wound closure advice

Re: wound closure advice

Gillian Mostyn — Sun, 08 Feb 2015 08:52:24 GMT

Sounds odd. They maybe had other conditions, like E Cuniculi?

Re: wound closure advice

Mark Holmes — Sun, 08 Feb 2015 07:50:52 GMT

[quote user="Gillian Mostyn"]

I've done quite a few hind limb amputations ... All successful as far as I can remember. What are your particular concerns?

Debs.... I would also be concerned that post op care for a skin graft/defect could end up costing a lot of money. No easy answer though..sounds like a difficult case...good luck!

[/quote] To be honest it's such a long time since I attempted it I cannot remember all the details. They just didn't adjust. They would flip over onto the missing side and get stuck. In fairness owners may not have been sufficiently attentive but I remember them both coming back in a terrible state. With infected perineal ulcers, urine scalding etc.

Re: wound closure advice

John Flynn — Fri, 06 Feb 2015 23:17:23 GMT

[quote user="Deborah Anwyl"]Do any of you surgery bods have any advise on getting closure in this region? Any suggestions would be much appreciated![/quote]

I treat about 1 rabbit a decade so am best ignored, but how do rabbit's tolerate tunnel grafts/flaps (i'm not sure what the technical term is) with the foot stuck through 2 x vertical incisions on the flank to cover the defect until the skin takes?

Personally, if ambulating well I would leave the lump be until such time as it was not (and then either amputate or euthanase) unless i was confident of definitely making the situation for the bunny better by intervening now.

Re: wound closure advice

Gillian Mostyn — Fri, 06 Feb 2015 20:50:58 GMT

I've done quite a few hind limb amputations ... All successful as far as I can remember. What are your particular concerns?

Debs.... I would also be concerned that post op care for a skin graft/defect could end up costing a lot of money. No easy answer though..sounds like a difficult case...good luck!

Re: wound closure advice

Mark Holmes — Fri, 06 Feb 2015 19:34:19 GMT

Just to be clear - people are seeing hind limb amputations in rabbits go well? I have tried it twice - both a disaster and I vowed I wouldn't do it again and that has stood for 10 or more years. Time to rethink?

Re: wound closure advice

Tim Charlesworth — Fri, 06 Feb 2015 17:45:23 GMT

I have never grafted a rabbit but it may not necessarily be a cheap option. Grafts are fastidious about their wound environment and have to be well bandaged and so the costs (eg GA1 - tumour excision + dress wound + period of open wound management to get good granulation bed + GA2 to perform graft + fun and games of redresses/graft care for a week or so) would prob add up to be fairly high..

Re: wound closure advice

Michael Woodhouse — Fri, 06 Feb 2015 17:42:08 GMT

Deborah - I don't understand how she can afford mass removal and a graft but not an amputation? Amputation is quick and simple surgery. I've spayed a few rabbits and I can take its leg off faster! Think we charge £60 for a a spay - I'd guess I'd charge £100 to take the leg off. 15 mins surgical time? 20?

IF I was removing the mass and doing a graft I would be charging more money.....

Re: wound closure advice

Deborah Anwyl — Fri, 06 Feb 2015 17:10:41 GMT

Unfortunately she doesn't qualify for pdsa and rspca refused to treat the rabbit when sent by the previous vet.

I was doing a bit of research and came across an article about free grafting in small mammals. It doesn't look that time consuming but I have no idea on success rate. Anyone ever attempted it? if it's just a case of literally borrowing a free skin graft and not worrying too much about keeping a pedicle it may be something she may be able to look at financially.

Re: wound closure advice

ChrisBVSc — Fri, 06 Feb 2015 10:23:57 GMT

Difficult one but I don't think there's really anything more you can offer, would they be entitled to PDSA treatment? If it's not bothering him it might just be a case of palliative care when it eventually does, i.e. metacam.

Re: wound closure advice

Deborah Anwyl — Fri, 06 Feb 2015 10:11:31 GMT

rabbit is not really that bothered as far as the owner can tell. he licks it a little but that is about it. The previous vet did an fna but I don't have results barring that it came back non-neoplastic. Finances are so tight with this owner that she is having to borrow for surgery so biopsy and repeat surgery aren't really an option. it was my first thought. I have had a further chat re amputation and unfortunately again it is not something she can afford. she really wants to try with this rabbit but options are seriously restricted.

Re: wound closure advice

Suzanne Kelly — Fri, 06 Feb 2015 00:38:04 GMT

+1 for biopsy. Is the mass bothering the rabbit?

Re: wound closure advice

Michael Woodhouse — Thu, 05 Feb 2015 10:22:05 GMT

If money is an option - leg off. Quick, good margins and curative.

Re: wound closure advice

Braden Collins — Thu, 05 Feb 2015 10:10:24 GMT

I think it would be very challenging to close. Remember the same principles apply for rabbits in that you need to get clean margins, so if it is malignant you may need to amputate the limb to obtain a surgical cure. (can you FNA or biopsy the mass to get a diagnosis prior to a more aggressive surgery?)

I've now seen two rabbits with amputations that have done very well, so I would put that option back on the table, especially if the client is cost restricted.

By the sounds of things, a flap or graft would be needed to close this wound, and they are certainly not cheap to do.