Abscess on rear leg

[olorin19]

Adult male grey squirrel, almost two years old. Dustin was successfully released spring 2015 and lives behind my house. In late June, I noticed his left rear leg was red and swollen, and he was holding it in the air and not using it. A heavy rain a few days later provided opportunity for me to contain him when he returned to his nest box. (He had not been indoors for 14 months. The nest box was outside and where he generally slept during cold or rainy weather, so rarely in summer.) I took him to the vet over four weeks ago, and he had anaesthesia to lance and drain the abscess (ankle joint) as well as a shot of Convenia. He has not two additional shots of Convenia and has now also started Enrofloxacin daily. For the past two weeks, I have also been soaking the leg in epsom salts for 10-15 minutes - he does tolerate this, if not happily.

While the abscess is much improved, he is still not using the leg fully. He will put weight on it standing, but little or none when walking/running or climbing.

Is there anything else I can do? In particular, is it safe to use PRID drawing salve? I have some, but have not applied it, as I am concerned about some of the ingredients and doubt I could prevent him from licking whatever is on him. (I rinse him off after the epsom salts since they have a laxative effect.)

Thanks!

[CritterMom]

The enrofloxacin (Baytril) is not a good choice for a deep abscess like this. It simply doesn't cover that bacteria. Can you get your hands on any Clavamox (amoxicillin trihydrate/clavulanate potassium, also sold as a human drug called Augmentin)? If you can get just a single pill - and we would need to know the size of the pill in milligrams because there are several available) and your squirrel's weight we can instruct you how to properly dilute and dose it. It is much more broad spectrum and will work much, much better.

[olorin19]

Thanks, CritterMom.

I am not sure where I would be able to obtain any amoxicillin. All I have on hand (from a dental surgery) are some 500 mg tablets of penicillin. i believe thyis is not safe for squirrels?

[olorin19]

If anyone has any suggestions on how to obtain Clavamox (amoxicillin trihydrate/clavulanate potassium, also sold as a human drug called Augmentin), much appreciated!

And does anyone have any experience as to whether or not PRID drawing salve is safe to use? Or any suggestions on anything else that might help? The epsom salt soaking does seem to help (and the vet told me to continue), but it is a bit stressful for both Dustin and myself. I have to either hold him against my chest with one hand while using the other to keep his leg in the epsom salt container, or else hold him with hands while someone else takes care of the epsom salt. He is much less stressed if nobody else is there, but he does wriggle, so there are challenges either way. I was hoping for something topical that could be applied once or twice daily.

[Shewhosweptforest]

Well aren't penicillin and amoxicillin closely related :thinking anyway, if you have an exotic pet store near by...or even one of the big chain stores....you can look in the fish department at their meds for fish...I'm not sure what their names are...but they have a variety of antibiotics sold under different names....if you read the label tho you can see what the AB actually is...hopefully they will have something in amoxicillin :great

As far as wound care....Milo'sMom has handled many abscess cases with phenomenal results....I know she's a firm believer in flushing the wound with saline....if you have a larger syringe....she also makes a flush with the actual antibiotics in it....not sure on the details on how to make it :dono I think you have to be very careful with any topical because you do not want the wound to heal with the infection still present.

Dustin is so lucky to still have you there for him :bowdown :Love_Icon

[olorin19]

Thanks, Shewhosweptforest

I will check the pet store, that is a great idea.

“An animal's eyes have the power to speak a great language.”
~ Martin Buber

Dustin and I are rather bonded with one another, to put it mildly. Much as he dislikes the epsom salt soaking, when I let him go, his first move is to perch on my arm to lick himself dry, after which he moves into the hood of my sweatshirt to relax. He was a summer baby, so I kept him all winter, spending quite a bit of time every day playing with him. Even after all this time in the wild, he still gently takes food from my hand and climbs around on me. (Other than when necessary due to the abscess, I do not handle him - it is more a question of letting him dictate the amount of physical contact. And I am especially careful around food and during mating season.)

My mum raised wildlife babies when I was a kid in Massachusetts. While not licensed herself, she did so under the license of a rehabber at a nature museum, and our local animal control officer used to bring her critters. We raised a summer squirrel that also seemed to have a much greater bond with us after release, presumably due to the much longer time in our care. But I do not believe even that squirrel would take food from our hands or climb on as this long after release.

