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#170281 - 11/11/06 10:06 PM Need some advice about flushing an infected cheek
Anonymous
Unregistered


Hey all,

The swelling in Wally's cheek is back again (third time now). The vet lanced it on Thursday and sent a sample off to be cultured, but it won't be back until at least Tuesday. In the meantime, he is on Medicam for pain (for 5 day) and Clavimox (sp) for an antibiotic (for 10 days) - one the culture comes back the antibiotic may change or be extended. We also have to flush the site with a Betadine solution twice a day and then put some gel stuff in it (removes the damaged tissue - starts with an 'I') for 8 days.

The first night wasn't too bad, but the next morning we couldn't get under the scab to do the flushing. We managed to soften the edge of the scab last night and again this morning and do the flushing, but it definately is stressful for him (and for me - I'm afraid that I am going to hurt him by holding him too tight or cutting off his airflow or blood supply). Right now, I am wrapping him in a towel and then holding his head as still as I can using my thumb and middle finger on either side of his neck and my second finger on top of his head. Gilles is doing the actual flushing and putting the gel into the site.

Any suggestions or tips on what/how we can do this that will be less stressful would be great.

Thanks.

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#170283 - 11/11/06 10:11 PM Re: Need some advice about flushing an infected cheek [Re: ]
Srlb Offline
Glideritis Anonymous

Registered: 10/30/03
Posts: 16745
Loc: St. Johns, Florida
I cant be of much help but on my way to try and find you some.
_________________________
Peggy
Critter Love
Critter Loveģ Diet Center

If you want to know what a person is like, watch how he treats others.

You'll never know what the outcome is if you don't step up and try.


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#170285 - 11/11/06 10:14 PM Re: Need some advice about flushing an infected cheek [Re: Srlb]
Anonymous
Unregistered


Gosh, I wish I could help you, but I haven't had any experience with this kind of thing either. Chris/Gliderz5 has had to do a lot of dental cleanings on her gliders. I will see if I can get her to help.

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#170291 - 11/11/06 10:33 PM Re: Need some advice about flushing an infected cheek [Re: ]
Anonymous
Unregistered


I had to do this with Twinkie awhile back...
I would use a qtip in warm water to soften the scab When I was able to see the edge soften a bit I would use the qtip again in the betadine solution and just kept doing it until the scab fell off. The trick is to keep the scab moist. Not an easy task beleive me.
I also used clavamox for 10 days...It worked.
The way we did it was my hubby held her in a towel and gave her mealies to keep her distracted. I am a big sissy when it comes to holding a animal too tight, SO I know whhat yiu are going through.
It took us about 20 mins the second day after the scab hardened the first time.
Just keep doing what you are doing. As long as the edges are lifting you should be getting some gel under there?
I am sending over Prayers that all goes well and everythign is ok.
One more thing...Sorry...When your vet lanced it open did he take out all the puss that was in there? or just let it drain?

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#170300 - 11/11/06 10:50 PM Re: Need some advice about flushing an infected cheek [Re: ]
Anonymous
Unregistered


Thanks PeeperKeeper, I am hoping that Chris/Gliderz5 can give me some suggestions, but thought that this might be information that others could find useful (and that others might have suggestions as well), so decided to post instead of sending a PM.

Thanks for the info Sissy. Yes, the vet did take all of the puss out.

We just finished treating Wally tonight, and it seemed to go fairly well. Gilles is slowly wetting the site with the Betadine solution until he sees that it is starting to go in the opening, and then he starts flushing it.

We have been giving Wally a mealworm or two after his treatment as a reward (and cutting back on the number of crickets he gets).

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#170308 - 11/11/06 11:03 PM Re: Need some advice about flushing an infected cheek [Re: ]
Anonymous
Unregistered


Wow, sounds like an icky situation! I can't say I know how to make it any easier on you or him though, sorry! It sounds as though you're doing the right things though (from what I'm picturing). (((HUGS)))

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#170334 - 11/11/06 11:41 PM Re: Need some advice about flushing an infected cheek [Re: ]
Anonymous
Unregistered


I went through my history and found my original post plus another one they might be able to give you needed info or even someone with experience.

http://www.sugarglider.net/ubbthreads/ub...=true#Post81955

http://www.sugarglider.net/ubbthreads/ub...true#Post103300

Hope they can help

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#170339 - 11/12/06 12:01 AM Re: Need some advice about flushing an infected cheek [Re: ]
Anonymous
Unregistered


So sorry you are going through this.

Another technique you can try is this:

Thouroughly wet the area with water or normal saline. You can get one of the saline nose drops. They are sterile and the saline will not damage any normal cells present. Or use plain water.

