Pet Grey Squirrel - Lesion under arm - Safe antibiotic?

[DavidDane]

I noticed again tonight he has this white milky stuff along the bottom of both eyes right on the eye lid. After he blinks a bit it goes away. Do you guys know what this could be??

[DavidDane]

Hey guys. Here are some updated pictures again. The bottom one is from this morning, the next is from this afternoon, and the top two are from tonight.

I'm really not sure what else to do. I'm giving him Benadryl, Betadine, and then Gold Bond at night. Every time it starts to heal, he chews it. They seem to slowly be getting larger. I started him back on the SMZ yesterday, and the local vet thinks I should start him on that Dermalone ointment too, although I'm not sure if it's safe because of the neomycin. Do you guys happen to know an actual squirrel vet that you could just ask if it's safe for me?? Or possibly even show them the pictures and get their opinion?

I'd also like to get you guys' opinion on continuing to give him Benedryl and Betadine, that being...

1. Could giving him Benedryl inadvertently cause him to actually chew it more when it wears off, because he has relief and isn't as used to the irritation as before? I don't know how safe it is to try to keep him on it around the clock for weeks until it heals all the way

2. Could the Betadine be causing it to get more irritated or causing him to want to chew it more?

I can say that during the first round of antibiotics where it was healing good, I didn't give him any Benedryl, and Betadine very very rarely.

Let me know what you guys think. Any and all information is very much appreciated. This is really stressing me out and I just don't know what to do

[Mel1959]

The white tears in his eyes that you mentioned are a sign of pain.

It seems like this wound is not getting any better. Can you share what your care routine is for it? The fact that it’s not improving makes me think that something needs to be tweaked.

[island rehabber]

Betsy, redwuff, stepnstone -- deeeeeep breath: Do you think, as I do, that this looks like pox?
It's behaving like it.

[HRT4SQRLS]

Betsy, redwuff, stepnstone -- deeeeeep breath: Do you think, as I do, that this looks like pox?
It's behaving like it.

This is an inside squirrel I believe.

[HRT4SQRLS]

This reply is in response to a PM.

David, I agree, this isn’t getting better so let’s look at want hasn’t specifically been treated for.
I see he is on SMZ/TMP again as it did get somewhat better the first time. You can continue that for a week but if it doesn’t get better you need to move past that. It is looking somewhat worse now but in my mind it has never looked particularly infected.

One thing that has not specifically been treated for is the possibility of a fungus. That could include a dermatophyte like ringworm (one of many) or a yeast. Yeast are usual flora in the mouth in low numbers so licking a wound can cause a wound to become contaminated or infected with yeast.

This is my opinion of the Dermalone ointment. It is specifically an animal product. ALL animals lick their wounds. It is a given. When making a product for the skin of an animal, manufacturers know that they will ingest a topical product so that is taken into consideration when considering toxicity. I am aware of the toxicity of Neomycin but let’s look at that closer. One of the measures of toxicity is measured as the LD50. It is the Lethal Dose required to kill 50% of the population when tested. The oral LD50 of Neomycin in a mouse is >8 grams/kg. When injected subcutaneously, the LD50 is 200mg/kg in a rat and 190mg/kg in a mouse. The oral amount to be toxic is HUGE (>8 grams/kg.…NOT mg but grams). There are 1000mg in 1 gram. Keep in mind that 50% of the population would even survive that amount (>8000mg)
The amount of Neomycin in the Dermalone ointment is 2.5mg/mL. It is unlikely you would use a mililiter (mL) in the entire topical treatment so the amount of Neomycin delivered is extremely small. Another thing to consider is that Neomycin is poorly absorbed from the GI tract. Even with its toxicity, Neomycin can be given orally to treat gastrointestinal infections because it’s activity is mostly confined to the GI tract and not much is absorbed into the blood. I personally believe the Dermalone is safe and I would use it. It has an antifungal in it (Nystatin) and that might be the piece of the puzzle you are missing. It covers the big 3 of skin issues… inflammation (allergy), bacterial infection AND fungal infection.

