Abscess won’t heal

[Cinnamontoast]

Big dog was bitten in November, both dogs under control, stopped to speak to owner who couldn’t hold his Akita x. More like a play nip, it’s a puppy, but huge. Anyhow, we took Brig to the vet because some pus appeared. Got antibiotics. It seemed to heal. A month later, despite regular hibiscrubbing, more pus appeared. More antibiotics, lots of regular careful cleaning with hibiscrub. It all smoothed out, Two days ago, it was again swollen and popped. Tonight, it’s poured out, I’d say 20ml of pus. Back to the vet tomorrow. I might ask for a sample to be sent so we can isolate the exact variety to get a targeted antibiotic.

Why is this not healing? I’ve clipped it several times, cleaned it, finished the antibiotics x 2. I’ve looked after a much worse wound with zero infection! I don’t understand. He’s had lots of injuries (goes through cover, never round!) but all have healed without issue. Why is it so stubborn?

 

[{97702}]

Has the vet opened up the wound properly? All I can think is that there might be some sort of foreign body in there that is stopping it healing?

 

[CorvusCorax]

Where is it?

You're very forgiving!

 

[druid]

Possibly foreign body in it causing repeated abscessation. Might be worth a proper flush and as you mentioned a culture so you know what it is

 

[blackcob]

Is it somewhere with enough skin that they could fully excise the capsule and get rid once and for all?

 

[silv]

Definately a high chance that a foreign body is present, I am surprised the vet hasn't sent of a swab for culture to ensure the correct antibiotic is being prescribed. Let us know how the vet visit goes.

 

[Sandstone1]

Once you are sure there is no FB. Manuka honey is good for wound healing.

 

[JennBags]

Once you are sure there is no FB. Manuka honey is good for wound healing.

This is what I was going to say, get some good quality high grade manuka honey, I have seen it make a huge difference in several wounds.

 

[HashRouge]

Has the vet opened it up and drained it properly? As others have said, it might be that there is something in there stopping it healing, or it might be that it just needs opening up and draining properly. I speak from experience, as my cat gets regular face abscesses that leave him looking like an extra from the Walking Dead! He has always had them opened and drained, but once had to have the same abscesses drained several times as it wasn't healing.

 

[skinnydipper]

Deleted

 

[missmatch]

Most likely some foreign body inside as others have said. Vets should really lance and flush it out.
Colloidal silver works well on abscesses to help them heal but if there’s something in there nothing will work till that’s removed.
Will pup allow you to poultice the site, see can you draw anything out?

 

[Clodagh]

Is this your old boy? His immune system might not be helping.
Wondering what could be in it - maybe a puppy tooth!!??

 

[Cinnamontoast]

Have had a good feel and can’t find anything, although it hasn’t been opened up. There are two distinct tooth marks like a vampire bite. It will be flushed if the latest antibiotics don’t work and a culture taken in 2 weeks if it’s no better. He’d somehow popped it today so there was almost no pus, so getting a sample would’ve been tricky.

Yes, it’s the big dog, 15 in a couple of months.

It’s to the right of his spine, behind shoulder. He can’t quite reach it. There’s not a lot of flesh there to excise a capsule.

He’s going to have an x ray on his heart, too. He’s coughing a heck of a lot, hard enough to almost be sick, I’m concerned that indicates heart failure, he has a murmur, nothing serious. We’re prepared, I think, for worst case scenario. I’ve said to the vet no anaesthetics, at least not a general, he’ll be ok for a light one to keep him still for an x ray, but I’m not sure he’d cope with deeper sedation.

Tricky. The vet blamed me for not taking him back last time, but the wound had closed and flattened, nothing to see, so it seemed pointless to go back, there was nothing there.

 

[AmyMay]

If he's having an xray to look at his heart get them to take a swab from the wound at the same time (rather than waiting another 2 weeks).

Healing vibes to the old boy xxxx

 

[Cinnamontoast]

X ray is in 2 weeks when he will have finished his antibiotics. Again! I’m hoping it gives up now. If not, yes, we’ll do a swab or open and flush, but that means deeper sedation. Currently they’re giving him amoxycillin, broad spectrum, I guess.

 

[SusieT]

heart problems really need a scan (done concious) rather than an xray. personally I'd go for a heart scan for a coughing dog with a murmur well before a sedated xray..

 

[Cinnamontoast]

We’ll see what the plate looks like. His murmur is very minor, he’s had no issues until the recent cough. It might not be related. He has multiple lipomas, I expect he may have some impacting on his airway, although I can’t see anything external.

 

[Cinnamontoast]

Big dog has had a heart scan. There’s an odd lump on the left ventricle, apparently a new one on the vet who has never seen such a thing. It may be related to his heart murmur, who knows. The blood is not going where it should, but the murmur has never caused issues to our knowledge.

