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  • Please Note - Medical Advice

    Please keep in mind that posts on this forum are from members of the public sharing personal opinions. It is not a replacement for qualified medical advice from a veterinarian. Many illnesses share similar symptoms but require different treatments. A medical exam is necessary for an accurate diagnosis, without which appropriate treatment cannot be given.

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PLEASE HELP Dental problems and not eating:Vet suggested potential PTS

Can you feel any lumpiness along his mandible and/or does he show discomfort when you put a bit of pressure on the area ?

Does he have weepy eyes ?

If he has advanced Dental problems this can involve tooth root elongation, this can only be seen from skull radiographs. Tooth root elongation can lead to tooth root abscesses and osteomyelitis ( bone infection)

This is just my personal opinion and I am not a qualified Veterinary professional. But given that there has been little improvement on a week of the current antibiotic and he already has known Dental problems involving the crowns of his teeth I think I would have to risk a GA Dental and Skull Radiography.. His lack of eating for so long will mean any problems with the crowns of his teeth are almost certainly worse, so he simply cannot eat.

Just trying another abx such as Depocillin won’t change that fact and could be more risky given his prolonged anorexia, even though you have been syringe feeding him.

I would want a Rabbit Savvy Vet to run a blood profile first, to check his major organ function. This should be able to be done ‘in house’ so the results are available on the day. If all is OK with the bloods then I would risk proceeding with the GA Dental and radiographs. A Rabbit Savvy Vet will know the best GA drug protocol to use and to give additional supportive care such as IV fluids.

If PTS is the only other option then IMO there is nothing to lose by risking the Dental procedure if major organ function is OK. If the radiographs show terrible problems involving tooth roots eg severe osteomyelitis, then the Vet can contact you before waking Ian up to let you know. In that situation I would request the Bunny was allowed to pass peacefully without being woken up from the GA. Osteomyelitis is very, very painful and if severe is unlikely to improve a great deal on longterm abx. Heavy duty analgesia would be needed for life too. Surgery to remove infected bone is not something I would agree to for a Rabbit in my care, but it is an option I have known to be offered.

As I said, the above is just my personal opinion and I hope it reads as intended and not as blunt and uncaring. I just feel that without knowing what is actually going on for Ian, the fact that despite a week of abx, heavy duty analgesia and prokinetics he is showing little signs of improvement just changing the abx is simply shooting into the dark.

I really hope Ian can pull through, you are doing everything within your power to try to help him. I know how stressful, upsetting and exhausting it is to be caring for such a poorly Rabbit.
 
Honestly from my point of wiev. If I don't see progress in behavior in 7 days (activitiy, eating) I always consult vet "what do we do now". If things go downhill I call even before so then they think and debate and sometimes they change meds, sometimes dosage. In case of URI he had last year. They changed treament and it worked like charm. Now he will be 7, so he is mature, not youngster. Been on meds on/off past 18 months. His heeling got slower. Plus I do think that if they have the same meds again and again, they might become somewhat resistent to it. Just like with us.

So the best thing is to have a vet you trust and work with them. Listen to your rabbit and if you see that there is too much for him, no imrpovement, not good enought quality of life. At some point we all say goodbye. But it is impossible to say from a distance what to do. I was on verge of putting him to sleep twice in the past 14 months. But he always not just pulled through, but thrived in a week of treament.
 
Yes I think you're both right. If our vet was here I'd feel confident about going and asking about these options, but she's away for 2 weeks. It's such horrible timing. He does seem a bit brighter today and is eating more on his own and his chewing seems better (not taking as long). Still only veg and herbs, not pellets though. I'll look around to see if there's other vets I could try nearby as there's no other expert at the practice (she said other who were good but I know she's the only expert). :(

Activity wise it is weird because he's acting quite normal. Hopping around and lounging with his legs out (though when we walk in he sits up as I think he knows it could mean syringe feeding). But obviously he's not wanting food he used to love.
 
I agree with Jane. He's holding his own (with help) and is feisty, so definitely hasn't given up. It's also still early days in terms of antibiotic treatment - there are other options, but you need to target it at whatever is going on. I would be very reluctant to PTS without skull x-rays to see if there was anything else that could be done, and to do any surgery required at the same time. As rabbit's teeth are continually growing, even a couple of weeks of not eating / chewing properly can result in spurs, etc becoming an issue again. If he's moving around OK, weeing & pooing fairly normally, bloods are normal, he's taking syringe food, etc and you can afford it and manage any after care, I always try to give them that chance. It may still not be a positive outcome, but at least you will know. It may also be treatable / curable - but you won't know without x-rays.

