Bicillin and Zythromax for Dental Abcess?!

[Jenny Durling]

I have a bunny with a dental infection/sinus abscess. I red so many posts about this on this forum that I really want to tell my vet I need a Pen-G/Zi\ythromycin combo to knock this thing out. He has no problem with Pen-G and honestly, after removing a tooth, Rocky was on Bicillin every other dayfor 28 days. We've long time thought he had snuffles with all of his sneezing so he's been treated with all of the wrong things over the past year now that we realize the problem is truly a dental abscess. I'm hoping someone here can supply me with the protocol to clear this up with the Bicillin/Zithromycin combination. Rocky is a dwarf dutch and just over 3 lbs. Lucky for us, he's a spunky thing. No issues eating, playing, or anything else. He's drooling and sneezing (ALOT!) or you'd never know he had any sort of problem. He's on daily Meloxicam for pain but he continues to drool. If Randy is still on this forum, you are apparently the man with the answers. If anyone else knows how much, how often and how long for this drug combination, please, please tell me!! I'm nebulizing him twice a day just to loosen things up. I can get him started on the Bicillin again right away but if he really needs these two drugs in combination, that's what I'd like to do. My vet says he's never heard of the combo and knows of no science that indicates they should be used together. That said, he's willing if we want to go that route. I just need some dosage info so I can have an intelligent conversation with him about it.

 

[jamesewaller]

I have a bunny with a dental infection/sinus abscess. I red so many posts about this on this forum that I really want to tell my vet I need a Pen-G/Zi\ythromycin combo to knock this thing out. He has no problem with Pen-G and honestly, after removing a tooth, Rocky was on Bicillin every other dayfor 28 days. We've long time thought he had snuffles with all of his sneezing so he's been treated with all of the wrong things over the past year now that we realize the problem is truly a dental abscess. I'm hoping someone here can supply me with the protocol to clear this up with the Bicillin/Zithromycin combination. Rocky is a dwarf dutch and just over 3 lbs. Lucky for us, he's a spunky thing. No issues eating, playing, or anything else. He's drooling and sneezing (ALOT!) or you'd never know he had any sort of problem. He's on daily Meloxicam for pain but he continues to drool. If Randy is still on this forum, you are apparently the man with the answers. If anyone else knows how much, how often and how long for this drug combination, please, please tell me!! I'm nebulizing him twice a day just to loosen things up. I can get him started on the Bicillin again right away but if he really needs these two drugs in combination, that's what I'd like to do. My vet says he's never heard of the combo and knows of no science that indicates they should be used together. That said, he's willing if we want to go that route. I just need some dosage info so I can have an intelligent conversation with him about it.

--dear jenny,--you are in California,issues with the teeth require an exam,facial radiograph,some gas,and etc.-,if there is an abcess flagyl,-something is not right here--maybe time for another-dvm exam,,drooling is generaly dental issues,sneezing maybe pasturella,must test,--sincerely james waller www.medirabbit.com

 

[Jenny Durling]

He has an upper jaw abscess from a dental infection. We already know this from when the vet pulled his tooth and found the infection. The vet told me that abscesses like this are really hard to treat and excising one in the sinus area is not likely to be successful. Nothing like being told that most people euthanize their rabbits at this point. I'm not going to do that with an otherwise happy animal! My questions about the Pen-G/Zythromycin protocal is based on posts I've seen in older threads on this forum. I'm really looking for anyone who has gotten this information from Randy Adkinson in the past or who has a vet who has used it successfully. Rocky is almost done with a month of Bicillin injections and is no longer drooling and sneezing very infrequently at this point. The drug is definitely helping but if it's synergistic with another drug, I'd really like to hear more.

 

[jamesewaller]

He has an upper jaw abscess from a dental infection. We already know this from when the vet pulled his tooth and found the infection. The vet told me that abscesses like this are really hard to treat and excising one in the sinus area is not likely to be successful. Nothing like being told that most people euthanize their rabbits at this point. I'm not going to do that with an otherwise happy animal! My questions about the Pen-G/Zythromycin protocal is based on posts I've seen in older threads on this forum. I'm really looking for anyone who has gotten this information from Randy Adkinson in the past or who has a vet who has used it successfully. Rocky is almost done with a month of Bicillin injections and is no longer drooling and sneezing very infrequently at this point. The drug is definitely helping but if it's synergistic with another drug, I'd really like to hear more.

