Help! Aspiration pneumonia!

[Ncorrea012]

Hi. I recently rescued a baby squirrel. I believe he is 3 weeks old as his ears have just come off of his head in the past few days. On Thursday or Friday morning, the syringe I was feeding the baby with got stuck and he ended up aspirating some milk. I tried to get all of it out of his nose and held him upside down.

He has been fine but last night I noticed he had discharge in his nose. I noticed he does sneeze occasionally and I think I hear some slight clicking when he breathes. I’m not 1000% confident on the clicking but he is sneezing.

I was able to get 500 mg tablets of amoxicillin and I was hoping someone would be able to help me dose him properly. Sprout weighs 55 grams.

He still is showing a lot of activity and he has been drinking normally.

[Ncorrea012]

Update: I’m fairly certain he is clicking. Please help us 😭

[Charley Chuckles]

[Spanky]

His appetite is till good and activity level not diminished?

Dosing sent via PM.

[Ncorrea012]

His appetite is till good and activity level not diminished?

Dosing sent via PM.

Yes that is correct. Thank you for your response! I messaged you again asking if I should treat him before/after/between feedings. Thanks again!!

[SamtheSquirrel2018]

Hi Ncorrea912:
I received your PM as I get email notification of those. It looks like Spanky has responded to your Thread and he is among the best! I am at work and will be indisposed for at least the next hour but I'll look back at your Thread when I am able. It would be much better to keep all posts on the open Board to preserve continuity and ensure that others who may have suggestions can offer them. Mixing and dosing instructions are handles by Private Message however.

It appears from your profile that you are not an experienced Squirreler (my created word, not an "official" term). Here is a link to Henry's Pets Baby Squirrel Care Guide. It is 6 concise pages. Please read the first 3 pages NOW! https://www.henryspets.com/1-baby-squirrel-care-guide/ All of the recommendations there are good EXCEPT, please do NOT use Fox Valley 32/40 formula. There have been serious issues with using this and it best AVOIDED. Henry's has not yet revised this.

Just a couple of questions pertaining to the presumed aspiration and what is now going on;
1) are you using a 1cc syringe with a baby animal specialty nipple such as a Miracle Nipple and does your syringe plunger have an o-ring. The 1cc syringe is essential and the specialized nipple and o-ring are desirable!
2) Is your Squirrel breathing through his mouth or does he seem in any way to be having breathing difficulties?
3) does he currently have nasal discharge and is it clear or cloudy?
4) is you Amoxicillin table plain Amoxicillin or is it Amoxicillin plus Clavulanate (Augmentin is a human brand of this)?
5) is table scored so that it can be precisely broken in half?
6) Spanky has already asked for clarification on this but to state this again, is Sprout behaving normally now; breathing, appetite, activity, interaction with you, pooping, peeing---ALL normal?

Edit: You are in good hands with Spanky! I just saw as I posted my comments that he had sent dosing instructions!

Regards,
SamtheSquirrel

[Ncorrea012]

Hi Ncorrea912:
I received your PM as I get email notification of those. It looks like Spanky has responded to your Thread and he is among the best! I am at work and will be indisposed for at least the next hour but I'll look back at your Thread when I am able. It would be much better to keep all posts on the open Board to preserve continuity and ensure that others who may have suggestions can offer them. Mixing and dosing instructions are handles by Private Message however.

It appears from your profile that you are not an experienced Squirreler (my created word, not an "official" term). Here is a link to Henry's Pets Baby Squirrel Care Guide. It is 6 concise pages. Please read the first 3 pages NOW! https://www.henryspets.com/1-baby-squirrel-care-guide/ All of the recommendations there are good EXCEPT, please do NOT use Fox Valley 32/40 formula. There have been serious issues with using this and it best AVOIDED. Henry's has not yet revised this.

Just a couple of questions pertaining to the presumed aspiration and what is now going on;
1) are you using a 1cc syringe with a baby animal specialty nipple such as a Miracle Nipple and does your syringe plunger have an o-ring. The 1cc syringe is essential and the specialized nipple and o-ring are desirable!
2) Is your Squirrel breathing through his mouth or does he seem in any way to be having breathing difficulties?
3) does he currently have nasal discharge and is it clear or cloudy?
4) is you Amoxicillin table plain Amoxicillin or is it Amoxicillin plus Clavulanate (Augmentin is a human brand of this)?
5) is table scored so that it can be precisely broken in half?
6) Spanky has already asked for clarification on this but to state this again, is Sprout behaving normally now; breathing, appetite, activity, interaction with you, pooping, peeing---ALL normal?

