Antibiotics for persistent abscess.

[HWilson]

I have an adult female fox squirrel who has been a daily visitor to my yard for about 5 years who showed up almost two months ago with a badly lacerated eye and two terrible abscesses, one on top of her head and one on the side of her jaw.

She was treated by a local wildlife vet who put a drain in and prescribed Baytril. The Baytril did next to nothing, but the vet wasn't interested in prescribing anything else, and I was told that sending a culture to a lab to help choose a better antibiotic wasn't an option. I added clindamycin to the Baytril, which helped more, but it's still not entirely sorted out - her eye has healed beautifully (she's clearly blind in it, but the vet expected it would need to be removed someday, and now he doesn't think that'll be necessary) and the upper abscess is gone, but the one by her jaw doesn't seem to want to heal, despite the antibiotics and daily cleaning and flushing (I flush with a hypochlorous acid wound wash and follow with Derma Gel.)

She's had three x-rays and her teeth look great, so the vet doesn't think that's the root of the issue. Aside from the small but persistent abscess, she's doing great, so I'm unwilling to give up on her, and I'm looking for some input on what antibiotic(s) might be worth a try.

Antibiotics I have on hand:
Amoxicillin clavulanate 875/125mg
Clindamycin 150mg
Metronidazole 250mg
Sulfamethoxazole trimethoprim 800/160mg

I don't have on hand but can easily get more Baytrl, or cefalexin, if needed.

I'd really appreciate any input on what antibiotic to try next, and dosing if possible. As of today she's 1lb 2oz.

Thanks in advance for any input anyone has!

[Spanky]

I believe I would try Bactrim... dosing sent in a PM. Uploading a pic would help us more to help you help her...

[HWilson]

Here are pictures, not sure if this is necessary but in case it's helpful I'll include some pictures of the abscesses at their worst and her healing along the way.

This was taken the day I trapped her:



The worst of the abscesses, taken shortly before they were drained:




The drain the vet put in:



Her progress around the three week mark, after initially looking much worse when a lot of skin sloughed off of the upper abscess area (I didn't get pictures because I thought I was going to lose her and didn't want to see that ever again...):



And here's how she's looking as of half an hour ago, after a warm compress + applying Derma Gel:

[Diggie's Friend]

To lend support to her immune system; recommend, soil based prebiotic and soil based probiotic source, "Pet Flora" by Vitality Science. In the wild it is from squirrels consuming soil-based organisms that not only lends essential digestive support for optimum bioavailability of nutrients in the foods that they consume; but also what keeps their immune system vital as over 70 percent of the whole body's immune system is made up of good bacteria forms located in the gut.

To read up on this form of, 'symbiotic', see: https://vitalityscience.com/product/cat-probiotics/

To order this source online: https://www.amazon.com/Vitality-Scie.../dp/B005PJN2HO

Reoccurrence of abscesses may be due to a foreign body lodged beneath the skin. In this case the removal of the foreign object may be needful to do surgically.

A Homeopathic remedy, known as, "gunpowder" can lend significant support to overcoming abscesses in tree squirrels. These can be most quickly be acquired on Amazon.com

https://www.remedia-homeopathy.com/h...-with-animals/

A squirrel’s stubborn abscess

A veterinary clinic called a local wildlife rehabilitator about a juvenile Golden-Mantled Ground Squirrel (Spermophilus lateralis) that had been attacked by a client’s cat. The veterinarian had found three deep punctures in the squirrel’s shoulder and left front leg. He had cleaned the wounds and started the squirrel on a week-long course of antibiotics before the rehabilitator picked up the squirrel at the clinic.

https://hpathy.com/veterinary-homeop...gainst-wounds/

[Diggie's Friend]

Here is the rest of the case as noted for the ground squirrel.

Golden Mantled Ground Squirrel being fed squirrel milk replacement formula with special feeding syringe. © 2006 Shirley Casey

Within two days, however, the squirrel’s shoulder and left leg were slightly swollen and inflamed. Another examination by the veterinarian resulted in adding a second and stronger antibiotic that would be given for ten days. The squirrel’s leg continued to swell and the inflammation increased. Within four more days, the leg became so hard and swollen that the squirrel could not bend his elbow or toes, and the leg seemed very painful when touched. Warm compresses helped to reduce the swelling and pain while they were applied, but by the end of the eighth day, the squirrel was clearly in a very serious condition, even with the antibiotics.

