Financial Crisis Budja’s needs a CT Jaw Changes and Mild Infection in Bulla

[Cassie119300]

For the past year my vet and I have been trying to get Budja’s better . She had a reoccurring abscess on her cheek and needed surgery a few times to get it under control. This was my original post regarding the abscess and what happened for those who don’t know about it. I believe my rabbit is having dental issues and has developed an abcess | BinkyBunny

With Azithromycin the abscess seems to be not reoccurring, however, the latest x-ray shows some possible bone destruction and changes, thinning of the jaw, the bone could be breaking up?, at first the vet said it was not lysis or osteomylitis when I asked then towards the end of the call it didn’t seem like she was sure it wasn’t. We don’t know why this is happening as this is not coming from her teeth or has any involvment with her teeth, but it must be due to some foreign object that we have not been successful in finding over this past year but that’s not the strangest bit. They also found a mild infection of her bulla (ear bone area) on the same side, how on earth it is now in her bulla I don’t know but the vet was surprised she has not had head tilt, I feel so depressed over all of this right now it’s unimaginable, I even had to put up a go fund me again. We now have no choice but to get a C-T if even to see if she is going to have any sort of good outcome here or should she need to be put to sleep, which honestly, everything in my gut is telling me this is osteomylitis if it’s now in her bulla, and the thickening of her jaw? one area feels squishy the rest feels as dense as bone and some even is similar feeling to an abscess but it’s not an abscess and the vet told me there is no more abscess capsule, even though the capsule was not removed when it was lanced last time, I’m very very confused. Cornell needs $2,000 to carry out the C-T Scan, and they are the only place I can go that I know of that is even nearby me.  Unfortunately, my husband and I are going to have a lot of trouble affording this as we just had to pay twice this amount for my visa to go and join him in the UK  for the spouse visa (I will have to go back in the next 5-6 moths) My parents have been helping me care for her in the meantime and in-between visits. I know she needs the C-T in the worst way, and it will also tell me more importantly, if any of this and any treatment involved would be worth her suffering or not, right now she is doing ok, seemingly anyways, she eats perfectly fine and if anything has an over the top appetite, is chewing on everything etc… but I have also read that, and drinking a lot of water can be a sign of trying to soothe any pain, so she may be ok today but I don’t know about in the next 5-6 months and more scary, if im not here to take care of her then. If you know of anything or anyone who can help please let me know. I’m looking into places that provide financial aid for vet costs and everything and the vet is trying to see what she can do. I have no idea now… or how in the word she even has a mild ear infection in her bulla that showed up on the x-ray when this entire time she has been on azithromycin the last 5 months, the only thing I did stop 5 months ago was the penicillin g because I had no choice, as far as this weird thickening on her jaw though… that has not seemingly grew any bigger but it has not broken down either or changed or gone away. She does also make this chewing motion with her mouth quite a lot and sometimes seems to gag on her spring mix?  I’m feeling so hopeless right now and I have no idea what’s right or wrong to do now.

[LBJ10]

Azithromycin does a better job than some other antibiotics at penetrating bone. That being said, sometimes these infections just keep spreading despite treatment with antibiotics. These cases often end with “chasing” the infection from one spot to the next (i.e. it clears up here, only to surface over there). It doesn’t surprise me that it has spread to the ear. Oddly, bunnies can sometimes have nasty inner ear infections and show little to no symptoms of it.

What will the CT scan really tell you? If you know the infection is there, then I guess I don’t see the value in it. It won’t tell you anything you don’t know, except maybe where the newest pockets are. I don’t see how it would change the outcome. At this point, I think it would be trying a different antibiotic (or combining Azithromycin with something else) and doing pain management. Or you can just do palliative care.

I don’t remember. Did you do penicillin injections before? Vets will sometimes do these combined with a different (oral) antibiotic.

[Cassie119300]