Anyways, browsing various posts here at TSB this morning, it has been great to read so many others who simply love squirrels and would do whatever it takes to give them the best life possible. Thanks, all!

[Spanky]

If anyone has any suggestions on how to obtain Clavamox (amoxicillin trihydrate/clavulanate potassium, also sold as a human drug called Augmentin), much appreciated.


Well aren't penicillin and amoxicillin closely related :thinking anyway, if you have an exotic pet store near by...or even one of the big chain stores....you can look in the fish department at their meds for fish...I'm not sure what their names are...but they have a variety of antibiotics sold under different names....if you read the label tho you can see what the AB actually is...hopefully they will have something in amoxicillin

Penicillin should not be used for squirrels. I also want to mention that the FishFlox (Amoxicillin) is not the same as the Clavamox or Augmenting which contain clavulanate potassium, which makes a huge difference in coverage. The other fish antibiotic is the equivalent to the enrofloxin you already tried.

CM is right on, treating with Augmentin or Clavamox will be much more successful in this case.

Is there a reason you cannot ask you vet for Clavamox?!? I know their goto is the enrofloxin, but after a month you'd hope he'd be open to trying something that may be more effective!

[Shewhosweptforest]

:klunk That magic bond is just that "magical" ...and yes here at TSB... we're all addicted to that magic....:serene it also says a lot about a person....that a wild animal, free in their natural habitat....chooses to remain friends :Love_Icon Dustin trusts you...with his life....after all, they are prey animals and their greatest fear is to be captured...that means death :sadness but Dustin trust you with his life...now that's magic....magic of love :klunk

[olorin19]

Penicillin should not be used for squirrels. I also want to mention that the FishFlox (Amoxicillin) is not the same as the Clavamox or Augmenting which contain clavulanate potassium, which makes a huge difference in coverage. The other fish antibiotic is the equivalent to the enrofloxin you already tried.

CM is right on, treating with Augmentin or Clavamox will be much more successful in this case.

Is there a reason you cannot ask you vet for Clavamox?!? I know their goto is the enrofloxin, but after a month you'd hope he'd be open to trying something that may be more effective!


Thanks, Spanky!

I left a message with the vet and will discuss with them later today.

Does anyone have an opinion on the PRID drawing salve? Here are the ingredients. I am not worried about the active, as these are homeopathic, more than inactive, in particular: petrolatum, stearyl alcohol, alcohol, methyl & propyl paraben

Active Ingredients | Purposes:

Acidum Carbolicum 2X HPUS: eases pain from red, swollen bites
Ichthammol 2X HPUS: helps to heal the skin
Arnica Montana 3X HPUS: eases pain and swelling
Calendula Officinalis 3X HPUS: eases pain from white hard bites
Echinacea ang. 3X HPUS: eases pain from itchy red bites
Sulphur 12X HPUS: relieves itching, sores, hives
Hepar Sulph. 12X HPUS: relieves abcesses, boils, itching
Silicea 12X HPUS: relieves eruptions, boils, urticaria

Inactive Ingredients: Rosin, beeswax, petrolatum, stearyl alcohol, alcohol, methyl & propyl paraben.

[olorin19]

:klunk That magic bond is just that "magical" ...and yes here at TSB... we're all addicted to that magic....:serene it also says a lot about a person....that a wild animal, free in their natural habitat....chooses to remain friends :Love_Icon Dustin trusts you...with his life....after all, they are prey animals and their greatest fear is to be captured...that means death :sadness but Dustin trust you with his life...now that's magic....magic of love :klunk

Thanks SWSTF

My mum is now 89, still living in Massachusetts. I often have long phone conversations with her while hanging out with Dustin. We both agree that there is something truly magical about having a squirrel on you. Whether it is running around using you as a tree or burrowing into hood, pocket, or under sweatshirt to use you as a nest, there is no feeling quite like it. A memory my mum often recalls was raising a pair of baby raccoons for release, and how they would gently stroke your cheek with their paws while you fed them formula, all the while looking into your eyes.

