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Dental Recurring Tooth Abscess On An Elderly Piggy

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AnnieSue

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I don't know where else to turn for advice on my guinea pig. Sorry this is so long, but I want to include the whole story and I'm terrible at being brief :/

TL;DR - 7-year-old guinea pig with tooth abscess that won't heal. Lance and drain for the 3rd time or insert surgical drain?

Caramel is 7 years old and very strong and healthy for her age. About two years ago, she started growing peg teeth on the bottom, which is strange for a 5-year-old and I'd never heard of it. She started eating less, but from what I could tell it just looked like her teeth were a little long and a bit crooked. Had them trimmed which seemed to take care of the problem, and the vet didn't say anything looked unusual. I had her teeth trimmed periodically and everything was fine. Months later, she stopped eating again, and it looked like her teeth were even more messed up but I still couldn't see exactly how. We went back and forth to different vets trying various solutions with little progess. After a few months, an abscess formed and her chin/neck swelled up. At this point she was miserable, skinny, barely eating, surely near death. Luckily I discovered critical care and force fed to keep her alive. I did some research on my own and read about peg teeth. I mentioned this to her vet, who hadnt thought of that. She removed her bottom teeth, cleaned out her gums, lanced the abscess and sent us home with topical and oral antibiotics. Within a few days the infection cleared up and she started gaining weight again! Good as new. From then on, I took her in every few months for a tooth trim and gum cleaning, which kept the problem under control.

In November, I took her in for her usual. A few days later though, an abscess formed. I was out of town so my ex took her back to the vet and only got antibiotics, which didn't help. I got home, took her back, got a stronger antibiotic, still no help. The next time, I had it lanced, but a few days later it filled back up even with new antibiotics. Had it lanced again a week later. They made two incisions so that I could squirt an antiseptic solution in one hole and let it drain out the bottom. This helped a lot at first, but the bottom hole quickly closed up and the abscess filled back up. Called the vet for advice, and she said either lance and drain it again and see what happens, or partially sedate her and insert a surgical drain for a while to drain it better. I feel like that's a bit extreme on an elderly guinea pig, but maybe that's the aggressive approach she needs. At the same time, what if she doesn't make it through the procedure? She's fairly strong but again, she's 7. She's still eating normally and it doesn't seem to hurt her much this time, so do I just let it go because she's old? Or should I try lancing it one more time? I don't understand why nothing is helping, but after all, she is two years older than the last time she got an infection and maybe she is just too weak to fight it. I hate to spend more time and money on something that we've already tried twice, but the alternative seems risky. In retrospect, I've been extremely busy lately and maybe I didn't clean it as often as I thought I did. I quit my second job and I'll be around a little more now, so maybe if I'm super obsessive about irrigating it and keeping it clean, that will keep the incisions open until it drains properly. But if that doesn't work, then what? To further complicate the situation, I'm moving out of state in 4 weeks and I want to kick this before we go. What are your thoughts?
 

AnnieSue

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Thank you for your help! Yes I am in Pittsburgh, Pennsylvania, US
 

AnnieSue

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Edit: even though the incisions are almost completely closed up, the abscess oozes frequently and the puss smells horrendous. It's stinking up my apartment! I've grown a bit numb to it but my roommate probably doesn't appreciate it
 

furryfriends (TEAS)

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Firstly, which antibiotic have you been prescribed? Also, when the surgery was done, did the vet marsupialise the abscess (stitch the abscess capsule to the skin and then lance it). This enables the abscess to be stitched open. It will still heal unless you peel the scab off as soon as it forms.
 

AnnieSue

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Firstly, which antibiotic have you been prescribed? Also, when the surgery was done, did the vet marsupialise the abscess (stitch the abscess capsule to the skin and then lance it). This enables the abscess to be stitched open. It will still heal unless you peel the scab off as soon as it forms.
We've tried sulfamethoxazole/trimethoprim, enroflaxin, and chloramphenicol. There were no stitches and the vet didn't mention this as an option. If it can still heal either way, what is the benefit of stitching? Is this more painful or traumatic than just lancing? I want to consider her comfort since she is older.
 

gizzy

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I had a pig with a very stubborn abscess abscess my vet eventualy removed the abscess and some surrounding live tissue , it was a rather drastic mesure, but it never came back ! Though it depends on were the abscess located

I will try and up load some photos
 

Freela

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Have you been keeping the abscess open and cleaning it out? It can take quite a long time for abscesses to stop producing pus, and often if you let the area heal over, it can seal up and refill very quickly in spite of antibiotics. One of my girls, Sundae, had a very nasty dental abscess and it took several months of opening the wound and squeezing out any new pus and irrigating it with saline to allow it time to heal from the inside out. My method was to use some hydrogen peroxide to soften any scabbing (it will foam up upon contact with the scab and will make it soft. I would then gently remove the scab and reopen the wound and irrigate the inside with a dental syringe of sterile saline (my vet also gave me a medicated wash to use, but said switching to saline was fine when it ran out.) Then after irrigating, I would gently express any softened pus from the wound (kind of like squeezing a pimple, some pressure at the sides.) It's wasn't fun for any of us, but it wasn't overly painful for her (having a full abscess is actually a lot more painful than the draining wound due to the fact that the pressure of the closed abscess is what causes the pain) so I wouldn't worry too much that re-lancing and keeping the wound until it heals from the inside out.

It's also possible in some cases to surgically remove the entire abscess capsule (picture a 'balloon' of tissue with the pus inside.) This will keep it from recurring. However, this is dependent on the location of the abscess (one of my pigs had a large cyst/abscess removed from her lower back this way, but Sundae's dental abscess could not be removed totally because there would not have been enough skin left to reconstruct her face properly afterwards, plus the abscess was too close to required jaw muscles and her neck arteries for it to be feasible.) Plus, of course, that is a more major operation and with a 7-year-old piggie you might not want to put her through that even if it was an option.

I have gotten a lot of great abscess advice on this board, hope it helps you out too!
 
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