Abscesses

TIP – Do not ignore any infection. You want to avoid a chronic infection as best you can.  If you nip infections in the bud you have the best chance of stopping abscesses or getting rid of them sooner. If an abscess has occurred then the best tip is to persevere & do not give up on the antibiotics too early, keep going. If you need some hope read Annie’s story.

Abscesses are pockets of pus that are caused by bacteria & other pathogenic organisms (an organism capable of causing disease in its host).

They enter the body through a wound & can also form on:

  • Internal organs such as the liver, heart & kidneys.
  • The skin, usually after injury or surgery.
  • The mouth generally due to an infection or dental disease.
  • The ear normally due to an infection or sometimes it is secondary to dental disease.
  • Tear ducts usually secondary to dental disease.

Some abscesses are formed by a foreign body such as a grass seed entering the rabbit.  The bacteria can hitch a ride on such objects.  For this type of abscess & for hope Read Teddy’s story.

There are a lot of challenges in curing an abscess. Rabbit pus is very difficult to get rid of as it has the consistency of thick cottage cheese making it difficult to drain.  It can also spread fibrous tracks into deeper tissue spreading the bacteria.
Abscesses have to heal from the inside out & if the skin heals over too quickly some  bacteria will be left. Then before long the whole process starts again & you’re back to square one.

Symptoms

These can all depend on the location of the abscess.

The most common are:

  • Swelling seen or felt under the skin any where on the body. The swelling can feel either soft or hard.
  • Loss of appetite, usually if the rabbit is in pain with the abscess.  It has to be noted that some rabbits will show no pain or actually have no pain.
  • Problems eating. This is not always caused by the abscess but could be an indication of dental disease or some other issue.
  • An abscess in the head can produce pus out of the eye sockets & nose.

Any internal abscesses are difficult to detect unless they are actually producing symptoms in the rabbit.

Treatment

This all depends on the individual abscess.   It’s location, size & how well your rabbit is needs to be taken into account.  You will need to have a thorough discussion with your vet as each case is usually different.

Some treatment options:

  • The abscess is opened & drained.  This can be very difficult as rabbit pus is like thick cottage cheese & does not want to drain away easily.
  • Some abscesses are left & monitored. This is sometimes considered if the rabbit is well, the abscess is contained & the owner does not wish to have extensive surgery on their rabbit. However, this comes with a risk that if it does start to change & grow you may end up operating on a much older & sicker rabbit.  Also, the open cavity may be much larger. An honest & thorough discussion is required with your vet.
  • An aggressive course of antibiotics.  You must be prepared for a long battle & at the end of it there is a good chance the abscess will return.  Therefore it is imperative that you & your vet are as sure as you can be that the infection has gone.    Nowadays, there are also different ways of administering antibiotics to some of the more difficult abscesses.  Antibiotic beads can now be used & implanted into the cavity, these release antibiotics slowly for up to 4 weeks & help stop the cavity refilling with pus. However, as with everything you always get a flip side.  The body can treat the beads as a foreign body & at some point they may have to be removed.  There is also a gel that can be used to fill the cavity.
    The advantage of these methods is that the cavity can be stitched closed. Meaning less handling & medicating  your rabbit. Once again though you will need to have a good discussion with your vet on the options available & what is right for your bunny.

My Experiences.

I have to admit, an abscess is one of my greatest fears for my bunnies.  They are notoriously difficult to cure, can appear in the most horrendous places & it can be one of the longest battles you’ll ever face.  Then after all that it comes back!

Comfrey – Eye Abscess.