-dear jenny durling,-I presented your post/,concerns to the administrator-hopefully they can direct you.--I do have more questions-sincerely james waller

 

[JBun]

Randy's not on here anymore unfortunately.

I have read others successful experiences just using the zithromax for cases of head tilt from ear infections. So it does sound like a very effective antibiotic for head infections. But some rabbits also react negatively to it, so that has to be weighed in as well when considering using it.

Here's some dosage info when it's just used on it's own. Not sure if it would be the same when used with pen g.
http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Azithromycin.htm
http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm
http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits

 

[Jenny Durling]

-dear jenny durling,-I presented your post/,concerns to the administrator-hopefully they can direct you.--I do have more questions-sincerely james waller

Thanks! What are your questions. I have head xrays and his records from prior to the tooth removal.

 

[Jenny Durling]

Randy's not on here anymore unfortunately.

I have read others successful experiences just using the zithromax for cases of head tilt from ear infections. So it does sound like a very effective antibiotic for head infections. But some rabbits also react negatively to it, so that has to be weighed in as well when considering using it.

Here's some dosage info when it's just used on it's own. Not sure if it would be the same when used with pen g.
http://wildpro.twycrosszoo.org/S/00Chem/ChComplex/Azithromycin.htm
http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm
http://wabbitwiki.com/wiki/Common_drug_dosages_for_rabbits

Thank you! I was able to track Randy down and send him Rocky’s records but he’s having health issues of his own and stopped responding. I saw somewhere on here that he pm’d the protocol to someone. I don’t know if that person is on the board any more.

 

[Jenny Durling]

More info on Rocky's issues.

My rabbit's symptoms are sneezing and drooling. He eats fine and acts normal otherwise. Initially, the vets thought it was snuffles. They both just assumed this and the poor guy has been on Baytril multiple times (once for six weeks!!) and then Chloramphenicol - neither of which worked. We moved Rocky to an exotic animal vet who happens to specialize in dentistry. This second/current vet did an in-office mouth check and spotted a spur on a top molar and tongue ulcer so we thought the drooling was associated with pain from that. He had already been treating him for what he thought was chronic snuffles even though a culture was never done. The only reason for this is that Rocky never has any discharge or runny nose. He could do a culture using a nasal swab but told me the infection is higher up in the sinuses and a swab wouldn't reach the cause of the problem. When Rocky was put under to remove the spur and check for other dental issues, the vet found a loose and infected tooth which he removed. Rocky was sent home with Pen G that we gave by injection every other day for 28 days. The sneezing stopped after about a week but drooling continued. When he got his recheck, the vet said Rocky appeared to have healed nicely. Well, apparently there's still infection as he began sneezing and drooling even more profusely. There was no longer an obvious pain source and that's when the vet declared that the sinus problem has likely been a dental abscess this whole time and surgical success would be iffy at best due to the location. We can drive Rocky 3 hours north for a CT scan to see exactly what we are dealing with. Honestly, since the surgical prognosis is not great, I don't see the point of spending the time and money or putting Rocky through any of that. I had read about non-surgical treatment with Bicillin (the Pen G he had been on previously) and posts by a past member on this board saying a combo of Bicillin and Zythormax was 100% effective for him when treating jaw abscesses. I'm now in search of details on the amount of each medication and the length of treatment required. PLEASE if anyone out there has this information, let me know!! My vet agreed to try treating solely with antibiotics. Rocky is currently on a new course of Bicillin .3CC every other day. The first injection was October 31. Rocky had stopped sneezing by November 7 and I was thrilled!! Just days later, I heard him sneeze once. The next day is sneezed a little more and now he's sneezing alot more though nowhere near what he had been prior to treatment and the drooling has not returned. So I'm left wondering why he is regressing even though he got his 12th injection this morning. I know everything will say I need to talk to the vet, and I will do that. My vet has never heard of using zythromax or any other antibiotic in conjunction with Pen G to treat a dental abscess. I don't know if the returned sneezing indicates that Pen G isn't working, that he needs a stronger dose, he needs an additional medication or?? The vet reiterates what I see everywhere - Abscesses are notoriously difficult to treat in rabbits and there just have not been enough studies done. Since the vet actually told me that this is the point at which most people euthanize their rabbits, I feel that it is up to me to try to find other options for treating Rocky. He's otherwise happy and healthy and I can't see ending his life while he's behaving so normally and not in any obvious pain. Even if we can't cure him, treating him with something that will improve his condition or keep him from getting worse will have to suffice. If anyone has any knowledge to share in this area, please do. I'm so worried now that I can't even sleep at night.

