# Long-term hock abscess



## rabbit_friend (Nov 3, 2010)

*The bunny:* spayed female, 5 years old, 10 pounds, black/brown, found as a stray when approx 6 mos old. Eats a mix of pellets, two big salads a day, oat hay and orchard grass. Drinks only dilute apple juice. Looks healthy, sleek glossy coat that all vets have commented on. Lost her female bondmate 3 years ago (probably to e.c.) Now bonded with a 6 pound male who takes good care of her. Never been sick, though had high pasteurella titer two years ago. Xrays show some spondylosis and hip arthritis. 
*
The problem:* Trouble hopping and wasn't using litterbox. Discovered ulcerated left hock in late January. Vet said it looked like it was healing, prescribed soaks and metacam. Pink, almost completely closed skin by late May, noticed swelling, squeezed, and out came some thick white pus. Went to new vet who insisted on reopening it to clean and culture. Wound would not heal, back to first vet again, and now wound is closed again but still looks somewhat swollen and inflamed. 

*Tests run:* 
*March:* basic blood panel, normal
*June: *culture (included part of abscess wall) showed only staph aureus, susceptible to nearly everything. Xray showed no bone involvement. 
*August:* xray, no bone involvement 
*late Oct:* culture (needle aspiration), showed only methicillin resistant staph schleiferi (subsp schleiferi) 

*Treatments tried:* 
*Feb - May*: two weeks of metacam .75 ml/day, then only as needed, with epsom salt soaks and Healx Soother Plus till ulcer almost completely closed. No abx. 
*June *(after infected and reopened): one month baytril 50 mg/day oral concurrent with chlorhexadine flushes and silver sulfadiazine cream. 
*July*: one month SMZ/TMP 120 mg 2x/day oral, switched from chlorhexadine to Vetericyn to flush halfway through. 
*August:* back to baytril (same dose as before). *
Sept:* pulsing baytril on and off weekly per vet's instructions (though mostly I kept her on since hock got inflamed when off). *
past Friday:* after culture, started on tetracycline 250 mg every 12 hours.
Benebac gel (1 g) given once or twice weekly since mid-July, every other day since starting tetracycline. Fluids given two days ago. Metacam last night.

*Other symptoms:*
Red rash on ears, worse on right ear, developed 2-3 weeks into baytril in June. Vet thought allergy, maybe to baytril, but when off baytril it would often get worse. Cleared when I upped the baytril to .75 mg/day for a week, came back with lower dose. Cleared after first dose of tetracycline, back now. 
In mid-August, the other hock (right) developed a small hard bump on the bony point, almost like a red bony protuberance. Xray showed no bone infection. Vet did not know what it was. Was a small pink bare spot prior to that.

*Concerns:*
-liver and kidney health after 5 months on abx (adding milk thistle a good idea?)
-risk of enteritis/clostridium overgrowth on tetracycline
-calcium in GI tract inactivating tetracycline (Frances Harcourt Brown)
-decreased number of antibiotics now available after resistance developed
-anaerobic bacteria, or others not cultured
-latest culture report returned after only 2 days -- doesn't seem enough time to grow all that might be in there 
-10 days of tetracycline enough?
-so far tetracycline doesn't seem to be doing anything. Hock red and inflamed.
-appetite suppression: hardly any appetite yesterday and isn't eating/drinking anything sweet. Still munching hay and some greens. I know this is common 48-72 hours after starting abx though. Gave more benebac last night. Appetite improved some this evening. 
-hot/cold ears. They seem to be alternately on fire and then ice cold. She seems to be cold at times, hunched up. Loved being wrapped in warm towel from dryer. Have taken temp a few times over the last few days and seems steady at 100.5. Seems to have some difficulty regulating body temperature though (due to not eating much?).

I've read many (all?) of Randy's posts about abscesses with great interest. Especially interested to read that pasteurella rarely shows up on culture, since that is what I suspected in June. I mentioned bicillin to the vet in June. When culture came back staph, he said "good thing we didn't try the penicillin since it wouldn't have worked on the staph." I said I had heard from others that their vets prescribed bicillin in addition to baytril in the assumption that anaerobic bacteria were present (which he admitted would not be cultured), but he said hock abscesses rarely involved anaerobic bacteria and that they were mostly found in facial abscesses. Didn't want to subject my girl to anything unnecessary, so dropped the bicillin subject. Now I wonder if we should have tried it, and whether it would help now. Also wonder if the MRSS is the prime culprit, or just one of those "tagalong" bacteria Randy has posted about. 

Sorry about the length -- I wanted to include as many details as possible. Any advice or comments highly appreciated. If you've made it this far, thanks for reading!

Petra


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## tonyshuman (Nov 3, 2010)

This is a serious issue and I wanted to let you know I'm taking it seriously, but for that reason I can't respond yet--I need to do some research.

I want to throw out a few quick suggestions to see if you've considered them: the antibiotics chloramphenicol and Convenia? If it was susceptible to Baytril, Convenia may be a good choice as it is a newer version of the compound in Baytril.


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## fuzz16 (Nov 3, 2010)

i cant add a lot of help to this, but i hope she gets better. 

best thing to do though is keep it as clean as possible...i have mrsa, dont know how it compares to mrss. but i have to use an anti bacterial soap twice a day and it still comes up now and then.

clean her cage as muh as possible daily, make her take plenty of fluids.


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## rabbit_friend (Nov 3, 2010)

Thanks fuzz16 -- sorry to hear you have mrsa. I've done a lot of reading about it in the last week, and it seems hard to beat. It's the staph aureus species, while mrss is the staph schleiferi. Unfortunately, she doesn't drink much, but I have given her subQ fluids twice in the last few days. I'll have to try antibacterial cleansers. Since it was found inside the abscess I didn't think about cleaning the outside since the skin isn't broken, but it may help her ear rash.


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## rabbit_friend (Nov 3, 2010)

Thanks Tonyshuman -- I'm glad to hear someone as knowledgeable as you is looking into it! This is unfortunately now resistant to baytril and a lot of the usual abx, including the Zeniquin that Randy speaks highly of. But it did come up sensitive to chloramphenicol, and I'm wondering after reading some studies if that wouldn't have been a better choice than tetracycline. I am worried about the bone marrow suppression and other side effects of that though. What experience do you have with the chloramphenicol?


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## rabbit_friend (Nov 3, 2010)

She had a bad day yesterday, wouldn't eat or drink most of the day. Midnight munched some salad and had full appetite this morning, so I'm relieved a bit. Gave more fluids today warmed to body temp since she was very cold - wrapped her in warm towel till her ears were warm and she was contentedly chattering. 

