Dental Abscess Broken Jaw

[bpotter2]

Bon Bon had dental surgery a few months back to treat a very bad abscess. Two teeth were pulled from the lower middle section. The infection had invaded the jaw bone and part of it had to be removed. She was put on ChlorPalm to fight any remaininginfection and she was doing great. On a check up, the vet said theteeth started growing again. It seems that if any tooth cells remain, they will regrow. I thought that would be a good thing but the vet insisted they had to be removed.

The vet went in again, this time from the outside cheek and removed thenew teeth and subsequently had to remove a bit more of the jaw bone. A few days later, on check up, it was discovered the stitches had come out so Bon Bon had to go under, again, to redo the stitches. When I came to pick her up, I was told her jaw was broken. Both of the main surgeries were done by a dental specialist.

I was told they did not want to wire the jaw but leave it to heal on it's own. I could not understand that decision but as it was the dental specialist, I succumbed. Assist feeding since the day of her jaw break, June 11,about 2.5 months. Bon Bons last x ray shows the jaw bone to be completely healed and looks to be in alignment. The vet was extremely happy with the results.

The problem is that although over the weeks Bon Bon has been able to eat some things on her own, she is not able to chew her leafy greens. They just get mangled and drop out of her mouth. Parsley, dandelions, kale, etc, is just impossible for her. She can eat carrots, apple, only the stalks of broccoli, if the outer tough layer is peeled as well as celery, again only if the outer stringy layer is peeled. She also manages large flake oatmeal and sunflower seeds. I just recently introduced her pellets, which she manages to eat quite well. She gets juiced greens mixed with Critical Care as well, which I have been feeding her since her surgery. I am worried that she cannot chew her greens. She had lost weight throughout all of this but maintained her weight through her assist feed until I introduced her pellets. Since then, she seems to have gained some, when I feel her spine and hip bones, they do not seem so prominent.

Anyone have any advice?

Thanks,

Kathy

 

[Pipp]

Yikes, Kathy, I had no idea you went through all this!

And my apologies, I went to check the email I previously sent you in response to yours and its still in my drafts folder. I'm just repeat the relevant info here.

Are you sure she CAN'T eat the greens? I had a similar problem with Pipp (EDIT: after her molar spur surgery) and the vet diagnosed 'SBS' -- Spoiled Bunny Syndrome. She was eating what she liked the most and had gotten quite used to me tempting her with just her favourites and the not-so-favourites peeled or otherwise specially prepared.

Maybe the other things really did bother her to eat, but if she's like my diva, she won't make much of an effort because she knows she'll get the good stuff soon enough.

Can she eat apple peels? Grass? Are there previous favourite leafy green delicacies you can try? Dill? Other herbs? I'd experiment a bit and see how selective she really is.

You can also try chopping the broccoli, etc, into small bits, and if she eats them, gradually make them larger.

If she really is 'off' the greens, I wouldn't worry too much. Bunnies can survive very well on quality pellets and hay. Carrot, apple and pumpkin will supplement it, just don't let her get overweight.

She honestly sounds like she's doing great, though.

I'll have to revamp that email and send it ASAP!


sas :bunnydance:

 

[pamnock]

As Pipp said, chop the greens into tiny bits in a food processor. Greens are very difficult to chew and break down, so you'll need to do the work of themolars for her.

You might also try a little Nutri Cal daily to add calories to maintain her weight.

Pam

 

[Pipp]

Ah, yes, I meant to mention Nutri-Cal. It really has worked for my brood, cats and rabbits, whenever they're not able to eat their full allotment of normal food. Perks them up and increases their appetites.

And Pam is also right to emphasize the processing. When the teeth aren't quite right and they can't chew as well, they lose nutrients by not chewing properly. Really best to cut everything up.


sas :bunnydance:

 

[ra7751]

Umm....I think this is one of those rare times recently that I have to say that I am impressed with the veterinary care. When the mandible itself is compromised, it is difficult to correct and sometimes if the damage is near the back hinge, it will fuse and that isn't good. Sounds like things are going very well considering what has been going on.

