chronic tear duct infection

Question
Sweetpea is a female harlequin, age unknown, suspect under 5 years.  We have been treating her for a chronic eye infection (in one eye) for 3 months.  She has been X-Rayed and it was found that her teeth are causing the problem.  Her tear duct cannot empty and becomes infected.  Our vet consulted with a rabbit specialist vet and they looked at the X ray images and decided that if the teeth causing the problem were removed (would need to remove 3 teeth which they felt was risky) then the scar tissue that would form in its place would more than likely cause the same problem with her tear duct.  We then discussed the idea of removing the eye and the rabbit specialist said that every time they have done this operation the rabbit has bled out and died and therefore did not think it was an option.

We have been treating her twice a day, gently massaging and removing the pus (oodles of it) and then treating her with medication.  We have tried various medications including chlorsig, baytril, chlorasone, soligental etc.  We have had her eye flushed twice and by the time she gets back home it is full of pus again.

It has gotten to the point where she runs when she see's us (through her good eye) and wimpers when we do her eye.  It is traumatic for all involved, her eye is red, and on 2 ocasions now has been so sore it has bled.  It is continually full of pus and once cleaned then filled up with medical goop. Any advice would be greatly appreciated.

Thankyou Jacqui

Answer
Dear Jacqui,

Unfortunately, this isn't an uncommon outcome for molar root infections.  You have not mentioned whether a culture and sensitivity test has been done on the pus:

www.bio.miami.edu/hare/culture.html

but that would be a good thing to try at this point.  You also don't mention long-acting injectable penicillin as one of the weapons in your arsenal, and this can be extremely effective for certain jaw abscesses.  Please read:

www.bio.miami.edu/hare/jawabscess.html

Is she on pain medication?  That can make a huge difference to her quality of life.  Combining metacam or banamine with tramadol can really help with the pain.

I agree with the vets that removing the teeth or eyes would be futile and do more harm than good.  But trying the appropriate antibiotic might do the trick.  A C&S will help with that.  Amikacin can also prove helpful, especially in conjuction with a fluoroquinolone, such as ciprofloxacin, marbofloxacin, etc.

Good luck


Dana