Abcess (Retrobulbar Abscess - Bulging eye) - Good antibiotic? Baytril Alternatives?

[rodneyc8063]

So for the past few months my chin has been having one issue after another in one of her eyes.

She initially had an abcess above her eye, and now her eye has started to bulge. With this eye bulge its also causing other issues (corneal ulcer and conjuctivitis currently).

I just got a new vet, and I am waiting to do further diagnostic testing. I have an appointment this coming week to do some xrays and take some blood work for my chin to see if the bulging eye could possibly be due to a tooth issue. I had no clue that a tooth issue could cause a bulging eye, but apparently it is definitely a possibility. I digress though, so while we are going to be doing diagnostic work to make sure we can pin point the root cause of the bulging eye - If there is nothing else that can be detected, based on my vets diagnosis right now they are saying its a retrobulbar abcess.

Or literally, the vet was saying that there is an abcess that is likely growing/grown directly behind the eye. Which is causing it to bulge. My vet advised that the best way to treat this, would unfortunately need to involve removing my chins eye in order to get behind the eye and fix what ever is going on behind it.

I really hate that it has to come to this point, where we likely need to remove the eye - But we will do what needs to be done.

But prior to removing the eye, I was hoping to explore one last possiblity.

My chin had been on baytril (enrolfloxacin) for about 3 weeks, with about one week mixed in taking metacam for pain management.

Unfortunately the baytril seems to have had very little effect, as her eye has remained bulging - No worse bulging really, but now shes developed a corneal ulcer. So her eye is getting issue after issue.

My vet did mention that unfortunately some antibiotics will have little to no effect on an abcess, since when an abcess is formed it creates almost a "capsule" of pus and debris. Taking an oral antibiotic, the baytril may not have been able to penetrate into the abcess in order to treat it.

So one idea is to possibly try another antibiotic to see if it can penetrate into the abcess. Thanks to tunes (forum member) I suggested maybe we can try Trimethoprim sulfa instead of baytril. The vet said that he will go back and chat with his network of connections to see if he can find another antibiotic that may have better properties of penetrating an abcess, and also look further into the trimethoprim sulfa as the standard these days seems to be baytril. So I appreciate that my new vet is willing to explore alternative antibiotics.

So I was wondering, for anyone else that has had to deal with an abcess - What kind of antibiotics have you tried?

Given the location of this abcess (suspected directly behind the eye) - Theres no way for us to drain the abcess as is without removing the eye. so lancing and draining isnt really an option. Baytril hasnt seemed to make a difference. So Im just wondering what other antibiotics we can try - Though trimethoprim sulfa is high on my list of things to try.

Though I do concede, these are just my last ditch attempts at trying to save my chins eye. In the next week or so, we are planning on removing the eye once we can validate that is is isolated to the eye and not something else like a tooth issue. Just in the mean time, if we can try another antibiotic and see positive results we could maybe delay the eye surgery until it gets better.

Makes me sad to have to remove her eye. But I just want to make absolutely sure that we are truely treating the root cause and exhausted all options.

Thanks for any insight and for reading this far

 

[tunes]

Ugh. It started bulging again. I was really hoping she was over the hump. When mine abscessed I tried both Baytril and TMS. As your vet stated though, unless you can drain the initial infection, antibiotics aren't going to do much of anything. You have to get the pus/infection out first. If it's a tooth, removing the eye isn't going to help. Malocclusion isn't treatable. It can be "managed" temporarily somewhat if it's a surface issue, but root issues cannot be helped. A chin with a root issue all the way into the eye would be in excruciating pain that no pain medication can relieve. Whatever the cause, I'm sure the pain is just horrible for her. I hope you get it resolved soon.

 

[rodneyc8063]

Ugh. It started bulging again. I was really hoping she was over the hump. When mine abscessed I tried both Baytril and TMS. As your vet stated though, unless you can drain the initial infection, antibiotics aren't going to do much of anything. You have to get the pus/infection out first. If it's a tooth, removing the eye isn't going to help. Malocclusion isn't treatable. It can be "managed" temporarily somewhat if it's a surface issue, but root issues cannot be helped. A chin with a root issue all the way into the eye would be in excruciating pain that no pain medication can relieve. Whatever the cause, I'm sure the pain is just horrible for her. I hope you get it resolved soon.

Hi tunes

Unfortunately yah.....I dont know where to begin to explain whats going on

Her eye was looking pretty good for a short time, but then it started to look like it was "smudging" on the surface, like her eye wasnt a smooth glassy glossy and there was something stuck in it. Then there was white sticky goop/discharge. This all happened within a week before we were able to get her into the vet.

This led us back to the vet (Southdown animal clinic in Missisauga, Ontario).

The vet advised us that her "bad" bulging eye has now developed a corneal ulcer. They did a fluorescence test apparently, dropped in some dye and looked at it and confirmed its a corneal ulcer.

We have been treating the ulcer with Optixcare eye lube, and ciloxan (ciprofloxacin) eye drops to keep it moist. The vet suspects that since her eye has had this "bulging" on and off again, that theres a strong possiblity that her eye is currently bulged "just enough" causing her eye to dry out - Which apparently can lead to a corneal ulcer.

The discharge from her eye is just awful. Its white and sticky, and a real mess to clean up. Overnight we have found her eye sealed shut from the build up of the pus, and we had to use a warm compress to pry the crap out of her eye.....heart wrenching to do

Im a bit on the fence about that diagnosis, since we have been giving the eye drops our chin apparently has had NO PROBLEM closing her eye lids fully shut so we cant get the eye drops in - So Im not sure if its really her eye not being able to close, and causing the ulcer.

