ABCESSES IN SQUIRRELS
ABCESSES IN SQUIRRELS
This thread begins with an excellent post originally contributed by HRT4SQRLS, and is intended to gather as much current information on the diagnosis and treatment of abcesses in squirrels.
I had wanted to start a thread about treating abscesses but had neglected to do it. I thought a dialog about this subject would be useful to find out what antibiotics rehabbers have used in the past and the outcome. Since I have been a member here I have read many threads and have seen many bad outcomes but I wanted to hear about the successes. The person from the UK that IR mentioned that had successfully used Clindamycin further prompted my interest.
I started studying the subject.
For those that are interested, I'll throw out some ideas. Sorry, it might be lengthy and boring to some so you might want to skip this post. It has always been disappointing to me to see squirrels succumb to infections that have gone global. One that particularly broke my heart was Linda's Hammie. Any time a vet will try to help a wildlife baby, I am appreciative because MOST won't even try. When they do try, I would never be one that would criticize their treatment. With that said, I think we all realize that the most of the case studies for treatment of squirrels is HERE on The Squirrel Board. Because of this, TSB needs to 'data mine' the information here to come up with things that WORK and things that DO NOT WORK.
Quinolone drugs (including Baytril) are excellent drugs and they certainly have their place in the treatment of infections. From information here on TSB it is obvious that Baytril or Ciprofloxacin is extremely effective in treating pneumoniae and UTI's ... Not so much with abscesses. When treating an abscess without a culture, you must cover all the possibilities with broad spectrum antibiotics or stack drugs to get full coverage of most organism groups. Infections, like little Dales that have involvement of the head, neck or mouth must have coverage to include all of the 'usual flora' organisms of the upper respiratory tract. All mucous membranes are colonized with normal or 'good' bacteria. This would include the upper respiratory tract, the GI tract and the genital tracts. As long as these organisms stay where they are supposed to, everything is great. When they don't, due to trauma, immunosuppressive or whatever, then big problems develop like the head abscesses we have seen on TSB. As we have seen, they get BAD very fast and are very aggressive and often fatal. It seems most Squirrel vets love Baytril. The problem with Baytril is that mucous membranes are polymicrobial and include anaerobes. Baytril has no activity against anaerobes. Anaeobes are the bacteria that grow without oxygen. That is why they are often found in deep seated infections and deep wounds ... NO oxygen. They are very nasty infections and stink like anything ... even the organism growing in the lab stinks BAD. Anytime a wound smells really foul, I would assume that anaerobes are involved and treat accordingly.
OK, what are the best drugs for treating anaerobes? Clindamycin, metronidazole and to lesser degree Chloramphical. Chloramphenicol is a very broad spectrum antibiotic that includes coverage for anaerobes. I believe it is used in veterinary medicine but it is seldom used in the U.S. for people because of issues with bone marrow suppression and toxicity (aplastic anemia). It is frequently used in developing countries because it is readily available and it is cheap. It is very good for treating the masses because it is very effective but because of the number of attorneys here it is seldom used here. I spoke with an Infectious Disease Docter about it. She said it is commonly used in her country (South America) and is now being looked at again in this country because of the extreme resistance problem we have with bacteria. I believe I have read about rehabbers that have used Chloro. I would love to hear the results. Due to its broad spectrum, it is probably quite effective.
Metronidazole ... The reason I like Metro is because it has a long tract record of being safe for squirrels. It is one of the drugs of choice for anaerobes. This is only my opinion, but I believe that any head, neck or mouth infection should include Metro because it will kill anaerobes that are probably involved as ONE of the players in a polymicrobial infection.
Clindamycin ... I am aware that the WMB book says that it should not be used in squirrels. The poster from the UK indicated that it worked great, as it should because it also targets anaerobes and a host of other Gram Positive organisms that are common in the upper respiratory tract. I wondered why the WMB said NO. From all that I could find it seems the GI issues are the reason. Again, according to an ID doc, it seems Clindamycin got a 'bad rap' because of its association with C.difficile infections. Of course, it does have the potential to cause this problem but it has been determined to be NO more likely to cause C.diff infections than other antibiotics. I was told that Clindamycin is used for treating head/neck infections while Metronidazole is used for treating anaerobes associated with abdominal infections. The anaerobic flora of the mouth (many anaerobic Streptococcus) respond better to Clindamycin, while the anaerobes of the GI tract (mostly anaerobic Gram negative flora) respond better to Metronidazole. I found that all the toxicity studies for Clindamycin were done with rats given high doses for long periods of time. I guess that's the best we can come up with as far as safety because there aren't many studies that use squirrels ... THANKFULLY.
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