Yeah that’s what I had thought about Azithromycin which is why I had really pushed to get her back on it in the beginning, what is weirder yet though, is that these changes in her jaw started to developed after abscess had burst on its own and it had been drained (but the capsule was not removed) the vet told me today that according to the x-ray (which I was told was very difficult to read) there is no capsule that is must have reabsorbed. These changes started to develop while she was on the penicillin and azithromycin meaning, the mild ear infection that is in her bulla (which i think is media interna) must have occurred sometime after I stopped the penicillin or during the treatment with azithromycin in the past 5 months. What is more confusing is that the vet, when she called to talk to me said it was not lysis or seemingly infected, in fact it didn’t seem to be connected to any tooth roots or teeth at all though she did note there was some changes going on with the alignment of 3 teeth due to the jaw bone changes and stated this tough dense material is bone, although to me it just “feels like bone” there are some spots that are still a bit squishy so I’m not so convinced it is all jaw bone related. So, there is no more abscess just a denseness of her jaw that feels like one if that makes sense, it has this weird bubble affect going around the side of her jaw and underneath her chin so you can’t actually feel the bone there just this dense bubble-like material. Towards the end of the call, when the vet kept using terms like changes in her jawbone, seemed more thinned out, bone break up possibly? then the vet seemed like she was possibly agreeing it was possible about the lysis and osteomyelitis, but they kept stressing they are not sure without a CT scan they cannot say anything for sure.  I’m sitting here wondering about things like a systemic infection. Something that could be detected in the blood, I remember the vet saying this in the past might be a possibility to test for. Budja’s does have sore hocks, I do put bag balm on them from time to time, they are cherry red but have not cracked or bled that I have seen, there is also a pad or two on her front two feet with the same thing. So, I know it is possible Osteomyelitis can arise from these sorts of things too. I don’t know how an infection could have started though without any pus occurring or being noticeable if it’s in her bulla…. it’s almost like it bypassed everything and went straight from her jawbone to her ear bone. So, it seems the vet is not sure whether or not there is an infection which just leaves me confused and feeling scared, is my bunny’s jaw going to suddenly break or something? I have no idea what I’m to do now, but I’m terrified for her. I’m not sure there are any pockets as such… but the vet kept stressing changes to the jawbone. Yeah, I’m thinking maybe penicillin again with the azithromycin unless there’s another type of antibiotic proven for penetrating bone/ear infections. I’m also beginning to wonder if the azithromycin has stopped working. I would think if it had though, things would be much worse. It’s just a matter of when/if I have to make a really tough call here, I know the prognosis is so poor with osteomyelitis. It’s so sad we have to put such a high price tag on a diagnostic procedure that could tell us if something is worse than we know or not. It’s so weird to me she would get any ear involvement on antibiotics, and now I feel like it’s some ticking time bomb waiting to get worse. The vet even asked if she had shown any symptoms yet of head tilt… and said it was odd she didn’t seem to be showing a lot of symptoms for her ear. She had been scratching her ear though lately but also because her ear was molting and had a lot of dandruff on it and sometimes, she flaps her ears like. I also knew something was funny with her ear because as strange as it sounds, I could feel a slight difference at the base of her ears, the vet told me I shouldn’t have been able to feel this as it is in the bulla though, somehow, I just knew it though. It’s bringing horrible flashbacks of my prior bunny Milo and how everything had affected only his one side as well. I’m not sure what is best now.

[DanaNM]

Oh dear, I’m so sorry 🙁

I don’t have any knowledge about lysis or osteomyelitis. I do think that if you are committed to “knowing for sure” , then a CT would be the way to go. But, it would be worth having the discussion with the vet about how the treatment would change with each different result. If there is no treatment for the things you are trying to identify, then care would likely be palliative. It sounds like she is currently doing OK, so it’s possible that she could be OK for a while with supportive care.

I had a bunny with really “icky teeth” and a jaw abscess. He had several molars that basically cracked and practically fell out when the vet extracted them. He passed unfortunately and the vet did a necropsy, but never identified a cause or source for the problems. So the conclusion could have been a genetic issue. Through some reading I found that bone cancer can manifest in the jaw in younger rabbits (he was only about 2), so that could have been at play as well. Has the vet discussed the possibility of a cancer?

 

. . . 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.  

[Cassie119300]

Thank you, I’m just trying so hard to think outside of the box here and yet remain ahead of the game at the same time, there’s no way I’d put Budja’s through any kind of extensive surgery when it comes to bone I know that much, I cannot imagine putting a little bunny through that, your right though that is a good thing to be asking my vet, I’m awaiting her response they are supposed to be getting in touch with Cornell (I email Cornell as well) to see if there are any other options financial wise, if it’s done as a teaching thing etc… reduce costs, to get her the C-T. I have also reached out directly to Dana Krempels and Esther Van Praag to see if I can get any of their advice/maybe a second opinion on the x-rays and the changes and what they think. I know that unfortunately, when it comes to osteomyelitis in the bone, treatment generally involves taking out parts of bone, sections, pieces etc. or at very best the bone can be saved and the surrounding areas/tissues will need to be completely disinfected etc… Apart from what looks like her chewing on nothing at times, she if anything seems to have even more of an appetite lately and is chewing on anything/everything she can try to. I also wonder if that’s how she may be compensating with this though too. I have her on Meloxicam and Azithromycin for the moment. So sorry about what happened to your bunny, unfortunately a lot of the times with bunnies and necropsies it is always inconclusive. It almost sounds as if something was taking all of the calcium away from your bunny’s teeth trying to compensate for something else, maybe calcium was not absorbing as it should have been.  I unfortunately am unsure of Budja’s age, I do know she has been with me though since November 2021 and at the time the person who gave her to me said she was a year old, I’m not sure that they knew 100% though. She has not been spayed unfortunately, that’s what she was scheduled for when I decided we might want to look back into this as well and yeah… Budja’s is an english spot rabbit weighing in at about 7.50 pounds approximately. I call her “warm toasty cinnamon bun” when she takes her naps haha.

