Jaw abscess?

[Mileybun]

So Miley has a long history of dental disease due to genetic malocclusion of her molars.
She has had osteomyelitis in her jaw in the past, but has healed well and the bone has recovered.
Her teeth above the gum line are now no trouble as the growth of her teeth has slowed dramatically. Below the gum line is a different matter!
She was at the vets Friday as her mouth was obviously sore.
Her teeth were fine, no signs of infection or abscesses. She had a patch of infected tissue on the bottom of her mouth, under her tongue so has started baytril. She is already on long term metacam 1.5mg/ml 0.8ml 2 x day.
Fast forward to Sunday and I could feel a hard, round lump, around the size of a marble on the side of her jaw, extending under the jaw and up towards her eye socket. It is very firmly attached to her lower jaw.
Appetite is limited and she can't settle, always getting up to go and lie down somewhere else.
She won't stop moving her mouth, chewing and grinding her teeth.

She is going to the vets this afternoon, I've got a feeling this is an abscess, her first one.

She turned 7 years old yesterday.

I don't really know why I've posted this. I'm just so worried for her. I have researched abscesses and dealt with them in guinea pigs in the past, but I know how serious they can be in rabbits. I'm terrified it's in the jaw.

My poor baby

 

[JBun]

How did the vet visit go?

 

[Mileybun]

She has injectable penicillin for the next two weeks. It's a tooth root abscess that has come through the jaw, making a small hole in the bone.
If there is no improvement in the next few days or she gets worse she's to go back.
Surgery would be difficult due to the location as it's unlikely the vet could remove the whole capsule.
It would involve increasing the size of the hole in her jaw to flush the pus from the other side.
The vet wants to see her eating better before he would attempt it so she had ranitidine and emeprid as well. It's a massive operation.
She has been eating a little for herself last night though and seemed quite happy hopping about so that's good.
I'll check on the abscess momentarily for growth.

Thank you for asking

 

[JBun]

I'm glad you got a good treatment plan going. Hopefully you'll see improvement on the pen g, though I'm presuming if you do, that a much longer course will be prescribed. Usually 4-6 weeks is minimum for an abscess. I have read of instances where an abscess was treated successfully with pen g injections and without the surgery. So it definitely can happen.

Something I would suggest while your bun is on the pen g injections, is making absolutely sure any leakage at the injection site is thoroughly cleaned off so none is ingested orally through grooming, as that can be very dangerous. Make sure bun is eating plenty of good grass hay. And a rabbit probiotic like fibreplex or bio lapis, may also prove helpful.

If you aren't seeing improvement on the pen g, I would suggest asking your vet about azithromycin. It's a good antibiotic for penetrating bone and tissue, and can be very effective treating infections in rabbits, provided the bacteria is sensitive to it. Though rarely some rabbits can develop severe digestive upset from it, in which it would have to be stopped. So this does need to be a consideration when deciding if it should be tried. But I had good success with it in treating some respiratory infections in a couple rabbits, and a retrobulbar acscess in another rabbit.

 

[Mileybun]

Thanks for your advice @JBun! She had Zithromax for the Osteomyelitis which seemed to clear it up nicely with little tummy upset.
It's good to know she may not need the surgery. The abscess doesn't seem to be changing one way or another.
I will make sure we wipe the injection site thoroughly, thank you

 

[JBun]

You don't necessarily need to wipe your rabbit off every time. Just if it seems at all damp or wet after the injection. I'm just extra careful when it comes to pen g and rabbits. Hopefully the injections go smoothly and it's not something you need to fuss with.

 

[Mileybun]

She seems to take them well. I can't stand needles but luckily my sister is a student vet nurse in her last year of training so she does it for me!

 

[Mileybun]

Still no change, still not really eating by herself so we're syringe feeding her. I just hope we see some improvement soon