Apply a fairly thick layer of plain neosporin ointment (NO numbing medicine)or triple antibiotic ointment or bacitracin ointment completely coating the area.

Feed treats or just hold him in a towel like a burrito and give him a little massage for at least 10 minutes (maybe 15 if the area is large or thick) Your goal is not to let him disturb the neosporin. You do not have to use the betadine which contains iodine and can irritate the skin.

Firmly wipe off the neosporin with a cotton ball, soft toothbush or gauze pad, whichever works best for you. The scab will come off with the ointment.

You can then express any pus, flush it and fill the pocket with the gel.

The neosporin will hold the water next to the scab and the water and the ointment will soften it. This way you will not damage the healthy tissue around the edges by picking at the edge of the scab. Only the dead tissue that needs to be removed will absorb the moisture and slough off.

Wally is certainly a lucky, lucky suggie to have you.

We will pray for you.

Angel and The Suggies




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#170344 - 11/12/06 12:27 AM Re: Need some advice about flushing an infected cheek [Re: ]
Marz Offline
Glider Guardian

Registered: 09/06/05
Posts: 708
Loc: Melbourne Australia
Hi MinnieMouse. I have recently been through all this myself. Sissy gives good advice about removing the scab. Softening it with warm water and a qtip and gently dabbing at it till it comes away is definitely works. Not a pleasant thing to do but it needs to be done to try and clean out that infection. I just noticed that angelskates has also posted another good idea on scab removing!

When we did this we were advised to actually flush out the infected area with saline (the vet supplied a saline drip bag, a syringe and two needles.)One needle to draw the sterile saline out of the bag into the syringe. Then the other needle is broken off right to the end so its just a stub, and this is used to actually flush the wound. You put the modified needle about an inch away from the wound and then firmly push the syringe. The shortened needle makes the saline flow strong enough into the wound to flush it out. If it's done right, and there is pus there, it will come out. Our glider hated this but it worked in cleaning the area up. We had to put some gauze (tissue) over her nose so she didn't get a nose or mouth full of saline!

Please feel free to email me as I see you mention this is an ongoing issue. Ours was too and we went through many tests,4 different antibiotics, several procedures,xrays, and finally major surgery to fix this issue. Some of my experiences may be beneficial to you in time and money saving.

Cheers Marz ( my email is grum@alphalink.com.au)

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#170357 - 11/12/06 02:05 AM Re: Need some advice about flushing an infected cheek [Re: Marz]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
I have a couple suggestions/questions. First...has he been on Clavamox all 3 times? If so, it's possible whatever is in there is now resistant. Also, you might want to ask the vet to combine that with Flagyl (metronidazole) which is better on anaerobic bacteria, and that is normally what is found in abscesses since there isn't any air in an abscess.

I am assuming this is on the outside of the cheek?

In addition, did the vet look at all the glider's teeth? (not just look, but make sure none of them 'wiggle'?) If this is a tooth issue...it will just keep coming back because bacteria are able to enter through the mouth.

Because of the recurrences, you may also want to extend the course of meds at this point to 21 days-it can take time in an area like that for the meds to penetrate and kill all the little invaders. I hope he starts feeling better soon!
_________________________
Jen/Colin :bb: Commander Riker 12 16 02-10 04 12 you will be FOREVER missed :wfb: Sinbad, :wfb: Gabby, :grey: Baby, and :grey: Alley

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#170368 - 11/12/06 05:00 AM Re: Need some advice about flushing an infected cheek [Re: Xfilefan]
Anonymous
Unregistered


This is a tough task to do i feel for you and the baby Minnie.

I used to work at a vet and i now work as a manager at a petstore we have to treat hamsters gpigs ect. at times

the best way to get the scab off and keep it off is to use a washcloth with a warm wet corner wrap him up in it. until the scab gets loose then take your syringe with betadine and gently put the end of it against the scab where it is loose by now. Slowly push betadine in what you are doing is getting the puss out so that the wound can heal from the inside out that is why the scab must come off so it stays open. keep flushing til you get some blood that means it is cleaned out. by then you should be able if not sooner to wipe the scab off. then put a big dollup of triple antibiotic into the hole to keep it open

if you are doing the antibiotic 3x a day then you must flush it at least that many times so the scab doesnt form

it will heal faster if you keep the scab from forming

my prayers are with you and yours

and good luck

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#170383 - 11/12/06 07:52 AM Re: Need some advice about flushing an infected ch [Re: ]
sugarglidersuz Offline
Glideritis Anonymous

