Milo’s ear is not responding to antibiotics

Discussion in 'Health & General Care' started by SqueakingJellybean, Oct 29, 2018.

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  1. Oct 29, 2018 #1

    SqueakingJellybean

    SqueakingJellybean

    SqueakingJellybean

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    What acts like an ear infection, causes a full-body tilt, and doesn’t respond to antibiotics?

    We had Milo on Baytril and Clavulin. He was fine with the Baytril, but refused the Clavulin after the first couple of days. Wouldn’t even swallow it if we squidged it into his mouth; he just let it run out and wiped it on the bedding, on the girls, on anything within reach. We usually mix their meds with mashed banana and/or peanut butter, but even that wouldn’t convince him to take the Clavulin. Unfortunately, the Baytril did nothing.

    He’s otherwise behaving normally. He eats, drinks, and excretes as usual. He’s more active and social than he’s been in ages, and enjoys the company of the three wee ladies. Coming out for playtime is hard on him because he doesn’t trust himself on the bridge any more. I have to pick him up to bring him out, and he is not nuts about that. He’s happy to be on the bed when he gets there. When he wants to go back, he waits by the bridge and then climbs into my hands. His activities usually involve the rearranging and sorting of nestmaterial, or cuddling with/grooming/being groomed by the ratgirls.

    Our vet has reached out to a specialist and is waiting to hear back. Milo is on Metacam while we wait, but it seems to be making things worse. Maybe it’s reducing inflammation enough that he can poke at it with less discomfort. He’s been digging at his ear enough to either make it bleed or leak porphyrin. Is ear porphyrin a thing? The staining on his neck is dry but still pink.

    We’re considering taking him for a CT scan, but my husband goes in for brain surgery this week. Timing would be tricky. We’d also probably be looking at taking him to Toronto or somewhere that’s not Guelph— the OVC may be great with dogs, cats, and farm animals, but they have become abysmal with rodents and other small fuzzies. Given that Cleo almost died as a reaction to the anaesthetic they gave her (and they missed finding the mass that showed up shortly after) I am reluctant to place another family member in their hands.

    Milo officially reaches Old Man status this week. He’s always been on the neurotic side. Car trips are hard on him on the best of days; the list to starboard is making travel that much more stressful on him. We’re not sure what else is kindest to try.

    I’m a bit worried there’s a mass. We lost a girl years ago when a mass in her ear/nose passage ruptured.

    Has anyone else dealt with an initially unresponsive ear problem? What did it turn out to be? Were you able to finally treat it once you found out what it was? What was the outcome?
     
  2. Oct 29, 2018 #2

    lilspaz68

    lilspaz68

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    If you think it's an inner ear infection you could add zithromax to the baytril. Bleeding from the ear doesn't sound good though,can you get a q-tip in his ear and see if it's straight blood or there's infection/discharge as well? Any swelling below the ear? Can you use one of those awesome flashlights and look for a tiny mass in the ear canal?
     
  3. Oct 29, 2018 #3

    SqueakingJellybean

    SqueakingJellybean

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    The vet can’t see far enough into his ear canal to see if there’s a mass. She didn’t see any discharge the last two times we’ve been in, and I don’t have the kind of flashlight you’re talking about. She hasn’t been able to detect any swelling below the ear.

    I think what might be going on is much the same thing that happens when you give a dog pain meds post-surgery— there’s no pain, they feel fine, so they run around like happy idiots when they’re supposed to be resting. If Milo is in less discomfort because of the Metacam, he may be in less pain when trying to have a really good ear scratch and inadvertently hurt himself.
     
  4. Oct 29, 2018 #4

    lilspaz68

    lilspaz68

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    those little LED tiny flashlights from Dollarama work fantastic when you need a good look at home.
    A ear polyp would be close-ish to the surface
     
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  5. Oct 30, 2018 #5

    Lise Patterson

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    Squamous cell carcinoma often affects of the base of the ear or ear canal area (see here http://ratguide.com/health/neoplasia/squamous_cell_carcinoma.php). I had an old rat suffer from this kind of cancer, but for a long time the vet thought it was just a very ugly infection. When finally diagnosed, there wasn't much we could do - it's a rather grim diagnosis, so I hope it doesn't apply to Milo.
     