 

[jamesewaller]

More info on Rocky's issues.

My rabbit's symptoms are sneezing and drooling. He eats fine and acts normal otherwise. Initially, the vets thought it was snuffles. They both just assumed this and the poor guy has been on Baytril multiple times (once for six weeks!!) and then Chloramphenicol - neither of which worked. We moved Rocky to an exotic animal vet who happens to specialize in dentistry. This second/current vet did an in-office mouth check and spotted a spur on a top molar and tongue ulcer so we thought the drooling was associated with pain from that. He had already been treating him for what he thought was chronic snuffles even though a culture was never done. The only reason for this is that Rocky never has any discharge or runny nose. He could do a culture using a nasal swab but told me the infection is higher up in the sinuses and a swab wouldn't reach the cause of the problem. When Rocky was put under to remove the spur and check for other dental issues, the vet found a loose and infected tooth which he removed. Rocky was sent home with Pen G that we gave by injection every other day for 28 days. The sneezing stopped after about a week but drooling continued. When he got his recheck, the vet said Rocky appeared to have healed nicely. Well, apparently there's still infection as he began sneezing and drooling even more profusely. There was no longer an obvious pain source and that's when the vet declared that the sinus problem has likely been a dental abscess this whole time and surgical success would be iffy at best due to the location. We can drive Rocky 3 hours north for a CT scan to see exactly what we are dealing with. Honestly, since the surgical prognosis is not great, I don't see the point of spending the time and money or putting Rocky through any of that. I had read about non-surgical treatment with Bicillin (the Pen G he had been on previously) and posts by a past member on this board saying a combo of Bicillin and Zythormax was 100% effective for him when treating jaw abscesses. I'm now in search of details on the amount of each medication and the length of treatment required. PLEASE if anyone out there has this information, let me know!! My vet agreed to try treating solely with antibiotics. Rocky is currently on a new course of Bicillin .3CC every other day. The first injection was October 31. Rocky had stopped sneezing by November 7 and I was thrilled!! Just days later, I heard him sneeze once. The next day is sneezed a little more and now he's sneezing alot more though nowhere near what he had been prior to treatment and the drooling has not returned. So I'm left wondering why he is regressing even though he got his 12th injection this morning. I know everything will say I need to talk to the vet, and I will do that. My vet has never heard of using zythromax or any other antibiotic in conjunction with Pen G to treat a dental abscess. I don't know if the returned sneezing indicates that Pen G isn't working, that he needs a stronger dose, he needs an additional medication or?? The vet reiterates what I see everywhere - Abscesses are notoriously difficult to treat in rabbits and there just have not been enough studies done. Since the vet actually told me that this is the point at which most people euthanize their rabbits, I feel that it is up to me to try to find other options for treating Rocky. He's otherwise happy and healthy and I can't see ending his life while he's behaving so normally and not in any obvious pain. Even if we can't cure him, treating him with something that will improve his condition or keep him from getting worse will have to suffice. If anyone has any knowledge to share in this area, please do. I'm so worried now that I can't even sleep at night.

