Jaw Abcess & Tooth Infection

Question
HI!! In very need of advice for my year and a half holland lop. She has infection in the bone of her lower jaw, due to both bottom front teeth. Our current vet says the outlook doesn't look good. He said he could remove both bottom teeth but the infection still may continue in the bone. We have her on baytril right now, with no progress, probably because teeth haven't been removed yet. He considers her to be a high maintance rabbit that will continue to need medicine and that her quality of life will be affected by the removal of her teeth and that she would need teeth trimming on her top teeth once a month due to the removal of the bottom teeth. Any advice??  What's your opinion or experience with this situtation?? Need to make a decision soon, I don't want her to suffer. She is a housebunny with another holland lop that have bonded from the start. Please send me any info you may have. THANK YOU!! Jennifer

Answer
Dear Jennifer,

I'm not sure how experienced your current vet is with rabbits, but from what you've told me here, it doesn't sound as if he is very experienced.

If the lower teeth are removed, then so should the uppers be, to avoid the overgrowth problem.  There is some evidence that the teeth won't grow as quickly without pressure from opposing teeth, but I've seen too much evidence to the contrary to believe that.

But I would not immediately resort to removal of the teeth, either.

Baytril is generally not effective against bone abscesses like this.  There are much better options, as described here:

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

The linked article by Tyrrell, et al. is also excellent, though I'm not a big fan of bead implantation, nor would I ever use lincosamine antibiotics (e.g., clindamycin) for a rabbit.  Just too risky.

If you are not in the UK (where bicillin is not available), then a very good option might be to combine bicillin injections (once every 48 hours) with zeniquin (marbofloxacin; once every 24 hours).  These are two very powerful antibiotics with good bone penetration and generally very effective against the bacteria usually at the root of infections like this.  If you're in the UK, then an alternative to bicillin would be Penicillin-G Procaine injections every 24 hours.

Has a culture been done?  If not, please insist on this:

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

and I would definitely search out another vet more experienced with rabbits in general, and rabbit dental problems in particular.  Please read:

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

and find a vet here:

www.rabbit.org/vets

I hope this helps.

Dana