Registered: 08/28/04
Posts: 14788
Loc: Cleveland, Ohio
While recently dealing with my Mareki having a patagium wound, we had to flush her wound with saline twice a day. In order to keep the wound moist, we applied SSD Ointment (ask your vet for some) to the wound multiple times daily. It helped keep the wound moist, prevented scabbing and is also a strong topical antibiotic to help prevent/treat infection. This really worked well and her wound is now completely healed. (She was also on oral antibiotics.)
_________________________
Suz Enyedy
:bb: Carina & Coobah
Allira & Gizmo :grey:
:grey: Picasso, Trinity Joy & Luna
:rbridge: DaisyMae; Darwin; Mareki; Mambo; Pika; Cricky; Reggie & Bobo, Pepe & Bittah


Suz' Sugar Gliders

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#170389 - 11/12/06 08:42 AM Re: Need some advice about flushing an infected ch [Re: sugarglidersuz]
glidrz5 Offline
Serious Glideritis

Registered: 06/13/01
Posts: 7297
Loc: Quincy, IL
I don't know if I'd be any help. I know about rinsing inside the mouth, but I've had no experience in softening a scab so you can flush out under it. It sounds tho like you've got some good techniques to try. Just be sure to give lots of love & treats when he's finished to help calm him down after his "ordeal".
_________________________
Chris
Illusion, Malcom, Isabell, Annabelle, Zach, Isis, Aly & Indy
AND Miss Emmy & Miss Chloe kitties

:rbridge: My Angels: You are always in my heart.

You've flown to the rainbow
and wait there for me
Someday I will join you
together to be



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#170405 - 11/12/06 09:45 AM Re: Need some advice about flushing an infected ch [Re: glidrz5]
BeckiT Offline
Glideritis Anonymous

Registered: 09/29/06
Posts: 16083
Loc: Manitowoc, WI
Suz, that's an excellent idea about the SSD, but I'm not sure it could be used inside the mouth?
_________________________
~Becki & Crew~
Glidin' High Sugar Gliders
So You Want to Own a Sugar Glider? Read and Share wink

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#170416 - 11/12/06 10:07 AM Re: Need some advice about flushing an infected ch [Re: BeckiT]
sugarglidersuz Offline
Glideritis Anonymous

Registered: 08/28/04
Posts: 14788
Loc: Cleveland, Ohio
No, you can't use SSD inside the mouth, however, I assumed this was an external scab. Scabs don't form inside the mouth usually due to the mucus keeping the inside of the mouth moist. My vet did say that if a glider licks the SSD, it won't hurt anything...
_________________________
Suz Enyedy
:bb: Carina & Coobah
Allira & Gizmo :grey:
:grey: Picasso, Trinity Joy & Luna
:rbridge: DaisyMae; Darwin; Mareki; Mambo; Pika; Cricky; Reggie & Bobo, Pepe & Bittah


Suz' Sugar Gliders

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#170448 - 11/12/06 11:04 AM Re: Need some advice about flushing an infected ch [Re: sugarglidersuz]
BeckiT Offline
Glideritis Anonymous

Registered: 09/29/06
Posts: 16083
Loc: Manitowoc, WI
Duh, didn't think of that wink Didn't sleep well last night, so need to go take a nap, lol
_________________________
~Becki & Crew~
Glidin' High Sugar Gliders
So You Want to Own a Sugar Glider? Read and Share wink

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#170545 - 11/12/06 05:34 PM Re: Need some advice about flushing an infected ch [Re: BeckiT]
Anonymous
Unregistered


Thanks for all of the suggestions everyone.

The opening is on the outside of Wally's cheek. I remembered that there had been several posts recently about gliders with teeth issues, so that was one of the first things I thought of when the lump came back again. I brought it up with the vet, and she checked all of his teeth while he was sedated - none loose.

Wally was given Aposulfatrim for the previous two incidence - hopefully the bacteria isn't resistant to the Clavomox (if it is the same bacteria as the first time, it was resistant to about 1/3 to 1/2 of the antibiotics that they would normally use). I will definately be double checking that what we are using is appropriate, and that we treat for long enough - 10 days seems to be their standard duration, once the Culture results are in (hopefully Tuesday), but I will check tomorrow to see if we should be adding a second antibiotic before then.

I am going to show this to Gilles before we do Wally's treatment tonight (this morning didn't go quite as well as the last few - Gilles had a hard time getting into the opening), and I will print out the entire this thread tomorrow morning and call the vet to ask about the various suggestions.

Thanks again, we all appreciate the information, suggestions, and well wishes.

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#170546 - 11/12/06 05:35 PM Re: Need some advice about flushing an infected ch [Re: ]
Anonymous
Unregistered


P.S. The antibiotics and the flushing are prescribed for twice a day.

The gel that we put into the opening is IntraSite.

