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Elderly bunny and nursing after abscess draining

L

louisa

Young Bun
Hello everyone :wave:. My elderly black mini lop, Pearl, is in the vet's overnight tonight after an operation today to drain an abscess (I'm finding it difficult to switch off and sleep). She's the last of my Greenfields buns (does anyone remember Greenfields in Bracknell?) and we've been through so much together. Towards the end of last week she started to find it very difficult to eat and by last night she could only take syringed yoghurt, despite wanting to feed. She was approaching the food bowl and then realising she couldn't open her mouth. I have been administering metacam orally and injecting 2ml saline solution two to three times a day while waiting for today's operation to drain the abscess.

She had the op today and the vet phoned to say that she was showing signs of recovery but was finding it difficult to move her hind legs. Since her legs were fine this morning I hope this is simply a temporary response to the anaesthetic. Towards the end of the afternoon they phoned again to say that her legs seemed a bit better but that they would prefer to keep her in overnight for observation. I was happy to agree with this, although I am now worrying about her being alone overnight, and worrying too about her husbun, the lovely Windwhistle, who is lost without her :(.

I'm hoping for some advice really about how best to take care of her when I get her home. I'm assuming I will need to syringe feed for a while as her mouth heals. Is there anything I can give her or do for her that might particularly facilitate the healing process? She's a few weeks short of her tenth birthday but until now has been fitting fit and game for anything so I have not had to think about how to nurse an elderly bunny before.

Many thanks everyone. ;)
 
I remember Greenfields :) I am sorry to hear that Pearl has had to have surgery for an abscess. I assume it is a Dental abscess ?

Your Vet should explain fully the exact nature of the after care Pearl will need. It will depend on the precise nature of the surgery performed and whether the wound has been left open and daily irrigation and wound packing (Medical Grade Manuka Honey being very useful for this purpose), is required. Good pain relief and appropriate antibiotic cover are always essential. The choice of antibiotic should be based on culture and sensitivity testing, the Vet takes a swab from the abscess wall (NOT just the pus, which may be sterile and thus provide no useful information re the bacteria involved). An injectable Penicillin is often the antibiotic of choice.

Syringe Feeds may be needed and your Vet is likely to provide sachets of Critical Care for this. Personally I would not feed a Rabbit Yoghurt, Rabbits are lactose intolerant. If Pearl refuses Critical Care you could make up a liquid feed by soaking her usual pellet feed in boiled water, mash it up and then add a small amount of vegetable puree to it. Prokinetics (gut motility medication) may also be required during the first 24-48 hours after surgery.

If Pearl is usually an outdoor Rabbit it may be a good idea to have her indoors now. She will find it hard to regulate her body temperature after a GA and also whilst fighting an active infection. Her old bones may be a bit arthritic now too, so the cold will not help that either.

I hope that you receive good news from the Vet this morning.
 
Hello Jane, thanks so very much for your quick reply and for the sensible advice. Really hope I haven't harmed anything by administering yoghurt. Yes, it's a dental abscess: it seemed to be equidistant between each jaw, so the vet wasn't sure which side it originated. I shall get more information later today, hopefully.

I've just spoken to the vet. Pearl is apparently making good progress now and I can collect her this morning. She (the vet) said that the wound has been left open but not packed with manuka honey (although the first vet I spoke to at that practice suggested to me that this would be the case) because she thinks the antibiotics will be sufficient. She suggested I massage it to ensure continuing discharge. She's an indoor bun and I work from home so I can monitor quite closely, I hope.

Just off to collect her now; thank you so much again :)
 
louisa said:
Hello Jane, thanks so very much for your quick reply and for the sensible advice. Really hope I haven't harmed anything by administering yoghurt. Yes, it's a dental abscess: it seemed to be equidistant between each jaw, so the vet wasn't sure which side it originated. I shall get more information later today, hopefully.

I've just spoken to the vet. Pearl is apparently making good progress now and I can collect her this morning. She (the vet) said that the wound has been left open but not packed with manuka honey (although the first vet I spoke to at that practice suggested to me that this would be the case) because she thinks the antibiotics will be sufficient. She suggested I massage it to ensure continuing discharge. She's an indoor bun and I work from home so I can monitor quite closely, I hope.

