[align=left]Poor little guy. Myrecently departed Jacques' abscess looked exactly like that.He came to us too late. It seems you are on the righttrack. Normal protocol is surgery to debride thearea. Really aggressive treatment will include beads lacedwith antibiotics...usually clindamycin...that are packed into theabscess. We have had good success with using Procaineinjections ((Pen G). Amikacin is also an excellentchoice. Lots of support therapies....additional hydration,proper nutrition and very aggressive pain meds are in order.A culture will show you exactly what pathogen is in there.Many abscesses contains anaerobic bacteria (doesn't need oxygen tosurvive) and between that and they thickness of the pus, it makes drugtherapy difficult. The lower molars are most likely impactedand will be extracted as the jaw itself is probably damaged.The molars on the opposing arcade should also be removed since theywill have no opposition.
Here is an interesting article off the Veterinary Information Networkand was written by one of the top rabbit vets in the country.
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SMALLMAMMAL HEALTH SERIES
By Susan Brown, DVM
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http://www.VeterinaryPartner.com
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Abscesses in Rabbits
An abscess is a cavity containing pus, surrounded by a capsule ofthickened inflamed tissue which is the usually result of a bacterialinfection. The pus is an accumulation of dead cells as the result ofthe battle to fight the infection. In humans, abscesses of the skin areoften caused by
Staphylococcus infections, but in rabbits,abscesses can be caused by many different aerobic bacteria (those thatrequire oxygen to survive) including
Pasteurella multocida,
Streptococcus,
Pseudomonas and
Staphylococcus anda whole host of anaerobic bacteria (those that do not require oxygen tosurvive).
Rabbits can form abscesses in nearly any organ of the body as well asin skin, tooth roots and bone. The most common causes of rabbitabscesses are bite wounds that become infected and infections in toothroots and tear ducts. Most facial abscesses are the result of dentaldisease. Tear duct abscesses can be the result of an elongated upperincisor tooth root blocking the tear duct. The accumulated fluid is aperfect breeding ground for bacteria and an abscess can form easily.Abscesses that form internally can be more difficult to diagnose ormanage and include areas such as the uterus, lungs, heart, liver,abdominal fat, intestine and kidneys.
Rabbit abscesses can be difficult to treat. One problem is that the pusfound in rabbit abscesses is very thick, about the consistency oftoothpaste, and does not drain easily when the abscess is opened. Thismakes it difficult to thoroughly clean rabbit abscesses. In addition,surgical drains should not be used in rabbit abscesses because they notonly do not work, but they can act as a source for continued infection.The reason for the thick consistency is that there is an enzyme missingthat is present in other animals, such as dogs, cats and humans, thatcan break the dead cells into a more liquid form. In addition rabbitabscesses often develop finger-like projections or tracts into thesurrounding tissue, which are places where new abscesses can form. Ifthese tracts are not removed or cleaned out, the abscess will return.
There are many thoughts on how to treat rabbit abscesses and muchdepends on the location of the infection, the cause of the infectionand the general condition of the pet.
It should be stressed,however, that no matter what treatment is chosen, it is vital toprovide your pet with a healthy diet, daily exercise and a cleanenvironment to enable the immune system to function at its fullcapacity. It will often be necessary to perform diagnostic tests toinvestigate the cause of the abscess and to determine if other diseaseis present. These tests might include bacterial culture of the wall ofthe abscess, x-rays to determine the location and extent of the diseaseand blood tests to determine the response of the immune system and thecondition of other organs.
No matter what treatment is selected, rabbit abscesses have a higherprobability of returning than abscesses in cats, dogs or humans. Thiscan be due to a number of factors such as difficulty in removing allthe abscessed tissue due to location, the inability of antibiotics topenetrate the capsule of the abscess, the presence of draining tractscoming off the abscess, and the possibility that the underlying causeof the abscess was not treated.
Most experienced rabbitveterinarians feel complete surgical removal of the abscess along withtreatment of the underlying cause gives the rabbit the bast chance fora complete cure. Ideally, all abscesses should be cultured for bothaerobic and anaerobic bacteria to determine the best choice forantibiotic therapy after surgical removal.
It is not always possible to surgically remove an abscess due to itslocation, other disease in the pet (making anesthesia or a lengthysurgery dangerous) or restraints on the finances of the caretaker. Inthese cases the abscess can be opened, cleaned out thoroughly andflushed with an antiseptic solution. This procedure is usuallyperformed under anesthesia, unless the abscess is very small. The wallof the abscess should be cultured for bacteria and an appropriateantibiotic can be selected for oral or indictable use. These woundsmust be left open to be flushed at least twice a day for several weeks.If the abscess closes too quickly, it will merely fill with pus again.Abscesses treated in this manner have a high rate of reoccurrence, butit may be possible to provide at least some measure of relief for yourpet for a period of time. Please note that using oral or indictableantibiotics as the sole treatment is usually unsuccessful because thesedrugs cannot adequately penetrate the thick capsule of the abscess tokill the bacteria inside.
Other methods that have been used to deal with rabbit abscesses includeinjecting the wall of the abscess with antibiotics or other solutionsat periodic intervals or packing caustic material or antibiotic beadsinto the cleaned abscess cavity to kill bacteria.
Most rabbit abscess cases will require oral or indictable antibiotics.If the entire abscess is completely removed, then the antibiotics mightnot be necessary or may be used for only a short time. If the abscesswas only lanced and drained, then antibiotic therapy might continue forweeks to months.
Some rabbits can live with abscesses on various parts of their body foryears by having them surgically drained as needed. Rabbit abscessesform a thick capsule around the infection that effectively walls it offfrom the rest of the body. If the abscess is not causing pain, therabbit may act as if nothing is wrong. However, this does not mean thatif you see a lump on your rabbit's body that you should ignore it. Yourveterinarian should investigate any unusual lumps or masses as soon aspossible. The sooner an abscess can be treated, the greater are thechances of a cure. In addition, some lumps are not abscesses at all butrather tumors or cysts and may need immediate removal.
To sum it up, here are the important points about abscesses in rabbit: [/align]
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- Feed your rabbit a healthy diet, provide amply exercise and a cleanand safe environment to minimize the formation of abscesses
- Have all lumps investigated as soon as possible by your veterinarian
- It is important to determine the cause of an abscess, not to just treat the abscess itself
- If the cause of an abscess cannot be treated, then there is a high probability that the abscess will return
- Complete surgical removal of the abscess along with correction of the cause gives the best chance for a complete cure
- Whatever the treatment choice it is imperative to follow throughwith requested recheck appointments and diagnostic testing to improvethe chances for abscess resolution
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