Abscess won't heal...

[Jessmvee]

My beardie, Stumpy, is having some major issues. Back in October I noticed his eye swelling. So I took him to the vet.

He got eye meds and a shot of antibiotics. He also had coccidia. I rescued him and never saw anything so i didn't know. We treated and cured that, but the swelling got worse. The next vet visit, it was determined an abscess and drained.

It was left open and I cleaned it twice a day and used prescription ointment on it. It got worse and it was lanced and drained 3 times more over the next month or two. Some tissue was also removed. Over the next few weeks, even with weekly vet visits, it got huge. The vet was concerned about it moving to his brain, so he made MORE cuts around the eye and put in drainage tubes, this time closing the wounds.

I now drain it every day by squeezing. I flush it with antibiotics, and he sees the vet weekly. But each day it swells bigger.

Here's his other eye for comparison.

I'm lost guys. He's my baby. I rescued him and do not know his age. I've had him for three years. I know my vet is knowledgeable, but I was hoping someone could offer suggestions? It just won't heal.

 

[AHBD]

Aw, poor guy [ and you ] are going through so much. So there's some type of abcess that keeps filling up ? Does it get bigger than what is in the picture ? If so , an you post a pic of how big it gets ? It's good that you got it seen to quickly. I don't know what will happen if it continues to fill up but there is something you can put on that is an excellent antimicrobial . It's raw honey [ from health food store ] ....unpasteurized it even can kill the MRSA virus. I've used it in 2 dragons that had eye wounds/infection. I diluted it 1-3 parts warm water. Here's some info on it as well as pics where vets used it on horrific wounds, scroll down for graphic pics.
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwiIxZvmhs7KAhUEGh4KHVueB_QQFggdMAA&url=http%3A%2F%2Fwww.evet.dk%2Ffiles%2FHoney%2520for%2520Wound%2520Care%25202.pdf&usg=AFQjCNGacBLxBFj8nZ2PA4kGFhyGguSTDw&sig2=TwayLNkPHZIQeeRhbZ5yVA

 

[kingofnobbys]

Poor boy....

When I had a nasty stare fall a few years ago, I developed a couple of very large haematomas in my left shin (where the sharp edge of the concrete front steps banged my leg, a few weeks later I wound up with cellulitis of the left lower leg and when this refused to respond to oral antibiotics and the upper shin sprung a leak (puss started coming out just below my knee) I was hospitalised and my leg opened up (an abscess was found by ultrasound) and it was removed (under a local - yes it still really hurt HEAPS !!!), and I was kept in the high dependency surgical ward (one step down from intensive care) and was put on intravenous broadspectrum antibiotics), cellulitis and leg swelling still refused to respond, sent to the big regional hospital for a leg scan and another abscess found, this was removed under a general, and in both cases the surgeon left my wounds OPEN to allow them to drain, important that abscesses be allowed to drain continuously (in my case a surgical wick in the deep abscess, and the wound was packed daily for the upper one).

Is that bit of clear plastic near the stitches a drain tube or just a plastic "wick" to keep the wound more or less open to allow puss to be removed ? Leave it in.

From my reading , the abscess should be left open and just packed with sterile antibiotic treated swabbing , else it will close up was the skin heals and it will reform if the bacteria are still present in the blood or tissues.

When we thought Puff had an abscess on the back of his head (a mis-diagnosis in his case as it turned out being an aneurism on his left jugular - he never woke up after surgery ) the vet was planning on leaving the open wound open and just putting antibacterial (butadiene soaked) swabs in the hole and then a surgical island dressing over it, followed up with suitable intramuscular antibiotic theropy until the infection cleared and to let the would heal from the outer edges in (he puss will accumulate and keep on reinfecting the tissues via the blood) .

Perhaps your vet needs to take some blood do some fresh cultures) and work out which exact agent is responsible for the infection (and hard to get rid of abscess) and to help him work out the most effective antibiotic or mix of antibiotics to kill off the germs.
Or perhaps there is another abscess somewhere else (hidden) that's keeping the blood infected.