Just off to collect her now; thank you so much again :)
Click to expand...

I am sure she'll be glad to get back home xx
 
louisa said:
Hello everyone :wave:. My elderly black mini lop, Pearl, is in the vet's overnight tonight after an operation today to drain an abscess (I'm finding it difficult to switch off and sleep). She's the last of my Greenfields buns (does anyone remember Greenfields in Bracknell?) and we've been through so much together. Towards the end of last week she started to find it very difficult to eat and by last night she could only take syringed yoghurt, despite wanting to feed. She was approaching the food bowl and then realising she couldn't open her mouth. I have been administering metacam orally and injecting 2ml saline solution two to three times a day while waiting for today's operation to drain the abscess.

She had the op today and the vet phoned to say that she was showing signs of recovery but was finding it difficult to move her hind legs. Since her legs were fine this morning I hope this is simply a temporary response to the anaesthetic. Towards the end of the afternoon they phoned again to say that her legs seemed a bit better but that they would prefer to keep her in overnight for observation. I was happy to agree with this, although I am now worrying about her being alone overnight, and worrying too about her husbun, the lovely Windwhistle, who is lost without her :(.

I'm hoping for some advice really about how best to take care of her when I get her home. I'm assuming I will need to syringe feed for a while as her mouth heals. Is there anything I can give her or do for her that might particularly facilitate the healing process? She's a few weeks short of her tenth birthday but until now has been fitting fit and game for anything so I have not had to think about how to nurse an elderly bunny before.

Many thanks everyone. ;)
Click to expand...

Hi Louisa

I certainly remember Greenfields and worked with them alongside Bobtails Rescue in Surrey!

I'm sorry to hear about your little one :(

Dental abscesses can be very well controlled and quite possibly cured by surgery and penicillin injections these days. The prognosis is very good usually! You need to have patience and good nursing skills, because an abscess cavity needs to be kept open and cleaned twice a day to heal from the inside.

I use Manuka Honey 25+ to clean and fill the cavity (though your vet may have a different procedure?) ... although any honey will cleanse and keep bacteria at bay in the wound.

It depends where the surgery was with regards to her eating - she may need help to begin with, though soaking pellets might be an option for her. I presume she will be on a good dose of Metacam for pain relief and inflammation?

She's reached a good age and nursing an elderly for an abscess is the same as for any age really. I think you will do just fine, and good luck xx
 
Hi there,

Thanks MightyMax and Jane! Just a quick update. I collected Pearl this morning and she has been very quiet all day, although enjoying the grooming from her partner, who was delighted to see her back :love:. She still hasn't eaten anything by herself, but I have syringed some Critical Care into her mouth - she'd only take a little, which worries me, but I imagine her mouth is very sore still. She's on Baytril 1.5ml and Metacam 0.75ml daily, too.

The vet didn't mention Manuka Honey this morning, but she suggested that I gently massage the wound in order to keep it open and to allow further draining, as well as wipe around it. The incision is surprisingly small given how enormous the abscess was, which is maybe why she didn't suggest I clean and fill the cavity. I hope it not that she assumed I wouldn't want to commit to that level of nursing; I'd be quite happy to do so.

Unfortunately, they didn't get time whilst she was under the GA to finish her dental, so all being well she will have to go back next week to have her molars burred. Really hope she will be up to that. She has been a strong bun historically so I am keen to give her every chance.

Thanks again! xx
 
louisa said:
Hi there,

Thanks MightyMax and Jane! Just a quick update. I collected Pearl this morning and she has been very quiet all day, although enjoying the grooming from her partner, who was delighted to see her back :love:. She still hasn't eaten anything by herself, but I have syringed some Critical Care into her mouth - she'd only take a little, which worries me, but I imagine her mouth is very sore still. She's on Baytril 1.5ml and Metacam 0.75ml daily, too.

