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My rabbit Budja's jaw abscess came back for the third time after 2 surgeries


Around September this year my rabbit Budja's developed a jaw abscess along with excessive chewing motions. She was prescribed Baytril and Meloxicam leading up to the time of the surgery and really had a hard time with the first abscess as there was a little hole in her cheek that was not found until the time of the surgery, that hole in her cheek acted as a sort of duct that communicated with the abscess on the outside of her mouth, she also had a dental done at the same time where some teeth were grinded down other than that they didn't seem too bad. When it became more difficult and she was eating less and less the vet opted to do the surgery sooner and the next day. I really had a hard time giving her both the baytril and azithromycin so the vet opted to give her an injection of Penicillin G that would last all week to make up for the Azithromycin. She got her sutures out just 3 days over the recommended two week timeframe, all was good, for about a month that is. She never really stopped the continuous chewing motions though. The second abscess developed just under her jaw bone this time and at this point the vet recommended getting her an x-ray and keeping the baytril and azithromycin going if possible. She did start to take the azithromycin for me however, her stomach did not agree with it so she had to be taken off of it and continued on the baytril and meloxicam. This time during the surgery a biopsy was done as well as both an aerobic and anaerobic culture. The x-rays were looked over and no abnormality was found, no connection of the abscess being into the bone, or any abnormal tooth issue, or anything showed up, just an abscess that was not connected to anything. For both surgeries the abscess and the abscess capsule have been entirely removed. The aerobic culture came back showing it was staph bacteria that is sensitive to penicillin and chloramphenicol. Unfortunately, not even 6-7 days after this surgery Budja's developed another abscess nearly in the same exact area underneath her chin/over some of the cheek bone yet again on the right side of her jaw and it's a pretty decent size again as well. It's just near where she just had her sutures taking out yesterday. So the vet sent for some chloramphenicol that has to be crushed and compounded which should be in for me to pick up next week (this place is an hour away) and she has also recommended that I now get Budja's a C-T scan at Cornell University, that's about an hour away as well but pretty out of the way. Affording this is getting pretty hard now.

I'm continuing on the Baytril and Metacam knowing its not doing any bit of good, for some reason the vet had me stop the baytril 7 days after this last surgery but restarted. There seems to be no probably cause for the issue and yet Budja's continues to do that chewing motion as if she has peanut butter stuck in her mouth she is swishing around or something. Totally stumped on what could be the issue. She also likes to lick her stuffed bunny excessively and her blankets. When I first got her I did notice her left eye had some tears and stuff like an overproduction but I haven't seen that happen since, I only noticed when my hand had touched it when I pet her. Not so much for this right side though. I just keep thinking it absolutely has to be something dental related or some foreign splinter they still haven't found yet. Does anyone have any experience with this? My vet thinks that Penicillin G once a week would be enough but it wouldn't be easy for me to go back and forth an hour each week and I'm not even sure for how long she'd want me to, but she also seems guarded now about me giving them at home to budja's as I'd have to learn how etc even though I'm willing, it just makes more sense to me, so not really sure what she wanted to do/not do regarding that, but I did have her give her a shot yesterday that lasts a week. I talked to the vet about using bicillin she is concerned about it creating a lot of sterile abscesses as it has to be injected every other day and I sent her information on it. I asked if the cloraphemincol would be enough to take down the abscess and the vet did not know, basically nothing is clear on this... the vet and I are both stumped. The vet did say however that we are also looking at another surgery and we are still waiting on the anaerobic results. I did ask about the possibility of putting antibiotic beads in the surgery site when the abscess is next removed, they did say it was possible, but I'm thinking what if her body rejects it and then it forms another abscess. She did look in her mouth yesterday with her tool and didn't see anything.

Does anyone have any ideas??? There is also a smallish brown scabby area, where the incisions were just removed that is just near where the new abscess formed again.

I have just had success clearing a recurring hock abscess using chloramphenicol directly into the hole where the abscess was. I would recommend topical application of chloramphenicol given the culture results indicate it would be a suitable abx.

A CT scan could show up the core of infection, probably in the jaw bone, that was missed by X-ray.

Is your current Vet a Rabbit Specialist ? Complex cases almost always require the input of a highly ‘ Rabbit Savvy’ Vet.
I've had depocillin to inject at home when rabbits had abscesses surgically removed. You can be shown how to do it, and either have a bottle at home to draw up yourself or have pre-loaded syringes from the vet. It can vary from daily / alternate days / twice a week injections, but will be over weeks / months rather than days.

The abscess holes have also been flushed with diluted hibiscrub solution and packed with medical grade manuka honey twice(?) a day to promote healing from the inside.

I've not used chloramphenicol before, so no experience there.
Hello, I think it has been decided to go ahead with the Penicillin G injections which the vet will show me how to administer so I can then do them at home. We are still waiting to hear back from Cornell University on the CT pricing. It is very strange though because as of currently there is no cause to this abscess, nothing showed up on the x-rays, the abscess has been entirely and completely removed twice already, so there has not been a need to leave it as an open wound. She does frequent jaw chewing motions but otherwise seems happy despite it, still stomach flops, eats and drinks normally. An expert was consulted on the x-rays that were taken not long ago before the second surgery and nothing was found on it, no bone involvement or anything. An expert was also consulted after the biopsy and two cultures were taken and the recommendation was for the C-T. I'm hoping the Penicillin G procaine on it's own helps, I've decided against the chloramphenicol as I live with those that are immunocompromised and it can be dangerous for human health I was reading, personally not a risk I want to mess with if possible.