[DanaNM]

Funny you mention that about the calcium, because he also drank and urinated A LOT, so it’s possible something was going on with his kidneys. We never looked into that though because we thought the drinking was likely to sooth the pain from his teeth. But perhaps there was something wrong with his kidneys and calcium absorption. In any case he was a very sick little bun.

I do hope you get a response from Dana Krempels, keep us posted!

. . . 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.  

[Cassie119300]

It’s definitely possible, the only other condition I know of off of the top of my head that would cause excessive peeing and drinking would be e. cuniculi but it doesn’t sound like this was the case with your bun, I’ve also done some reading about vitamin d deficiency and not getting enough calcium, as I’m currently trying to get more sun for my bunny Budja’s whos an indoor rabbit and with everything going on trying to make sure she has enough vitamin d to help with everything. I did get a call from my vet today and they spoke with the specialist at Cornell exotics department and the C-T Scan is going to be 600.00 instead of 2,000.00. What a change, also the vet did say that yes there is some thinning of her jawbone and what looks to be an area of lysis infection but that it’s nothing as serious as I was playing out in my head, she’s not at risk of her jaw breaking or having multiple bone fragments etc… so I went ahead with being put on the referral list and Cornell will be giving me a call in the future to set up an appointment, we have probably a few months to help us financially as well, but we’re that much more closer. The specialist at Cornell my vet trusts very much and they are both in agreement a C-T is what’s needed to move forward here to find what is thought to be a foreign object causing this. They also informed me that mild ear infection change was noted on the x-ray prior to the x-rays she just had done. Also, Dana Krempels did reach back out to me. They said sorry about the difficult situation I am dealing with, jaw abscesses in rabbits are a dreaded condition and that they are about as easy to cure as cancer is. They wished they could tell me something more cheerful. They told me that in a case of this complexity, and if my vet is willing to get a second opinion, that they strongly recommended they contact a Dr. Loic Legendre, who is one of the most foremost experts in Rabbit Dentistry.  She sent me this link https://petdentist.ca/about-us/ and told me he will be the very best person to give me viable options for treatment.

[DanaNM]

That is excellent news about the CT scan, I hope you can get it soon and it gives you some more answers!

. . . 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.  

[Cassie119300]

Me too, Thank you <3

[LBJ10]

I’m glad you will be able to get a CT scan for a lot less. That will make it easier for you to decide what you want to do. I’m sorry if what I said earlier didn’t come off the right way. I only meant that sometimes these expensive tests and procedures aren’t worth it because they don’t change the outcome. If the treatment is the same regardless, then people will often opt not to do the expensive test.

Perhaps doing a combination of oral and injection would be good to try again. I don’t know how long she was on the penicillin/azithromycin regimen lasted last time, but maybe it wasn’t long enough.

[Cassie119300]

Me too it’s definitely a big game changer, no worries I was having the same sort of thoughts honestly, up until I talked to Budja’s Vet today and she was able to help me put to rest that things weren’t as extensive as I thought and she said it’s nowhere near having to think about a surgery for taking out pieces of bone etc… that’s what changed my mind overall in addition to the cost of the C-T being reduced. That and along with Budja’s overall quality of life right now in my mind, she’s eating perfectly normal, drinking perfectly fine, curious, inquisitive, wants affection and follows me all around all day long, so that also tells me I have to give her a good fighting chance at this. Not only that, we were successful at stopping the abscess from coming back after the first three times, it seems that last time when the abscess burst on its own and azithromycin was introduced long term that was the other big game changer, so I look at it this way, we have been successful in getting the abscess to stay away which that in itself is a huge accomplishment that it seems most people cannot even achieve alone and it was only ever that side of her face. We don’t know 100% that it will change a bad outcome from happening, but I do think we’ve got a real fighting chance here and since Budja’s has an overall great quality of life, I think it’s worth the shot. I totally understand that what seemed impossible yesterday has now become possible. I also was able to get a go fund me going and may or may not be able to receive some help from the ASPCA I will find out on Friday. Every little has been helping though. I also hope that through the vigilance taken on my vet’s part, Cornell’s part, my husband’s part, and everyone else who reads, replies, comments, and through what we have been able to accomplish in Budja’s treatment and further treatment, we may be able to not only save her life, but so many more lives in the process and find a way to treat such difficult things. I am actually going to ask my vet about that, because I’m also wondering if she should be on another antibiotic in the meantime for her ear, the Cornell vet actually was suggesting stopping her antibiotics to see if the abscess would reoccur again in general/if I was not going to be able to go ahead with the C-T scan, I was not comfortable in doing so though. The penicillin/azithromycin regime lasted at least 3 months, it was right before I had left for England to get married and had to discontinue. The Azithromycin has seemed to hold things pretty steady though because the last x-ray before the most recent one had also shown the mild infection in her ear as well and that was just before I had left to get married.  The Penicillin Injections in combination with Azithromycin do seem to be very helpful though in overall abscess treatment and seemed to be very effective for what bacteria had been cultured in the last abscess surgery she had, had. Fingers Crossed.

