Multimodal Management of a Severe Pseudomonas aeruginosa-Associated Postoperative Wound Infection in a Pet Rabbit (Oryctolagus cuniculus): A Case Report

Postoperative wound infection in rabbits can be complicated by self-trauma, pain, anorexia, and gastrointestinal stasis. An 8-month-old female Lionhead rabbit (Oryctolagus cuniculus) was referred on Day 0 with a severe ventral abdominal wound infection after chewing and removal of the cutaneous sutures had necessitated repeat suturing following an ovario-hystero-hemivaginectomy. Initial laboratory findings included neutrophilia (8.21 × 109/L), marked hypoalbuminemia (0.6 g/dL), hyponatremia (115 mEq/L), and hyperkalemia (5.9 mEq/L). Trimethoprim-sulfamethoxazole was initiated on Day −4, at the original surgery, and continued for 14 days (Days −4–9, inclusive). On Day 0, metronidazole (20 mg/kg PO q12h) was initiated for five days (Days 0–4). A deep wound swab collected on Day 1 identified Pseudomonas aeruginosa on Day 5. In the limited disk-diffusion panel, amikacin was the only agent reported as susceptible by the laboratory using EUCAST criteria where applicable; the panel did not establish acquired multidrug resistance. On Day 5, amikacin (8 mg/kg SC q24h) was initiated for 14 days (Days 5–18), with concurrent subcutaneous Ringer’s solution (50 mL/kg). Management also included multimodal analgesia, fluid, nutritional and gastrointestinal support, serial debridement, lavage, daily dressings, laser therapy, and four sessions of perilesional ozone infiltration. Marked erythema at the infiltration margins after the fourth ozone session prompted discontinuation. The erythema was resolved within approximately 5–7 days, but concurrent infection and local treatments prevented clear causal attribution. Progressive granulation, contraction, and epithelialization were documented, with complete closure on Day 111. Because wound measurements were not standardized and several interventions overlapped in this uncontrolled case, the independent efficacy of ozone or laser therapy cannot be inferred.