About twelve years ago, when I was raising my first baby squirrel, there was a chipmunk in my backyard that seemed inordinately curious. Being curious myself, I started leaving food out for him on the wall where he perched. In a surprisingly short time (under 20 minutes), this chipmunk was taking peanuts right out of my hand. So long as I stood still, Pippin was quite happy to come out and eat. The first time I held a peanut for him, he missed and got my finger - very gently, not a bite, just a mistake - so after than, I made sure the peanut extended past my hand. Eventually he would actually fill his cheeks with sunflower seeds from my hand while leaning on my hand with his front paws. This went on for the next four years. Never managed this with another chipmunk since then, although many have been happy enough to feed 2-3 feet away.

[JPlagg]

Working on healing an abscess here too. Last weekend my son noticed our guinea pig Rodney had a wound about the size of a nickle on his side....yep a popped abscess....nice Well at least I didn't have to figure out how I was going to drain it!!! I'm successfully treating it by flushing with saline solution and applying Derma Gel. https://www.amazon.com/Veterinus-Derma-Gel-100ml-fl-oz/dp/B001JYDBEI/ref=sr_1_9?s=pet-supplies&ie=UTF8&qid=1469891683&sr=1-9&keywords=derma+gel. It's less than dime size as of a few minutes ago.

[olorin19]

Working on healing an abscess here too. Last weekend my son noticed our guinea pig Rodney had a wound about the size of a nickle on his side....yep a popped abscess....nice Well at least I didn't have to figure out how I was going to drain it!!! I'm successfully treating it by flushing with saline solution and applying Derma Gel. https://www.amazon.com/Veterinus-Derma-Gel-100ml-fl-oz/dp/B001JYDBEI/ref=sr_1_9?s=pet-supplies&ie=UTF8&qid=1469891683&sr=1-9&keywords=derma+gel. It's less than dime size as of a few minutes ago.

Thanks, JPlagg

First, good luck with your son's guinea pig.

As far as flushing with saline, I am not really sure how to do this. Does this mean getting a needle syringe and using that to poke into the abscess and squirt saline? Or is this meaning squirting saline into an already open wound?

And does the guinea pig lick where the Derma-Gel is applied? Or would this be safe with a squirrel, who will definitely lick whatever is there?

Thanks!

[olorin19]

As far as wound care....Milo'sMom has handled many abscess cases with phenomenal results....I know she's a firm believer in flushing the wound with saline....if you have a larger syringe....she also makes a flush with the actual antibiotics in it....not sure on the details on how to make it :dono I think you have to be very careful with any topical because you do not want the wound to heal with the infection still present.



I am not clear on flushing with syringe. Since the wound is not open, does this mean i obtain a needle syringe to stick into the abscess then squirt in the saline solution?

[Shewhosweptforest]

Derma Gel can be licked without any problems :great as far as flushing the abscess, I assumed it's was open for drainage :dono I'm not an expert...but, when as abscess is lanced...you try to keep it open so the infection can drain...when it closes the infection can linger and fester back up...or even spread. When talking about flushing with a syringe...you can get the large syringes with longer tips that can get into the wound a bit...no needles. They do sell saline in a spray can...but it is messier and not as accurate, but will do in a pinch. I am worried that the wound has closed up :( you will have to treat the infection more aggressively....hopefully, some of our wound wizards will check this out...I'll pm someone for help:great

[olorin19]

Derma Gel can be licked without any problems :great as far as flushing the abscess, I assumed it's was open for drainage :dono I'm not an expert...but, when as abscess is lanced...you try to keep it open so the infection can drain...when it closes the infection can linger and fester back up...or even spread. When talking about flushing with a syringe...you can get the large syringes with longer tips that can get into the wound a bit...no needles. They do sell saline in a spray can...but it is messier and not as accurate, but will do in a pinch. I am worried that the wound has closed up :( you will have to treat the infection more aggressively....hopefully, some of our wound wizards will check this out...I'll pm someone for help:great

Thanks SWSTF

While the wound drains a bit after lancing, I do not believe it stays open. The epsom salts do seem to help draw it to a head, although hard to say if that erupts or not - most likely if that happens, Dustin has already licked it clean before I would see it.