My first experience of an abscess in one of my rabbits was in a male Dutch rabbit called Comfrey. It all started at the age of 4.  Up until then he had been a fit & healthy bun.          The first thing I noticed was one of his eyes was starting to bulge, other than that he had no other symptoms.
Now I must stress this was back in the early nineties.  Anaesthetics , experience & knowledge were limited.
At the vets an abscess was suspected so a course of antibiotics were prescribed. This back then was no easy feat, as the antibiotics often caused severe digestive problems & could not be given for a prolonged period.  The antibiotics started with a vengeance much to Comfrey’s distress.  He became very stressed at having his twice daily dose administered &  it definitely helped to knock him off his food.  Fortunately, he would eat enough to keep him ticking over but was losing weight.
As the 10 day course continued I noticed the eye was bulging more & more.  He was going downhill too.  I returned to the vets.  His eye was bulging so much it was obvious the abscess was growing & the antibiotics weren’t helping. He had also started to loose some balance & was not quite compus mentus. It looked like the abscess had got to his brain. After a discussion I had him put to sleep as there was nothing more that could be done for him.  I learnt in later years that this kind of abscess, one that sits behind the eye, is called a retrobulbar abscess.  Today, it is still difficult to treat, but there are more options available.

 

Casanova – Leg Abscess.

My second experience was with my large male crossbreed called Casanova. This was also back in the nineties.
He was 3 years old when I noticed he was limping on his front leg. On investigating his leg I found a lump under his skin.  Other than the lump & limp he showed no other symptoms.    At the vets a suspected abscess was diagnosed.  This time it was decided to operate & it was confirmed as an abscess. They opened & drained it the best they could.  It was then  a course of antibiotics, administered twice a day.  I also had to empty & clean his open wound of pus twice a day.  Fortunately, Cas was not in the least perturbed by all this handling.
Half way through the course of antibiotics he began with his stomach upsets, but we had to persevere as it was going so well.  The only thing I was advised to do was withdraw all his vegetables.  We finished the course of antibiotics & it had much improved but you cannot leave a speck of the bacteria behind, otherwise within days you’d be back to square one.  So it was back to the antibiotics which we did have to keep stopping intermittently. This meant that everytime we stopped we took steps backwards until we could start again.
Quite frankly it was a hard slog as this went on for several months. We got in a routine of administering the antibiotics, judging how long he could last with a stomach upset & how long we could stop the antibiotics. Eventually, we got there & finally his wound was allowed to heal.  The next month was a very anxious time as there was always a good chance it would return but fortunately it never did & he went on to live until the age of 9. We never found out what caused the abscess.

 

Smokey – Ear Abscess.

My next experience was with my male Dwarf Lop, Smokey. He was 6 years old. He’d had a sore eye in the past which was from a skirmish with one of my other bunnies.  This was dealt with & sorted out. A short time later he seemed irritated with his ears & had a build up of ear wax.  He was also slightly off his food. These were the only symptoms, other than that he was well in himself.  On inspection of his ears at the vets there was a solid white ‘plug’ inside his ears which the vet removed & underneath was a mass of thick pus. It was decided to flush his ears which was done.  A huge amount of pus came out. He then had a course of antibiotics & we were hopeful we’d got everything.
Unfortunately, the pus returned not long after the antibiotics stopped.  He was put straight back on the antibiotics.  Just to point out we are much later into the 90s now & the antibiotics didn’t cause the severe stomach upsets as before.
Over the course of the next few months it was a case of antibiotics & emptying his ears everyday.  You could literally squeeze the pus out of his ears.  One ear we were managing to keep well controlled, the other as time went by became increasingly difficult to keep at a good level. It had also become apparent that his infection had now become chronic.  Even though he had more ear flushes when too much pus had built up, the flushes were never going to get the remaining bacterial infection out of all of his ear chambers.
We had no option but to go on a maintenance plan, this consisted of regular ear emptying & cleaning, flushes & antibiotics when required.   We felt this was the best option as Smokey was generally in good health, happy, being his naughty self & was not phased by the maintenance. This continued to the age of 8 & that is when he started to deteriorate. His immune system was struggling & he had started to lose weight.  He was also experiencing  some age related problems.
He lasted several more months having regular reviews but Flystrike struck him Read about Smokey’s flystrike & I had to have him put to sleep.

Bubbles – Wound Abscess after her spay.

