Hi everyone, I don't really know what to do for the best. Our Molly has an abcess in the side of her face. It started on the left side so we took her to the vet and she had antibotics for a week. After 2 days the swelling had gone but it came back on the opposite side just as big. She went back to the vet and she has been on antibiotics for 10 days which has made no difference to the size of the swelling. Vet advised against operating on her and we had just about given up hope and then tonight the abcess has burst. I have squeezed out as much of the infection as I could, washed her down and she is now sitting in our lounge drying out and recovering from the shock of everything. I put her in her pet carrier with a blanket over the top to make it dark and she has just this minute hopped out and started to wash and dry herself off. Has anyone got any advise, although we have had our rabbits for 6 years we aren't that knowledgable as all you out there and any advise would be gratefully received. We will obviously be going back to the vet tomorrow but just need some immediate advise is possible.
Thanks Linda,Katie & Nicola
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Hello. Did the Vet explain her reasons for not wanting to operate ? Generally speaking in most cases abscesses require surgery and abscesses around the face need to be investigated for the possibility of them being tooth root related. You say that Molly's abscesses are 'in the side of her face'. Do you mean they are along the jawline ? If so this frequently indicates some sort of tooth root involvement.
Just giving systemic antibiotics is unlikely to be curative for several reasons, one being that the antibiotic may not penetrate the abscess wall and thus not reach the core of infection. Also, obtaining a swab for culture and sensitivity testing (swab taken from the abscess wall, not just the pus) would enable the exact bacteria involved to be identified and the most appropriate antibiotic to treat it with.
Exactly what type of surgery may be needed would depend on the individual case, but on the whole some sort of surgical intervention is almost always essential. For Molly the Vet may just debride the abscess cavity and remove as much diseased tissue as possible. The cavity may then be left open and would require flushing out 2-3 times a day, every day. Many Exotics Vets recommend using F1O for this (Marie Kubiak is an Exotics Qualified Vet)
It may be worth discussing using F10 to flush the wound. It is a very effective antibacterial but without the irritant effects of hibiscrub. We use it for wound cleaning without any adverse effects and it kills pretty much all bugs
The wound could then be packed with a medical grade manuka honey or a wound packing made up with intrasite gel and a tetracycline antibiotic.
If tetracyclines have been indicated on the sensitivity, another little trick is to get some itrasite gel from your vet and also some ornicure sachets. Ornicure is doxycycline. I mix some with the intrasite gel and this makes a doxycycline paste to apply to the abscess. Intrasite encourages healing and granulation. I sometimes pack abscesses with this mixture and it works well. I have a whole array of treatments i use for specific abscesses and the doxycycline intrasite mixture is one i have had significant success with.
Goodluck
(rodneyvet is another qualified Exotics Vet)
He also comments on the importance of good debridement of abscesses and maybe the use of an antibiotic impregnated bead which is inserted into the wound.
Can you post the whole sensitivity. This is one I would consider the use of Antibiotic impregnated methylmethacrylate beads as well as as much debridement as possible. Have you had radiographs, this will let you know about bony involvement and affect prognosis and aggression of debridement
Goodluck
If you could get one that would help. If the bone is affected you will need a long course of systemic treatment as well as topical. If what you say is correct and you are getting necrotic tissue out, I would consider the possiblity of a nidus of infection that would require debridement. these are very frustrating cases and I frequently end up being quite radical about debriding, closing the dead space and removing anything that looks in any way necrotic. Is ther communication with the oral cavity?
It may be that if they still have the culture, further sensitivities could be carried out. Also I wouldnt rule out the fact that in vitro sensitivity doesnt always apply in vivo so penicillin injections might not yet be ruled out
Hope this helps
So I would go back to the Vet for a further discussion about treatment options. If you feel that your current Vet is unable to help or you are in any doubt about how 'Rabbit Savvy' they are you could start a thread in Rabbit Chat asking for 'Rabbit Savvy Vet' recommendations in your area.
Good luck, Rabbit abscesses are a real challenge to treat. But in some cases they can be overcome. Even if they cannot be totally 'cured' the infection can be contained to enable the Rabbit to continue to enjoy a good quality of life.
If you wanted to read up any more about abscess treatment options here is a bit more info'
*WARNING GRAPHIC IMAGES ON FIRST TWO LINKS*
http://www.medirabbit.com/EN/Dental_diseases/Treatment/Facial/abs_dental.htm
http://wildpro.twycrosszoo.org/S/00dis/Bacterial/Abscessation_rabbits.htm
http://www.rabbitadvocates.org/newsletters/Spring_13.pdf