This photo is from a week ago.

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[JPlagg]

An abscess needs to heal from the inside out or it will re-fester. With Rodney his wasn't discovered until it popped wide open so it didn't have to be lanced. It was/is a decent size crater so not difficult (as of yet) to keep the wound open as it heals. I made my own saline solution following instructions I found online. The syringe I use has no needle. I think I bought it at TSC or Family Farm and Home. I also tried and failed to cover it with a telfa non stick dressing and vet wrap. When I was all done the dressing promptly slid up to his natural waist line and the wound was exposed. As SWSF said the Derma Gel is fine if licked so I left it open to air.....so far so good.

[Nancy in New York]

CM is right on, treating with Augmentin or Clavamox will be much more successful in this case.

Is there a reason you cannot ask you vet for Clavamox?!? I know their goto is the enrofloxin, but after a month you'd hope he'd be open to trying something that may be more effective!


Great post!
Here's a link explaining why the Clavamox is the choice drug for abscesses.
I hope your vet listens to you! :hug

http://thesquirrelboard.com/forums/showthread.php?40628-ABCESSES-IN-SQUIRRELS

[olorin19]

An abscess needs to heal from the inside out or it will re-fester. With Rodney his wasn't discovered until it popped wide open so it didn't have to be lanced. It was/is a decent size crater so not difficult (as of yet) to keep the wound open as it heals. I made my own saline solution following instructions I found online. The syringe I use has no needle. I think I bought it at TSC or Family Farm and Home. I also tried and failed to cover it with a telfa non stick dressing and vet wrap. When I was all done the dressing promptly slid up to his natural waist line and the wound was exposed. As SWSF said the Derma Gel is fine if licked so I left it open to air.....so far so good.

Thanks, JP, and glad Rodney is healing well.

[olorin19]

Great post!
Here's a link explaining why the Clavamox is the choice drug for abscesses.
I hope your vet listens to you! :hug

http://thesquirrelboard.com/forums/showthread.php?40628-ABCESSES-IN-SQUIRRELS

Thanks, Nancy

I am still waiting to hear back from the vet, but perhaps the link will come in handy.

[HRT4SQRLS]

Olorin,
I just saw the pic of your friends ankle. If the photo is from a week ago (after Covenia & Baytril) and it is still draining pus, the antibiotic needs to be changed ASAP.

That is a very bad location on a joint. If that continues to drain pus (indicating active infection) there is very good chance this could, if not already, become a bone infection. Bone infections are very difficult to treat. Maybe the vet could give you Clavamox and/or Clindamycin.

[olorin19]

Olorin,
I just saw the pic of your friends ankle. If the photo is from a week ago (after Covenia & Baytril) and it is still draining pus, the antibiotic needs to be changed ASAP.

That is a very bad location on a joint. If that continues to drain pus (indicating active infection) there is very good chance this could, if not already, become a bone infection. Bone infections are very difficult to treat. Maybe the vet could give you Clavamox and/or Clindamycin.

Thanks, HRT4SQRLS.

Just got back from the vet and now have Clavamox.

When that photo was taken, Dustin was not quite four weeks after the surgery (lance/drain) and had been give two shots of Convenia but had not yet started the Baytril.

[CritterMom]

Yay - excellent!

[SammysMom]

How many MG is the med and how much does he weigh? I am so happy to see the vet gave clavamox!:w00t

[olorin19]

Thanks, HRT4SQRLS.

Just got back from the vet and now have Clavamox.

When that photo was taken, Dustin was not quite four weeks after the surgery (lance/drain) and had been give two shots of Convenia but had not yet started the Baytril.

Just got a good look at the wound: Whether doing the epsom salts solo, or me holding Dustin then my girlfriend doing the soak, it has not been easy for me to see the leg well while holding Dustin. I managed to hold him with one (gloved) hand and position so so the inside of the ankle was visible. Good news: There iss an opening, with some clear discharge. The photo was from last Saturday (so one week ago), and the wound was drained again on Wednesday. From memory, the vet just squeezed rather than using a needle or other tool, so it must have been at least in a head if not open by then.