[Cassie119300]

Hello everyone, I just wanted to give an update as it has been a while since I last wrote. Budja’s is scheduled to go and see the vet at Cornell for October 12th to get an examination/CT possible on the same day and get a game plan together, we have just a little while left to go now.  Budja’s is currently still on the regime of Meloxicam once a day, Azithromycin once a day, and Benebac once a day. She continues to eat normally, drink normally, chew on her wood toys and eat a lot of hay. I give her Azithromycin to her on a small bowl of salad each night as that is the only way she will take it, and the meloxicam she takes via syringe willingly. I try not to give her any kind of new product/treats because if/when I do this seems to give her a bit of mushy poop. She also gets 2 pouchfuls of Free Choice Timothy Hay pellets by Sherwood mixed with oxbow’s garden variety select pellets each morning and night. I’m not sure if I had talked to everyone here about what felt like a smallish bubble lump on the edge of her jawbone cheek/ but this lump within the last month grew a little bigger and moved up to her cheek and moved closer near to her mouth area. It now seems that the bony dense tissue underneath her jaw, and the above hardened capsule/bubble on her cheek are in the same area. Rabbit abscesses are literally the weirdest things, at least in Budja’s case… the abscesses she has seemed to have crop up always start by shifting and moving to another area. I am crossing my fingers that it stays at the size it is until a resolution can be reached. Just to give an idea of the price range here when I spoke to this vet at Cornell directly, I was told for 950.00 we could get bloodwork done, examination, A C-T scan and maybe even a minor surgery. Thankfully my husband and I have managed to collect a little over that amount now with some hard work and determination. Budja’s enjoyed a lovely vacation with my husband and I while we submitted for my next visa. I have no idea what we are in for now, I just hope everything goes well and that we get some answers. I swear there is a piece of what feels like a sharp pointy bone at the end of her jaw where all of this stuff is going on. The problem is Budja’s likes to chew on any wood in sight and while I’ve done a very good job barricading off most of the furniture in this room and the trims of the walls…. She does continue to chomp on things she shouldn’t at times despite having willow chunk wood toys, vine balls, etc… you name it. She especially loves the willow baskets from Binky Bunny… Is it normal for my bunny to want to chew on everything in sight?? Also, has anyone ever had a bun that’s stomache was growling a lot? Budja’s stomache seems to be very loud and we just went through an episode where her poops were way larger than normal like a mega sized garbonzo. She’s always had varying sized poops though.

 

Thanks everyone!

[LBJ10]

Thank you for the update and good luck with your upcoming visit! When infection/disease is present in the bone, sometimes you will see some crazy bone remodeling/growth in response. I’m sorry it seems like the abscess is still moving around though.

Chewing could be a response to discomfort in the mouth. Will they be looking at her teeth too? I can’t imagine nothing has shifted with all the stuff going on. As for the poop… long term antibiotic use can do some weird things with poop. So I guess I wouldn’t be overly concerned as long as she is pooping OK (even if it’s a bit weird).

[Cassie119300]

Thank you! Yeah, that’s what I was thinking with the chewing, she has always been a big chewer though so it’s hard for me to tell, I bought her one of those willow vine baskets and she had the entire thing gone by the next day! I’m almost more than certain they will be doing a very thorough examination, if not I will definitely ask but Cornell is regarded as one of the best veterinary places in Upstate New York and for cases like this, certainly we will be getting an entire C-T of her head done. She definitely has had a lot of gas, and a bit of teeth grinding here and there but usually just when I’m up close to her can I hear it, what you say makes sense though, her appetite has been amazing despite it all. Fingers Crossed….