Consultation with the veterinarian resulted in the rehabilitator contacting a homeopathic veterinarian who prescribed Hepar sulphuris 30c because it is frequently effective with abscesses. Unfortunately, there was no change in the abscess by the next day. In light of the small squirrel’s rapidly deteriorating condition, they gave Lachesis 200c since it is often effective with abscesses and infections that are becoming septic. Again, there was no improvement in 12 hours–and there should have been if the remedy was the correct match for the condition.

They decided to switch to homeopathic Gunpowder and gave the squirrel one dose in the 200c potency. Within eight hours, the swelling had softened and a cream-colored discharge started draining through small holes that had appeared in the leg. The swelling soon decreased 40% and the squirrel was able to bend his elbow and toes.

The rate of improvement slowed at about 48 hours. Another dose of Gunpowder 200c was administered and the squirrel’s improvement continued steadily. Within four days of the original dose of Gunpowder, all signs of infection were gone and the squirrel was not showing any difficulty with the leg or shoulder. After another month in rehabilitation during which he appeared healthy and active, the squirrel was released back to the wild.

Depending upon the drainage, 30 C homeopathic, remedy, "gunpowder". may be more appropriate for use in support of keeping the abscess from building up again.

https://www.amazon.com/Gunpowder-30C.../dp/B0006PKN1U

[HWilson]

Thank you, I appreciate all of this information. If a round of Bactrim doesn't clear this up, the vet is going to do exploratory surgery to see if there's a foreign body and surgically drain anything necessary.

[TubeDriver]

SMZ-TMP is a solid choice for an infection in this location. It can be used for extended periods if needed. If she appears to be responding but not completely cleared up, you can dose for 2 weeks or longer if needed.

Thank you, I appreciate all of this information. If a round of Bactrim doesn't clear this up, the vet is going to do exploratory surgery to see if there's a foreign body and surgically drain anything necessary.

[HWilson]

I'm later to update this than I'd hoped to be, but am very happy to say that the new antibiotic helped. I kept up the flushing and warm compresses, and after three days a deeper abscess that must have been keeping the problem going burst. Within another week, there was no more pus at all, and as of today that area has healed up beautifully.

Unfortunately some other issues have come up, some confusing issues with her back legs (and what may be an abscess forming on one of them.) Not sure if I should make a new thread about it or if posting on this one would make more sense.

[CritterMom]

Go ahead and stay on this thread. Poor baby.

[Sadachara]

Hypochlorous is amazing, and powerful.

I make it here with a generator in the home and we use it everywhere.

However, for a critter, I would recommend a hypochlorous GEL to ensure the contact is a long time. Hypochlorous while exceedingly potent and safe, is best on a wound like this with longer surface contact so some can soak in. Many companies make a gel form. Give it a shot!

[JLM27]

Is this a possible staph infection? Sounds like she has a new abscess. Just a thought.

[Sadachara]

Staph is a consideration here, they seem to be common and come out of nowhere.

I had staph built up around my eye a few months back according to my eye doctor. He said it's super common, and to just spray hypochlorous on it a few times a day for a few days. My cat got staph a couple of years in a row, and the vet prescribed Poly Dex, which kills it FAST. I used this on my squirrel combined with hypochlorous and it killed it immediately. (Opthomatic)

What is crazy is, so much in the USA is locked behind paywalls (Vets, Doctors, etc) but most of this stuff is OTC, or at least easily obtainable in other countries. No vet around here would fill Revolution for me, but it was a click away ordering it online. The same goes for Baytril.

[JLM27]

What is crazy is, so much in the USA is locked behind paywalls (Vets, Doctors, etc) but most of this stuff is OTC, or at least easily obtainable in other countries. No vet around here would fill Revolution for me, but it was a click away ordering it online. The same goes for Baytril.

Where online are you going?

[Sadachara]

Where online are you going?

It depends on what it is. Almost everything in the USA is locked behind paywalls, which I find disgusting, and greedy.

For Baytril I go here;
https://birdpalproducts.com/products...42318808416482

Revolution I use this;
https://www.canadavetexpress.com/

Ivermectin is pretty easy to find anywhere now, but apparently not the choice thing to use.,

Poly-Dex Opthamatic I have not found a good non-prescription source. However I did find a virtual vet who just sent me a tube of it for only the cost of the medication and no RX/Office visit. But ideally I would like to find a source for Poly Dex Ointment online. It's a really good medication for all pets/rescues to have on-hand because it is extremely active against Staph and such.