While he definitely is not using the leg much when moving, within the past week he has started to stand up on his hind legs when on a flat surface and eating with both front paws, whereas not so long ago he was eating with right front while leaning on right rear and left front paws. And he is using the left rear to scratch behind his ear with actual contact, whereas a few weeks ago he was going through the motion but no actual contact.

[olorin19]

How many MG is the med and how much does he weigh? I am so happy to see the vet gave clavamox!:w00t

0.25 ml/mg every 12 hours

He has not been precisely weighed at the vets, but he must be at least 1 lb and probably more like 1.25 or more.

[Spanky]

0.25 ml/mg every 12 hours

He has not been precisely weighed at the vets, but he must be at least 1 lb and probably more like 1.25 or more.

I am very happy that you were able to get clavamox! The weight is good info... sounds as if you were given Clavamox as a suspension? Is the concentration 50mg Amoxicillin per 1ML? It would not hurt to double check the dosage since not many vets treat a lot of squirrels!

[olorin19]

I am very happy that you were able to get clavamox! The weight is good info... sounds as if you were given Clavamox as a suspension? Is the concentration 50mg Amoxicillin per 1ML? It would not hurt to double check the dosage since not many vets treat a lot of squirrels!



Suspension - yes
per mL - 50 mg amoxicillin and 12.5 mg clavulanic acid

Thanks!

[Spanky]

The 0.25 ml of 50mg/ml Clavamox suspension, every 12 hours, for a 1.25 lb (568 gram) squirrel is exactly 1/2 the dose per WMB guidance!

I would hate to see him not progress due to under dosing his antibiotics, especially since the infection as been festering for so long?

[CritterMom]

WMB = "Wild Mammal Babies" - the guide we use for all of our dosing and a ton more...it is the rehabber's bible...

[olorin19]

The 0.25 ml of 50mg/ml Clavamox suspension, every 12 hours, for a 1.25 lb (568 gram) squirrel is exactly 1/2 the dose per WMB guidance!

I would hate to see him not progress due to under dosing his antibiotics, especially since the infection as been festering for so long?




Thanks - we will double up to 0.5 ml every 12 hours.

This gives me enough for about 15 days. Is that long enough, or do we need to go a month?

And I greatly appreciate the expert help for Dustin from each of you.

We have been through a lot together. When Dustin was about three months old, he startled at something on my front porch and hid under my car. Luckily, I saw him disappear, but even so it took quite awhile to find him, as he had wedged himself up at the top of my strut. I had to jack up the car and remove the wheel to extricate him. Quite the ordeal for both Dustin and me.

275971

[Spanky]

The 0.25 ml of 50mg/ml Clavamox suspension, every 12 hours, for a 1.25 lb (568 gram) squirrel is exactly 1/2 the dose per WMB guidance!


WMB = "Wild Mammal Babies" - the guide we use for all of our dosing and a ton more...it is the rehabber's bible...


Thanks - we will double up to 0.5 ml every 12 hours.

Sorry to be confusing, but I just realized that was a change to the Clavamox dosing recommendations in the new (2016) version of the WMB "bible". Let me get this clarified and I will post an update?

[olorin19]

Sorry to be confusing, but I just realized that was a change to the Clavamox dosing recommendations in the new (2016) version of the WMB "bible". Let me get this clarified and I will post an update?


I had already given him the morning dose of 0.25 ml before I saw the post, and was not going to increase to 0.5 ml until this evening. So yes, please check the dosage and I will follow that starting this evening.

Much appreciated, and count me a huge fan of all you fine folks at TSB!

[HRT4SQRLS]

WHOA! Do NOT increase the dose to 0.50 ml!

I will explain in the next post but didn't want you to increase the dose.

[HRT4SQRLS]

Here's the deal.... there is confusion regarding dosing of Clavamox because it is a combo antibiotic (Amoxicillin + Clavulanic Acid). In this case 50mg/ml of Amoxicillin and 12.5mg/ml of Clavulanic acid.

The Wild Mammal Baby book adds all combo drugs and calculates the dosing based on the total. In other words the dosing is based on the 62.5 mg/ml total.
Based on this the dose for a 570g squirrel would be 0.18ml.