I've had 3 rabbits on lifetime dentals. One was standard molar spur burring as required, and two had strange jaw abscess issues and were treated by rabbit specialist FHB. One was offered a partial jaw removal as the bone was badly affected. I declined that procedure as it wasn't bothering the rabbit as it was (although it wasn't really useful as a jaw), so I thought the op to remove it was an unnecessary step for him (and me). Both had abscesses surgically removed, open wounds in their cheek for a while, daily washing out of the wound, with pain relief and depocillin injections for the rest of their lives. They were all mature rabbits at the time. They were able to eat mostly for themselves, with an adapted diet and a little intervention. Daily meds just became part of my routine and were not an issue for me or the rabbits.

The ones with jaw abscesses lived about another 18 months (can't remember exactly) with a good quality of life. I think the infections got them both in the end - one didn't recover from emergency surgery, the other went downhill very quickly at home and died the same day - it was really obvious that she was going. The one with spurs lived to be over 9 years old, outlived his brother and death was not related to dental issues. So rabbits can cope with quite a lot of intervention and they adapt, but a lot depends on the rabbit, and how much you are able to put in as it can be costly in terms of time and money. Most jaw abscesses are not as extreme as the ones mine had, and it is possible to get a complete cure for many. Mine were in FHBs top 10 'interesting' ones, and she saw a lot over her time as a practicing vet.
 
Shimmer said:
Will he eat softened pellets from a saucer?
Click to expand...

He wasn't interested last time I tried but will try again today. He's just had a feed so is in a mood with me right now. I just rang the vets and spoke to the receptionist and asked about the person my vet recommended and apparently he sees a lot of rabbits and is an exotics vet so I've booked him in with him on Tuesday (he's not in until then). On Monday I'm going to try to see if my old vet will see him but she's about an hour away so it's a lot to take him there if we'd be going back and forth, but maybe best to know if she is an option. I definitely don't want to put him through too much more of this when he's had such a terrible couple of weeks already, but as you say if it's something curable to a point of a good quality of life then it's worth knowing if we can.
 
InspectorMorse said:
Can you feel any lumpiness along his mandible and/or does he show discomfort when you put a bit of pressure on the area ?

Does he have weepy eyes ?

If he has advanced Dental problems this can involve tooth root elongation, this can only be seen from skull radiographs. Tooth root elongation can lead to tooth root abscesses and osteomyelitis ( bone infection)

This is just my personal opinion and I am not a qualified Veterinary professional. But given that there has been little improvement on a week of the current antibiotic and he already has known Dental problems involving the crowns of his teeth I think I would have to risk a GA Dental and Skull Radiography.. His lack of eating for so long will mean any problems with the crowns of his teeth are almost certainly worse, so he simply cannot eat.

Just trying another abx such as Depocillin won’t change that fact and could be more risky given his prolonged anorexia, even though you have been syringe feeding him.

I would want a Rabbit Savvy Vet to run a blood profile first, to check his major organ function. This should be able to be done ‘in house’ so the results are available on the day. If all is OK with the bloods then I would risk proceeding with the GA Dental and radiographs. A Rabbit Savvy Vet will know the best GA drug protocol to use and to give additional supportive care such as IV fluids.

If PTS is the only other option then IMO there is nothing to lose by risking the Dental procedure if major organ function is OK. If the radiographs show terrible problems involving tooth roots eg severe osteomyelitis, then the Vet can contact you before waking Ian up to let you know. In that situation I would request the Bunny was allowed to pass peacefully without being woken up from the GA. Osteomyelitis is very, very painful and if severe is unlikely to improve a great deal on longterm abx. Heavy duty analgesia would be needed for life too. Surgery to remove infected bone is not something I would agree to for a Rabbit in my care, but it is an option I have known to be offered.

As I said, the above is just my personal opinion and I hope it reads as intended and not as blunt and uncaring. I just feel that without knowing what is actually going on for Ian, the fact that despite a week of abx, heavy duty analgesia and prokinetics he is showing little signs of improvement just changing the abx is simply shooting into the dark.

I really hope Ian can pull through, you are doing everything within your power to try to help him. I know how stressful, upsetting and exhausting it is to be caring for such a poorly Rabbit.
Click to expand...

