From:
brandy.a@accesscomm.ca
Date: 2005-04-09 17:55:20 UTC
Subject: Resolution of Facial Swelling and Draining Pus
To: ferrethealth@smartgroups.com
Message-ID: <11317592.1113086560043.JavaMail.nobody@chromium.smartgroups.com>
It would appear that Meeka has an Actinomyces Infection. Below is a reprin=
t of the discharge instructions from Dr.XXXX at the XXXX of Veterinary Medi=
cine at the XXXX in Saskatoon. If she reads this, I want to thank her so m=
uch for her patience and skill in dealing not only with Meeka and her probl=
ems, but with me and my worry wart nature where my babies are concerned."Hi=
story: Meeka was referred to the XXXX for an abscess on her jaw. The absc=
ess had been recurring ever since it was first diagnosed November 15, 2004.=
The referring veterinarian had been treating the abscess with Clavamox. =
The abscess would respond to the antibiotic treatment but would recur two w=
eeks after treatment was discontinued.Physical Exam Findings: On physical =
exam, Meeka was bright and active. There was soft welling on her left jaw =
extending over the maxilla to just below her left eye. This swelling appea=
red to be painful on palpation. Aside from the abscess, Meeka appeared ver=
y healthy on physical exam.Summary of Case Management: Meeka was anestheti=
zed and the skin over the abscess was clipped and cleaned. A scalpel was u=
sed to lance the abscess in three locations and we were able to express a f=
air amount of pus and blood that had a foul odor. The pus contained small =
tan pieces of material that was suggestive of the =93sulphur granules=94 of=
ten found in actinomyces species infections. We collected samples for cult=
ure and sensitivity and also for cytology (looking at the sample under the =
microscope).We examined Meeka=92s mouth while she was under anesthetic and =
did not see any lesions or loose teeth that could indicate the sources of t=
he infection.Laboratory/Medical Imaging Findings: Radiographs of Meeka=92s=
skull did not indicate any bony involvement or tooth involvement on the vi=
ews taken. This may indicate that the abscess is continued only to the sof=
t tissue or it may simply mean that there is bony involvement that is too s=
mall to see on radiographs at this time.Preliminary results from cytology d=
id support an Actinomyces infection, although we will have to wait for the =
culture results to confirm this diagnosis.Meeka=92s CBC (complete blood cou=
nt) results were within normal ranges indicating that the abscess is not af=
fecting her systemically. The only abnormality was a low PCV that may have=
been due to the gas anesthetic (ISO) we used.Diagnosis: Abscess of the le=
ft mandible/maxilla, tentatively diagnosed as an Actinomyces infection.Reco=
mmended Treatment/Management: The abscess on Meeka=92s face has been left =
open so that it can drain. There are three incisions and these may continu=
e to drain over the next few days. You can apply a warm compress over the =
area one to two times daily over the next few days in order to keep the are=
a clean and to help it heal.Meeka may be a bit sleepy tonight from the anes=
thic (Brandy: =93I doubt it. She was as active as anything.=94) You can o=
ffer her food in small amounts. She should be back to normal by tomorrow.I=
deally, Meeka should be kept separate from the other ferrets for the next w=
eek or so until the wounds have had time to heal. (Brandy: =93Dr. XXXX didn=
=92t mention this when I picked up Meeka and I didn=92t read it until after=
I left the hotel room for supper, leaving all three ferrets together. But=
no bad results there.=94) Meeka will be going home on the antibiotic Amox=
icillin. She needs to take this liquid by mouth twice daily for at least 8=
weeks. The shelf life of this antibiotic is only two weeks so you will ne=
ed to have the prescription refilled every two weeks for three or more time=
s. We can either write a prescription that can be filled at a human pharma=
cy or your regular veterinarian will be able to refill it for you.We hope t=
hat by removing the contents of the abscess, we will help it to resolve. U=
nfortunately, in some species (i.e. cows), Actinomyces can be difficult to =
cure and it does have the tendency to come back. Please make sure that you=
finish all of the antibiotics prescribed to give it the best chance of res=
olving.Thank you for bringing Meeka in to see us =96 she was a very good fe=
rret to work with! Please feel free to call us or your referring veterinar=
ian if you have any questions or concerns."Earlier I'd written asking for h=
elp as follows:Could this be chronic sinusitis and, if so, does it need tob=
e physically drained or would a strong antibiotic do thetrick (have only us=
ed Clavamox to this point)?HISTORY: Meeka (3 year old sprite) had the flu =
lastNovember. She became very lethargic but came out of thiswith some TLC =
and medications. Right after this, however,she developed a recurrent large=
swelling on the left side ofher face. It started as a pea sized shape on =
the bottom leftjaw, near where the upper and lower jaw meet. This grewquic=
kly and she was started on an extended course of Clavamox(turned out to be =
nine consecutive weeks) and then it seemedto resolve, only to reappear agai=
n two weeks later. Anotherround of antibitoics (14 days) and two weeks sym=
ptom-free,then it recurred again (this is now).She's been x-rayed (nothing =
found suggesting it is a problemwith her teeth), aspirated (only pus and bl=
ood found), andnow we've sent a slide to the laboratory to culture (willhav=
e results early next week). [NOTE: Came back inconclusive, just pus and blo=
od.]The really freaky thing for me is that today she has copiousamounts of =
pus draining from the left ear (the side of theface where the swelling is).=
This was present at 8:30 am, again at 10:30 am but not at 2:30 pm checks.=
Is it possible that she developed recurrent sinusitis following the influen=
za and we're not treating with a powerful enough antibiotic?Other than the =
facial swelling and pus drainage from the left ear, she's eating and elimin=
ating as before, bouncing all over the place for a short period of time but=
then wanting to go and be by herself, probably to recuperate. She'd be a =
good candidate for surgery but I'm hoping there's an easier (and, yes, chea=
per) way to treat this. So far treatment has cost $800 Canadian for numero=
us vet visits, medications, x-rays, subcutaneous fluids, culturing the slid=
e, etc.I'd appreciate any insight that could be offered for this.Thank you,=
Brandy and Meeka[Moderator's Note: Changes to bring post into compliance w=
ith FHL rules] =
End of ferrethealth Digest
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