Exophthalmos

Question
Good afternoon Mr. Atkinson. My name is Andrew and I have a question
relating to Exophthalmos in my pet rabbit, Yuki. First some background if I
may.

Our nearly two year old rabbit first started showing medical issues when we
noticed her left eye starting to weep at an abnormal rate. After seeing the vet,
he informed us that there was a scratch on the eye that was most likely
inflicted by our newly bought puppy. She was prescribed eye drops and it
appeared to have been fixed not too long after that. A couple weeks ago we
noticed Yuki was starting to salivate frequently, so we took her to the vet
again to see if something might be wrong with her teeth this time around. It
turned out that she had a deep gash in the left side of her jaw. The vet
informed us it was probably the result of a run in with a wall or hard object.
Thinking it was our puppy again who often would chase her, we gave her the
antibiotics she was prescribed and attempted to keep them separate. Soon
after that Yuki had started to loose her appetite and would tilt her head to the
left as if that area was in some sort of pain. After taking her to the same vet,
we were informed that she had a discharge buildup in her left cheek due to
the gash in her jaw. More medicine was prescribed, but her health and her
weight were dropping with every visit. After a couple more days we had
noticed that her left eye started to bulge out of its socket with tissue being
visible near the duct. I was shocked when I learned that there was a separate
discharge buildup, due again to the gash in her jaw, that was forming behind
her eye socket. As a result, the vet has told me and my fiance that she will
eventually loose that eye and, quite possibly, her life.

My question is if there might be some way we can get that wound to heal so
she can regain her strength and pull through. Our vet has told us that any
injuries to rabbits are very severe due to their discharge being extremely thick
and very resilient to antibiotics. She is our first pet together and it would be
very distressing if she were to pass away due to this problem. Any comments
or advice would be appreciated. Thank you very much for reading.

Answer
Hi Andrew,

I think I can help Yuki.  I have dealt with just that very scenario....and considered the decision you are faced with.  I must applaud you for your dedication and determination to help her.  And we are going to do our best.  I am not a vet but I do treat very sick rabbits under the supervision of some very talented exotics focus vets.  In fact, all my volunteers in my wildlife rescue are veterianary professionals.  Most vets are very unfamiliar with treating this type of condition.  They receive very little exposure to species like rabbits while they are in school....and I know because my animals are seen quite a bit by senior vet students doing clinical rotations from a nearby major vet school.  Many vet also will not venture "outside the box" to treat conditions like this due to either liability issues (some states in the US do have veterinary malpractice laws) or they are limited by practice policy to use only treatments found in reference material.  The really bad thing here, in many cases with rabbits we have found that available information is outdated, inaccurate, ineffective and in some cases harmful.

"Bulging Eye Syndrome" is normally caused by a severe abscess usually in the molar roots and deep inside the jaw.  Your vet is very correct, it is very difficult to treat these infections partly due to the thick pus found in rabbits.  And many vets don't attack the "root cause" and that is the core of the abscess in the molar roots.  To effectively treat a jaw abscess you have to get the drugs to the core of the abscess.  There have been some attempts at placing antibiotics, usually in the form of beads impregnated by the drug Clindamycin, into the core of the abscess.  This is expensive and very painful.  It was a near total failure.  Not only was the pain a concern, the Clindamycin would migrate to the GI and that was deadly.  The problem with treating these abscesses is that the core usually contains both faculative and obligate anaerobic bacteria....and those little bugs are difficult to identify and to treat. I have treated many jaw abscesses with a combination of Pen G (a penicillin with a very specific combination of Procaine and Benzathine) along with a high dosing of Zithromax.  These drugs, when used in the correct combination, can penetrate the pus and start to punch holes in the cell walls of the bacteria. It has never failed me.  WARNING:WHILE IT MIGHT BE POSSIBLE TO ACQUIRE THESE DRUGS WITHOUT A VET...DO NOT ATTEMPT TO TREAT WITH THESE DRUGS.  IMPROPER DOSING, EITHER IN THE AMOUNTS OR ADMINISTRATION ROUTE, WILL RESULT IN DEATH.

Treating abscesses is involved....and it appears you have the dedication and commitment to do so.  You will need to learn to do injections both for meds and fluids.  Pain meds are essetial.....and in this stage, a narcotic aspect is really helpful.

Unfortunately, since I am not a vet, I can't legally give you the details of the treatment as far as specific dosing.  But I can consult with your vet personally.  This is a treatment I developed and some vets have discussed it among themselves and in various forums so I know some are using it.  As I mentioned, it has never failed me.  At your earliest conveneience, ask your vet if she would be willing to discuss your case with me.  The only stipulations are that she has to be totally aware that I am not a vet (for her ethics) and I would need to have proof that I am really talking to a licensed doctor (little legality thing).  If she is willing and we can make our verifications, we can talk either by phone or by e-mail.

I have been in the same situation with one of my rescues...in fact we were scheduling the enucleation.  I didn't feel he could survive the surgery to remove his eye so I decided if he was going down, it was going to be "in a blaze of glory".  I started him on my drug treatment with the reluctant approval of my vet (she is professor at a major vet school).  It only took 3 days before I saw some improvement.  It was tough and we are always watching for this monster to make a curtain call....but he has been abscess free now for over 4 years.  But just remember, if you and your vet decide on using my protocols...it is involved and will require a lot on your part as far as being very astute at maintaining drug intervals.  An abscess is one of the most challenging of rabbit issues....it can be beaten but it will be a tough fight.  I'll be waiting to see what your vet thinks....and I hope I can help Yuki.  Healing vibes are headed to her from our large warren of critters.