Nena (tooth root abscess) - Final U/D December...she's still fine :)

[yaretzi]

It's now been a month since she was diagnosed, but the abscess appears to be no smaller from what I can feel.

She was putting on weight at the beginning but hasn't done for 2 weeks now. She's 2.350ish kg when she should be at least 3kg. Still painfully thin.

She doesn't mind medicine time too much... she dislikes being syringed the meds twice a day but will happily eat recovery food/pellet&puree mush afterwards most of the time. She's dribbled off her cheek, chin, and neck fur. We had to have her clipped as there was a massive, wet matt on her chest. She's now naked there and we need to clean with hibiscrub every day which she absolutely hates and she won't eat after and is very unhappy.

My mom is getting very frustrated with the routine as I need her help to syringe the meds twice a day. It takes up a lot of time and is very restrictive to her. She doesn't deal well with stress and this is stressing her out and causing problems with us.

Nena's tooth root abscess is the furthest back tooth, and her entire set of teeth are growing very deeply and wonky. The affected tooth is growing very deep.

We're on penicillin injections every 2 days, 0.8ml baytril twice a day and 0.8ml of metacam once a day. She doesn't appear to be in any pain. I have asked about metronidazole and she was going to look into it. Nena doesn't mind the injections, I do it while she's eating pellets and she doesn't really care.

The vet is very hesitant to attempt to remove the tooth because of the very high chance of breaking her jaw given how deep it is and the fact it's so far back. She's very experienced and knowledgeable about bunnies, and said in normal circumstances she'd drain it and use those beads soaked in ABX, but the placement makes this basically impossible.

The vet has suggested we put Nena under GA soonish to have an X-ray to determine how much smaller it's become, if any. This is fine by me. I know why she doesn't want to do it sooner. I just worry it's not any smaller, it certainly doesn't feel it.

I'm just not really sure what to do right now. I've always been very determined that I will not put Nena through something if there's a high chance she might not recover, but after nearly a month of treatment it's really not looking very good. But it's also not fair to have her put down now, as once the abscess is gone we could have months or years before another one reoccurs.

Has anyone got any experience of tooth root abscesses in very deeply growing teeth or the very back teeth? What did your vet do? Did it work?

I feel terrible for Nena if this goes on for much longer. I can't subject her to another two months of this or more. If it's not going to go it's not going to go, and it's not fair to keep pushing her. The abscess can't be comfy and I'm having to feed her pellet mush around 4 times a day including at syringe times. She's not sustaining her weight by herself, that's not a real life for a rabbit in my eyes. She's pretty much only eating pellet/puree mush, oats and pellets. She has been eating hay, we're pretty sure about that. The only fruit/veg she'll eat is coriander sometimes and apple sometimes. She is brighter in herself than she was at the beginning, as the ulcer in her mouth has gone. However, she is almost always quite subdued and 'sad' looking.

She has a checkup at the vets tomorrow.

 

[ripminnie]

Aww I'm sorry she doesn't seem any better I don't have any experience of this, but just wanted to send mega vibes for your poor girl xxx

 

[chloemurray]

Just wanted to send vibes xxx

 

[natandfluffs]

Sending HUGE hugs.

I sympathise with a lot of this- from the question about quality of life through to the frustrated helper, relationship difficulties as a consequence, and personally for me, wondering how much more stress I can take... (I tend to ignore the latter and plough on regardless anyway however :lol

Abscesses are a and I still can't believe how much it's impacted on our lives...

