Advice please – molar malocclusion and extraction

[Rachael]

Hello all,

I’ve come here for some advice and possibly experience stories relating to mole malocclusion. My 2.5 year old lion lop has 4 long molar roots on one side. He doesn’t currently have an abscess but his jaw bone has grown out of shape. The vet says it is bad but not the worst she has seen. He had 1 of the molars removed rather than more as he also had a loose incisor which had to be taken out. This was 3’weeks ago and his recovery has been slow. The first week was traumatic, not eating, several vet trips for suspected gut stasis and dehydration. He was having 5 separate meds syringed 3 times a day and as a result is now a very unhappy bunny. Long story short 3 weeks later the pus coming from his gums is no different. The next step is penicillin injections every 2 days which I’m
Not prepared to do as I already feel His quality of life has been destroyed.
Basically I don’t know what to do. He’s just a baby and the vet is telling me that euthanasia is probably the best option. I’ve stopped his antibiotic as his stools are soft and he is not himself. I’ve managed to trick him into taking his metacam in spinach so he is no longer being syringed.
Does anyone have any experience? I don’t know whether to continue metacam long term until he is clearly in too much pain, ask about more extractions or have him put to sleep. I’m having sleepless nights over the decision. I have taken out a new credit card to pay for any further treatment so I am not concerned about further vet bills. The vet is leaving it up to me as she says she doesn’t know what to suggest.

Apologies for the huge post but I don’t know where else to turn.

Thank you in advance x

[Serenity]

Hello Rachael! I’m so sorry to hear about your troubles!
I’m very sorry but I don’t have any experience with this particular problem, but hopefully someone who does will notice the post and reply to it. Until then I can only suggest that you keep going with the treatments because he just might pull through. You could also ask about another extraction if money isn’t an object but I’m not sure what that might do to inhibit his ability to chew. :/ If you think he’s in too much pain or he can’t handle it and you don’t want to put him through any more, you might have to prepare yourself to have him put to sleep. I am so, so sorry.

[Rachael]

Thank you for your kind reply Serenity, I appreciate it. I wish more than anything that I could just ask him how he feels as they cover their pain so well. I’m also concerned about how bad the pus must taste and if it is making him feel poorly. I think I will ask about further extraction but she has advised that this usually causes the molars on the top to grow into the gaps and create further problems.

Thank you xx

[Muchelle]

Sadly I have experience about this, my bun had to have 2 molars removed when he was about 1 and a half years old, he still has a deformed jaw but so far the roots stopped growing it seems.
For us it was a very bad experience, he almost died because of a very bad case of pain-derived GI stasis and had to be kept under heavy pain meds (opioids) and tons of stuff to keep his guts going + antibiotics.

Your vet is correct in saying it’s better not to extract too many molars, it is not only traumatic but it may cause further problems later on. Don’t skip the antibiotic cause it will make the bacteria inside him more resistant and don’t be afraid to inject him, I think it’s much less traumatic for them to get a shot than to be force-fed oral drops. Keep on trucking and keep a tight schedule: meds, critical care, water if needed, rinse and repeat. Don’t give up on him! He will bounce back when he’s strong enough to do so.

I do strongly recommend to discuss a better pain management therapy if all that you’ve been given is metacam, because that is not nearly enough to cover for an extraction pain. If the vet’s ready to give up on him, maybe you could ask for a second opinion to another vet.

I hope I could be of some help, if you need me do write me. Be strong!

[DanaNM]

Hi Rachael, sorry your bunny is poorly.

I don’t have experience with this exact issue, but I’m dealing with dental issues with my 1 year old guy, Moose (so I feel the pain of the vet bills). He went in for a molar trim, and they ended up finding a rotten tooth and extracted two molars (both were so loose they came out easily). He went back in for another check up, and the original side was healing well, but they then had to extract another. Time will tell how many teeth he will lose, but from other members here, I’ve learned that they can do very well with quite a few molars missing.

He will need trims for likely the rest of his life, but they can bounce back quite quickly from those. It sounds like it’s his teeth causing the pain, rather than the procedure.