For the record, here are the drugs tested for this staph infection:

resistant: ampicillin, clavamox, cephalothin, methacillin, enrofloxacin, trimethoprim/sulfa, marbofloxacin

susceptible: chloramphenicol, clindamycin, erythromycin, gentamicin, neomycin, tetracycline

In June, the only resistance was to ampicillin :-(


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## tonyshuman (Nov 4, 2010)

What I'm finding is that S. schleiferi is really rare, but can be susceptible to penicillin.

Based on the resistance/susceptible data you showed, I think a course of chloramphenicol and azithromycin would be a good idea. The resistant drugs are the beta-lactams (ampicillin, methicillin, clavamox, cephalothin), the fluoroquinolones (enrofloxacin=Baytril, marbofloxacin), and sulfa drugs (trimethoprim/sulfa). For this reason, something like Bicillin (penicillin G procaine/benzathine) or ciprofloxacin won't help. Convenia (cefovecin) also has a related mode of action to the the beta-lactams, so it probably won't help either, and Zeniquin is a fluoroquinolone so it too may not be helpful.

I think trying some of the other classes of antibiotics will help. The ones that it is susceptible to act on a different cell pathway to kill the antibiotics--they are protein synthesis inhibitors as opposed to compounds that destroy the bacterial cell wall (like beta-lactams). 

At the bottom of this page there's a really helpful table of different types of antibiotics
http://en.wikipedia.org/wiki/Macrolide

Choosing from different categories is a good idea. I think chloramphenicol and azithromycin is a good idea.

They are both on the safe list for rabbits:
http://www.medirabbit.com/Safe_medication/Antibiotics/Safe_antibiotics.htm

(these are the unsafe antibiotics for rabbits)
http://www.medirabbit.com/Unsafe_medication/dangerous_antibiotics.htm

With chloramphenicol, the bone marrow issue can be avoided by you not handling it directly (wearing gloves). I have not heard of it causing issues in the rabbits it is administered to.

Tetracycline may be one of the susceptible antibiotics, but it is usually not dosed correctly for rabbits and does cause more harm to the GI bacteria than other antibiotics.

About the ears--was she really hot on those days? I wonder if it's a result of trying to lose some body heat by pumping extra blood into the ears? It may be good to give her aspirin to help reduce the fever so she doesn't have the hot/cold alternating episodes, and maybe it will reduce the rash.

I do think there may be anaerobic bacteria in there too, but you will have to start with the bacteria you can find and hope that treating that will take care of the anaerobes as well.

A topical ointment may help too, including on the other hock. I use bag balm a lot on sore (non-infected) hocks, and neomycin is an ingredient in triple antibiotic ointments like neosporin. Another really good topical antibiotic is Silvadine cream. Using a topical one might help a little at least.

You can give the Bene-Bac 1g daily if she's not eating well. Another product some people like to stimulate appetite in rabbits is Nutri-Cal. It's made for carnivores, not rabbits, but it does contain B vitamins that can stimulate appetite and it has a lot of calories.

Is there any chance you might be able to find a vet specialist in bacterial infections? It's clear that your vet is doing the right things, but a consult at a nearby veterinary school may be helpful.


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## rabbit_friend (Nov 4, 2010)

Here's an interesting article about s. schleiferi in pets I ran across while researching:
http://www.wormsandgermsblog.com/20...nresistant-staphylococcus-schleiferi-in-pets/

That's a great chart on the Wikipedia page -- very helpul! One thing I'm confused about: since erythromycin is unsafe for bunnies, how is it that azithromycin is safe? Just curious. I see it can cause diarrhea. Unfortunately, it wasn't tested on the C&S, but I agree it might work since it's in the same class as erythromycin.

The Zeniquin was on the resistant list (marbofloxacin). I was sorry to see that because I was excited about Randy's successes with it.

I didn't know the bone marrow suppression with chloramphenicol was only for the human. I was going by the chart in "When Your Rabbit Needs Special Care" where it was listed as a side effect for the rabbit. 

The tetracycline is being dosed at the recommended doses I've seen (50 mg/kg every 8-12 hrs) -- do vets go above that for abscesses? I wouldn't want to risk that given what I've seen at this dose. 

I've taken her temperature when her ears are hot and flushed, and she hasn't had a fever. But she does feel hot at the back of the neck too. I have given metacam a few times when the ears seemed really inflamed -- wouldn't that reduce a fever too? 

I still have some silver sulfadiazine cream(same as Silvadene, I think) that I put on it when it was more open. Given the new culture, it's a good idea to go back to it. I've been using topical creams, but only calendula gel or Healx soother since the wound has been closed. The ears are a much larger surface area, and licked by her partner a lot, so I would worry about using it there. Bag balm didn't seem to help as much as the Healx or calendula. 

I'll check into the Nutri-Cal. Closest vet schools are 2 hours away, so a trip would stress her too much, but a consult is a good idea. Wish he'd done one 5 months ago! 

About the azithromycin and chloramphenicol -- I see they can both be given orally once a day. Should one be given in the morning and the other in the evening then? And just keep giving it till the abscess is gone, plus some extra? I see they both have good penetration and the azithromycin gets a lot of anaerobes too. Seems like a good call. Could I switch immediately from the tetracycline or have to wait (or finish the 10-day course)? 

Thanks for your time!


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## fuzz16 (Nov 4, 2010)

why wont they do penacilin...just wondering because dogs wit mrsa get penacilin to help clear it up. and the infection is on the skin forever pretty much, how it was explained to me. and on anything you touch.
when it gets in the bloodstream theres nothing you can do which is whystaph an be so dangerous. not eating could mean she isnt feeling well. are her ears hot at all? 

put some anti bacterial on her hock maybe and wrap it with something. will be hard to get her not to chew on it...but its an idea to try to keep the area clean


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## PixieStixxxx (Nov 4, 2010)

When I picked up my stray Uvic bunny.. she had two mass abscesses hanging off her right hind ankle. Xrays showed it had seeped into the bone. At the time, the option was to amputate.. but my vet wanted to try and save her leg.

He had told me a combination of penecillian injections + zithromax oral antibiotics has proved to go inside the bone and kill a staph infection. After one month, the abscesses shrank an enormous amount. Then I had cold laser therapy done on the leg, but I don't know if that played a role in the abscess shrinkage.. the therapy was for the fact that the hock was fused together and it was to stimulate break down of the damaged bone cells. She can move her ankle now thanks to cold laser therapy.

