Non-healing skin lesion - Update Feb 16/12

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Joanne

Joanne

Well-Known Member
Joined
Jan 5, 2009
Messages
11,989
Location
Nova Scotia, Canada
OK, some background info:
Hotch was rescued in the summer and was intro'd to my group starting in August. He got a scratch on the inside of his left leg at that time. In Sept I noticed that it still wasn't healed so started treating the area:
Sept 6 - started on Clavamox and Polysporin (Polymxin B Sulfate, Bacitracin Zinc, Gramicidiin & Lidocaine)
Sept 16 - no improvement noted. Topical treatment changed to Canesten (antifungal). Clavamox continued.
Sept 24 - no improvement noted. Topical treatment changed to BNPH (Neomycin & Polymyxin B Sulfates, Bacitracin & Hydrocortisone Acetate). Clavamox continued.
Oct 1 - two new areas cropped up on the same side.
Oct 3 - no improvement noted. Cephalexin added to Clavamox. BNPH continued. Started with 3% Benzoyl Peroxide Shampoo Mon/Wed/Fri, soak for 10 min.
Oct 7 - two newer sites seem to be healing (?). No improvement noted on initial site.
What the heck do I try now???
Pictures from tonight:
P1010389-HotchOct072011-1.jpg

P1010392-HotchOct072011-1.jpg
 
Not sure about what meds would be best, but have you treated for parasites? I think most people give an anti-inflammatory (usually Pred but my mice were prescribed Metacam for their dermatitis) for pyoderma as well as abs.
 
Is he bothering with it? Is he always trying to clean it or does he leave it alone. It hasn't grown? Just stayed like that. Wow...that is just bizarre. I'm shocked the Clavamox didn't help. You could try Bactrim/Septra, it's a really good med for dermal issues.
 
I did treat everyone with Revolution just in case.
He does not seem to be at it all the time.
I have considered doing a biopsy and even an excision, but I am worried that the wound wouldn't heal and then the site would be even bigger. I am going away next weekend and he will be at my friend's place for 4 days so I didn't want to do anything surgical in case there were problems. (She is great but inexperienced with treating medical issues in rats.)
The Metacam I could give him, but he doesn't seem to be in any pain unless I am touching the area applying meds.
I have not tried Baytril yet. I also have some Doxy on hand. Perhaps a Baytril/Doxycycline combo?
Should I give the Cephalexin more time to work? It has been 5 days.
I also have Prednisone on hand, but I am worried that if it's an infection it will just make it worse.
 
This is s tough one. I want to say pred but then if he's got an internal infection going on, it wouldn't be wise to use pred.
What does your vet suggest at this point?
 
My vet feels that I know more about rats than she does!!! LOL See what hanging out on the Shack will get you ;)
She thinks we should do a biopsy/excision and send it off. I am all for that except that I am going away this weekend and he will be with a relatively inexperienced baby sitter, so I don't want to leave him with a fresh incision. I did switch him over to Baytril/Doxycycline to see if a change in antibiotics will make a difference. That was on Saturday, so it's too soon to really tell. If it looks like it's healing when I come back, I'll just keep him on the current meds. If not, we will do surgery. Keep your fingers crossed that the Baytril will help!
 
Still there - Can you say ridiculous?
Do you think I should get the area excised? I'm worried that if I do, the skin won't heal properly and then there will be a gaping hole in his leg.
Would swabbing it or scraping it get enough material to be useful?
 
That's a tough call. It could very well delay any healing but from the sounds of it, it's not healing at all anyway. I probably would have biopsied but I don't think a simple scraping is enough. They will need the tissue.
 
Joanne said:
Ug, the stress! Poor Baby Boy.... he just can't catch a break. I will do the excision and pray it heals...
Click to expand...

Does your vet recommend this? Even though he claims you have more rat knowledge, he can still draw on his experience with the bigger animals too.
 
I would try a round of Baytril myself. That seems to be the wonder drug of the world in my house. I've always had good results with it. Not always fast results, but the outcome has been good. Keep us posted.
 
