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Ear discomfort but nothing in the scope UPDATE tooth pulpectomy

neeshkabeesh

neeshkabeesh

Warren Scout
We took our rabbits to the vets this evening for their RHD2 vaccine and I mentioned that I thought Juno had been flicking her head/ears about lately and scratching at them, mainly the right one. It's not the kind of flicking they do as a binky or in excitement, it's definitely a flick like her ear was uncomfortable.

The vet had a feel and both ear bases feel the same and no lumps, although she did react being touched there but she is a huffy flighty thing anyway so we weren't sure if she was moving because she was uncomfortable or just because she didn't like being touched that way. He had a good look down both ears with a scope and couldn't see anything but said he wouldn't be able to see the middle or inner ear just with a scope. He offered an x-ray to see whether she has an abscess forming, or we could wait a day or two as we'd noticed the head flicking and itching only, no other symptoms, and it might be nothing.

Now she is home she has been holding her ear back while the other one is up and normal, so I think all the squeezing and feeling has caused her some pain. Either way it seems like there must be something wrong in her ear(s), despite the lack of any other symptom. I don't understand why x-ray was the first suggested option considering she's had 4 dentals in 12 months so she's had enough anaesthesia, and surely a course of antibiotics or topical drops would be the way to go first?

If she is the same in the morning we'll book another appointment, but is an x-ray really the next course of action?
 
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neeshkabeesh said:
We took our rabbits to the vets this evening for their RHD2 vaccine and I mentioned that I thought Juno had been flicking her head/ears about lately and scratching at them, mainly the right one. It's not the kind of flicking they do as a binky or in excitement, it's definitely a flick like her ear was uncomfortable.

The vet had a feel and both ear bases feel the same and no lumps, although she did react being touched there but she is a huffy flighty thing anyway so we weren't sure if she was moving because she was uncomfortable or just because she didn't like being touched that way. He had a good look down both ears with a scope and couldn't see anything but said he wouldn't be able to see the middle or inner ear just with a scope. He offered an x-ray to see whether she has an abscess forming, or we could wait a day or two as we'd noticed the head flicking and itching only, no other symptoms, and it might be nothing.

Now she is home she has been holding her ear back while the other one is up and normal, so I think all the squeezing and feeling has caused her some pain. Either way it seems like there must be something wrong in her ear(s), despite the lack of any other symptom. I don't understand why x-ray was the first suggested option considering she's had 4 dentals in 12 months so she's had enough anaesthesia, and surely a course of antibiotics or topical drops would be the way to go first?

If she is the same in the morning we'll book another appointment, but is an x-ray really the next course of action?
Click to expand...


Hi there :D

I'm sorry to hear about Juno's ear problem :( Bit of a worry for you.

It's good that the vet could feel no lumps or bumps, and could see nothing down the scope. But he is right - you can't see the middle or inner ear.

Yes, an X-ray is a way to determine whether there is an abscess forming, or ear infection. However, the other procedure she could have is a CT scan, which is an excellent diagnostic tool. It's also very expensive though - is Juno insured?

If an inner ear infection is suspected, antibiotic cover would usually be given, and there’s some info here:

**please note there are some very graphic images on this link**
http://www.exoticpetmedicine.com/article/S1557-5063(16)30173-2/pdf

.... it's very detailed (takes a while to load), and gives you far more info than you need at this stage, but pick out the relevant bits :)

http://www.veterinarywebinars.com/m...oads/2016/03/Study_Notes_Ear_Nose_Rabbits.pdf

http://www.medirabbit.com/EN/Neurology/Otit/otitis.htm


The antibiotics, which I would expect your vet would consider if they have suggested an X-ray, could be Baytril and possibly combined with an injectable penicillin like Depocillin. Giving the two at once will hit the bacteria quicker than any single one at a time. I guess your vet wants to 'get on' with the process of diagnosis and find the extent of the problem. He seems fairly sure what you're dealing with, and better to begin treatment earlier rather than later.

