Transverse planar ultrasonographic images of the left eye and retrobulbar area in the same rabbit as in Figure 1. aImage of the left eye and retrobulbar area at the time of initial examination. Atlantic Coast Veterinary Conference 2001. He confirmed there was a mass behind the eye, but is was way back behind the eye. Systemic problems may also affect the metabolically active apical germinal tissue and odontoblasts.13,19-23, Diagnosis and treatment of dental disease are often complicated by a vague clinical history, examination late in the disease process, variable and nonspecific clinical signs, and the difficulty inherent in performing detailed oral cavity examination in conscious rabbits. Medical Information Search. Baumgartner JC. Due to the close apposition of the globe to the posterior dental molar roots , dental disease and root infection can lead to severe exophthalmos. Uh oh. Notice the soft tissue mass representing the exophthalmic left eye (white arrow) and the abnormally located left maxillary molar (black arrow). [47] record evidence from . This case report describes a 13-month-old female neutered Netherland Dwarf rabbit that was diagnosed with a dental associated infection of the right maxillary third premolar. The ear normally due to an infection or sometimes it is secondary to dental disease. Moderate to expensive, if computed tomography, Due to manipulation with the eye, oculo-vagal reflex (bradycardia) was seen by the author in two cases. Remeeus PG, Verbeek M. The use of calcium hydroxide in the treatment of abscesses in the cheek of the rabbit resulting from a dental periapical disorder. MeSH With endoscopic guidance, an angled curette was used to debride and remove inspissated material from the socket in piecemeal fashion (Figure 3). 2020 VetPartners Practices Limited t/a Willows Veterinary Centre, Registered Address Spitfire House, Aviator Ct, York YO30 4UZ. Download Free PDF . Exophthalmos is the most prevalent clinical sign associated with orbital disease. cView of cavity debridement being performed with an angled curette. If the abscess was only lanced and drained, then antibiotic therapy might continue for weeks to months. The elongated root of the 5th maxillary cheek tooth has penetrated the bone and continued to grow into the abscess cavity in the orbit (arrowed). CAB Direct This was very abnormal for her as she is a ravenous beast that will eat anything in her path. Fluorescein stainingf revealed a superficial corneal ulcer in the left eye. Accessibility ago. Practice repositioning of proptosed globe and drainage of retrobulbar abscess via pterygopalatine fossa . It is also possible that the acute pain and ocular signs were actually a result of retrobulbar hemorrhage. } Jenkins JR. Soft tissue surgery. Microbiological and molecular analysis of endodontic infections. Treatment of retrobulbar abscesses is an extremely difficult procedure and, unfortunately the majority of chronic retrobulbar abscesses may recur. Intraocular pressuree was 14 and 13 mm Hg in the right and left eye, respectively. .avma_container div{ Surgical treatment of rabbit retrobulbar abscesses by enucleation and abscess drainage procedure. For a better experience, please enable JavaScript in your browser before proceeding. Notice that the material caudomedial to the curvilinear line is less echogenic than the wall and that the structure displaces the globe rostrolaterally. Unlike dog and cat pus (exudate), rabbit exudate is thick and semi-solid, much like toothpaste, making it difficult to flush. INTRODUCTION. Would you like email updates of new search results? The reason for the thick consistency is that there is an enzyme missing that is in other mammals, such as dogs, cats and humans that can break the dead cells into a more liquid form. Surgical or medical management of subperiosteal orbital abscess in children: a critical appraisal of the literature. The .gov means its official. A bacterial abscess of the tooth roots can come about rather quickly (hours-days), but other things can cause eyes to protrude (called exopthalmos), such as tumors, which grow on the order of weeks-months. Abscesses that form internally can be more difficult to diagnose or manage and include areas such as the uterus, lungs, heart, liver, abdominal fat, intestine and kidneys. We have