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Dental Azithromycin (Zithromax)

Poofters & Fuzzy Bear

New Born Pup
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Aug 8, 2019
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Canada
Hello! I'm completely new to the forum, so I don't know if I should post this thread under "Introductions" or "Health & Illness".

My piggies are Poofters and Fuzzy Bear. Poofters is my sweet senior piggy who is 7 years and 8 months old, and I have questions regarding azithromycin. Poofters had a dental abscess last November after she broke her bottom left incisor. This was her only bottom incisor because when Poofters was a young piggy she would bite the bars waiting for her breakfast and supper veggies. She broke her bottom right incisor three years ago. It grew back fine, but then she got an abscess several months later. She had surgery and was put on Sulfatrim for a little over two months. However, during floor time zoomies, she crashed into the outside of her pen and that incisor fell out a few days later. It didn't grow back. That ended up not causing much of a problem, though. Along with sometimes getting hay stuck between the top incisors, she just sometimes had a waxy build-up in her ear after that, and had to get her ears cleaned regularly. I'm not sure of the connection, and it could just be coincidence. However, it could be that the irregularity in the jaw led to some ear issues. We managed to get her to completely stop biting the bars after that first tooth problem, but somehow last November she managed to break the other bottom incisor. I'm not even sure how it happened, and her chewing was similar to her waxy ear chewing, and I had a vet appointment already set up for a few days later, so I assumed that she just needed an ear cleaning. However, the chewing got worse rapidly and I had to take her in as an emergency. By then, infection had already set in, so Poofters was put on chloramphenicol. She had surgery to have the abscess removed followed by regular wound flushing. She was doing well, but the abscess itself didn't heal up and the tooth didn't grow. She had to get wound care for four months. Then suddenly the abscess did close up and the tooth looked like it was finally growing again, but there was a big chip around the gum line. Our vet thought that the tooth probably wasn't growing but that it was being expelled. Then in April the abscess returned and during surgery the tooth had to be removed. The x-rays from back in November didn't show that the tooth had fractured, but our vet had suspected it. By April it was in fragments below the gum line. Because the bacteria had gotten resistant to the chloramphenicol, Poofters was switched to Duplecillin by injection (this is not safe for guinea pigs except by injection, and even then it's a bit risky). Poofters had actually tolerated the chloramphenicol very well. She didn't have any intestinal flora issues like she'd had with the Sulfatrim. By the way, Poofters is actually sensitive to probiotics, so that's another thing we have to be careful of. Anyways, in May the abscess returned because the infection had spread to the first cheek tooth beside the incisor. She had surgery again, and the wound was drained, and our vet put her on azithromycin and Baytril. The cheek tooth also was rotten and had to be removed. I know that in the UK azithromycin (or Zithromax, which is the brand you have) is the antibiotic of choice for dental abscesses. Our clinic didn't have Marbocyl in the right form for guinea pigs readily available, so our vet chose Baytril. After draining and the new antibiotics, the abscess cleared up and healed. In fact, our vet said that for the first time since November there was no swelling or sensitivity in the jaw area. Poofters did develop an intolerance to the Baytril on the 14th day of treatment, and we almost lost her and we had to take her off that, and she had some issues for a few weeks after, but she is still on the azithromycin. On the Baytril, Poofters had to have a small amount of probiotics (Bene-Bac). She has now been on the azithromycin for 12 weeks. We tried taking her off it for four days in the first week of July, but then she had some pain when our vet examined her jaw, so we decided to continue with the azithromycin for longer. Our vet is on holidays this week, but we're hoping to take Poofters off the azitrhomycin when she returns on Monday. With the help of top incisor filings, Poofters' chewing has become better than it's been since November. Around the middle of July she seemed to finally turn a corner in her health. The only thing now is that for the first time on all these antibiotics, Poofters' intestinal flora is starting to be affected. I've had to start a small amount of Bene-Bac. All through this, I've also been giving Poofters a small amount of Oxbow Critical Care three times a day to help with weight gain and to buffer her tummy when giving antibiotics. As well, Poofters has a good diet of massive amounts of hay (mostly timothy but some orchard grass too), fresh vegetables, and a vitamin C supplement. She also gets weekly subcutaneous fluids with a vitamin C injection to boost her immune system.

Could any of you please share your Zithromax experiences with me? How long did your piggies remain on the antibiotic? Is it safe to take a senior piggy who is close to 8 years old off the antibiotics? Zithromax is not commonly given to guinea pigs in Canada, and even our vet who is an experienced exotics vet, is in somewhat uncharted territory, due to the fact that not a lot of people have guinea pigs in this part of the world.

