Al´s bite wound abcessed--long post.

Post Reply
User avatar
Ciaytee
Almost Inbred

Post   » Sun Apr 07, 2002 1:25 am


For those who might not remember, about 2 weeks ago Beau bit Al on the shoulder during floor time. I kept the wound open and kept it slathered in Neosporin, and I believed it had healed fine. As of last weekend, the wound was completely closed and flat, so I stopped paying as close attention to it. Obviously I was wrong in doing so, because today I discovered a huge lump on his shoulder.

After much trouble and drama, I found an emergency vet that treated exotics. Or so I believed. I thought I heard the receptionist say, "Yes, he sees guinea pigs." when apparently what she actually said was, "Yes, he will see a guinea pig." But he ended up not being that bad. He didn´t just make assumptions based on his dog/cat experience. He took his time and did some research before he started treating Al.

Al is a little ´off´ tonight, but he doesn´t seem too worse for the wear. He´s tired, but he´s not lethargic. He´s not quite eating or drinking as much as normal, but he´s not starving himself, either. Since Kleenmama told me that he shouldn´t have physical contact with the other pigs, I´ve set him up on a section of the floor, on towels. And his digestion seems to be fine, as the towels are already covered in well-formed poops.

However, I do have a concern regarding the dosage of antibiotic he gave me. He prescribed 3 cc of SMZ-TMP twice a day. I spoke with Kleenmama about this, and she informed me that this is possibly 6 times the recommended dosage for pigs, depending on how diluted the formula is. Tomorrow I´ll call to find out what the dilution strength is, but in the meantime, my question is whether or not any of y´all have heard of this being diluted that much.

I also have a question about flushing the wound. The vet didn´t give me anything to use; he just told me to flush it with hydrogen peroxide. After I´d already done it, I read I AM My Pig´s Mom´s post, where I saw that she was told to flush with 6 cc´s. I ended up using just 1 cc of the peroxide. I stuck the tip of a 1 cc syringe into the hole and did short bursts of .10 cc. I did this until the peroxide no longer bubbled when I inserted it, which ended up being after about 6 shots. The last four were just to be certain. Does that sound right? Or should I be doing 6 cc´s also? Oh, and I also manipulated the wound after every flush, but no pus ever came out of it.

My third question is about the hardness of the wound. The vet said that because of the abcess, the muscles surrounding it had hardened, and that since the abcess was gone, they would soften up and go back to normal. Was he correct?

I´m going to try to post pics of the wound. I have a crap camera without zoom, so hopefully these won´t look too bad.

User avatar
Ciaytee
Almost Inbred

Post   » Sun Apr 07, 2002 1:30 am


Another pic.

User avatar
Lynx
RESIST

Post   » Sun Apr 07, 2002 9:43 am


Did you read the Abscess thread in the Reference Forum? http://www.guinealynx.info/forums/thread.php?threadid=136&boardid=3&styleid=1 ? I think Imanut4u used a betadine solution to flush the wound. I know Josephine does not like hydrogen peroxide and feels it inhibits healing. Yes, the dose you have for the bactrim sounds too high. It should be closer to 0.5 cc for the average pig (weight determines it). I do think it is a standard mix for the pediatric solution. A call to the vet will get you answers.

I posted on another thread (I read the info from a bottle I had in my refrigerator):
It is also known as sulfa trim or sulfamethoxazole and trimethoprim oral suspension, usp 200mg/40mg per 5 ml. I think the dosage is on Squeak pig´s safe med page (a link can be found in the index in Guinea Lynx).

Last edited by Lynx on Sun Apr 07, 2002 9:44 am, edited 1 time in total.

User avatar
Jill

Post   » Sun Apr 07, 2002 10:25 am


Ciaytee, the solution I flushed Piggie´s wound was called Nolvasan. I don´t know if that would make any difference in the amount used.

The area around the abscesses seemed to harden before they went away. My vet said it was scar tissue. One of the abscesses was near the bald spot by the ear. As it was healing, it felt hard and still like a lump. I was concerned that it wasn´t healing, but it ended up being scar tissue and is now gone. I can´t even tell she had a wound there.

Good luck with Al´s abscess, I know how frustrating they can be.

User avatar
Becky

Post   » Sun Apr 07, 2002 1:44 pm


Ciaytee, when Cookie was taking sulfatrim for her UTI, it was .5 cc twice a day. She weighed 2lbs. 5oz at the time.

Josephine
Little Jo Wheek

Post   » Sun Apr 07, 2002 3:42 pm


<<I know Josephine does not like hydrogen peroxide and feels it inhibits healing.>>

This is not an opinion. Hydrogen peroxide&acute;s corrosiveness and danger to living tissue is well known in the medical community. Sometimes that destructive nature is called for, but not usually. Betadine (weakened Iodine) is excellent for flushing abscesses. Chlorhexidine (the active ingredient in Nolvasan Flush and Scrub) is even better. I would choose either over the H2O2 (peroxide).