My first surgery abscess, was in Bubbles my 6 year old crossbreed.  As soon as I adopted her I had her spayed as it was likely she was already starting with uterine cancer at that age. After the spay operation whilst checking her surgery wound, I noticed a discoloured part of her skin & what looked like a hole.  See photo above. I took her to the vets & it would seem that she’d had a small abscess around a couple of the stitches.  The abscess had in fact burst & the ‘hole’ I could see was in actual fact a very deep red scab. Miraculously, she did not have an infection, the pus must have come out & drained away from her. I had to monitor her even more closely to make sure no infection returned. I think Bubbles was very lucky & we got away with no antibiotics because the abscess was so small & had burst early on.

Rumble

Within my bunnies, Rumble had an allergy that caused him to be very snotty some days & sometimes makes one of his eyes water.  Read more about Rumble’s allergy.  For Rumble the constant mucus he had put him at great risk of developing an abscess within the head area. I absolutely kept on top of any sign of too much mucus, his watery eye & anything else suspicious around his head.
It was my worst fear that he developed an abscess & then a chronic infection.  There was no doubt in my mind that it will shorten his life.  In the end, we think that is what happened, only the abscesses were within his chest not around his head. It’s possible one of these abscesses burst inside his chest & that ended his life. To read more about Rumble’s final day, click the link above.

My latest experiences with the dreaded abscess were with Teddy & Annie in 2020. Annie was the first to be diagnosed with an abscess.

Annie Eye Abscess.

It all started back in July 2020, I noticed Annie’s right eye didn’t look right & on inspection she had thick yellow pus on the top of her eyeball & it had started to sit on her lashes. I got her to the vets within 24 hours as I was so concerned it was an abscess. The vet checked her out & a diagnosis of Conjunctivitis was given, at this point there was no lump.  Treatment was eye drops twice a day for 5 days & it should clear up. After the 5 days the pus had reduced but was still there, so I carried on after a discussion with my vet with the eye drops. Annie had no pus in her eye 4 days later, all I found was a small fleck of white pus on her eyeball. After a vet visit, Annie was given the all clear & the eye drops were stopped.
I was wary of the all clear as I was worried it was an abscess & we had only temporarily contained it. I monitored Annie closely & after 6 days of being clear I noticed she had pus in her eye again, I immediately started the eye drops & the pus reduced to milk the following day & did continue to improve, but on the third day when I administered her eye drops it was difficult to do, yet everything seemed the same. However, by evening when I went to administer the drops she had a massive lump on her head, right above the pus eye. I instantly knew it was going to be an abscess.

Annie’s abscess, you can see the size.
A top view, practically the size of a golf ball.
This photo shows the abscess position to the eye & here you can see the eye is weeping.

I immediately took her to the vets.  He examined her & stuck a needle in the lump, he then wiped the needle tip on a slide & you could pretty much tell it was pus. It was devastating news; the position is so bad too. I think one of the most shocking things was the speed it had come up, less than 24 hours to get to that huge lump.  She started an aggressive course of Penicillin & was to continue for a week & hopefully, it will do the job & start reducing it, otherwise it would be an op to lance it. What was worrying about the op, as the wound would have to be left open, was the position of the cavity left & how on earth do you stop flies from going into it as the flystrike defence cannot be used on an open wound. The other mega worry was,  What if it is an abscess behind the eye? I remember Comfrey so well.

Annie was well in herself although was slightly stressed with all the handling. The vet said the Penicillin should break down the pus/bacteria into proteins & other bodies that can be absorbed back into the body.  It will upset her tummy so she is to go on Fibreplex & have Protexin put in her water, both probiotics. Her eye drops were changed to a cream, the hope was that the cream would work better on the infection.
The Penicillin did not do enough for Annie, it only slightly reduced it. So, on the 4th August, Annie had her op to lance & drain it. My worst fears were confirmed & it was a Retrobulbar abscess, an abscess behind the eye, just like Comfrey, because of it’s position Annie could not be left with an open wound as it would expose her to brain infections like meningitis.  She was given a slim chance of survival.

Annie just after her op recovering.

