Infection on cheek near eye

[olorin19]

Dustin is a male, almost 2.5 years old. (I have several other threads with his history, so will not repeat all the details.)

Anyways, he has been thriving in the wilds of my backyard since being re-released in early September after a summer recovering from a severe abscess in left ankle joint. Two nights ago, I noticed he was swollen on the cheek under his right eye. So yesterday morning when he came out of his nest box, I brought him back inside then took him to the vet. She says the eye itself is fine, but there is definitely an infection there under the eye, with a large scab. She thinks likely a scratch, but maybe even a tooth infection. I started him on clavamox last night, the plan being to keep him inside with me until the infection clears up, then a couple more days on probiotics.

Question: Is it okay to use Derma Gel right by the eye? If not, is there anything else I could be doing?

I will get a photo later today when there is another set of hands here, but holding Dustin and trying to snap a photo with an ipad is beyond my two hands, and I have not managed to get one when is still enough otherwise.

[Spanky]

I do not have knowledge about the Dermagel, but I have seen folks post that it is not toxic so licking it is not a danger. A picture would be a big help for folks to advise about using Dermagel as the nearness to the eye may play a factor.

Using Terramycin or some other Ophthalmic (eye) antibiotic would help with any possible eye infection and / or help prevent an infection from spreading to Dustin's eye if it is not infected now.

If Dustin does not start responding to the Clavamox in a few days, you might considering asking the vet about using Clindamycin. Clavamox is not a bad choice, since it is effective against bone, mouth and skin infections (among others) but Clindamycin seems especially effective in infections involving the head and neck (downside is that it tastes awful, so harder to dose!).

And if he does not respond to the antibiotics (or God forbid later redevelops) an x-ray would determine if there is any underlying teeth issues....

[olorin19]

Thanks, Spanky

Here are two photos - the one with the closed eye is not due to swelling, Dustin just had his eye shut for that one.

[Spanky]

Oh my, poor Dustin!

Were it me I would definitely try to treat that eye with Terramycin or Neosporin type of Ophthalmic (specifically for eyes!) antibiotics. I would think the solution would be easy to get in the eye than the ointment, but you know Dustin best! I treated HBC wild with a nasty eye injury recently, but I had to abandon putting anything directly in his eye as those wrestling episodes seemed to causing him more distress than perhaps the good terramycin may have been doing (he did receive a course of oral antibiotics). But this was a true wild, not one of my releases.

Is he eating okay and not having difficulty with chewing? Giving him an in the shell nut and observing may be a good idea to assess if he might be having any problems in that arena.

When looking head on to Dustin, how significant is that swelling? Difficult to see in pictures from that angle.

[olorin19]

Thanks, Spanky

I had not noticed anything off with his eating, and I know he did eat a walnut in the shell yesterday. But i will watch carefully and make sure his chewing is okay - good idea, thanks.

Are these opthalmics prescription items?

Here are some photos head on to give some idea of the swelling

[Spanky]

Are these opthalmics prescription items?

Tractor Supply Stocks it (decent price too!) if you have those around:
http://www.tractorsupply.com/tsc/pro...intment-1-8-oz

Chris tries to have it at Squirrels and more but it looks like she is out of it at the moment.... sells out quick
https://www.squirrelsandmore.com/pro...almic-ointment

Some Amazon sellers have it (for more $$) but a longer delivery time... (10 days?)... "Prime" seller is out of stock.
https://www.amazon.com/gp/offer-list...&condition=new

Doctors Foster and Smith have it in stock, not sure of shipping time (or costs?).
http://www.drsfostersmith.com/produc...5QDRoCTSfw_wcB

The swelling looks better than I had imagined, but it is good to have both head on and side views because the head on does not show the redness and general irritation of the area.

If you can get some Terramycin quickly, I would definitely recommend it if you think Dustin will cooperate?
(edit: By "quickly" I mean to say that 10 day expected arrival time on some of those links probably would take too long to do Dustin much good!)