--dear jenny during,-the question here is-can rocky make the 3 hour trip,-if so,go..-this will provide you with some hope that something can still be done...-sadly you are at a crossroads that I have encountered-many times,-I have heard it all..-we are the stewarts of our critters-,first in line of any medical problem,-at sometime or another everyone on this website will fall into the same situation-,so you have massive support-sincerely james waller for joseph r cottontail/bdenium rip

 

[JBun]

There will be multiple types of bacteria involved, especially with dental infections . I'm guessing that the pen g was able to take care of some of the bacteria but not all. So now you have other bacteria that isn't susceptible to the pen g, taking hold.

If I was in your position, I would either try the zithromax even without the pen g, or stop the pen g and try another antibiotic other than the zithromax since the pen g appears to no longer be working. Though I think I would opt for the zithromax, because of it's ability to penetrate tissue and bone effectively, which is what you really want for dental infections. I would just make sure to always give with food, based on info that it's less likely to cause digestive upset when given with food , and monitor closely for signs of digestive problems occurring.

If you want to read personal accounts of rabbit owners using zithromax for their rabbits, google 'azithromycin use in rabbits'. I think it was on Flickr that I read a thread discussing it's use with rabbits .

 

[jamesewaller]

There will be multiple types of bacteria involved, especially with dental infections . I'm guessing that the pen g was able to take care of some of the bacteria but not all. So now you have other bacteria that isn't susceptible to the pen g, taking hold.

If I was in your position, I would either try the zithromax even without the pen g, or stop the pen g and try another antibiotic other than the zithromax since the pen g appears to no longer be working. Though I think I would opt for the zithromax, because of it's ability to penetrate tissue and bone effectively, which is what you really want for dental infections. I would just make sure to always give with food, based on info that it's less likely to cause digestive upset when given with food , and monitor closely for signs of digestive problems occurring.

If you want to read personal accounts of rabbit owners using zithromax for their rabbits, google 'azithromycin use in rabbits'. I think it was on Flickr that I read a thread discussing it's use with rabbits .

dear j-bun-I thought flagyl{metrondiazole}-was for dental infections-,i did not want to add to rocky,s misery,--{ gitract is always vulnerable with antibiotics}-I know you are aware of this fact-,i am praying for him.,-sincerely james waller

 

[Jenny Durling]

He could totally make the trip but I dont see the point. The drive to Davis would be just to get a CT scan. It’s not like there’s a rabbit specialist there who is going to do anything with the results. My vet here is the local specialist and he doesn’t think surgery would have a great outcome. I’m looking only for non-surgical options at this time. If you know of a drug combination that shrinks jaw abscesses, please let me know.

 

[Liung]

*waves hands frantically* YES HI HELLO I AM ONE WHO HAS HAD BICILLIN SAVE BUNNY

http://people.umass.edu/~jwmoore/bicillin/bicillin.htm

This is the paper that has the treatment protocol that saved Lahi. His abscess was caused by his upper left backmost molar, discovered when his eye began protruding from his head.

The vet said the only treatment was to surgically remove the abscess and his eye along with it. And abscesses being horrible, no guarantee that it would all be removed and stay gone. And he was 7 at the time. I told my friends and family and they all immediately assumed I would choose to put him down rather than pay thousands of $$$

Someone on this forum (pretty sure it was @JBun!) linked me that paper. It looks sketchy. It doesn’t look real. 12 patients with severe abscesses, multiple failed surgeries, every one of them on a last Hail Mary before they were put down, and EVERY ONE of them completely cured?? No major complications, no major issues, every one of them, just like that?

That just doesn’t happen in medicine. 100% success rate sounds like a scam. I didn’t think it could be real. I showed it to my vet and they didn’t think it could be real. But he had to go on antibiotics anyway while I decided if I could go through with the surgery, so it wouldn’t hurt to give him a shot.

Three days after the first shot there was noticeable improvement. We continued the treatment as specified in the paper, though we did every three days instead of every other day. We did it for 8 weeks. By the end of it he was pronounced completely cured. It hasn’t come back. That was in 2014. He’s turning 12 in two months, and still has both his eyes <3







Hand that paper to your vet and I’ll have my fingers crossed it works as perfectly for you as it did for me!!

