DISEASE SUMMARY PAGE

Osteomyelitis in Lagomorphs

Summary Information
Diseases / List of Bacterial Diseases / Disease summary
Alternative Names  
Disease Agents
  • Various bacteria, particularly Pseudomonas spp. (B602.35.w35) also Pasteurella multocida. (B600.16.w16)
  • Following either traumatic injury or surgery, associated with avascularity of bone, contamination of the wound (more than 105 organisms per gram tissue) and a suitable environment - e.g. a haematoma. (B602.35.w35)
  • Dental disease, particularly periapical abscesses. (B600.8.w8)
    • Malnourishment can exacerbate abscessation. (B600.8.w8)
  • Secondary to Ulcerative Pododermatitis in Lagomorphs. (B600.9.w9)
Infectious Agent(s)  
Non-infectious Agent(s) --
Physical Agent(s) --
General Description
Clinical signs
  • In a rabbit following fracture repair: fluctuant swelling of the foot, inability to bear weight on the affected foot. On incision of the swelling, thick, partially inspissated pus was released. The fracture failed to heal despite wound flushing and appropriate systemic antibiotics. (J4.185.w7)
  • Mandibular swelling, bony. (J196.70.w1)

(B602.35.w35)

Pathological findings

Gross pathology

  • Affected mandible grossly and irregularly enlarged, containing a 2.5 cm diameter well-circumscribed holly bony mass, the inner wall of which was lined with inspissated pus, and a fistulous tract through the bone. (J196.70.w1)

Histopathology

  • In a rabbit following fracture repair: 
    • Fracture site abscessation, extending into the medullary cavity of the affected metatarsal, with little overlying cellulitis. (J4.185.w7)
  • In a rabbit with mandibular osteomyelitis: hollow bony mass with a fibrous capsular wall, acute and chronic inflammatory cells and inner degenerative heterophils. Numerous irregular exostoses with degenerative (lytic) changes. Throughout the affected mandible, fibrosis and inflammatory cell infiltration. (J196.70.w1)
Further Information
Susceptibility
  • Open fractures are more likely to develop infection leading to osteoarthritis in rabbits than in most other species. (B601.17.w17, B602.35.w35)
  • Compromised blood supply to the bone increases the risk of infection. (B602.35.w35, J4.185.w7)
Transmission
  • Infection may be from gross contamination or blood-borne spread from another site of infection in the rabbit. (B602.35.w35, J4.185.w7)
Diagnosis
  • Clinical signs.
  • Radiographic findings.
    • In osteomyelitis of the mandible, bony proliferation around central osteolytic areas. (J196.70.w1)
    • Periosteal reaction and osteolysis; sometimes an involucrum. (B602.35.w35)
    • Radiography is important to show the extent of bone (and joint) involvement and destruction. (B600.8.w8)
      • The prognosis is poor if osteomyelitis affects more than one limb. (B600.8.w8)
  • Culture of pus and sensitivity testing is required. (J4.185.w7)
    • Send samples for both aerobic and anaerobic culture. (B602.35.w35)
  • Differential diagnosis for dental-related facial osteomyelitis swellings includes neoplasia. (B600.8.w8)
Treatment
  • Aggressive treatment is required; treatment of osteomyelitis in rabbits appears to be more difficult than in most other species and is not always successful. (B601.17.w17, B602.35.w35, N12.38.w1)
  • Surgical drainage and debridement followed by appropriate antibiotic treatment. (B602.35.w35, J196.70.w1)
    • Infected bone and any foreign bodies (including elongated tooth crowns, if these are penetrating tissue) must be removed, as well as infected tooth roots in osteomyelitis associated with apical abscesses. (B600.8.w8)
    • All sinuses and tracts must be thoroughly explored to detect deeper connecting abscesses. (B600.8.w8)
    • Antibiotic treatment should be based on culture and sensitivity, using an antibiotic which is effective against the causal agent and reaches therapeutic levels in the affected tissues. (B600.8.w8)
    • Antibiotic-impregnated beads, containing appropriate antibiotics at appropriate concentrations, may be implanted under sterile conditions. (B602.35.w35)
      • This provides a high concentration of antibiotic at the required site. (B600.8.w8)
      • As an added advantage, some owners may find the stitched-up wound more aesthetically pleasing than an open cavity which is receiving topical treatment. (B600.8.w8)
      • Note: care is required. If the abscess capsule is not intact (i.e. the abscess is not fully walled off), there may be leakage of antibiotic into the surrounding tissues and thereby the systemic circulation. If this occurs, the usual considerations apply regarding possible effects of antibiotics on the rabbit's gut flora. (V.w65)
  • Repeated surgery may be required. (N12.38.w1)
  • Amputation may be an option if extensive bone destruction affects one limb only. (B600.8.w8)
    • Note: following amputation, there is an increased risk of development of ulcerative pododermatitis in the remaining limbs, due to increased pressure. (B600.8.w8)
  • Improve general health by good husbandry including a good diet, companionship, comfortable bedding and appropriate exercise opportunities. (B600.8.w8)
Prevention
  • Ensure strict sterile technique during orthopaedic surgery, as well as careful tissue handling, good haemostasis and good anatomical closure. (B602.35.w35)
Associated Techniques
Host taxa groups /species
Disease Author Dr Debra Bourne MA VetMB PhD MRCVS (V.w5)
Referees John Chitty BVetMed CertZooMed MRCVS (V.w65)

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