Bunny acting strange - something in mouth

Question
QUESTION: I have a 5+ year old female bunny. She was abandoned and we took her in. Not knowing anything about them we did a lot of reading.
Didn't know her breed but after posting pics of her at a web site we were told she's a mix between a rex and polish.  We've been through hairballs a few times and even a hysterectomy this year, July to be exact. The later being cancerous but thankfully it was confined within the uterus wall. She recovered within a week and is back to normal. What's happening now has me worried. She'll be sitting or lying around comfortably and then suddenly jumps up and starts to gag, like there's something in her mouth. She then sticks out her tongue and starts licking her mouth like there's something stuck there. She'll do this for about 20 seconds and she's back to normal. I noticed she runs for something to eat at times after this attack. We did have her to a vet but he didn't find anything wrong except for a small growth under her tongue which we gave her Baytril for two weeks. My vet treated it thinking it may be an abscess. Her follow up visit showed the growth was almost gone but she was still acting like something is still in her mouth. She'll do this action about 10 to 20 times a day. She is eating great - mostly pellets, timothy hay, and orchard grass, some parsley for a treat. She is drinking water with no problems and her poops and pee is as normal as they should be. She will run up and down our hallway without any problems. She is a very active bun.
I tried posting this on other sites but my response was see a vet. I did and I don't know where to turn next. My vet is old school but he saved her life when he did her hysterectomy.
I read a post here about hair wrapped around a bunnies tooth that made it gag. I hope it could be something simple like that.
What are your thoughts? Thanks for your time....

ANSWER: Dear Bill,

What you describe are classic signs of molar spurs, and pretty bad ones if they are causing gagging.  You really need to find a vet who is more experienced with rabbit dental problems, and who can also check to see if there is an abscess in the back of the mouth or throat.  This, too, can cause signs like what you are seeing, as can the hair caught on a tooth, as you read about in another post.  But just suspecting it isn't enough.  There is obviously a problem and it needs to be properly diagnosed and treated.

You can find an experienced rabbit vet here:

www.rabbit.org/vets

for a second opinion.  I'm sure your vet, however wonderful he may be, will be okay with your seeking advice from a specialist if he is not experienced enough to help your bunny.

Hope she will be fine soon!

Dana

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

QUESTION: Thanks for your time. I may have a few follow up questions as I'm doing some research on molar spurs.
My first follow up one is how long can bunnies go with these spurs?
She was acting like this since August (2010) but it wasn't as bad as it is now. I'd say since early Nov. it was more noticeable. At first we thought it was respiratory related.
As far as an experienced rabbit vet the nearest one from the web site link you posted is over 1 hr. away. My bun gets v e r y stressed going just 3 miles to her vet now. I just can't put her through that at the moment.
Thanks Dana

ANSWER: Dear Bill,

Some bunnies can go for months with these spurs without showing much sign of trouble.  That's why some of them can grow to such horrific proportions as to do things like grow right into the cheek or tongue, or even form a "bridge" over the tongue.

If you are concerned about the stress of a vet visit, that's small potatoes compared to the stress of having a huge molar spur jabbing you in the mouth constantly.  Please call up that rabbit vet and ask about having a prescription for Valium (diazepam) called in to your local pharmacy.  A bit of Valium can work *wonders* for your bunny's stress level in the car and at the vet.  He just won't care.  :)  Very safe drug; we have used it many, many times on rabbits, hares, and cottontails with great results.

So please get your bun to the vet for proper diagnosis and treatment.  You'll be glad you did.

Hope this helps.

Dana

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

QUESTION: Hi Dana, Just a few more follow up questions. Your answers make me very comfortable and that means a lot. I want to have this same feeling with my vet before going elsewhere. I know he does dental surgery on other pets. (There was a dog there during one of my visits that needed 6 teeth removed. The vet was very confident of its recovery. We overheard the conversation.) I will consult with him first and if I'm not comfortable with him I will get another opinion and do the Valium approach.

What should I expect the vet to do first - will he do a visual of the teeth or will he take an x-ray?
If he sees spurs I'm sure he will grind them down. If so, is this painful to the bunny?
I'm also confused on what causes spurs. I thought I read somewhere that bunnies with spurs ate too many pellets.

Like I mentioned above, if I'm not comfy with his answers I will seek a second opinion. I appreciate you being patient with my follow ups but like all other bunnies they grow on you...And I want the best for her.

Thanks Dana.

Answer
Dear Bill,

"What should I expect the vet to do first - will he do a visual of the teeth or will he take an x-ray?"

A very experienced, rabbit-savvy vet will usually visually inspect the molars with an otoscope.  This is tricky to do, and unless the vet is experienced, I would be loathe to let anyone do this "in the back" where you can't see, as this would suggest to me that s/he isn't really confident about what s/he's doing.  Rabbits can be injured easily with inappropriate handling, and it is of paramount importance that the vet *and* the techs know how to do a dental exam without putting your rabbit at risk of a back injury.

Some vets may take head radiographs to check for spurs.  But in all honesty, I don't think you can see much unless the spurs are really dramatic.  Even a very small spur poking into the tongue can cause misery for some very sensitive rabbits, and these are not likely to show up on a radiograph.

I'd hope for any vet to do a visual inspection before suggesting radiographs.

"If he sees spurs I'm sure he will grind them down. If so, is this painful to the bunny?"

No pain.  The teeth grow continually, and the part you see is neither vascularized nor innervated.  
But molar work usually requires general anesthesia, and for tooth work that doesn't involve a lot of post-procedure pain, gas anesthetic is safest (with perhaps a mild sedative in advance, to make the bunny more comfortable).  Ask the vet what type of anesthetic is used.  If it's injectable only, then I would not be very comfortable with this if it were my rabbit.

"I'm also confused on what causes spurs. I thought I read somewhere that bunnies with spurs ate too many pellets."

Many things.  But basically it's caused by a slight misalignment of the teeth.  Rabbits are hypsodonts:  their teeth grow continually (the molars more slowly than the incisors).  This means that their normal chewing motion will grind the teeth down as they wear against each other.  If the teeth are not aligned correctly, some of the chewing surface may not meet its "grinding partner" adequately, and spurs will develop as they grow without being "filed" by the opposing tooth.

Food can affect spurs, too.  Pellets require mostly up and down motion for grinding.  To keep molars smooth, the rabbit needs to move the lower jaw from side to side, getting a good grind across the entire surface of the molar.  Fresh grass and grass hays are the best foods for promoting healthy chewing motion and reducing the likelihood of spurs.

Good luck with the vet.  Your bunny is lucky to have such a caring advocate for a "dad".  :)

Dana