So I continued the injections and antibiotics and the abscesses are so small that when we went to do a FNA, we werent able to draw any pus out. So I'm just going to continue until both abscesses are gone.. they're about the size of my pinky. And I used to be able to hold these abscesses in my hands. She doesn't need a leg amputation anymore =]


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## rabbit_friend (Nov 4, 2010)

Fuzz16 -- she's not eating just since the tetracycline, and that's a known side effect and mostly just the third day. Her appetite is getting better and she's eaten pretty much salad today (yay). Her ears are hot sometimes, cold sometimes. May just be the antibiotic messing her thermostat up. She's feeling better this evening -- just did a bunny flop beside me as I write this.

I haven't seen any stories about penicillin with dogs, but as Tonyshuman pointed out, it's in the same class as methicillin so probably wouldn't do more than maybe control it a bit. I did see some interesting stories about Zeniquin and other abx in German Shepherds:
http://www.germanshepherds.com/forum/health-issues/98156-staph-infection-mrsa.html

What you say about the "bug" getting on anything you touch worries me, since my bunny is free roam and so that would mean it's on the carpet everywhere with no way to sanitize, and she'll just keep getting it (and maybe my others too). 

I've put antibacterial cream on it today. I'll try a bandage, but she doesn't leave those on for long  I feel like I clean her litterbox constantly, but she also licks it so that helps keep it cleaner.


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## rabbit_friend (Nov 5, 2010)

PixieStixxxx -- what an inspiring story, and what a great vet you have! I wish I had someone that dedicated and knowledgeable in my area. Luckily, my bunny's abscess isn't nearly that large. 

I would like to try the Zithromax - sounds like a good antibiotic. Never heard of the cold laser therapy -- sounds cutting edge. How long have you had her on the injections and Zithromax, and how has she tolerated those? And did your original culture show sensitivity to penicillin? 

Hope your success continues and she gets completely cured. You're a very dedicated bunny mom!


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## rabbit_friend (Nov 5, 2010)

She just ate another big salad, and had a lot of poos -- first large batch I've seen in several days. Very elongated and some dried out while others soft, but it's good to see her pooping again. Maybe her system is getting more used to the tetracycline. The abscess seemed to be getting larger the first few days, but now seems back to where it was while on the baytril. Maybe it'll start getting smaller now (I hope).


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## rabbit_friend (Nov 5, 2010)

Fuzz16, I meant to ask -- has anyone mentioned microcyn (human form) or Vetericyn to you? Seems to do wonders with skin infections and other problems, and is supposedly effective in reducing bacterial colonies including mrsa. I used it on my bunny's abscess when I was flushing it and it seemed to work well with no irritation. May get some more and try cleaning her ears with it, though it's expensive stuff.


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## tonyshuman (Nov 5, 2010)

There should be improvement on any antibiotic within 3-4 days of starting it. If there's improvement, it should be taken for 14 days or as long as symptoms persist (with an upper limit being considered if it's been 28 days or something).

I would stick with the tetracycline since you have seen some improvement and take it to at least 14 days. You can add the chloramphenicol but it might be better to wait to see if the tetracycline finishes off the infection. Zithromax does have some GI side effects, althouhg I think they're less than tetracycline, so if she's gotten acclimated to tetra, stick with it.

Probiotics should be given 1hr before or 2 hrs after an antibiotic dose.

If she fusses with the wound a lot you can make a sock out of a cotton glove finger, and have it kept on by an elastic band (not too tightly). Angieluv did this for some bad hocks--you could PM her to ask about it.

The Silvadine is good stuff. I'm not sure what is going on with her ears. Is there a chance it might be mites? The stress on her system could allow other common diseases to come up. I am really stumped about the ears. Yes, meloxicam (metacam) should bring down a fever too--it's a lot like ibuprofen.


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## Pipp (Nov 5, 2010)

I think its common for the rabbit to go off food and look miserable for the first 24 to 48 hours on antibiotics but I agree that the infection should start healing.Â  And my vet says to give the pro-biotic 3 hours after the antibiotic, but I'd prefer one hour before, didn't know that was an option.Â  Good to know.

What's her weight like?Â  The diet sounds like it could be packing on some pounds.Â  She may not appear obese, but the fat gathers under the skin and around the organs.Â  Given the other problems as well as the sore hocks, sounds like she'd do better at a lighter weight.Â Â  Healthier for her organs, too. 

What's the flooring?Â  Certain kinds of carpet and other flooring can be really tough on the feet.Â  

My mini-rex went through a similar regime, at least in terms of a mildly ulcerated hock that caused me great concern.Â  I had surgery done on it while he was under for his neuter and he was put on betadine, ointment, chlor palm and penicillin shots regime.Â  He almost stopped eating (this guy is a food shark, he'd eat with his last breath), and he was miserable.Â  

The cure was looking worse than the problem.Â  It wasn't in the bone and although there was a pus pocket and a bit of an open wound, it didn't look life threatening, and I honestly couldn't say the same for the treatment.Â  So I stopped.Â  He perked up and I never had a problem with him again.Â  The foot cleared up nicely on its own.Â  Sometimes it comes back, but it clears up with no treatment.Â  

I had put rock mats down over the parts of the carpet he was using as a launching point for jumping onto his second level, which I'm sure helped a lot. 

I'm really wondering if sometimes our treatments are overkill. We're conditioned to panic when we see bunny abscesses, and nobody wants to test a theory with under-treating and ending up with infection in the bone, so its a tough call, but I'd like to hear more experiences.Â Â  

With the opportunistic nature of these pathogens, I keep thinking the stress of grabbing, clutching, poking, cleaning and medicating twice daily has to be detrimental.Â  

Regardless, I'd like to see a bit more emphasis on giving the rabbits' natural immune systems a chance to work, making positive changes to the environment and diet, reducing stress, etc., and not just blasting them with chemicals.Â Â  I'm not sure how to boost an immune system beyond the obvious, but its something I'd like to look into. 

sasÂ  :clover:


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## rabbit_friend (Nov 5, 2010)

Tonyshuman, she does seem to be acclimating to the tetra -- she's eating up a storm this morning and she was drinking a lot of the dilute apple juice. Still avoiding her apple and carrot bits -- seems to know that sugar isn't good for her tummy right now! I also haven't seen her eating pellets in the last 5 days, but gave her some pellet mush last night and she ate some of that. The abscess does look some better, though it took 5 days to respond at all, which worries me. 

She doesn't fuss with it, as it's not an open wound. Just licks it occasionally to clean it. It's only about 1/2 inch in diameter, but has looked like fluid (pus) collected under surface rather than solid flesh underneath. I'll see if I can get some pictures. I have some from earlier stages, so it would be good to compare. The glove finger might be good just to keep it clean and prevent any abrasion, though I'd worry about it getting wet with urine.