If you are still fearful of the Dermalone, you could try a topical antifungal that is available OTC like miconazole or the many other antifungals for athletes feet or vaginal yeast infections. The best product I ever used was a Nystatin powder but it is a prescription. It’s dry and literally heals overnight.

You can try it. If it doesn’t work or he has a irritation from it you can discontinue and move on. It’s just easier to treat by covering all the bases than to treat things individually when you don’t even have a diagnosis. Just my opinion.

[DavidDane]

This reply is in response to a PM.

David, I agree, this isn’t getting better so let’s look at want hasn’t specifically been treated for.
I see he is on SMZ/TMP again as it did get somewhat better the first time. You can continue that for a week but if it doesn’t get better you need to move past that. It is looking somewhat worse now but in my mind it has never looked particularly infected.

One thing that has not specifically been treated for is the possibility of a fungus. That could include a dermatophyte like ringworm (one of many) or a yeast. Yeast are usual flora in the mouth in low numbers so licking a wound can cause a wound to become contaminated or infected with yeast.

This is my opinion of the Dermalone ointment. It is specifically an animal product. ALL animals lick their wounds. It is a given. When making a product for the skin of an animal, manufacturers know that they will ingest a topical product so that is taken into consideration when considering toxicity. I am aware of the toxicity of Neomycin but let’s look at that closer. One of the measures of toxicity is measured as the LD50. It is the Lethal Dose required to kill 50% of the population when tested. The oral LD50 of Neomycin in a mouse is >8 grams/kg. When injected subcutaneously, the LD50 is 200mg/kg in a rat and 190mg/kg in a mouse. The oral amount to be toxic is HUGE (>8 grams/kg.…NOT mg but grams). There are 1000mg in 1 gram. Keep in mind that 50% of the population would even survive that amount (>8000mg)
The amount of Neomycin in the Dermalone ointment is 2.5mg/mL. It is unlikely you would use a mililiter (mL) in the entire topical treatment so the amount of Neomycin delivered is extremely small. Another thing to consider is that Neomycin is poorly absorbed from the GI tract. Even with its toxicity, Neomycin can be given orally to treat gastrointestinal infections because it’s activity is mostly confined to the GI tract and not much is absorbed into the blood. I personally believe the Dermalone is safe and I would use it. It has an antifungal in it (Nystatin) and that might be the piece of the puzzle you are missing. It covers the big 3 of skin issues… inflammation (allergy), bacterial infection AND fungal infection.

If you are still fearful of the Dermalone, you could try a topical antifungal that is available OTC like miconazole or the many other antifungals for athletes feet or vaginal yeast infections. The best product I ever used was a Nystatin powder but it is a prescription. It’s dry and literally heals overnight.

You can try it. If it doesn’t work or he has a irritation from it you can discontinue and move on. It’s just easier to treat by covering all the bases than to treat things individually when you don’t even have a diagnosis. Just my opinion.

I appreciate the replies everyone. Okay I will try the Dermalone. I just thought it was strange that it was almost completely healed on the SMZ first round, and then flared back up after stopping it.

What I'm concerned about, is if it's a bacteria and it developed a resistance from me stopping early, could that make it less effective this time? The vet didn't seem to think so... But if so, what other antibiotic would I use in it's place??

Other than than, should I continue to use the Betadine or have you guys ever notice it cause more irritation? I've been on and off with it since I wasn't sure

[DavidDane]

The white tears in his eyes that you mentioned are a sign of pain.

It seems like this wound is not getting any better. Can you share what your care routine is for it? The fact that it’s not improving makes me think that something needs to be tweaked.

In the beginning I just gave him 0.2cc of SMP-TMP twice a day, and Betadine once a day, and it was almost completely healed by the tenth day. After stopping, it started to flare up again and he started chewing it. Attached picture is from the day I stopped the antibiotics.

Then last Thursday I started giving him Benadryl twice a day, then 3 times a day along with Betadine twice daily. It looked better for a day but then it starting getting worse again. Sunday I started him back on the SMP and have continued to give him Benadryl, but I've been on and off with the Betadine. Today I just started giving him some Dermalone ointment on one of the areas as well to see what it does.

