possible eye abscess

Question
QUESTION: Dear dana
My bunnies eyes has started to protrude and is runny, clear but no discharge. My vet
did an x-ray as he suspects an abscess behind the eye. He couldn't see anything on the x-ray and said the teeth also look o.k. She is on baytril but the eye is
the same. She has lost weight over the last few weeks as she had a bit of a chest infection which she is now over but is still losing weight. Her appetite
did go off but she is eating well again. This week she has lost 60 grams. Not a great deal, but i was hoping it would stop now she is eating better. She doesn't
obviously seem in pain, although i know they can hide it well.
I am at a loss of what to do!! my vet still thinks it is an abscess and thinks we should maybe remove her eye but he doesn't want to do it unless absolutely
necessary. I know abscesses are terrible things! Because i can't tell if she's in pain I don't no weather i should just wait and monitor her or go ahead with
the op. Are there any other problems that could make an eye protrude? any advice would be most grateful
best wishes
Lisa

ANSWER: Dear Lisa,

The problem with a retrobulbar abscess is that you can't get into the capsule of the abscess to take a sample for culture and sensitivity:

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

which would tell you the most effective antibiotic for the job.

That said, we have not usually had good success treating these abscesses with Baytril.  However, we have found that a combination of injectible bicillin and zeniquin (marbofloxacin) works when other things don't, as both have long "hang time" in the body, and excellent abscess penetration--especially for head abscesses.   

Please share this article with your vet:

http://jcm.asm.org/cgi/content/full/40/3/1044?view=full&pmid=11880435

Although there is no evident molar involvement, we have found that almost all head abscesses are seeded from the mouth, and that often makes the bacterial population similar to any one would find in a jaw abscess.

I hope removal of the eye won't be necessary.  And truly, bicillin is your bunny's best chance of avoiding that, though it could take a couple of weeks before you start to see noticeable results (rabbit abscesses are awful!).

I hope this helps.

Dana

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

QUESTION: thanks dana, that is helpful. I am in the Uk so Bicillin is not available as far as i am aware. I have read about Metronidazole, do you think this might help?
kind regards Lisa

Answer
Dear Lisa,

There's no way to know whether *any* antibiotic will work, but metronidazole is pretty nasty stuff, and I've not heard of it used with great success for this type of abscess.  I would use it only as a last resort.

Although you can't get bicillin in the UK, you may be able to get Penicillin-G Procaine, and ask your vet whether Benzathine is available there.  Those are the two active ingredients in bicillin, and I do wonder if giving them both together might work.  It might be worth asking.

I do know you can get zeniquin (marbofloxacin) where you are, so please ask the vet about that.

I hope your bunny will make a good recovery soon!

Dana