Also - are you using anything to kill off any germs on the surface around the wound (when you squeeze it to get the puss out) , 1/4 strength butadiene wash / soak (for 10 - 15mins using a soaked surgical swab) will help. as will giving him a soak in a weak solution of butadiene (enough drops in the water to make it look like weak tea in colour).
Might be worth getting the vet to show you how to use a syringe to wash the cavity where the abscess was using a syringe filled with butadiene and inserting a needle into the place the puss is coming from. (That will be scary to do IMO.)

If you visit a pharmacist , they'll likely be able to sell you a "once only use sterile woundcare kit" (includes sterile plastic tweezers (2 or 3), a bunch of cotton surgical swab (3 in x 3 in) , a blue plastic sheet and plastic dish to prepare the soaked swabs in, a bottle iodine solution and some sterile surgical wound swabs (in sealed packets). You'll also need a syringe (10ml is a good size) and a some NON-SHARP aspirating needles to suit the syringe - essential draw in 2 - 3 ml of concentrated iodine (butadiene) , the add cooled boiled water (which will be sterilised by the boiling , or sterile saline). soak the swab.
Place soaked (NOT DRIPPING WET SOAKS, BUT SOAKED AND WET) swab (or piece cut to size using sterile scissors) on the skin near over the whole the puss comes out off and leave it their for 5 - 10 (or longer) minutes while giving you sick / injured pet a cuddle and some loving.
Wash off with a swab soaked in sterile saline or cooled boiled water.
Probably do this each day to help with getting rid of the bad bacteria on his skin.

I'd be inclined to leave wound without a dressing over it unless he's a digger in which case you need to put a barrier island style dressing (Hydrofilm Plus is water proof, or Opsite or some surgical self-adhesive hypafix tape) over it to keep it clean. These come off very easily with a soak in luke warm water (may as well be very weak butadiene solution body soak - DON"T LET HIM DRINK IT !!.

Maluka honey is probably going to help applied to the surface around the wound , or maybe F10 ointment (will definitely kill of the bugs on the surface).

Hope he comes good and you can resolve his abscess problem.

 

[Jessmvee]

You guys are so awesome!! Thank you so much for those responses! I'm seeing the vet this afternoon, so I will bring up the honey and iodine ideas to him. I will also ask if we can culture the puss. We never cultured it at all, as he's been administering broad spectrum antibiotic shots and oral liquid.

I've included a picture of the swelling since last night. The pictures just don't show the magnitude of this large lump. And it swells so fast!! I'm so worried. He just seems to be acting weird. He will occasionally shift his head back and forth and it almost looks like a seizure. I hope this isn't affecting his brain. I'm a nervous wreck.

 

[Jessmvee]

Also, this is how it looked after daily cleaning RIGHT BEFORE we got the second cut and stitches.

 

[AHBD]

Poor guy....he's probably just shaking his head at times because he can feel this strange object and because of the wound. I do think the honey would help. One of my hatchlings had a huge swollen eye that went down in days with application of raw honey. Of course, there may be more going on under the surface with your dragon, but I'd give the honey a try [ 1 part to 3 parts water ]

 

[Jessmvee]

We just had our vet visit. The doc said its just filling quickly because it's near a sinus.

He stuck the back of a sterile q-tip through the top hole and out the bottom hole and it drained flat. Then filled right back up within 10 minutes.

He said honey is great, but the ointment I have is "better," so he wants me to use that. He said iodine will drain into his mouth, and he doesn't want to risk using that.

SO....we are still back to draining at the vet weekly, and I'm supposed stick the q-tip through a few times a day.

I'm so stressed.