  6. Nov 2, 2018 #6

    jorats

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    My sister had a boy like that, it ended up being a tumour deep in the inner ear, pushing up into the brain.
     
  7. Nov 3, 2018 #7

    SqueakingJellybean

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    We’re picking up a new antibiotic for him today. If this doesn’t work, the vet will start exploring other possibilities.
     
  8. Nov 15, 2018 #8

    SQ

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    how is he doing?
     
  9. Nov 15, 2018 #9

    SqueakingJellybean

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    He’s doing a bit better, though still not all the way healed. The vet is sending out a swab for culturing. This should tell us more about what’s going on, if it can be treated, and, if so, how.

    The wee ladies had their first trip to the vet; they came along as company for Milo, and to get them used to going in the carrier and coming home. In the space of about fifteen minutes, they destroyed the inner wall of the carrier. We’ve replaced it with a hard shell carrier and a stern talking-to, the latter of which was about as effective as you’d think.
     
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  10. Nov 15, 2018 #10

    SQ

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  11. Nov 15, 2018 #11

    SqueakingJellybean

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    We tried Clavamox and Baytril concurrently. He refused to even swallow the Clavamox.

    He's currently on Sulfadiazine. It seems to be helping some. We'll be able to tailor the treatment a bit more once we get the culture results back.
     
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  12. Nov 16, 2018 #12

    lilspaz68

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    For myself with persistent inner ear infections I had a culture and sensitivity test done and was able to determine the bacteria and used baytril and zithro with success.
     
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  13. Nov 17, 2018 #13

    SqueakingJellybean

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    The culture came back. It's a Corynebacterium. Doesn't respond to what he's on now; since he's been showing improvement, the vet thinks there are two different elements at work. Whatever is going on with his inner ear has been affected by the Sulfadiazine. The outer ear will require a course of Doxycycline. We've got him on a bit of Metacam for the inflammation as needed. It didn't seem to help much prior to the Sulfadiazine, but it might help a bit more now. He's having a rough night. Hopefully we'll be able to start him on the Doxy tomorrow.
     
  14. Dec 2, 2018 #14

    SqueakingJellybean

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    Well, the outer ear infection is cleared and he's not digging at his ear any more. Now there's a swelling below his ear. We're thinking it may be a Zymbal's gland tumor. On the other hand, he may just need another round of Sulfadiazine in case the inner ear infection isn't completely cleared up. His ear canal is completely blocked and the scab seems to get a little bigger each day. If it's not a mass, it might be trapped blood or a cyst/abscess of some kind that's leaking fluid more slowly than it's accumulating.

    I'll be talking to the vet about pain meds on Monday. We might not need to be doing palliative care yet, but it couldn't hurt to start. She's said there's not much else we can do without advanced imaging; even then, that article linked above doesn't leave a body with much hope. She's treating a wee guy with a Zymbal's gland tumor right now, and it just seems like a long and painful process that will only prolong the inevitable.

    Milo is a neurotic little old man. Schlepping him to Guelph for imaging and thrice-weekly debridement would be cruel and unusual, and that's if he survived the imaging (or if they even got it right-- they missed a tumor on Cleo and almost killed her with their sedation procedure). We're giving him soft food and keeping him as comfortable as possible while we monitor his condition. He's still pretty social and he comes out a fair amount, but he's having a really rough night. For the first time in a couple of weeks, he opted to stay inside instead of coming out for evening zoom time.

    His condition is wigging the girls out a little-- they're a bit better now that he's not bleeding everywhere, but they're still worried about him and are just a touch porphyriny on and off due to that stress. We're trying to make sure they have more out time than usual if they want it, but I'm not sure what else we can do to help them deal with their friend's illness. Any suggestions are welcome.

    Our wee guy isn't well and my heart hurts for him. He's had a crap year.
     
  15. Dec 2, 2018 #15

    jorats

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    Poor little man. I would try another round of antibiotics as well..some of those infections can be extremely stubborn.
     

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