My thought after reading about MRSA rashes is that her ear rash is similar to that and caused by the bacteria. A red bumpy itchy rash is the first symptom they look for in MRSA from what I've read, and they've had to educate doctors to look for it and think possible MRSA, so I'm sure no vet (at least around here) would look at it and think MRSS. But the sites I've seen about dogs with MRSA talk about itchy rashes that were mistaken for allergies. No sign of mites. Vet took a swab of ear and looked under microscope and didn't see anything. It does seem to be getting better on the tetra -- it hasn't been flaming red since two days ago. That's been the pattern in the past -- rash gets worse first 3-4 days on a new antibiotic, then gets better. Weird. I'm going to try cleaning them with a pad soaked in Vetericyn -- should reduce any bacterial colonization on the skin if that's what it is. I've seen bleach water soaks recommended for MRSA patients for that purpose. 

I'll phone and get a refill -- I only have enough for 10 days right now. As slow as it was to respond, I'd like to go 20-28 days actually, if you say it can be given that long. 

I've been giving probiotics about midway between doses, 6 hours before or after. I figure that gives the little buggers the best chance to survive. I've never really understood about giving it just an hour before -- seems like the antibiotic would immediately kill them off before they could proliferate. But I have seen that mentioned in other places.


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## rabbit_friend (Nov 5, 2010)

Pipp -- you make some excellent points, but first I'll address the questions about my bunny. 

Her weight is actually a bit lower now than I'd like after 11 months of dealing with this hock. She was overweight and on a hard indoor-outdoor carpet at the start, which I'm sure is what caused the problem to begin with (in conjunction with some spondylosis of the spine which shifted her weight from toes to hocks). After discovering it, I moved her to a room with softer carpet with underpadding and put down lots of soft cotton rugs. What do you mean by rock mats -- those shower/bath mats with the pebbles on them? Can he get a grip on that?

My vet, fortunately (or maybe unfortunately in some cases), believes very much in letting the natural immune system work. That's why he didn't give antibiotics the first four months even though she had an open cratered hock wound with crustiness. I did epsom salt soaks to remove the crustiness and dead tissue and he said her licking it to keep it clean was the best thing for it. There wasn't any pus, and there were no pockets. It granulated and started filling in and the skin started growing over. I do think now that if he'd given antibiotics during the time when it was closing up and she couldn't get in to clean it any more, it would have healed fine (5 months ago). That was a case of undertreatment, in my opinion.

When it did become infected, I think just trying the antibiotics first would have been the right treatment, but the second vet we went to insisted on doing the same as yours -- "surgery" to clean it out and culture it. The "textbook" approach. But I think surgery on a hock is a mistake. There's always weight on the wound, it's hard to keep clean without bandaging, it's too close to tendons and bone. My first vet wouldn't do it for all those reasons. I allowed the second vet to do it with grave misgivings, and it was a huge mistake. Then on top of that, he prescribed chlorhexadine flushes that I think just ate up any healing tissue and destroyed the wound bed. All of that was definitely overkill, and has cost us 5 months (and more to come) and heaps of dollars and time. Not to mention the pain for my bunny. 

But then prescribing baytril at 50 mg/day was undertreatment again. I think that's what is recommended every 12 hours. Plus I've read an interview about resistant staph in pets, and the comment was that staph becomes resistant to baytril very quickly (and we had staph aureus in the initial culture). My theory is that it only took 2 weeks, since that's when that ear rash started appearing that I attribute to the resistant staph. So starting with a better drug might have wiped it out quickly while it was still susceptible.

My first vet believes in letting the immune system handle many things. One of my bunnies has been in a fight three times and gotten three wounds, and I trusted the vet when he said she didn't need antibiotics. One was a very nasty hole in her paw that did get some pus. Everyone on a list I posted to at the time was urging me to get her on antibiotics. The vet said leave it open and let her clean it. No flushing, no abx. And she did clean it out thoroughly more times a day than I could, and it healed fine. So did the other two wounds. But these were all open and not abscessed. In fact, when the skin healed over on the foot wound and I saw a yellowish spot that looked like pus underneath, she broke it open and cleaned it out. 

I still remember an episode of Meerkat Manor which I found while channel surfing and thought "what a neat program." One of the meerkats got a scratch on his face in a fight. A minor scratch, but it got infected, and he couldn't reach it to clean it. They followed him around with the cameras apparently until he died of the infection. I haven't watched it since then. I was so mad, though I know that's nature. Animals don't always miraculously heal themselves. So I'm glad for antibiotics and all that, but not glad for vets (or doctors) who want to jump in with the entire arsenal for everything.

The treatments twice a day were stressful at the beginning, but we found some less stressful ways of doing things and I think she actually started enjoying all the attention. But she is a big, laid-back bunny. If I'd had to do that with one of my dwarves, I don't think he would have survived. The stress would have killed him outright or really compromised his immune system. So I think it depends on the bunny. And also on developing some less stressful techniques, like:
1. I never grab her -- I put the carrier in front of her and gently urge her into it. Much less stressful than grabbing and picking up.
2. Everything is warm and ready -- meds, rinse water, towels.
3. At first I was trying to lift her hind leg to work on the hock, or trying to turn her on her back, and she was struggling against me. Then we found a way to just gently stretch her out with her hind end twisted like she lays on the ground. She would lie there for 30 minutes while I cleaned the hock and only jump if I hurt her a lot or she needed a potty break.
4. I give meds only with a 1 ml syringe. Anything bigger she really hated, and this is easy to slip in the corner of her mouth and I don't worry about squirting too much at one time.
5. Lots of massage and petting time afterwards. I think she actually was calmer and moved easier after than before.

Anyway, I agree completely about boosting the immune system, making positive changes in the environment, and reducing stress. The first thing I did when she was in a lot of pain and very morose from the ulcerated hock was to bond her with an upstairs bunny she had been visiting only through a fence. I think his grooming and comforting her made a lot of difference. Chemical-free immune system boost!


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## rabbit_friend (Nov 6, 2010)

Well, she was dancing around and standing on hind legs today for her morning salad -- so good to see her perky again after the first days of tetracycline. I picked up a refill of the tetra and will keep her on it. 

One question -- does anyone know if giving her some milk thistle will interfere with the tetra? Or have any other suggestions for supporting liver and immune system that won't interfere with the treatment? Since she's been on abx for 5 months, I'd really like to get some supplement support going.


