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Large dental abscess treatment

G

Gizboo

Junior Guinea Pig
Joined
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Location
Wales, UK
Hi All, I noticed before the weekend that one of my guinea pigs, Blackjack, had started to develop a lump under his jaw. It came on very quickly, I usually stroke him under his chin so I could tell straight away something wasn't right, a few hours later it was much bigger and over the weekend it seemed to grow more. Monday morning I managed to get an appointment for him at my local exotic vets. They took a look and told me that it was a dental abscess and because of the position, squarely under the middle of the jaw its likely to be from one of his lower incisors.

The vet told me dental abscesses can be tricky to manage and recommended doing some imaging to identify which tooth is causing it and to have surgery to marsupialise the abscess and also to extract all four incisors to prevent the abscess returning.

I was quite shocked that the vet recommended extracting all four incisors but he assured me that Blackjack would still be able to eat using his molars. I’m just after some advice on whether this seems like the best way forward? I’ve had a read through other threads posted here about similar issues and it doesn’t seem like the norm to have all four incisors extracted so I’m concerned this might be a little extreme?

*To give some more background Blackjack will be 5 years old in June, he’s still eating and behaving normally since the abscess first appeared. Around 6 weeks ago he went to the vets for a dental because he had been off his food and when they examined him they saw that there was a slant in one of his lower incisors so he had a dental operation to bring all the teeth back into alignment. He was much better after the surgery, eating and behaving as normal, he’s usually a very happy chappy. This abscess has been the only issue since, almost 6 weeks after his op.
Vets also recommended doing CT to be sure which tooth was causing the issue but I opted for an X-ray since it was slightly cheaper than the very expensive CT, and vet seems very sure its related to one of the lower incisors.
 
I’m sorry to hear this.

Antibiotics (Azithromycin), painkillers, surgery on the abscess - all would be within what I would expect.

Removal of all four incisors? There are piggies who do have to have incisors removed but it can often mean they require assistance with picking up food and eating.

I’m going to tag @furryfriends (TEAS) as she has lots of experience with dental issues and she may have advice to help here
 
Please don’t agree to the removal of all the incisors. In most cases they don’t need to lose any, although occasionally the incisor the abscess is under may be lost. Guinea pigs don’t cope as well as rabbits do, after having all incisors removed. Marsupialising the abscess along with twice daily flushing and a good antibiotic, such as azithromycin, your piggy should make a good recovery.
 
furryfriends (TEAS) said:
Please don’t agree to the removal of all the incisors. In most cases they don’t need to lose any, although occasionally the incisor the abscess is under may be lost. Guinea pigs don’t cope as well as rabbits do, after having all incisors removed. Marsupialising the abscess along with twice daily flushing and a good antibiotic, such as azithromycin, your piggy should make a good recovery.
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Thanks both. So if I go ahead with just the marsupialisation it will be a case of flushing the abscess twice daily and treating with antibiotics until (hopefully) the infection clears? What does flushing the area involve?

I will call the vets and ask if we can go ahead with the marsupialisation but not the extraction, since it does seem to be a bit extreme.

He is currently on 0.7 ml Baytril (antibiotic) twice daily and metacam (0.45 ml also twice daily).
 
I’ve had a piggy with a very large tooth root abscess. It was marsupialised. He was given a 6 week course of the antibiotic Zithromax and pain medication. I flushed it three times a day and managed to keep it open for 10 days so it could drain (although not much came out of it) and heal from the inside. He did eventually lose one incisor. But he managed well with only three. Good luck I hope it gets sorted out and he’s soon feeling better.

I bet it’s been there 6 weeks and was brewing when he had his dental as Peppers first signs was going off food, losing weight and having slanted incisors.

Also the Zithromax did stop his appetite so he was syringe fed for 8 weeks.

Here is his thread if you’re interested
Dental? Pepper is off to the vets tomorrow
 
weepweeps said:
I’ve had a piggy with a very large tooth root abscess. It was marsupialised. He was given a 6 week course of the antibiotic Zithromax and pain medication. I flushed it three times a day and managed to keep it open for 10 days so it could drain (although not much came out of it) and heal from the inside. He did eventually lose one incisor. But he managed well with only three. Good luck I hope it gets sorted out and he’s soon feeling better.

I bet it’s been there 6 weeks and was brewing when he had his dental as Peppers first signs was going off food, losing weight and having slanted incisors.

Also the Zithromax did stop his appetite so he was syringe fed for 8 weeks.

Here is his thread if you’re interested
Dental? Pepper is off to the vets tomorrow
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Thanks so much for this!

I found Pepper's thread whilst I was searching through posts about dental abscesses, really helpful!

I spoke to the vet earlier and asked if it would be okay to go ahead with the marsupialising only and leave the teeth alone. He pushed back against it, said it wouldn't be the recommended advice and that he was sure the abscess would come back unless the tooth (and all the incisor teeth) were extracted but I said I'd be keen to try to get rid of the abscess first before doing any tooth extraction so he agreed. Really hoping I can get rid of the abscess so that we don't need any more surgery.
 
Gizboo said:
Thanks so much for this!

I found Pepper's thread whilst I was searching through posts about dental abscesses, really helpful!

I spoke to the vet earlier and asked if it would be okay to go ahead with the marsupialising only and leave the teeth alone. He pushed back against it, said it wouldn't be the recommended advice and that he was sure the abscess would come back unless the tooth (and all the incisor teeth) were extracted but I said I'd be keen to try to get rid of the abscess first before doing any tooth extraction so he agreed. Really hoping I can get rid of the abscess so that we don't need any more surgery.
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I’m glad Peppers experience could help another piggy. That seems like a good plan. Get rid of the abscess and see what happens to his teeth. Keep us posted on how everything goes. We are here to support you and your piggy through this. ❤️
 
We’ve had many piggies fully recover from incisor root abscesses, and haven’t removed the incisors. I could sort of understand them suggesting removing the tooth with the abscess in the root, but why would you remove healthy teeth and make it difficult for the guinea pig to eat?!?
 