updated the search filter for evidence-based literature in our databases. Similar endoscopic techniques performed with an intraoral camera system have been reported in human and equine dentistry.29 In the rabbit of the present report, a 2.7-mm telescope permitted detailed examination and assisted in successful tooth extraction and abscess debridement. Euthanasia typically involves an injection into a main vein which will quickly and painlessly send the rabbit to sleep. If you would like to, you can learn more about the cookies we use. It depends on the underlying cause. opacity: 1; Case description: A 1-year-old sexually intact female Netherland dwarf rabbit was examined because of a 3-week history of signs of lethargy, decreased appetite, left unilateral exophthalmia, a previous draining sinus from a left maxillary facial abscess, and bilateral nasal discharge. background: #EBF6F7; A concurrent medical treatment . 2019 Oct;12(10):1546-1553. doi: 10.14202/vetworld.2019.1546-1553. official website and that any information you provide is encrypted Abstract Case DescriptionA 1-year-old sexually intact female Netherland dwarf rabbit was examined because of a 3-week history of signs of lethargy, decreased appetite, left unilateral exophthalmia, a previous draining sinus from a left maxillary facial abscess, and bilateral nasal discharge. van der Woerdt A. Ophthalmologic diseases in small pet mammals. Atlantic Coast Veterinary Conference 2001, Advances in diagnosis and treatment of small exotic mammal dental disease, Clinical aspects of lagomorph dental anatomy: the rabbit (, A review of clinical conditions in pet rabbits associated with their teeth, Calcium deficiency, diet and dental disease in pet rabbits, Parathyroid hormone, haematological and biochemical parameters in relation to dental disease and husbandry in rabbits, Soft tissue surgery and dental procedures, Endoscopic assessment and treatment of cheek teeth malocclusion in pet rabbits, Endoscopy as an aid to the examination and treatment of oropharyngeal disease of small herbivorous mammals, Diagnosis and management of a retrobulbar abscess of periapical origin in a domestic rabbit, Microbiological and molecular analysis of endodontic infections, The use of calcium hydroxide in the treatment of abscesses in the cheek of the rabbit resulting from a dental periapical disorder, Peridontal bacteria in rabbit mandibular and maxillary abscesses, Ophthalmologic diseases in small pet mammals, Departments of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, Departments of Anatomy and Radiology, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, COPYRIGHT ASSIGNMENT AND Clinical findings: Continuously growing dentition predisposes rabbits to development and persistence of dental problems.13-15 Dental disease in pet rabbits can be staged.3,16,17 The precise etiology of dental disease in pet rabbits is still unknown and is likely to be multifactorial and include genetic, dietary, metabolic, traumatic, and infectious components.17,18 Dental disease can be caused by primary (inherited) or secondary (acquired) malocclusion. Blackwell NJ. The abscess cavity may also need debriding and being packed with antibiotic impregnated beads. London: Mason Publishing Ltd, 2005;113144. 2006 Sep;9(3):657-65. doi: 10.1016/j.cvex.2006.05.022. Semin Avian Exot Pet Med 1999;8:139141. Medical treatment is generally unrewarding and surgical removal of the eye (enucleation) is usually necessary. Hillyer EV. Take a look at our filter for Evidence Synthesis! A case report and review of the literature. Ideally, all of the wall of all abscesses should be cultured for both aerobic and anaerobic bacteria to determine the best choice for antibiotic therapy with or without surgery. During this time subscribers will be able to start accessing subscribed content on CABI Digital Library and enjoy the platforms many benefits. . Retrobulbar and facial abscesses of periapical origin in rabbits often carry a poor prognosis [1,2]. 