Jaw abscess - has anyone had success treating one with antibiotics only?

[RosieMaia]

Hi there! My Maya very recently stopped eating overnight, it was just so sudden: literally one day wolfing down hay, and dropping 100 grams on the next. Her teeth are in occlusion, but she had obvious trouble chewing, so we did a CR scan, which revealed not one, but two jaw abscesses. One will be addressed surgically, but the other one seems to have spread to the bone and our vet is not 100% sure she will be able to remove it fully/partially. She has been started on azithromycin and she will likely have surgery next week.

Has anyone had success treating a jaw abscess non-surgically? If so, how did it go for you, how long did it take, were you able to completely heal the abscess, or did the infection become chronic and you simply managed it? What antibiotics did you use? We will make a bacterial staining from the antibiotic that is operable, but I do know very few guinea-pic safe antibiotics have good enough penetration in bone and puss.

I really need to read a success story, as I'm getting a bit desperate for Maya. We are suspecting an aggressive bacterial stain, because her overall condition deteriorated so frighteningly quickly, in the space of 2 days she went from her normal, popcorning, chubby self to 100 grams down and incapable of eating anything at all for herself, even grated cucumber. The change was noticeable enough we caught it quickly, but now I'm getting desperate.

 

[furryfriends (TEAS)]

I've treated a lot of abscesses, but surgery is needed, as without drainage, you won't get on top of the infection. You are using an excellent antibiotic, so that's great. We have dealt with a few abscesses, that haven't responded to Zithromax and with those we have used a combination of Metronidazole and Marbocyl.

We have one piggy, Tilly, whose abscess has continued to discharge and with her, we just keep it clean as antibiotics don't seem to make any difference, one way or another now.

 

[Sunny1]

I had marsupialization surgery performed on my piggy for an abscess that had affected the bone in his jaw just over a week ago and his recovery is going extremely well. I opted to have this performed by a specialist and I feel that that has made a huge difference. If you have an exotics specialist near you I would definitely recommend that route. My ordinary vets tried antibiotics at first but it got worse, then they operated but I don't think they cleared it all as it came back straight away and they thought it wasn't affecting his jaw. The specialist did xrays and discovered his jaw was affected and the op she performed seems to of been 100% successful. Hope this helps.

 

[Gadzy]

One of my pigs has a suspected abscess or cyst. We are all unsure and the vets are doing their best with samples etc to find out what we are dealing with. If it's an abscess, would it stay the same size or would it gradually get bigger? It doesn't seemed to have not any bigger and my guess would be if it was an abscess it would get bigger gradually? And @RosieMaia my vets are doing the same, but after the medicine I'm getting a second opinion because I don't think we are taking the correct approach@furryfriends (TEAS)

 

[furryfriends (TEAS)]

One of my pigs has a suspected abscess or cyst. We are all unsure and the vets are doing their best with samples etc to find out what we are dealing with. If it's an abscess, would it stay the same size or would it gradually get bigger? It doesn't seemed to have not any bigger and my guess would be if it was an abscess it would get bigger gradually? And @RosieMaia my vets are doing the same, but after the medicine I'm getting a second opinion because I don't think we are taking the correct approach@furryfriends (TEAS)

They normally increase in size, often rapidly, if an abscess, although cysts can also increase in size, very quickly. Be wary of vets doing fine needle aspirations of the lump, as I have recently had to deal with a guinea pig, where an abscess tracked right through his body, after the previous vet stuck a needle into the lump, to check what it was. The abscess leaked, under the skin, affecting the whole length of his body. He's now abscess free, after 11 weeks of treatment! It was touch and go, for a very long time!

 

[Gadzy]

They normally increase in size, often rapidly, if an abscess, although cysts can also increase in size, very quickly. Be wary of vets doing fine needle aspirations of the lump, as I have recently had to deal with a guinea pig, where an abscess tracked right through his body, after the previous vet stuck a needle into the lump, to check what it was. The abscess leaked, under the skin, affecting the whole length of his body. He's now abscess free, after 11 weeks of treatment! It was touch and go, for a very long time!

This is such a strange one for me, it's a lump which the vets think it's an abscess, but it hasn't got any bigger at all and seems the same. I am adamant it's a fatty lump, but she said the substance that came out of the area wasn't anything of a fatty lump. Our next port of call is to send the sample away to be sure which is 130 pounds! Then we have the treatment for whatever it is on top of that. The trouble is the I've had a second opinion on guniea pigs before and they take the same approaches. Also she's not in any discomfort when squeezing the area and fiddling. No pain, no nothing

 

[furryfriends (TEAS)]

This is such a strange one for me, it's a lump which the vets think it's an abscess, but it hasn't got any bigger at all and seems the same. I am adamant it's a fatty lump, but she said the substance that came out of the area wasn't anything of a fatty lump. Our next port of call is to send the sample away to be sure which is 130 pounds! Then we have the treatment for whatever it is on top of that. The trouble is the I've had a second opinion on guniea pigs before and they take the same approaches. Also she's not in any discomfort when squeezing the area and fiddling. No pain, no nothing

If it's an abscess, the pus often doesn't culture, as you need to send away the abscess capsule, to get a result, so you could get an inconclusive result, and be no further forward.

 

[Gadzy]

If it's an abscess, the pus often doesn't culture, as you need to send away the abscess capsule, to get a result, so you could get an inconclusive result, and be no further forward.