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## fuzz16 (Nov 6, 2010)

i wouldnt give any milk thistle along with the antibiotics, the compounds could interact and you could not get the same effects 

good thought hat shes feeling better.

and yes staph gets on blankets and couches and anything...for the carpet not a lot you could do. ask the vet how easily it could be transferred to you. vaccumm plety and keep the place clean, do laundry when needed and youll be fine.

i have not had an outbreak for two months, but due to ack fo insurance i stick with two types of antibiotics that work fine to kee it in control. the antibacterial soap i use is meant specifically to kill germs, so it helps. and because my immune system is so compromised from it i eat good to give my body a fighting chance.

so keep her healthy, litte stress as possible, and she will be able to fight it off.


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## tonyshuman (Nov 6, 2010)

The milk thistle should be fine but it's up to you.


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## rabbit_friend (Nov 8, 2010)

Hey Fuzz16, is that bun in the avatar picture with you Fallow? I saw him on your RO blog and he looks a lot like my girl. Saw how he had sore hocks too -- are they all better now? Carpet can definitely do that! And tile has abraded my feet and put holes in my socks, so it's pretty rough too. We'll just have to plant grass throughout our houses for our buns' feeties


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## fuzz16 (Nov 8, 2010)

LOL! o how they would love to have grass everywhere...id have a goodreason to get a goat to keep it down!! that or a few more buns  

and ya thats my baby boy Fallow. his is hereditary so its just something i have to try and avoid, but even my best efforts are normally not enough. his dad was notorious for sore hocks. 
if i notice a spot getting sore i will put some coronas on it. its an oinment a lot of people use on baby butts for diaper rash. i used it on my staph (thin layer with vaseline on it to keep it kinda more there)and it kept things from getting to bad. i didnt think about the use of coronas for you just because it wont help infetion much and my bun never licked it much i dont know how it would affect them. but its a horse salve so you could find it at a horse feed store


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## rabbit_friend (Nov 9, 2010)

Well, the infection is inside the abscess, so maybe the coronas would help on the outside. For now, I'm putting on the silver sulfadiazine. But last night a new development appeared. The vet had put some surgical glue (superglue) on a spot where some bleeding started when he did the needle aspiration for the culture. On one side of that "glue plug" the skin has now opened to a hole where the original hole was in June when the other vet cut the abscess open. Seems like it never really healed closed. Can't tell how far the hole goes down, but this is, I guess, all part of the abscess wall, and it all seems not very well formed.

I have heard about abscesses "drying up and dropping off" on long-term antibiotics (usually penG). Does anyone know what exactly happens in these cases, or what that looks like? This abscess wall seems intertwined with blood vessels and other tissue, so I can't picture how or whether it would do that.


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## rabbit_friend (Nov 9, 2010)

Had two thoughts about the ear rash, and have looked up some info but not much on rabbits. Seems possible the rash could be due to the liver being compromised after 5 months on abx. Or maybe a yeast infection due to long-term abx. Her hot/cold swings without fever lean more towards the liver. Thoughts?


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## tonyshuman (Nov 9, 2010)

Abscesses heal best from the inside out, meaning that if you close them up surgically, they will just continue to trap infection in there. Now, this does not include if there is exposed bone at the bottom of the abscess. Usually you shouldn't glue or stitch an abscess closed, it should be left open. In most animals, the abscess can drain and heal from the inside out with a small drainage hole. With rabbits, as you know, the pus is very thick and will not leave through a small drainage hole. I hope this makes sense.

I think when people talk about abscesses drying out and dropping off they mean that the tissue that was on top of the pus pocket becomes a scab that falls off. This is because with long-term strong antibiotics, the abscess is not opened or drained. The pus pocket is left there. The tissue under the pus pocket heals, and then the tissue on top of the pus pocket dies, dries out, and falls off.

I do expect that the liver could be damaged. You may consider a blood chemistry panel and complete blood count to check that. I am really not sure about the ear. It could be a skin infection of yeast--if you treat with miconazole (athlete's foot cream) it might help. Athlete's foot or ringworm are similar yeast infections of the skin, but they usually look crustier than you described her ears.

She is indoors, right? No large temperature fluctuations in the environment?


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## rabbit_friend (Nov 9, 2010)

Yes, she's indoors, and I am keeping the temp at a constant 72 now (was fluctuating between 70 and 74 earlier). I've read today that liver damage can impair the fluid circulation in the body and lead to itchy skin as well as heat flushes in the head and neck, both of which she has had. She's also had a brown fleck on the worse ear which has baffled the vets but now that I think about it looks like the brown spots people get with liver disease. 

I will schedule a blood test, though I hate to stress her out with a vet trip again. Last time I requested a full CBC I got only a basic because the vet couldn't get enough blood. If that happens again, would a basic CBC be enough to tell liver damage? 

Is the miconazole something that would not be harmful if licked off? There has been a lot of flakiness (wouldn't call it crustiness) at times, like her inner ear skin is coming off in big flakes.

I do know all about healing from the inside out with rabbits, and that's what we did the first time around, but apparently there was still a small pocket inside that could fill with pus. The second vet cut a small hole to get a culture sample -- didn't find much pus, just thick abscess wall. That hole closed over too by itself (eventually -- long story), but now seems to be reopening. The abscess has never been surgically closed -- the glue was just to seal off some bleeding during the needle aspiration a few weeks ago. Unfortunately, I think the vet trapped some surrounding hair under the glue and it caused a localized infection/inflammation. It's been red around that spot since then and that's where the tissue is now separating. It's like the glue plug (or blood vessel it's attached to?) is a little island and the surrounding abscess wall is retreating and opening up to that inner cavity again. Guess I'll just watch it and see what happens.


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## fuzz16 (Nov 9, 2010)

i cant bemuch help anymore. i reallyhope she pulls through just fine...hopefully the infection doesnt go into the bone...ill be praying for that among her getting better soon. good luck


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## tonyshuman (Nov 9, 2010)

I would make sure a chemistry panel is done on the blood. A CBC, which counts the different types of cells in the blood and other components, will give you some idea of the liver function, but the chemistry panel would be more informative.


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## rabbit_friend (Nov 10, 2010)

Thanks for the advice. I just checked her file and what was actually done in March was a "mammalian standard chemistry." There were 7 values given (total protein, total bilirubin, urea nitrogen, creatinine, phosphorus, glucose, calcium). Total protein was high, phosphorus a bit low, other values normal, but this was before any antibiotics or obvious infection. The ALT (SGPT) did not have a result value ("quantity not sufficient"), and the comment said "hemolysis 1+ could decrease direct bilirubin by 80%." Am I correct that the bilirubin and creatinine are the ones to watch for liver problems? And are there other values I should have checked that weren't on the standard chemistry? Thanks again.


