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Rabbits/Ruby and her hock abscesses

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Question
Dear Dana,
Please help me!!!
My bunny lady Ruby was diagnosed with a bacteria called sphingomonas paucimobilis after taking a culture. The vet put her on 1ml of bactrim per day. The abscesses did not go away and grew much larger, so the vet decided to surgically flush it with saline.
He then told me to spray twice a day Vetericyn spray on it. No word about keeping it soaked or open or giving her any pain meds. She first ate well right after surgery, but the last 2 days after surgery she seems to be miserable and does not want to eat much. I also suspect she has some sort of racer burn. I also just saw a new abscess forming and puss is coming out. This is 3 days after surgery. Iím furious. I ask why she can't be put on a painkiller, and he said he can't dose it. She weighs 8 lb and is a French angora. My vet is not an exclusive exotics/bunny vet and I might feel like I want to switch, since it does not look any better, but worse. I think he does this whole treatment wrong. I heard now from everywhere that the wounds need to be kept open and soaked and treated with various things and nobody seems to give bactrim to any bunny. Is there anybody that can help me? I was also told that Manuka honey is very good. Please help; I don't want my big girl in ANY discomfort. She also will not put any weight on this foot. It looks horrible....Please respond back to

Answer
Dear Jennifer,

I agree with you:  You need to find a vet who is more experienced with rabbits.  Bactrim is going to be pretty much useless against something like this.

Pain management is CRITICAL for rabbits.  Shame on the vet for saying he "can't dose it".  Can't he look it up, or find a colleague for a reference?

Metacam and Tramadol are both excellent for pain, and the combination of both can give your girl a lot of relief.  If your vet can't get a dose, please find another vet, or write to me at dana@miami.edu and I can provide you with more information from professional formularies.

A more serious antibiotic is likely to be needed here.  Sphingomonas paucimobilis is a common soil bacterium, and more of an opportunistic pathogen than a common one.  Oddly, (in humans, at least), this bacterium most often causes infections acquired in a hospital setting.  Leads me to wonder if there has been contamination.  But the most important thing is:  how is it effectively treated?

Because the hock and foot are not as vascularized as some other areas, there could be a problem with systemic antibiotics actually reaching the infection.  This is why a poultice might really help.  Manuka honey or other hyperosmotic sugar solution (e.g., 50% dextrose) might be helpful.  But the leg must be cleaned and re-wrapped at least twice a day for this to work, as the key is to keep the bacteria in the wound overloaded with the hypertonic honey/sugar so that they become desiccated and die.  It's a purely physical mechanism.  If you leave the poultice unchanged too long, it can actually *promote* bacterial growth by providing the bacteria with a less concentrated source of organic nutrients.  :(

But it might be worth a try, especially if you are willing to consistently change the dressings to be sure the bacteria are really getting nailed.

Time to find a rabbit-savvy vet:

http://www.rabbit.org/vets

I hope this helps.

Dana  

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Dana Krempels, Ph.D.

Expertise

I've lived with companion rabbits for more than 35 years, and consider them members of my family. I can answer any questions about the biology and health of rabbits, from the commonplace to the unusual. But please note:

RULE #1:
THE INTERNET IS NOT THE PLACE TO SEEK HELP IN AN EMERGENCY.

...it is an EMERGENCY.

Find a rabbit vet at www.rabbit.org/vet for immediate help, and don't risk your bunny's life by spending time asking questions online! If you can't get in touch with your vet, read these Emergency Sick Bunny Instructions.

If you have found a wild baby rabbit, please read these EMERGENCY INSTRUCTIONS FOR WILD BABY RABBITS and then use this link to FIND A LOCAL WILDLIFE REHABILITATOR who can give you the right advice.


RULE #2:
Help me help you! Please make your subject line informative if you have an urgent question. then LET ME KNOW IN THE SUBJECT LINE so I can give your question highest priority over non-urgent questions. If you don't do this, then I can't guarantee timely assistance!

For all the best, most accurate rabbit health, care and behavior information, visit The House Rabbit Society.

Experience

I have been rescuing and rehabilitating domestic and wild rabbits for about 30 years. I have written articles for many rabbit rescue publications, as well as for the veterinary journal, Exotic DVM. I own EtherBun, the internet's largest listserve dedicated to health, care, and behavior of domestic rabbits.

Organizations
Houserabbit Adoption, Rescue, and Education, Inc. (H.A.R.E., Inc.) president National House Rabbit Society (Board member)

Publications
Exotic DVM
Warren Peace (Journal of the House Rabbit Society of Miami)
Various newsletters of the House Rabbit Society, nationwide

Education/Credentials
Ph.D - Biology
B.S. - Biology
B.A. - English

Awards and Honors
Lightspan Academic Excellence Award for web site on rabbit health and biology
(http://www.bio.miami.edu/hare)

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