Fortunately, Annie got over the op well but it left her with a bruised head & a lot of swelling. She was given painkillers for the next few days & was allowed to go back out into the rabbit shed, which was the best place for her.  I knew Annie would feel better back in her own home, however, her partner Thumper could not join her as we couldn’t risk him picking at the stitches. Within 5 days, Annie was back to eating normally but all the while having her daily Penicillin injections.  A week after the op, Annie saw the vet.  The swelling & bruising had gone but there was a lump, we were hoping it was scar tissue.  The vet removed her stitches & once again inserted a needle & that confirmed the abscess was back as it had pus on it.  It was again devastating to hear, I knew from then on we were in for a long haul to get rid of the abscess, if that was even possible.  If the abscess didn’t start reducing then big decisions would have to be made, does she go through another op & have her eye removed & if the Penicillin hasn’t worked first time round is it fair to put her through another op or do I let her go? Even though she was well in herself, the handling was very stressful for Annie, in fact I stopped the Fibreplex early on & stuck to just the Protexin in her water to reduce the stress. Regarding the next op, the vet said this would be removal of her eye and find the root of the abscess and remove.

Annie’s abscess two weeks after the op.

Her treatment of daily Penicillin injections were to continue & all the time the probiotic was put in her water to counter act the good bacteria being killed by the Penicillin. The probiotic seemed to be working as Annie’s digestive system showed no adverse effects. This continued for the next month & over this period it was difficult to say if the abscess lump was reducing, all we knew is that the abscess wasn’t getting any bigger & while that was the case, I wasn’t giving up & she was going to keep with the Penicillin.  Her stress levels had also reduced, she got used to the handling & I found an easier way to take her back to her pen.  Annie has never liked to be picked up due to an incident when she was  pregnant.

Annie found it less stressful being carried back to her pen in a cat bed.
Annie’s abscess after a month had started to reduce.

After a month, I noticed that Annie’s abscess had slightly reduced & was starting to change shape. In fact this seemed a turning point & from now on the abscess continued to reduce & change shape.  I couldn’t believe it.

Another week gone & another reduction!

Annie had a recheck with the vet after nearly 2 months on the Penicillin, you could feel a really hard tiny lump on her head, once again the vet said it could be the abscess capsule or scar tissue but it’s a bit unusual in both instances that the lump is so hard, so we weren’t really sure. Once again if it’s the capsule it’s bad news, if it has to be removed because of its position, Annie may lose her eye so I really hoped that the lump went in the next two weeks.  She was to continue on the same plan, which was continuing the injections of Penicillin everyday.

Annie’s abscess now reduced to a tiny lump. The lump being between by fingers on the photo.

Annie had another vet recheck 3 weeks later & the lump had reduced but she still had a tiny lump & a flatter lump on her head which were both very hard. The vet checked & said it was still hard to tell if it was an abscess or scar tissue as both can feel very hard. It was decided that it was time to stop the Penicillin to see what the lump actually is. Her Penicillin was stopped. The next couple of weeks were nerve wrecking to see if the abscess came back. If it did, she may have to have an op as it may be the capsule & if it is,  the dreaded eye op was mentioned, which I wanted to avoid at all costs. The vet said that because of the amount of Penicillin, it’s possible Annie’s gut may grow bad bacteria so I need to monitor her carefully for any upset.  It is good she has been on the Protexin all the time & I was to continue with it for a couple of weeks.

Annie in December 2020. No return of the abscess so far!

 

The lumps continued to change shape & reduce slightly over the next 3 weeks, it was only really in December that the lumps remained the same & up to January of 2021, the lumps have not changed. I visually check her everyday & twice a week I have a feel. The more time passes the greater chance we’ve got rid for good. The vet has cautiously given her the all clear. I hope Annie’s story gives hope to anyone with a bunny in the same situation, & whatever you do, don’t give up on those antibiotics too soon.  It took 4 weeks for Annie’s to start reducing. It still feels like a miracle that she has got this far as her prognosis was slim.  I must also mention, I kept in weekly contact with my vet via email, sending photos of the abscess & an update on how Annie was doing.