[Cassie119300]

Hey everyone, so from the X-ray that was taken of Budja’s jaw in July to the C-T scan they literally just did on her at Cornell (without contrast) It is showing advanced signs of disease. In her left jawbone, two teeth have pretty much disintegrated, two upper molars on the same side are showing some disease, as well as the upper right side are showing some mild disease. These two teeth that have disintegrated will need to come out, the vet said she will have to be aggressive with treating this and with the surgery and a small piece of bone that’s affected will need to come out as there is osteomyelitis and the jawbone has been affected.  A culture of the bacteria will also be done. They will be keeping her at Cornell for 5 days at the minimum and they will be leaving an open incision which antibiotics in gauze will be instilled into and will be flushed out. We talked about quality of life and how we will probably need to have a C-T done each year to keep on top of this, she expects good quality of life at least for a couple of years but it’s not known where this road will lead, but she is confident Budja’s will have a good quality of life after this procedure and assured me it’s not at the point where I should consider Euthanasia. She is in the operating room as we speak so it will be a few hours, but they will be calling me back with an update. Dana, I believe your bunny went through something similar, and yes… I do believe this has something to do with genetics. Budja’s is an English spot rabbit. Was the bunny you had with the same kind of teeth the same type of bunny?

[Cassie119300]

Budja’s in is recovery now and is doing good, the surgery went very well, she was under for a couple of hours. She had to have three teeth removed as well as the two abscessed areas on the same side. Some small bone bits around the jaw had to be removed as well. Her gums were sutured, and an antibiotic gel was put in, they said there was food/debris/pus beneath the teeth and through the abscessed areas. The hope is with the sutures not always able to stay so well in the gums, and with syringe feeding the first few days or more no food can get in and cause any secondary infection, fingers crossed! We will have to keep the incision near her jaw area open for at least a month. The good news as well is that her sore hocks are doing good, she does not have an ear infection, we will repeat a C-T scan most likely in another year.

[LBJ10]

I’m glad to hear things went well. Hopefully this will provide a turning point for Budja.

[DanaNM]

I agree, sending good vibes that things will start healing for her now!

. . . 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.  

[Cassie119300]

Thank you Dana! Budja’s is doing well, the hospital called me this morning and said that she has started to eat some hay on her own, her poops are still a little abnormal but that’s to be expected after a major operation and after being under for a few hours. She does have an ulcer on her eye from being under and whatnot too but that is also being treated and doing good. They did marsupalize the abscess capsules, as I don’t think it was an option to completely excise, she had capsules they had to open up. We are hopeful she will be able to come home by Monday or Tuesday but she is doing really good.

[Cassie119300]

Hello everyone, Budja’s came home on Monday and has been doing really well. She’s on quite a few medicines, and on eye drops with an eye lubrication for superficial ulcers on each eye from when she was under for surgery. Her marsupialization hole has been healing very rapidly already, I flush it twice a day with saline water and pack it with a gel. She is also on metronidazole, enrofloxacin, gabapentin, and meloxicam. She is back to her normal self, eating, drinking, pooping, peeing etc.. and has been enjoying lots of cuddles. We go for her re-check on Monday. She does have extensive dental disease which will need to be monitored and checked on every 6 months, with a periodic C-T recommended to make sure no new abscesses are cropping up.

[LBJ10]

That’s great! I’m glad to hear she is doing well!

[Cassie119300]