The vet didn't mention Manuka Honey this morning, but she suggested that I gently massage the wound in order to keep it open and to allow further draining, as well as wipe around it. The incision is surprisingly small given how enormous the abscess was, which is maybe why she didn't suggest I clean and fill the cavity. I hope it not that she assumed I wouldn't want to commit to that level of nursing; I'd be quite happy to do so.

Unfortunately, they didn't get time whilst she was under the GA to finish her dental, so all being well she will have to go back next week to have her molars burred. Really hope she will be up to that. She has been a strong bun historically so I am keen to give her every chance.

Thanks again! xx
Click to expand...

Hi Louisa

It's great to hear back from you, and I can understand you'd be a little worried about her intake. Hopefully she will take little and often, as you seem very committed to her care, which is lovely :) Maybe you could also try some critical care mixed with some Ella's kitchen organic baby food pouches? I keep a couple in my first aid box as they are so delicious and sometimes perk up the appetite.

Regarding the Manuka Honey, it's really good stuff, and would be OK to use anyway but you could ask your vet about it if you want that extra healing element. It's very often used.

Just to say, I would think carefully (with vet's advice) about her having another GA a week after the previous one. Obviously if it's really necessary, then it must be done, but ten is getting to be quite an old lady for Pearl, bless her :love:
 
Hi there. Just a little update on Pearl (thanks again, MightyMax :))... She didn't seem too good yesterday but today has been much better. She is resisting syringe-feeding now and her kick-ass spirit is more in evidence! She still can't feed for herself, so I'm spending a lot of time cutting up tiny bits of food for her. Just a small amount of saline solution as she is a lot more hydrated now, too. I'm massaging the wound to keep it open, as the vet suggested. It has occurred to me that perhaps I will need to do this indefinitely... surely allowing it to close up will prompt the growth of the abscess again? I'm quite new to abscesses as, despite many years of having bunnies, I've been lucky enough not to experience a dental abscess before.

MightyMax, I think you are correct: I will be very wary about putting her under GA again so soon. The vet did say the molars 'are not horrendous', so I think I will need to get clarification on what that really means.

Lxx
 
louisa said:
Hi there. Just a little update on Pearl (thanks again, MightyMax :))... She didn't seem too good yesterday but today has been much better. She is resisting syringe-feeding now and her kick-ass spirit is more in evidence! She still can't feed for herself, so I'm spending a lot of time cutting up tiny bits of food for her. Just a small amount of saline solution as she is a lot more hydrated now, too. I'm massaging the wound to keep it open, as the vet suggested. It has occurred to me that perhaps I will need to do this indefinitely... surely allowing it to close up will prompt the growth of the abscess again? I'm quite new to abscesses as, despite many years of having bunnies, I've been lucky enough not to experience a dental abscess before.

MightyMax, I think you are correct: I will be very wary about putting her under GA again so soon. The vet did say the molars 'are not horrendous', so I think I will need to get clarification on what that really means.

Lxx
Click to expand...

Well I like the sound of her feisty attitude :D

So, the abscess wound .. You will only be able to keep it open for a certain amount of time, as the tissue itself will heal up. It can take anything between about 10 - 20 days before abscess holes heal up. Getting a cotton wool bud in there to clean it gently and keep it open is the best thing. As I mentioned, I always use Manuka Honey to clean the inside of the cavity.

You may find that the opening to the wound will scab over. You will have to gently remove that scab each time - each day if necessary, to clean inside and help healing from inside out.

I think you're doing really well! :D
 
Thank you :wave: . I had wondered about what the time-scale was for healing.

All is about the same today. She's a bit shaky on her feet but anxious to feed albeit still only hand-feeding from me. Hates syringe-feeding with a vengeance! My confidence levels in relation to nursing have improved a bit, too, so I feel ready to acquire and apply the Manuka Honey. I haven't ventured to investigate inside the wound until now - just massaging and cleaning outside it. A friend of mine once said how their buns taught them so much and I feel this is what Pearl is doing right now.

Lxx
 
louisa said:
Thank you :wave: . I had wondered about what the time-scale was for healing.