This is the way other combo drugs are calculated like SMZ-TMP. It is a combo of Sulfamethoxizole and Trimethoprim. Both components are an antibiotic. The concentration of each drug is added together.

The issue with Clavamox is that only the Amoxicillin is an antibiotic. The Clavulanic acid portion is not an antibiotic. It is a beta lactamase inhibitor. I won't talk about that right now because it isn't relevant to this discussion.

There are 2 schools of thought. Those that add the 2 together like the WMB book and those that use ONLY the antibiotic portion (Amoxicillin) to calculate the dosing which in this case would be 50mg/ml.
Based on this, the dose for a 570g squirrel would be 0.23ml.

If you look at the difference in dosing between the two methods ... 0.18 vs 0.23... the difference is not very large. Actually it is within the margin of error when dosing with a crude device like a 1cc syringe.

More that likely your vet dosed based on the 50mg/ml to get the 0.25ml dose. Because you don't have a true weight on the squirrel and are using an estimated weight, I think the dose that he has prescribed is good, so I would stick with this.
If you wanted to bump it down a little that would be OK but without an accurate weight, I don't think it's necessary.

Please let me know if I have totally confused everyone. :tilt

[olorin19]

Here's the deal.... there is confusion regarding dosing of Clavamox because it is a combo antibiotic (Amoxicillin + Clavulanic Acid). In this case 50mg/ml of Amoxicillin and 12.5mg/ml of Clavulanic acid.

The Wild Mammal Baby book adds all combo drugs and calculates the dosing based on the total. In other words the dosing is based on the 62.5 mg/ml total.
Based on this the dose for a 570g squirrel would be 0.18ml.

This is the way other combo drugs are calculated like SMZ-TMP. It is a combo of Sulfamethoxizole and Trimethoprim. Both components are an antibiotic. The concentration of each drug is added together.

The issue with Clavamox is that only the Amoxicillin is an antibiotic. The Clavulanic acid portion is not an antibiotic. It is a beta lactamase inhibitor. I won't talk about that right now because it isn't relevant to this discussion.

There are 2 schools of thought. Those that add the 2 together like the WMB book and those that use ONLY the antibiotic portion (Amoxicillin) to calculate the dosing which in this case would be 50mg/ml.
Based on this, the dose for a 570g squirrel would be 0.23ml.

If you look at the difference in dosing between the two methods ... 0.18 vs 0.23... the difference is not very large. Actually it is within the margin of error when dosing with a crude device like a 1cc syringe.

More that likely your vet dosed based on the 50mg/ml to get the 0.25ml dose. Because you don't have a true weight on the squirrel and are using an estimated weight, I think the dose that he has prescribed is good, so I would stick with this.
If you wanted to bump it down a little that would be OK but without an accurate weight, I don't think it's necessary.

Please let me know if I have totally confused everyone. :tilt

Thanks much!

I have not given the evening dose, so will stick with the 0.25.

Much appreciated!

[olorin19]

Thanks, HRT4SQRLS.

Just got back from the vet and now have Clavamox.

When that photo was taken, Dustin was not quite four weeks after the surgery (lance/drain) and had been give two shots of Convenia but had not yet started the Baytril.

When I looked at the wound yesterday, there did appear to be a small opening. No sign of pus (although Dustin might have licked that off) but possibly some clear discharge. Today, the wound seems closed. While the skin is not an angry red, it does appear like the swelling is bigger than yesterday. Is this due to the Clavamox, of which he has now had five doses?

Basically, I am wanting to do whatever it takes here. Dustin is getting to wrangle, as he does not like either the oral meds or the epsom salt soaking. So i have discontinued the epsom salt for now. Should I resume the epsom salt, or is the main thing to make sure he gets his Clavamox twice daily?

Will the Clavamox likely lead to the abscess coming to a head then bursting? Or does it disappear inwardly?

[HRT4SQRLS]

I would not let the wound close just yet. It needs to heal from the inside. Can you do warm compresses to soften the opening? If not, you might try the warm Epsom salt soak again.

It's difficult to say how the wound will heal. If it stays open it shouldn't form a head.

