Amputee with infection

[Shellysfriend]

Hi, Irrel is a 11 week old 520 gram male fox squirrel that was found approximately 3 weeks old, and I have had about 6 weeks now. He was found with his front left wrist and paw missing. He’s been healing quite well, is very active and hasn’t been bothered by it much. He always has let me put salve on the end of his stump and not complained about it. I had to go out of town the other day and noticed before I left that the end seemed kind of big and thought it might just be swollen tissue from being active and still healing. My wife called and said at his last feeding it started draining white discharge. It must have been an abscess I felt. She helped it drain the best she could. I have a new 1 ml miracle syringe, cipro 250, clindamycin 30, amoxicillin clavoxonate 875/125, smz/tmp 800/160, baytril 10% 1ml/100mg endoflaxin.

[CritterMom]

We will need his weight, too.

Before the meds, can you get to a drug store or Walmart and pick up a bottle of Betadyne 10% povidone iodine (or the store brand if they have it for less $). It looks like a squeeze bottle of blood! Dilute it at 1/2 teaspoon betadyne to 1/4 cup boiled and cooled water. Either dunk the stub in there or use a cotton ball and dribble it over the wound so it is saturated, and just let it air dry. It doesn't burn or sting at all - works great on humans too. It is a powerful antibacterial and antifungal so it will clean and disinfect what is there now and if you do it a couple times a day it will continue to keep it clean without a bandage.

Speaking to someone else about which med to choose. Get us the weight and you will have info shortly.

By the way, the iodine WILL stain stuff so dress accordingly.

[Shellysfriend]

520 grams is his weight

[CritterMom]

Thanks - sorry - can you get a good photo of the site? Like head on so we can see what is going on? Does it look like a flesh thing only or is there bone involvement?

[Shellysfriend]

Sure, I’ll be home in a few hours and will try to get some good pictures. In the meantime I’ll have my wife pick up the Bentadyne

[Sadachara]

Others with more experience in this area can weigh in on internal medications, but I'd honestly also start topical treatment with a serious but totally safe substance like Hypochlorous Acid. I would immediately order 0.2% strength hypochlorous acid and soak it in it. It is completely safe, and indicated for infections. I've never heard a single bad thing about it. In terms of wound infection protocols for humans and from what I am told veterinary is 2 minute exposure minimum, but ideally 10-15 minute exposure, ideally with immersion in it, or at the least soaked gauze.

You can make your own Hypochlorous of varying strength by getting a machine. I like 0.3% for heavy infection treatments. A machine like this is priceless for around the house, cleaning, wound treatment, etc.

https://www.amazon.com/Eco-One-Porta...machine&sr=8-5

At the very least, you can order Cleansmart. It's all the same - hypoclorous acid, and cleansmart is extremely pure. We've used it for wound treatment for many years, but now generate our own. This is the same stuff doctors, dentists, and vets use and often sell in their offices.

https://www.amazon.com/CleanSmart-Su.../dp/B011AJRJZI

You can even combine treat with Betadyne between Hypochlorous without issue. I was able to stop a staph infection in my rescue in just a 24 hour period with full remission and healing activity using this combination to strike it fast. Generally, I'd do hypochlorous during the day, and Betadyne before bed so it stays on with the staining. My 2 cents.

[Shellysfriend]

So I had left for work Saturday and got home today and his stump was way swollen and the big red area was not there before. It had looked really good before. The darker more recessed looking area is the original wound. The more deflated looking picture is after I drained it tonight. I thought my wife drained it but didn’t really. I got a ton of stinky thick white puss out of it in till it turned to more reddish color at the end. Then it was bath time which he used to enjoy but not so much anymore! I did put the iodine solution on it. I know the pictures are hard to tell but hopefully you’ll be able to see what we are dealing with. He was active as usual when I got home and seemed his usual self.

[Shellysfriend]

Others with more experience in this area can weigh in on internal medications, but I'd honestly also start topical treatment with a serious but totally safe substance like Hypochlorous Acid. I would immediately order 0.2% strength hypochlorous acid and soak it in it. It is completely safe, and indicated for infections. I've never heard a single bad thing about it. In terms of wound infection protocols for humans and from what I am told veterinary is 2 minute exposure minimum, but ideally 10-15 minute exposure, ideally with immersion in it, or at the least
You can make your own Hypochlorous of varying strength by getting a machine. I like 0.3% for heavy infection treatments. A machine like this is priceless for around the house, cleaning, wound treatment, etc.

https://www.amazon.com/Eco-One-Porta...machine&sr=8-5

At the very least, you can order Cleansmart. It's all the same - hypoclorous acid, and cleansmart is extremely pure. We've used it for wound treatment for many years, but now generate our own. This is the same stuff doctors, dentists, and vets use and often sell in their offices.

https://www.amazon.com/CleanSmart-Su.../dp/B011AJRJZI

You can even combine treat with Betadyne between Hypochlorous without issue. I was able to stop a staph infection in my rescue in just a 24 hour period with full remission and healing activity using this combination to strike it fast. Generally, I'd do hypochlorous during the day, and Betadyne before bed so it stays on with the staining. My 2 cents.