Prayers that he'll respond to the antibiotics and you'll see improvement quickly. While you never want infections to get out of control, that is especially true with injuries like this... keep us posted!


Here are some photos head on to give some idea of the swelling

[olorin19]

Thanks, Spanky, glad I asked!

Just got off the phone with TSC and they have t-mycin, so I am off to get a tube. Dustin just bedded down for the night, so I will start him on that tomorrow morning.

[olorin19]

Started the t-mycin this morning.

Photo is today - prior to any t-mycin, and after three doses of clavamox (Friday pm then twice Saturday). Dustin does look much improved to me: the skin is more pink and less red, eye more open, etc.

Dustin ate an unshelled hazelnut with no problem last night. While he did seem to chew more on the left, this may not mean anything.

He is certainly full of energy, exploring my house. (He had not been inside since his re-release in early September, and I am in the final stages of remodeling, so lots of new stuff for Dustin to explore. Besides the three months inside last summer, he was largely inside from when I got him in Septemebr 2014 until first release spring 2015, so my house is familiar.)

I did find two scabs on the back of his neck (derma gel for these). Any chance these head scabs come from the back legs of another squirrel? If so, a male he was chasing, or a female? Any ideas?

[olorin19]

Just gave Dustin a whole pecan, and he effortlessly shelled it. He does not seem to favor either side for chewing - in particular, he took some vigorous bites way up on the right side nearest the scab with no apparent discomfort or hesitation. So, I do not believe there is a dental issue here. Plus, the other two scabs (one is tiny, the other maybe half the size of the one on the face) point to an altercation. Neither of these other scabs is visible, I only found the first one while applying the t-mycin this morning. After that, i examined him all over, and these three are all I can find. The two on the neck may even be older - and no fur loss involved on these.

[olorin19]

Scab on cheek has come off, either on its own or by Dustin scratching. Dustin has been running around my house the past 5.5 hours, lots of energy and looking good.

This looks to be healing well. Earlier photo was after three doses clavamox and no t-mycin - this is after four does clavamox and 1 t-mycin.

Not able to get the t-mycin into eye, but spread it liberally on scab and onto eyelids, etc.

Dustin did not seem bothered by the t-mycin, it is more the dropper in the mouth and horrible taste that he dislikes.

By the way, the eye just happens to be closed in this photo - it is not swollen shut or anything like that.

[olorin19]

While it is hard to tell from the photo, the wound has some depth to it and looks like a slash. My best guess is that Dustin was clawed, whether front claws or rear.

[Nancy in New York]

Wow that area looks SO much better!

[Spanky]

I agree with Nancy, Dustin seems to be doing extremely well!

[olorin19]

Thanks Spanky (and Nancy)

Here is Dustin this morning -

[olorin19]

Dustin's cheek continues to improve - I did not manage to get a photo this morning, but I would say the depth of the wound seems to be filling in quite well.

A few days ago, I noticed a decent size scab plus a smaller one on the back of his neck. Neither was visible, and I only noticed them when handling him for his clavamox and t-mycin. Last night and even more this morning, in the area of the larger scab there is a soft mass under the skin that can be moved around under my finger somewhat. Any ideas? I am putting derma gel on it twice daily.

It kind of reminds me of fatty cysts on people, in that it is quite mobile and does not seem painful to Dustin. Then again, it is large enough that I do not see how I did not notice it when I first felt the scab. Then again/again, Dustin was squirming about, so I might have missed it.

With the cheek alone, I would guess that clavamox would not be needed much longer. My plan is to keep Dustin inside about two days past the clavamox to give him lots of probiotics to get his gut back in shape. Giving him probiotics every time her gets clavamox, his gut seems much less stressed (judging by poop) than during the clavamox last summer.

[Spanky]

The wounds on the back of Dustin's neck make me wonder if something got a hold of him but he was able to escape?

I would keep him on the Clavamox a full 10 days. Best guess with the small mass on the next is that there is some infectious puss under the scab. If it is puss, draining would help progress the healing... minimally keep track and see if is seems to be getting smaller each day. I know that may be difficult to judge if it is pretty small.

