Ripped open incision from removed abscess (GRAPHIC PHOTOS)

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Monkey
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Ripped open incision from removed abscess (GRAPHIC PHOTOS)

Post by Monkey » Mon Nov 11, 2013 7:32 pm

I took in a boy who was found inside of a wood working shop. He had a broken arm, a broken leg, and a huge abscess from one arm, across his chest, up his other arm, as well as a few open gashes. The abscess had been left for so long that it had completed hardened. He went in for surgery on Wednesday (Nov. 13th) and the vet tried to remove as much of it as she could. She said it was impossible to get it all, she was literally scraping it off of his arm and his ribs. She also said since the tissue was so incredibly infected, it was impossible to tell if it was a very infected tumor - or a very infected abscess that had been left for a very long period of time. Well, he is on Cephalexin and two types of pain medication, and he is trucking around like a little champ! However, he ripped open the incision on his chest and it is now gaping and smells terrible. It also looks as if nothing was removed from inside of there. :shock:

From before the surgery:
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After the surgery:
The incision on his shoulder:
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The incision on his chest:
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acapae_wolf
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by acapae_wolf » Mon Nov 11, 2013 7:40 pm

I would go for a strong abscess-hitting AB combo of drugs, rather than just cephalexin. The ones best regarded for this are co-amox (penicillin type), clindamycin (brand Antirobe) and metronidazole (brand Flagyl). These are all suitable to be applied topically rather than just orally - which can be useful if the abscess is encapsulated as chances are the blood supply isn't so great, so the drugs have a harder time getting to where they're needed :luck:
Last edited by acapae_wolf on Mon Nov 11, 2013 7:41 pm, edited 1 time in total.
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Maltey
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Maltey » Mon Nov 11, 2013 7:40 pm

I've found that if abscesses don't get completely cleared they are pretty quick at filling up. My guess would be that since the abscess is no longer closed since she scraped it out it's now just leaking everywhere.
I would take him back to the vets, put him on a course of ABs, have her drain it again and do regular flushes at home.
What I'd personally do but I suspect others will have better, more educated advice.
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Monkey
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Monkey » Mon Nov 11, 2013 7:51 pm

Thank you both so very much!
acapae_wolf wrote:I would go for a strong abscess-hitting AB combo of drugs, rather than just cephalexin. The ones best regarded for this are co-amox (penicillin type), clindamycin (brand Antirobe) and metronidazole (brand Flagyl). These are all suitable to be applied topically rather than just orally - which can be useful if the abscess is encapsulated as chances are the blood supply isn't so great, so the drugs have a harder time getting to where they're needed :luck:
Can I give orally and topically?

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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by acapae_wolf » Mon Nov 11, 2013 8:07 pm

Monkey wrote:Thank you both so very much!
acapae_wolf wrote:I would go for a strong abscess-hitting AB combo of drugs, rather than just cephalexin. The ones best regarded for this are co-amox (penicillin type), clindamycin (brand Antirobe) and metronidazole (brand Flagyl). These are all suitable to be applied topically rather than just orally - which can be useful if the abscess is encapsulated as chances are the blood supply isn't so great, so the drugs have a harder time getting to where they're needed :luck:
Can I give orally and topically?
Amzy's now making me question whether Flagyl can be given topically rather than just orally... I'm sure I've used it that way before, but now I'm doubting my memory :? The other two can be anyway. I'd discuss dosing (amounts and methods) and such with your vet though. One of the main side effects from them can be nausea, which vets often state as a reason not to prescribe, but on the other hand, having a whacking great abscess (or several) is probably going to be doing similar anyway. But just advance warning so you have time to prepare a counter-argument to that should it come up. I'd rather have a targetted AB combo and have to work a bit with tempting foods to start with than a singular more general AB given the severity :)

Definitely agree with twice daily flushing and getting your vet to help as much as possible to start with too. In terms of what you use to flush with, saline and Hibiscrub (unless you want a vat it's often cheaper to buy through your vet) are generally the best things to use. And then you can also use Gold Label brand purple spray as a longer lasting antibacterially thingy on top once you're done flushing. The main thing is to get all the pus and not let the wound heal (and from the inside) until there's only healthy pink flesh left as otherwise the cycle will just continue.
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Monkey
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Monkey » Mon Nov 11, 2013 8:19 pm

Thank you! :dumbogirly: Well, my vet is pissing me off. At first they told me to just give TMP/SMZ. I said no. Then they said only Baytril. At which point I just gave Cephalexin myself. I just called the vet and asked for the drugs you recommended and they said "Well that's up to the vet..."

