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#82827 - 02/11/06 08:10 PM Swollen Head, unsure if in jaw or behind eye
Anonymous
Unregistered


I've got a female glider who is around 5yrs old. In the last 3-4 days one side of her head has become severely swollen. Almost as if she has a cyst or infection in the back section of her jaw area.

The swelling is behind her eye and causes the entire side of her head to be deformed and her eye to pertrude out. As if she took a major fall from the top of the cage to the bottom and now has a goose egg.

She doesn't seem to have any problems from what I can tell with eating, which makes me think that it may not be in the jaw. But not ruling it out either.

She is still active as normal when out having a run about the living room, but in the cage she has been staying in the nest a bit more than normal. I've rubbed the area and she doesn't seem to mind so either it doesn't hurt or it feels good, but it doesn't cause to much pain otherwise she would shy away from it and protect it more than she does.

I did have a similar experience with a male glider a while back, but not this severe and the swelling only lasted a couple of days.

So the question is has anyone else experienced this? If so what was the cause and the cure?

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#82828 - 02/11/06 08:21 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
Infections that start in the jaw or gums frequently present as swelling in the side of the face/head, and can put pressure behind the eye, making it bulge. At its worst, it can infect the eye itself, necessitating removal if enough damage is done. I have a 3 year old male I have gone thru this with three times.

First, the vet should take an Xray, to see whether the infection has spread into bony tissue. I will attach a pic of Riker's Xrays...it shows two views...one looks almost deformed, because of the diffusion of the Xrays as they passed thru the infected bony tissue. The other is normal and symmetrical.

His treatment, to clear it, was 6 weeks of both Clindamycin and Metronidazole, to cover all possible infective agents, with another 6 weeks beyond that of the Clindamycin-a total of 3 months treatment. His 2 courses prior to that did not eradicate it...if the infection is in the bony tissue, it is extremely difficult to eradicate. Riker also presented with swollen cheek and bulging eye.

Urine and Fecals will do nothing to identify whether infection is present in this case. IF the vet can get a sample, if there is a defined pocket of infection or fluid, have them do a Culture and Sensitivity..C&S...to identify the bacteria so treatment can be targeted. Sometimes that isn't possible, if the infection is diffused within the tissue like in Riker's case. Either way, start the above meds while waiting for the results, so healing can start..meds can be changed later upon the results of the C&S, if necessary. If a sample cannot be obtained, just go with the above. MINIMUM 4-6 weeks...go longer if all symptoms have not been gone completely for at least a week by the end of treatment.

Just a sec, and let me go find the pic of Riker's Xrays...I'll attach it in a reply. Good idea is to print this and the pic and take with you for the vet to reference. Be Right Back.
_________________________
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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#82829 - 02/11/06 08:29 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
Okay..I can't find the one I want with both Xrays in the same pic for comparison, so I'll post them both.

First Xray-not normal-Infected bones in head
(See Attachment)


Attachments
530137-RikerXray110104NotNormal.jpg (76 downloads)

_________________________
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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#82830 - 02/11/06 08:32 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
Pic 2..Symmetrical. This is how it should look.

Also, since you have had issues with this before..are you feeding them any hard foods? Dry pellets, nuts, hard dried fruits, breakfast cereal, etc? ...all of these can cause tiny scratches in the gums that can allow bacteria entry and lead to this type infection. If so, I'd recommend eliminating them. Although there are other things that can cause these, these are the avoidable risk factors.