Sorry for the very long post. Any assistance is greatly appreciated. I feel like it's time to stop the azithromycin, but I'm also hesitant due to the fact that the jaw bone had been affected.

Thank you!
 
Hello! I'm completely new to the forum, so I don't know if I should post this thread under "Introductions" or "Health & Illness".

My piggies are Poofters and Fuzzy Bear. Poofters is my sweet senior piggy who is 7 years and 8 months old, and I have questions regarding azithromycin. Poofters had a dental abscess last November after she broke her bottom left incisor. This was her only bottom incisor because when Poofters was a young piggy she would bite the bars waiting for her breakfast and supper veggies. She broke her bottom right incisor three years ago. It grew back fine, but then she got an abscess several months later. She had surgery and was put on Sulfatrim for a little over two months. However, during floor time zoomies, she crashed into the outside of her pen and that incisor fell out a few days later. It didn't grow back. That ended up not causing much of a problem, though. Along with sometimes getting hay stuck between the top incisors, she just sometimes had a waxy build-up in her ear after that, and had to get her ears cleaned regularly. I'm not sure of the connection, and it could just be coincidence. However, it could be that the irregularity in the jaw led to some ear issues. We managed to get her to completely stop biting the bars after that first tooth problem, but somehow last November she managed to break the other bottom incisor. I'm not even sure how it happened, and her chewing was similar to her waxy ear chewing, and I had a vet appointment already set up for a few days later, so I assumed that she just needed an ear cleaning. However, the chewing got worse rapidly and I had to take her in as an emergency. By then, infection had already set in, so Poofters was put on chloramphenicol. She had surgery to have the abscess removed followed by regular wound flushing. She was doing well, but the abscess itself didn't heal up and the tooth didn't grow. She had to get wound care for four months. Then suddenly the abscess did close up and the tooth looked like it was finally growing again, but there was a big chip around the gum line. Our vet thought that the tooth probably wasn't growing but that it was being expelled. Then in April the abscess returned and during surgery the tooth had to be removed. The x-rays from back in November didn't show that the tooth had fractured, but our vet had suspected it. By April it was in fragments below the gum line. Because the bacteria had gotten resistant to the chloramphenicol, Poofters was switched to Duplecillin by injection (this is not safe for guinea pigs except by injection, and even then it's a bit risky). Poofters had actually tolerated the chloramphenicol very well. She didn't have any intestinal flora issues like she'd had with the Sulfatrim. By the way, Poofters is actually sensitive to probiotics, so that's another thing we have to be careful of. Anyways, in May the abscess returned because the infection had spread to the first cheek tooth beside the incisor. She had surgery again, and the wound was drained, and our vet put her on azithromycin and Baytril. The cheek tooth also was rotten and had to be removed. I know that in the UK azithromycin (or Zithromax, which is the brand you have) is the antibiotic of choice for dental abscesses. Our clinic didn't have Marbocyl in the right form for guinea pigs readily available, so our vet chose Baytril. After draining and the new antibiotics, the abscess cleared up and healed. In fact, our vet said that for the first time since November there was no swelling or sensitivity in the jaw area. Poofters did develop an intolerance to the Baytril on the 14th day of treatment, and we almost lost her and we had to take her off that, and she had some issues for a few weeks after, but she is still on the azithromycin. On the Baytril, Poofters had to have a small amount of probiotics (Bene-Bac). She has now been on the azithromycin for 12 weeks. We tried taking her off it for four days in the first week of July, but then she had some pain when our vet examined her jaw, so we decided to continue with the azithromycin for longer. Our vet is on holidays this week, but we're hoping to take Poofters off the azitrhomycin when she returns on Monday. With the help of top incisor filings, Poofters' chewing has become better than it's been since November. Around the middle of July she seemed to finally turn a corner in her health. The only thing now is that for the first time on all these antibiotics, Poofters' intestinal flora is starting to be affected. I've had to start a small amount of Bene-Bac. All through this, I've also been giving Poofters a small amount of Oxbow Critical Care three times a day to help with weight gain and to buffer her tummy when giving antibiotics. As well, Poofters has a good diet of massive amounts of hay (mostly timothy but some orchard grass too), fresh vegetables, and a vitamin C supplement. She also gets weekly subcutaneous fluids with a vitamin C injection to boost her immune system.

Could any of you please share your Zithromax experiences with me? How long did your piggies remain on the antibiotic? Is it safe to take a senior piggy who is close to 8 years old off the antibiotics? Zithromax is not commonly given to guinea pigs in Canada, and even our vet who is an experienced exotics vet, is in somewhat uncharted territory, due to the fact that not a lot of people have guinea pigs in this part of the world.

