Pre/post surgery care and anesthesia info - help needed

[Toni80]

We need help from kind people of TSB!

My little beauty is to be operated in two or three days and we need every advice you can send our way!
It seems that her toe infection progressed in some sort of a tumor. The "tissue is proliferating" were the exact words!
Our vets are completely inexperienced with anesthetizing a squirrel! And they don`t even use isoflurane gas recommended here.
Are there any other safe anesthetics for them or should I be looking for another vet??

Are there any pre-op suggestion, should they fast and how long?

Additionally, they are lost as how is a squirrel to be handled post-op. They instructed me to ask around...will she chew on the wound and how to stop her.
Should a bandage be put (in other rodents they avoid any sort of bandages and covering of wound, they give antibiotics and analgesics IM)?
They advice against an antiseptic post-op, apparently it delays healing.
Does anyone have any kind of advice?

I`ve read something about a special sort of cage after surgery? What is that exactly and which bedding should I use?

I˙m so lost and worried :sadness

[stepnstone]

I don't know what is available to you there as far as veterinary care for wildlife and or rodent type animals, exotics etc.
I am aware that anesthetizing a squirrel can be risky even with an experienced veterinarian, inexperience is another risk.
I do not know if the "surgery" to be preformed can or could not be done by local anesthetics or what would/could be used.
I would think not due to the stress factor it would cause the squirrel which claims many.
If no other options I personally would suggest your veterinarian consult with an experienced veterinarian if at all possible.

What is the proposed surgery to accomplish? Amputation of the toe or is it more involved?
Could you possibly post a picture of your little's foot...

[Toni80]

The problem is I don`t know of any experienced vets in my country that have performed any kind of surgery on squirrels.
Current vet routinely operates on rabbits, hamsters, guinea pigs, dog and cats but not on squirrels or rats.

Procedure is simple actually, amputation of the toe, because of the rapidly growing tissue (I really hope it`s not malignant) which bleeds everytime she grazes it, and causes her pain.
I`m not worried about the amputation itself, I trust they`ll do it right but I`m worried sick about anesthesia (I do believe local anesthesia is not possible in this case) because I read it can be very dangerous for them.
Also, I`m worried how it`s going to heal afterwards and what steps I need to take to ensure everything goes well.

I`ll try to post a video tomorrow but she is very protective of the toe, constantly hiding it, I`ll have to restrain her somehow. :(

[HRT4SQRLS]

Sorry to bail on you Toni. I was out most of the day yesterday.

I'm also worried about your girl. I'm not sure how they react to other anaesthetics.
Step is right, squirrels do get unstable while under anaesthesia. It makes me feel a little better that they have done surgery on other small mammals.
A FL vet stated in regard to surgery on squirrels that she uses the least anaesthesia needed to put them under. She doesn't knock them out deep. She also has a vet tech that monitors them during the entire procedure. That's where the gas is useful. She can back off or add more as needed during surgery.

Do you want to consider the SMZ before going the surgery route? It has a broader coverage and hasn't developed resistance as much as other antibiotics have.

If you can post a pic, that would be good.

The biggest concern post surgery would be chewing the foot.

[Toni80]

288401

[Toni80]

It's really dark here today and our phone cameras are horrible. I'm uploading some videos but I doubt they're much better :(

Thank you for your time and effort, to both of you, I wish more people would pitch in with their experience.

I've managed to get in touch with 2 DVMs that work in ZOO in our capital city. They said they had 4 successful surgeries done on eurasian squirrels using ketamin, medetomidine and butorphanol. Tomorrow they'll get in contact with our vets regarding the dosage.
That has reassured me, just a tiny bit.

Two DVMs will be performing the surgery.

[Toni80]

And yes, SMZ dosing would be helpful, al least after the surgery if not now (I'll try to persude them to give AB another shot if there's any chance it could still be an infection).

What are other possibly safe antibiotics for resistant bacteria?
Doxycycline, oxytetracycline, moxifloxacine...?
If something goes wrong after surgery I want to be prepared.

[Toni80]

https://vimeo.com/217654088

[Toni80]

https://vimeo.com/217654162

This is the best I could do with our phone cameras.:embar

So these are fresh pics and videos.
See how the growth is under and on the right side of her toe.

[Toni80]

This is what we started with:


https://vimeo.com/217654205

It`s from 21th of April after 12 days of cephalexin and 10 days of Clavamox but BEFORE clindamycin. It looked much more inflamed, it was more like an abscess on her left side of the toe, there`s only a small scab in its place today.