97. Treatment of a retrobulbar abscess secondary to dental associated infection in a rabbit . Causes of exophthalmia include orbital or retroorbital abscess, cellulitis, neoplasia, hematoma, orbital cyst (including Taenia serialis cyst), retrobulbar fat prolapse, salivary mucocele, myositis, lacrimal gland disease, foreign body, granuloma, and trauma.7-10 Exophthalmia must be distinguished from buphthalmia secondary to congenital glaucoma or other diseases such as uveitis, trauma, tumors, or Encephalitozoon cuniculi infection.11,12 Retrobulbar disease is the most common cause of exophthalmia in rabbits.7,12 Retrobulbar abscesses may be the result of endodontic infection, penetrating foreign bodies, local injury, or spread of infection from the bloodstream.13, Understanding rabbit dental anatomy and physiology is essential to diagnosis, treatment, and prognosis of conditions involving the oral cavity. Table 1. Hence, a rabbit that presents for primarily ophthalmologic signs such as epiphora or exophthalmus should receive a full dental examination. 2007 Jul 15;231(2):284-9. doi: 10.2460/javma.231.2.284. The most common signs of a retrobulbar abscess are bulging of the eye, protrusion of the third eyelid across the eye and inability to close the eyelids completely. complications from abscess. Two months after the initial surgery, only minimal exophthalmia was evident and no further physical, radiographic, or ultrasonographic changes were noticed. Rabbits can form abscesses in nearly any organ of the body as well as in skin, tooth roots and bone. Legendre LFJ. Federal government websites often end in .gov or .mil. An 18-gauge catheter was directed into the cavity, which was copiously flushed with 200 mL of warm sterile saline (0.9% NaCl) solution. Usually an abscess is the result of a bacterial infection. Preoperative assessment and long-term monitoring were achieved with a combination of radiography, ophthalmic ultrasonography, and CT. Extraoral rigid endoscopy via a fenestration in the maxilla was used to facilitate surgical debridement of the lesion, and extraction of multiple cheek teeth has been fundamental to achieving control. In:Lemox AM, ed.Rabbit and rodent dentistry handbook. Rabbit abscesses can be challenging to treat. Bacterial infection or abscessation - foreign bodies in young animals and dental disease in older animals; Fungal infection behind the eye - not common Figure-4. The course of antimicrobial treatment was consequently extended until complete clinical remission was observed. J Small Anim Pract 2001;42:130136. Lake Worth, Fla: Zoological Education Network Inc, 2005;109110. Surgery will be required to go behind the eye, drain the pus and prevent any further damage. width: 100%; Open in a separate window. This image shows the left upper arcade of cheek teeth in the mouth of a rabbit with a retrobulbar abscess affecting the left eye. Kelleher SA. The effect of the abscess (es) will depend on the location and the organs affected. There are over 15,022,000 records available in CAB Direct | Last updated on March 3, 2023, In early 2023 CAB Abstracts, Global Health and CABIs Database Subsets are scheduled to begin their migrating journey to our new platform CABI Digital Library. Tyrrell KL, Citron DM, Jenkins JR, et al. Anesthesia was discontinued, and the rabbit recovered from anesthesia without complications. Vet Clin North Am Exot Anim Pract 2002;5:341356. It can be caused by an abscess or a growth. Complete surgical removal of the abscess along with correction of the cause gives the best chance for a complete cure. This causes a high recurrence rate, since only a small amount of exudate needs to be left inside the abscess cavity for it to return. Abstract. dCloseup view of the cavity remaining after extraction of the molar and debridement and flushing; notice the root of the adjacent left maxillary first molar (arrow). Definitely not the worst, but it's good she'll be seen soon. Holy was put on antibiotics. Also, abscesses can be internal or develop under the skin. This is exophthalmos caused by a retrobulbar space occupying mass. Calcium deficiency, diet and dental disease in pet rabbits. Indian J Ophthalmol 2000;48:129134. Clinical aspects of lagomorph dental anatomy: the rabbit (Oryctolagus cuniculus). The symptoms that are present with a retrobulbar abscess in dogs will prompt a thorough eye exam to be completed. (See. He has a retrobulbar abscess which we will be removing soon but I've noticed that recently there began to appear egg-shaped droppings. J Am Vet Med Assoc. Dorsoventral (a) and right dorsalleft ventral oblique (b) radiographic views