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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by acapae_wolf » Mon Nov 11, 2013 8:44 pm

What's TMP/ SMZ?
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Stovokor » Mon Nov 11, 2013 8:45 pm

acapae_wolf wrote:Amzy's now making me question whether Flagyl can be given topically rather than just orally... I'm sure I've used it that way before, but now I'm doubting my memory :? The other two can be anyway. I'd discuss dosing (amounts and methods) and such with your vet though. One of the main side effects from them can be nausea, which vets often state as a reason not to prescribe, but on the other hand, having a whacking great abscess (or several) is probably going to be doing similar anyway. But just advance warning so you have time to prepare a counter-argument to that should it come up. I'd rather have a targetted AB combo and have to work a bit with tempting foods to start with than a singular more general AB given the severity :)
Yes you can do regarding Flagyl.

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Monkey
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Monkey » Mon Nov 11, 2013 9:03 pm

Trimethoprim/sulfamethoxazole or co-trimoxazole.

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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Monkey » Mon Nov 11, 2013 9:10 pm

Can you please give me a detailed explanation of how they work together and why he should be on this combo, that I can explain to my vet?

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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by acapae_wolf » Mon Nov 11, 2013 9:46 pm

Monkey wrote:Trimethoprim/sulfamethoxazole or co-trimoxazole.
That's good for UTIs, but not specifically recommended for abscesses.

If your vet isn't willing to try most helpful things (and actually possibly anyway - I initially scrolled very fast over the photos as I can't deal with pus photos :oops: ) then I think the kindest thing is probably pts. It's not the happily ever after option, but he'll have had some time of care.
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Lillyland » Mon Nov 11, 2013 9:51 pm

I'm probably not going to be very popular here, but that looks really, REALLY bad, and must be absolute agony for the rat. The extent of the necrosis that is apparent even in that one picture (never mind what's going on where you can't see it underneath) would very very strongly imply to me that the infection has taken too much of a hold. I can't see how there is enough healthy tissue there for it to heal correctly.
I don't know if anyone here has ever had an abscess, and knows just how bloody much they hurt? :(


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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Tori30 » Mon Nov 11, 2013 10:05 pm

I would be inclined to agree with you lillyland, and I have dealt with a hideous abscess in the past. Stimps had a hige deep open hole in his abdomen next to his penis for weeks, and was resident at the vets for nearly a week having saline flushes and honey dressings etc. But his problem was in a relatively immobile area. Id think with a lack of healthy tissue to knit together and the amount of movememt their shoulders do itd be quite a difficult site to get good healing in. Especially if hea not on appropriaye antibiotics to cover that infection.

If the vet was having to scrape pus of his bones etc thats an incredible level of infection.
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Monkey
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Monkey » Mon Nov 11, 2013 10:44 pm

Yes, euthanizing him was a very realistic option. But - I decided to give him a chance first. I am not going to give up on him quite yet. I am going to try to the combo and see what happens. He has a vet appt. this evening.

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Monkey
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Re: Ripped open incision from removed abscess (GRAPHIC PHOTO

Post by Monkey » Mon Nov 11, 2013 10:48 pm

acapae_wolf wrote: Definitely agree with twice daily flushing and getting your vet to help as much as possible to start with too. In terms of what you use to flush with, saline and Hibiscrub (unless you want a vat it's often cheaper to buy through your vet) are generally the best things to use. And then you can also use Gold Label brand purple spray as a longer lasting antibacterially thingy on top once you're done flushing. The main thing is to get all the pus and not let the wound heal (and from the inside) until there's only healthy pink flesh left as otherwise the cycle will just continue.
I have been flushing with saline, but I cannot get Hibiscrub or the purple spray because I am in the US. I just tried to order it from Amazon UK and they will not ship to the US.

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