There are also some members' threads here which may help to reassure you that you are not alone:


http://forums.rabbitrehome.org.uk/s...tent-ear-infection-U-D-Smudge-amp-Harley-gone

http://forums.rabbitrehome.org.uk/s...fection!-(-(&highlight=ruthyjones89+infection


Also, our lovely member Roxyroller88 has loads of experience - I haven't seen around for a while, so perhaps ping her a PM?

Loads of luck xx
 
neeshkabeesh said:
We took our rabbits to the vets this evening for their RHD2 vaccine and I mentioned that I thought Juno had been flicking her head/ears about lately and scratching at them, mainly the right one. It's not the kind of flicking they do as a binky or in excitement, it's definitely a flick like her ear was uncomfortable.

The vet had a feel and both ear bases feel the same and no lumps, although she did react being touched there but she is a huffy flighty thing anyway so we weren't sure if she was moving because she was uncomfortable or just because she didn't like being touched that way. He had a good look down both ears with a scope and couldn't see anything but said he wouldn't be able to see the middle or inner ear just with a scope. He offered an x-ray to see whether she has an abscess forming, or we could wait a day or two as we'd noticed the head flicking and itching only, no other symptoms, and it might be nothing.

Now she is home she has been holding her ear back while the other one is up and normal, so I think all the squeezing and feeling has caused her some pain. Either way it seems like there must be something wrong in her ear(s), despite the lack of any other symptom. I don't understand why x-ray was the first suggested option considering she's had 4 dentals in 12 months so she's had enough anaesthesia, and surely a course of antibiotics or topical drops would be the way to go first?

If she is the same in the morning we'll book another appointment, but is an x-ray really the next course of action?
Click to expand...

Unfortunately a middle ear abscess can only be seen by Xrays/CT scans. Does Juno have any other symptoms such as being a bit unsteady on her feet, a slight head tilt or going off harder foods ?

When she has her Dental treatment are skull radiographs ever taken too (too assess tooth roots ?) Pain from tooth root elongation can sometimes be mistaken for ear pain if the elongated root(s) are those of the very back molar teeth.

See bottom right image



Some additional information on the following links, some of which contain graphic surgical images:

http://www.veterinarywebinars.com/m...oads/2016/03/Study_Notes_Ear_Nose_Rabbits.pdf

http://www.exoticpetmedicine.com/article/S1557-5063(16)30173-2/pdf

http://www.ivis.org/proceedings/navc/2006/SAE/617.pdf?LA=1

If you type 'Treatment of otitis externa, media and interna in rabbits - Vet Times' into Google you can download the PDF of the article onto your computer.

Is Juno likely to be needing another Dental soon ? If so then perhaps the Vet could take the skull radiographs at the same time, assuming her ear(s) remain uncomfortable ?

I am assuming that the Vet had a good look at the outer surface of Juno's ears for any signs of dry, flaky skin ?
 
neeshkabeesh said:
We took our rabbits to the vets this evening for their RHD2 vaccine and I mentioned that I thought Juno had been flicking her head/ears about lately and scratching at them, mainly the right one. It's not the kind of flicking they do as a binky or in excitement, it's definitely a flick like her ear was uncomfortable.

The vet had a feel and both ear bases feel the same and no lumps, although she did react being touched there but she is a huffy flighty thing anyway so we weren't sure if she was moving because she was uncomfortable or just because she didn't like being touched that way. He had a good look down both ears with a scope and couldn't see anything but said he wouldn't be able to see the middle or inner ear just with a scope. He offered an x-ray to see whether she has an abscess forming, or we could wait a day or two as we'd noticed the head flicking and itching only, no other symptoms, and it might be nothing.

Now she is home she has been holding her ear back while the other one is up and normal, so I think all the squeezing and feeling has caused her some pain. Either way it seems like there must be something wrong in her ear(s), despite the lack of any other symptom. I don't understand why x-ray was the first suggested option considering she's had 4 dentals in 12 months so she's had enough anaesthesia, and surely a course of antibiotics or topical drops would be the way to go first?