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## rabbit_friend (Nov 23, 2010)

Okay, finally got the mailed bloodwork report (the over the phone report was very skimpy). These are the out-of-range values (though with Kathy Smith's expanded ranges most are still within normal):
Low: Hemoglobin 9.7; Hematocrit 28.5; WBC 2.7, RBC 4.44, lymphocytes 1026 (38%); phosphorus 2.4

and high: alk phosphatase 58

calcium on high end of normal range at 13.4

Any thoughts?

She has now been on the tetracycline for 3-1/2 weeks. Tonyshuman -- I think you said 28 days should be the most. What was the thinking on that -- gi/liver/kidney damage potential? You said most vets don't dose high enough or long enough with tetra -- what is long enough for mrss do you think? 

She seems to have stabilized on the tetra after some gi troubles, great appetite today, no lethargy. Hock skin is more pink, not inflamed any more, but size of enlargement hasn't really changed. Vet says once off tetra he wants to give her a rest off abx and see how she does. She's been on abx for 6 months now.


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## Maureen Las (Nov 25, 2010)

I don't have any experience with this type of bacteria nor the use of tetracyline


increased alkaline phosphotase could indicate liver problems and increased calcium could indicate kidney problems but I cannot tie this in with the use of the antibiotic. 
Would you be able to talk with the vet about this; 
I also see you posted on Etherbun 

Ihope that you get a satisfactory response there although this problem is complex and not everyone is on-line due to the holiday.


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## rabbit_friend (Nov 25, 2010)

The vet seemed unconcerned when he phoned the results, but he is not entirely rabbit-savvy and also doesn't know her every move and mood like I do. He did say she was mildly anemic, so maybe that's the tiredness. The tetracycline is rough on the liver and kidneys from what I understand. 

I have gotten a few private responses on Etherbun, including a lead to someone experienced who I hope can give me more advice. I just get nervous when a bunny isn't doing well over the holidays. I've lost a guinea pig on Thanksgiving day, and a bunny on Easter Sunday before -- the latter died horribly in my arms because the emergency clinic said they wouldn't put him to sleep without him being evaluated by a rabbit vet, and none was available :-( 

I've been on Etherbun for several years -- am new to Rabbits Online but like the way things are organized here  Thank goodness for groups like these where you can learn from others' experience.


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## Maureen Las (Nov 25, 2010)

*rabbit_friend wrote: *


> The vet seemed unconcerned when he phoned the results, but he is not entirely rabbit-savvy and also doesn't know her every move and mood like I do. He did say she was mildly anemic, so maybe that's the tiredness. The tetracycline is rough on the liver and kidneys from what I understand.
> 
> I have gotten a few private responses on Etherbun, including a lead to someone experienced who I hope can give me more advice. I just get nervous when a bunny isn't doing well over the holidays. I've lost a guinea pig on Thanksgiving day, and a bunny on Easter Sunday before -- the latter died horribly in my arms because the emergency clinic said they wouldn't put him to sleep without him being evaluated by a rabbit vet, and none was available :-(
> 
> I've been on Etherbun for several years -- am new to Rabbits Online but like the way things are organized here  Thank goodness for groups like these where you can learn from others' experience.



It does seem with me also that "events" tend to occur when I am least able to get help

Ihope that she is not worse today


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## rabbit_friend (Nov 25, 2010)

She is looking a lot better today. Gave her a plate of parsley and endive around 1:30 a.m. and she gobbled it. Also ate quite a few pellets, which she has hardly touched in the last week or so, and drank some dilute apple juice. 

This morning she ate a big part of her salad. Then was looking for her "treats" around 2 pm (benebac in mashed banana, myristol/actiflex mix in olive oil and oats). Ate that plus a big plate of parsley. Now she's napping.

I didn't give the tetracycline this morning -- she's been on it 27 days and I'm hoping that's enough. Her hock looked completely pink this morning -- not a bit of red. So there is definite improvement. Just hope I didn't stop it too soon. I'm continuing to put HealX on it.

Do you know what happens to tetracycline if it isn't refrigerated? When I first got it, I called the pharmacy and asked did it have to be refrigerated because I was surprised it wasn't on the label. They said no. Then after giving it for two weeks, when I went back for the refill, they handed it to me and said "this needs to be refrigerated." Say WHAT?! So I'm wondering if the first two weeks might have been less effective. It does seem to have done more in the last 9 days since the latest refill (refrigerated now), but maybe it's just that she's been on it more total days. 

Anyway, not as worried about her today, though still wondering if I should continue the tetracycline. However, pretty much everyone I'm hearing from now even from other groups is mentioning azithromycin (I know it has praises here), so if she relapses we can try that next.

Off to check on the turkey


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## Maureen Las (Nov 25, 2010)

I'm glad thatshe isbetter. 

Ibelieve that tetracylcine is not commonly used at least by the long term members on this forum. 
Azithromycin is a great drug if the rabbit can tolerate it; it sometimes causes a loss of appetite


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## rabbit_friend (Nov 25, 2010)

Well, she certainly had a loss of appetite on the tetracycline, so that won't be anything new. I've read that tetracycline almost always causes that whereas azithromycin only occasionally does, but I have no experience with either. I was a bit dubious too about the vet prescribing it after reading Francis Harcourt Brown did not recommend it being given orally. And then articles about rabbits hypersensitivity to it and some dying from enteritis even 10 days after treatment . . . let's just say I will be sure to continue the benebac, fluids and other support treatments for at least another few weeks!


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## tonyshuman (Nov 29, 2010)

Sorry I have not been giving advice. I have been just way too busy. I think it sounds like he's doing much better, right? So you are stopping the tetracycline? It is an older medicine than azithromycin and can have GI issues, although zithro does too.


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## rabbit_friend (Nov 30, 2010)

Understand about busy, believe me! Just wanted to know why you said max of 28 days on tetracycline, and how long you've kept bunnies on zithro. We've had gi issues on tetra, so are prepared (though not happy about the possibility of more). Right now I am just cleansing twice a day with Vetericyn and applying silver sulfadiazine. Five days off meds and it is looking a tad redder. 

She also has a hot spot between her shoulder blades that she is scratching that I can't identify.


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## tonyshuman (Dec 1, 2010)

It was just a guess, based on a 14-day course (typical) x 2. I actually spoke to a different vet than usual last weekend and she said that bunnies have immune systems like AIDS patients, and it's not uncommon for a bunny to have to be on an antibiotic indefinitely. Now if my bunny were prescribed that, I would want to investigate other options first, especially if yours is having GI issues on tetra.

I have not had bunnies on zithro myself but have heard up to 40 days, I think. The GI issues are usually the limiting factor if it doesn't clear up the infection rapidly (within a 14 day course). With zithro it seems to be more of a reduced appetite than mussy poo, if that helps. Sometimes buns on zithro have to be force-fed Critical Care.