[Mel1959]

HRT4SQRLS gave a wonderful breakdown of the toxicity level in the ointment. She’s one of the smartest people I know and has the credentials to back up her knowledge.

I’m not sure what others may say, but my gut says to use the Dermalone by itself. I think the rule “less is more” would apply here. I don’t think it would be wise to have anything else on the skin prior to applying the Dermalone. That way it will come in complete contact with the skin.

Fungus infections on the skin are rather difficult to clear up and many times turn into staph infections. My dog is prone to this repetitive cycle. He has been treated with some unordinary antibiotics and it clears up every time. I think you should try the Dermalone by itself first and see what happens. An antibiotic can be added, if needed.

Follow the label on the Dermalone for applying. It might recommend that before each new application the area is cleansed. If that’s the case, I’d use plain water or a very mild soap and water, being sure to dry it well. Dampness is a fungus’s favorite friend, so keeping the area dry will be helpful.

[HRT4SQRLS]

The Betadine is good because it’s an antiseptic so it would have a bit of activity against a lot of infection causes but it’s not quite getting it here. So as not to confuse the issue with SO many different things, I would stop the Betadine and use just the Dermalone on the wound for a few days and see if there is any change…good or bad. Again, just my opinion.

[DavidDane]

Thanks alot you guys. I will do that. What would a staph infection look like, and could this be one? If so, and the SMP was resistant, what other antibiotic would treat that?

[Mel1959]

I think it’s best to consistently try one thing at a time. As HRT recommended, try the Dermalone for a few days and see what happens.

[DavidDane]

I think it’s best to consistently try one thing at a time. As HRT recommended, try the Dermalone for a few days and see what happens.

Well I already have him taking the SMP again, and this is the third day already. I did add the Dermalone but I don't really want to stop the SMP midway. I am wondering though if you guys think this looks like staph, and what the best antibiotic is for that. Just for my own personal knowledge

[CritterMom]

The Betadine is good because it’s an antiseptic so it would have a bit of activity against a lot of infection causes but it’s not quite getting it here. So as not to confuse the issue with SO many different things, I would stop the Betadine and use just the Dermalone on the wound for a few days and see if there is any change…good or bad. Again, just my opinion.

David, please listen to HRT4SQRLS. She knows more about medications and antibiotics than anyone on here by about a factor of 50 and has taught most of us most of what we know. Really.

[DavidDane]

David, please listen to HRT4SQRLS. She knows more about medications and antibiotics than anyone on here by about a factor of 50 and has taught most of us most of what we know. Really.

Oh I am She never said to stop the SMP mid-way. In another post she said to continue it for another week. She was just telling me to hold off on other stuff like Betadine, and just use the Dermalone. I was just curious if it looked like Staph to you guys, and what is normally used to treat Staph, and if SMP itself is good against it

[DavidDane]

This is an inside squirrel I believe.

He is, but I do have a squirrel that I raised and released. She comes almost daily onto the screened in porch where I let Rocket play. But I haven't seen any lumps on her. Once in a while a wild one will come into the porch as well

[DavidDane]

Step, I think the SMZ-TMP is an excellent choice for this particular issue. I can’t say definitely if this is an infection but if it goes down hill it certainly will be an infection. If it started as a sting or ant bite it might have been inflammation. It is looking a little oozy so I wouldn’t hesitate to start the antibiotic.

In this location on the arm, the SMZ-TMP is very good. It has the added benefit of being effective against MRSA. If the wound was on the head, neck or face… Clamamoz would definitely be better. On the head, neck or face you want to target oral organisms because of proximity to the mucous membranes of the mouth. The mouth is loaded with bacteria including both aerobic and anaerobic. These bacteria are often involved in infections of the head, neck, face. SMZ-TMP doesn’t have coverage for anaerobes. Clavamox does. Clavamox is a beta lactam antibiotic or a “penicillin” type antibiotic. You always want to use a beta lactam antibiotic when treating any infection near the mouth because the mouth is loaded with Streptococcus and anaerobes. If you were having a dental procedure and you have a heart issue, you would always be prescribed a beta lactam antibiotic like penicillin or amoxicillin. The reason is because it best targets the flora of mouth.