If she is the same in the morning we'll book another appointment, but is an x-ray really the next course of action?
Click to expand...


How is she this morning? :)
 
MightyMax said:
How is she this morning? :)
Click to expand...
Completely back to normal, ear is back up looking cheerful, obviously! But I don't believe it!! :roll: :lol:

Thanks so much for your responses and the links, I'm going to go through them all now. That image of the x-rays is great, I have absolutley no expertise in these things and it surprises me how much you can see/diagnose from them.

She isn't insured, when I saw her on the charity website I could see from her eyes that she had dental problems so I never looked into insurance, she and Timmy fell in love straight away so I adopted her, despite her teeth!

Juno's only symptom is the suspected ear pain/discomfort (head flicking, scratching, flinching when squeezing ear/s, and holding her ear back yesterday). She only had her last dental last Tuesday so I could have had her x-rayed then but it wasn't offered. It has been offered before but more "if the vet thinks it's worth it when they see her teeth under anaesthetic do you want to go ahead?" and I've said yes, but they have never done it. I think in future with a rabbit with dental problems I'll just say yes to one straight away!

Even with her teeth, rather than drooling or not eating or other symptoms, the only sign that she needs a dental is her behaviour gets worse, in that she has obsessive behaviours and gets very agitated and bitey (hard, breaking-the-skin-biting, not nipping). I assume this is from the pain and discomfort. She does hold hay in her mouth and move it around but never quite eating it, also. For her first 6 years she was "left in a hutch at the bottom of the garden", so since I've had her she has been getting better at hay eating but she needs reminding, and she is fed an amount of wet pellets every morning on her own to keep her weight up (Timmy steals all food).

I rang today and she is booked in tomorrow for the x-ray, I was going to add a smiley face but I think I have to wait and see if that is the case! :?
 
Last edited:
neeshkabeesh said:
Completely back to normal, ear is back up looking cheerful, obviously! But I don't believe it!! :roll: :lol:

Thanks so much for your responses and the links, I'm going to go through them all now. That image of the x-rays is great, I have absolutley no expertise in these things and it surprises me how much you can see/diagnose from them.

She isn't insured, when I saw her on the charity website I could see from her eyes that she had dental problems so I never looked into insurance, she and Timmy fell in love straight away so I adopted her, despite her teeth!

Juno's only symptom is the suspected ear pain/discomfort (head flicking, scratching, flinching when squeezing ear/s, and holding her ear back yesterday). She only had her last dental last Tuesday so I could have had her x-rayed then but it wasn't offered. It has been offered before but more "if the vet thinks it's worth it when they see her teeth under anaesthetic do you want to go ahead?" and I've said yes, but they have never done it. I think in future with a rabbit with dental problems I'll just say yes to one straight away!

Even with her teeth, rather than drooling or not eating or other symptoms, the only sign that she needs a dental is her behaviour gets worse, in that she has obsessive behaviours and gets very agitated and bitey (hard, breaking-the-skin-biting, not nipping). I assume this is from the pain and discomfort. She does hold hay in her mouth and move it around but never quite eating it, also. For her first 6 years she was "left in a hutch at the bottom of the garden", so since I've had her she has been getting better at hay eating but she needs reminding, and she is fed an amount of wet pellets every morning on her own to keep her weight up (Timmy steals all food).

I rang today and she is booked in tomorrow for the x-ray, I was going to add a smiley face but I think I have to wait and see if that is the case! :?
Click to expand...

Do you mean it was just 2 days ago that she had her last Dental ? If so, do you think that it might be a good idea to ask the Vet if it'd be better to hold off on the Xray until next week ?
 
neeshkabeesh said:
Completely back to normal, ear is back up looking cheerful, obviously! But I don't believe it!! :roll: :lol:

Thanks so much for your responses and the links, I'm going to go through them all now. That image of the x-rays is great, I have absolutley no expertise in these things and it surprises me how much you can see/diagnose from them.

She isn't insured, when I saw her on the charity website I could see from her eyes that she had dental problems so I never looked into insurance, she and Timmy fell in love straight away so I adopted her, despite her teeth!

