Need Advice on Stubborn Abscess/Possible Ear Infection.

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Nic

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Hey everyone. I joined this forum for advice/a second opinion concerning an ongoing health issue with one of my rats, Spot. It's a bit of an odd situation so you'll have to bear with me.



It all started when I noticed Spot, who is about 2.5 years old, had developed a lump on the side of his face (between the eye and ear area) a little under two months ago. It popped up pretty quickly and I was worried that it was a tumor, so I made an appointment with the only local vet that would see rodents. When I got to the vet, he poked a syringe/needle type thing into the lump to see if it was a mass of tissue or just an abscess. He drew a bunch of pus out with the needle, which obviously meant it was abscess. After that he lanced it and drained out the rest of the pus. He then prescribed an antibiotic (Baytril) to give orally and steroid cream to apply directly into the wound. I was told to give Spot the antibiotic twice daily for two weeks and apply the cream into the wound once a day until it stopped making pus. I was so happy at the time that it was just a simple abscess that would go away and not a tumor.. unfortunately things would eventually become more complicated.


The abscess filled up again the next day (which I was told to expect), so I gently squeezed out the pus and cleaned the wound with warm, soapy water before applying the cream and giving him the antibotic. I continued treatment as instructed and after a few days, the abscess seemed to stop making pus and the swelling started to go down. After it stopped making pus, I stopped using the cream (kept cleaning it though) like the vet said and kept giving the antibiotic. Around day 10 of treatment, the abscess started filling up and swelling again. I called the vet and voiced my concern, so he prescribed a different antibiotic (Amoxicillin) to be given for another two weeks.



So I stopped giving Spot the Baytril and started him on the new antibiotic the next day. I continued to drain and clean the wound normally. After a about a week of that, the abscess stopped making pus again and the swelling subsided. I kept up with the antibiotics + cleaning, and after the two weeks were up, the abscess seemed to have dried up and the swelling was totally gone. The wound began to scab and I thought I had the infection beat.



A few days after I discontinued antibiotics, the abscess started filling up swelling AGAIN. Of course, I called the vet and he told me to kept it clean and start giving him the Amoxicillin again (there was extra). So I did and am still doing that now. It's been over a week since then and the abscess keeps filling up yet trying heal and close at the same time. It's very difficult to clean at this point and it's very swollen. Also, this time around he has developed some new symptoms that really worry me. The past few days, his jaw has become slightly crooked (due to the swelling, I guess?) which is making it difficult for him to eat and now there is little blood coming out of his ear. I'm worried he's in a lot of pain, too.



Obviously I'm going to take him back to the vet, but can anyone offer any insight on what's going on? I'm starting to wonder if it's ear infection gone wrong or if the infection from the abscess has somehow spread to his ear... maybe that's the cause for the blood? Also, if the swelling goes down, will do you think his jaw return to normal? Has anyone ever encountered a situation like this?



I apologize or such a long post and all the questions, but I'm so worried and confused at this point. I feel like I've done something wrong even though I'm trying my hardest to help him get rid of this thing. I want him to get better so badly...



Any help is appreciated. Thank you for reading.
 
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Can you take a pic from the side of this lump/abscess?

I have some crummy news for me if my instincts are right...rats develop this tumour underneath their ear called a zymbal's gland tumour. It often presents as an abscess, then eventyually bursts, then the tumour underneath starts to grow. There can be jaw shifting causing the teeth issues, blood in the ear etc.

Another not very nice option is a tooth abscess, these are pretty serious and the vet needs to check inside the mouth, check all the teeth (including molars). These are very tricky, can shift the jaw as well, even if just from pain and not bruxxing/grinding the teeth down on that side. You may also want to consider pain meds.

IF I am wrong and it is just a surface abscess we need to change your treatment. Normally we flush out an abscess with saline or diluted betadine, etc. At least twice a day. I prefer saline is it flushes and dries out the cavity, breaks down any cheesy pus inside and helps get it out. You do NOT put any ointment on it as it encourages healing, in this case the surface will heal over the cavity trapping any bacteria inside so the abscess recurs. We tell people to just flush, until the bottom of the abscess has healed up near the surface then you can let it scab over and heal properly.
 
cccce213c07172c2a74c835310544f87.jpg


This is what it looks like this morning. Yet a new development, his eye on that side has began to drain mucous. I wiped it off with a warm wash cloth, but it was covered with reddish mucous before this photo. The abscess also is trying to close up again and I can't get it to drain.