 

[Liung]

Though, warning, we very nearly stopped after the first shot because Lahi immediately lost his appetite, we only kept going because of the obvious improvement. Those 8 weeks were definitely a challenge of trying to keep enough food in him to ward off GI stasis. Expect to need probiotics, a stockpile of critical care and a feeding syringe, and for your bunny to truly come to despise the vet assistants for jabbing him in the butt with that many needles. BUT ITS WORTH IT.

Also, for me it was $20 per shot. My vet doesn’t charge for seeing a pet for the same problem beyond the initial exam, so I just brought Lahi in every three days to get the needle. But I know some vets charge for every single visit, or even to administer medication, so when I was reading about it some owners learned to give the injection themselves at home.

$20 every three days for 8 weeks is still pretty pricey, but it’s pennies compared to the cost of what surgery would have been.

 

[Jenny Durling]

dear j-bun-I thought flagyl{metrondiazole}-was for dental infections-,i did not want to add to rocky,s misery,--{ gitract is always vulnerable with antibiotics}-I know you are aware of this fact-,i am praying for him.,-sincerely james waller

Thank you, James, for the prayers for sure! I don't know anything about metrondiazole so I will have to do a bit of research on that.

 

[Jenny Durling]

There will be multiple types of bacteria involved, especially with dental infections . I'm guessing that the pen g was able to take care of some of the bacteria but not all. So now you have other bacteria that isn't susceptible to the pen g, taking hold.

If I was in your position, I would either try the zithromax even without the pen g, or stop the pen g and try another antibiotic other than the zithromax since the pen g appears to no longer be working. Though I think I would opt for the zithromax, because of it's ability to penetrate tissue and bone effectively, which is what you really want for dental infections. I would just make sure to always give with food, based on info that it's less likely to cause digestive upset when given with food , and monitor closely for signs of digestive problems occurring.

If you want to read personal accounts of rabbit owners using zithromax for their rabbits, google 'azithromycin use in rabbits'. I think it was on Flickr that I read a thread discussing it's use with rabbits .

There will be multiple types of bacteria involved, especially with dental infections . I'm guessing that the pen g was able to take care of some of the bacteria but not all. So now you have other bacteria that isn't susceptible to the pen g, taking hold.

If I was in your position, I would either try the zithromax even without the pen g, or stop the pen g and try another antibiotic other than the zithromax since the pen g appears to no longer be working. Though I think I would opt for the zithromax, because of it's ability to penetrate tissue and bone effectively, which is what you really want for dental infections. I would just make sure to always give with food, based on info that it's less likely to cause digestive upset when given with food , and monitor closely for signs of digestive problems occurring.

If you want to read personal accounts of rabbit owners using zithromax for their rabbits, google 'azithromycin use in rabbits'. I think it was on Flickr that I read a thread discussing it's use with rabbits .

JBun, Thanks for your input. I'm inclined to try Zithromax as well. It does seem like the Pen G WAS working. It worked the first time he was on it as well so it's odd that symptoms returned before he even got through the first 28 days of taking it. Since it is the drug most prescribed for getting rid of head abscesses and needs to be taken long-term for that, I'm afraid to take him off of it. The only way to see if the abscess is resolved would be more head xrays. I don't want to make him resistant to this drug by starting and stopping it yet again. The return of the sneezing would indicate the problem is not resolved. I will definitely do more xrays but would really like to have the sneezing gone first.

The last time Rocky was under general anesthesia he had status. That's so scary! He's usually an eating machine and acts like he's starving so zero interest in food is anything but normal for him. We got him on a motility drug and forced him to eat Critical Care and he was fine within 24 hours. I give him Benebac every day when he's on antibiotics and recently added Fiberplex once I was able to find it. https://www.protexin.com/products/fibreplex-for-rabbits/26 Hopefully I will be able to talk to the vet tomorrow. I left a message for him to call me on Tuesday afternoon but I have yet to hear back. Every time Rocky sneeze my heart hurts a little more!