But there is this huge growth on the right side that doesn`t respond to any antibiotics so far, only to dexamethason. Without it she experiences pain, the growth bleeds a lot, she refuses food and water. :(

And her right toe is approximately 2 or 3 times thicker than her healthy, left toe.

[Mel1959]

It's reassuring that you have some vets conferring with the vet who will do the surgery. As HRT4SQRLS said, using the least amount of anesthesia possible will be best for her.

I'll be sending prayers. :grouphug. Please keep us updated.

[Toni80]

Thank you, I will.
I`m so worried that I`m more and more inclined to HRT4SQRLS idea to give antibiotics one last shot (SMZ-TMP) although our vets are not thrilled with the idea.

[stepnstone]

Thank you, I will.
I`m so worried that I`m more and more inclined to HRT4SQRLS idea to give antibiotics one last shot (SMZ-TMP) although our vets are not thrilled with the idea.
Has HRT seen these last pictures to be able to see/understand just what it is your dealing with?
I'm thinking that growth might change her thoughts on that... :dono

[HRT4SQRLS]

Toni, it's a bit difficult to see the extent of the problem but it appears that there is a lump near the nail. Am I seeing that correct? It's really hard to say if this is a growth or cellulitis in the tissue. I'll defer to your vets on that because, even though they don't treat a lot of squirrels, I'm sure they have seen similar issues on other animals. They can clearly see the problem whereas what we see is a dark pic.

If you want the SMZ-TMP dosing I need the concentration of the tablet or the liquid suspension. I went back through the threads and couldn't find it. I might have missed it. We dose SMZ-TMP at 25mg/kg. I can give the exact amount to dose if you can get that info.

Toni, it does sound like your vets are doing valuable research before they jump into surgery. I'm glad they are seeking out vets with squirrel surgery experience. That makes me feel better.

By the way, Aria is gorgeous. :grin2 Those ear tufts are the cutest thing EVER! I wish we had squirrels like that.

[Toni80]

Thank you. :)
But I`m jealous of your american red squirrels and the greys...they seem waaay more interested in cuddling than mine. :grin

Yes it is a lump. When she was off dex for 3 days it started growing again and bleeding. Underneath the blood I could see a white lump (not like a abscess with a pus on top).
You can`t see any better on the videos? Do you see them at all (I`m asking because on my phone I can`t see the embedded video or a link, only on computer)?

I have Sinersul tablets (400mg sulfamethoxazole + 80mg trimethoprim).

But I fear there`s no time for antibiotics...she started developing side-effects from dexamethason (she has problem peeing and muscle weakness).
I`m afraid she`ll develop MBD form it so I`m taking her to get a calcium injection and we`ll slowly take her off from dex.
When we do in a couple of days time, the inflammation will increase significantly and she will stop eating...it`s a vicious circle.
So amputation seems to be the only option at this moment.

[Toni80]

Has HRT seen these last pictures to be able to see/understand just what it is your dealing with?
I'm thinking that growth might change her thoughts on that... :dono

You`re suspecting a tumor too? :(

[HRT4SQRLS]

Toni, I don't think that's a malignancy. It might be granulation tissue ("proud flesh"). Don't know.
https://en.m.wikipedia.org/wiki/Granulation_tissue

Do you have a medical background? You sound like you do. (Knowing about the association of steroids with calcium/osteoporosis/MBD)

By the way, the thought that American red squirrels and grey squirrels are "cuddly" is an illusion. :tilt MOST are not cuddly at all! The ones you see posted about on TSB are the rare ones that are. We don't post much about the mean ones. :grin2

Edit... I didn't see a video.

[stepnstone]

You`re suspecting a tumor too? :(
I'm just as baffled as you are and probably more so with not actually being able to examine the thing.
Is it hard, is it soft, does it feel like it's fluid filled? Does it have any movement to it or does it appear fixed to the spot?
I have seen "lumps" similar that are fluid filled and can be drained, lumps where the fluid/infection has turned to paste inside
that can't be drained without lancing it open and cleaning it out. I'd have my hands all over that thing and ultimately be doing
the same you have done to seek out a veterinarian.

[HRT4SQRLS]

I sent dosing info for the SMZ/TMP.

