Abscess

Question
QUESTION: My 9 year old rabbit has an abscess on the top of his front foot and a bit further down. My vet thinks it may be more than an abscess and could be cancer as the skin is very thin. If it is, we are not sure what action to take from there. Do we amputate? Do we just have them remove the nodule and see what happens? He is a great little rabbit and we hate to put him to sleep if we don't have to, of course. Any advise would be very helpful.

ANSWER: Dear Karen,

You need to find a vet who is not so timid about examining the nodule more closely, and perhaps taking a biopsy.  It is far more likely to be an abscess than a tumor, but a tumor isn't impossible.  Dental abscesses are very common in rabbits, and are quite treatable with the appropriate antibiotics.  Please read:

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

and

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

If this is a tooth root abscess (not uncommon), the vet may wish to take a pus sample for culture and sensitivity:

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

or just start the bunny on bicillin, which can be very effective in many of these cases.  Combining bicillin with zeniquin (marbofloxacin), our vets have had excellent success at battling jaw abscesses.

You should be able to find a more experienced rabbit vet here:

www.rabbit.org/vets

I hope this helps, and that your bunny will be on the road to recovery soon.

Dana

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

QUESTION: Dana, Thanks for the quick response! This is a foot abscess, not a jaw abscess. I guess our first step is to get this biopsied? If it is not cancer, but just an abscess should we have them do a sensitivity & culture test or have them give what you suggsted when you thought it ws a jaw abscess (bicillin with zeniquin (marbofloxacin)

ANSWER: Dear Karen,

Oh, good grief.  I just re-read your original message and see that for some weird reason I misread "foot" as "tooth."  Now *that's* a first.
Sorry!

I think the first step would still be a biopsy.  Once the lesion is identified, treatment options will be narrowed.  I hope it's something treatable, but in a 9 year old rabbit there can be similar problems to a later middle-aged human, in terms of circulation, etc.  If this is an abscess, it could be difficult to treat.  But that doesn't mean it's not worth a try!

Is this a lump?  Does it move freely with the skin, or is it firmly attached?  Does it have a yellowish tinge through the skin (suggestive of an abscess, as this is what pus will look like through thin skin).  All these things would help me guess what you might expect from a biopsy.

But even if it *does* turn out to be something nasty, I would surely opt for amputation before even considering euthanasia.  Many rabbits live completely happy as "tripods," and some can race around so that you'd never know anything was wrong.

So I'd recommend getting the lesion identified first, and then go from there.

Dana


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

QUESTION: Dana, no worries! I see how many people ask you questions on a daily basis. They did squeeze the abscess and did get pus from it. The vet thought these abscesses were a side result from a cancer? She thinks one looks unabscess like. Looks pink to me and it is attachd to skin, not loose, but had a head on it. It's hard to see because it is in his fur.

Answer
Dear Karen,

Errrrr...I would not assume that the abscess is related to cancer without histopathology.  And truly, if it's not going to change the way you *treat* the abscess if you know there's cancer, then I'd recommend just treating the abscess!

A culture would help identify the bacteria, but if you had to make me guess, it would be either Pasteurella or Pseudomonas (the latter more likely if the pus has a yellowish or greenish tinge and a "sweetish" smell; Pasteurella has a very foul odor in most cases.).  Pseudomonas strains tend to be very resistant to a wide variety of antibiotics, but usually respond to zeniqin (marbofloxacin).

There is a new cephalosporin on the market, Convenia, that is said to last an entire week in the body, and has strong anti-Pseudomonal activity.  The only problem is that the long "hang time" has been established only in dogs, and there is no guarantee the drug lasts that long in (or is safe for) rabbits.  I know of one person whose vet has used this on a rabbit.  While there were no adverse side effects (cephalosporins are not a drug of first choice for rabbits), and there seemed to be improvement in the infection, there's still no way to know whether the drug really had the same "hang time" in the bunny as it supposedly has in a dog.  The jury's still out, but I thought I'd mention it.

Another option, as I mentioned before, is bicillin.

So my advice doesn't really change:  I'd ask the vet about starting the bunny on zen and bicillin, and hope for improvement.  What is there to lose?  (Except the possibility of losing the foot.)

I hope this helps.

Dana