Sorry, this was probably TMI but it explains why one antibiotic would be chosen over another.
SMZ-TMP is a good antibiotic for this but if he continues to lick the wound … ‘mouth organisms’ … it could get more complicated.

I wanted to ask you about this HRT. Is this saying SMP is good against staph, or that Clavamox is better? Also, now that we know he weighs 1lb, what is the actual correct dose for the SMP at his size?

[HRT4SQRLS]

David, I do NOT think this is Staph but if it was, the SMZ/TMP would be an excellent drug to use.
It has the added benefit of having activity against MRSA which is a resistant Staph. Since you already started another round of the SMZ/TMP it won’t hurt to continue it for a week (total). I personally don’t think it will help but no harm in using it. If it was a Staph infection the first round of treatment should have resolved it completely.

It doesn’t look like Staph but I can’t definitively say that without a culture. Staph would spread far beyond the 3 spots and would be red and angry looking. It tends to produce red bumps like little blisters or pustules. We have pretty much done all an online forum can do. There is a squirrel friendly vet in Pinellas county. If it doesn’t resolve I would recommend you take him to the vet for diagnostic testing like cultures, etc. I know you have concerns about resistance. Those concerns would be laid to rest with a culture. Things like this are usually treated empirically (based on most likely cause and agent to work) initially but if that doesn’t work, testing would be necessary.

[DavidDane]

David, I do NOT think this is Staph but if it was, the SMZ/TMP would be an excellent drug to use.
It has the added benefit of having activity against MRSA which is a resistant Staph. Since you already started another round of the SMZ/TMP it won’t hurt to continue it for a week (total). I personally don’t think it will help but no harm in using it. If it was a Staph infection the first round of treatment should have resolved it completely.

It doesn’t look like Staph but I can’t definitively say that without a culture. Staph would spread far beyond the 3 spots and would be red and angry looking. It tends to produce red bumps like little blisters or pustules. We have pretty much done all an online forum can do. There is a squirrel friendly vet in Pinellas county. If it doesn’t resolve I would recommend you take him to the vet for diagnostic testing like cultures, etc. I know you have concerns about resistance. Those concerns would be laid to rest with a culture. Things like this are usually treated empirically (based on most likely cause and agent to work) initially but if that doesn’t work, testing would be necessary.

Thanks alot, that is very helpful information. Just to let you know, during the first round I was only giving him 0.15cc half the time and then 0.2cc the other half, and I remember you saying even that was a little on the low side. Maybe that's why it worked mostly and didn't clear all the way? I would like to get him a culture. When I went to see my local vet yesterday, I only took pictures, not Rocket himself. He mentioned possibly getting a culture but that it would take a week to get back. I may go ahead and try to get him to do it. Is the squirrel friendly vet in Pinellas Dr Zellner? If so, they told me she isn't taking any new patients when I called them. They did however say one of the other vets there would see him, although I don't know how good he is. The only opening they had was Tuesday of next week.

Do you happen to know the actual correct SMZ dose for 1lb .02 ounces?

Edit: I just spoke with the local vets office about getting a culture or biopsy done, and she said it wouldn't be accurate if he's already on antibiotics. Is this true?

[HRT4SQRLS]

Edit: I just spoke with the local vets office about getting a culture or biopsy done, and she said it wouldn't be accurate if he's already on antibiotics. Is this true?

Yes, that is absolutely true. He would need to be off antibiotics a week to get the best results. No need to spend the money if it won’t be accurate.

Yes to Dr Zellner but I don’t know the ‘other’ new vets so wouldn’t be able to recommend them.
This isn’t a ‘squirrel specific’ problem so any vet willing to treat a squirrel should be able to figure this out with testing. I hope you’ll at least TRY the Dermalone and give it a fair chance.

I would need the concentration of your med to calculate it.