Ben entered the bicillin program with a residual open wound that was still about 6 cm in length along and under his jaw from sever abscess debridement and repeated cleaning, flushing, and dextrose packing. Ben was receiving an oral suspension of Ciprofloxacin 25 mg BID at the time (as he had been since May 5). The attempts to keep this wound clean before we began the bicillin regimen were horrifyingly unsuccessful; within 24 hours of every cleaning, whether severe veterinary work or at-home expression and flushing, purulence and inflammation would redevelop and require soaking, loosening, and expressing... again and again. This was a source of continuous discomfort for Ben, who clearly showed as much by his limited interest in food and concomitant weight loss, and by his generally depressed and withdrawn, unplayful, inactive demeanor often punctuated by hunched posturing.
Ben received his first injection of Durapen (weighing < 4 lbs. or 1.81 kg, he is at the 0.25 cc QOD dose) on Friday, June 29. By his third injection on July 3 Ben had started to show marked improvement by demanding and consuming more foods, initiating more active play and exercise, and by the evidence of healing closure of his wound site beginning to take place from the inside out. It was a pleasure to watch the gash shrink and flatten to sound new clear skin as the edges became less and less productive of pus. He saw his vet again July 7, at which time I gave him (having passed SubQ Admin 101) his 5th injection. The wound was down to a 1.5 cm long thin scab with uninflamed, pus-free edges. Ben's vet could discern no palpable or visual evidence of abscess. Last night I gave Ben his 7th QOD injection and took the opportunity to lift his sweet head enough to check the site carefully and was amazed to find it now completely covered in soft, clear, pale, intact skin, as though it had never been ravaged by either the abscess or the horribly invasive debridement processes that followed before we began the bicillin regimen. The nightmare of enduring the 'traditional' and medically inadequate management of Ben's severe abscess is over, and we are so grateful for the bicillin regimen that is so effective, non-invasive, and so expedient in accomplishing its work of defeating the persistent bacteria that had caused such significant tissue destruction. Bicillin is easy on the patient, which gives him the benefit of a stress-free recuperation, it is easy for the bunny caregiver to administer, and it is a very inexpensive program. Ben is once again feisty, demanding, engaging, he initiates play with enthusiasm, he appears happy, bright and relaxed, he has a lusty appetite and consumes such quantity of food that he is beginning to regain lost weight. He gained 2 ounces (56.7 grams) between his last two vet visits.
We will complete the recommended program of 8 weeks QOD followed by 4 more weeks at 3OD injections. At the beginning of this process, which for me was when Ben had his incisors removed and it became likely that a lower one would abscess, I researched comparative courses of treatment and determined that both the AIPMMA bead implantation and calcium hydroxide packing treatments were possibly too invasive and caustic for my comfort level with Ben, who had already experienced two surgeries and stressful follow-up work, and I was not able to locate practitioners near us who were skilled in either, which would have meant releasing Ben to the additional stresses of hospitalization away from home. I wonder if he would even have survived to this point, if we had not heard about Marcy Rosenfield's work, and if our vet had not been willing to review her protocol and agree to monitor Ben through the treatment period. The vets at Ben's clinic are overwhelmingly positive about his progress. I am pleased to realize that Ben's success will be reason for his vets to prescribe the bicillin regimen in other rabbit abscess cases. For Ben, thanks to bicillin, the good news keeps getting better. No doubt more bunnies will have bicillin prescribed first, as it continues to gain recognition as the most appropriate way to address and resolve bunny rabbit abscesses, particularly of the head
You can carry your bunny to the vet for all of these shots (bunny stress, time, and $$$) or you can gather enough courage and have your vet teach you to administer these subcutaneous injections (see this site also) at home, if you have an assistant there who can hold bunny in place. I took Ben to the vet for his first few shots, but each time I administered the injection under supervision and after tutoring. You can probably do this, too.
Your vet will have to teach and supply you, but these clues from my experience with Ben may help. Ask your vet to prescribe a 'microencapsulated' form of bicillin. This means the particles in the liquid are finer and will be easier to aspirate from the bottle to load the syringe, and also to inject. I have been taught that bicillin needs to be kept refrigerated and needs careful handling--it should be gently agitated (rocked back and forth slowly a few times) but not shaken furiously, prior to aspirating a dose. You will be surprised to discover that, as fine and slight and soft as they are, bunnies have tough, 'kevlar' skin, and you will need to use short needles in two gauges. I use a large #18 to aspirate the dose from the bottle, then discard that needle and install a finer #21 to the loaded syringe to inject the dose into Ben. Inexpensive disposable needles are designed to be used one time, and a second puncture can be very rough on the second membrane, which in this case is your bunny's skin, so be sure your vet dispenses two needles for each dose. You will be injecting at the shoulder/scruff area, just through the skin and into the space between skin and muscle. Make notes so that you can switch sides every time, and try to move from spot to spot so that you don't encounter a tough bit of scar tissue. Sometimes you will find a needle simply won't penetrate. Give it one good try, relocate in case you were pushing against scar tissue, and if you fail again, change to a new needle. There are dull needles, and you'll get some. Trust your judgment; you'll learn to recognize the difference. Grasp the syringe on the shank above the needle while you penetrate the skin (this gives you good, close grip and control; stay away from the injector end while you insert the needle); hold the syringe as parallel to the bunny's back as possible (to help prevent accidental entry into muscle); and insert with the needle point toward bunny, the bevel toward you; once you have the needle inserted through bunny's skin, before you inject, aspirate out slightly to be sure you are not at a blood supply. If you withdraw pink, remove your needle without injecting -- this is critically important so be sure your vet explains this point and that you understand it.
BenBun seems totally oblivious to these repeated injections. I console myself by giving Ben his favorite blueberry treat or a dab of pumpkin with his daily BeneBac dose as a reward for being such a tolerant patient. Ben and I wish you much success with Bicillin, and hope that, like Ben, your bunny will easily return to radiant, robust, good health.
- Sharon Lloyd, July 12, 2001
Poor BenBun; early last fall I discovered a
small, new jaw abscess. His vet assured me that it was unrelated to the
original one that had been caused by a decayed and infected tooth root.
He guessed that a hard, sharp stem of alfalfa hay might have poked BenBun
in the mouth to cause this second abscess. It was a week before Ben's
vet could schedule an exam and treatment, so by then we had to have this
new abscess opened and debrided also. We resumed bicillin subQ injections
at the 0.25 cc dose and opted for dailies for the first two weeks, then
tapered back to
every other day. Ben's second abscess resolved quickly and his Christmas present last year was the last of the two-month series of these unobtrusive little shots that once again saved him the stress, and me the great expense, of surgical bead implantation, and allowed his body to return to radiant, fine health easily again.
BenBun and I are deeply indebted to Marcy Rosenfield
Moore for having the intelligence to design this protocol, and the caring
wisdom to share it with companion rabbits like BenBun and hundreds of other
bunnies whose health and lives have been restored following this easy
program of at-home care.
- Sharon Lloyd, March 25, 2002