Pet allergies/itching, Clemastine Fumarate is by far the best. It's pay-walled in the US, but easy to find overseas, even on eBay.

[SamtheSquirrel2018]

It depends on what it is. Almost everything in the USA is locked behind paywalls, which I find disgusting, and greedy.

For Baytril I go here;
https://birdpalproducts.com/products...42318808416482

Revolution I use this;
https://www.canadavetexpress.com/

Ivermectin is pretty easy to find anywhere now, but apparently not the choice thing to use.,

Poly-Dex Opthamatic I have not found a good non-prescription source. However I did find a virtual vet who just sent me a tube of it for only the cost of the medication and no RX/Office visit. But ideally I would like to find a source for Poly Dex Ointment online. It's a really good medication for all pets/rescues to have on-hand because it is extremely active against Staph and such.

Pet allergies/itching, Clemastine Fumarate is by far the best. It's pay-walled in the US, but easy to find overseas, even on eBay.

Hello Sadachara:

I just want to make a couple of comments about medications for Squirrels.

We currently have a fairly wide experiential database on most medication that can be considered safe for Squirrels. Often, the "research" has been accomplished in Rats before this was utilized in Squirrels. There are many medications that are used in Veterinary and Human medical practices that may actually be safe and effective in Squirrels but we just don't have any definitive evidence to support this. Clemasine is one of these. It is an H1 type antihistamine as is Benadryl but it is not (as far as I am aware) been utilized regularly for Rats ( a close relative of Squirrels) or in Squirrels themselves. Since Benadryl use in Squirrels has a considerable experiential database suggesting both safety and efficacy for treatment of allergic symptoms; it would IMHO be best to utilize Benadryl if an antihistamine is needed in Squirrels. Any of the Admins here on The Squirrel Board (TSB) can help with mixing and dosing instructions.

I have not heard of Poly-Dex but I am familiar with Neo Poly Dex ophthalmic (eye) products. There are two concerns about this particular medication and others similar to it that contain either Neosporin or a Steroid (Neo Ply Dex contains both)! First of all is the use of steroids in the eye; the justification for prescribing Steroids for ophthalmic (use in the eye) use is that they are anti-inflammatory medications and if there is inflammation from any cause, this may help with the inflammation. There are potential great risks with using steroids in the eye and the genral "rule" in both Veterinary and human Medicine is that steroids should NEVER be use in the eye unless an eye specialist (ophthalmologist) prescribes this! This is because it it can can suppress inflammation, it this attenuation of the inflammatory response often masks the continuation of an infection or other primary eye disease and while everything may appear like all is going well, it may actually continue or be getting worse. Again, my stance on ophthalmic steroids is that would be I would not recommend using any eye medication that contains a steroid unless it was prescribed by a Veterinarian who is fully knowledgeable about animal eye diseases and has thoroughly examined the animal!

Next is the use of Neomycin! This is a commonly use antibiotic and is a major component of the skin ointment called Neosporin. The ads for this medication make it appear that Neomycin is a miracle drug and safe as well! Unfortunately, Neomycin, compared with almost all of the other topical eye and skin antibiotics, is probably the one most likely to cause an allergic reaction. Sometimes, this can be so severe as to make it difficult to tell the difference between and an allergic reaction and a new or worsening infection!

Well, there you have it; my comments and suggestion, for whatever they may be worth!

Thanks for coming to The Squirrel Board! I know that you were being helpful, caring and involved and nothing that I said was meant to discourage this! I also posted some comments on your other thread about moving your Squirrel to a larger cage.

Regards,
SamtheSquirrel

[SamtheSquirrel2018]

I did a search for Ploy-Dex and did find it. It is the same as the Neo Poly Dex and contains Neomycin (an antibiotic), Polymyxin B (an antibiotic) and Dexamethasone (a steroid).
StS

[Sadachara]

Here's the thing. Poly-Dex ointment is actually highly regarded by veterinarians, and that's also where I got it. It's primary benefit is it rapidly reduces inflammation, and also is aggressive at eradicating staph infections. Hypochlorous Acid is also an anti-inflammatory, but more than that - both of these are mast cell stabilizers. It's critical with wound healing to stabilize mast cells. As for Poly-Dex, it's not just for the eye, it is very potent elsewhere apparently. (at least a vet told me this) But I agree - with any medication caution is warranted. I did find some rehabbers seem to like Poly-Dex.

