Rabbit, otic abcess and then some!

Re: Rabbit, otic abcess and then some!

Marie Kubiak — Tue, 12 Aug 2014 12:30:08 GMT

[quote user="Robin Grimmer"]

This is a 7 year old rabbit with multiple problems, none of which sounds like an easy fix. Time for euthanasia maybe?

[/quote]

Perhaps if an extreme case, difficult to say from just the text. However, if you get the ear infection under control then you are left with a 7yr old rabbit with dental disease and this is a common situation and these can live perfectly happily, often with infrequent veterinary intervention.

Marie

Re: Rabbit, otic abcess and then some!

Evelyn Barbour-Hill — Tue, 12 Aug 2014 12:15:34 GMT

Don't blame the teeth for the abscess or for any dacrocystitis until you can reasonably demonstrate their involvement on radiographs.

"Spurs" don't cause abscesses unless so great as to severely traumatise the soft tissues.

Of course "spurs" may indicate that the teeth are becoming abnormal in conformation which may mean there is disease at the deep ends: radiographs will show you.

As Marie says, the particular arrangement of edges and "spurs" might be normal for this rabbit. Only periodic monitoring can tell: is it a steady state or are the apparent overgrowths increasing? I do not believe that every rabbit needs its teeth ground into the theoretical ideal. Even if this rabbit does need periodic correction of overgrowths, I'd stick with doing that unless you can demonstrate that it really needs something more drastic.

In other words, I wouldn't worry about messing with the teeth right now, unless the radiographs say you must – there seem to be higher priorities for this rabbit.

Re: Rabbit, otic abcess and then some!

Robin Grimmer — Tue, 12 Aug 2014 11:54:37 GMT

This is a 7 year old rabbit with multiple problems, none of which sounds like an easy fix. Time for euthanasia maybe?

Re: Rabbit, otic abcess and then some!

Marie Kubiak — Tue, 12 Aug 2014 09:33:56 GMT

Are both ears affected? Did it have a LWR or a TECA?

Aural abscesses are generally associated with the ear canal diverticulum found in lop eared bunnies - debris accumulates in the pocket and eventually bacteria make the most of this nice food source. The best approach is a TECA (+ bulla osteotomy as Catherine has mentioned if the bulla is also involved). I would try and clear up the infection if possible before considering further surgery (re-opening LWR stoma/completing Sx to a TECA/bulla osteotomy/marsupialising a big mess). Ideally antibiotics should be directed by C&S as many of these bugs are multiresistant. I have found on our bacteriology sensitivities that penicillins are frequently ineffective. Recent cases have had single sensitivities for aminoglycosides or cephalosporins which is concerning. If culture fails now antibiotics are on board then consider a broad combined antibiotic approach but even this may fail with multiresistance.

I would avoid injecting baytril (though I'm sure you are planning oral treatment anyway) - it causes skin necrosis. As bunnies with abscessation have a following downregulation of their immune function you may get less severe skin reactions but potential for forming abscesses at the inection sites.

If there are only minor points on cheek teeth then this may be normal for this bunny and if not causing any change in eating patterns (food types eaten/quantity) then I would not rush in yet and plan to GA, flush tear ducts, assess teeth fully (including radiographs) and address residual ear issues when things have settled a little. If clear spurs and likely/evident tissue trauma then I would go in now and do radiography, tear duct flush, dental and clean ear thoroughly. If a small number of teeth are affected then removal is an option but I refuse to do this where there is existing infection as you may end up creating a compromised area in the mandible that is vulnerable to further infection. Bear in mind that extraction is a fairly major procedure and has knock on effects for the surrounding/opposing teeth. I would consider pulpectomy as a preferable option, but again not until you have an infection-free rabbit face.

Marie

Re: Rabbit, otic abcess and then some!

CatherineThomas — Tue, 12 Aug 2014 07:35:25 GMT

It could be regrowth of spurs, they can grow pretty fast, particularly if there are issues with reduced appetite or not eating fibrous foods. I wouldn't jump straight in to removing teeth, i'd x-ray the skull and burr teeth plus discussion of diet, ensure adequate pain relief so that the rabbit will eat fibrous food.

I don't think weekly penicillin is enough, I only use weekly injections for syphillus. For abscesses you need every other day dosing. Enrofloxacin will be no use at all for abscesses.

It sounds like the ear might need a bulla osteotomy. Kevin eatwell is a big advocate of these he says that the majority of rabbits with ear problems have otitis media and so lateral wall resections don't do much on their own and they need bulla osteotomies. If it's bad you might see changes in the bulla on x-ray but some are only really detected on CT.