Edit: You are in good hands with Spanky! I just saw as I posted my comments that he had sent dosing instructions!

Regards,
SamtheSquirrel

That’s concerning about the formula because that is what I have been using the past couple of days. What should I switch to?

I had a 1ml syringe when this happened and the plunger got stuck causing aspiration. I moved to a 3ml with nipple and it has been much smoother to feed with.

I noticed that I will hear little noises in his breathing after feeding but he is not breathing through his mouth and seems mostly fine besides sneezing every so often.

I saw nasal discharge last night and it appeared to be clear when I wiped it with a q tip.

The medicine is a pink amoxicillin tablet with an A on one side and a 99 on the other. The prescription bottle just says amoxicillin 500 mg. There is no scoring on the tablet but I do have a scale if I need to measure out a smaller amount.

I know you said the FV 32/40 should be stopped but in the past few days on the formula, he’s become more active, has gained weight, and seems to be urinating and defecating well after each feeding. Poops are rounded and pee is clear.

Can you recommend another formula to use? I also have the FV 20/40 on the way. Should I return that as well?

Thank you for your help!

[CritterMom]

LOL - I sent you dosing too.

[Ncorrea012]

LOL - I sent you dosing too.

Thank you for responding, I was so desperate earlier that I messaged like 9 senior members and administrators so I’m sure your dosing message won’t be the last lol

[SamtheSquirrel2018]

That’s concerning about the formula because that is what I have been using the past couple of days. What should I switch to?

I had a 1ml syringe when this happened and the plunger got stuck causing aspiration. I moved to a 3ml with nipple and it has been much smoother to feed with.

I noticed that I will hear little noises in his breathing after feeding but he is not breathing through his mouth and seems mostly fine besides sneezing every so often.

I saw nasal discharge last night and it appeared to be clear when I wiped it with a q tip.

The medicine is a pink amoxicillin tablet with an A on one side and a 99 on the other. The prescription bottle just says amoxicillin 500 mg. There is no scoring on the tablet but I do have a scale if I need to measure out a smaller amount.

I know you said the FV 32/40 should be stopped but in the past few days on the formula, he’s become more active, has gained weight, and seems to be urinating and defecating well after each feeding. Poops are rounded and pee is clear.

Can you recommend another formula to use? I also have the FV 20/40 on the way. Should I return that as well?

Thank you for your help!

Hi Ncorrea012:
A 1ml syringe is ideal but it helps to have one with the o-ring as its purpose is to prevent the plunger from sticking. A 3ml syringe is ordinarily much too large for a tiny baby and what would happen if the plunger of the 3ml syringe gets stuck (a rhetorical question)? The risk of aspiration increases as size of the syringe increases and the amount of formula dispensed form the syringe increases! This is why a 3ml syringe is far from ideal for tiny Sprout! It is essential that you and NOT the Squirrel, control the plunger! If you can get different 1cc syringes, preferably with an o-ring; it would ordinarily be safer than the 3ml syringe. Are you using a specialized infant animal nipple such as the Miracle Nipple?

Going back to the Fox Valley 32/40; I didn't really say it should be stopped; just that I don't recommend it but there is some background for me to make that recommendation for anyone seeking information on how to care for a baby Squirrel! The problem that many were having with 32/40 was that the formula was forming a hard mass in the stomach and there were many fatalities! This being said; this was happening almost exclusively with Pinkies under 2 weeks of age. For someone just starting out needing a feeding plan, I always recommend simply NOT using the FV 32/40. In Sprouts case; he is an "older" baby and you have been using the 32/40 for some time without issues and it is apparent providing good nutritional support so it is probably quite ok to keep using it! Most of us recommend using Esbilac Puppy Milk Replacer POWDER (the liquid is NOT the same and has cause diarrhea and other problems). Transitioning to FV 20/50 at 3-1/2 to 4 weeks is fine! There are No problems with 20/50 as long as the powder is kept in the freezer, the mixed formula is allowed to mix completely and that the prepared formula is kept in the refrigerator and disposed of within 24 hours of being prepared!
Now back to work!
Regards,
SamtheSquirrel