Within 2 weeks of Annie being diagnosed, Teddy was next to get an abscess confirmed.
*********Warning********* within his story there are some graphic abscess photos.

Teddy

Teddy had been slightly ‘off’ at the end of July, I couldn’t put my finger on it & he was certainly not showing any symptoms that warranted a vet visit.  I decided I would check him over again & take him to the vets. On entering the shed, I was shocked to see the state of Teddy.  He had a huge swelling on the left hand side just below his jaw, I just knew it was an abscess.  Just like with Annie,  the abscess had grown huge in less than 24 hours.  At the vets the abscess diagnosis was confirmed & it just so happened to be the day that Annie was having her op, so it was decided that Teddy would have the same op to lance & drain it. One of the most stressful days ever!
There was bad news on Teddy, when the vet drained the abscess, he found a lot of necrotic tissue really deep inside him, it was so deep he was unable to remove it all, this means that the abscess had a very high chance of coming back as the bacteria was still probably there. The vet also found in the abscess a grass seed; he thinks somehow a grass seed has got down deep inside & caused the whole thing. We are not sure how this grass seed got in there, the first suspects were his teeth, if they were misaligned & crooked, there could be gaps the seed could pass down, but on inspection, Teddy’s teeth were great. My only other thought was that Teddy had a fall out with his missus, Daisy, & they did have quite a go, I do wonder if she had given him a wound that I missed.

Teddy recovering from his op.

Teddy struggled to get over his op, he took a lot longer than Annie, who had also had the same op. To help with the bacteria fight, the vet had implanted some antibiotic beads inside the wound, so they could get straight at the bacteria.  His wound had to be left opened & cleaned twice daily expelling any pus I could, Teddy also ended up with a Hematoma after the op which meant it was going to be bloody too. His operation site was very bruised & swollen so for the first few days we could not tell if the abscess had grown back quickly or if was just swelling. It looked massive. He was also put on daily Penicillin injections & painkillers.  Protexin, a probiotic, was added to his water to counteract the Penicillin killing off his good bacteria in his digestive system.  Close monitoring of any upsets were required.

Teddy recovering.

Teddy had to stay in a make shift pen in the house which caused him a lot of stress, my bunnies always do better back in their shed with their fellow bunnies. However, I could not let him back in the shed as it was the middle of summer & he had an open wound which would have attracted flies.  It was bad enough having him in the house & I was constantly checking his room for flies.  Eventually, we had a plan & bought Teddy a mosquito net that we could hang over a pen, that way he could get back to the shed & have a semi normal routine.  He wasn’t allowed to go back to Daisy though.

Teddy in his fly proof pen.

Just to be on the safe side we also stuck up a fly tape just in case any of them got in. I was constantly checking his pen for the next few weeks.  Once Teddy was back in the shed he turned a corner.  After a week of not eating properly & being really stressed he was like a new bunny, not his old self by any stretch of the imagination but a huge improvement.
Teddy managed to pull one of the staples off his wound but fortunately he was due to see the vet. Secretly, I was glad the staple had come out as a lot of matted, bloody fur was becoming too entangled in it, his wound wasn’t the easiest to access & Teddy is a strong lad when he wants to be, with the staple gone I managed to clean him up pretty well. On checking his wound the vet said the other staple could come out too which was good news.

Teddy’s open wound with one of the staples missing.

At the point of the vet check, I had got some blood out & little bits of pus, no where near as much as I was expecting especially if the size of it was all abscess.  Nothing further came out for the next few days.  The vet advised we stop squeezing for now if no pus was coming out, we were to continue cleaning twice a day & carry on with the Penicillin. Teddy also had to get back on painkillers as his wound was inflamed.  He was still not eating great & had lost a lot of weight, it was very worrying. I picked him everything I could think of that he likes from my garden just to keep his guts going.  After 3 weeks from the op, Teddy turned a corner & started to eat better.  A few days later I came across  a really hard lump near the surface of his wound, I thought it might have been an antibiotic bead but these would have dissolved by now.  The vet said it was probably a hard piece of pus & a couple of days later I got it out, & that is exactly what is was. Unfortunately, what followed was a huge mass of the most awful smelling pus, it absolutely stank, & because of it’s consistency it took me ages to clean Teddy up.