All is about the same today. She's a bit shaky on her feet but anxious to feed albeit still only hand-feeding from me. Hates syringe-feeding with a vengeance! My confidence levels in relation to nursing have improved a bit, too, so I feel ready to acquire and apply the Manuka Honey. I haven't ventured to investigate inside the wound until now - just massaging and cleaning outside it. A friend of mine once said how their buns taught them so much and I feel this is what Pearl is doing right now.

Lxx
Click to expand...

They really do!

Will Pearl eat the syringe food out of a shallow dish instead?

{{{Pearl}}}
 
louisa said:
Thank you :wave: . I had wondered about what the time-scale was for healing.

All is about the same today. She's a bit shaky on her feet but anxious to feed albeit still only hand-feeding from me. Hates syringe-feeding with a vengeance! My confidence levels in relation to nursing have improved a bit, too, so I feel ready to acquire and apply the Manuka Honey. I haven't ventured to investigate inside the wound until now - just massaging and cleaning outside it. A friend of mine once said how their buns taught them so much and I feel this is what Pearl is doing right now.

Lxx
Click to expand...

Yes they certainly do. So many things. Forbearance being a big one.

I remember cleaning out many abscesses, and the bunny being so patient, and only flinching when it really hurt. Brave doesn't come near it. They are certainly an example to me :)
 
Hi there. Thank you, MightyMax and jerseygirl :wave:. Well, my lovely girl is still being brave (which is more than can be said for me!). I have made an appointment with the vet for tomorrow because I am worried that the abscess is starting to come back already. I went to apply the manuka honey to the opening today only to find that I cannot open it now. It is only day six so I wasn't expecting that. At the same time, there is a small sac under her chin which I think is the abscess rearing its ugly head again. She is still only feeding from my hand, so perhaps she is in discomfort beneath her jaw.

I hope I am not being unfair but I must admit I am feeling pretty upset at the advice the vet nurse gave me, which was simply 'to gently massage around the incision to allow the pus to drain out'. I have done that religiously and it wasn't until I started to investigate for myself on the internet - mainly on this amazing site - that it started to dawn on me that that might be giving a rather diluted impression of the reality. I did ask her about packing with manuka honey, for example, and she said that prob wouldn't be necessary because the antibiotics would fight the infection. I feel so sad to think I might have not done the best for my bunny from the start, and I can't help thinking that they had a duty of care to give me a more accurate picture. I hope tomorrow's appointment will prove me wrong in my fears :cry:.
 
louisa said:
Hi there. Thank you, MightyMax and jerseygirl :wave:. Well, my lovely girl is still being brave (which is more than can be said for me!). I have made an appointment with the vet for tomorrow because I am worried that the abscess is starting to come back already. I went to apply the manuka honey to the opening today only to find that I cannot open it now. It is only day six so I wasn't expecting that. At the same time, there is a small sac under her chin which I think is the abscess rearing its ugly head again. She is still only feeding from my hand, so perhaps she is in discomfort beneath her jaw.

I hope I am not being unfair but I must admit I am feeling pretty upset at the advice the vet nurse gave me, which was simply 'to gently massage around the incision to allow the pus to drain out'. I have done that religiously and it wasn't until I started to investigate for myself on the internet - mainly on this amazing site - that it started to dawn on me that that might be giving a rather diluted impression of the reality. I did ask her about packing with manuka honey, for example, and she said that prob wouldn't be necessary because the antibiotics would fight the infection. I feel so sad to think I might have not done the best for my bunny from the start, and I can't help thinking that they had a duty of care to give me a more accurate picture. I hope tomorrow's appointment will prove me wrong in my fears :cry:.
Click to expand...

Louisa, you are doing a very good job! Vets don't always have so much experience of abscesses. I have been given some wild advice by vets on how to care for abscesses over the years. Good job that I learned by experience long ago what seems to be a good way to go :thumb:

At day six it's possibly just scabbed over. If you hold a warm compress you may be able to carefully and gently prise the scab off. It's to be expected that the skin on top will heal up before the inside. Manuka honey cleanses the inside and helps healing. The nursing care is truly as important as the antibiotics! I usually get a cotton wool bud into the wound twice daily to keep it open and clean.