I just don't know what to do then. I don't want to send away for 130 pounds to have no conclusive outcome. She seems pretty oblivious to it. Anyway sorry for hijacking the original users thread. I was just in a similar situation to them

 

[furryfriends (TEAS)]

I just don't know what to do then. I don't want to send away for 130 pounds to have no conclusive outcome. She seems pretty oblivious to it. Anyway sorry for hijacking the original users thread. I was just in a similar situation to them

Why are they just not removing it?

 

[Betsy]

Why are they just not removing it?

I was wondering the same thing.

 

[RosieMaia]

In our situation, Maya has 2 abscesses. One is accessible, on the left mandibular joint and near the base of her ear. It is larger, but manageable and our vet (who is indeed specialised in exotics and has a special interest in rodent dental medicine) is confident we will deal with in successfully. The other one is trickier - the CT scan shows it starts the root of her upper cheek teeth on the right, affects the bone (so osteomyelitis) and expands inwards and deeply towards the sinus cavity. It is smaller and narrower. She thinks she could be able to remove endoscopically, but that she would be in a lot of pain post-op, the sinus being quite sensitive. Additionally, the shape of the abscess makes debriedmebt challenging, as well as subsequent cleaning of the abscess. This is why she is reluctant to remove the abscess on the right - she fears Maya won’t survive the post-op days.

The prognosis is rather unfavourable, we haven’t discussed pts yet, but I wanted to hear if someone had any success with non-surgical treatment with antibiotics.

TEAS, I have heard amazing things about your vet, Simon. International travel at this time (with COVID quarantines) is out of the question, but do you thing he would agree to consult and give me a second opinion on the basis of radiographies / CT scans (needless to say, I will pay whatever his normal consultation fee is)?

 

[furryfriends (TEAS)]

In our situation, Maya has 2 abscesses. One is accessible, on the left mandibular joint and near the base of her ear. It is larger, but manageable and our vet (who is indeed specialised in exotics and has a special interest in rodent dental medicine) is confident we will deal with in successfully. The other one is trickier - the CT scan shows it starts the root of her upper cheek teeth on the right, affects the bone (so osteomyelitis) and expands inwards and deeply towards the sinus cavity. It is smaller and narrower. She thinks she could be able to remove endoscopically, but that she would be in a lot of pain post-op, the sinus being quite sensitive. Additionally, the shape of the abscess makes debriedmebt challenging, as well as subsequent cleaning of the abscess. This is why she is reluctant to remove the abscess on the right - she fears Maya won’t survive the post-op days.

The prognosis is rather unfavourable, we haven’t discussed pts yet, but I wanted to hear if someone had any success with non-surgical treatment with antibiotics.

TEAS, I have heard amazing things about your vet, Simon. International travel at this time (with COVID quarantines) is out of the question, but do you thing he would agree to consult and give me a second opinion on the basis of radiographies / CT scans (needless to say, I will pay whatever his normal consultation fee is)?

Yes, Simon would absolutely be willing to do a telephone consult, or to communicate over email, or both! Whatever works best for you. You can email the practice at [email protected]

www.catandrabbit.co.uk

 

[RosieMaia]

Thank you, I will gather our x-rays, CT and blood test results and email them. I don’t know what else to do

 

[Gadzy]

Why are they just not removing it?

The surgeons wanted to take this approach first and they said where the lump is, it's near some important structures and because she wriggles so much she'd want to be careful in the area lancing it. Also because of the manor of my guniea pig she would need to be sedated as she just doesn't keep still and wriggles everywhere. I think the next option is to remove it, but she has spoken and shown other surgeons who have done work on guniea pigs and they said the same that it's doable, but it's near some important structures and it's a last resort. I'm not on any pet insurance or anything. What price are we looking roughly for a removal of any lump? I will need to put some aside. I have emailed a exotic vets specialist about it and they said they would of done the same procedures, but if she was to have surgery the exotic specialist would be my favoured option for surgery

 

[RosieMaia]

I have an update.

Maya is still here, abscess number one has been successfully removed using a non-invasive endoscopic method. She is capable of chewing better, her weight is going up and she is feeling better in herself, even attempting to eat soft grass. Plan was to get her stable, put her weight up (as this abscess was preventing her from swallowing well), put her on an antibiotic therapy to prevent the second abscess from growing further, and then attempt a second, more invasive surgery (remove 2 teeth and her eye) in order to clear abscess number two.

Unfortunately, the antibiotic susceptibility test shows the bacteria is an aggressive stain (which we suspected considering how she got unwell overnight) and this particular stain is resistant to azithromycin, erithromycin (baytril), metronidazole and chloramphenicol, and is susceptible only to the piggy-unsafe antibiotics. We are now consulting with other vets to see if there is a anything at all we can do for her, but it doesn't look promising. We are considering injectable antibiotics, since they have less of an impact on the gut, plus to place an antibiotic-infused cement bead locally to see if that might help. For now, she's on heavy pain relief and I believe she's in less pain than before, so I won't put her to sleep, unless we'e exhausted all reasonable options.

I'm not sure why I'm posting... Maybe I'm looking to see if someone had a similar situation that was successfully resolved or any insight to offer.

 

[LMPigs]

Unfortunately I cannot offer any insight into Maya's situation, but I read you post so wanted to send some support. It's good that Maya is feeling better in herself while you consider the longer term options. Wishing you both the best.