We've had dental abscesses opened up and lanced/marsupialized before, without removing any teeth. I would try that first before okaying the removal of any teeth (especially not all the incisors, some of which are bound to be healthy!)
 
Thanks everyone for your advice and support! Just to give an update Blackjack had his surgery to marsupialise the abscess yesterday, it all went well and he is back home with me and his brother. He is on Metcam for pain relief twice daily and Baytril antibiotics to clear the infection (also twice daily). The vets also gave me saline and manuka honey to apply to the wound, they told me to flush it out twice daily and then apply the honey once the wound dries. I’ve seen a few posts mention that they flushed the wound out 3-4 times a day so I might do it more regularly than twice a day. We had our first go at it earlier, I was surprised by how well behaved he was, he took it really well but it didn’t seem like much came out of the wound. Followed the advice given in other posts, propping him up against a pillow and then flushing the site with a needle and syringe and 10ml saline. Plan to go again later. He is doing well bless him, taking his meds (antibiotics reluctantly) and with lots of veg coercion but getting through it. He’s also started eating some hay which I’m taking as a good sign and moving around a fair bit but has been quite lethargic, as you might expect after surgery. Vets have asked him to come in weekly so they can monitor the wound and check how its healing.
 
furryfriends (TEAS) said:
Sounds good! Ideally you could do with a better antibiotic than baytril but see how it goes. We always use Azithromycin, or occasionally we have used a combination of Marbocyl and Metronidazole.
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Yeh that's one of my concerns, they did say Baytril was a strong one but maybe when I take him back in next week i can specifically ask about Azithromycin.
 
I don't have much to add here, just to say that Baytril can clear an abscess, although I don't want to pretend it's a certainty. Bann had an abscess that was either a tooth root abscess that traveled upwards or it was behind the eye and travelled down, it had burst and was draining via the eye (that was a very weird vet trip) but his upper molar was also loose. Baytril cleared whatever it was.

Here's hoping for a speedy recovery regardless!
 
Lorcan said:
I don't have much to add here, just to say that Baytril can clear an abscess, although I don't want to pretend it's a certainty. Bann had an abscess that was either a tooth root abscess that traveled upwards or it was behind the eye and travelled down, it had burst and was draining via the eye (that was a very weird vet trip) but his upper molar was also loose. Baytril cleared whatever it was.

Here's hoping for a speedy recovery regardless!
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Thanks for the info, that’s really good to know! Okay well hopefully Baytril will do the trick with a bit of luck and perseverance 🤞
 
Hi All, just wanted to give an update on Blackjack.

We spent the last week flushing out his abscess wound and removing any gunk, I didn’t seem to get loads out but there was a little bit each time. He’s also been getting his twice daily antibiotics (Baytril) and pain relief (Metacam). In himself he seems to be okay, he’s behaving normally if a bit less active than usual and maybe eating a bit less hay but still going crazy for veg and breakfast pellets.

We went to the vets yesterday for a post-op checkup, 7 days since he had his surgery. They were happy with how the wound was healing. They also had some results back from the lab on a sample from the abscess which showed two different pathogens, so he was prescribed Metronidazole on top of the Baytril. I recognized the name from one that TEAS mentioned earlier in this thread – so thank you for that! – hopefully these two antibiotics will do the trick and get rid of his infection.

The process of giving him the medicines is a total nightmare. I know there are plenty of people on here who have dealt with much worse but for me its been a lot to handle! It takes an hour on average to give him all the meds plus washing out the wound, he absolutely hates it bless him, squirms away from the syringe every time. I’ve tried giving leaves after each dose, wrapping him up like a burrito, our latest technique is to fill a syringe with water and ‘wash down’ the meds, which he seems to like but it still takes a while to get through it all. Just my moan! Any tips with this appreciated.

One thing I’ve noticed is he really struggles to pick up sliced bell pepper now and get it in his mouth, I’m guessing this might be to do with some discomfort in one of his front teeth, whichever one is infected, but otherwise eating herbs and leaves fine.

Hoping these meds clear his infection and that he’s back on top form eventually! Plan to keep flushing out the wound and giving his meds and he will have another check up with vets next week.
 
Is his weight stable when you weigh him each morning?
If he is eating less hay then you may need to step in with syringe feeding (if you haven’t already) to replace the lost fibre.

I hope he is ok
 
Piggies&buns said:
Is his weight stable when you weigh him each morning?
If he is eating less hay then you may need to step in with syringe feeding (if you haven’t already) to replace the lost fibre.

I hope he is ok
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Thank you! He has lost a little bit of weight yes, I have been giving him some critical care as well.
 
Hey All, thanks so much to everyone who gave me really useful advice on this thread. I ended up treating Blackjack’s abscess with a combination of Baytril and Metronidazole as prescribed by the vet. He lost a lot of weight because he wasn’t eating very much and at one point wasn’t able to eat solid food (like pellets or pepper), I think because of the pain in his tooth. Eventually we stopped the meds so he could put some weight back on. He did and he seemed to clear the infection because he eventually started being able to eat solid food again and I noticed just today that the lower left incisor that we suspected was infected looks like it’s come out on its own (like a few people said it would after treatment of the infection). So all that seems really positive.

Just wondering if anyone know what comes next in terms of the three incisors left over, will the upper one grow too much without the lower one to bore it down? Will he need regular dentals? Thanks.
 
That’s great news. My Pepper managed perfectly well with 3 incisors after his abscess. He didn’t need any dentals.
 
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