Abscess in rabbits foot

Question
QUESTION: Sorry to be a pain. It wouldn't let me ask another follow up. Before I take Stewie back to the vet on Thursday, should I have them put him on the bicillin & zen before he has had a sensitivity exam? Also, how long does he need to stay on the bicillin?

Thanks for all of your help! My vet is on your website of bunny doctors but i feel they are limited in their knowledge about rabbits.

ANSWER: Dear Karen,

A sample for culture and sensitivity should be taken *before* the bunny is on any antibiotics, for best results.  How long the bun will stay on bicillin will depend on the progress of the abscess--but taking him off too soon (especially if it's starting to work) is worse than keeping him on too long.

Also consider a 50% dextrose wet dressing (must be re-dressed 2-3 times a day, minimum, to be effective). Sometimes when antibiotics don't work, the really old-fashioned methods can save the day.  And the foot.

Hope this helps.

Dana

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

QUESTION: Dana,
My vet was very reluctant to do a culture & sensitivity test on Stewie. He has had 2 shots of penccilian one week at a time and it doesn't seem to be doing anything for him. We are suppsoed to  bring him back this week for another but should we even bother? We hate to keep stressing him by going to the vet for a shot if it isn't working. My husband & I both get the feeling that the vet thinks this won't be healed and that he is too old (9.5 years) to bother fighting it. He has chnaged his eating habits lately. Won't eat carrots ( but will eat the greens), picky about clover which he loves and dives on apples and parsley. I know our vet thnks this is cancer but there has been no testing for it. Should we bring him to someone else and should we keep on with the penicillan shots?

We feel the vets are not optomistic at all and really need some help on how to proceed. I mentioned he bicillin & zeniquin and it was pretty much poo-pooed.

Thanks!

Karen


ANSWER: Dear Karen,

I hate to be blunt, but you need a different vet.  One who will take Stewie seriously as a patient, even if he is an elderbun.  I'm insulted on Stewie's behalf that the vets you're seeing don't seem to want to bother with aggressive treatment of his abscess.  

I hope you can find a good rabbit vet here:

www.rabbit.org/vets

who will take his problems seriously, as they *are* treatable.

Another concern I have about these vets is that they are giving him one Penicillin-G Procaine shot *per week*.  There is no evidence to suggest that Pen-G lasts that long in the body, and giving the drug that infrequently can foster the selection/evolution of resistant bacteria.  With antibiotics, you have to hit *hard* and be *aggressive* or not bother.  I'm surprised that the vets you're seeing don't seem to be aware of this, unless they're just worried that the pen will upset Stewie's GIT (this almost never happens with injectible Pen-G).

While it's true that a foot abscess is difficult to treat, and may not resolve, this is no reason not to *try* with all the tools available.  This is why I suggested the dextrose wet dressing, which can be very effective--if old-fashioned.

Not sure why the vets would pooh-pooh the idea of zeniquin and bicillin if they've never tried these two long "hang time" drugs, which is *exactly* what you need to promote abscess penetration.  But I suspect it's because they're essentially pooh-poohing poor Stewie as a lost cause, which I don't think he is!

Even if amputation eventually is the last resort, he can live a completely happy life as a tripod.  I can help with that, if necessary. But I'd suggest a different vet, and hope it never comes to that choice.

Take care,
Dana


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

QUESTION: Thank you for the quick reply! The Vets are on that list you have posted as  bunny experts! They have used bicillin but feel this is just as good. I called last week and spoke to the vet about everything you have told me & other articles I have read. She said, "yeah but" to everything I asked about. The Bicillin & zeniquin, C & S Test....They didn't jump on any of these ideas. They told me the pus has no bacteria usually ( which I know) and they would have to scrape the abscess wall. Do they have to put him under to do this? I can switch vets but I live in an isolated area that doesn't deal with many rabbits. I am not sure I will get a different response, to be honest. At this point, I don't even know if we are dealing with an abscess. They did say they could give him a shot twice a day when I mentioned every other with the bi & zen but I think that was just to say "yeah, we could do that but..."  maybe I just need to be more forceful on what I want them to do. Thanks for the support that you feel he is treatable. We are starting to doubt it based on the vets!!!

Answer
Dear Karen,

Yes, bicillin is controversial.  Yes, vets argue about treatment protocols all the time and what will and won't work.  And I'm certainly not saying your vets are not competent to work with rabbits.  I don't know them.  They might be fantastic!  But it does seem that they are not very open to trying treatments with which they are not already familiar.

What they sometimes seem to forget, though, is that every patient is a sample size of ONE.  What they are practicing is *art* based on science, not scientific experiments.

So my question to the vets would be:  if there are no other options, and the present treatment is not working, then WHY NOT try something more aggressive, if the alternative is euthanasia?  I just don't understand.
I really don't.  The only thing I can guess is that they have so much ego invested in Always Being Right that they're not willing to entertain ideas that challenge their dearly held dogma.  And to tell you the truth, I have no suggestions as to how you can argue with that.  They are the attending vets, and they decide on the treatment protocols they want to use.  Case closed.

Some vets are more receptive than others to outside information.  Some are completely closed off and convinced they have all the answers.

So that's where you are.  At that latter point, it's no longer about the  patient.  It's about ego.  I wish I could say otherwise.

I hope you have some success at gently trying to get other treatments for your bunny, but you have to do this in a non-threatening way that doesn't challenge the vet's authority.  Suggestions and questions always work better than demands.

Just some thoughts.  And I truly wish you good luck with this!

Dana