Juno's only symptom is the suspected ear pain/discomfort (head flicking, scratching, flinching when squeezing ear/s, and holding her ear back yesterday). She only had her last dental last Tuesday so I could have had her x-rayed then but it wasn't offered. It has been offered before but more "if the vet thinks it's worth it when they see her teeth under anaesthetic do you want to go ahead?" and I've said yes, but they have never done it. I think in future with a rabbit with dental problems I'll just say yes to one straight away!

Even with her teeth, rather than drooling or not eating or other symptoms, the only sign that she needs a dental is her behaviour gets worse, in that she has obsessive behaviours and gets very agitated and bitey (hard, breaking-the-skin-biting, not nipping). I assume this is from the pain and discomfort. She does hold hay in her mouth and move it around but never quite eating it, also. For her first 6 years she was "left in a hutch at the bottom of the garden", so since I've had her she has been getting better at hay eating but she needs reminding, and she is fed an amount of wet pellets every morning on her own to keep her weight up (Timmy steals all food).

I rang today and she is booked in tomorrow for the x-ray, I was going to add a smiley face but I think I have to wait and see if that is the case! :?
Click to expand...


You're really welcome :)

I have to agree with you about X-raying when a rabbit has a dental. My vet doesn't do them either, and says that often they don't show anything up :? But like you, I push for them now!

For an X-ray, the sedation required wouldn't be so great as for a dental. It should be a fairly swift thing.

Good luck with that :)
 
Juno had her x-rays yesterday, I only spoke to the vet on the phone about it as he wasn't around for an appointment in the evening when I went to pick her up. He said there was nothing in or around her ears as they had a good look while she was under, and also the x-ray didn't show anything. They did see her teeth, I can't remember what he said about the top ones but he said the bottom teeth roots were growing in a way that it has already damaged her lower jaw bone.

He spoke to the rabbit specialist and she suggested they could cut into the lower jaw and remove the tooth pulp which would kill the tooth and stop it causing more damage, but that tooth would eventually fall out and cause problems for the other teeth. I thought this sounded a bit barbaric and like 'Supervet' on TV.

I asked whether the apparent ear pain could be transferring from this tooth problem and he said possibly. The vet rang 3 hours earlier than I expected, and the way he was talking to begin with I thought she had died under anaesthetic or that he was going to suggest putting her to sleep on the table, so the beginning of the conversation about her upper teeth is kind of a blur!

I think in future if I have another rabbit with dental problems I will ask for an x-ray on the first dental, rather than after the fourth. It seems like this could have been bothering her all along and possibly causing her pain for a long while which I've been complaining about as behavioural problems :(

We have her on metacam now, and seeing the vet and the x-rays in person on Friday 22nd for a review.
 
neeshkabeesh said:
Juno had her x-rays yesterday, I only spoke to the vet on the phone about it as he wasn't around for an appointment in the evening when I went to pick her up. He said there was nothing in or around her ears as they had a good look while she was under, and also the x-ray didn't show anything. They did see her teeth, I can't remember what he said about the top ones but he said the bottom teeth roots were growing in a way that it has already damaged her lower jaw bone.

He spoke to the rabbit specialist and she suggested they could cut into the lower jaw and remove the tooth pulp which would kill the tooth and stop it causing more damage, but that tooth would eventually fall out and cause problems for the other teeth. I thought this sounded a bit barbaric and like 'Supervet' on TV.

I asked whether the apparent ear pain could be transferring from this tooth problem and he said possibly. The vet rang 3 hours earlier than I expected, and the way he was talking to begin with I thought she had died under anaesthetic or that he was going to suggest putting her to sleep on the table, so the beginning of the conversation about her upper teeth is kind of a blur!

I think in future if I have another rabbit with dental problems I will ask for an x-ray on the first dental, rather than after the fourth. It seems like this could have been bothering her all along and possibly causing her pain for a long while which I've been complaining about as behavioural problems :(

We have her on metacam now, and seeing the vet and the x-rays in person on Friday 22nd for a review.
Click to expand...


