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Susceptibility/Transmission
- Predisposed by immunosuppression, penetrating injury to the joint,
and chronic infection. (B609.2.w2)
- In Lepus europaeus - Brown hare,
infection may occur following fight wounds. (J514.1.w1)
Diagnosis
- Clinical signs and findings of the physical examination. (B609.2.w2)
- Radiography - synovial effusion, thickened periarticular
tissues, osteolysis, joint space irregularities/erosions,
periarticular osteophytes. (B609.2.w2)
- Synovial fluid may be turbid, with an increased leucocyte
count (mainly neutrophils), and bacteria free in the fluid or within
neutrophils. (B609.2.w2)
Treatment
- Antibiotics chosen based on culture and sensitivity. (B609.2.w2)
- Monitor for development of intestinal problems and discontinue
of the rabbit develops anorexia or diarrhoea. (B609.2.w2)
- Analgesia:
- NSAID, either meloxicam 0.2 - 0.5 mg/kg orally once daily or
carprofen 2.2 mg/kg orally twice daily. (B609.2.w2)
- Additional post-surgical analgesia: buprenorphine, 0.01 - 0.05
mg/kg subcutaneously or intramuscularly every 6 - 8 hours. (B609.2.w2)
- Surgery:
- Note: Septic joints in rabbits contain thick exudate and
simple lancing and drainage is unlikely to be effective. (B602.35.w35,
B609.2.w2)
- Open arthrotomy: debride the synovium - remove all
necrotic tissue - curette out all visible exudates, and flush with
copious quantities of warmed physiological saline. (B609.2.w2)
- Antibiotic-impregnated polymethyl methacrylate beads can
be placed into the joint space to give high antibiotic
concentration at the site of infection. (B609.2.w2)
- Choose the antibiotic according to culture and sensitivity,
choosing an antibiotic known to elute from polymethyl
methacrylate (PMMA) beads appropriately. (B609.2.w2)
- Mix 2 g cephalothin, cefazolin or ceftiofur per 20 g PMMA
powder, or 1g gentamicin or tobramycin per 2 g PMMA, or 1.25 g
amikacin per 2 g PMMA, then make into spherical beads. (B609.2.w2)
- Insert beads into the joint aseptically.
- Remove beads after 4 - 6 weeks. (B609.2.w2)
- See: Production of Antibiotic-Impregnated Beads (Techniques)
- 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)
- Amputate the affected limb - this is appropriate if
severe infection does not respond to treatment. (B609.2.w2)
- In general, rabbits cope well following amputation of one
limb (B609.2.w2),
particularly a hind limb. (V.w65)
- Supportive care:
- Soft bedding, changed daily.
- Restricted activity.
- Encourage feeding and fluid intake.
- Wet leafy foods as well as providing fresh water. (B609.2.w2)
- Provide a good range of green leafy foods, also concentrate
pellets. (B609.2.w2)
- If the rabbit is anorectic, feed with a syringe, or if necessary
by nasogastric tube. (B609.2.w2)See:
- For information on appropriate foods see: Food and Feeding for Mammals
- Convalescent Diets / Nutritional Support
- Note: prognosis is good to fair for acute infection with
aggressive treatment, but guarded to poor for more advanced disease,
if the responsible organism is particularly virulent or resistant to
antibiotics, or if several joints are involved. (B609.2.w2)
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