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Dental Huge jaw abcess *Photos attached unpleasant

thewheakybeans

thewheakybeans

Junior Guinea Pig
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I'm looking for some advice regarding my guinea pig Macchiato who has been battling a recurrent jaw abcess for two months now.

Her first surgery in August was an initial success however we think her sutures became infected and she developed a 2nd small pea sized abcess above the initial surgical site. Yesterday she had 2nd surgery to remove this lump, any remaining pus and it was sutured then glued together. Later yesterday night, the glue started coming away and today the whole wound has opened back up revealing a deep hole in her neck.

My vet has advised me that the best way forward is to flush out with iodine twice daily (and sterile saline solution whenever I find hay etc in it) until it heals from the inside out as suturing would lead to further infection.

He also thinks it's possibly caused by a condition called caseous lymphadenitis (so prognosis doesn't look hopeful) however it could simply be a recurring abcess in this difficult to treat area. She has had a full Xray and dental check-up to rule out dental issues (all OK) and she is very bright, active and eating lots despite being only 24 hours post surgery. She is on a course of doxycycline, metacam for pain relief and will be given antibiotics injections from next Monday.

Does anyone have experience of persistent jaw abcesses similar to hers before? Have there been any things that have worked or helped the healing process? I'm struggling to see how the wound can heal as it is so deep to flush out, like a well in her neck.

Unfortunately, if the abcess was to return a third time in 3 months I'd have to consider putting her to sleep so I'm just looking for advice to give her the best possible chance of a full recovery.

Thank you in advance.
 

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I’m so sorry Macchiato is going through this. You too! The wound looks clean and healthy at the moment. My pig Pepper has recovered from a tooth root abscess. His wound was stitched open and I flushed it three times a day for two weeks. Hopefully that will work for you. Is she eating ok? Zithromax antibiotic is a good one for abscesses. Good luck.
 
Ouch... that's quite a wound! I've had pigs with jaw abscess before where the wound was lanced and left open to continue to drain, but the openings were not that large. When they did the surgery, did they lance and drain and the abscess or did they fully remove the whole abscess capsule (the little 'pouch' that surrounds the abscess contents.) I'm just trying to figure out what I'm looking at looking in the wound.

If they left the capsule in place and just lanced and drained, you can keep giving a heavy duty antibiotic and irrigating the wound with sterile saline and perhaps using some manuka honey in the wound if you can get it. If they took the entire capsule out, the vet might prefer to re-stitch to close it up again.

I really hope it doesn't reform into an abscess. It might take awhile to heal and leave a big scar, but it does look clean right now.
 
Thank you for your comments 😊 She's eating like a trooper & maintaining weight, you wouldn'nt even know she was poorly if it wasn't for the horror show that is her neck!

During the first surgery, a huge abscess plus capsule was removed and after it got re-infected, all the pus plus the small new abscess was completely removed in the 2nd procedure two days ago. Since it reopened, it's a very deep wound with muscular tissue showing with flaps of skin at the side.

My concern is the wound is so deep with lots of crevices so I'm struggling to keeps bits of hay out of it. Flushed it with iodine twice this morning already and tried to pick out the bits of grass but there's still a few bits stuck in the corners, deep inside. Would a wound this deep heal properly or would I be better getting it stitched up by the vet and hoping it heals from there?
 
thebiscuittinpiggies said:
Thank you for your comments 😊 She's eating like a trooper & maintaining weight, you wouldn'nt even know she was poorly if it wasn't for the horror show that is her neck!

During the first surgery, a huge abscess plus capsule was removed and after it got re-infected, all the pus plus the small new abscess was completely removed in the 2nd procedure two days ago. Since it reopened, it's a very deep wound with muscular tissue showing with flaps of skin at the side.

