Old rabbit - persistent conjunctivitis

Question
QUESTION: Hi Dana,

I have a 10 year old female rabbit. She has had splayed front legs for the last 2 years probably as a result of arthritis developing in her carpal joints. We are managing this by massages, letting her nap on her rabbit bed and hock bandages to ease pressure on her hocks.

Over the past 2 months she has had recurring conjunctivitis (membrane on inner eyelid very red, watery and eye held shut) ONLY in her left eye. Her left eye has also been affected by cataracts and a displaced lens for the last few years (no conjunctivitis until recently though). Her right eye is normal, with less severe conjunctivitis, lens looks normal.

I brought her to the vet, where it was confirmed that there was no glaucoma, corneal ulcers or other visible surface damage to the eye leading to the conjunctivitis. She was prescribed with Acular eyedrops (NSAID to reduce inflammation) and Genoptic (antibiotic eye drops). The antibiotic eye drops seem to have more of an effect than the anti-inflammatory ones.

I was wondering what possible causes there could be leading to persistent conjunctivitis in one eye only, especially in an older rabbit. She has never had any dental problems, is eating OK now (lots of hay!), and there is no visible swelling around her jaw - is this sufficient to rule out a tooth root abscess?  

The vet suggested allergies to surrounding environment but as her right eye is 100% normal (no watering, redness at all) I doubt this is the case.

Thank you very much for your help!

ANSWER: Dear Jo,

I agree with you that allergies seem to be a very unlikely explanation.  While you say that she has no signs of dental problems, my prime suspect in a case like this would be dental disease.  This can be very, very subtle.  A problematic tooth root impinging on the tear duct and causing mild inflammation might have no other sign but inflammation of the eye tissue.  It's not the root itself, but the hospitable environment for bacteria it creates by blocking normal drainage.

She might not have an abscess.  But one of her roots on that side might be overgrown and causing this problem.  The article here:

http://www.bio.miami.edu/hare/rabbit_dental.pdf

has a detailed explanation your vet might find useful in diagnosing whether your bunny has cryptic dental disease.  But head radiographs will need to be taken.

Once it's determined what's wrong, appropriate action can be taken, even if it's just palliative care that you're already giving her.

I just wanted to mention that you can brace her front legs with a VetWrap brace similar to the one shown here:

http://www.bio.miami.edu/hare/splayleg.html

Some rabbits tolerate it better than others.  But we have a bunny right now with splayed rear legs who can run around like a champ when his braces are on.  Which is all the time.  :)

We no longer use the corks between the legs.  Just a soft padding secured with waterproof tape to protect the fur and lower legs and a somewhat-stretchy brace made of VetWrap (stretchy, slightly self-adhesive bandage) will do.

We have a video of Mr. Bips, if you want to see it.  But I'd have to find it.  It was posted by someone else (who came to visit and was so impressed with his mobility, despite his splay problem.)


Hope this helps.


Dana

---------- FOLLOW-UP ----------

QUESTION: Thanks Dana, a very helpful reply as always. Have printed out the paper you recommended and will read through it now and show my vet as well.

Just wondering - if the conjunctivitis I am seeing is the beginning of a tooth root putting pressure on the tear duct, is it likely to get much worse? Obviously you have no way of telling in this case, but in your experience do many of them require more drastic action such as tooth removal? Or would regular flushing/ eye drops keep the problem from developing into a more serious one?

I suppose taking an X-ray will shed some light on how severe the situation is now. I will book an appointment with my vet to get this done.

As for the video of the rabbit Mr. Bips with the braced hind limbs, I would love to see it if you manage to dig it up!

Thanks again.

Answer
Dear Jo,

Pulling a tooth will not likely effect a cure, though it might help resolve some of the problem if there is a tooth root abscess.  Still, scarring from the intrusion might still block the duct, so there's no way to know in advance of the constant tearing will clear up.

In many cases, our vets will try a medical approach (for an abscess like this, dual-acting Penicillin G Procaine/Benzathine injections every other day for several weeks is a good first start) before resorting to surgery, unless there's an obvious abscess that needs to be debrided and packed with antibiotics or disinfectants.

It can't hurt to try.  I hope it helps.

Dana