He did have a weepy eye but it was looking better. There's still the area where it was weeping but it seems to be dry now. Thank you for this, it doesn't read as blunt at all, it's really helpful to hear what you would all do in this situation. And absolutely agree that if it's something that sinister that it would be best to let him go than have him continue fighting. I just wish it was easier to do all this without causing him so much stress :(

I also asked about cisapride after trying to get through for ages yesterday and they said they have to order it in so it wouldn't arrive until tuesday anyway and I'd need to talk to the vet directly and he isn't in until Tuesday. :(

also, I cant feel any kind of bump and the vet couldn't either so you might be right about it being right at the root. The vet seemed to think. it could be a tooth root infection and that that was causing the weepy eye and affecting his sense of smell, making food smell wrong for him potentially. but like you said, with no significant change in a week and not knowing what is actually wrong, more ABs might just prolong this struggle for him :(

I wish I'd known to ask for an xray when they did his last dental, but as far as we knew it was the teeth that was the issue and assumed he'd bounce right back like he did last time :(
 
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You are doing a good job with him. He is still hopping around and relaxing. Without his friend he may just be less confident when you come in the room which causes him to run away.
Also, your bunny will pick up on your stress. Sending vibes for you and your bun.
 
You really are doing a fantastic job with Ian, and it's not an easy one. I really can't offer any additional advice, so sending loads more vibes for both you and Ian xx
 
I hope Tuesdays appointment goes well. It can't hurt to have a fresh pair of eyes reviewing the situation. Topping up the vibes for Ian
 
I hope he's maintaining his weight and taking all his meds. Hoping all goes well and you will get some more options for diagnosis and treatment today.
 
Thank you all,

We ended up seeing a different vet to who we booked with as he'd called in sick. Frustrating. The vet we saw seemed very good but still, really wanted the most experienced person possible. He has lost a bit of weight now, which isnt good. She smelled in his mouth and said she can't smell any infection so thinks the ABs are working so that there is probably another reason (probably pain) that is causing him to not want to eat. I asked about a scan and she said it's unlikely a scan would show us anything that they can do anything about at this point, but has booked me in provisionally for a scan next Thursday (when the rabbit vet is in) and suggested taking the week to see if he's getting better and to assess his quality of life. She said she didn't think trying another anti-biotic was going to do anything as the smell in his mouth has gone and his eyes look brighter so she thinks they've worked and that something else is going on. His teeth look ok, apart from a small spur on one side next to his cheek but nothing too uncomfortable. So basically it looks like we're out of options and will have to hope he picks up over the next week. She said that based on what she's seen that even if he does get a bit better she doesn't think we'll have much longer with him. Based on what she's said I'm not sure I'd want to put him through the ordeal of waiting around for a GA for a scan if it's not going to tell us anything we can do anything about but I'm not sure. Really wish our vet was here :(
 
You can always ask for a referal to a specialist rabbit vet. If they are too far away for an initial visit, your vet can send across the medical history and bloods & x-rays, etc - which would still need to be done. They may be able to offer some suggestions which your vet could carry out, or it may require a personal consultation with them once they have any information to hand. You should be able to get a quote before you go down that route. My specialist was no more expensive than my regular vet, just a longer initial consultation which was based on the hourly rate.

Personally, I would be pushing for extending the antibiotics and to do some x-rays. I like answers when things are not straightforward. Information gives you a better picture of what's going on, and more targetted options. I hate to have a rabbit written off just because it's not entirely recovered in a couple of weeks. Sometimes you can't do much more, but PTS is a once-only option.

Is he covered by insurance for the scan?

Pain etc has to be coming from somewhere, and so far it's not been located. There's also the spur, which can be removed under sedation for x-rays / scan, and may be causing some of the issues. If he's looking brighter, then that's a good sign. Can you increase his syringe feeds for a week to see if that helps with his weight? And how are you coping?
 
Shimmer said:
You can always ask for a referal to a specialist rabbit vet. If they are too far away for an initial visit, your vet can send across the medical history and bloods & x-rays, etc - which would still need to be done. They may be able to offer some suggestions which your vet could carry out, or it may require a personal consultation with them once they have any information to hand. You should be able to get a quote before you go down that route. My specialist was no more expensive than my regular vet, just a longer initial consultation which was based on the hourly rate.

