Odontogenic Abscesses in Pet Rabbits: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment Advances
Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Literature Search Strategy
2.2. Study Selection and Standardization Criteria
2.3. Data Aggregation for Comparative Heatmaps
3. Anatomy of Rabbit Dentition
4. Etiology and Pathogenesis
5. Clinical Presentation
6. Odontogenic Abscess Structure
7. Diagnostic Approach
8. Complications and Prognosis
9. Treatment
9.1. Surgical Approach
9.2. Systemic Antimicrobial Therapy
9.3. Local Antimicrobial Therapies in Rabbit Odontogenic Abscesses
9.3.1. Honey as a Topical Antibacterial Agent
9.3.2. Antibiotic-Impregnated Polymethyl Methacrylate (AIPMMA) Beads
- Gentamicin—This agent is heat-stable, commercially available in veterinary PMMA kits, and active against the Staphylococcus–Pseudomonas spectrum common to mandibular abscesses [98].
- Amikacin—This agent has broader Gram-negative coverage (including multidrug-resistant Pseudomonas) and is safe locally, even in animals with marginal renal function; the beads must lie flush against the bone because diffusion rarely exceeds 5 mm [32].
10. Practical Considerations for General Veterinary Practice
10.1. Diagnostic Prioritization Without Advanced Imaging
10.2. Optimizing Microbial Culture: Focus on Anaerobes
11. Prophylaxis in Rabbit Dental Health
- Dietary management: The cornerstone of prophylaxis is dietary fiber. Feeding a hay-based diet (timothy, meadow, or orchard grass) promotes prolonged mastication, which supports dental wear and overall oral health. Pellets should be offered in limited amounts, and muesli-type commercial mixes should be avoided due to their association with selective feeding and malocclusion. A calcium-balanced diet remains important—not because dietary hypocalcemia is a common issue in rabbits but due to the ongoing demand for calcium in continuously growing teeth and bone. However, this does not imply a need for high calcium or vitamin D intake, as excessive supplementation may lead to serious health problems such as hypervitaminosis D and renal pathology. Notably, rabbits can maintain normal serum calcium concentrations even in the presence of metabolic bone disease through compensatory mechanisms such as increased parathyroid hormone activity, which mobilizes calcium from the skeleton. This bone resorption, in turn, contributes to alveolar bone loss and dental instability [41,46,62,101].
- Regular comprehensive examinations: Every 6–12 months, rabbits should receive a full physical exam plus a conscious intraoral inspection with an otoscope or small speculum. In high-risk cases (e.g., lops, dwarfs, or rabbits with prior dental disease), stomatoscopy, a rigid endoscopic examination of the oral cavity performed under general anesthesia, provides a magnified view of cheek-tooth arcades and should be scheduled at longer intervals (e.g., every 12–18 months) or sooner if clinical signs appear [59].
- Environmental enrichment: Providing fibrous forage and appropriate items for oral activity supports a normal masticatory pattern, which is essential for even tooth wear, particularly of the cheek teeth. While chewable items such as untreated wood blocks or willow branches primarily engage the incisors, long-stemmed hay and leafy greens are critical for promoting proper lateral jaw movement and physiological attrition of the cheek teeth [46,70,102].
- Owner education: Prophylactic success hinges on owner compliance. Educating clients on the importance of nutrition, the signs of early dental disease (e.g., epiphora, weight loss), and the dangers of improper trimming (e.g., with nail clippers) is crucial [103].
- Preventing iatrogenic injury: Dental procedures must be performed by trained professionals. Improper burring or incisor trimming can result in pulp exposure, leading to infection and abscess formation [59].
12. Discussion
13. Gaps in the Literature and Research Needs
- Limited data on anaerobic bacteria: While anaerobes such as Fusobacterium spp., Peptostreptococcus spp., and Bacteroides spp. are known contributors to abscesses in other species, their detection in rabbits remains rarely reported due to limitations in anaerobic culture and diagnostic protocols. Future studies employing molecular tools (e.g., 16S rRNA sequencing, metagenomics) are needed to clarify their role in polymicrobial infections.