 

[AHBD]

I now you're super stressed, I can believe it. Is he eating all through this ? Losing weight ? And as far as the ointment being better than honey, I would still suggest trying the honey since you say he's gotten worse + worse over time wit his treatments. I think I saved my dragon's eye because I used honey right away. Just my suggestion since the ointment hasn't really worked for you so far. Here's another link to info on how + why honey heals better than man made ointments:
https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&ved=0ahUKEwiWyNP3s9DKAhVFhhoKHVtlDFIQFgg7MAM&url=http%3A%2F%2Fwww.drdavidwilliams.com%2Fuses-for-honey%2F&usg=AFQjCNEuoYlgW6r-HWK0tGszvkANNPHUhg&sig2=iRglf23IjpueNyuVBZO8JQ

 

[Jessmvee]

I'm for some reason so scared of the honey. What if I make it worse? I'll read up on it from the links you sent. Do I just put it directly in the open wound?

And yes he's eating and drinking very well. Still fairly active, although I think he'd really like me to let him brumate. He's actually gained weight this week.

I just feel so bad he's in pain.

Also, my vet suggested feeding him eggs. Is that a normal treat for a dragon?

 

[AHBD]

Honey can be diluted with 3 parts warm water [ not hot ] and put directly in the eye or in any wound. It would probably help to actually put it directly in the abcess. If you read the second link I posted it explains things in an easy way and the article is not very long. There are many reputable clinical studies on use of honey.

And that's great that he eats well, I don't think he's in a lot of pain....animals do not eat well when they're sick or in pain. Eggs are O.K for part of his diet, but keep up whatever you had been feeding him since he's eating so well. You can microwave a scrambled egg for 1 minute and feed him a couple of quarter sized pieces at a time.

 

[kingofnobbys]

I really feel for you and your little pal....I've recently been through a very similar experience with my big boy Puff , he wound up banging his left eye very badly and had a very swollen eye towards the end. A very worrying and stressful experience for you (and the pet).

I'm surprised no culture was done at the start of treatment. Vet's essentially flying blind without the information from a culture.

Maybe F10 Ointment might help (applied to the Q-tip) ?

In addition to the ointment you are using and the diluted honey , or raw manuka honey on the Q-tip and inserted into the cavity.

 

[Jessmvee]

I've been sobbing for hours. Stumpy developed a lump of tissue in his eye, so I took him back to the vet even though he saw him Friday. Apparently my vet thinks it's myxosarcoma. He didn't biopsy, but he wants to do surgery to remove the eye and dig around. It will cost over $1200 and there's no guarantee.

He said my other option is to just try and manage the growth as much as possible until it begins affecting his daily life, and then we have to make decisions.

I'm still skeptical. His eye was so flat with no masses when he put in the stitches (see the original post for that picture) and then within two weeks the mass grew. Could that be a cancer? That fast?? I'm hoping maybe it's just puss filled tissue or something.

Maybe I'll try the honey now. The mass in his eye is stretching his eye open. It's so sad. But he's still SO active. Running and playing and eating well. Regular bowel movements. I need some serious advice. I'm so devastated and defeated today.

 

[Jessmvee]

It's just so big.

 

[AHBD]

Aw, I'm so sorry. Ask the vet to do a fine needle aspiration rather than guessing....that should determine if it's actually a large abscess or if cancer is growing. It seems that there was just fluid before, I don't think a tumor would grow that quickly [ though I could be wrong ] At least he's still acting normally for the most part. I wonder if it would help if the drain was taken out and honey applied.

 

[kingofnobbys]

Can't believe this vet is refusing to get some cultures done.

I really do feel your pain and fears , having recently been through a similar experience with our lovely boy Puff, spent near $800 and wound up with a dead dragon who never woke up after surgery.

Maybe it's time to seek a second opinion from a good reptile vet in another practice ASAP before committing to the cost of the operation the current vet wants to do. What's the harm if seeing another vet in another practice to get a second opinion and maybe this guy might actually do a fine needle aspiration and some cultures FOR STARTERS rather than guessing and flying blind and just accumulating vet fees from you.