of the head of a rabbit examined because of unilateral exophthalmia and a history of a draining sinus in the left maxillary area of the face. Oof, poor girl. We started with antibiotics, vet said it could be 4-6 weeks before we saw results. Clinical signs may include decreased appetite, chewing or swallowing difficulties, ptyalism, palpable facial or mandibular swellings secondary to periapical pathologic changes or soft tissue infection and abscess formation, exophthalmia, ocular or nasal discharge, abnormal rabbit anisognathous occlusion, and unkempt body fur.17 Diagnostic imaging techniques including radiography, computed tomography, and ultrasonography are useful for localizing dental and associated soft tissue lesions before undertaking surgical correction.11,24, Although a cursory examination with an otoscope or illuminated nasal speculum can be conducted in anesthetized rabbits, endoscopic examination is superior for providing a focused light source and magnification.4,20,25 Radiography has limitations in assessment of dental disease20; however, it is indicated as a primary diagnostic tool.17,20 Although its use has not been well documented in the investigation of dental disease in rabbits, computed tomography may also be useful in selected instances of refractory dental disease.24, Endoscopy has been advocated for evaluation of the oral cavity in lagomorphs and rodents.4,26,27 To the authors' knowledge, the use of rigid endoscopy in the assessment and treatment of a retrobulbar abscess has only been previously reported in association with an extraoral approach.28. The rabbit was hospitalized for supportive care overnight and was scheduled for elective surgery for tooth removal and abscess debridement the following day. Crossley DA. Antimicrobials were flushed into the tooth abscess cavity, and antimicrobial treatment was initiated on the basis of cytologic findings and results of bacterial culture and susceptibility testing.Two months after the initial surgery, minimal exophthalmia was evident and no further physical, radiographic, or ultrasonographic changes were evident. Atlantic Coast Veterinary Conference 2001. . Leukocytosis with neutrophilia may be present. At the time of initial examination at the teaching hospital, the rabbit weighed 1.0 kg (2.2 lb) and was in poor body condition (body condition score, 1.5/5). Recommended surgical treatment of such abscesses involves complete excision of the lesion, aggressive debridement of affected bone [3], and removal of associated teeth or tooth fragments [1]. Some rabbits can live with abscesses on various parts of their body for years by having them surgically drained as needed. Recommended surgical treatment of such abscesses involves complete excision of the lesion, aggressive debridement of affected bone [3] , and removal of associated teeth or tooth fragments [1] . width: 100%; The abscess capsule is defined by the hyperechoic curvilinear line (arrowheads) caudomedial to the globe (arrow), and the abscess contents are the hypoechoic material ventral to the line. Vet Clin North Am Exot Anim Pract 2006;9:657665. Please email CABIsupport@cabi.orgwith your LibKey API Key and LibKey Static ID whichmay berequested from Third Ironsupport@thirdiron.com. Unfortunately a lot of the pics people put online are the most obvious cases they've seen, and many of those occur with total neglect of the rabbit, or someone not paying very close attention to their rabbit. During those examinations, improvements in demeanor and appetite were observed, along with a 14% weight gain to 1.14 kg (2.5 lb) at the time of the first reevaluation. https://www.cabi.org/join-our-research-panel/. In addition, some lumps are not abscesses at all but rather tumors or cysts and may need immediate removal. 