All bunnies/ abscesses are different, but from memory, one month in, Charlie's abscess had done absolutely sod all in terms of improving... it was 6 weeks before it looked like it was going the right way and about 8 before it had healed over cleanly (he did have surgery and has eaten well almost all the way through) and then when it started to look better he got an ear abscess and then the jaw blew up again. And then magically leaked a bit and disappeared... miracles are possible. Though I'm not kidding myself that he is 'cured'

Have you tried echinacea at all? I've used it- no idea what it has done, but it won't hurt and my vets opinion was very favourable. Has she had a culture done to help identify best abx? Could you use surgery as a last resort if nothing else is working? (This was my approach to his abx- can be quite nasty, but it was try that and give him a chance and take the risk, or have the abscess get the better of him)

Surgery wise Charlie had all his teeth removed on the left side, top and bottom, and roots were right on the bottom edge of jaw for most teeth (I think!) he has been described my my vets as having 'a complete disaster mouth'!! My vet is an experienced exotic vet and got them out with no fractures. It's a real risk though and I suspect there is an element of luck involved. Charlie did however manage to fracture his jaw (kamikaze jump) about 10 days post extraction. I'm not trying to say you should try surgery though- I think each bun and abscess is different and you just sort of feel your way along and if you're anything like me, whatever you do you'll still doubt yourself. charlie has a very high pain threshold it would seem which has probably helped him.

Just my experiences/ thought processes that I've had on the way- I hope it helps a little

 

[Alvins mummy]

Poor Nena. Sending lots of vibes. X

 

[MimzMum]

Just wanting to send some healing vibes and prayers for Nena. She reminds me of my Mimzy, I really hope something can be done to help her with her abscess.
Has anyone suggested manuka honey for it? I've read that a few folks on here have used it, but perhaps the abscess isn't accessible for this treatment?
(((((Hugs))))) for you. Will be keeping you both in my thoughts. xxxx

 

[Barn Yard Bunnies]

Big hug. I cannot offer anything practical but hope Nena's problem can be sorted eventually. xxx

 

[yaretzi]

Thank you for all your vibes and advice Unfortunately the vet has cancelled on me today as she's ill, so I have an appointment Monday instead. I have to make the 1 and a half hour round trip to the vets to get more metacam though, yay! :roll:

Sending HUGE hugs.

I sympathise with a lot of this- from the question about quality of life through to the frustrated helper, relationship difficulties as a consequence, and personally for me, wondering how much more stress I can take... (I tend to ignore the latter and plough on regardless anyway however :lol

Abscesses are a and I still can't believe how much it's impacted on our lives...

All bunnies/ abscesses are different, but from memory, one month in, Charlie's abscess had done absolutely sod all in terms of improving... it was 6 weeks before it looked like it was going the right way and about 8 before it had healed over cleanly (he did have surgery and has eaten well almost all the way through) and then when it started to look better he got an ear abscess and then the jaw blew up again. And then magically leaked a bit and disappeared... miracles are possible. Though I'm not kidding myself that he is 'cured'

Have you tried echinacea at all? I've used it- no idea what it has done, but it won't hurt and my vets opinion was very favourable. Has she had a culture done to help identify best abx? Could you use surgery as a last resort if nothing else is working? (This was my approach to his abx- can be quite nasty, but it was try that and give him a chance and take the risk, or have the abscess get the better of him)

Surgery wise Charlie had all his teeth removed on the left side, top and bottom, and roots were right on the bottom edge of jaw for most teeth (I think!) he has been described my my vets as having 'a complete disaster mouth'!! My vet is an experienced exotic vet and got them out with no fractures. It's a real risk though and I suspect there is an element of luck involved. Charlie did however manage to fracture his jaw (kamikaze jump) about 10 days post extraction. I'm not trying to say you should try surgery though- I think each bun and abscess is different and you just sort of feel your way along and if you're anything like me, whatever you do you'll still doubt yourself. charlie has a very high pain threshold it would seem which has probably helped him.

Just my experiences/ thought processes that I've had on the way- I hope it helps a little

Thank you for sharing your experience. It's reassuring to know that it took 6 weeks to start showing any improvement. When did he have his surgery - near the beginning of treatment or later on? It's such a difficult thing to judge . I owe it to her to keep going because so many bunnies have made great recoveries, but I also don't want to medicate her/stress her for months on end only to have the abscess never heal or reoccur very quickly. Nena is due her vaccs on about the 20th-25th June (need to double check), and right now the vet isn't happy to vaccinate her. So that's an extra worry too, since they're outdoor bunnies and there was a VHD outbreak very nearby in Kidderminster several months ago that has likely spread now.

