicillin isnt an option. The reports sounds very positive and alot less evasive than surgery but im not sure if jaspers abscess would be too bad for this anyway.
I would agree that 6 is not very old and was hoping to have him around for alot longer.
I wonder if the vet appeared to be swaying towards putting him to sleep due to the severity of his swelling. I should of asked more questions at the time but i was too upset

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With regards to your vets attitude, he obviously realises it's a serious condition, but if Jasper is in good health, I am surprised he thought that surgery wasn't an option because of his age. This makes me think (only my opinion) that you may want to seek a second opinion from another vet?

I have had rabbits where the infection has penetrated the bone .... One of my rabbits for example had this from being three years old. (This was at the start of the 'bicillin' era). He eventually died at the age of 9 and a half years, unrelated to any abscess.

Antibiotic beads would be sewn into the cavity, and you would not have to clean the wound. It's certainly something to discuss with your vet (or whoever you feel confident in). It's VERY important you feel confident with the vet, and have asked all the questions you feel you need to. There is not so much of a hurry that you have to rush with the first option. You are wise to come on here and gather opinions.

Please feel free to ask any more questions, and we'll all do our best for you

Just replied to your PM.

Also, ask your vet for some Metacam for the meanwhile (while you decide what to do) just in case. You may not need it, but best to be prepared ....

Thank you its great to gain advice from fellow rabbit owners. I feel alot more positive already !!
The vet did say that surgery was an option, however i got the impression that she did not feel confident that the outcome would be positive for jasper. I will definitely be contacting additional local vets on monday to see if anyone can offer alternative treatment. I would definitely go for surgery if the beads would prevent the cleaning. I was thinking the cleaning would make jasper scared of me and associate me with pain and discomfort instead of love. I was also worried that if i couldnt clean the wound properly it would lead to further infection. I definitely will look into this and see if any local vets offer this procedure.
Thank you very much. There is hope for him yet x
J

jjasper2 said:

Thank you its great to gain advice from fellow rabbit owners. I feel alot more positive already !!
The vet did say that surgery was an option, however i got the impression that she did not feel confident that the outcome would be positive for jasper. I will definitely be contacting additional local vets on monday to see if anyone can offer alternative treatment. I would definitely go for surgery if the beads would prevent the cleaning. I was thinking the cleaning would make jasper scared of me and associate me with pain and discomfort instead of love. I was also worried that if i couldnt clean the wound properly it would lead to further infection. I definitely will look into this and see if any local vets offer this procedure.
Thank you very much. There is hope for him yet x
J

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There is MUCH hope

There is a lady on here: Yaretzi, who has extensive (and current) experience with rabbit abscesses. It might be worth sending her a PM to ask her experience. Good luck and keep in touch! x

It is worth asking your vet for a referral to a rabbit specialist. There are a few dotted around the country - we could point out one near you.

Abscesses are usually removed surgically - preferably with the whole capsule removed. Otherwise, they are opened up and drained, then left open for twice daily cleaning (and maybe packing with high UMF Manuka honey). Mine have also been on injectable penicillin (depocilin) - daily or twice weekly -which you can learn to do at home; plus something like oral Metacam for pain relief.

I have no experience of packing the abscess with antibiotic beads, but it is a viable option.
X-rays are usually taken to assess the extent and impact of the abscess. If these are taken by your vet, they could be used by the referral vet as well to save costs and another GA. If the jaw is visibly deformed, I would suggest that x-rays are essential to see what you are dealing with.

Both of my rabbits that had invasive jaw abscesses lived around another 18 months after diagnosis. 6 years old is not that old and I wouldn't be worried about a GA if everything else is OK. It might be worth getting a blood screen done to check on the overall health of your rabbit before any other decisions are made.

The surgery is quite invasive and may require a few days stay at the vet to get them eating properly and maintain the wound, etc. Mine have coped OK. The worst bit is seeing them after surgery and getting used to all the cleaning out. Rabbit abscesses do not drain freely - it's very thick white gunge which needs scraping out.

There are a few people on here who have experience of dealing with jaw abscesses, so keep asking questions on here and at your vet.

Mighty max, again thank you, i will send yaretzi a message in the morning if able to find her

Shimmer, thank you for your reply. I live in sunderland. Is there any specialists that you are aware of in the north east?
18 months would be great compared to losing him this week to euthanasia. I would prefer not having to clean the wound twice a day myself and to have the beads as im scared jasper will just struggle and become very stressed. However the beads were not an option my vet gave me. She did tell me to go away and do some research online and get back to her so maybe i could request this procedure.
She wanted to xray his jaw because she could feel the bone had grown round the abscess and she could not see if he had any problem with his teeth, this would need to be explored during surgery.
I am new to this site so i will continue to browse and weigh up our options.
Thank you for offering your help. Its a very hard decision to make and just want to make the best decision possible for him

Here is yaretzi's thread about her rabbits abscess treatment, along with a link to her original thread. It is quite extensive though, and will take some time to read through.
http://forums.rabbitrehome.org.uk/showthread.php?415173-Post-op-news-post-372-Nena-s-jaw-tooth-root-abscess

Personally I would have some doubts about a vet that told me to do my own research on options and didn't explain these options to me themselves. I would certainly want a specialists opinion. And I agree, your rabbit isn't that old, and there are definitely more options available to you than just pts.