Hello everyone, providing an update. Budja’s two eye ulcer’s healed up fine. The next two subsequent re-checks were with another doctor which I wasn’t told was going to be with another doctor. The original doctor who did the surgery I expressed some concerns to them that budja’s was still doing some teeth chattering/grinding noises on and off which I could see her doing (grinding her teeth in a circular motion) but I couldn’t hear unless I got upclose to her, and she wasn’t eating her hay as well as she had been prior to the surgery, I was cutting up hay etc until I discovered I was starting to get hives pretty bad, not sure if it’s from the hay or not, but I’m controlling my hives still with antihistamines, as I just seem to break out with them every few days for no reason. Thankfully Budja’s has since gone back to her hay regularly and even seems to be eating longer strands now. I think what happened is at the first re check with the other vet, they went in and cleaned out her wound and when Budja’s came back it looked a bit bloodied, I was rather upset I had not even been told they were doing this, and she wasn’t sedated or anything that I know of, So I think she was pretty sore from this for a while. The original vet thought a sedation oral exam was needed to make sure the wound was not communicating with the mouth..etc, and despite me calling a lot with concerns etc and discussing what the inital vet recommended, this did  not happen at either appointment and this other vet said they looked in her mouth (without sedation) and everything looked fine and that nothing felt/looked swollen underneath her jaw ( it still continues to feel lumpy/bump underneath her jaw and Budja’s still seems to get flinchy/respond uncomfortably about that lumpy area underneath her jaw. It doesn’t feel as bad as it used to but I’m also not sure if anything has grown/changed since the surgery. At the last appointment this other vet literally just like blurted out “the abcess was in her bone, that feeling of lumpy/bumpy will be there forever, as it could not all be entirely removed (the capsule/all of the bone). I did not receive the discharge sheet which explains everything which the student who accompanies the vet at every appointment said would be emailed a day later. I had to call and ask again for this, I’ve been asking them a lot what is the long term prognosis, will this ever completely heal etc… “The hope is new tissue will formulate/healthy bone etc” Yet another second I was being told this lump like feeling will be there forever and to come back for a C-T in 2-3 months to asess any kind of changes when the prior veterinarian who did Budja’s surgery had told me a year, in a year to do the C-T and to do an exam in 6 months. I called and asked about one of Budja’s medications which is a weird one I’ve never even heard about as I read it can cause some dermal reactions to human skin, and asked if this stuff causes rashes? and I was advised they are not human doctor’s and to wear gloves. So that’s a bit scary. I was also charged 74.00 extra for more of this medicine that I will probably not be using as I need to give her it until the 23rd of this month and I have just completed a months worth of the Metradoniazole today, so that is no longer needed as well. So although they calculated the meds, they gave me way more and the initial vet’s response to this was “that’s annoying” but generally once you leave the building with the med it cannot be returned, even though I have never even opened the package. I had emailed more concerns/and called to let the staff know that I forwarded this email as I had quite a few questions. Instead after the inital vet had hardly been around to answer anything anymore, and ignored the last email she gets on the phone and got angry with me for her now having to answer questions on the phone when she was also at the same time looking at my email without me knowing that, or knowing I was going to be speaking with her directly and she even told me they should start charging me for this and that the whole email/call etc.. is getting rediculous that most of my questions can be answered by me looking at the  write up sheets after the appointments, and by me asking all the questions at the appointments. They even made sure to let me know I will be getting a very detailed sheet at my next appointment, as they agreed to look at her wound for me and do the sedation, they “squeezed me in” for my appointment with Budja’s tomorrow (it was scheduled last week). So I’ve been made to feel I should not be asking a lot of stuff and that I’m basically disrupting them when I explained the sedation never happened despite me talking to the other vet about it and they told me maybe it was because the other vet thought I couldn’t financially do it at this time? Like what? I never said I couldn’t, the initial surgery was agreed to be 1,000 as that’s all I could afford and I ended up paying more than that in the end, and at the re checks, but apart from the initial surgery I never once said I couldn’t do it because of the costs, just that I wanted to know the cost. So I have written things down for tomorrow for the student to pass on information wise to the vet, and that the vet and I discussed doing a sedated exam for tomorrow’s appointment etc… and all concerns and things to be answered. Even if I am asking the question such as Will it be possible to eradicate the ostemeyletis and remaining abcess/capsule in her bone over time? more than once, and if this isn’t possible is her condition going to worsen? Because at best the only answer I’ve been given is, it is uknown the long term outcome but it’s possible for the remaining capsule to go away without recurrance of abcess etc. I’m trying my damndest without trying to ask such long things etc… but it’s really hard right now because the marsupilization wound is not entire closed, even after I packed it for two weeks with cotton string etc, then stopped doing that as per the second vet’s advice to let it close and to continue to flush etc… two vet’s with differing advice, and if it weren’t for me asking for the next discharge sheet I wouldn’t have even known when I was supposed to be stopping Budja’s medications. Add to this the stress of me returning to england mid January and having to schedule everything for my visits back to the USA for Budja’s. It’s all crazy, so I’m hoping tomorrow we can get to the bottom of why her marsupilzation wound is not entirely closing still, whether or not her enlarged looking eye is from the one infected tooth they couldn’t remove during her surgery as it was risky, they couldn’t tell if her jaw was too lax and/or were afraid of her jaw fracturing trying to get it out, but the tooth still seemed firmly in place, they injected the tooth somehow with doxycycline gel and left it there, but on the CT it did show there was a little pocket behind the tooth, so I’m concerned something weird is happening there. The original vet also told me that once teeth are removed the opposing top teeth will stop growing? I’m pretty sure everything else I’ve read says the opposite. So it’s all confusing and conflicting. If her condition worsens though, if they say all of these things cannot be eradicated entirely, and they don’t know, I’m making it clear that I don’t want her surffering or put her through anything that is only going to pro long her life with the outcome being the same. No doubt they are probably going to get upset about the whole paper I’ve written up explaining my concerns, even if I do have a lot of concerns, how am I at fault here for wanting them answered and “annoying them” when I didn’t even know they were not going to be at her follow ups which I explained was confusing to me and also I was confused why the other vet refused to do the sedations if the original vet was recommending them still. Then it was explained they are only there two weeks on and off. I’m also asking tomorrow, whether Budja’s should be on some sort of long term pain regime, because although she is eating and pooping and peeing fine it is also because I’m still giving her gabapentin twice a day, I don’t know how she will be without it yet. The other vet was of the opinion she didn’t need any pain meds before even after they had cleaned out her wound and it looked bloodied, though on paper they said it was iodine. Right. So I’m also going to ask, what kind of pain medicine regime should she be on and I’ll explain that I’ve heard it can be very painful for bunnies so I don’t want her in any pain. She also goes crazy still when I give her, her pain meds, or gets up on her kennel sometimes as if waiting for it, I can read my bunnies mind, but I would think she’s telling me, Hey I want some of that pain medicine.

