ear abscess

Question
QUESTION: For the past year my bunny has suffered from an ear abscess, which has been surgically removed twice and lanced and flushed. I found a rabbit specialist who has performed a lateral ear canal resection (zepp procedure) in the hope that this will help. My bunny is doing very well and is healing nicely. The only problem is that the new ear canal entrance keeps closing over. It has gotten very small now and I am having difficulty opening it back up.

I took him to the vets and she told me that if it does close over completely, he may have to have a total internal canal ablation. This is something I am not keen on as its very extreme and can only be performed by experienced vets (my vet has only even performed them on dogs).

How can I keep the hole open? Ever time I go to open it, I am causing trauma, making it want to scab over?

Apart from that he is very happy, healthy and eating well.

Many Thanks

ANSWER: Dear Suzan,

Tissue wants to heal!  

I'd suggest that if the vet can "freshen the edges" of the incisions where the ablation was done, then application of Tegaderm (artificial skin plastic bandages) to the edges of the wounds will help prevent them from rejoining while still allowing the open tissue to breathe and heal.

You can get Tegaderm at many good pharmacies and hospital supply stores, but you might have to call around.  It's a little hard to handle (it tends to fold on itself and stick to itself), so get several patches so you'll have spares if you need them.

Ask the vet about this, and see what he thinks about another try before resorting to such drastic surgery.

Hope this helps.

Dana

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

QUESTION: Thanks for that. Just a question, what would 'freshening to edges' of the incisions where the ablation was done actually involve?

Thanks again.

ANSWER: Dear Suzan,

Unfortunately, it involves cutting the edges again, so that repair cells will migrate to the area to heal it again.

Did the vet actually cut tissue *out* of the resection area, or just slice the ear canal open?  Our vets actually remove a strip about 5mm wide to be sure the edges don't re-join.  I've never heard of an ear canal resection wanting to close up before.  But I guess it does happen.

Hope that helps.

Dana

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

QUESTION: Dear Dana,

I have spoken to my vet and she is willing to try the tegaderm. However I need to know a few more details. I live in the UK therefore I need to know the specific type of tegarderm that can be used, so I can get hold of it, which may have to be imported from the US. My vet also wants to know exactly what she has to do with the plasters, as she has never experienced an ear canal entrace is closing. The reason why the entrance is so tiny is because my vet had to cut away all the infected tissue from the abscess, and usually you would fold down 'flaps' of skin to ensure the hole stays open, however, there was no tissue she could use so we were just left with a hole, which is closing. My vet is currently trying to get into contact with a rabbit specialist to ask his opinion, but wanted to know the exact type of tegaderm and exactly what she needs to do.

I am very lucky to have a vet willing to try anything to help my bunny!

Many Thanks!

Answer
Dear Suzan,

I've never used Tegaderm for this type of problem, so I'm sorry I can't really help with the specific type of bandage.  The only one I know of is what we've used to cover large wounds and cover up a de-gloved tail during healing.

You may have an analog in the UK:  Tegaderm is designed as a breathable "artificial skin" to cover burn wounds or large wounds while they granulate and heal from below.  I'm sure there must be something similar in the UK, so you won't have to go to the time and expense of importing it.

The type of Tegaderm we've used can be seen here:

http://www.jrsmedical.com/TRANSPARENT_DRSG/MMM1624W/product.aspx

I'm not sure it will work.  But it's the only thing I could think of to prevent the open edges of the wounds from coming into contact and re-sealing.  Note that it is *hard* to handle at first, without some practice.  I'd suggest you order a bit extra, just in case.

I hope the Tegaderm (or similar product) will work for you!

Dana