I’ve never heard of it before. Does it sting or burn? Just wondering what I’d be in for?

[Sadachara]

I’ve never heard of it before. Does it sting or burn? Just wondering what I’d be in for?

Hypochlorous does not sting or burn, or damage soft tissue. In fact, it is EXCEEDINGLY soothing to the point animals often enjoy when it is applied (same with people, lol) Hypochlorous reduces inflammation by stabilizing mast cells, which also improves healing, but it is a rapid agent for the eradication of harmful pathogens.

In fact, I have a small infection on my toe right now from an injury, and I am soaking it in HOCl 3x a day. Our vet and ophthalmologist actually sell Hypochlorous in their offices. It's a rather potent cure for staph infections (as well as C-19, MRSA, etc), and is a great topical agent and wound cleaner.

https://ivcjournal.com/hypochlorous-acid-solutions/

I started making hypochlorous (with a machine) about a decade ago, and consider it one of the most suppressed potent therapies ever for a variety of things. But let me explain how I first encountered it.. I purchased some initially after never hearing about the fact it could be stabilized in a bottle, but I knew our cells produce it. I used it to clean around the house and inhaled some of it. But something remarkable happened - I used to get persistent sinus infections, almost like I 'permanently' had a sinus infection. After inhaling it while cleaning with it I felt my sinuses drain out, and then I expelled some pretty terrible old mucus and biofilm. From that day forward, I never had a sinus infection again. My ENT thinks I got enough of it up there to destroy some latent biofilm that was 'existing' in my sinus cavity.

https://www.clireon.com/pages/hypochlorous-acid

I would order it without delay to be honest.

[Shellysfriend]

This is this morning so 8 hrs after I drained it last night.

[CritterMom]

It is difficult to tell - is it swollen again or does it look pretty much like it did last night? Simply from appearances, does it look like the infection is in the skin around the would or dies it appear to be involving the bone stump? We will get you some meds info for it very soon.

I am going to say something that will probably be rejected at first, but... There is a reason that when vets are faced with unhealable wounds on the lower part of the leg, they amputate the leg to the shoulder instead of just taking the wounded part. It is because the end of the leg is NEVER going to be suitable for being used to walk on - no tough paw pads and they are not going to produce callouses that will help. But they WILL use it to walk on because the leg is there to do so. I fear that this is going to be a recurring theme. Even if you devise an environment that involves NO wire mesh, NO cage bars, every surface covered with microfleece, that little stub is still going to be getting wear and tear it isn't able to handle.

I would begin canvassing for a vet who would be willing to take the leg off. We have a well known rear leg amputee that belongs to one of our admins who has spent the years since losing it outrunning her dad and regularly faking him out of his shoes. They do way better than we do with things like this.

[Spanky]

This is this morning so 8 hrs after I drained it last night.

How much of her arm remains? Hard to tell from the angle if this is "above the elbow", which for a squirrel would be closer to the torso than with a human.

I am assuming you opened and drained the abscess... or did it open on it's own? Is the bone exposed at all from the incision to drain (or exposed period I suppose!).

[CritterMom]

Dosing sent by PM

[Shellysfriend]

How much of her arm remains? Hard to tell from the angle if this is "above the elbow", which for a squirrel would be closer to the torso than with a human.

I am assuming you opened and drained the abscess... or did it open on it's own? Is the bone exposed at all from the incision to drain (or exposed period I suppose!).

It is right below his elbow. I am actually not sure if it is scab or bone at the end. The area has been steadily getting smaller since I got him and was hoping that the skin over time would envelop it if it was bone. Working on my burrito technique to keep that arm out but all the others contained. Seems to be harder than it sounds. It started draining on its own yesterday when my wife was feeding him, at first she thought he had formula on his arm. When I got back to town last night I could tell right away it was way swollen. After hugging the stuffings out of him when I started messing around with the area it started draining on its own. I just applied pressure to facilitate the process and to try to get as much as I could out. It is NOT coming out from the original scab/bone site. The swollen area is to the side of it. The dark spot on the red swollen area almost looks like what is left of a blood blister and almost seems to be the center of it. The puss started draining from between the “blood blister” and the original wound. Not saying that it isn’t the original wound that is the problem but I don’t know for sure.

[Shellysfriend]

Dosing sent by PM

Thank you, started today

[Shellysfriend]

It is difficult to tell - is it swollen again or does it look pretty much like it did last night? Simply from appearances, does it look like the infection is in the skin around the would or dies it appear to be involving the bone stump? We will get you some meds info for it very soon.