Not sure about the other spot but sometimes long-term antibiotics can cause fungal infections to sprout up--like thrush or yeast infections in humans.


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## rabbit_friend (Dec 1, 2010)

*tonyshuman wrote:*


> With zithro it seems to be more of a reduced appetite than mussy poo, if that helps. Sometimes buns on zithro have to be force-fed Critical Care.
> 
> Not sure about the other spot but sometimes long-term antibiotics can cause fungal infections to sprout up--like thrush or yeast infections in humans.


Thanks for the info. She's only had reduced appetite and lethargy on the tetra -- no mushy poo. But I was giving Bene-bac every other day throughout, so maybe that kept her stable (though the poos were oval and very light colored). She never quit eating entirely, but did quit eating pellets and also quit drinking for several days. So she lost weight, especially muscle. Luckily, she had some spare to lose, but she's now down to no extra. 

I was thinking the hot spot looked like something fungal. The Vetericyn sprayed on in the last two days has already helped it a lot (with blow-drying till completely dry afterwards). She had scratched it raw with scabs, and those are all pink skin now. She even did a bliss roll two nights ago after I treated the spot and then fed her Bene-bac treat and her myristol/actiflex mix. Seems to be feeling a lot better off the abx, though the abscess does seem to be getting slightly bigger again. 

I am looking into alternatives. Have you heard anything about olive leaf extract in bunnies with abscesses (or fungal infections)?


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## tonyshuman (Dec 1, 2010)

Not familiar with that treatment. Most fungal treatments are topical, like miconazole, ketoconazole, or stuff like Vetericyn. Another option is to use a chlorhexidine or betadine cleaner daily. That won't work as fast as the -conazoles, but is less drugs in the system if that is a bother.


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## rabbit_friend (Dec 12, 2010)

An update -- she's been off all abx for a little over two weeks now. She seemed to "crash" a bit about 4-5 days after discontinuing, so I think she's still suffering some from the gi effects. Her appetite and spirits are up and down -- last night she looked worse than when on abx, but some fluids perked her up. Continue to give bene-bac every other day.

I'm also still cleaning the abscess twice a day with Vetericyn and applying silver sulfadiazine. Although it is not open, cleaning it seems to keep it healthier looking -- when I've skipped a cleaning it has gotten a bit redder. It does seem to have enlarged slightly and I am concerned about infection spreading to the bone. Would xrays be the only way to tell if this is happening, or are there other warning signs? 

The hot spot between her shoulder blades has responded well to Vetericyn. I tried putting on various creams after cleaning (HealX, Silver Sulfadiazine), and they all seemed to make it worse (maybe by trapping moisture on skin?). I went 24 hours yesterday without using the Vetericyn, just applying some aloe gel, and the crusty/flaky stuff started returning. So I think the Vetericyn is just inhibiting whatever it is, not killing it. Will try the miconazile, but is it safe to lick off?

Thanks for everyone's help on here. Pipp, I am hoping your story about your bun's abscess resolving on its own will end up being our story as well! I have been looking into boosting her immune system and have heard good things about beta glucans, so may try that.


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## fuzz16 (Dec 12, 2010)

hopefully things get better with time


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## Maureen Las (Dec 12, 2010)

I believe that (at least with humans) a diagnosis of osteomyelitis would be based on a combination of previous history, physical exam, review of all previous blood tests and cultures and then an x-ray (which may not show osteomyeltis in the very beginning stages). ..Ultrasounds and Pet scans are better diagnostic tools.
I agree that this infection doesn't really sound resolved and would really be interested in how she would do on some of the other antibiotics mentioned above including chlorampenical and/or azithromycin .
I used Chloramphenical opthalmic solution on a bun who had an eye infection which would not resolve with any previous number of antibiotic salves/drops. It was my last attempt to save this bun and the chloramphenical improved the eye after the first instillation of the drops. ( almost seemed miraculous) 
I used plastic gloves whenI gave the drug and it caused no issues with my rabbit other than improvement. 
In terms of treating withanti fungal medsI would check with a vet first. you really do not know if this is fungal?

MRSA is zoonotic and contagious so it is really important to keep the environment 
as sterile as possible.


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## tonyshuman (Dec 14, 2010)

If you don't put too much of the miconazole cream on, it should be fine. I would not let her lick at it for a good 15 min after applying it though, and apply only enough to cover the area in a transparent layer. I think it would be a good idea since the other creams didn't seem to work--that's why I'm guessing fungal. The vet can tell you definitively what it is if you go, though.


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## rabbit_friend (Apr 1, 2011)

Update: no abx since Thanksgiving, and everything was going along fairly well till this week. I've just been cleaning with Vetericyn and putting on silver sulfadiazine when the hock looked inflamed or getting larger again. 

She gained back some weight, regained full appetite, was even binkying and running up and down stairs a few times. Mass around hock seemed much thinner two weeks ago and a scab had formed over the hole in the center. I was getting excited thinking it might be healing. 

Then this week I noticed it enlarging again, and the scab looked more yellowish. Tuesday night there was pus oozing from it, and I soaked and got the scab off. Major thick white stuff underneath. Tried to pull some out with tweezers, and I caught hold of some stringy pieces and then some long translucent tubes like jellyfish arms. They seemed to be attached to blood vessels and looked like blood vessels, only almost transparent. I have never seen this jelly-like stuff before. Have been reading about mucoid degeneration and wondering if that's what this is? 

Have been flushing twice a day for two days with Vetericyn and using the ssd and she seems to be feeling better (was favoring that foot for the first time in a long while). 

Very disturbed at this new development, I scheduled an appt for yesterday with regular vet and for today with backup/2nd opinion vet, just to make sure I had some clue and a plan for the weekend. Regular vet told us when we showed up that he wouldn't look at her because he'd found out we were going to another vet. Oy veh.


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## ra7751 (Apr 3, 2011)

Just wondering....who is your vet? Had a minute so I thought I would pop in and check the forum. I talked with a very nice vet from TN aday or so agoregarding a long term hock abscess. Thought this might be the same case. Seems to be a lot of concern about the staph issue....staph isn't the major concern here. It is a "tag-along". Most skin infections in any species will grow staph. And there is probably yeast infections all over this rabbit due to the long term abx use. If the "root cause" is addressed, resolution of that issue will resolve these tag-alongs. The vet was very interested in our protocols. If this is your vet, she gave me the feeling that she is on her "A" game and I was very impressed with her. Thought we had a very interesting conversation. Regardless....hope your rabbit improves.

