Severe problem with loose teeth

Question
Hi.
I have a bunny who has been suffering for two years of some unknown illness that causes his teeth to become loose.He has had two molars removed so far and as you could imagine,had all kinds of side problems such as uneven wear,overgrown teeth,etc.
He does not eat hay and never showed an interest in it.When the problem developed,he could only eat pellets. Every time after they would extract a tooth,he would feel better for some time and go back to eating hard stuf such as carrots and also leafy vegetables for awhile. But some time later,he would stop and eat only the pellets.Then eventually he would gradually slow down on eating untill the point where he could not eat any longer on his own.And then he would have another dental procedure after which the whole story would repeat again in exact same pattern.
He has always had trouble with leafy stuf and more luck with something bigger in volume and size.Except pellets he would also eat oats.No need to say that he would always show great interest in food and then show obvious displeasure with not being able to actually consume it.
He is drooling really bad - his fur is coming off because of being constantly wet.And his eyes are runny and i dont know how to get rid of that - i have tried all kinds of stuff and nothing helps.We did the culture test and it is nothing life threatening,but just causing him certain discomfort.
A few days earlier we went to see our vet and again,they perform teeth leveling - one side was less worn that the other.And the bunny has been already on softened pellets for a month.
I am calling the vet tomorrow to let him know that my rabbit's condition has worsen and he needs a pain medication.I am looking on the Internet for info on loose teeth,but have not seeing much yet except for maloclusion,which is in our case not the culprit,but the consequence.
His stool is ok,his appetite is slowly decreasing,and I can tell he is in pain.  

Answer
Dear Lola,

You don't mention how old your bunny is, or what breed.  But some rabbits have a very unfortunate genetic predisposition for metabolic bone disease that results in osteoporosis throughout the skeleton.  Because the bones of the jaws are very light and thin to begin with, this problem often shows up first in the jaws as loose teeth.  

Once the molars and/or incisors become loose and wiggling in their sockets, the gate is open for bacteria to enter the spaces between the teeth and gums, and this results in jaw abscesses starting at the tooth roots.  It was a good idea to have a culture and sensitivity test done to see what type of bacteria are starting up in the sockets.  But even if they are "nothing life threatening," (they may be a normal part of the mouth and intestinal flora, such as Bacteroides sp.), they do NOT belong in the bones and tooth roots.  For this reason, antibiotic therapy is often prescribed by vets very experienced with this unfortunate problem.  Longer-acting antibiotics such as bicillin (injectible only!) and zeniquin (marbofloxacin) might be good choices for this, since they are given only once a day (zeniquin) or once every other day (bicillin), reducing stress of too much medication.  We have actually had good results in combining the two medications I just mentioned--but they will work only if the culture indicates that the bacteria in the bunny's abscesses are sensitive to them, of course.

There's probably not much here that you don't already know, but please read:

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

and

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

and

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

When the vet pulled the teeth, were they removed entirely, root and all?  Or were just loose portions removed so that they eventually grew back?  In a severe case like your bunny's it might be time to consider actually *removing* all the offending teeth and keeping him on antibiotics until the sockets heal up.  Even if he loses all his teeth, he can still have a balanced diet that you'd prepare in the blender and/or by making pellet mush as you already are doing.

I think you're also very wise to ask about pain relief.  We've found that a combination of metacam and tramadol can work *miracles* for this type of pain, so please ask your vet about that.  I think it will give your bunny enough relief so that he'll be comfortable while the other medications take effect.

If you think you'd like another opinion from a rabbit-savvy vet, then you can find a list of them here:

www.rabbit.org/vets/vets.html

I hope this helps.

Dana