Attachments
530141-RikerXray111504Normal.jpg (54 downloads)

_________________________
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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#82831 - 02/12/06 06:02 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


thanks for the info Xfilefan. I've printed this off and will take it to our vet along with the glider. It will save us from having to take a 2.5hr trip to a exotic small animal vet and a higher bill. Instead we can see our local vet and get the meds from him with a smaller bill.

thanks,
Joe

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#82832 - 02/13/06 02:15 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


Good post, Jen.
I agree that UA, Urine cultures and fecal smears are not the work-up for facial swelling. A few quick points I'd add:
1) Soft tissues infections are not as difficult to eradicate as when there is bony involvement. It isn't necessary (or even likely) that every case of infectious facial swelling has become osteomyelitis and invaded bone.
2) Very long courses of meds aren't for everybody and every situation.
3) Meds that didn't work in one glider's infection one time are not necessarily ineffective the next time. It depends on the germ cultured.
4) An abscess needs to be drained. That has two huge benefits. Debulking the infection into which the meds are not likely to penetrate, and getting a sample of the germ to determine exactly which med is best. To not culture and guess at what the germ is and then guess at treatment makes for a more difficult cure. Then bony involvement might occur.
5) Incision & drainage followed by a course of antibiotics is the best treatment for an abscess. Facial abscesses around the eye are especially tricky in that they are in a bad location, and can quickly progress to worse things.

Good luck.

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#82833 - 02/13/06 10:20 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


Ok while I'm waiting for the vet appointment this after noon (UK time, 5hrs ahead of EST)I've been looking up info on the two drugs recommended and have a question. How is this given to the glider? The reason I ask is she is currently in a cage with 3 others, so if by food or water I'm going to have to seperate her. If by injection then this should not be a problem. My wife holds training that is equal to that of a vet assistant in the US.

She has grown worse in the last 12-18hrs to being dehydrated, I'm nursing her with gliderade about every 30-45 minutes at the moment. Her entire head now is showing signs of swelling. Doesn't appear that she has eaten much of anything last night. Making it worst is that the male decided he needed a bit of bed action by mating with her all night, which I'm sure has stressed and weakened her more.

Anymore info on this would be appreciated.

thanks,
Joe

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#82834 - 02/13/06 11:12 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
glidrz5 Offline
Serious Glideritis

Registered: 06/13/01
Posts: 7297
Loc: Quincy, IL
All of the medications that I have given my gliders have been oral medications. I would measure the correct dosage in a 1cc syringe & squirt it in the gliders mouth. Jen (xfilefan) gave some good directions on how to do this here
_________________________
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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#82835 - 02/13/06 11:47 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


If your veterinarian wants to give an injection to boost the med levels at the beginning, that is not a bad idea. Usually oral meds are given as gliderz5 noted. Entire head swelling is concerning, as meningitis and sepsis can complicate such an exposure. I like Clavamox for this initially, pending germ identification from the cultures. The amoxicillin component penetrates the CNS well. If resistant bugs are found, then med change is in order. Good luck.

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#82836 - 02/14/06 12:46 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
glidrz5 Offline
Serious Glideritis

Registered: 06/13/01
Posts: 7297
Loc: Quincy, IL
Sorry about forgetting injections but "I" can't give those, I have to go into the vets office for that, so I was sticking strictly with medications that I can give at my house. But you're right, my vet will usually give an injection to jump start the process & when my gliders have been very ill such as Sassy after his dental surgery he had to go in every day for about 5 days for injections & sub-q fluids.
_________________________
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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#82837 - 02/14/06 08:01 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


well we went to the vet and whe was given a injection of Marbocyl and a secondary injection anti-inflamantory. Unsure of the size of the injection as both had been mixed with fluids to hydrate her.

We was given 5 days worth of Marbocyl to give oral at .07ml once per day.

She was active last night as we continued to give her glideraid.

As for a food supplement last night, as she is not able to chew very well, we mixed up a paste of glideraid, apple & pear sauce baby food, bit of honey and apple juice. Which she lapped at through out the night.

I used our brooder (as seen made with the aquarium heater and two plastic cages, I forget which website it is on, but most here should know which one I'm on about). She slept for most of the night untill about 4am when she decided to come out of the nesting material and wanted to have a jump and crawl about waking me up wanting out.

Even though I had added a water bottle with glideraid I still gave it to her direct from the syrenge and she crawled back into the bedding and curled up.