The wound with the hard white pus almost in the centre.

After expelling the disgusting pus, Teddy’s abscess had reduced significantly & while it confirmed the abscess was still there, at least we had reduced it for now.  Everyday after this I began to get pus out, what was unusual was that some of the pus was runny & you just don’t get that with bunny pus. It was good though as it meant I could expel more.  As the weeks went on Teddy was doing ok in himself but inevitably his wound was starting to close, which we didn’t want as it would mean sealing in the pus.  After a discussion with my vet it was decided that Teddy would have an op to widen the wound & if possible squeeze any pus out.  I requested he just be sedated as he took so long to recover from the anaesthetic last time. The op was done & my vet said that the pus came out as one big lump & he saw no need to reopen the wound anymore.

Teddy’s abscess after the second op.

As you can see there was a massive reduction in size, quite amazing really. The usual routine was put back in place, keep cleaning, giving Penicillin injections & keep on the Probiotic. I had to hope the Penicillin would keep doing it’s job otherwise it would mean more of an aggressive surgery compared with when we lanced it, to really try and remove all of the thickened tissue.  I wanted to avoid that surgery if possible. Whilst he had his second op, some of the bacteria was taken & cultured. I requested this as I wanted to make sure that Teddy was getting the correct antibiotic for combating his abscess.  Teddy’s results came back as E. Coli which is susceptible to penicillin, (and all other antibiotics), which was good news. Therefore continuing on the penicillin was the right thing to do. This knowledge was a comfort in a way as it meant we were doing the best we could for him. In hindsight if I ever had to deal with an abscess again, I may well have the bacteria tested at the beginning so we can crack on with the best antibiotic available.

Teddy’s abscess reducing & the wound healing.

After the second op, Teddy’s abscess just kept reducing & I eventually stopped getting anything out.  To help with the expelling of pus as the wound healed, I applied a little Manuka honey.  This helped reduce the thick consistency of the pus & reduced the awful smell. I was also applying the honey to Teddy’s back, he had started to have a reaction to all the injections.  No wonder really as he was still being a pin cushion! The honey got rid of the angry redness on his skin & I think helped heal them quicker.

The reaction site behind his ears on the photo.
The reaction site healing after the Manuka Honey was applied.

Not all bunnies have a reaction, for instance, Annie who had more injections had no reaction at all. Over the next couple of weeks Teddy’s abscess got smaller & smaller.

Teddy’s abscess now the size between my fingers.

Then the lump turned to something that felt like a string & his skin showed no lump at all. Once the wound was healed he was allowed to go back with his missus, Daisy.  It was a little tense to begin with as they had been separated for a while but within 24 hours they were good again.

Teddy back with his Daisy.
No lump or wound.

Teddy had a recheck 6 weeks later & the string had gone, no lumps or bumps could be found. It was decided that Teddy would continue for another week on Penicillin just to be sure & then we could stop, which we did. It was nerve wrecking.  The probiotic continued as after a long course of antibiotics the gut can start to grow bad bacteria & the probiotic should help stop that.

Teddy back with his Daisy in Dec & no abscess!

As of January 2021, no abscess has returned & he has regained all his lost weight.  I visually check him everyday & twice a week I have a feel. The more time passes the greater chance we’ve got rid for good. The vet has cautiously given him the all clear.  I cannot stress enough that as long as your bunny is doing ok & they are managing, keep going with the antibiotics & don’t come off them too soon. Once again I hope Teddy’s story gives hope to anyone who has a bunny in this dreadful predicament, Teddy was given a poor prognosis & now it seems he’s come out the other side.  I must also mention, I kept in weekly contact with my vet via email, sending photos of the abscess & an update on how Teddy was doing.