Warm compresses several times a day (about 5-10 minutes) also speed healing. Flushing should be done 2-4 times a day. I usually recommend flushing several times past the disappearance of any discharge/pus.


Is the pig now separated from the one that inflicted the bite wound? I would certainly do so if he&acute;s not. Not only is the risk of more abscesses and bite wounds possible, but there is a chance of cross-infection/contamination and keeping tabs on the ill piggy is more difficult in a pair/herd situation.

User avatar
Lynx
RESIST

Post   » Sun Apr 07, 2002 3:53 pm


I didn&acute;t remember all the reasons you had, just that you didn&acute;t advise it. I thought it was interesting saying that "Sometimes the destructive nature is called for." Out of curiousity, what kind of circumstances would hydrogen peroxide be especially useful?

Josephine
Little Jo Wheek

Post   » Sun Apr 07, 2002 4:06 pm


You wouldn&acute;t want to know. Usually it is avoided altogether, but some vets will use it with very dead, necrotic tissue to help debride. The worst of the worst. We had a nice one a few weeks back. People just never learn they have to keep wounds clean to heal. The newer vets usually manually debride (often with the patient under anesthesia) and use betadine or chlorhexidine.

I still wouldn&acute;t call H2O2 "especially useful," unless you&acute;re talking about getting blood stains off of fur. Even then, it tends to turn the blood brown on light-colored animals!
Last edited by Josephine on Sun Apr 07, 2002 4:07 pm, edited 1 time in total.

User avatar
Ciaytee
Almost Inbred

Post   » Mon Apr 08, 2002 12:29 am


Ya know, I didn&acute;t even remember that there was a Reference forum here. I was so addled yesterday that I was doing good to remember my own name. But I did check out GuineaLynx, so that&acute;s something.

The vet that worked on Al yesterday wasn&acute;t there today, and he didn&acute;t write on Al&acute;s chart how much he diluted the antibiotic, so I have to try again tomorrow. So just to be safe, I gave Al 0.5cc twice today.

I also got confirmation of what Josephine said about the peroxide from 2 other people. While I was in Walgreen&acute;s getting the Betadine, I struck up a conversation with a nurse at Texas Children&acute;s. Later, I spoke with my sister, who is also a nurse, and they both said that Betadine is better to use as an antiseptic, as peroxide kills both the good and bad cells, thus inhibiting healing. They also both said that they actually switch off using peroxide and Betadine. First, they&acute;ll flush with a 50/50 solution of saline and peroxide. The next time they&acute;ll use Betadine. My sister also said that it&acute;s important to flush out the Betadine with sterile saline, as bacteria can grow in the Betadine. Does this hold true for pigs? My sister thought it would, as she believes a wound in any mammal would require pretty much the same treatment.

And one more stupid question. How do I know if I&acute;m opening the wound enough before I flush it? Is it supposed to bleed? Or am I just supposed to open to where it&acute;s whitish/pink inside? I&acute;ve been stopping at the whitish/pink point, because I don&acute;t want to hurt him any further. Is that right?

I apologize if these are really simplistic questions, but I have no idea what I&acute;m doing here, and I didn&acute;t find an idiot&acute;s guide to flushing abscesses post.

And yeah, Josephine, Beau--the one who bit Al--will never be in the same area as him again. They don&acute;t live together, and they rarely had floor time together. And because of this, they never will again.

Evangeline

Post   » Mon Apr 08, 2002 10:34 am


"Opening the wound" refers to opening the incision that was made when the abcess is lanced. Did the vet lance it or did it open by itself? From the picture, it looks like a tiny hole. Usually, the vet will open a big gash. That&acute;s what you need to keep open.

User avatar
Ciaytee
Almost Inbred

Post   » Mon Apr 08, 2002 1:44 pm


It is a tiny hole--about a centimeter wide. The vet reopened the initial wound (from Beau) and drained it that way. And from what you&acute;re saying, I&acute;m guessing he probably then didn&acute;t do it the right way. Damn.

imanut4u

Post   » Mon Apr 08, 2002 2:30 pm


Were you in there when he opened it? Did pus come out? Is there a lump there now or is it scar tissue?

The pic does look like a tiny bite. If you can&acute;t feel anything inside, just keep opening and flushing. It should heal up fine that way. If there&acute;s a lump, he probably should have opened it up a lot more than how it looks here in order to drain it properly.

User avatar
Jill

Post   » Mon Apr 08, 2002 6:15 pm


Ciaytee, that is how my vet treated two of Piggie&acute;s abscesses. They had scabbed over for whatever reason (I&acute;m guessing they were scabs from bites) so he removed the scab and flushed the abscess. Pus did come out of the wounds. Sent me home with Nolvasan to flush at home. Imanut4u suggested just picking off the scab dry rather than soaking it off. The dry method seemed to work better.