I think that if she can eat pellets, she certainly can eat greens. The only modifications to husbandry we have done to our dental extractions (incisors and molars) are to tear greens into small pieces. I am not a fan of Nutri Cal at all. But, in this case, it might be worth using as long as she is properly hydrated. I cringe when I hear of someone using Nutri Cal in a rabbit that is suffering GI problems and is most likely dehydrated. Gel type stuff like this(and laxatives such as Petro Malt or Laxotone) compresss and dehydrate ingesta which makesGI transit concerns worse. A more clinically correct way to accomplish what you need here is an injection of B Comp. But if the gut is moving correctly....moderate use of Nutri Cal might be of help. Can't believe I actually said that.

And if there is any small part of a root, the tooth will regrow and sometimes at odd angles. Plan on occlusion issues if the tooth does fully regenerate.

Randy

 

[jamesedwardwaller]

bpotter2 wrote:

Bon Bon had dental surgery a few months back to treat a very bad abscess. Two teeth were pulled from the lower middle section. The infection had invaded the jaw bone and part of it had to be removed. She was put on ChlorPalm to fight any remaininginfection and she was doing great. On a check up, the vet said theteeth started growing again. It seems that if any tooth cells remain, they will regrow. I thought that would be a good thing but the vet insisted they had to be removed.

The vet went in again, this time from the outside cheek and removed thenew teeth and subsequently had to remove a bit more of the jaw bone. A few days later, on check up, it was discovered the stitches had come out so Bon Bon had to go under, again, to redo the stitches. When I came to pick her up, I was told her jaw was broken. Both of the main surgeries were done by a dental specialist.

I was told they did not want to wire the jaw but leave it to heal on it's own. I could not understand that decision but as it was the dental specialist, I succumbed. Assist feeding since the day of her jaw break, June 11,about 2.5 months. Bon Bons last x ray shows the jaw bone to be completely healed and looks to be in alignment. The vet was extremely happy with the results.

The problem is that although over the weeks Bon Bon has been able to eat some things on her own, she is not able to chew her leafy greens. They just get mangled and drop out of her mouth. Parsley, dandelions, kale, etc, is just impossible for her. She can eat carrots, apple, only the stalks of broccoli, if the outer tough layer is peeled as well as celery, again only if the outer stringy layer is peeled. She also manages large flake oatmeal and sunflower seeds. I just recently introduced her pellets, which she manages to eat quite well. She gets juiced greens mixed with Critical Care as well, which I have been feeding her since her surgery. I am worried that she cannot chew her greens. She had lost weight throughout all of this but maintained her weight through her assist feed until I introduced her pellets. Since then, she seems to have gained some, when I feel her spine and hip bones, they do not seem so prominent.

Anyone have any advice?

Thanks,

Kathy

she can eat normal,,but not her vegy,s??sounds like the loss of teeth does affect all chewing,,maybe grind it up if she will eat that way/unfortunately it sounds permanent/how does she eat fiber ie timothy/orchard grass??,sincerely james wallerray:

 

[bpotter2]

Thanks, everyone!!! Bon Bon has become very suspicious of everything I do, due to her multiple daily captures every day for the last couple of months. She does not like to be picked up. By the way, once I could not find her anywhere. I looked for over an hour to no avail. She finally gave herself away, when exhausted, I sat down, worried out of my mind. She poked her head out from under the sofa to check things out. Just for half a second. I got myself on the floor and discovered she had torn a hole in the lining under the seat of the sofa and had crawled in! She will not be caught the same way twice so you can imagine how difficult it has been.

Anyway, I tried the chopped up veg a number of times, she avoided it like the plague. Her mate Twinkles thought it was great, though and chowed down! I tried giving her the juiced veg [fiber put back in] with and without the Critical care in a dish on the floor. No way! The stuff she will eat now, as I said is apple, carrot, peeled celery and peeled broccoli stalks, something stiff she can sink her teeth into. Her favourite, dandelion, parsley and bok choy gets her full attention and she will work it for 20 minutes leaving it looking like she got all the juice out. leaving a pulpy mess. On inspection, I can see her tooth marks, but no actual cut marks. Apart from the few days after being put under, she seems to have a healthy appetite. I will keep trying the chopped veg, though. We all know how bunnies sometimes take their time deciding something is acceptable.