Randy


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## rabbit_friend (Apr 4, 2011)

Yep--that was our first visit to our new vet after the other two who have been "handling" this for the past 15 months washed their hands of us. Glad to hear she impressed you. 

Her first words were that we needed surgery, that you couldn't cure rabbit abscesses with just abx. I said I really would like her to call you, since you seemed to be able to do it, and we'd already tried the surgical route with disastrous results. She just asked me for the number and called right then and there, which definitely impressed me.

She said she uses bicillin and zithro, but that it has never resolved an abscess for her, so I'm curious how your protocol differs from hers. 

She'll be willing to prescribe any of it -- zithro, chloramphenicol, bicillin, but how do we determine the "root cause"? I'll do a culture swab in the morning, but I remember your abscess posts saying that a culture wouldn't show several key players. The staph was methicillin-resistant schleiferi (gram-neg), by the way, not your garden-variety staph. But could be the tetracycline knocked that out and there's something else left, as you say. 

Don't think she has yeast problems any more. No abx since November and daily olive leaf since then. The surgery in June tore the hock tissue up, leaving a hole and some cuts right on the weight-bearing part that have never healed. Have read since then that any surgery on a hock should be sure to preserve weight-bearing tissue - ha. Wish we'd run across your posts and gone to this new vet back then...


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## rabbit_friend (Apr 4, 2011)

meant to update: very watery, runny pus coming out of the abscess opening yesterday. Not as much today, but she had a massive amount of mushy poo stuck to her butt (yuck). Seems to have cleared up tonight.


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## rabbit_friend (Apr 11, 2011)

New culture results: no methicillin staph reported, but now we have enterobacter chloacae, a gram-neg rod which is resistant to chloramphenicol and doxycycline and susceptible to carbenicillin and neomycin (haven't been mailed the full report yet). New vet is thinking pen-G injections might take care of it. Any thoughts?


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## rabbit_friend (Apr 15, 2011)

Went for practice session with bicillin injections yesterday -- we'll see how that goes. First one went without incident. She says to give daily injections of 0.7 ml for 7 days, then continue if needed. Earlier this week, she said 2 weeks past resolution, and I've read 8 weeks should be the minimum, so a bit contradictory.


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## rabbit_friend (Jun 12, 2011)

So we've been doing bicillin (combipen-48) injections once daily for 8 weeks now. Abscess has gotten much smaller, especially in the last week or two. But after soaking the now small hole in the abscess to open it a bit, I keep getting some clear, very slimy fluid when pressing on the abscess. Any idea what this is and whether it represents some other type of bacteria present? I've read that strep can produce clear fluid in abscesses, but this doesn't seem like any pus I've ever seen.

She is tolerating the bicillin well. But the clear fluid seems to keep collecting. Also, the bare skin over the abscess has developed some brown spots in the last week or two. She has had these on her other hock as well and the vet just said they're pressure points. But one of the ones on the other hock has now turned more reddish, like a blood blister.


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## rabbit_friend (Jun 20, 2011)

Talked to vet, who says the clear fluid might be serous fluid produced by muscles trying to heal. Don't know how many muscles there are around a hock bone, but hope she's right. 

I also tried to get a new bag of LR from this vet since the bag from the old vet ran out, and the new vet said LR would be the last thing she'd use for a rabbit since it was high in sodium and could cause kidney stones. I had never heard of that, and have given LR in the past. I do know LR contains some calcium, so maybe she said sodium by mistake? Any comments?


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## tonyshuman (Jun 21, 2011)

There's nothing wrong with lactated Ringer's solution for hydration of a bunny. Even if there is more calcium, which I'm not sure of off the top of my head, it wouldn't be enough to cause a problem.


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## rabbit_friend (Jun 21, 2011)

That's what I was thinking. She gave me Normosol-R instead. Do you know if there's a preference (or contraindication) for one or the other in diluting bicillin injections? I've been following the advice on here and using the LR (and now the Normosol) to dilute the bicillin I'm giving.


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## tonyshuman (Jun 22, 2011)

I don't think it matters which you use. They are both sterile saline solutions made to be injected.


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## rabbit_friend (Dec 30, 2012)

Realized when looking up some of the newer health issues with my bunnies that I had never updated this thread. It took 10 months of bicillin injections, but the hock is healed now (though still bare). Gave probiotics, metacam and supportive fluids as needed. She tolerated the bicillin much, much better than the oral antibiotics. Did blood tests and follow-up xrays about 8 months into the bicillin and everything looked fine. 

About a month before the end, when we weren't sure if the hock was fully healed, my vet suggested trying to taper off the bicillin by going to once every 3 days instead of every 2. The hock got worse again. But then I did the bicillin three days in a row before going back to every 2 days for 3 weeks, and that seemed to do the trick. I didn't taper - just quit - and just kept the healed hock clean and coated in udder balm when it looked dry so it wouldn't crack. Knock on wood, but the hock has been fine for the last 10 months and she has been a much happier bunny. 

Now we just have to work on her spondylosis and arthritis


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## fuzz16 (Dec 31, 2012)

love udder butter..i am realy glad that this turned out for the best and hopeully he didnt turn into an angry bun because of all the meds


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## rabbit_friend (Apr 25, 2013)

No, she is sweeter than ever, and she put up with a lot without much complaint during 2 years of treatments!


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## rabbit_friend (Jul 31, 2013)

Thought I would update this (very long) thread with the news that we lost our dear Cocoa on June 7 of this year. Her hock had been no further trouble after my last update, but she had developed scoliosis and arthritis in addition to the original spondylitis, probably somewhat due to the altered gait with the hock. Nonetheless, her death was very unexpected and the cause of death remains mysterious. After a day out of town, we found her lying peacefully on her side as if asleep, and necropsy showed no abnormalities other than some hemorrhaging in the brain. No liver or kidney problems as I was afraid of after her long run with abx,and no evidence of e.c. which I worried about with some of her symptoms. She did have brittle bones (maybe a side-effect of the abx?). We are still waiting for the final pathology report. 

A huge thank you to all of you who helped me through that anxious time with our big, beautiful bunny. She put up with a lot of treatments and was always sweet and loving and appreciative of my efforts. We bonded very closely during the long ordeal and I wished for her many more years of abscess- and treatment-free living. I miss her a lot. Binky free, dear Cocoa.


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## tonyshuman (Jul 31, 2013)

I'm so sorry she passed away. I'm not sure what would have caused this. Thank you for the update. It sounds like she had many happy years with you, although we always will want more for our pets.


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## rabbit_friend (Aug 1, 2013)

She came to us weighing 8 pounds (and grew from there!), and we had her for 8 years. Yep, would always like more!


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