Veterinary Vertex

Revolutionizing Rabbit Dental Health: Treating Odontogenic Abscesses

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Expand your knowledge of rabbit dental health with Dr. Ivana Levy, who joins us to shed light on the intricate challenges of treating odontogenic abscesses in rabbits. Unpack the details of this JAVMA study that boasts an 85% success rate in treating these painful afflictions with a non-invasive method that could change the game for veterinary care. Ivana's expertise doesn't just stop at treatment; it extends into the realm of preventive care and the vast array of bacteria that can complicate these conditions. This episode is a resource for anyone invested in the well-being of rabbits and eager to expand their knowledge in zoo medicine.

JAVMA article: https://doi.org/10.2460/javma.23.12.0718

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Speaker 1:

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Speaker 2:

Dogs should be tested for existing heartworm infection prior to starting a preventive. To learn more, visit nextguardpluscliniccom. You are listening to Veterinary Vertex, a podcast of the AVMA Journals. In this episode we chat about the diagnosis and outcome of odontogenic abscesses in client-owned rabbits with our guest, ivana Levy. Ivana, thank you so much for being here today.

Speaker 3:

Thanks for having me, this is a pleasure.

Speaker 2:

Let's hop on over your Javma article discusses the diagnosis and outcome of odontogenic abscesses in client-owned rabbits. Please share with our listeners the background on this study and client-owned rabbits.

Speaker 3:

Please share with our listeners the background on this study. Yeah, so rabbits are one of the most common companion pet species and seen so frequently in veterinary clinics. However, they have like a completely different dental anatomy than cats and dogs due to their constantly growing teeth, and are unfortunately really prone to dental disease. A known complication of dental disease in rabbits is the formation of these adonogenic abscesses, which can be painful and even life-limiting.

Speaker 3:

We designed this study because there was minimal information about the treatment and outcome of this condition in the available literature and, ideally, the findings from our study can be utilized day-to-day in veterinary clinics.

Speaker 2:

What were some of the pivotal findings from this study?

Speaker 3:

Yeah, I would say one of the most important findings is that we determined that an abscess packing technique, which has been previously described, combined with systemic antibiotics can be a successful way to treat even aggressive odontogenic abscesses and rabies. It was really positive that we found an 85% success rate with this treatment protocol. The abscess packing technique just really quickly just includes excising the abscess capsule, removing that material, packing the site with antibiotic soaked gauze and then suturing it closed. The surgical procedure does occur under general anesthesia and it usually requires an average of like four to five anesthetized events for resolution. The benefits of it is that this technique doesn't require invasive surgical intervention or even like tooth extraction. So any veterinarian who feels comfortable treating rabbits in clinical practice and may not be as comfortable with like extensive surgery or manipulation could really easily treat this condition. So it's pretty exciting.

Speaker 2:

Yeah, that sounds really really great and super useful. I am going to put in a plug for our video manuscripts, which you may or may not have heard of, but even a manuscript category and they're called technical tutorial videos and they serve as clinical teaching techniques. So things designed for students, house officers, early career or even mid-career veterinarians that are looking to dip their toes into a different species to work with. So something to keep in mind for the future. They do receive a DOI and are fully citable. Put that in there.

Speaker 2:

Yeah, I should check that out, yeah, no they do receive a DOI and are fully citable. Put that in there. Yeah, I should check that out. Yeah, no, they're pretty neat. Yeah, so what sparked your research interest in rabbit odontogenic abscesses?

Speaker 3:

Yeah, like a little bit about the background. I mean, rabbits are such a popular companion species, they're seen at all veterinary hospitals, not just specialty institutions.

Speaker 3:

They're really fantastic pets because they're long-lived and they're really quite sociable. When we are assessing rabbits where I work at the University of Wisconsin right now, one of the most common and frustrating conditions we diagnose and try to treat in rabbits is dental disease. It can be so stressful and frustrating to treat because it can be a lifelong condition and it can lead to the formation of these really painful odontogenic abscesses. We suspect odontogenic abscess formation in rabbits is more common than what's described in the literature right now. So in describing the kind of treatment and outcomes and even like the clinical signs which are listed in this paper, we want it to be helpful for other clinicians to get more information trying to treat it and discuss options with rabbit owners.

Speaker 2:

Always nice to have another tool in the toolkit, especially when it comes to client communication. So I think this manuscript will be very helpful. And then, selfishly, why did you choose to submit this manuscript to JAVMA?

Speaker 3:

That is an excellent question. So JAVMA seemed like a great choice for us because it covers such a broad range of veterinary topics I don't know where else I could read a sheep article and then read a rabbit or a reptile article, know where else I could read a sheep article and then read a rabbit or a reptile article and because it has such a wide reaching audience. I think a lot of zoo medicine or zoo companion comes from like word of mouth and who you know and I really like Javma because they're kind of on the forefront of helping zoo medicine become more kind of wide reaching and reaching a more general audience.

