sick raabit with lump

Question
QUESTION: Hello.

I have a 5 month year old dwarf rabbit. She has discharge coming  from her left eyes and left nostril, staring two weeks ago. A few days ago a lump suddenly appeared. The lump is hard, located under her left eye, to her neck, and halfway across her face. I know that rabbits hide their pain, but sometimes when I touch it she flinches, so shes probably in pain. Fur is shedding alot, especially around and on the lump.
I have just noticed that there is a red circle blog on the center of her lump. It looks like she may have been bleeding (since there is no wet blood on her fur), or it may be bleeding form underneath her skin.
Lastly she is eating normally, but she is not as active and energetic as she use to be.
What is this, and what can I do until I take her to the vet?
Thank you for any help you may offer.

ANSWER: Hi Sara....I would certainly get your rabbit to a vet as soon as possible.  I have two possibilities for you.  One isn't very likely due to the time of year and your location but we have seen some interesting and unusual things occur during the past couple of years so we consider everything these days.

A cuterebra larvae is a remote possibility.  This is basically a maggot.  Depending on the region, they are known by various names including bots, warbles or wolves.  The usual presentation of these larvae is a constantly growing lump.  It will have a red crusty center with some possible discharge of pus or blood.  If you have a bot, you can see the "gill" as it exits to allow the beast to breathe.  Warbles should be professionally removed.  If the body of the larvae is compromised inside the host, it releases toxins much like anaphylaxis.

A much more likely scenario is a jaw/dental abscess.  Dwarf rabbits (including Holland Lops) seem to have some dental issues....possibly from the flat shape of their face.  There are several things that can cause a dental abscess.  Something as simple as a piece of hay stuck between either the pre-molars or molars can become infected.  Overgrown teeth can cause them....rabbits have open rooted teeth so they constantly grow.  This condition is usally found to be from malocclusion....a misalignment of the teeth.  Misalignment can be genetic, trauma or a metabolic condition from improper nutrition....Metabolic Bone Disease.  The most common cause of these abscesses is am impaction of the incisors roots (rabbits have 6 incisors....4 upper arcade and 2 on the lower) or even more likely, the molar roots.  Radiology is required to see this condition....a vet can't do a visual and see the roots.

A dental abscess is very painful and challenging to treat.  Most vets will immediately go to surgery.  Since I have dealt with so many very sick rabbits, surgery wasn't an option for many of them.  So I developed a treatment using drugs only that has never failed to resolve an abscess.  The problem in treating these abscesses are that it is difficult to get drugs to the core of the abscess.  That is the heart of the infection.  It usually contains anaerobic bacteria (a type that can grow in an environment devoid of oxygen) along with many "tag along" aerobic bacteria.  And rabbits do not handle many antibiotics particularly well.  I use a specific version of penicillin known as Pen G (safe only as an injectable) along with Azithromycin.  I don't this this particular version of Penicillin is available in Canada.  I usually suggest Procaine and modify the dosing to get appropriate coverage for my Canadian friends.  I use aggressive pain meds.  A NSAID is employed to reduce swelling along with a narcotic (usually Buprenex) or a narcotic-like drug (Tramadol).  Supplemental fluids (via sub-q or IV) is usually necessary along with husbandry modifications.

I would get to a vet quickly.  If it is a jaw abscess, the infection can damage the basic structure of the bone and that can lead to additional problems.  Best wishes to your rabbit.

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

QUESTION:  Thank you very much for your advice. Do you have any advice on cleaning the surface of the lump? Also about how much would the vet and medication cost?

Answer
I think I would probably get to a vet quickly.  Trying to clean something like this would probably be very painful....and you know rabbits don't tolerate pain so well.

As far as costs, that is hard to say.  I will tell you that not all vets, regardless of what they say, can properly treat a rabbit.  Many vets advertise themselves as "exotic specialists" but what they really do is consult the VIN (a web based forum for vets).  Depending on what part of Canada you are in, it might be a challenge to find an experienced rabbit vet.  If you provide your general location, I do have listings of vets in the US and Canada that are rabbit savvy.  If this is an abscess, plan on an extended treatment plan.  The drugs I use are not all that expensive....the Azithromycin is more expensive than the Penicillin, but the initial vet visit might be a bit pricey due mostly to the x-rays that most likely will be needed.  After the initial costs, the follow up treatment won't be that bad financially...more time consuming for you.  And if this is an abscess, you will need to learn to do injections if you don't already.  Being able to inject meds and administer fluids can save a lot of money with complex and long term treatments and most vets are aware of the financial strains of people there days and try to help out any way they can.