Then around 9:30 this morning I took her out of the cage and she was active as normal having a good run about the room. After about 30 minutes she came back to me and crawled into her nesting pouch which I carry around my neck, did a bit of cleaning and for the last 3hrs has been asleep.

So it looks like she may pull through it all, her head is still swollen, but looks like the kick start of the meds may have put her back onto the road to recovery.

Getting certain medications here in the UK can be hard, even for vets. The drug laws here are some of the strictest in the world. One of the reasons that many drug companies from around the world use the UK as a place of research insuring that drugs meet high standards.

I'll keep this updated to let you know how things progress.

Oh and as for the "love bites" on the back of the neck thanks to her male, those had a coating of neosprin ointment to help make sure they don't become infected while she recovers.

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#82838 - 02/23/06 10:11 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


Just a follow up on this to bring it up to date.

So far our glider is still alive, she is having good days and bad days it seems. The main swelling in the jaw and behind the eye has gone down. This is mainly due to the fact that last Friday the abscess ruptured and relieved the pressure. The bad news is that the rupture has occurred on top of her head. We gently massaged it each night when we gave her the antibiotic (which she is still on). Using Q-tips and warm water we tried to keep it drained best we could. Basically the entire scalp built up so much pressure it pulled away from the skull. She was looking like Yoda. The problem though with this is that her scalp begining to act like that of a large blister. Festering up during the day and needing to be drained nightly. After a few days of us cleaning it we left it be as we was afraid we was going to make it to tender.

The next part is where we are now entering into a secondary infection it appears. With the scalp acting like a blister she has picked at it and revoved a portion of it leaving it raw and exposed. It has also begun to have a very strong smell. No blood has been shown, and no darkening of the skin, so we know it is not dying off. I think the smell may be coming from her scent gland being more exposed than it normally would be. She has always had a exposed scent gland in her head and chest compared to our other females, so I'm hoping it is just that by it being exposed more this is where the smell is coming from.

We still have her kept in a seperate part of the house so she can not hear the other gliders at night or smell them. To keep her from being stressed out anymore than she already is.

We let her out to run about and play which she does, but then comes back after a short time to make a nest either in her temporary cage or up under the covers if we are in the bed. Of course she gets put back into her cage, so we don't roll over and crush her at night.

I'm taking her back to the vet on Saturday to see if we can put her to sleep long enough now to examine her more closely. Two weeks ago when we went she was so weak we was afraid she may not recover so we did not risk it. Last week with the rupture of the abscess we was hoping to be in the clear with it drying up and healing, but this week with it seeming to be getting worse again, we may have to switch to a stronger antibiotic. Hopefully Saturday will reveal what is causing the infection and we can resolve it. I noticed tonight she is once again having some difficulties eating solid foods, which confirms that she is taking a downward slope again.

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#82839 - 02/23/06 10:28 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
If the vet can get a sample of the fluid that's draining from the wound, and do a C & S (culture and sensitivity)..that could be very beneficial. It could help target the specific invader. She may just be on the wrong med at this point, or the "bugs" have developed a resistance. An antibiotic injection to give a boost to the oral meds might help, too. If she's having difficulty eating, might I suggest feeding her whatever she likes..just to get food in her..temporarily. Sustagen is an option for vitamins as well-most gliders really like it, and they only have to lick it so it's easy to eat. Even people food would be preferable to nothing at this point, as long as something is going in.

What med is she on now? If a resistance is possible, you may want to change to something like Clindamycin until the C & S results come back...it's one of the strongest broad spectrum antibiotics I know of.

An ecollar might also be an option...to keep her from getting at the wound and making it worse.

Thank you for the update, and be sure and let us know what the vet has to say. <img src="/ubbthreads/images/graemlins/hug2.gif" alt="" />
_________________________
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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#82840 - 02/23/06 10:35 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
the gliders angel Offline
Glider Addict

Registered: 08/08/01
Posts: 3058
Loc: u.s.a.
i also advise a culture and sensitivity of her urine to make sure its nothing as far as bacteria on the inside either.