Clemastine I am not advocating in Squirrels, let me clarify - I am advocating it has an astoundingly good 'vet' based H1 that has a 70 year safe use history in the USA. It actually was one of the most popular H1's in the USA until for some reason, someone bought up the producers and closed them for 3 years, then re-opened them for pet RX only. Weird eh? Wal-Hist, and others were actually Clemastine. I actually purchase Clemastine overseas and we use it for ourselves in the house because it is not only an H1, but is also antiviral, and is a novel cure for C-19 that is safe, and maybe safer than Benadryl.

Also, interestingly - in regards to poly-dex;

https://www.squirrelrefuge.org/infections-in-squirrels
Neo-Poly-Dex Ophthalmological antibiotic (generic name Neomycin, Polymyxin B sulfates, and Dexamethasone ophthalmic) are generally considered safer alternatives for topical treatments in areas at risk for ingestion through licking or normal grooming. Prescription required.

https://www.squirrelrefuge.org/treat...s-in-squirrels
Older babies (with their eyes open) will generally lick at the wound and ingest the ointment, which can seriously imbalance their digestive system and result in diarrhea. Instead, use Neo Poly Dex or other Ophthalmic ointment where a topical antibiotic is indicated.

https://thesquirrelboard.com/forums/...p/t-61381.html
I know i need ciprofloxacin or neo-poly dex ophthalmic drops but they only with prescription.

https://thesquirrelboard.com/forums/...924-Ear-Issues


https://thesquirrelboard.com/forums/...p/t-56683.html
Thank you, Her vet gave her a steroid injection and started her on Neo polydex drops.

Hello Sadachara:

I just want to make a couple of comments about medications for Squirrels.

We currently have a fairly wide experiential database on most medication that can be considered safe for Squirrels. Often, the "research" has been accomplished in Rats before this was utilized in Squirrels. There are many medications that are used in Veterinary and Human medical practices that may actually be safe and effective in Squirrels but we just don't have any definitive evidence to support this. Clemasine is one of these. It is an H1 type antihistamine as is Benadryl but it is not (as far as I am aware) been utilized regularly for Rats ( a close relative of Squirrels) or in Squirrels themselves. Since Benadryl use in Squirrels has a considerable experiential database suggesting both safety and efficacy for treatment of allergic symptoms; it would IMHO be best to utilize Benadryl if an antihistamine is needed in Squirrels. Any of the Admins here on The Squirrel Board (TSB) can help with mixing and dosing instructions.

I have not heard of Poly-Dex but I am familiar with Neo Poly Dex ophthalmic (eye) products. There are two concerns about this particular medication and others similar to it that contain either Neosporin or a Steroid (Neo Ply Dex contains both)! First of all is the use of steroids in the eye; the justification for prescribing Steroids for ophthalmic (use in the eye) use is that they are anti-inflammatory medications and if there is inflammation from any cause, this may help with the inflammation. There are potential great risks with using steroids in the eye and the genral "rule" in both Veterinary and human Medicine is that steroids should NEVER be use in the eye unless an eye specialist (ophthalmologist) prescribes this! This is because it it can can suppress inflammation, it this attenuation of the inflammatory response often masks the continuation of an infection or other primary eye disease and while everything may appear like all is going well, it may actually continue or be getting worse. Again, my stance on ophthalmic steroids is that would be I would not recommend using any eye medication that contains a steroid unless it was prescribed by a Veterinarian who is fully knowledgeable about animal eye diseases and has thoroughly examined the animal!

Next is the use of Neomycin! This is a commonly use antibiotic and is a major component of the skin ointment called Neosporin. The ads for this medication make it appear that Neomycin is a miracle drug and safe as well! Unfortunately, Neomycin, compared with almost all of the other topical eye and skin antibiotics, is probably the one most likely to cause an allergic reaction. Sometimes, this can be so severe as to make it difficult to tell the difference between and an allergic reaction and a new or worsening infection!

Well, there you have it; my comments and suggestion, for whatever they may be worth!

Thanks for coming to The Squirrel Board! I know that you were being helpful, caring and involved and nothing that I said was meant to discourage this! I also posted some comments on your other thread about moving your Squirrel to a larger cage.