3-mm round long burr, Surgical Innovations Inc, Suwanee, Ga. Consil, Nutramax Laboratories Inc, Edgewood, Md. A review of clinical conditions in pet rabbits associated with their teeth. Two months after the initial surgery . These tests might include bacterial culture of the wall of the abscess (culturing the pus itself is not useful), x-rays and/or ultrasound to determine the location and extent of the infection, and blood tests to determine the response of the immune system and the condition of other organs. Date Reviewed/Revised: 01/05/2012. It is the bodys natural defences to try and wall off infection to stop it spreading elsewhere within the body. Endoscopic examination was performed with a 5-mm, 0 otoendoscope and a 2.7-mm, 30 Hopkins telescope attached to a xenon light source via a fiber-optic cable and a camera providing video feed to a monitor.4,m Digital video and still images were captured with a documentation system. Brook DL. Ultrasonography (scan) of the eye can be performed when the animal is conscious or under light sedation depending on the nature of the animal. . What is a retrobulbar problem? Results of susceptibility testing revealed that no single antimicrobial was effective against both bacteria. Most facial abscesses are the result of dental disease. In:Manning PJ, Ringler DH, Newcomer CE, ed.The biology of the laboratory rabbit. Philadelphia: WB Saunders Co, 2004;221229. The edges of the lytic bone were curetted back to healthy tissue, creating After induction, the rabbit was intubated by use of a fiberoptic laryngoscopeg and a 2-mm uncuffed nasotracheal tube.h A 24-gauge IV catheter was placed in the cephalic vein, and 22.2 mL of half-strength lactated Ringer's solution (NaCl concentration, 0.45%) containing 2.5% dextrose was administered at 10 mL/h during the anesthetic period. }. Citation: Journal of the American Veterinary Medical Association 230, 6; 10.2460/javma.230.6.868. @article{Ward2006DiagnosisAM, title={Diagnosis and management of a retrobulbar abscess of periapical origin in a domestic rabbit. This can prove long and expensive, and treatment may need to be aimed at palliative care, to keep the rabbit comfortable for as long as possible. Orbital abscess as a complication of odontogenic infection. Capello V. Other diagnostics. Would you like email updates of new search results? Retrobulbar abscess may be distinguished from other causes of exophthalmos on the basis of its acute onset, pain, and often pyrexia. sharing sensitive information, make sure youre on a federal Dental and oral disease in lagomorphs. That's good. Harcourt-Brown FM. Ultrasound to examine the "ocular and periocular tissues will help identify a retrobulbar abscess." Finally, aspiration using a fine needle can help rule out other conditions such as neoplasia (abnormal tissue growth. Tooth root abscesses in llamas and alpacas: 123 cases (1994-2005). The accumulated fluid in the tear duct is a perfect breeding ground for bacteria and an abscess can form easily. Drainage of a retrobulbar abscess through the mouth can be successful in mild cases, and if caused by a tooth. .item01 { Retrobulbar abscesses Eye: retrobulbar abscess are also common. Notice that the previous hyperechoic curvilinear line caudomedial to the globe is absent. bView of the soft tissue defect (arrow) remaining after removal of the left maxillary second molar. San Diego: Academic Press Inc, 1994;467472. Synonyms for retroarticular abscess in Free Thesaurus. Diagnostic investigation revealed anemia, neutrophilia, severe dental disease, a superficial corneal ulcer of the left eye, and a retrobulbar abscess. Available at: www.vin.com/VINDBPub/SearchPB/Proceedings/PR05000/PR00293.htm. X-rays will not only show abnormalities behind the eye, but will also give the opportunity to confirm or rule out dental disease. Unauthorized use of these marks is strictly prohibited. Philadelphia: WB Saunders Co, 1986;711725. A small angled elevator was used to break down the soft tissue attachments securing the molar. Physical examination revealed generalized muscle atrophy, bilateral mucopurulent nasal discharge, and severe left-sided exophthalmia. This type of abscess is known as "retrobulbar abscess" leading pet owners to think there is something wrong with their pets eye, when in reality the abscess is caused by the decay on the tooth. An abscess is a cavity containing pus surrounded by a capsule of thickened, inflamed tissue. It will often be necessary to perform diagnostic tests to investigate the cause of the abscess and to determine if other disease is present. Crossley DA. 24 Survival . The rabbit Abnormal ocular or oculonasal discharge can also develop as a consequence of the eye irritation and the rabbit may show signs of discomfort such as excessive blinking and grinding .
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