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#170676 - 11/12/06 11:20 PM Re: Need some advice about flushing an infected ch [Re: ]
Anonymous
Unregistered


A few observations & suggestions:
1. Agree with angelskates that betadine can be a little harsh on newly forming cells. Not bad at the packing - pus stage, but as healing begins it can slow down improvement.
2. I would also use triple antibiotic ointment for two reasons, but suggest perhaps carefully checking out the one WITH the numbing med. The ointment keeps the scab soft and will help keep the wound open and draining. The numbing will help pain and allow a little easier flush. In that location, the one precaution might be to keep the amount used small and wipe away excess. Iíve noted the numbing one allows less grooming at the wound if itís hurting less. If the glider insists on rubbing it off and licking it, then avoid it. But some will leave it alone.
3. Most abscesses are not about drug failure. Opening and draining is the treatment. Adding a second antibiotic can sometimes make things worse and clearly adds to gut flora attack. Some antibiotics interfere with each other. Side story Ė

When penicillin first came out, it was a wonder cure for meningitis, as drug-induced resistance hadnít shown up yet. But although 80% got better, 20% died. Then tetracycline came out and worked 60% of the time, and had a different spectrum of which germs it was good at killing. 60% cure, 40% died. A good thought was to use both, with hopes that what the one med missed the other might get, right? Wrong Ė 100% died. Each med got in the otherís way to work the way it works.

4. An alternative to numbing med in the ointment is to get a little lidocaine in the flush syringe and numb the area with a couple of drops before flushing to provide for more comfort and not worry about the glider licking and numbing the mouth.
5. Most of the facial abscesses Iíve seen were gram + aerobes. Clavamox would be a great first choice. If an anaerobe is found, check the sensitivities to see if clindamycin has activity against the germ. A single med that has good coverage for the bug recovered would be best.
6. But the name of the game is drainage more than med selection. Antibiotics alone rarely fix an abscess.
7. My favorite flush tool is an IV needle. Discard the metal inner needle and use just the Teflon catheter that would be what normally sits in the vein. Itís soft and bendable, and you are less likely to poke an eye or tissue that would hurt. Once something like that happens, the next irrigation will not go as well.

Good luck.

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#171234 - 11/13/06 09:48 PM Re: Need some advice about flushing an infected ch [Re: ]
Anonymous
Unregistered


Hi all,

We got the culture results back and only one bug (I'm going to get the vet to write it down for me so that I get the name right), and it is sensitive to the Clavomox, so we don't have to change the meds. It is a different strain of the same bacteria that was cultured the first time (which I looked up and was in April 2005). The vet agreed to extend the antibiotic to 12 days from 10, and then re-evaluate.

This morning I soaked a makeup removal pad in warm water and put that against the opening for around 30 seconds and then waited another 30 seconds or so. Gilles said that it made it a lot easier to get into the opening, so we will continue doing that.

Wally is acting normal (or at least as normal as a lonely glider can) so that is a good sign.

Thanks again for all of the suggestions and information. I'll keep you posted on Wally's recovery.

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#175601 - 11/23/06 01:14 PM Re: Need some advice about flushing an infected ch [Re: ]
Anonymous
Unregistered


Thought I would give everyone an update.

Wally had his post-treatment check last night, and the vet is very happy with the improvement and doesn't think that we need to extend the antibiotics anymore (he was on them for 12 days).

He has lost some weight (down to 65 grams - he had been maintaining around 70 grams), but his activity level is back up and he is playing again. Now to get him a new girlfriend.

Thanks again everyone. thanks

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#175608 - 11/23/06 01:54 PM Re: Need some advice about flushing an infected ch [Re: ]
Anonymous
Unregistered


hug2 Thank you for the update, I'm so happy that he is getting better smile Sending lots of wishes that he gets his weight back to normal very soon.

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#175609 - 11/23/06 01:56 PM Re: Need some advice about flushing an infected ch [Re: ]
Xglider Offline
Glideritis Anonymous

Registered: 01/18/05
Posts: 11157
Loc: Tampa, FL
Glad to hear he is doing better...
_________________________
* ~ * John * ~ * Sorry store is closed at this time.. <br>
Link -> ~~ XtremeGlider ~~ Home of the original Re~set Toys! ~~ <br>
Oct 2012 update.. miss my gliders and my
glider family and think of my friends often!!!

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#175645 - 11/23/06 06:21 PM Re: Need some advice about flushing an infected ch [Re: Xglider]
BeckiT Offline
Glideritis Anonymous

Registered: 09/29/06
Posts: 16083
Loc: Manitowoc, WI
thank you for the good update! Hope you find him a girl he likes, what a Chistmas gift that would be for him smile
_________________________
~Becki & Crew~
Glidin' High Sugar Gliders
So You Want to Own a Sugar Glider? Read and Share wink

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