I can't get him to the vet for a few days, I will be taking him as soon as I can though. So you really think it could be a tumor? And I hadn't really considered his teeth. The vet never mentioned that they could be the cause.
 
Also, it looks much more swollen when you look at his face straight on. I'll try to get him to sit still long enough for a picture of that.
 
f7da2d7f3aabaf185fa768cbf37f7841.jpg


He looks scruffier than usual and has lost some weight throughout this ordeal, as you can imagine. I tried softening his rat blocks and feeding baby food yesterday he ate most of it and is drinking normally thankfully.. he didn't have much trouble eating at the beginning but this past week he's been eating significantly less hard food.
 
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A vet should be able to tell from fine needle aspiration whether or not there are cancer cells present. I do know that abscesses can take a long time to clear up. I once had a male rat who developed a lump in a similar area as your rat. I took him in to the vet who also found a lot of hard, creamy pus in the lump. He underwent surgery to clean it right out, and was put on some antibiotics (it was a while ago, but I believe he was on amoxicillin, then eventually Chlorapalm 250) and this abscess persisted for almost seven months; it took constant cleaning, ongoing meds to finally clear it up. The vet said some male rats are very prone to these things and that they will often keep coming back.

Rule out cancer cells and tooth abscess; the vet need only give your boy a tiny bit of general anesthetic to be able to fully open the mouth and take a good look with a good light to see if any teeth look infected in/around the gum area. If that vet won't do it, find another experienced exotic vet who will. If the teeth look fine, ask him to fine-needle aspirate specifically to look for any signs of cancer cells. If that comes back 'negative' then just keep persistently medicating and cleaning the wound. As I said, my guy's abscess finally went away, but it took months and month until the area closed right up. After that it never bothered him again. Best of luck with your little one. Does he seem to be in pain at all? My boy did find the area painful; you might ask for some painkiller, if that's the case.
 
Oh, and the stuff from his eye is likely porphyrin, located on the same side as the abscess, simply because something stressful is going on in the area. If the eye itself began to change (bulge, etc.) then I'd be concerned with infection trying to spread up into that area; antibiotics should quell this.
 
Thanks guys. It looks like it will be Monday before I can get him to the vet again. Is there anything I can do until then to make him more comfy? And yes, it does appear to be painful and the swelling is causing his jaw to go to off to the side slightly.
 
This photo him taken about a week or so before all the drama, by the way. I just want everyone to know he doesn't always look so sickly.
016babe70ba579455bab7e534421348d.jpg
 
Did the vet give you any pain medication for him, like Metacam? Perhaps something like infant ibuprofen in the meantime; I don't know dosages, so someone here may be better able to advise. Swelling alone can cause the jaw to distend/go out of alignment, and that may be due to infection taking place. Whether it's tooth-related, or infection-related, if there's discomfort, he probably won't want to chew hard foods. You can offer him soft baby foods, rice pablum and rice milk, soak his rat block in rice milk, soft cooked rices, egg, etc. or Ensure to keep him eating and hydrated, as well as soft fruits like watermelon, red grape, etc. Just keep the area as clean as possible, and him on clean blankets or pieces of clean sheeting. Some rats will take Ensure or soft foods from a small plastic non-needle syringe when offered, as encouragement to eat, or off the tip of a finger. If he's still eating well on his own, wonderful. Just try to keep him as comfortable as possible; give him a cuddle or pat to let him know you're there. Perhaps Lil'Spaz can advise on some over-the-counter pain medication for the weekend? Best of luck with your little guy; here's hoping it is just a continuing abscess that is just being stubborn and just needs more ongoing meds and maintenance for it to clear up. No matter what, all you can do is your best and just love him and keep him as comfortable as possible. Healing thoughts going your way.
 
I'd be worried that it's a tooth/molar abscess. If so, you will need long term antibiotics, preferably chlorpalm. And keep draining and cleaning. This will be a long fight.
 
I'd be worried that it's a tooth/molar abscess. If so, you will need long term antibiotics, preferably chlorpalm. And keep draining and cleaning. This will be a long fight.
The draining part is an issue at this point. It keeps trying to close up and when I try to gently squeeze some of pus out, he shrieks softly and pulls away. What else can I do to make it drain?
 