People tend to be more active on here in the mornings, so I am sure you will get some more people offering suggestions then. It may also help to post a thread in rabbit chat for a 'rabbit savvy vet in Sunderland'.

jjasper2 said:

Shimmer, thank you for your reply. I live in sunderland. Is there any specialists that you are aware of in the north east?
18 months would be great compared to losing him this week to euthanasia. I would prefer not having to clean the wound twice a day myself and to have the beads as im scared jasper will just struggle and become very stressed. However the beads were not an option my vet gave me. She did tell me to go away and do some research online and get back to her so maybe i could request this procedure.
She wanted to xray his jaw because she could feel the bone had grown round the abscess and she could not see if he had any problem with his teeth, this would need to be explored during surgery.
I am new to this site so i will continue to browse and weigh up our options.
Thank you for offering your help. Its a very hard decision to make and just want to make the best decision possible for him

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An X-ray may well give more information on how the abscess has affected the bone. However, I am not sure your vet has seen or treated lots of abscesses, so it's impossible until you've seen someone more knowledgeable to know the extent of the problem.

I found this about antibiotic beads from the Rabbit Welfare site:

Antibiotic beads: Some abscesses are too deep and painful to clean every day, or are inaccessible. Antibiotic impregnated beads can be packed into the abscess cavity which is then sewn shut. They are left there for anything up to a few months and provide a slow but continuous release of antibiotic as well as filling in the hole left by the abscess and preventing it being filled by newly formed pus.


You may have seen their info, as you've found out about the bicillin (really interesting story ... My rabbit was one of the first to be involved in injecting penicillin to 'cure' rabbit abscesses) ... http://www.rabbitwelfare.co.uk/resources/content/info-sheets/abscesses.htm It's an old article now, but written by my friend Lucy who is a (human) doctor. There is much to research so you can go to your next vet with some good questions

Jbun said:

Here is yaretzi's thread about her rabbits abscess treatment, along with a link to her original thread. It is quite extensive though, and will take some time to read through.
http://forums.rabbitrehome.org.uk/showthread.php?415173-Post-op-news-post-372-Nena-s-jaw-tooth-root-abscess

Personally I would have some doubts about a vet that told me to do my own research on options and didn't explain these options to me themselves. I would certainly want a specialists opinion. And I agree, your rabbit isn't that old, and there are definitely more options available to you than just pts.

People tend to be more active on here in the mornings, so I am sure you will get some more people offering suggestions then. It may also help to post a thread in rabbit chat for a 'rabbit savvy vet in Sunderland'.

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Hi jbun,
I have read yaretzi's thread (thank you for the link) which initially filled me with dread and anxiety. She has done a brilliant job with her bunny but i worry that i may not have the same success with my jasper who does not enjoy being handled unless its for a head scratch and stroke. I was, however, alot more optimistic when i read about the antibiotic beads and the success that she had with these. I definitely need to enquire about these and see if i can find a local vet who can offer this. I definitely have my doubts about my vet who only gave me 2 horrific options.
I will see if i can figger out this site and find rabbit chat. Thank you again

MightyMax said:

An X-ray may well give more information on how the abscess has affected the bone. However, I am not sure your vet has seen or treated lots of abscesses, so it's impossible until you've seen someone more knowledgeable to know the extent of the problem.

I found this about antibiotic beads from the Rabbit Welfare site:

Antibiotic beads: Some abscesses are too deep and painful to clean every day, or are inaccessible. Antibiotic impregnated beads can be packed into the abscess cavity which is then sewn shut. They are left there for anything up to a few months and provide a slow but continuous release of antibiotic as well as filling in the hole left by the abscess and preventing it being filled by newly formed pus.


You may have seen their info, as you've found out about the bicillin (really interesting story ... My rabbit was one of the first to be involved in injecting penicillin to 'cure' rabbit abscesses) ... http://www.rabbitwelfare.co.uk/resources/content/info-sheets/abscesses.htm It's an old article now, but written by my friend Lucy who is a (human) doctor. There is much to research so you can go to your next vet with some good questions

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Thank you for the information on the beads. I definitely like the sound of this option and just hope i can find a vet who will perform this procedure as an alternative.
I read the bicillin article which i was excited about but fear that this will not be available for jasper.
I just dont want to put jasper to sleep so soon while hes still so full of life. I wish he could be treat with medicine rather than the drastic surgery and being left with an open wound. I understand i may not have jasper for as long as id hoped but even a few months with him would be better than losing him in the next week or so

jjasper2 said:

Thank you for the information on the beads. I definitely like the sound of this option and just hope i can find a vet who will perform this procedure as an alternative.
I read the bicillin article which i was excited about but fear that this will not be available for jasper.
I just dont want to put jasper to sleep so soon while hes still so full of life. I wish he could be treat with medicine rather than the drastic surgery and being left with an open wound. I understand i may not have jasper for as long as id hoped but even a few months with him would be better than losing him in the next week or so

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I wouldn't make any negative assumptions at this stage. There's still so much hope, if you and Jasper are willing!

I have had serious abscess bunnies for years and years (7/8 years after a poor abscess prognosis) xx

Yeah we're both definitely willing. 7/8 years? I didnt realise they could live with them for so long. I will ring round vets tomorrow and hopefully i can locate a specialist who can help us. X

. The very very best of luck.... I hope you find a savvy vet who will advise you on what the options are...

Good luck
Fee xxx

If you live in Sunderland you need to see Honor at vets4pets, she is brilliant. I was recommended her by someone else as my vet failed to diagnose the problem. I have to travel just over an hour to get there but it's so worth it. My rabbit just had abscess surgery done by her on Thursday.
My rabbit is already like a different bun compared to how she was for the week leading up to her surgery. The aftercare isn't as hard work as it sounds, you quickly get into a routine as at when they need their meds etc. I am still wary about doing her wound though, as I'm scared I aren't doing it right but she's back there for a checkup tomorrow.