Gosh, you seem to have had quite a time of it! I agree with you about cutting into the lower jawbone being a bit beyond the pale. Sounds very drastic :shock:

I do agree with you about having an X-ray first off. Believe me, if I could turn back the clock, I would have asked for one and saved one of my rabbits such a terrible amount of pain :(

I will be interested to know whether you feel the Metacam makes a difference to her pain levels, and behaviour x
 
neeshkabeesh said:
Juno had her x-rays yesterday, I only spoke to the vet on the phone about it as he wasn't around for an appointment in the evening when I went to pick her up. He said there was nothing in or around her ears as they had a good look while she was under, and also the x-ray didn't show anything. They did see her teeth, I can't remember what he said about the top ones but he said the bottom teeth roots were growing in a way that it has already damaged her lower jaw bone.

He spoke to the rabbit specialist and she suggested they could cut into the lower jaw and remove the tooth pulp which would kill the tooth and stop it causing more damage, but that tooth would eventually fall out and cause problems for the other teeth. I thought this sounded a bit barbaric and like 'Supervet' on TV.

I asked whether the apparent ear pain could be transferring from this tooth problem and he said possibly. The vet rang 3 hours earlier than I expected, and the way he was talking to begin with I thought she had died under anaesthetic or that he was going to suggest putting her to sleep on the table, so the beginning of the conversation about her upper teeth is kind of a blur!

I think in future if I have another rabbit with dental problems I will ask for an x-ray on the first dental, rather than after the fourth. It seems like this could have been bothering her all along and possibly causing her pain for a long while which I've been complaining about as behavioural problems :(

We have her on metacam now, and seeing the vet and the x-rays in person on Friday 22nd for a review.
Click to expand...

Well it is good that there are no signs of ear disease, but I am very sorry to hear about the Dental problems. I hope that the Metacam will help to keep Juno as comfortable as possible xx
 
Thanks so much both of you. I think she is going to be one of these where I wonder every day whether we should put her to sleep now, and then finally do and wish I should have done it sooner :( It's always hard to time it right. Anyway I'll see what the vet and x-rays say on Friday. She is happy enough now and loves the metacam.
 
neeshkabeesh said:
Thanks so much both of you. I think she is going to be one of these where I wonder every day whether we should put her to sleep now, and then finally do and wish I should have done it sooner :( It's always hard to time it right. Anyway I'll see what the vet and x-rays say on Friday. She is happy enough now and loves the metacam.
Click to expand...


You're very welcome :)

Yes, it's always very difficult in these situations. Sad to say I have been through so many, and it never gets any easier for me.

I don't know whether any of these links will be helpful at all, in thinking about her quality of life:


http://www.rabbit.org/journal/2-8/quality-of-life.html


http://rabbit.org/end-of-life/


http://www.disabledrabbits.com/quality-of-life.html


http://forums.rabbitrehome.org.uk/showthread.php?270142-Quality-of-Life


I am so glad she is happy at the moment, loves the Metacam and is living day by day. It's hard for us not to constantly jump ahead and try and look into the future, and I always find myself remembering that my rabbit is OK at this moment, and I should be too. Seldom do any of us feel we got just the right moment to make the decision, and in the end we have to forgive ourselves for the decision we do make, as guilt is such a big part of grief.

Hugs for you x
 
neeshkabeesh said:
Thanks so much both of you. I think she is going to be one of these where I wonder every day whether we should put her to sleep now, and then finally do and wish I should have done it sooner :( It's always hard to time it right. Anyway I'll see what the vet and x-rays say on Friday. She is happy enough now and loves the metacam.
Click to expand...

Whilst tooth root elongation can be painful the pain can often be well controlled and the effected Rabbit can continue to have a good quality of life for a period of time. I'd just take things one day at a time. It's great that she loves the Metacam, it makes medicating her less stressful for both of you x
 
I took Juno back to the vet this week, she has been acting like she is ravenous all the time jumping up and scratching and biting in agitation. Long story short we are going ahead with the pulpectomy now, just waiting to hear from the vet when she can do it. One tooth either side on the lower jaw to be done, these are the teeth that they burr when they give her dentals, so should stop those growing. She said when the teeth fall out the others will keep the upper teeth in check because of the way the jaw moves when grinding.