[Toni80]

I do hope so. :)
I`m a pharmacist tehnician, a very eager one, every PharmD`s nightmare, I`ve been called :laugh2:laugh2

Hahaha, then I`m jealous of the cuddly ones :grin2

[HRT4SQRLS]

I do hope so. :)

I`m a pharmacist tehnician, a very eager one, every PharmD` nightmare I`ve been called :laugh2:laugh2

Hahaha, then I`m jealous of the cuddly ones :grin2

:laugh2. If it wasn't for that cute tufted ear squirrel you have there, I would swear that you are American. :grin2



Croatia.... :thinking :rotfl

[Toni80]

I'm just as baffled as you are and probably more so with not actually being able to examine the thing.
Is it hard, is it soft, does it feel like it's fluid filled? Does it have any movement to it or does it appear fixed to the spot?
I have seen "lumps" similar that are fluid filled and can be drained, lumps where the fluid/infection has turned to paste inside
that can't be drained without lancing it open and cleaning it out. I'd have my hands all over that thing and ultimately be doing
the same you have done to seek out a veterinarian.

It`s hard, doesn`t feel fluid filled and it`s fixed. Skin around is very dry and coarse.

But I think I`m done with this.

She just got 10 ml of saline and 100mg/kg calcium gluconate/calcium glycerophosphate SC and vomited within 20 minutes or so. I have never seen her vomit before! It was white, sticky foam and a fair amount of it! :eek

AND calcium SC/IM STINGS like a bitch!:madd
Luckily she drank 3 times when we got home (after all that fluids?).

As soon as she feels better, she`s going to surgery. Right now, medicines seem to be doing more damage than they`re helping.

[Toni80]

https://vimeo.com/217654162
https://vimeo.com/217654088

And this is form 21st of April:
https://vimeo.com/217654205

Can you see the links to videos now?

[Toni80]

:laugh2. If it wasn't for that cute tufted ear squirrel you have there, I would swear that you are American. :grin2



Croatia.... :thinking :rotfl

Well, thank you, my english must be good. :grin2

Anyways, we`re just across Italy (over the Adriatic sea), we`re a great "newly discovered" vacation spot, come visit! :grin2

[Toni80]

OMG she vomited again!

Vets say to withhold water for 2 hours at least and then give only small amounts often.
Does anybody have experience with this??

[stepnstone]

It`s hard, doesn`t feel fluid filled and it`s fixed. Skin around is very dry and coarse.

But I think I`m done with this.
She just got 10 ml of saline and 100mg/kg calcium gluconate/calcium glycerophosphate SC and vomited within 20 minutes or so. I have never seen her vomit before! It was white, sticky foam and a fair amount of it! :eek
AND calcium SC/IM STINGS like a bitch!:madd
Luckily she drank 3 times when we got home (after all that fluids?).
As soon as she feels better, she`s going to surgery. Right now, medicines seem to be doing more damage than they`re helping.
If it tastes like it stings it could be a good reason why it's coming back up.
I hope what your seeing is regurgitation and not really vomiting which could
be serious for a squirrel as they are not designed to vomit.
Poor baby, poor you. :grouphug I will send prayer to you both for strength and hope
whatever procedure is performed is a complete success. Once healed, missing
a digit won't slow her down at all. ~ Good luck

[HRT4SQRLS]

Toni, I can see the videos now. They're good. I can see what you're talking about now.

I hope Aria is better and has stopped vomiting. Poor girl.

[Toni80]

If it tastes like it stings it could be a good reason why it's coming back up.
I hope what your seeing is regurgitation and not really vomiting which could
be serious for a squirrel as they are not designed to vomit.
Poor baby, poor you. :grouphug I will send prayer to you both for strength and hope
whatever procedure is performed is a complete success. Once healed, missing
a digit won't slow her down at all. ~ Good luck

Thank you for your kind words.

If I saw correctly (I was in complete schock), it was regurgitation.
It hasn`t happend again in the last 28 hours, I think we`re in the safe zone regurgitation wise.

She`s still weak in her back legs, and eats like a little bird, two nibbles of her favourite food at a time and that`s it. I even took out the big guns: chestnuts, pistachio, watermelon, her favourit egg-cookie and the reaction is more of a non-reaction. :sniff:sniff
I think it`s her esophagus again, sore from the stomach-acid? Refuses all fruit and veggies except zucchini and cucumber (eats only the middle part with seeds).
She`s touching her face and head with her little paws, but it`s not grooming...:(

I have hope that she will fully recover soon, my precious little girl :Love_Icon