But after all this, the vet did say that it is likely time we explore the idea of removing her eye. The vet told us that initially, we could try treating with antibiotics (didnt seem to work) and if that didnt work another option would be palliative care. So even though our chin's eye is bulging, she doesnt seem overly bothered by it as she still eagerly wants her treats, chin scratches, play time and is eating normally. So we could just "leave it" as well if shes totally normal, at least that was the hope.

But given the fact that she has now developed a corneal ulcer, and there is a strong chance that she may continue to get issues with the eye going forward that we may want to fix it and just remove the eye and clear things out once the eye is removed.

When I asked the vet what was involved and the quote they informed me that they would also recommend taking xrays to rule out any potential tooth problems.

This annoyed me, as I had asked this vet a few months ago whether we should consider taking an xray. Their initial reply was that an xray wouldnt show much if it was a soft tissue issue - Fine fair enough, I get that. But after aaallll this they finally only now recommend taking an xray. And they wanted to take an xray on the day of the surgery!! Which I highly disagree with, as I would think it makes a lot more sense to do all your diagnostic imaging BEFORE surgery - Then you go into things knowing whats your game plan. I dont know, but the xray was part of the quote and I assume its on the same day since they didnt say anything about doing it before.

So this is when I decided to try another vet and get a second opinion.

Fast forward, we just got our chin in yesterday to get some xrays. Our new vet (Jameson Queen Animal Hospital in Toronto, Ontario) had to put our chin under anesthesia as they wanted to do a number of xrays, oral endoscopy and potentially blood work. We ended up getting about 10 xrays, which Im hoping to get shortly and share on this forum.

Our vet had a long discussion with us regarding the xray results. Im glad we got the xrays, as it helps give us more information but at the same time it didnt give us anything more then we know now. My vet was also able to do an oral endoscopy along with the xrays, but apparently had issues getting blood? But at this point I dont know if theres any value in trying to do blood work anyways.

The vet showed us a "textbook perfect" chinchilla xray (literally from a textbook), and compared it to our chin's xrays. My vet noted that obviously, we can see how bulged out our chins eye is now. Also he noted that hes a bit concerned with the root length of some of her teeth on her lower jaw. He said that a possibility is if the teeth on the bottom of her jaw is longer then normal, it could cause opposing pressure on her upper teeth - Which happens to be the ones right under her eye. He also noted that there seemed to be a bit of a tiny gap between her teeth which could potentially cause issues with food getting stuck in there and causing issues with the root becoming infected. He also noted that based on the xrays, we could see that the bulging eye seemed to have more "white" around it - It basically looked like it was "busier" with whats going on versus the good eye. But of course he also noted that every animal is an individual, so comparing a textbook perfect picture to our chin there will be some variances.

But all in all it didnt sound like there was anything that jumped out screaming saying its a tooth issue

My vet said he would try posting on one of his "veterinarian" networks to see if he can get anymore feedback and opinons on the xray results.

But basically this brings us all back to a few possiblities

-Remove the eye, see whats going on behind it and cleaning it up - The most straight forward path, but of course we lose her eye
-After removing the eye, he could confirm whether theres any potential teeth issues and potentially at the same time may also suggest removing a tooth (of course this leads us down a whole other road of concern)
-Lastly is palliative care - If it is a tooth issue, he said that it would just be fighting fires. He would fix one thing, then something else may pop up etc etc.

Our chin, outside of her bulging eye - Quite honestly seems perfectly normal - But of course we dont want her getting any worse, or getting to a point where we cant do anything.

I appreciate you sharing your experience with the Baytril and TSM. I was debating trying anti biotics one last time for maybe a week to see if it makes any difference before jumping to removing the eye. We are planning on removing the eye within the next couple of weeks, I just wanted to try the antibiotics once more possibly, but it doesnt sound like its going to really do much

One thing that my vet noted though, was that when he was doing the oral endoscopy he believes he saw some pus in her mouth. I have read of dogs/rabbits where they get a retrobulbar abcess, and one treatment method was to go through the oral cavity - Make an incision there and potentially draining the pus out from there. I never heard of this in a chinchilla, and Im not sure how feasible it is given how tiny their mouths are but I was going to bring it up to my vet.

As you noted, we NEED to get the pus out first, otherwise just hitting it with antibiotics isnt going to do much. And outside of removing the eye and fixing the infection there, Im desperate to see if we can somehow go through the mouth and drain it there. I also read about potentially using antibiotic beads?

Has anyone ever used antibiotic beads to treat an infection? Just curious

And right again, if we remove the eye and it turns out its a tooth..........well we now lost an eye and its not going to fix the tooth problem.

But then if we try to deal with the tooth - For example pulling it - Theres a whole host of other issues there that I havent even explored, one of the biggest things is by pulling a tooth - I would assume we would need to pull the "opposing" tooth as well, since you need teeth in pairs to grind against each other. My vet didnt explicitly say that it is for sure malocclusion yet though, but it is a possiblity.

Can malocclusion happen in only one side of the jaw? Or in only one tooth? Im personally not convinced it truely is malocclusion yet, as our chin seems to be eating perfectly normal. As you mentioned, if it was malocclusion and all the way into the eye I would expect my chin to have stopped eating months ago - But this eye thing has been ongoing since Jan (6 months total now). She doesnt display any other traditional malocclusion problems (losing weight, drooling, difficulty eating). And I dont even know how malocclusion can only happen on one side?

Has anyone had a tooth removed from a chinchilla? Again just curious

So yah, we are flip flopping now ..........

- Fix the eye, what if its actually a tooth?
- Fix the tooth, what if the eye gets worse?
- What if its both the tooth AND the eye?

Yeesh...............

Sorry for the long post........................we are just bouncing around so many ideas as we need to get this resolved sooner then later. We want whats best for her. And we dont even have anything definitive outside of the fact that her eye is bulging