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#82841 - 02/23/06 11:15 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


getting a sample will not be hard to do at all of the fluid. It is a white/yellowish liquid. Not a goo, but a free flowing liquid. By just gently dampening the top of the head opens up a number of small pin holes that have formed allowing the fluid to escape.

She is still on Marbocyl oral at .07ml once per day.

Clindamycin is not a drug used here within the UK on a normal basis. I believe it can be obtained, but not easily. As noted in one of my earlier post the UK has some of the highest drug standards in the world. At times this is good, at other times when we know of a certain med in the US (or other country) that would work, it becomes a major pain in the backside.

As for the collar, my wife thought about this, but decided it would do more damage than good. The reason being is that the scalp is pulled away from the skull nearly all the way back to where the neck starts. You can feel this when I was massaging the area the other night. The skin has become weak and thin. Best way to describe this is to think of a blister being wet all the time and how easy the skin tears.

We know that when we put the collar on she is going to begin the backwards crawl followed with the four feet pushing against it... even though she isn't super strong, i would say she is strong enough to literally push the collar off and tearing the scalp away with it since the skin is so thin and weak.

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#82842 - 02/23/06 11:19 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Xfilefan Offline
Serious Glideritis

Registered: 02/22/03
Posts: 8899
Loc: Jacksonville, FL
Well, it was a thought. <img src="/ubbthreads/images/graemlins/ohwell.gif" alt="" /> I know you're doing all you can for the little girl. All our hopes and prayers they find what's wrong and she gets better! <img src="/ubbthreads/images/graemlins/hug2.gif" alt="" />
_________________________
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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#82843 - 02/24/06 08:05 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


I would definatly get the vet to check her again! The spot on her head is sounds terrible and its getting worse! I would also suggest baytril-its and antiflamtory antibiotic.Its another common broad spectrum antibiotic that our vets here use alot.

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#82844 - 02/24/06 08:17 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Dancing Offline
Glideritis Anonymous

Registered: 09/10/04
Posts: 22746
Loc: 80 acres of paradise in KS
Metacam is a pain reliever/anti inflamitory medication that may be of benefit. I bet she hurts, poor baby!


Scent glands on her head and chest? I have 15 female gliders here in the house and not one has a scent gland on her head or chest. Are you sure She isn't a HE?


Edited by Dancing (02/24/06 08:18 PM)
_________________________
620-704-9109
Judge not until you have walked in their shoes and lived their lives. What you see online is only part of the story.

I could have missed the pain
But I'd of had to miss the dance


The soul would have no rainbow if the eyes had no tears.

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#82845 - 02/25/06 02:44 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


Female gliders do have a scent gland in both the head and chest area. It is not normally very prominant though. I have 30 gliders in over 6 colonies and a couple of our females show them, more so than others.

Trust me this one is a female, she has had 8 joeys.

What makes her very unique is when she is out of the cage she rubs against you as a male glider would to scent. She is the only one that does this out of all our gliders. She is also the most friendliest out of all of them as well.

Off to the vet though now to see what we can find out and get her some new meds to help with the pain and inflamation. She is much stronger now and should tolerate being put to sleep to allow more thorough exam than last time.

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#82846 - 02/25/06 06:33 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


Ok back from the vet now. We are going to continue the same treatment for the meds as w have been doing for the last two weeks. She is looking alot better this morning as well... typical.

The smell is coming from the puss between the scab and the flesh on her head. The abscess itself has gone away. It's just the healing part to do now which is going to take some time.

While tempting to remove the scab from the wound, due to her size you would be looking at removing a large part of the scalp and leaving to much exposed flesh open for her to pick at and become infected or inflamed worse than what it is now.

If the scab doesn't begin to flake away and shrink over the next 3-4 days we will begin to pick at the edges a bit and try to wash out from under it with iodine using a syringe. This should keep it clean and help promote it to heal faster.