I don't believe you are saying the probiotics are given at the same time as the Clavamox, but just in case...
Best to give the probiotics a couple hours after the Clavamox instead of with it, the idea being to restore good flora to the gut the Clavamox kills off with each dose.

[island rehabber]

WOw, that wound looks so much better. I'm inclined to agree with Spanky that something got hold of him around his head and punctured both eye and back of the neck where you found that other wound. Abcesses do pop up later after incidents like this, and if you feel a lump or cyst-like thing it is most likely an abcess forming. Yes, keep him on the ABs for 10 days as suggested....you don't want another abcess taking hold after you've done such a good job with the first one!

[olorin19]

The wounds on the back of Dustin's neck make me wonder if something got a hold of him but he was able to escape?

I would keep him on the Clavamox a full 10 days. Best guess with the small mass on the next is that there is some infectious puss under the scab. If it is puss, draining would help progress the healing... minimally keep track and see if is seems to be getting smaller each day. I know that may be difficult to judge if it is pretty small.

I don't believe you are saying the probiotics are given at the same time as the Clavamox, but just in case...
Best to give the probiotics a couple hours after the Clavamox instead of with it, the idea being to restore good flora to the gut the Clavamox kills off with each dose.

Thanks Spanky

Perhaps a hawk or falcon? I am not sure what else around here could have grabbed him around the head/neck.

I will take a good look (and feel) of the neck tonight.

Understood on the relationship (and relative purposes) of antibiotics and probiotics, thanks.

[olorin19]

Dustin is now 5.5 days (11 of 20 doses of 0.5 ml) through the 10 days of clavamox and 4 days of t-mycin.

The wound on the right cheek that originally drew my attention looks great, just a small scab and no swelling, etc.

There are what appear to be two abscesses on back of the neck near shoulder on the right side. They are somewhat smaller than a few days ago, and do not feel as liquidy or full. No obvious sign of discharge, so perhaps being reabsorbed? They are both quite superficial, just below the skin.

I just noticed (after his nightly treatment, so seeing this on a moving target) that on his left rear foot one of the toes seems quite red.

At this point, my best theory is that a cat grabbed him but Dustin got away with a few scratches and perhaps two punctures (neck).

Dustin has a good appetite and lots of energy.

Several related questions:

Any advantage to adding clindamycin to the mix? If so, start now, wait until after clavamox is done, or take a few days in between?
Also, I have a bottle of clindamycin from August. It has a 10/31/2016 expiration date stamped on it. Is this still good, or should I get another bottle? (It takes me about 90 minutes or more to go to the vets and back, so hoping to avoid the trip, but happy to do that if needed.)

Thanks!

[Nancy in New York]

Dustin is now 5.5 days (11 of 20 doses of 0.5 ml) through the 10 days of clavamox and 4 days of t-mycin.

The wound on the right cheek that originally drew my attention looks great, just a small scab and no swelling, etc.

There are what appear to be two abscesses on back of the neck near shoulder on the right side. They are somewhat smaller than a few days ago, and do not feel as liquidy or full. No obvious sign of discharge, so perhaps being reabsorbed? They are both quite superficial, just below the skin.

I just noticed (after his nightly treatment, so seeing this on a moving target) that on his left rear foot one of the toes seems quite red.

At this point, my best theory is that a cat grabbed him but Dustin got away with a few scratches and perhaps two punctures (neck).

Dustin has a good appetite and lots of energy.

Several related questions:

Any advantage to adding clindamycin to the mix? If so, start now, wait until after clavamox is done, or take a few days in between?
Also, I have a bottle of clindamycin from August. It has a 10/31/2016 expiration date stamped on it. Is this still good, or should I get another bottle? (It takes me about 90 minutes or more to go to the vets and back, so hoping to avoid the trip, but happy to do that if needed.)

Thanks!

WOW .5 seems like a huge dose. Is this amount given twice daily?
What is the strength on the Clavamox?
How much does Dustin weigh?