My vet must have cleaned them out well, because whenever I squeezed the wound while flushing, no pus came out.

The funny thing is, the vet said she put up more of a fuss when they shaved the areas than when they flushed the wounds.

User avatar
Ciaytee
Almost Inbred

Post   » Mon Apr 08, 2002 8:26 pm


Well, that makes me feel better. I&acute;ve been worried about him all day.

Got in touch with the vet, and he told me that the med contains 200mg of SMZ & 40mg of TMP per 5ml. Al is 2 lbs 4 oz, so should I be giving him the full 3cc&acute;s the vet prescribed, or go with a lesser amount? I read on Squeak&acute;s page that the dosage should be 30ml/kg, but I&acute;m mathmatically challenged and I don&acute;t know if what he gave me is the normal ratio of meds to base.

Nuts, I wasn&acute;t in the room when he drained it. I didn&acute;t know I had the option of being present during something like that. There is still a lump both underneath and on the top side of the hole, but the vet said that it was because the muscle had hardened around the abscess and that it would soften up and go down. His skin does feel a little looser around the lump, but there&acute;s still a definite lump there. Should it still be there 2 days after the abscess was removed?

User avatar
Lynx
RESIST

Post   » Mon Apr 08, 2002 9:50 pm


Your vet is wrong about the dose.

The method of figuring out how many mg in a med with two components are in a ml (I learned from people more knowledgeable than I) is to add the two mgs together. There are 240mg/5ml. That means 48mg/ml (48mg/cc -- 1cc=1ml). So your vet is prescribing a 144mg dose for your pig. If the dose should be 30mg/kg and your pig is slightly over one kg (2lbs 4 oz = 1.02kg) your pig should be getting about 30mg, your pig would get about 0.62cc of the suspension.

I have no idea how he came up with such a high dose. You might also call and ask what the dose he is using in mg/kg so you can compare it to Squeek&acute;s 30mg/kg (make sure he tells you mg/kg and not cc&acute;s. You want to be able to figure out if his math is correct or if he&acute;s using some wildly different dose rate).

User avatar
Ciaytee
Almost Inbred

Post   » Mon Apr 08, 2002 10:43 pm


Thanks, Lynx. I&acute;m so glad that Al hasn&acute;t had any problems since the vet gave him a full 3cc&acute;s right after he drained the abscess.

Oh, and he&acute;s not my vet. I haven&acute;t found a vet in Houston yet. This guy was just the emergency vet at the clinic my vet in New Orleans recommended. I won&acute;t be going back to him.

User avatar
Ciaytee
Almost Inbred

Post   » Thu Apr 11, 2002 11:41 pm


One last question. For now. Maybe.

Al&acute;s progress is steady, but slow. His incision is still open, but smaller. And he still has the lump underneat the incision, but it&acute;s about 2/3 the size it was right after he had the abscess removed.

I&acute;ve been giving him 0.6cc of the Bactrim 2x a day. The vet said to give it to him for 5 days, but we already know that the vet really doesn&acute;t know about meds and pigs. Today is the 5th full he&acute;s gotten it. How long do I need to dose him? Until the incision is completely healed, or is there a time-limit? He&acute;s tolerating the meds really well. He&acute;s not had any decrease in his appetite and he&acute;s still pooping up a storm.

pinta

Post   » Thu Apr 11, 2002 11:44 pm


I&acute;d dose him for at least 10 days - preferably until the incision is healed. Any wound that is open runs a risk of contamination.

Antibiotic courses can run for as along as a month. 3 weeks isn&acute;t unusual.

User avatar
Ciaytee
Almost Inbred

Post   » Thu Apr 11, 2002 11:52 pm


Thanks. But Al won&acute;t like it, so I don&acute;t think he&acute;ll be thanking you.

It&acute;s weird, though. I think we&acute;re experiencing that bonding thing some of y&acute;all talk about when you have sick pigs. He struggles when I dose him, and he hates having the wound flushed, but he&acute;s started to actually snuggle on me. He&acute;s also started doing this odd stare thing. He&acute;ll stand with his back legs on my lap and his front paws on my stomach, and he&acute;ll just watch me while I stroke up between his nose and eyes. Very atypical behavior for Al.

kleenmama
I GAVE, dammit!

Post   » Sat Apr 13, 2002 11:21 am


Glad to hear he is on the mend. I had never read that regarding peroxide, that is very good to know!
Also glad to hear you double-checked that dosage. 3cc just sounded way to high. Ollie is a four pounder and he was getting .6 twice a day.
Keep us posted.

Post Reply
20 posts • Page 1 of 1