 

 

[Cassie119300]

 

Budja’s marsupialization area is taking longer than expected to close and heal, last Tuesday they opened it up a little further and stitched around it, I continue to flush it twice a day. Has anyone ever encountered bone when flushing a jaw abscess area? There is now thick brown bone in the actual marsupialization hole that I can hardly even flush around, unfortunately this is emitting pus which now makes sense why I was seeing some pus before the area was opened up more last Tuesday. I’m continuing to flush it as best as I can meanwhile waiting for a callback/some advice from the veterinarian’s her next appointment to get her sutures removed isn’t until the 30th next Thursday…. I’m literally just dealing with the unknown and continuing to put wound gel on it after the flushing. I think 1. This brown bone that looks like it’s pushing itself, is going to end up pushing itself out…. or b. this thing is unfortunately going to fester until I can get her in, and hopefully I get a call back so I can get her in sooner.

 

[Cassie119300]

Hello everyone, I have not updated this in a while now.  The brown material I had previously reported on was actually old antibiotic gel that was pushing its way out of the remaining pocket area and once this had finished happening, the wound healed properly thereafter. Budja’s has been doing wonderful, has a great appetite, and is binkying almost daily. She has been antibiotic free for the last 4 months now. Budja’s will go back to Cornell for her recommended spay surgery with a combined C-T re-check next month to see how everything is doing in her jaw. The marsupialization surgery on her jaw abscess, having the three affected teeth removed, and the antibiotics metronidazole as well as vanomycin she took after surgery, have provided great results so far in treating not just her jaw abscess but also the osteomyelitis that had been affecting that area of her jaw. We have also estimated Budja’s to be about 3 years old and 6 months to date. Hoping this thread will be of help to others. I will leave another update soon.

[DanaNM]

That’s wonderful news!!! Thank you for the update!

. . . 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.  

[Bam]

Thank you for the update! This is wonderful news!

[LBJ10]

I’m glad to hear Budja is doing better! Thank you for the update!

[Cassie119300]

Thank you everyone!

[Cassie119300]

Hello everyone, I just wanted to provide some updates on Budja’s. She had her C-T and routine bloodwork done on 5/28 followed by her Spay Procedure on 5/29. She has recovered exceptionally well from her Spay Procedure, she seemed a little more sleepier than usual the first couple of days with small poops which gradually increased but her poops have been a little weird since the spay, they have been all different sizes, moist, and I think she is leaving what is called “Cecal Juice” on her mat at night ever since, her stomach also makes growling noises at times, this isn’t the first time she has had growling noises but generally I don’t see small poops mixed in with the others. Every year she also gets flaky scales and fur that kind of falls off her ears, I don’t think it’s mites but she is scratching her ears/jaw/and eye areas a lot, I would think if there was any ear issues the C-T would have picked it up. Here are some pictures of what I’m seeing.

View post on imgur.com

 

The C-T findings were as follows, it was done without contrast.

” Diagnostics 5/28:
PCV/TS: 45/6.5 – Within normal limits
Chemistry: Within normal limits
Head CT: Below is the CT report from our radiologists:
SUMMARY OF FINDINGS:
Mildly improved (since 10/12/23), locally extensive, expansile bone lesion
(historic, presumed tooth root abscess), left mandible with new mineralized bodies
Mildly overgrown, 206 and 207 [teeth]
Mild, dental points, left maxillary and mandibular cheek teeth
IMPRESSION: The appearance of the left mandibular tooth root abscess
demonstrates some signs of healing with improved mineralization of the lingual margins,
however persistent lysis buccally may be due to persistent infection and drainage.
The new mineralization is prioritized to be mineralization associated with
retained tooth root buds; a sequestrum is possible.

 

Tomorrow I will be dropping Budja’s off for her second marsupialization procedure as the abscess is still present. I myself, have found pus leaking from time to time from the old marsupialization wound, so I don’t think it ever 100% properly closed, there is also a weird marble feeling bump in-between the area of her eye and nose almost directly above the old marsupialization area. I went down the rabbit hole so to speak with her C-T findings looking up the term on google “locally extensive, expansible bone lesion” which led me to the result of osteosarcoma in rabbit jaws, needless to say I’m pretty anxious right now and wanting to ask the veterinarian about this being a possibility, although I would think if it was they would have told me so already but the panic from reading this and just about Budja’s having another surgery in general really sucks right now. She will be staying a few days again with a drop off of 2:45 pm tomorrow at Cornell. I will be going in with a list of questions. Fingers crossed.

