Complex Rabbit Dental Abscess (Second Opinion)

Rabbit Facial Abscess and Severe Dental Disease Treatment for Long Island Patient at Long Island Bird & Exotics Veterinary Clinic

Rabbits have a remarkable ability to hide when something is wrong. As prey animals, they naturally conceal signs of pain or illness, and this tendency makes dental disease both common and risky if left unnoticed. What often looks like a small eye issue or a minor swelling on the cheek can actually be the tip of an iceberg, hiding a serious infection within the jawbone.

Recently, Long Island Bird & Exotics Veterinary Clinic received a complex case involving the patient, a 5-year-old male rabbit from Nassau County, NY. The patient was brought to us for a second opinion. The rabbit had been suffering from facial swelling and ocular discharge that previous treatments had failed to resolve. This case serves as an example for pet owners throughout New York, including Great Neck, Queens, Brooklyn, and beyond, of why advanced imaging and specialized exotic surgical care are essential when treating complex rabbit health issues.

The Patient: Seeking Answers for a Recurring Issue

The patient presented to our facility with a history of recurring dental issues. The patient's owners had noticed a mass developing on the left side of the rabbit's jaw, accompanied by significant facial swelling and discharge from the rabbit's eye.

The rabbit had a known history of dental issues, but despite previous attempts at management with antibiotics, the condition was worsening. The owners were faced with a list of possibilities: was it a simple tooth spur? Lymphadenitis (inflammation of the lymph nodes)? Or perhaps neoplasia (cancer)?

When the patient arrived at our clinic in Great Neck, our team knew that standard physical exams would not be enough. To save this patient’s jaw—and ensure the rabbit's overall health—we needed to see what was happening inside.

The Diagnosis: Why X-Rays Aren't Enough

In many veterinary practices, dental disease is initially evaluated with a physical exam and standard X-rays. While X-rays are helpful, they provide only a 2-dimensional view of a complex 3-dimensional skull. In rabbits, tooth roots extend deep into the jaw and skull, and infections or dental abnormalities can be hidden behind bone, making them easy to miss on X-rays.

To fully assess the extent of the dental disease, identify any hidden infections, and help guide treatment, especially for potential recurring issues, our veterinarian recommended a CT scan. This advanced imaging provides a detailed, 3-dimensional view, allowing for a more thorough and precise approach to dental care.

The CT Scan Findings

The results of the advanced imaging were immediate and revealing, uncovering pathology that was far more severe than a physical exam suggested:

• Multifocal Severe Dental Disease: The issues were not limited to the swelling on the left. The scan revealed advanced disease on the right side as well, which had not yet shown external symptoms.

• Intraosseous Abscesses: There were multiple abscesses located inside the bone (intraosseous) and surrounding the roots of the right mandibular cheek teeth.

• Soft Tissue Extension: On the left side, a tooth root abscess was beginning to spread into the soft tissues of the face.

• Nasolacrimal Involvement: The extensive facial swelling was originating near the tear ducts (nasolacrimal puncta), explaining the chronic eye discharge.

• Calciuria and Lung Concerns: The scan also allowed us to check the patient's overall health, identifying calcium in the bladder and some concern for pulmonary issues, which helped us tailor the anesthesia protocol.

This diagnosis changed the entire treatment plan. We weren't just treating a "swollen face"; we were battling deep, multi-site osteomyelitis (bone infection).

The Treatment: Advanced Surgical Intervention

Treating rabbit dental abscesses is one of the most difficult challenges in exotic medicine. Unlike dog or cat abscesses, rabbit pus is thick (caseous) and does not drain on its own. Furthermore, the infection is often encapsulated in the bone. Antibiotics alone cannot penetrate these thick capsules; surgical intervention is mandatory.

Based on the CT roadmap, our doctors formulated a precise plan.

1. Oral Endoscopy and Debridement

We utilized video endoscopy to get a magnified view of the oral cavity. This allowed us to address the dental disease intra-orally with high precision, filing down points and removing compromised teeth that were acting as a source of infection.

2. Surgical Excision of the Abscess

The surgical team performed a debridement of the facial abscess. This involves:

• Surgically opening the infected area.

• Removing the necrotic (dead) tissue and thick caseous pus.

• Locating and removing the source of the infection (the affected tooth roots).

3. Open Wound Management

In complex rabbit abscess cases, closing the wound immediately can be a mistake, as it may trap microscopic bacteria inside, leading to recurrence. Instead, the incision site was managed to allow for flushing and cleaning. We treated the area with antibiotics directly at the source. The incision was flushed daily with antibiotics for several days to ensure the infection was cleared from the inside out before the site was fully closed.

Recovery and Long-Term Management

Post-operative care for rabbits is critical. Pain causes stress, and stress can cause a rabbit's gastrointestinal tract to shut down (GI Stasis). The patient was hospitalized and monitored closely by our specialized nursing staff.

• Pain Management: The patient received a multi-modal pain management protocol.

• Nutritional Support: Assisted feeding ensured the patient's gut kept moving while the patient's mouth healed.

• Antibiotic Therapy: The patient was discharged with specific antibiotics to combat the deep bone infection.

Following the procedure, the patient's owners reported the rabbit is doing well at home. The swelling has resolved, the eye discharge has ceased, and the rabbit has returned to its normal, happy self. By catching the disease on the "silent" side of the mouth via CT scan, we also prevented a future emergency.

Frequently Asked Questions (FAQs)

My rabbit has a runny eye. Is it always an eye infection?

Not always. In rabbits, the roots of the upper teeth sit just below the tear ducts. If a tooth root grows abnormally or becomes infected (a tooth root abscess), it can block the tear duct, causing the eye to weep. If your rabbit has chronic eye discharge that eye drops aren't fixing, they likely need a dental exam.

Why do you recommend a CT scan instead of just an X-ray?

Rabbits have very complex skull anatomy with many overlapping bones. X-rays are 2D shadows and often hide infections located between teeth or deep inside the jaw. A CT scan provides a 3D, 360-degree view, allowing us to see the exact size and location of an abscess, which is vital for successful surgery. CT is used for complex cases, where understanding the full extent of the infection can make the difference between recurrence and a complete cure.

I live in Brooklyn. Do I really need to travel to Great Neck for rabbit dental care?

We believe it is worth the trip. Long Island Bird & Exotics Veterinary Clinic is one of the few practices in the Tristate area with an on-site CT scanner and Doctors who specialize exclusively in avian and exotic animals. We frequently treat patients from Brooklyn, Queens, Manhattan, and the Bronx who require this higher level of diagnostic capability.

Contact Long Island Bird & Exotics Veterinary Clinic:

• Website: https://www.birdexoticsvet.com/

• Phone: (516) 482-1101

• Schedule Online: Contact Us