[Milo's Mom]

Derma-Gel would help keep the wound open and allow it to heal from the inside out, as it should.

It is non-toxic too.

https://www.amazon.com/Veterinus-Derma-GeL%C2%AE-Tube-100mL/dp/B003MCHX4E

[olorin19]

Derma-Gel would help keep the wound open and allow it to heal from the inside out, as it should.

It is non-toxic too.

https://www.amazon.com/Veterinus-Derma-GeL%C2%AE-Tube-100mL/dp/B003MCHX4E

Thanks, MM

I have now ordered the Derma Gel.

Thanks!

[olorin19]

I would not let the wound close just yet. It needs to heal from the inside. Can you do warm compresses to soften the opening? If not, you might try the warm Epsom salt soak again.

It's difficult to say how the wound will heal. If it stays open it shouldn't form a head.

I will try the warm epsom salts and the warm compress and see if this helps open the wound.

Thanks!

[olorin19]

Received the Derma Gel yesterday, and applying it twice daily.

Question: How long should Dustin be on the Clavamox?

Thanks!

[stepnstone]

Received the Derma Gel yesterday, and applying it twice daily.
Question: How long should Dustin be on the Clavamox?
Thanks!
At least 7-10 days, possibly even longer depending on improvement.

[olorin19]

At least 7-10 days, possibly even longer depending on improvement.

Thanks stepnstone - expert advice always appreciated!

I will look at how he seems to be doing in a few more days - it has now been 6 days on the Clavamox and 1 day with the derma gel.

[olorin19]

Recap and update:

Dustin is an adult male, two years old as of this week (came into my care 9/15/2014 at 5-6 weeks). Successfully released spring 2015, has lived in my back yard ever since, and while otherwise a wild squirrel, has remained friendly with me, sleeping in nest box during cold/wet weather.

Injured leg first observed 6/24 so bite wound likely at least a few days prior, as it looked nasty by then.
Bite to ankle joint on left rear leg.
Managed to contain him in nest box a few days later.
Surgery to lance/drain abscess on 6/29 and first Convenia injection.
Abscess drained and Convenia injections again on 7/11 and 7/27, started also on Enrofloxacin on 7/27.
Limited improvement from all of this, i.e. joint still large and inflamed, and little or no use of leg in motion, limited use when not moving (resting on it somewhat, scratching behind ear). But where the is life, there is hope.
Started soaking leg in epsom salts on 7/15 with some okay results.
Contacted TSB 7/29 and started on Clavamox.
Mea culpa - did not realize Clavamox needed to be refrigerated until tuesday, so got a fresh batch 8/3.
Received Derma Gel on 8/4.
Over the past 3-4 days, I am seeing some great improvements:
Dustin is making extensive use of the left rear leg when running and climbing. By no means 100%, but far mroe than previously. He is definitely pushing off with it when running and using it when climbing upwards.
The joint itself is (finally) starting to reduce in size. Still larger than the other leg, but nothing like it has been over the past six weeks.

Anyways, many thanks from Dustin and myself.

So the short version of all the above for any of you who find yourself in my position (i.e. squirrel lover but not expert):
Do not wait to get advice from the fine folks at the TSB.
Had I done that, Dustin would have been on Clavamox from the start, and likely already enjoying summer outdoors.

With that said, I am extremely grateful to the vets who were willing to treat Dustin, and no disrespect is intended. They most likely saved Dustin's life.

My plan (based on start date of refrigerated Clavamox of 8/3) is to reassess on 8/10 and solicit opinions as to whether or not to continue and for how long.

When Dustin is ready to return to the wild (and as a check on his really being over the infection), I was thinking of returning him for a week or so to his larger outside cage, along with the nest box which is now in his indoor cage. (The outdoor cage has been stored in my basement but was his original pre-release cage. The nest box has moved around with Dustin since he was four months old, i.e. from indoors to outdoors and now temporarily back indoors. It is very much his safe place.) He has been in a smaller indoor cage the past few weeks, as it is not really possible to give him his meds twice daily otherwise. As he has also been absent from the backyard for six weeks, it might also help him to reinsert himself into the squirrel hierarchy. (Prior to this bite, I would have said he was the alpha of the immediate area, but I guess things change.)