The abscess is still oozing. Had I been there, I’d have requested it be opened, cleaned properly etc. However, we have bigger, stronger antibiotics, which I know will not resolve the issue if there is a foreign body. Back to scrubbing and trying to keep one hole open so it’ll drain. Were it opened, it would be a pretty substantial wound given the distance between the 2 teethmarks/holes, but ill give these antibiotics a go. If it doesn’t clear, I will ask for a cut to be made under local anaesthetic, I really don’t want him undergoing a GA.

 

[Clodagh]

How strange and worrying.
I know nothing of abcesses, but does it have a shunt in?
OIngoing infections are such a PITA, that is why Tawny had her tail off in the end, everything just broke down. Good luck, are the ABs 7 days? Keep us updated.

 

[Cinnamontoast]

2 weeks of the latest abs, after which I’m demanding it be opened, flushed, investigated, stop messing and actually do something! It kee0s healing up, then swelling, then bursting. I’m sure there’s more in there than we’ve seen.

 

[Clodagh]

How is he doing?

 

[Cinnamontoast]

Bar the occasional accident, he’s fine. Lively, happy, wound has healed, but oozing lymph fluid. I’m going to ask the vet to open and flush it.

 

[Clodagh]

Sounds like the only answer now, I hope it works.

 

[Cinnamontoast]

Saw a different vet today, older guy. I phoned and said I want it opening and flushing, I was prepared to de-register him and go back to my old vet if I was again fobbed off. Luckily the vet looked at the history and agreed that there may be a foreign body and the body is clearly trying to expel something. It helped that the lower of the holes re-opened and sludged out pus this morning. The hole is huge!

He’s booked in for debriding on Wednesday. I’m worried about anaesthetic (theatre lady said more likely heavy sedation) given his age/heart issues and I have put a DNR on file. I wouldn’t be amazed if he just bounces back, tho, he seems very lively/happy currently. We said we wouldn’t do GAs, but this isn’t healing and he’s too wriggly/wound is too big for a local.

 

[Aru]

I actually wouldn't be as worried about a ga as you are.

While theres always a risk involved, particularily with heart issues its isn't necessarily as risky as you may think. The modern anaesthetic protocols are a world apart from the days when it was injectables and hard to modify once given. Sometimes its actually easier to control blood pressure and manage a heart issue under anaesthetic then under deep sedation so I really wouldn't rule it out completely if you vet tries to convince you to go that way.
Of course your vet will do whatever they think is best for the dog in front of them but it is worth knowing the above as most people do fear anaesthetics more then they should in these cases.

 

[Clodagh]

At least hopefully it will now be sorted, poor old boy. Does it hurt him?

 

[Cinnamontoast]

Hi Aru, to be fair, given his general good health and the vet telling me there’ll be a tube down his trachea plus all the monitoring they do, I’m actually quite calm about the whole thing!

I think the lower bite hole having opened again is very sore, Clodagh. I’m hibiscrubbing-gently-but given it just ruptured and is bigger than the original hole, gaping, it is bothering him when touched. Luckily it’s not in the way of his usual lying down position.

I know how you lot like icky pics!

 

[skinnydipper]

I hope everything goes well for your big lad tomorrow.

 

[Aru]

Hope all went well with your boy!
And yes it really does help to know a bit more about what we do with anaethetics in the hospitals. Its less scary when you know a bit more about them so il throw a brief summary here.
Our senior anaesthetics get bloods, fluids and specially modified drug protocols depending on what old age conditions they have and how they present. All if the above is not alway required for every animal or at each clinic for the record!
Theres usually 3 steps to anaethetics.
Using a mix of premeds-anxiety and pain relief meds usually-taking away the pain and fear makes a lower dose of the other anasthetics.the lower the dose rate the less likely you are to have issues with blood pressure etc and it also makes putting in ivs less scary for the animal.

induction agents-given intraveneously by dose required for each animal,these causing a swift and stress free introduction to the anaesthetic sleep.sometimes we use these on their own for very short procedures.

gas anaethetic and oxygen given via an e.t tube that can be increased or deceased by breath.The tube also allows us to breath for the animal if required.

We leave an iv in give fluids throughout surgeries to maimtain the blood pressure.The iv also means any required drugs can also be given asap if there are any issues during the surgery.
These steps tend to produce reliable controlled anaethetics.
We have multiple monitors.
Breathing alerts that alarm if breathes drop below a certain rate.
Pulse ox that means oxygenation amounts and heart blood pressure rate monitoring etc
And most importantly a nurse whos hands on watching the animal checking rates and making sure everythings going well while the vet works. People are much more relaible then machines.Machines produce errors sometimes or give incorrect results as it the nature of technology a nurse being hands on is priceless.
Most small animal anaesthetics methods and drug lists are very similar to human medicine. There is a risk involved in everything in life but there are multiple steps present to try and catch issues before they are big issues.

Hope that helps any of you out there that are worried.

 

[Aru]

Apologies for my usually awful spellings and autocorrct mistakes. I can never edit quick enough on thr phone!