The vet advised not to put any ointment on it like neosporin. Just leave it as it is for now.

Stopped by the pet store on the way back home and picked up a couple of larger clear plastic boxes and will create a larger enclosure for her now, rather than her being cramped up in a small critter carrier that we normally use as a brooder. So that will be a task for tonight. I'll have to come with a way to put her wodent-wheel in this one so she can exercise more as well. I've got to trim her nails tonight as well, she is having a extremely difficult time crawling on the carpet, shirts, or any fabric material. The claws are curving back since she is not able to run and play as much as she normally would have been.

She did eat better last night as well, more than she has over the past couple of nights. Her weight has dropped near 2 ounces over the last couple of weeks. So guess we will be giving her a selection of foods letting her eat what she wants and can...hmmm guess her own private buffet. Good thing I have a few spare food dishes.

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#82847 - 02/25/06 07:42 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


I'm sooo glad she seems to be doing better! I only just ran across this thread. but It makes me feel good that she's gonna be ok. ^-^ she seems to be a sweety. After everything she's been through I think a little pampering is ok *wink wink* <img src="/ubbthreads/images/graemlins/grin.gif" alt="" />
<img src="/ubbthreads/images/graemlins/heartpump.gif" alt="" />
Cele.

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#82848 - 02/25/06 09:38 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


Glad to hear she is doing better! I was getting worried for the poor girl! Yeah- i agree some pampering is in order

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#82849 - 03/01/06 12:45 AM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


We haven't had an update on this little gal in a while. Still improving?

One additional thought on Marbocyl - it is a fluoroquinolone. Like the Baytril we use on this side of the pond a lot, it has good and bad points. The one biggest concerns to consider with long-term fluoroquinolone use is the development of MRSA (methicillin resistant staph aureus)infections. Since Staph is a major gap in the spectrum of these meds, resistance can develop. In the US, MRSA frequency has exploded since Baytril and its cousins like Cipro and Marbocyl came on the market. If drainage is continuing, a follow-up culture may be helpful. Staph might actually have been the original culprit, but even if not, it can opportunistically gain access to an open wound and colonize the goo. It can be stubborn to clear.

Clindimycin is normally targeted at gram negatives and anaerobic germs. It happens to have reasonable Staph coverage. It would not normally be what I would select first for a facial abscess or cellulitis, but for a re-treatment strategy after a failure of a more conventional medication it is quite reasonable. Culture directed selection is best. Good luck, and I hope she is coming along.

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#82850 - 03/04/06 08:09 PM Re: Swollen Head, unsure if in jaw or behind eye [Re: ]
Anonymous
Unregistered


She is doing well. I have some pictures of her head after the abscess went away, but leaving the scalp a complete nightmare. I'll get those posted up on here ASAP. I'll also do some updated pics to show the progress.

At this time she is doing well still scabby, very thick and hard, but expected. We treat the wound every other day with a iodine solution which normally break a pin hole in the scab area and some drainage does occur. Not like it use to be though.

The smell is nearly gone and it seems to be healing well. She may show scaring after this, I'm just not sure yet.

We removed her from the heated brooding box tonight, well it was in a larger plastic crate, but now she is strong and no longer needs the brooder to keep her warm, so she is just in the larger crate for now. As of tonight a new problem arised with a pair of 1 day oop which we needed the brooder for. Abandoment and facial trauma so they had to be removed from the parents. We lost one of the pair within 30 minutes, he was already to far gone. The female is taking milk by syrenge and staying warm in my pocket along with another joey from a seperate colony who is 3-4wks oop.

So now not only am I playing doctor every night with one glider, I'm playing mommy for another one. Though the joey being only 1-2 days oop and surviving I know chances are slim.

However I'll get the pictures up here on the female with the abscess and down in the breeding section I created a topic called "Fostering, does it work?" or something to that extent.

thanks,
Joe

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