Maple said:
I would try a round of Baytril myself. That seems to be the wonder drug of the world in my house. I've always had good results with it. Now always fast results, but the outcome has been good. Keep us posted.
Click to expand...
I switched out his antibiotics - he has been on Baytril and Doxycycline since October 8th. The only thing that seems to have made any difference is the Pyoben shampoo, and since I was away for a few days, he did not have a bath for six days, and any gains we may have made are gone. It seemed to have cleared up the little extra spots, so I'm hopeful that it will help the bigger area. I do a full bath because I worry that he may have other little areas that I haven't found yet and I don't want them to get out of hand. I never catch him digging at it, so I don't think it's self-mutilation. I am just really worried that if we do surgery and excise it, that instead of having a sore he will have an actual hole in his skin. Ug! I know, I know - indecision kills... LOL
 
Joanne said:
Maple said:
I would try a round of Baytril myself. That seems to be the wonder drug of the world in my house. I've always had good results with it. Now always fast results, but the outcome has been good. Keep us posted.
Click to expand...
I switched out his antibiotics - he has been on Baytril and Doxycycline since October 8th. The only thing that seems to have made any difference is the Pyoben shampoo, and since I was away for a few days, he did not have a bath for six days, and any gains we may have made are gone. It seemed to have cleared up the little extra spots, so I'm hopeful that it will help the bigger area. I do a full bath because I worry that he may have other little areas that I haven't found yet and I don't want them to get out of hand. I never catch him digging at it, so I don't think it's self-mutilation. I am just really worried that if we do surgery and excise it, that instead of having a sore he will have an actual hole in his skin. Ug! I know, I know - indecision kills... LOL
Click to expand...

If its not really bothering him, then I wouldn't excise. Can you just do a biopsy instead of a removal?
 
lilspaz68 said:
Joanne said:
Maple said:
I would try a round of Baytril myself. That seems to be the wonder drug of the world in my house. I've always had good results with it. Now always fast results, but the outcome has been good. Keep us posted.
Click to expand...
I switched out his antibiotics - he has been on Baytril and Doxycycline since October 8th. The only thing that seems to have made any difference is the Pyoben shampoo, and since I was away for a few days, he did not have a bath for six days, and any gains we may have made are gone. It seemed to have cleared up the little extra spots, so I'm hopeful that it will help the bigger area. I do a full bath because I worry that he may have other little areas that I haven't found yet and I don't want them to get out of hand. I never catch him digging at it, so I don't think it's self-mutilation. I am just really worried that if we do surgery and excise it, that instead of having a sore he will have an actual hole in his skin. Ug! I know, I know - indecision kills... LOL
Click to expand...

If its not really bothering him, then I wouldn't excise. Can you just do a biopsy instead of a removal?
Click to expand...
I would assume that the biopsy will be full-thickness so instead of bringing together bad skin and bad skin, wouldn't it be better to remove it all so that at least the healthy skin is approximated? Wouldn't that give it a better chance of healing?
 
Joanne said:
lilspaz68 said:
Joanne said:
Maple said:
I would try a round of Baytril myself. That seems to be the wonder drug of the world in my house. I've always had good results with it. Now always fast results, but the outcome has been good. Keep us posted.
Click to expand...
I switched out his antibiotics - he has been on Baytril and Doxycycline since October 8th. The only thing that seems to have made any difference is the Pyoben shampoo, and since I was away for a few days, he did not have a bath for six days, and any gains we may have made are gone. It seemed to have cleared up the little extra spots, so I'm hopeful that it will help the bigger area. I do a full bath because I worry that he may have other little areas that I haven't found yet and I don't want them to get out of hand. I never catch him digging at it, so I don't think it's self-mutilation. I am just really worried that if we do surgery and excise it, that instead of having a sore he will have an actual hole in his skin. Ug! I know, I know - indecision kills... LOL
Click to expand...

If its not really bothering him, then I wouldn't excise. Can you just do a biopsy instead of a removal?
Click to expand...
I would assume that the biopsy will be full-thickness so instead of bringing together bad skin and bad skin, wouldn't it be better to remove it all so that at least the healthy skin is approximated? Wouldn't that give it a better chance of healing?
Click to expand...

Can you take another pic for us?
 
Picture from today - it's hard to get a good shot because he's squirmy!

P1010454_1.jpg


P1010454cropped_1.jpg


It looks virtually the same as it has for almost two months now...
 

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