I have been giving Moose penicillin shots every other day for 6 weeks now, and he doesn’t seem overly stressed by them. Honestly it is probably easier than syringe feeding! I give him lots of treats and rub the area after ward, and I am quickly forgiven.

Moose will eat critical care off a plate (the apple banana flavor), have you tried offering it that way?

Also what is your pain med dosage and frequency? Some bunnies do better with a smaller dose twice per day.

My understanding with molars is that pulling healthy molar is dangerous as it can break the jaw, but problem molars are usually so loose that that risk is low. Having an experienced vet is key. Your guy might just need them filled down so they line up properly. Even small spurs can cause pain.

I think you’ll need to make your decision based on how well he handles the procedures, as he will likely need several more in the near future to get things in order, and then regular trims throughout his life.

Penicillin shots long term are possible, but my vet said this was only used as a viable option when the rabbit was very old and unlikely to handle the anesthesia well. The penicillin injection shouldn’t affect his gut (although it can make poops smaller and harder). I have been giving probiotic (Bene-bac) along with Moose’s antibiotic and it seems to keep his poops looking better.

Pus coming from the gums probably means more teeth should come out. From my research on this, and from my vet’s opinion, it’s best to treat dental infections aggressively from the start if at all possible for the highest chances of a true cure.

I think if I were in your shoes, I would have his teeth checked again to figure out the source of the infection. He might not have bounced back because the root of the problem isn’t dealt with. If your vet is not that experienced with rabbit dentistry, get a second opinion. Pus means teeth are rotten and need to be removed. Your vet can show you how to do the Pen injections at home (and you will get better at them). Ask about his pain management. Also see if he’ll eat Critical care from a plate. Mixing in canned pumpkin sometimes makes it more tasty for bunnies.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

[jerseygirl]

Completely agree, Dana & Muchelle.
Rachael, I do think another opinion will help you in make a decision on what to do for you rabbit. The current meds may need to be reviewed if upsetting his appetite or causing some soft stools.
Penicillin injections are usually well tolerated and much more effective for treating infections like these then oral antibiotics are. Some rabbits may be sensitive, so the first one or two should be done during a period where you can return to the vet if not tolerated – i.e. at the beginning of a week rather then going into a weekend.

[Rachael]

Thank you so much to all of your for your advice. I’m so pleasantly surprised to hear some positive stories of bunnies actually getting better because all of the others that I have read have ended in euthanasia. He is on 0.7ml of metacam twice a day which he is now taking in food. This means syringing has been stopped for the last few days and as a result he is much happier. He is excited to see his pellets in the morning and is back eating his favourite veg again so he must be feeling better.
I may start the antibiotics again on your advice if nothing else to keep the abscess at bay. Injecting penicillin myself really scares me and I’m not sure I could manage it let alone him.
I may ask about further surgery in a few months once he is over the ordeal to hopefully remove the source of the pus.

Thanks so much for your help, I was so lost and confused and now feel so much more confident about his future x

[Wick & Fable]

Wick’s on penicillin injections for a different reason at the moment, and it’s our second time with them. It definitely seems scary, but if it’s something you may end up needing to do, just post and many people, including myself, can give you some advice on how to do it a way that’s more smooth for both you and your bun bun.

The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.

[Muchelle]

Glad to hear the little fellow seems to be feeling better! Giving injections is relatively easy compared to force-feeding, I have a VERY feisty/demonic rabbit so I can guarantee that. Do ask us for advice anytime Glad to be of help <3

[DanaNM]

Glad he’s perked up!

My vet doesn’t charge an office visit fee if you go in for penicillin injections, and offered to have me do them in front of them for a while until I got the hang of it. I do them at home for convenience, but nice to know it’s an option if Moose is every being extra feisty about it. I do find having a helper is nice, but not always necessary.

. . . The answers provided in this discussion are for general guideline purposes only. The information is not intended to diagnose or treat your pet. Seek the advice of your veterinarian or a qualified behaviorist.  

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