I am going to say something that will probably be rejected at first, but... There is a reason that when vets are faced with unhealable wounds on the lower part of the leg, they amputate the leg to the shoulder instead of just taking the wounded part. It is because the end of the leg is NEVER going to be suitable for being used to walk on - no tough paw pads and they are not going to produce callouses that will help. But they WILL use it to walk on because the leg is there to do so. I fear that this is going to be a recurring theme. Even if you devise an environment that involves NO wire mesh, NO cage bars, every surface covered with microfleece, that little stub is still going to be getting wear and tear it isn't able to handle.

I would begin canvassing for a vet who would be willing to take the leg off. We have a well known rear leg amputee that belongs to one of our admins who has spent the years since losing it outrunning her dad and regularly faking him out of his shoes. They do way better than we do with things like this.

Thanks, I was hoping not to have to go there but won’t rule it out. Kind of felt since I got him that there may have to be some sort of intervention at some point but figured we’d see how the initial healing went first. Was actually going and looking really well till this. I’m not so sure a vet isn’t a bad idea anyway with this sort of injury. Is there any sort of list of “pet” friendly vets in not “pet” friendly states that can be pm’d? I know there are good ones in far away states which can be done but if there are closer ones…could be handy to have?

[Spanky]

The dark spot on the red swollen area almost looks like what is left of a blood blister and almost seems to be the center of it.

I am wondering if the "blood blister" might be the end of the bone and the red the morrow / center of the bone....

[SamtheSquirrel2018]

Hi Shellysfriend:
Thank you for your concern and care you are bestowing upon this little injured Squirrel, Irrel! In you original post, you mentioned having used a "salve." What is it and are you still using it? Also, apparently an antibiotic is now being given. If I missed this in your thread, I apologize but would please identify the particular antibiotic now being given to your baby? You also mentioned that Irrel's amputation is below the elbow which means that the remaining portions of both of the forearm bone, the radius and ulna may be exposed. Infections can easily develop from injuries such as this and it does sound like that is what has developed with the visualizing of pus but there can actually be other causes. That is one reason I am asking about the particular "salve" that was used or is still being used. Ointments for marketed for use on the skin such as Neomycin and Triple Antibiotic among others contain the antibiotic called Neomycin. The ads for Neosporin imply that this medication is a miracle drug and it will prevent and infection or cure an infection if one already exists. It is doubtful that it can do either but that is not the issue with Neomycin. This medication is perhaps the most allergenic of the skin antibiotics and there can result from this such a severe allergic reaction that is difficult if not impossible to differentiate this from an infection by looking at!

I am in whole hearted agreement with the suggestions made previously for Irrel to be evaluated by an experienced and Squirrel friendly Veterinarian. Ideally, the Veterinarian should be experienced with Squirrels but a second choice would be someone who has experience with pet Rats and these two species are related and much of the treatments and medications we utilize for our Squirrels came from evidence derived from Rats.

I am NOT a Veterinarian and I do want you to know this but I would like to give you my opinion regarding the injury Irrel has sustained anyway and what I would consider an optimal plan. Obviously, there is no technology for a forearm prosthesis (an artificial limb) for a Squirrel and that would be the only possible reason to conserve the remainder of the radius and ulna and leave them in place. I would like to suggest that a Veterinarian be consulted and to also consider the options of removing the remainder of the radius and ulna while conserving the arm above with its bone, the humerus. With the radius and ulna removed, and the damaged tissue debrided (removed), a skin flap could be advanced over the end of the humerus. With my tendency toward wishful thinking and optimism; hopefully, your Squirrel would then be "willing" to walk on three paws and not try to walk on the injured extremity and not "mess" with the the stump (and these are probably some of the concerns that CritterMom has and that is why she has suggested a "complete" amputation of the injured extremity) although I truly suspect that there is more of a risk of these problems in a Squirrel with a partial amputation of one of the rear extremity than with a partial amputation of a front extremity as this would be. Once healing had taken place; Irrel could at least use the remaining arm to assist with holding food or for some balance benefits. These are just thoughts but I do think a Vet visit is imperative!