I am fairly sure she is not dehydrated, she has been regularly checked by the vet. Apart from the days just after her surgeries when she was given numerous Sub Q fluids, the vet said she is in good shape apart from her loss of weight, which I have been working on. She lost weight every time she was put under. It always took 3 to 5 days for her to be herself. Even with the assist feeding, she still lost the weight. She needs to gain her weight back and now the vet has allowed the pellets, she feels like she is putting on the weight.

Even the vet is a bit confused by this. We just did her x ray and he was very pleased with the results. He said it was as good as normal. It had been a complete break along with a significant portion of missing jaw bone from the surgeries. He said the missing portion had grown back and the break had healed together well aligned. Very pleased.

I had a thought. At the very beginning of all this, back in Feb, the vet filed down some of her teeth. No problem from that as she was eating normally after. My thought is that, if by some chance the jaw grew back with the alignment off, even slightly, that the teeth not meeting properly will possibly eventually grow into position? Is that even possible? I know bunny teeth are always growing.

One thing, she is just recently off her meds, ChlorPalm, buprenorphine, except the Metacam. The vet recommended she still be on minimum dose of Metacam .1 cc a day. If she is completely healed, would she still be in pain? Maybe it may have something to do with her problem? She is producing perfectly. A bit hay coloured from the Critical Care but otherwise perfect size, perfect shape and not too moist or too hard. Her pee is also perfectly normal.

Thanks to all. I credit everyone here for both my bunnies lives. I am sure neither would be here today had I not had the information I was given here.

Kathy

 

[bpotter2]

Sorry, James. I have just recently started giving her a mix of alfalfa and timothy hay on vet's recommendation. Alfalfa to be removed when weight back to normal. It's hard to see if she actually swallows any, she sure tries, though! I am making sure it's always available.

Thanks,

Kathy

 

[pamnock]

ra7751 wrote:

I am not a fan of Nutri Cal at all. But, in this case, it might be worth using as long as she is properly hydrated. I cringe when I hear of someone using Nutri Cal in a rabbit that is suffering GI problems and is most likely dehydrated. Gel type stuff like this (and laxatives such as Petro Malt or Laxotone) compresss and dehydrate ingesta which makesGI transit concerns worse. A more clinically correct way to accomplish what you need here is an injection of B Comp. But if the gut is moving correctly....moderate use of Nutri Cal might be of help. Can't believe I actually said that.

And if there is any small part of a root, the tooth will regrow and sometimes at odd angles. Plan on occlusion issues if the tooth does fully regenerate.

Randy

I've found that Nutri Cal actually helps the rabbits stay hydrated. It's composition doesn't at all resemble products such as petromalt or laxotone. It's a caloric supplement that is excellent to use in animals that are not metabolizing their food well because it's easily absorbed. It also contains some fiber.

Pam

Pam

 

[ra7751]

Actually, we have research vets that avoid Nutri Cal in most exoticspecies....this actually was theissue of a discussion at last year's wildlife seminar. Got a bit off the stated topic. Came up in a squirrel discussion.The discussion continued on Nutri Cal and similar products well after the stated finish time of the forum. But it came up with some of the different things that people do...right or wrong....to some of these animals. It was a lot like a political convention....divided among party lines. The old school peopleuse these productsand the new breeddoesn't. Most of the older rehabbers took the line that Nutri Cal...among a few other things....were the only way to go.....but those of us with more clinical experience deemed it to be mostly non-beneficial and potentially harmful. And from a clinical viewpoint....in a GI event (and I noted a GI event)....hydration is paramount. Anything that is not a liquid will continue to dehydrate....and a paste/gel is not a liquid. Plus any paste/gel is heavy and will compact already dehydrated ingesta. And believe it or not, Critical Care can also cause this if used at a critical time. Critical Care will dehydrate itself. The important thing is the hydration...as it always is and most rabbits that have medical issues are clinically dehydrated. But there are times when those products can be potentially beneficial. I don't use Nutri Cal myself since I have ways of doing things a different way. But as I stated in my prior post, this might be one of those rare times that it would be beneficial.

Randy