- Lack of standardized treatment protocols: Most rabbit abscess treatments are empirical or based on isolated case reports. There is a clear need for randomized clinical trials comparing surgical, systemic, and local therapies, as well as long-term outcome data.
- Insufficient data on long-term outcomes: Few studies track rabbits beyond the immediate post-operative period. Long-term recurrence rates, quality of life, and complication rates (e.g., from AIPMMA bead retention) need evaluation.
- Underrepresentation of regional pathogens: Most microbiological studies originate from Western Europe and North America. There is a lack of data from Asia, Eastern Europe, and developing regions, despite evidence of regional variability in bacterial isolates.
- Diagnostic imaging thresholds: The criteria for when to escalate from radiography to CT or CBCT remain unclear. Studies are needed to define cost–benefit thresholds, especially for general practitioners working in resource-limited settings.
- Manuka honey and natural therapies: Despite promising in vitro data, there is a lack of controlled in vivo trials on honey’s effects on wound healing, osteogenesis, and recurrence prevention in rabbits. More research is needed to validate dosing protocols and establish safety over prolonged treatment periods.
14. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Antibiotic | Compatible with AIPMMA? | Remarks |
---|---|---|
Gentamicin | Yes | Heat-stable. Released via concentration gradient, achieving higher local levels than systemic levels. Effective against Gram-negatives. Common in mandibular infections [32,98]. |
Amikacin | Yes | Heat-stable. Effective against Gram−, including Pseudomonas spp. Ideal for local use due to systemic nephrotoxicity [32,98]. |
Tobramycin | Yes | Heat-stable. Similar spectrum to gentamicin. Used in both human and veterinary medicine [32]. |
Neomycin | Yes | Heat-stable. Narrower spectrum but useful against Gram−. Toxic systemically and, hence, good for local use [98]. |
Cefazolin | Yes | Heat-stable. Active against Gram+; stable during polymerization [32]. |
Ceftazidime | Yes | Heat-stable. Broad-spectrum, including Pseudomonas spp. Suitable for co-infections [32]. |
Ceftiofur | Yes | Heat-stable. Commonly used in veterinary medicine. Active against Gram− bacteria [32]. |
Lincomycin | Yes | Heat-stable. Similar spectrum to clindamycin. Useful against anaerobes, with similar risks for gut flora [98]. |
Clindamycin | Yes, with caution | Heat-stable. Good local release; active against anaerobes. Risk of enterotoxemia in rabbits if ingested accidentally [56,98]. |
Enrofloxacin | No | Heat-labile. Degrades during polymerization. Not recommended [32]. |
Penicillins | No | Heat-labile (e.g., ampicillin, penicillin G). Inactivated during PMMA polymerization [32]. |
Metronidazole | No (partially) | Heat-labile. Microencapsulated versions under research; not compatible in standard form [100]. |
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Crăciun, S.; Nadăş, G.C. Odontogenic Abscesses in Pet Rabbits: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment Advances. Animals 2025, 15, 1994. https://doi.org/10.3390/ani15131994
Crăciun S, Nadăş GC. Odontogenic Abscesses in Pet Rabbits: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment Advances. Animals. 2025; 15(13):1994. https://doi.org/10.3390/ani15131994
Chicago/Turabian StyleCrăciun, Smaranda, and George Cosmin Nadăş. 2025. "Odontogenic Abscesses in Pet Rabbits: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment Advances" Animals 15, no. 13: 1994. https://doi.org/10.3390/ani15131994
APA StyleCrăciun, S., & Nadăş, G. C. (2025). Odontogenic Abscesses in Pet Rabbits: A Comprehensive Review of Pathogenesis, Diagnosis, and Treatment Advances. Animals, 15(13), 1994. https://doi.org/10.3390/ani15131994