Rabbit jaw abscesses - duration of penicillin injections?

RE: Rabbit jaw abscesses - duration of penicillin injections?

ChrisBVSc — Mon, 03 Oct 2016 13:56:03 GMT

Agreed that was a very helpful grumble Marie!

Hopefully you'll be pleased to know my rabbit did have the abscess cavities marsupialised (sp?) - kept everything open far longer than just lancing alone. And we had the rabbit on daily metacam until everything appeared healed & settled, haven't tried tramadol in rabbits though - will bear that in mind next time.

Elivet - the owner has been happy to give daily depocillin injections at home, with regular checkups at the clinic. I'm just at the point now of deciding how long to keep going with the daily injections, but based on the responses here we're going for 3 months total followed by careful monitoring.

RE: Rabbit jaw abscesses - duration of penicillin injections?

Hannah Wynne Richards — Fri, 30 Sep 2016 15:42:42 GMT

Another who's adding Marie's observations to my "rabbit notes"

Wynne Thanks

RE: Rabbit jaw abscesses - duration of penicillin injections?

Elivet — Fri, 30 Sep 2016 15:09:59 GMT

Thanks Marie, that was a very helpful grumble

RE: Rabbit jaw abscesses - duration of penicillin injections?

Marie Kubiak — Fri, 30 Sep 2016 07:46:01 GMT

[quote user="Elivet"]

Hi Chris,

Does the owner administer the depocillin injections at home or make daily visits to your practice to have this done? I have a similar case and the abscess drainage ports have closed too soon. Planning to re-admit for daily flushing and depocillin injections but can't keep in hospital for long.

[/quote]

If there is still infection and necrotic tissue then revision surgery is likely to be needed otherwise whatever happens the deep-seated portion will persist and form another abscess. Any teeth with radiographic evidence of alveolar lysis should be extracted and aggressive bone debridement carried out. These are tricky cases to fix and need pretty hefty treatment. Again, penicillin may not be effective on the bugs you are trying to treat so sending an abscess capsule piece away at surgery will help greatly.

I have seen too many of these where a token attempt at surgery has been made (not saying this is the case here, just moving on to a general grumble now!). Abscesses will be opened and cleaned with either no attempt to keep open or marsupialisation without sufficient debridement or dental extractions. Radiographs are mandatory for planning surgery as they will tell you if it is pointless and detrimental to welfare, or the extent of debridement and number of extractions needed. These are pretty gruesome things for a rabbit to have done and should be done properly to avoid just inflicting a slow decline on the patient. Additionally these cases absolutely need pain relief- there is healing bone and daily interference with an open wound (even if the patient doesn't show a pain response clearly). No analgesia, or metacam at an insufficient dose equivalent to those used in cats or dogs is not fair to the patient. A rabbit dose (>0.4mg/kg bid meloxicam) plus 10mg/kg bid tramadol post-op with intra-op opioids and rescue analgesia of low dose (2mg/kg) ketamine is usually sufficient. Blind antibiotic use can also be a problem- I have had plenty of cases where C&S has been crucial as multi-resistant bacteria are frightening common and the number of cases of Pseudomonas related abscesses in particular, with sensitivity only to gentamicin, amikacin and ceftazidime, has sky-rocketed in the last 12-18months. These can never have a quick, cheap fix other than euthanasia so if the owner expects immediate results and won't support a proper job then PTS is likely better for the rabbits welfare than a compromised surgery.

Ok, grumble over!

Marie

RE: Rabbit jaw abscesses - duration of penicillin injections?

Elivet — Thu, 29 Sep 2016 20:41:03 GMT

Hi Chris,

RE: Rabbit jaw abscesses - duration of penicillin injections?

ChrisBVSc — Thu, 29 Sep 2016 09:24:10 GMT

Thanks for the replies. As the rabbit is doing so well I'm tempted to go for the full 3 months if the owner is willing. I guess it's then a case of monitor very carefully & if any sign of recurrence get straight back on long term/possibly pulsed treatment. I don't think we'll have the budget for xrays unfortunately, so will have to be a case of regular palpation of the site.

RE: Rabbit jaw abscesses - duration of penicillin injections?

Martin Atkinson — Wed, 28 Sep 2016 16:29:23 GMT

What about packing with antibiotic impregnated breeds and/or Manuka honey.

RE: Rabbit jaw abscesses - duration of penicillin injections?

Marie Kubiak — Wed, 28 Sep 2016 16:06:02 GMT

There is no set answer as every abscess is different - it will depend on radiographic extent of osteomyelitis, culture and sensitivity results (many abscess cultures I have had are already resistant to penicillin), whether all pieces of necrotic bone and tooth have been fully excised and whetehr this rabbit has normal immune function post-abscess. Some I am happy to stop as soon as the marsupialised wound is granulating well, some I accept cannot be resolved and remain on antibiotics (permanently/pulsed) lifelong, the majority fall info 2-12weeks post-op.

Marie

RE: Rabbit jaw abscesses - duration of penicillin injections?

Hannah Wynne Richards — Wed, 28 Sep 2016 15:17:52 GMT

I can't remember where I heard/read this, but I'm almost certain I've heard/read alternate day depocillin for 3 months.

Wynne