Personally, I would be pushing for extending the antibiotics and to do some x-rays. I like answers when things are not straightforward. Information gives you a better picture of what's going on, and more targetted options. I hate to have a rabbit written off just because it's not entirely recovered in a couple of weeks. Sometimes you can't do much more, but PTS is a once-only option.

Is he covered by insurance for the scan?

Pain etc has to be coming from somewhere, and so far it's not been located. There's also the spur, which can be removed under sedation for x-rays / scan, and may be causing some of the issues. If he's looking brighter, then that's a good sign. Can you increase his syringe feeds for a week to see if that helps with his weight? And how are you coping?
Click to expand...

We're going to try to get him booked in with the rabbit vet we were supposed to see today (not sure of the illness that he is off for so hoping it's not something that he will be off for a while with). Otherwise I have found a vet that is a bit of a trek but we could try. It's hard because he was already having issues then Puck died and it feels like we're putting him through a lot. I'm worried now because he's now seen 3 different vets who all seemed to think we didn't have a lot of options and we don't have long with him but am going to try to see this one and if I can't get in with him then try this other practice.

He's not covered by insurance because I couldn't find any that would cover dental problems when we got him so I've just been putting the equivalent into an account for them over the years so have savings for vet things, thankfully. I'm going to try increasing the feeding if he'll let us. It's so hard because he was seeming a bit brighter but he'll have a good day then will go down again so it's hard to know overall. My hope was to get him well enough to get him a friend and for him to have a friend to live out the rest of his life, even if that wasn't for very long. But the longer this goes on the less likely it feels that he will ever be well enough to be able to cope with the potential stress :( The vet we saw today seemed to think he might not make it through the GA the way he is now so the week could hopefully see some improvement and get his strength up. But of course it could go the other way too.
 
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Naomi1988 said:
We're going to try to get him booked in with the rabbit vet we were supposed to see today (not sure of the illness that he is off for so hoping it's not something that he will be off for a while with). Otherwise I have found a vet that is a bit of a trek but we could try. It's hard because he was already having issues then Puck died and it feels like we're putting him through a lot. I'm worried now because he's now seen 3 different vets who all seemed to think we didn't have a lot of options and we don't have long with him but am going to try to see this one and if I can't get in with him then try this other practice.

He's not covered by insurance because I couldn't find any that would cover dental problems when we got him so I've just been putting the equivalent into an account for them over the years so have savings for vet things, thankfully. I'm going to try increasing the feeding if he'll let us. It's so hard because he was seeming a bit brighter but he'll have a good day then will go down again so it's hard to know overall. My hope was to get him well enough to get him a friend and for him to have a friend to live out the rest of his life, even if that wasn't for very long. But the longer this goes on the less likely it feels that he will ever be well enough to be able to cope with the potential stress :( The vet we saw today seemed to think he might not make it through the GA the way he is now so the week could hopefully see some improvement and get his strength up. But of course it could go the other way too.
Click to expand...

Have now tried to get in with 3 different vets and all are fully booked or on holiday. We've booked him in with a practice with a rabbit expert about 30 minutes away so hopefully that wont be too much of a trek. I obviously don't want to put him through too much but want to make sure we've given him a good chance. thank you all for the help and advice <3
 
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Naomi1988 said:
Have now tried to get in with 3 different vets and all are fully booked or on holiday. We've booked him in with a practice with a rabbit savvy vet who is still undergoing qualification tomorrow at 5.30 (the gold standard practice I called to book in with is fully booked because of the BH weekend but this is part of the same practice and apparently she is the best there for rabbits, but I was ringing for the gold standard practice. It's a nightmare!). I'm not sure if it's worth doing the journey if she' not actually an expert but I can't find anyone else nearby who is better. The timing is awful :(
Click to expand...

I really feel for you, these decisions are never easy. its made worse when you hope for clarity from a vet appt but come out more confused or despondent. Best for rabbits sounds good - esp when attached to gold standard practice. I don't think it always takes an expert - she wants to be so she'll be interested, have researched lots, hopefully willing to bounce ideas of her colleagues etc, have an open mind. Admittedly it could go either way but based on the above I'd be hopeful
 
I rang back to clarify about the practice and it turns out she is an expert from the other practice, the only difference is the practice we're going to isn't small animals only so there may be dogs in the waiting room but they have a separate small animal area. Feeling hopeful that we'll at least potentially get some answers tomorrow, or feel that if this vet thinks PTS is the best that she is experienced enough to make that call.
 
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