 

[natandfluffs]

Thank you for sharing your experience. It's reassuring to know that it took 6 weeks to start showing any improvement. When did he have his surgery - near the beginning of treatment or later on? It's such a difficult thing to judge . I owe it to her to keep going because so many bunnies have made great recoveries, but I also don't want to medicate her/stress her for months on end only to have the abscess never heal or reoccur very quickly. Nena is due her vaccs on about the 20th-25th June (need to double check), and right now the vet isn't happy to vaccinate her. So that's an extra worry too, since they're outdoor bunnies and there was a VHD outbreak very nearby in Kidderminster several months ago that has likely spread now.

I wonder whether Nena may take even longer than Charlie's six weeks before you start seeing improvement- given that the pus doesn't have the same escape channel and it can't be cleaned the same way it may take longer for the abx to get it under control?

Charlie's surgery was pretty early on. I got him in December, had him in for a check up in Jan when my vet said his teeth were really higgeldy piggeldy and he needed a dental and a couple out. I was told to book him in within 4 weeks... 4 weeks later he was booked in- they had no idea what it was like til he was out (silly me declined x rays as we thought it would be relatively straightforward) and found several infected and wobbly teeth, so they came out then. He was on abx at that point, and the lump on his jaw came up 2 weeks later- the abx obciously hadn't done it, plus he'd also cracked his jaw by then- so thats when they cleared it out and sent him home with a hole to flush. He had another surgery after that to clear it out some more as it wasn't draining well, and to but abx beads under the gum line (pus was going up into mouth and down through jaw bone and they wanted it to run down). I was told at that point that they couldn't remove it fully as if they took all of it out (the end nearest his nose) his jaw would collapse because it had taken over that big an area. So they did what they could and we flushed like mad. So it's not been straightforward...

I think the hardest thing, for me, is the not knowing how its going to go. I feel like I'm blundering around in the dark trying to make the best decision without really having any idea of how its going to go. I'm trying to take it day by day and play it by ear, but its easier said than done!!

 

[yaretzi]

I wonder whether Nena may take even longer than Charlie's six weeks before you start seeing improvement- given that the pus doesn't have the same escape channel and it can't be cleaned the same way it may take longer for the abx to get it under control?

Charlie's surgery was pretty early on. I got him in December, had him in for a check up in Jan when my vet said his teeth were really higgeldy piggeldy and he needed a dental and a couple out. I was told to book him in within 4 weeks... 4 weeks later he was booked in- they had no idea what it was like til he was out (silly me declined x rays as we thought it would be relatively straightforward) and found several infected and wobbly teeth, so they came out then. He was on abx at that point, and the lump on his jaw came up 2 weeks later- the abx obciously hadn't done it, plus he'd also cracked his jaw by then- so thats when they cleared it out and sent him home with a hole to flush. He had another surgery after that to clear it out some more as it wasn't draining well, and to but abx beads under the gum line (pus was going up into mouth and down through jaw bone and they wanted it to run down). I was told at that point that they couldn't remove it fully as if they took all of it out (the end nearest his nose) his jaw would collapse because it had taken over that big an area. So they did what they could and we flushed like mad. So it's not been straightforward...

I think the hardest thing, for me, is the not knowing how its going to go. I feel like I'm blundering around in the dark trying to make the best decision without really having any idea of how its going to go. I'm trying to take it day by day and play it by ear, but its easier said than done!!

I forgot to reply to this, sorry about that. What you've said has been really really helpful to me and given me quite a lot of hope. I must admit, despite the fact I did know it'd take a while to work, after 4 weeks with no progress I was feeling very demoralised. To actually have someone say that their bun took 6/8 weeks to start improving has given me a lot of hope! I think you're definitely right, that it may take Nenas longer to start going down because it can't be lanced.

