# Abscess wont heal



## Cinnamontoast (20 February 2018)

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?


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## {97702} (20 February 2018)

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?


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## CorvusCorax (20 February 2018)

Where is it?

You're very forgiving!


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## druid (20 February 2018)

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


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## blackcob (20 February 2018)

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


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## silv (21 February 2018)

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.


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## Sandstone1 (21 February 2018)

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


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## JennBags (21 February 2018)

Sandstone1 said:



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


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## HashRouge (21 February 2018)

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.


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## skinnydipper (21 February 2018)

Deleted


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## missmatch (21 February 2018)

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&#8217;s something in there nothing will work till that&#8217;s removed. 
Will pup allow you to poultice the site, see can you draw anything out?


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## Clodagh (21 February 2018)

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


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## Cinnamontoast (21 February 2018)

Have had a good feel and can&#8217;t find anything, although it hasn&#8217;t been opened up. There are two distinct tooth marks like a vampire bite. It will be flushed if the latest antibiotics don&#8217;t work and a culture taken in 2 weeks if it&#8217;s no better. He&#8217;d somehow popped it today so there was almost no pus, so getting a sample would&#8217;ve been tricky. 

Yes, it&#8217;s the big dog, 15 in a couple of months. 

It&#8217;s to the right of his spine, behind shoulder. He can&#8217;t quite reach it. There&#8217;s not a lot of flesh there to excise a capsule. 

He&#8217;s going to have an x ray on his heart, too. He&#8217;s coughing a heck of a lot, hard enough to almost be sick, I&#8217;m concerned that indicates heart failure, he has a murmur, nothing serious. We&#8217;re prepared, I think, for worst case scenario. I&#8217;ve said to the vet no anaesthetics, at least not a general, he&#8217;ll be ok for a light one to keep him still for an x ray, but I&#8217;m not sure he&#8217;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.


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## Amymay (21 February 2018)

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


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## Cinnamontoast (21 February 2018)

X ray is in 2 weeks when he will have finished his antibiotics. Again! I&#8217;m hoping it gives up now. If not, yes, we&#8217;ll do a swab or open and flush, but that means deeper sedation. Currently they&#8217;re giving him amoxycillin, broad spectrum, I guess.


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## SusieT (21 February 2018)

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..


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## Cinnamontoast (21 February 2018)

We&#8217;ll see what the plate looks like. His murmur is very minor, he&#8217;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&#8217;t see anything external.


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## Cinnamontoast (9 March 2018)

Big dog has had a heart scan. There&#8217;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&#8217;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&#8217;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&#8217;t clear, I will ask for a cut to be made under local anaesthetic, I really don&#8217;t want him undergoing a GA.


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## Clodagh (9 March 2018)

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.


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## Cinnamontoast (12 March 2018)

2 weeks of the latest abs, after which I&#8217;m demanding it be opened, flushed, investigated, stop messing and actually do something! It kee0s healing up, then swelling, then bursting. I&#8217;m sure there&#8217;s more in there than we&#8217;ve seen.


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## Clodagh (17 March 2018)

How is he doing?


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## Cinnamontoast (17 March 2018)

Bar the occasional accident, he&#8217;s fine. Lively, happy, wound has healed, but oozing lymph fluid. I&#8217;m going to ask the vet to open and flush it.


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## Clodagh (17 March 2018)

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


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## Cinnamontoast (9 April 2018)

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&#8217;s booked in for debriding on Wednesday. I&#8217;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&#8217;t be amazed if he just bounces back, tho, he seems very lively/happy currently. We said we wouldn&#8217;t do GAs, but this isn&#8217;t healing and he&#8217;s too wriggly/wound is too big for a local.


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## Aru (10 April 2018)

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.


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## Clodagh (10 April 2018)

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


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## Cinnamontoast (10 April 2018)

Hi Aru, to be fair, given his general good health and the vet telling me there&#8217;ll be a tube down his trachea plus all the monitoring they do, I&#8217;m actually quite calm about the whole thing! 

I think the lower bite hole having opened again is very sore, Clodagh. I&#8217;m hibiscrubbing-gently-but given it just ruptured and is bigger than the original hole, gaping, it is bothering him when touched. Luckily it&#8217;s not in the way of his usual lying down position.

I know how you lot like icky pics!


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## skinnydipper (10 April 2018)

I hope everything goes well for your big lad tomorrow.


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## Aru (11 April 2018)

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.


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## Aru (11 April 2018)

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


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## Clodagh (11 April 2018)

Good luck today.


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## Moobli (11 April 2018)

Great post by Aru and hopefully very reassuring for you today OP.  Hope it all goes well.


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## Cinnamontoast (11 April 2018)

Poor little lamb, he&#8217;s feeling extremely sorry for himself and is very wobbly on already wobbly back legs. The vet made an elliptical cut, removed all infected tissue and said there were several tiny encysted abscesses under the swelling of the bite wound, so antibiotics would never work. 


















The vet said he stopped breathing several times during the operation and that he was very &#8216;flat&#8217; throughout as well as afterwards. At first she wanted to keep him in but then phoned to say he was getting very stressed so he&#8217;s home. Starving but unwilling to eat and flopped onto the lawn and I had to pick him up and bring him inside.


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## MurphysMinder (11 April 2018)

Aw poor lad,  glad he is back home with you,  I'm sure he will be more himself after a good nights sleep.   So it was just the original bite causing the problem,  no foreign body ?