Regards,
SamtheSquirrel

[SamtheSquirrel2018]

Here's the thing. Poly-Dex ointment is actually highly regarded by veterinarians, and that's also where I got it. It's primary benefit is it rapidly reduces inflammation, and also is aggressive at eradicating staph infections. Hypochlorous Acid is also an anti-inflammatory, but more than that - both of these are mast cell stabilizers. It's critical with wound healing to stabilize mast cells. As for Poly-Dex, it's not just for the eye, it is very potent elsewhere apparently. (at least a vet told me this) But I agree - with any medication caution is warranted. I did find some rehabbers seem to like Poly-Dex.

Clemastine I am not advocating in Squirrels, let me clarify - I am advocating it has an astoundingly good 'vet' based H1 that has a 70 year safe use history in the USA. It actually was one of the most popular H1's in the USA until for some reason, someone bought up the producers and closed them for 3 years, then re-opened them for pet RX only. Weird eh? Wal-Hist, and others were actually Clemastine. I actually purchase Clemastine overseas and we use it for ourselves in the house because it is not only an H1, but is also antiviral, and is a novel cure for C-19 that is safe, and maybe safer than Benadryl.

Also, interestingly - in regards to poly-dex;

https://www.squirrelrefuge.org/infections-in-squirrels
Neo-Poly-Dex Ophthalmological antibiotic (generic name Neomycin, Polymyxin B sulfates, and Dexamethasone ophthalmic) are generally considered safer alternatives for topical treatments in areas at risk for ingestion through licking or normal grooming. Prescription required.

https://www.squirrelrefuge.org/treat...s-in-squirrels
Older babies (with their eyes open) will generally lick at the wound and ingest the ointment, which can seriously imbalance their digestive system and result in diarrhea. Instead, use Neo Poly Dex or other Ophthalmic ointment where a topical antibiotic is indicated.

https://thesquirrelboard.com/forums/...p/t-61381.html
I know i need ciprofloxacin or neo-poly dex ophthalmic drops but they only with prescription.

https://thesquirrelboard.com/forums/...924-Ear-Issues


https://thesquirrelboard.com/forums/...p/t-56683.html
Thank you, Her vet gave her a steroid injection and started her on Neo polydex drops.

Thanks for writing back Sadachara! I have no intention of arguing the Neo Poly Dex issue for a couple of reasons and the first is that this forum is not designed for this. It is a place for people in need of information for their Squirrel care can come and feel safe and learn for those others who have experience with care of Squirrels and can share their information, experiences and rationales also in a safe environment with the goals of educating and/or guiding others in their care of Squirrels! Also, although in my opinion, any use of a mediation containing multiple antibiotics along with a steroid would not ever be my own choice of empiric (therapy based upon experience and how things appear and before an actual determination of specific causation) ophthalmologic treatment; as you pointed out, Vets do use it and I certainly would not want to appear to be getting between someone and their Veterinarian. Hopefully, when this type of medication is prescribed, the Veterinarian doing so has actually performed a complete eye examination on the Squirrel which would ordinarily include a Fluoresceine as did the Veterinarian in the last link you provided. Apparently this person had some ophthalmology experience beyond the basics and to him it appeared that there was no reasonable likelihood of there being a a corneal ulcer or a fungal or herpetic cause for the Squirrel's eye condition are usually contraindications for steroid use in the eye. In my tiny, humble little part of Squirrel World; for eye infections such as conjunctivitis or for corneal ulcerations in Squirrels, I usually prefer plain Ofloxacin ophthalmic solution.

I'm with you as recognizing the potential benefits for use of Hypochlorus acid for aspects of wound care!

Again, thanks for coming to TSB!

Regards,
SamtheSquirrel

[Sadachara]

I like to make my own Hypochlorous in the lab, which allows me to vary the PPM of it for the task at hand. 0.01 is the traditional base strength. 0.018-0.02 has more of an impact on germ pathogenesis. But for serious infections, and a rapid positive outcome I like to make 0.03, which I equate to a prescription strength form, which of course doesn't exist but if it did, I'm pretty sure it would be 0.03. Yet still completely safe. (100ppm, 180ppm, 200ppm, 300ppm) Eradication is effective at all PPM but contact time necessary for pathogenic enfolding varies by strength.

Staph eradication is quite rapid with HOCI, however contact duration is important, so a gel form can be created (or purchased).