Regards,
SamtheSquirrel

[Shellysfriend]

Hi Shellysfriend:
Thank you for your concern and care you are bestowing upon this little injured Squirrel, Irrel! In you original post, you mentioned having used a "salve." What is it and are you still using it? Also, apparently an antibiotic is now being given. If I missed this in your thread, I apologize but would please identify the particular antibiotic now being given to your baby? You also mentioned that Irrel's amputation is below the elbow which means that the remaining portions of both of the forearm bone, the radius and ulna may be exposed. Infections can easily develop from injuries such as this and it does sound like that is what has developed with the visualizing of pus but there can actually be other causes. That is one reason I am asking about the particular "salve" that was used or is still being used. Ointments for marketed for use on the skin such as Neomycin and Triple Antibiotic among others contain the antibiotic called Neomycin. The ads for Neosporin imply that this medication is a miracle drug and it will prevent and infection or cure an infection if one already exists. It is doubtful that it can do either but that is not the issue with Neomycin. This medication is perhaps the most allergenic of the skin antibiotics and there can result from this such a severe allergic reaction that is difficult if not impossible to differentiate this from an infection by looking at!

I am in whole hearted agreement with the suggestions made previously for Irrel to be evaluated by an experienced and Squirrel friendly Veterinarian. Ideally, the Veterinarian should be experienced with Squirrels but a second choice would be someone who has experience with pet Rats and these two species are related and much of the treatments and medications we utilize for our Squirrels came from evidence derived from Rats.

I am NOT a Veterinarian and I do want you to know this but I would like to give you my opinion regarding the injury Irrel has sustained anyway and what I would consider an optimal plan. Obviously, there is no technology for a forearm prosthesis (an artificial limb) for a Squirrel and that would be the only possible reason to conserve the remainder of the radius and ulna and leave them in place. I would like to suggest that a Veterinarian be consulted and to also consider the options of removing the remainder of the radius and ulna while conserving the arm above with its bone, the humerus. With the radius and ulna removed, and the damaged tissue debrided (removed), a skin flap could be advanced over the end of the humerus. With my tendency toward wishful thinking and optimism; hopefully, your Squirrel would then be "willing" to walk on three paws and not try to walk on the injured extremity and not "mess" with the the stump (and these are probably some of the concerns that CritterMom has and that is why she has suggested a "complete" amputation of the injured extremity) although I truly suspect that there is more of a risk of these problems in a Squirrel with a partial amputation of one of the rear extremity than with a partial amputation of a front extremity as this would be. Once healing had taken place; Irrel could at least use the remaining arm to assist with holding food or for some balance benefits. These are just thoughts but I do think a Vet visit is imperative!

Regards,
SamtheSquirrel

Hi Sam the Squirrel, thank you for taking the time to reply. This is the salve that I had been but am no longer applying. It seemed to work well to keep the area from drying out and keep healing. When I got him it was scabbed and then the scab would fall off and be raw. I was afraid that he would lick at something like coconut oil and knew Neosporin was a no-no. Silvedyne had been recommended but I was not able to obtain any yet. The antibiotic being used now is SMZ-TMP. He let me poke and prod a bit around the area without any objection and played as hard as ever tonight. This picture is from tonight. The dark spot to the right (top, picture rotated) is the original injury and the infected area is to the left

[SamtheSquirrel2018]

Hi Sam the Squirrel, thank you for taking the time to reply. This is the salve that I had been but am no longer applying. It seemed to work well to keep the area from drying out and keep healing. When I got him it was scabbed and then the scab would fall off and be raw. I was afraid that he would lick at something like coconut oil and knew Neosporin was a no-no. Silvedyne had been recommended but I was not able to obtain any yet. The antibiotic being used now is SMZ-TMP. He let me poke and prod a bit around the area without any objection and played as hard as ever tonight. This picture is from tonight. The dark spot to the right (top, picture rotated) is the original injury and the infected area is to the left

Thanks Shellysfriend!
The whole injured area appears fairly good to me! It may be that the photo is just not revealing some of the more concerning issues but as it appears in the photo, it does not look bad to me! Is there any likelihood of a Vet visit? It may be worthwhile to consider "formal" wound care. I have used what is called Moist Wound Healing for some fairly significant wounds and this method is used as a standard in wound care. Wounds should not be permitted to dry out and there are some very neat wound dressing materials that both protect the wound and keep it moist and the choice of which to use is based upon how wet or dry the wound tends to get (is there a lot of drainage of very little for instance) in order to keep the wound moist but not saturated or "dripping."

One of the things that concerns me beyond what seems like an infection is what I have mentioned and that is that currently, the remainder of the "forearm" is never going to be an asset for functioning and is also where the open wound a probably the infection itself resides and ideally, this should be surgically debrided (removed) and once the wound is clean and healthy tissue remains, a flap of healthy skin may be able to be brought down over the end of the upper part of the extremity that contains the single bone called the humerus after the remainder of remnants of the forearm portion of the extremity has been surgically removed and unhealthy tissue debrided! Again, hopefully, an experienced Vet can help and will be able to knowledgeably perform the necessary surgical procedures and assist with coordinating a wound care protocol hopefully utilizing Moist Wound Healing!

Thanks again for your care of and your love for this little injured Squirrel!

Regards,
SamtheSquirrel