Speaker 2:

And, speaking of that too, we're actually going to be creating a virtual collection of freely accessible rabbit articles because we are getting so many and our readership does seem to enjoy them. So this will cover things from like zoo companion, like you said, to lab, animal wildlife, etc. So be on the lookout for that. Now you touched on the pivotal findings from the study, but what was the most surprising finding from the study?

Speaker 3:

Yeah, I would say. Going through the data, I was surprised there was such a variety of bacteria that were isolated from these abscesses. I know previous studies have found a mix of bacteria, but I was always. It was really wild that anything can be growing in that area, bacteria wise, whether it was gram, negative, positive, aerobic and anaerobic, and so I feel like we just couldn't stress enough the importance of trying to take a culture and sensitivity if it's feasible to figure out what's growing in there.

Speaker 2:

I did a study at the Marine Mammal Center with Dr Zach Ruddy and we're looking at lymph node abscesses, sea lions, and it was the same thing. We found a huge variety and we're like culture, culture, culture and sensitivity always. And then, for those of you just joining us, we're discussing the diagnosis and outcome of odontogenic abscesses in client-owned rabbits. So now, moving to a bit of a more personal note, ivana, how has your advanced training prepared you to write this manuscript?

Speaker 3:

Yeah, I would say the biggest benefit of my advanced training has been giving me the time and the resources to plan to collect this data. I think the other benefit of my advanced training is that I have the ability to work with such a variety of mentors who have kind of gone through this process before with regards to all aspects of data collection. So I feel like it would be a bit harder if I was in, you know, private practice or seeing appointments all the time to kind of formulate a study, and so the residency and my internship has really given me like the time and the resources to figure out what's a good research question. How do I get it off the ground? Where does funding come from?

Speaker 2:

just really the basics of building a research project yes, definitely nice to have that academic support, especially when you're trying to publish and, I'm sure, trying to sit for boards at some point too.

Speaker 3:

So yes, trying to get all those publications for the ACPM residency can be intense.

Speaker 2:

And now these next set of questions are really important for our listeners. The first one's going to be about the veterinarian's perspective. What is one piece of information the veterinarian should know before discussing odontogenic abscesses in rabbits with the clients?

Speaker 3:

Yeah. So something I wasn't expecting when we started this study is that I do think it's really important for veterinarians to know there's a distinction for rabbits between treating retrobulbar and odontogenic abscesses in rabbits. When we first started writing it, we were like an abscess is an abscess is an abscess and we wanted to include it all in one paper. But we ended up including retrobulbar abscesses in their own data set because the treatment recommendations were totally different between the two, which we weren't expecting found that retrobulbar abscesses so basically an odontogenic abscess that has spread into the space behind the eye in rabbits is more likely to resolve not only with the abscess packing treatment, like our odontogenic abscesses, but they also resolved with tooth extraction, flushing and long-term systemic antibiotic treatment, which was not a feasible option for our odontogenic abscesses. And again, for both of these conditions odontogenic versus retrobulbar, versus a combination of both we found that antibiotics alone weren't a great option to treat these conditions and unfortunately or fortunately, if you love surgery you do need some sort of surgical intervention to get a higher resolution rate.

Speaker 2:

And on the other side of the relationship. What's one thing clients should consider around odontogenic abscesses and rabbits?

Speaker 3:

I would say that it's really important for clients to know that odontogenic abscesses, dental disease and rabbits it's not an easily fixable condition that will resolve with a single veterinary visit resolved with a single veterinary visit. Usually successful treatment of this condition will take months of treatment with systemic antibiotics and probable surgical intervention. But I think it's also really important to know that this is definitely a treatable condition and rabbits can have an excellent quality of life for years post-treatment. But definitely an investment to start out, yeah it's an excellent point.

Speaker 2:

Thank you for bringing that to the attention of our listeners. So now we're moving on to the more fun part of our podcast. What is the oldest or most interesting item on your desk or in your desk drawer?

Speaker 3:

Yeah, so I have a spider plant that I keep like right by my desk on my like dresser. That's a baby from a plant that my grandmother used to have in her home in the 80s, but she's really struggling right now.

Speaker 2:

It's hard with plants. We have a few succulents, and even those are not thriving right now. I'll be honest.

Speaker 3:

We're trying, but it's hard.

Speaker 2:

Yeah, plant mom. Life is rough. Thank you so much, ivana. I really appreciate you being here today and also for contributing your manuscript to JAVMA.

Speaker 3:

It was really lovely to be here, thank you.

Speaker 2:

Of course, and to our listeners. You can read Ivana's article and print JAVMA or online using your favorite search engine. I'm Sarah Wright and I'd like to thank each of you for joining us on this episode of the Veterinary Vertex podcast. We love sharing cutting edge veterinary research with you and we want to hear from you. Be sure to leave us a rating and review on Apple Podcasts or whatever platform you listen to.