My concern is the wound is so deep with lots of crevices so I'm struggling to keeps bits of hay out of it. Flushed it with iodine twice this morning already and tried to pick out the bits of grass but there's still a few bits stuck in the corners, deep inside. Would a wound this deep heal properly or would I be better getting it stitched up by the vet and hoping it heals from there?
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I was thinking that looked like internal muscular structure, ouch! Has the vet seen these pics? I would be forwarding them urgently and asking what he wants to do. In my (admittedly limited) experience, my pigs who had the abscess capsule left behind were left open to drain, but those where the capsule was removed entirely were stitched up. If he initially tried to glue this wound, he may very well want to stitch it up again because it sounds like he intended it to be closed. My worry here is that the skin hanging at the sides may die off, leaving a big open wound without much tissue to cover it, and with a wound that deep it will take a long time to fill in and may well get contaminated with hay/bedding/who knows what in the meantime, leading to more infection. I'm not a vet and don't know for sure what his intentions were for this wound healing, but I would make sure that he gets a copy of this ASAP so that he can decide where to go from here.
 
Thanks for your input Freela.

Yes it was sutured and glued shut on Thursday and after showing the vet these photos, they've decided it's best to let it heal from inside out however my concern is the deepness of the wound and how open it is to infection even with regular flushing.

He believes if he stitches it up now, it will just get re-infected again then if a third abscess returns, we will have to discuss either pts or referring her to the vet school in Edinburgh which will be ££££s.

I just don't know which option gives her the best chance of full recovery because this gaping wound is so vulnerable to infection.
 
It’s probably a ridiculous idea and normally they are left open to the air, I wonder if there is any way it could be “dressed” to prevent hay etc getting in as I think you are right, the placement and depth seems to be inviting detritus into it. I’m thinking a tube of stretchy fabric with holes to poke her legs through, like a little tee shirt. Not ideal as if it gets wet then that poses it’s own risk 🤔
 
Actually that's something I haven't thought of so will ask the vet when I see them later this morning. Thanks for the suggestion!
I'm more of the view that I should have it stitched closed once they've removed all the lodged bits of hay and see what happens with time.

I'm not sure it's even feasible it would heal because some parts of the wound are far deeper than others and the longer it's left open, the more dirty stuff that can get in (and I've already flushed it out at least 5 times over last 24 hours).
 
I’m sorry I can’t offer any experience of abscesses but just wanted to send some healing vibes to your brave little lady :hug:
 
She's bounced back quickly already (surgery #2 and #3 have only been 48 hours apart) and was running around as soon as she woke up from the op! The wound looks alot healthier already its been stitched up leaving a small opening at top and bottom to flush out with sterile saline x2 a day while it heals. There wasn't enough healthy skin to completely stitch it up & the vet is hopeful it will heal. I'm just relieved that it's not so exposed to hay etc now so it's just a waiting game now 🙏🏻 Thank you for all your support and healing vibes. It's a lovely community on here 😊🥰
 
I only got a quick look at your thread earlier on. Poor girl! So glad she’s doing ok after this latest surgery. Hang in there. You are doing great x
 
Glad all has gone well.
Will continue to hold you in my thoughts for a speedy and complete healing.
Look after yourself too.
Caring for a sick piggy can be very draining
 
That’s great news, wishing her a speedy recovery and hugs to you, it’s hard and emotionally draining when you have a poorly piggie :hug:
 
Macchiato update: She's had a 100ml depocillin injection this morning (she will have 5 in total over the next 10 days) and seems to be out of sorts now after doing so well.
Does anyone have experience of their piggies being on these injections at all?
 
Shes currently on 0.1ml doxycycline too twice daily. I think she's had a bad reaction to the penicillin so will contact my vet tomorrow
 
Piggies&buns said:
If she is in a bad way it may be better to call an out of hours vet.
I hope she is ok
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Thank you, I decided to in order to get some advice so I need to start syringe feeding and give her a cisapride dose until a vet sees her tomorrow. I think everyone in the veterinary practice knows her now!
 
What a terrible experience you and your piggie are having, you must be exhausted. I can't help on advice but send hugs. Hang on in there, you are doing your best ❤️
 
munchmonster said:
What a terrible experience you and your piggie are having, you must be exhausted. I can't help on advice but send hugs. Hang on in there, you are doing your best ❤️
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Thank you so much, its been an extremely challenging few months and she is such a tough cookie so it's sad to see her take a down turn like this. Just trying to remember to look after myself first aka eat and sleep 😅 in order so I can show up for her!
 
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