Did the vet give you any pain medication for him, like Metacam? Perhaps something like infant ibuprofen in the meantime; I don't know dosages, so someone here may be better able to advise. Swelling alone can cause the jaw to distend/go out of alignment, and that may be due to infection taking place. Whether it's tooth-related, or infection-related, if there's discomfort, he probably won't want to chew hard foods. You can offer him soft baby foods, rice pablum and rice milk, soak his rat block in rice milk, soft cooked rices, egg, etc. or Ensure to keep him eating and hydrated, as well as soft fruits like watermelon, red grape, etc. Just keep the area as clean as possible, and him on clean blankets or pieces of clean sheeting. Some rats will take Ensure or soft foods from a small plastic non-needle syringe when offered, as encouragement to eat, or off the tip of a finger. If he's still eating well on his own, wonderful. Just try to keep him as comfortable as possible; give him a cuddle or pat to let him know you're there. Perhaps Lil'Spaz can advise on some over-the-counter pain medication for the weekend? Best of luck with your little guy; here's hoping it is just a continuing abscess that is just being stubborn and just needs more ongoing meds and maintenance for it to clear up. No matter what, all you can do is your best and just love him and keep him as comfortable as possible. Healing thoughts going your way.
No, the vet didn't prescribe a pain med. When he originally lanced it, he numbed the area but that's it. He gave me an antibiotic (Baytril) to be given to Spot twice a day for two weeks and a steroid cream to apply into the abscess. He said the cream would help it dry up. It started to get better, but eventually it began to get worse and the Baytril didn't seem to be helping anymore. He then prescribed another antibiotic, Amoxcillin(sp?). That's what he's on now and I've been giving it to him for over two weeks.
 
Did the vet give you any pain medication for him, like Metacam? Perhaps something like infant ibuprofen in the meantime; I don't know dosages, so someone here may be better able to advise. Swelling alone can cause the jaw to distend/go out of alignment, and that may be due to infection taking place. Whether it's tooth-related, or infection-related, if there's discomfort, he probably won't want to chew hard foods. You can offer him soft baby foods, rice pablum and rice milk, soak his rat block in rice milk, soft cooked rices, egg, etc. or Ensure to keep him eating and hydrated, as well as soft fruits like watermelon, red grape, etc. Just keep the area as clean as possible, and him on clean blankets or pieces of clean sheeting. Some rats will take Ensure or soft foods from a small plastic non-needle syringe when offered, as encouragement to eat, or off the tip of a finger. If he's still eating well on his own, wonderful. Just try to keep him as comfortable as possible; give him a cuddle or pat to let him know you're there. Perhaps Lil'Spaz can advise on some over-the-counter pain medication for the weekend? Best of luck with your little guy; here's hoping it is just a continuing abscess that is just being stubborn and just needs more ongoing meds and maintenance for it to clear up. No matter what, all you can do is your best and just love him and keep him as comfortable as possible. Healing thoughts going your way.
No, the vet didn't prescribe a pain med. When he originally lanced it, he numbed the area but that's it. He gave me an antibiotic (Baytril) to be given to Spot twice a day for two weeks and a steroid cream to apply into the abscess. He said the cream would help it dry up. It started to get better, but eventually it began to get worse and the Baytril didn't seem to be helping anymore. He then prescribed another antibiotic, Amoxcillin(sp?). That's what he's on now and I've been giving it to him for over two weeks.
 
I have seen too many posts on here where an abscess in that location was a tumour or the infection never cleared up. You should rule out a tooth abscess as that would be the easiest fix - take out source of infection and it will heal up. I am worried for your boy though...
Pain medication is important. If you do not have any Metacam from the vet, you should pick up some infant Advil (liquid). You also need a current weight for your boy for proper dosing. There is information on it in the Rat Guide but we can help you if you need.
http://ratguide.com/meds/nsaids/ibuprofen.php
 
Lets try to make him more comfortable for the weekend.

Can you go get infant liquid ibuprofen at the drug store? Advil grape flavoured dye-free is one rats like. The box looks like this

advilinfantdyefreepediatricdrops.jpg~original


We would need a guess on his weight to give you his dose.

Its usually 50 mg/1.25 ml's (on the box) which works out to 40 mg/ml :D
 
Thanks everyone. I actually did a warm compress before I went to be last night, my aunt suggested it to me and I figured it couldn't hurt. I also flushed the with a homemade saline solution (1tsp salt to 16oz of water) and this morning the swelling has noticeably gone down some and the abscess feels a little softer. The flushing was kind of a challenge because I couldn't get the syringe into the opening of the wound, but I just put it right against the opening and flushed in the salt water. I'm about try to flush it again.

I'll see about picking up some of the Children's Advil this afternoon.
 
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