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Urgent dental advice please

22 10:37:59

Question
Hi Dana,

Need some advice please regarding my bunnies who have regular dentals for molar spurs and elongated crowns.  They are elderly buns, 9 & 10 yrs old and have had these burrings for 2 & half years now,  I recently changed vet because a previous vet injured my 9 year olds mouth and she had a bruise in her cheek for about 5 weeks, she barely ate anything in all that time and was syringe fed almost entire time.

Since starting at my new vet, both rabbits have had poor recoveries from their dentals and are eating very poor amounts.  At first dental my 10yr old came back from dental and I noticed a chewing discomfort 3 days later, teeth were checked at 10 day point, but looked good, I saw more discomfort, she was taken in at 3 week point and vet filed a molar that was bit longer than rest, but that was it.  After this second dental, she still couldn't eat, was presenting with her usual molar spur signs (she does small sneezes after chewing a little bit and was licking her lips after, also continued chewing with nothing in mouth) so I took her back a week later.  This is 3rd time I've been in with her, the vet said all she found was one tooth that had a bit of a ledge, (her words were, 'possibly a tiny sharp edge on upper right molar laterally,') so she burred edge to round but not sharp more of a ledge.  She remarked that the first premolar is under gum line, but no infection, looseness or ulceration.  That was 2 days ago. She still cannot eat much, plus she's still doing these small sneezes after she chews a bit, I am really worried now.  She was x-rayed for roots week before and they have not changed from what I already knew, no new problems with them or infections, some are a bit long though.  She is not showing any signs of any other problems, she is her normal self, poops are fine, but only because I have to intervene with regular syringe feedings, the only thing I can tell is wrong is by watching her eat and what she does with her mouth.  My vet is insisting she is very happy with her teeth and that she has done a thorough check, and that she uses a mirror and feels too.  I don't understand why she's still so slow to eat and still does these spur signs ( what she has always done with spur formation).

My other 9 yr old bun is also eating small amounts, hardly anything since dental, before the dental she was eating better, was eating some veg, now not eating any.  I handed her a treat (small bit of cracker, usually loves) and she chinned it and dropped it.

My bunnies are not allowed to have metacam at the moment because they had been on a course of it at my previous vets and he gave out high dosages so they had a few weeks on it and my vet was very concerned.  I got some torbugesic from her instead and I gave the dosage she told me to give them yesterday ( one or two drops, she said one drop = 0.02ml) but it did not help them at all. My bunnies both weigh about 1.4kg, does that dosage sound right?

They don't look like they are in pain to me, just frustrated when they are eating, they take little bit, then stop and sneeze or keep nashing teeth without anymore in it, when they do chew I can hear the teeth kind of rubbing together making a squeaky type of noise.  Does any of this mean anything.

I'm getting very desparate because I end up syringing my bunnies all the time from what is supposed to be a simple molar trim.  Would the premolar that is under the gum line affect a rabbits eating habits, only other thing I can think of, was my 10 year old had a slab fracture tooth diagnosed a couple of months ago, but this turned out not to be as bad as thought as the previous vet was thinking about extracting it.  My new vet hasn't mentioned it so I did not think it would of been of any concern.

Any help or thoughts would be so much appreciated,

Thank you

Sue

Answer
Dear Sue,

Wow, this does sound very frustrating.  From the sound of it, your bunnies *are* having some mouth discomfort, but if your new vet is as thorough as she sounds, then I can't imagine the problem would be spurs.

I wonder if just having the teeth done causes some residual pain, as once the bunny is under anesthesia it can take quite a bit of pulling the mouth open to get a really good view.  If the bunny is not completely under, s/he can fight the opening tool, and this can just cause muscle or connective tissue pain after the fact.  Anti-inflammatory drugs would help, but since your vet would like to keep them off metacam for a while, this might not be an option.

We've found that torbugesic is next to useless for pain.  It lasts a very short time, and doesn't seem to offer much relief for many rabbits.  Instead, we've begun to use tramadol, a synthetic opioid, and it has given fantastic results, especially when combined with metacam.

I would ask the vet about trying tramadol, and restoring a low dose of metacam as soon as she feels its safe.  I'd avoid going into the mouth again for at least a week, and just see if the discomfort resolves without any more fiddling with the teeth or mouth:  it could be the treatment itself that causes enough "after burn" to make the bunnies picky.

Short of that, I'd suggest finding yet *another* vet to take a look and give a second opinion.  I hope you will get to the bottom of this annoying mystery!  

I hope this helps a bit.

Dana