[Ncorrea012]

Hi Ncorrea012:
A 1ml syringe is ideal but it helps to have one with the o-ring as its purpose is to prevent the plunger from sticking. A 3ml syringe is ordinarily much too large for a tiny baby and what would happen if the plunger of the 3ml syringe gets stuck (a rhetorical question)? The risk of aspiration increases as size of the syringe increases and the amount of formula dispensed form the syringe increases! This is why a 3ml syringe is far from ideal for tiny Sprout! It is essential that you and NOT the Squirrel, control the plunger! If you can get different 1cc syringes, preferably with an o-ring; it would ordinarily be safer than the 3ml syringe. Are you using a specialized infant animal nipple such as the Miracle Nipple?

Going back to the Fox Valley 32/40; I didn't really say it should be stopped; just that I don't recommend it but there is some background for me to make that recommendation for anyone seeking information on how to care for a baby Squirrel! The problem that many were having with 32/40 was that the formula was forming a hard mass in the stomach and there were many fatalities! This being said; this was happening almost exclusively with Pinkies under 2 weeks of age. For someone just starting out needing a feeding plan, I always recommend simply NOT using the FV 32/40. In Sprouts case; he is an "older" baby and you have been using the 32/40 for some time without issues and it is apparent providing good nutritional support so it is probably quite ok to keep using it! Most of us recommend using Esbilac Puppy Milk Replacer POWDER (the liquid is NOT the same and has cause diarrhea and other problems). Transitioning to FV 20/50 at 3-1/2 to 4 weeks is fine! There are No problems with 20/50 as long as the powder is kept in the freezer, the mixed formula is allowed to mix completely and that the prepared formula is kept in the refrigerator and disposed of within 24 hours of being prepared!
Now back to work!
Regards,
SamtheSquirrel

I’ll go to the pet store and purchase another syringe now! Your reasoning and logic makes a lot of sense, I’ll make sure to purchase a syringe with an o-ring.

CritterMom mentioned that if he’s still active and eating he may not need medication so I decided to hold off. Is that something you recommend as well? Thanks again

[SamtheSquirrel2018]

I’ll go to the pet store and purchase another syringe now! Your reasoning and logic makes a lot of sense, I’ll make sure to purchase a syringe with an o-ring.

CritterMom mentioned that if he’s still active and eating he may not need medication so I decided to hold off. Is that something you recommend as well? Thanks again

Hello again Ncorrea:
Antibiotics ALWAYS have potential risks but they do NOT always have potential benefits! The vast majority of formula aspirations in baby Squirrels do not result in a pneumonia but NO aspiration should be taken lightly and all pertinent precautions should be utilized with every feeding to help minimize the likelihood of an aspirration occurring! That being said, aspirations occur and if I might be so bold, they happen to all of us! There are also other problems that can result from the aspiration beside a pneumonia including asphyxia where there is so much fluid in the breathing passages and lung that air exchange becomes futile and death can occur form this without any infection whatsoever! In most cases of aspiration, I do not lean toward the "let's get started on antibiotics to prevent a pneumonia" point of view. If a Squirrel is behaving normally (appearance [not gasping for air or mouth breathing for examples], appetite, activity, interaction with you and/or littermates, pooping, & peeing), the likelihood of a pneumonia is far less than if he was lethargic and not eating!

Observation would be a very valid option in many of those cases and Sprout's case as well! Again, this pertains to formula feeding in baby animals incapable of vomiting! Squirrels, incidentally cannot vomit.

When aspiration includes acidic stomach contents (this NOT the same mechanism associated with aspiration of an excessive amount of formula or inadvertent push of the seeding syringe plunger); the risks are far higher as the presence of this acidic material in the lungs and breathing tubes cause an inflammatory response called a pneumonitis and this is serious in itself and while it is NOT an infection; it can easily set the conditions for a pneumonia to develop.
Regards,
SamtheSquirrel