Let your vet help you with advice tomorrow - it seems she wouldn't be averse to you using the honey? Also, she may help ease the wound open again so it can drain. All is not lost, believe me! Keep your spirits up :D
 
Thank you - your words mean so much; it is tough, isn't it, being on a learning curve with the health of such wonderful creatures? I did feel as if the tissue had started to heal but perhaps I was being too squeamish to push around, and in any case I didn't want to hurt the bunny. Anyway, I shall impress upon the vet tomorrow that I am keen to learn as much about nursing her through this as I possibly can.

Thank you so much for your encouragement! :D
 
louisa said:
Thank you - your words mean so much; it is tough, isn't it, being on a learning curve with the health of such wonderful creatures? I did feel as if the tissue had started to heal but perhaps I was being too squeamish to push around, and in any case I didn't want to hurt the bunny. Anyway, I shall impress upon the vet tomorrow that I am keen to learn as much about nursing her through this as I possibly can.

Thank you so much for your encouragement! :D
Click to expand...

Oh you're so welcome! :thumb:

Hopefully your bunny is on pain relief (or has some available if necessary?). Sorry I can't remember if you said. You can ask the vet for some tomorrow perhaps ...

I know it's uncomfortable and we never like to cause pain, but you know what it's like to get a scab off - the 'pain' doesn't last long, and better than the wound healing completely and having to be lanced and drained again.

Good luck tomorrow. Yes, don't tell your vet you're in the slightest bit squeamish and be bold in saying what a good nurse you'll be :D

If it's any consolation, almost 20 years ago when I came across my very first bunny abscess, the vet insisted I look at it with a view to cleaning twice a day. It looked so awful I felt sick and I fainted over the table ... I have learned to be much stronger, and you will too :D
 
Hi everyone, just wanted to update you on what is happening to my lovely Pearl bunny, who has celebrated her 10th birthday in the last week (!). Ten days ago I could feel the abscess coming back, and very quickly, too. Two vets at my local surgery advised that we were in a palliative situation, and talked about PTS. I wanted to give her more opportunity to heal, though, so after some googling, I took her to a specialist rabbit vet about 16 miles away. That was last Tuesday. She was operated on almost immediately, and was discharged with a suture dressing stitched to her jaw/throat, which was kept in place for a week. It was removed yesterday and the next step is for me to clean the wound twice daily for a week.

I've never done this before and am SO hoping I do the nursing correctly. So far, I have done it twice - last night and this morning - and she seemed to be relatively happy to let me do it. I soaked gauze in saline solution (as advised) and gently wiped at the area. Please keep fingers and paws crossed for Pearl - the vet has been/is excellent and I don't want to be the one to let the side down! xxx
 
louisa said:
Hi everyone, just wanted to update you on what is happening to my lovely Pearl bunny, who has celebrated her 10th birthday in the last week (!). Ten days ago I could feel the abscess coming back, and very quickly, too. Two vets at my local surgery advised that we were in a palliative situation, and talked about PTS. I wanted to give her more opportunity to heal, though, so after some googling, I took her to a specialist rabbit vet about 16 miles away. That was last Tuesday. She was operated on almost immediately, and was discharged with a suture dressing stitched to her jaw/throat, which was kept in place for a week. It was removed yesterday and the next step is for me to clean the wound twice daily for a week.

I've never done this before and am SO hoping I do the nursing correctly. So far, I have done it twice - last night and this morning - and she seemed to be relatively happy to let me do it. I soaked gauze in saline solution (as advised) and gently wiped at the area. Please keep fingers and paws crossed for Pearl - the vet has been/is excellent and I don't want to be the one to let the side down! xxx
Click to expand...

Wow, you are still doing wonderfully well with the beautiful and elderly Pearl :D I bet she's so proud of her Mum!

I don't know whether the abscess wound has been sewn open, but if it hasn't and begins to close up, you can always use a cotton wool bud to get in there, making sure it doesn't scab over.

Good luck Louisa :thumb:

By the way, is she on penicillin injections, or anything like that?
 
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