I definitely know what you mean about the hardest thing being not sure how it's going to go. I feel terrible about the possibility that I'm putting her through this but she might not even recover from it. It's heartbreaking encouraging her to eat all the time and having her be cheeky to you at medicine time, when you know it might not be long before you have to end her life. It really is just blundering around in the dark with no idea which way is the best way to go!

I have the vets at 5, so I guess we'll see if there's been any progress or not then.

 

[natandfluffs]

How did you get on? We've got the same tomorrow...

Relieved by emotional turmoil is of use to someone. Lol. That's the best thing about this forum, there is normally someone who has been thru similar and has learnt something useful.

 

[yaretzi]

How did you get on? We've got the same tomorrow...

Relieved by emotional turmoil is of use to someone. Lol. That's the best thing about this forum, there is normally someone who has been thru similar and has learnt something useful.

Indeed it can really help!

Vets went well, she's pleased that she's put on about 350-400g in the time since she was first diagnosed a month ago. Taking her in next tuesday for a good check under GA (or sedation) to see how the tooth is looking, and there's a possibility she might try to extract the tooth depending on how she finds it. She says that they can sometimes become more loose when infected, so that would be really good if she can manage it! Vet will also be able to make a judgement based on what she finds about whether to continue the same treatment or switch things around a little.

Gotta keep her on the same meds until next tuesday.

Really pleased that she's going to have a good checkup to see if what we're doing is the right thing and to see how things are going. With her weight up she's much stronger for the GA, but obviously I'm still concerned about the possible problems and also the risk of breaking her jaw when removing the tooth. I have a feeling if she's concerned about breaking the jaw she'll leave it though.

Good luck at the vets tomorrow, do let me know how it goes! Tooth root abscess owners should unite

 

[Mrs. Bunnykins]

Pleased to hear some positive news about Nena.:thumb::thumb:

She's lucky to have such a caring and loving owner.

 

[Kermit]

Have dealt with abscesses but not tooth root ones......I hate them all!

Hope that wee one gets on well and recovers xx

 

[Barn Yard Bunnies]

Pleased it went well for Nena. Best of luck next Tuesday.

 

[yaretzi]

Thank you everyone! I'm feeling very positive about seeing where we are in a weeks time. It's nice to know how it's going rather than be trying to make judgements based off things we don't know!

 

[natandfluffs]

Pleased things are finally looking up... Fingers crossed for Tuesday xx

 

[yaretzi]

Pleased things are finally looking up... Fingers crossed for Tuesday xx

Thank you.

I've repainted inside their shed while they're away, but now I've finished painting and I'm fretting instead

 

[Debster]

Just read through, I hope everything goes well for Nena today. Sending lots of vibes and keeping my fingers and toes crossed!xxx

 

[yaretzi]

Just read through, I hope everything goes well for Nena today. Sending lots of vibes and keeping my fingers and toes crossed!xxx

Thank you

Picked Nena up about 7. She came round from the anaesthetic well, and the vet could see that the ulcer is much much smaller so that should be causing her less pain. The abscess appears to be about the same but she managed to squeeze some pus out and wondered whether she'd maybe made the hole bigger. I'm to continue massaging at home to try and get some out. Easier said than done, Nena gets annoyed by it!

Treatment wise, we're going to do the full 6 weeks of depocillin which takes us to about the 19th/20th June, and then I'm to take her in on the 24th for GA and a proper look. Depending on whether the abscess has gone down and how much pus is present, she's going to look into surgery. Andy Barstow is very knowledgeable too and Nena is booked in on a day that he'll be there so they can discuss it between themselves and see what's best. Surgery will involve going through her cheek which is obviously rather risky because of the nerves and blood vessels, but if nearly 7 weeks on baytril and depocillin hasn't improved the abscess at all we don't have much of a choice. Surgery will involve either removing the tooth or inserting a drain.

I'm with my vet 100% on this. We have to give the depocillin a good chance to work or the last 4/5 weeks have been pointless.