Sorry for the very long post. Any assistance is greatly appreciated. I feel like it's time to stop the azithromycin, but I'm also hesitant due to the fact that the jaw bone had been affected.

Thank you!

Hi and welcome!

I am very sorry about your worries, but what great age and loving care you are giving!

Guinea pigs can stay on azithromycin for as long as needed. In chronic case it is to my knowledge better to give it every second day.

Have you got other healthy guinea pigs? In this case, you might want to try 'poo soup' made by soaking literally just dropped poos in a little water and then syringing the still live microbiome in the water to your ill guinea pig. This mimics natural behaviour in recovering guinea pigs and is actually more effective than probiotics.
Ideally you take a healthy piggy out for a little veg treat and then collect the inevitably freshly laid poos. For some reason eating triggers the output at the other end; you can that way be reassured that the poos are as fresh and effective as can be! ;)

I have had a older piggies on at least two consecutive courses of zithromax. Once for a persistent dental abscess and once for an eye injury that had penetrated deeper very quickly in an older sow where an eye removal operation would not have been a good option.

@furryfriends (TEAS)
 
Hi and welcome!

I am very sorry about your worries, but what great age and loving care you are giving!

Guinea pigs can stay on azithromycin for as long as needed. In chronic case it is to my knowledge better to give it every second day.

Have you got other healthy guinea pigs? In this case, you might want to try 'poo soup' made by soaking literally just dropped poos in a little water and then syringing the still live microbiome in the water to your ill guinea pig. This mimics natural behaviour in recovering guinea pigs and is actually more effective than probiotics.
Ideally you take a healthy piggy out for a little veg treat and then collect the inevitably freshly laid poos. For some reason eating triggers the output at the other end; you can that way be reassured that the poos are as fresh and effective as can be! ;)

I have had a older piggies on at least two consecutive courses of zithromax. Once for a persistent dental abscess and once for an eye injury that had penetrated deeper very quickly in an older sow where an eye removal operation would not have been a good option.

@furryfriends (TEAS)

Thank you for replying to me!

Was each course of Zithromax a month long? When I was lurking on this forum for quite a long time reading about Zithromax, I noticed that most piggies were on it for at least a month. Did the piggy with the abscess get completely well after the Zithromax? How old was he or she at the time?

I've considered giving poop soup. Fuzzy Bear is young and healthy. The thing that makes me hesitate is that Poofters is very fastidious and proper, and she would probably be traumatized. If our vet decides to keep her on the azithromycin, however, I would definitely try it. Poofters actually was tolerating all the antibiotics (except Baytril) remarkably well until a couple of weeks ago. All the medical professionals I've spoken to, even human doctors, have heard of the speculation that once an antibiotic has done what it needed to do, then the body starts getting more side effects, but everyone says that there's no definitive proof.

I forgot to mention something in my post. When I was telling about Poofters' diet, I forgot to mention pellets. Poofters is also on Oxbow pellets. I give her a little more than the recommended amount in order to get more weight onto her.
 
I have another question about azithromycin. If a piggy takes it every second day, do you think that the bacteria could become resistant? Poofters sees our vet tomorrow, and we'll have to decide how to proceed regarding the azithromycin. Poofters has been seeing the vet twice a week every week since November, except when our vet was away, but this coming week I have three appointments booked in order for her to be more closely monitored if she goes off the antibiotic.
 
We use Zithromax a lot, here at TEAS. We give it every day though, so not sure why you think it would be given on alternate days?
I'm giving it every day. We're on week 12. My question was regarding Wiebke's response about chronic cases when the intestinal flora is affected but the piggy still has to remain on Zithromax.

How long do your piggies usually stay on Zithromax? Do you have any that can't go off it? Do you think that 12 weeks is long enough to get rid of all the bacteria that it's targeting in the bone? The infection had been in the jaw bone, as it had spread from the bottom incisor roots to the roots of the first cheek tooth. That was before trying azithromycin, however. That antibiotic has been a real game-changer for us. Poofters also tolerated it very well, with no tummy issues, up until about three weeks ago. Then her poops got mushy and she starting getting a dirty bottom. She doesn't do very well on probiotics, but I am giving her a small amount now. It only helps a little.

Tomorrow we see the vet, and we will probably try taking Poofters off the antibiotics, with close supervision. The vet and I will be making the decision, but it's best to hear others' experiences, as azithromycin is relatively new in guinea pig dentistry in Canada.
 
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