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## Pearlsasinger (11 April 2018)

Poor lad and poor you!

I usually think that once the surgery and immediate recovery are over, they make better progress at home in familiar surroundings with people that they know and trust. 

It certainly is a big operation site.


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## {97702} (11 April 2018)

Aru said:



			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.
		
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This is really interesting and useful, thank you Aru   I always had bloods and fluids every time Islay had an anaesthetic, and I always had to be a neurotic owner and tell the vet that greyhounds don't take anaesthetics very well....

The induction meds you mention, would that be when the vet puts the dog under very quickly then can give them another injection to bring them around again equally quickly?  I've seen that used when they stitch up the greyhounds, it is amazing


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## Clodagh (11 April 2018)

Poor old boy. I am sure a night at home will help. Will be along one for you, though.


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## Cinnamontoast (11 April 2018)

Multiple infected cysts under the original bite wound, so I suppose many foreign objects! I think that must mean that the original bite left behind multiple bits of stuff, fibres from the dogs ball, mud, leaves, who knows? Vet said shes never seen anything like it. They said theyd never seen anything like the thing on his left ventricle either :rolleyes3: Im glad I saw an older vet who agreed that it needed opening up and rolled his eyes at the amount of antibiotics hed been prescribed. 

Im just glad hes home, although he doesnt know where to put himself, bless him.


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## Moobli (11 April 2018)

So glad he is home.  I hope he gets a good night's sleep and is more himself in the morning.


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## rara007 (11 April 2018)

Out of interest what was it that made you change your mind about getting it done? I'm often faced with owners who really don't want a GA for their older dogs (sometimes due to cost simply not being worth it especially for the working dogs, sometimes due to fear of GAs for the pets). As a younger vet I don't tend to push too hard to make people do what they don't want to as they'll just ask to see one of the 'men' in the future who will just give them the antibiotics without discussing GAs and testing. I always offer what I think is the best option but don't go on about it when it's been clearly stated as not an option. I have several on my books that are having 'palliative' care when really doing more would get them out of pain and in better health so wondering what I should do when next faced with one to get better quicker results for the animals!

Glad he's made it home! Bet he sleeps well tonight but hope he starts to pick up soon


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## Cinnamontoast (11 April 2018)

I didnt have a choice, really, rara. The abscess wasnt healing and I thought there was more to it than a simple abscess. I cant lie, the idea that he might not make it crossed my mind, a lot, but how else were we going to sort this? The vet who agreed to cutting it out said hed have a tube down his trachea, theres lots of monitoring. Seeing Vet on the Hill last week and the amount of times animals stop breathing but him being able to get them back helped! 

One of the men, rara?! Jeez, do you live in the 1950s?!

Little lamb has been even more confused than usual tonight, sleeping in odd positions/places, but is finally interested in food and followed me to the kitchen. Yay!


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## JennBags (11 April 2018)

So glad he's on the mend,  hope he perks up in the morning.  That's a huge area they've had to operate on given the original bite area.  Suzie says she's sending over some of her biscuits to make him feel better


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## Cinnamontoast (12 April 2018)

Hell bite the hand for biscuits! Back to usual perkiness this morning, but with lots of whining, probably last bit of anaesthetic wearing off.


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## skinnydipper (12 April 2018)

Glad to hear he has come through this okay, what a relief for you.


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## ester (12 April 2018)

I don't think it's rara living in the 1950s, it's some of the clients! 

I too find it interesting how people decide to anaesthetic or not, I wonder whether because I did loads of vet work experience a fair few years ago (not adding it up!) and everything was tubed and very well monitored so I would always think that (and I presume the vet on the hill did similar for you). 

Pleased to hear he is doing well, and hopefully it will heal up and not give any more bother


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## Cinnamontoast (12 April 2018)

He was tuned throughout, stopped breathing several times, I think the vet was panicked given how she spoke to me afterwards! 

Dementia dog has taken to whining with separation anxiety, him being 2 feet away from us in the hall, us being in the sitting room. Bless! He&#8217;s perky, hungry, usual self.


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## rara007 (12 April 2018)

cinnamontoast said:



			One of the &#8216;men&#8217;, rara?! Jeez, do you live in the 1950s?!

!
		
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Rural north essex! I'm the only female but also the youngest. We're actually owned by a lady who spends most of her time abroad so many of the clients don't know her (she is a vet), it does make me smile when they say the receptionist said it would be OK for XYZ on the phone  No, that's actually the boss  I'm building up my bank of clients but most days will take a call for someone who wants to see one of the boys (which we happily accommodate) or when I go to call them in they say oh I thought I was seeing one of the partners (we have no partners....). 

Thanks for that  I'd never have considered people didn't realise that GAs were intubated with the capacity for ventilation and monitored closely (the only ones we don't intubate are rodents and camelids), will remember that!


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## Aru (13 April 2018)

Glad hes on the mend cinnamontoast! 
I wouldnt worry to much about the breathing. They will have kept on top of it and taken breaths for him because we monitor for things like this and then take the steps required to keep on top of it.

But we always let owners know about issues so they can give the likes of the emergency vets/new vets if you move  the heads up etc . Easier to anticipate and have the drugs ready to fix or avoid breathing issues if you know to expect the problem  
Sounds like it was definately a good idea to cut though!


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