 

[Cassie119300]

Hello, I got a call earlier on today and spoke with the Budja’s Doctor, She recovered well from her second abscess surgery and I was told that the previously infected tooth that was removed at her last abscess surgery had indeed grown back again and was infected again, so it had to be removed a second time. They cleaned everything very throughougly down to her jaw bone and I will have to flush the marsupialization wound out again for about a month. Scratching my head as to how it even grew back, she is still continuing to have the abnormal shaped megacolon like poop, they will be looking at the cecal stain under a microscope to rule out any bacteria, they have recommended Sherwood’s digestive tablets to me for her poop. She has had the large poops before but the fecal staining and small poops and large oval poops mixed in with regular but all kind of moist feeling poops have been on going since her spay. They did have her on some kind of sulfa antibiotic drugs for two days when she had her spay as a preventative but I do wonder what is stressing out her poor gut so much.

[LBJ10]

Aww, poor thing. I’m sorry she had a setback. I don’t think it’s unheard of for a tooth to grow back. If enough root cells are left behind, then there would be the possibility.

[Cassie119300]

I know it, I feel so bad for all she has been through already, she needs a break. Yeah that is what the veterinarian was pretty much saying to me. Budja’s has been back at home for 3 days now, she has a re-check coming up this Friday. I am currently giving her injectable penicillin for 21 days and we are waiting on the results of the bacteria culture. I flush her marsupialization wound out 2x a day with iodine sterile saline and instill a hydrogel/silver sulfadiazine cream. She also needs eye gel/antibiotic drops for 1 superficial ulcer on her eye, hands are quite full right now! She is also on meloxicam and gabapentin should be arriving in the mail shortly, unfortunately they forgot to give that to me at the hospital but they said she should be fine without it either way. She has been eating and drinking great and her poops are almost back to normal. It’s crazy how fast this marsupialization pocket is trying to heal up already though. I also bought her the Sherwood Digestive Support tabs in case her mega colon like poops start up again as recommended by the vet. I am still skeptical of a few of the ingredients and was speaking with someone from Sherwood but still a bit unsure. I also got her a mixture of orchard grass/western timothy hay from oxbow as I wait for the Small pet select second cut timothy hay to come in the mail, very soon! She has already tried to start chewing on some wood/cardboard and continues to amaze me with her fast recovery.

[DanaNM]

I’m glad to hear she is recovering well! What a trooper!

. . . 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.  

[Cassie119300]

Thank you!  I just wanted to update this thread.

Budja’s just recently had another CT done (this time with contrast) I was told they weren’t too sure what was going on last time due to the lack of contrast, so they decided this time to go ahead with it. Everything on the CT looked good and the lower bottom jaw does appear to be healing and gaining more bone (yay), however two of her upper top teeth were slightly overgrown and were getting closer to her outer cheek (not yay) and I was told the two teeth were “wiggly”. I know that’s really not so good news, and I’m not really sure what wiggly teeth are a sign of. I have also noticed a noticeable size difference underneath the eye bone area on her original affected jaw side. I can’t tell if it’s changed or not, but I do think it the past I had to press in a little to find the type of marble bone feeling, now it may be a little bigger, yet no abscess was detected on the CT. I was told we will have to monitor her carefully over the next 8 months which is when they want to repeat her CT scan again, probably with contrast again as well, to make sure an infection doesn’t occur in these two teeth. These teeth are also the opposing teeth where the bottom three were removed. Overall she still seems to eat her hay pretty well but she does seem to avoid the longer stick like pieces, I can’t tell if it’s just been because the hay batches are changing and there’s some brown in them here or there, but she will literally burrow out a hole in her hay box no matter how good the hay is that I put in and ignore the rest. She doesn’t seem to be dropping food out of her mouth as much anymore, just occasionally little bits of greens or pieces of hay she doesn’t want to eat the entire stem of. She is drinking well, and occasionally seems to pee on her nice cotton pad I got her? Not very regularly but I’m keeping an eye on that. She has started chewing on some wooden pieces again too, like my desk, her apple sticks which she doesn’t normally care for or bother with, she always loves the willow baskets from binky bunny though. She doesn’t appear to be having difficulty with urination. She does still have the occasional odd small poo’s but there are times she gets really anxious as well if she hears the littlest noise. She is continuing to binky and act overall happy though. I was told she will always have dental disease and need to be monitored. Overall though her original surgery did seem to have very good results for her osteomyelitis combined with the use of the antibiotic vancomycin.

 

[LBJ10]

I so happy to hear Budja is still doing well. It’s no surprise that you would start to see problems with the opposing teeth since some were removed. Hopefully they can keep that in check.

[BrunosMama]

Hello!

It sounds like you and Budja have been though a lot! I’m so glad to hear she is doing well despite all the health problems.

I know caring for a sick bun can be hard on both the bun and their bunparent, so I hope you have been doing well, too! 🙂

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