In the meantime, Juno isn't a good hay eater we think from the pain in her jaw. She reacts with discomfort when having greens, and it doesn't have to be many greens, so the vet advised going from Burgess to Science Selective as it has longer strands of grass in the pellets which will help her digestion keep moving if she isn't able to have a lot of greens. She needs to gain a bit of weight too, that was another of my concerns that she is so very boney :-( She advised readigrass which we've tried but I'll try again and different brands, and to feed more grass or new grass. Also mentioned the Burgess grass hay which is more expensive but because it's cut when the grass is short it's higher in carbs and protein and more like what they'd eat in the wild. She also said they're finding more and more once a day isn't enough for metacam to keep on top of pain so advised I could try 0.35ml twice a day (currently 0.4ml once a day, 0.35ml is lowest dose for her weight).

As for her ear, she has peeling skin around the base of her ear but no redness or damage to the remaining skin. We think she might have had a problem with mites or something in the past, which has now fixed itself but the skin has come off and is caught in her fur, and now will probably remain there until her big Spring moult. She allows me to scratch the skin off the fur but only temporarily, and it's not irritating her now, so I'm just leaving it.

I've searched the forum for pulpectomy and there aren't many references to it, so I'll share what I can on here for future rabbits.

The vet who will do the procedure is Deborah Stafford at Gilmoor Vets in Durham, apparently they take referrals from other vets for the procedure.
 
neeshkabeesh said:
I took Juno back to the vet this week, she has been acting like she is ravenous all the time jumping up and scratching and biting in agitation. Long story short we are going ahead with the pulpectomy now, just waiting to hear from the vet when she can do it. One tooth either side on the lower jaw to be done, these are the teeth that they burr when they give her dentals, so should stop those growing. She said when the teeth fall out the others will keep the upper teeth in check because of the way the jaw moves when grinding.

In the meantime, Juno isn't a good hay eater we think from the pain in her jaw. She reacts with discomfort when having greens, and it doesn't have to be many greens, so the vet advised going from Burgess to Science Selective as it has longer strands of grass in the pellets which will help her digestion keep moving if she isn't able to have a lot of greens. She needs to gain a bit of weight too, that was another of my concerns that she is so very boney :-( She advised readigrass which we've tried but I'll try again and different brands, and to feed more grass or new grass. Also mentioned the Burgess grass hay which is more expensive but because it's cut when the grass is short it's higher in carbs and protein and more like what they'd eat in the wild. She also said they're finding more and more once a day isn't enough for metacam to keep on top of pain so advised I could try 0.35ml twice a day (currently 0.4ml once a day, 0.35ml is lowest dose for her weight).

As for her ear, she has peeling skin around the base of her ear but no redness or damage to the remaining skin. We think she might have had a problem with mites or something in the past, which has now fixed itself but the skin has come off and is caught in her fur, and now will probably remain there until her big Spring moult. She allows me to scratch the skin off the fur but only temporarily, and it's not irritating her now, so I'm just leaving it.

I've searched the forum for pulpectomy and there aren't many references to it, so I'll share what I can on here for future rabbits.

The vet who will do the procedure is Deborah Stafford at Gilmoor Vets in Durham, apparently they take referrals from other vets for the procedure.
Click to expand...

I really hope that the procedure will be of benefit to Juno and that she makes a good recovery from it.

Re her diet, have you tried her on Fibafirst, It has a much higher crude fibre content than any other pelleted feed ?

http://supremepetfoods.com/fiba-first-2/

If a Rabbit wont eat them at first they may do so if you break the sticks up.
 
Hi, thank you. Yes our box just ran out recently. She does eat it but only when I break it up, as you suggest. Is it okay to give a lot of it? They were having half a stick each per day as a treat.
 
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