Does that approach make sense?

[HRT4SQRLS]

I'm very happy to hear that Dustin is responding to the Clavamox. We have has excellent results when treating wounds with it. I'm glad your vet helped also but I will say it once again (as it is my NUMBER 1 pet peeve) CIPROFLOXACIN/BAYTRIL should not be used for wounds. Sorry... I had to get that out of my system. :rotfl
It just does not cover the organisms that are usually found in wounds. Once upon a time it was an excellent drug but due to rapidly developing resistance it has lost a lot of it's punch. I've found that a lot of vets still use it though. Drives me crazy. :tilt

I would continue the Clavamox for at least 10 days due to the fact that this was so close to the joint. There is a chance this infection could have invaded the bone. Let's hope not. If it appears to be greatly improved at the end of 10 days I would discontinue the AB and observe it closely for a possible recurrence. If it does, we would probably want to switch to Clindamycin for it's excellent bone penetrating properties.

I think putting him in a release cage before release is an excellent idea. It would give you more time to observe the ankle and also give him time to start getting used to the heat and outdoors again. He's had a long treatment so a slow transition outside would be a good idea. I'm very happy for you and Dustin.,

[olorin19]

I'm very happy to hear that Dustin is responding to the Clavamox. We have has excellent results when treating wounds with it. I'm glad your vet helped also but I will say it once again (as it is my NUMBER 1 pet peeve) CIPROFLOXACIN/BAYTRIL should not be used for wounds. Sorry... I had to get that out of my system. :rotfl
It just does not cover the organisms that are usually found in wounds. Once upon a time it was an excellent drug but due to rapidly developing resistance it has lost a lot of it's punch. I've found that a lot of vets still use it though. Drives me crazy. :tilt

I would continue the Clavamox for at least 10 days due to the fact that this was so close to the joint. There is a chance this infection could have invaded the bone. Let's hope not. If it appears to be greatly improved at the end of 10 days I would discontinue the AB and observe it closely for a possible recurrence. If it does, we would probably want to switch to Clindamycin for it's excellent bone penetrating properties.

I think putting him in a release cage before release is an excellent idea. It would give you more time to observe the ankle and also give him time to start getting used to the heat and outdoors again. He's had a long treatment so a slow transition outside would be a good idea. I'm very happy for you and Dustin.,

Thanks again!

And just to confirm: Ten days from Wed 8/3, since I screwed up by not refrigerating the first batch of Clavamox started on 7/29?

[HRT4SQRLS]

Thanks again!

And just to confirm: Ten days from Wed 8/3, since I screwed up by not refrigerating the first batch of Clavamox started on 7/29?

Yes, It wouldn't hurt. :tilt

[olorin19]

As of tomorrow morning, Dustin will have completed ten days of (properly refrigerated) Clavamox 2X daily, plus nine days of Derma Gel 2x daily.

He has been indoors in mid 70s AC environment for over a month, and the new few days are high 80s to low 90s and very humid. Between that and wanting to give him lots of probiotics to help get his microbiome back in shape , I was figuring on waiting until Tuesday or so before returning him to his outdoor cage.

Does this seem reasonable?

The ankle joint is far smaller than it was a week ago, although still a bit larger than on his uninjured leg. He has been pushing off with the injured leg for over a week, spends lots of time standing upright on his back legs at the windowsill, and over the past few days he has resumed that "squirrel telegraph" motion where the back legs alternate coming up and down when on all fours as the tail twitches.

There was a mention of possibly needing a different antibiotic if the infection went into the bone. How and when will I be able to tell? Should I wait a week and look for signs of the ankle joint enlarging or reddening? Observe his physical capabilities?

I have not seen him really use the injured leg for descending, but with that said his temporary indoor cage does not provide much space for that. His outdoor cage is six feet tall wire mesh, and it will be pretty obvious once he gets out there whether or not he is capable of flying around and using both legs to dangle and descend, etc.

So if after a week or so outdoors there is no sign of infection and he seems to be moving fine, is that enough to release him? I am not in a hurry, by the way, and would prefer to err on the side of caution.