Antibiotic: Clavamox or Bactrim ?

[Treedweller]

I have an adult squirrel with a severe inner ear infection. I am in disagreement with my vet about which antibiotic to use. She is new to wildlife rehab. I want to use Clavamox, she wants me to use Bactrim. Opinions ?
Her reasoning is that Clavamox can cause fatal gut issues ( according to the vet research) in exotics. I have used it with squirrels for nearly fifteen years with no issues.

[Milo's Mom]

Hmmm, this is interesting. I have one with an ear infection also. I was going to use Clavamox, but after speaking to another rehabber decided on SMZ (Bactrim) and I'm seeing good results, so far.

A few years ago a vet told me NO CLAV in rodents! I explained that we use it all the time for squirrels and it works very well. Fast forward a few years and the conversation came up again...turns out it's GRASS eating rodents that can't handle Clavamox.

So, based on what I know, have read, and have experienced within the last week I'd start the SMZ, and if you don't see an improvement, go to the Clavamox.

[Treedweller]

Hi !

Thanks for your quick response.
Can you direct me to any articles ir other information relating to the grass fed rodents and Clavamox ?
My vet wants me to give all my Clavamox back, I don't want to, and don't want to break up with my vet !!!
Where did you read that ?

My adult squirrel has lots of pus in her ear, vet cannot see with otoscope. Gave me Eye irrigating solution/saline to rinse out the ear canal to try and clean the pus out. Q-tips are too big. Any recommendations on a soft gentle alternative?
We did get a good culture of the schmatz, two dif strains of bacteria.

You say you're having good results with the Bactrim ?

I guess the issue with Clavamox / any pennacillin variant is something called chlostridial entero toxemia, which is a nasty bug that crosses into the bloodstream and results in immediate death. Squirrels tend to tolerate the Clavamox better than other rodents, but this is a possible outcome of using Clavamox.

[Milo's Mom]

Hi !

Thanks for your quick response.
Can you direct me to any articles ir other information relating to the grass fed rodents and Clavamox ?
My vet wants me to give all my Clavamox back, I don't want to, and don't want to break up with my vet !!!
Where did you read that ?

My adult squirrel has lots of pus in her ear, vet cannot see with otoscope. Gave me Eye irrigating solution/saline to rinse out the ear canal to try and clean the pus out. Q-tips are too big. Any recommendations on a soft gentle alternative?
We did get a good culture of the schmatz, two dif strains of bacteria.

You say you're having good results with the Bactrim?

I don't know exactly where I read it's the grass eating rodents. That was awhile ago. It was more than likely right here on TSB.
I did not have a culture done so I don't know which bacteria I'm dealing with. There was a good deal of pus and I was able to swab it out with a q-tip (guess mine has bigger ears). I also did several swabs with a dilute Chlorhexidine solution. Then after I realized I needed more than just good cleanings I started with the SMZ. So far, yes, I am seeing positive results, but to be 100% honest with you I have my Clavamox on standby. I don't use SMZ often and the few times I have I haven't been thrilled, so I am a bit skeptical, but it does seem to be working for this particular issue.

[Treedweller]

Sorry to keep asking questions, but....

My squirrel weighs 1 pound 8oz, the dose prescribed is .5 mL, seems like a lot to me. I don't know what the suspension is.

Any thoughts ?
I'm waiting for a call back from the vet right now. She said there is a wide dose range and she went to the high end.
I am very nervous about this.

[PennyCash]

Did a very quick search and found this but I'm not sure it covers what your looking for.
Will keep looking into it.
http://www.vspn.org/vspnsearch/aow/drugtherapyinpetrodents.htm

http://ratguide.com/meds/antimicrobial_agents/clavamox_amoxicillinclavulanate.php

https://www.jstage.jst.go.jp/article/bpb/35/7/35_b110639/_article
Here's one that mentions scientists giving rats Clavamox after maiming them for study
http://pubmedcentralcanada.ca/pmcc/articles/PMC3433532/

[Milo's Mom]

my suspension is 50mg/ml - be sure to find out what yours is
the dose range is 15-30mg/kg
your squirrel is 680 grams
dosing at 25mg/kg the WMB dose would be .33 PO BID
If the vet is going heavy on purpose and is suggesting .5 PO BID, I, personally, would be inclined to agree.

The squirrel I am dosing currently is just a tad heavier and I'm using .45 PO BID...but I'm not a vet and a vet did not dose for me. And I tend to err on the side of caution...

Just keep in mind SMZ is a Sulfa drug and as with any sulfa drugs you'll want to keep the squirrel well hydrated.