As others have noted, promoting drainage and debulking the sheer size of the infection and pus is key, as antibiotics won't be able to penetrate a loculated collection of germ goo. I would be reluctant to squeeze to express pus unless the opening is big and this can be done without high pressure or squeezing hard. This is especially true in the face.

You can rinse the eye. Artificial tears and other balanced salt solutions made for the eye can be obtained over the counter. One can also use a little Johnson's "No More Tears" shampoo to scrub dried goo off the lashes and hair in the area if warm compresses aren't getting it done. I like a drop of shampoo in the capful of water, and carefully use a Q-tip to gently cleanse.

Given as much germy drainage as you are seeing in the eye, it may be a good idea to consider an antibiotic eye drop or ointment until the drainage improves. It is a good idea to protect the eye from further damage. I think eye drops (solution) are a lot easier to get in, and are handy for the excessively uncooperative patient. If Cricky is cooperative, ointment is nice because it sticks around longer. It is trickier to get where you need it.

The gram stain/micro report is curious. It is surprising to see a multi-organism mixed infection in such a location. Gram + or gram - information may help you lose some of those meds and get focused on what is the causative organism. Was that micro check from your vet directly from drainage, or was that micro exam from the plated culture results? Did they not identify any of the crud swimming in there?

The combo of meds is interesting. The Clavamox cover gram + aerobes and many gram - bugs, and is broad spectrum. Baytril is very good at gram - aerobes, but also has activity against many gram + bugs and is broad spectrum. Metro gets anaerobic bugs and many gram - germs. A comparable trio is used when an appendix ruptures and many different germs are dumped into the abdominal cavity causing a life-threatening mixed infection. Haven't seen it usually for sinus and facial abscess.

That is an extremely unfavorable combo for flora. Any one of them alone is bad for flora, but all three together kill about everything in site except the abscess infection. The reason they don't work quickly or well or permanently in an abscess is not that the dose was too low or the spectrum of coverage wasn't right. The reason you can't clear an abscess with meds is that the med can't penetrate the loculated goo and so can't kill the germs due to poor delivery. Actually any one of the three may have great activity against the causative germ. There is no substitute for a correct identification of the bacteria in order to allow an accurate diagnosis and appropriate treatment plan (and more importantly an effective treatment plan.)

Good luck. I hope something in here helps.

OK, just spoke with the vet... Machu's anerobic results came back negative, but he did test positive for the aerobic "Strep" bacteria. Still not sure how this happened? She said it could have happened if he scratched the inside or the outside of his cheek and infection grew... but we didn't see any injury or scar or scratch. And I'm afraid this could happen again... how can I help prevent this in the future???? His swelling is looking a little tiny bit better still today...I think he is recovering (I hope!!!) just junk in the eye now, which I wiped away with warm water. The vet told me to keep an eye on that and call her if I see any discoloration in the eye junk (now it's more white/clear) incase he needs eye drops. I am keeping him on the clavamox for the strep. she said the metro would have helped if it was anerobic, but since it is aerobic, then the batryl or clavamox will work on the infection. <img src="/ubbthreads/images/graemlins/thumb.gif" alt="" />

Keep all the nails trimmed on a reg basis. This way.... if there is a disagreement and one glider takes a swipe at the other one... the nails will be blunt and less likely to break the skin.

If feeding dry food... moisten a small amount nightly and discard in the am.

I've been wiping his eye with a warm cloth... I just did again, and his eye is looking better. swelling is looking better too... I've left it alone except I wipe it when I wipe the eye.. and of course Machu's appetite was never affected! <img src="/ubbthreads/images/graemlins/wink.gif" alt="" /> He took his medicine a little bit better when I mixed with yogurt. Except Picchu tries to eat it first... I can't keep her away from it, she loves it unlike Machu. He won't eat it unless he is inside his cage, (so easily distracted when he is out) so I have to take her out while he eats... he took his sweet time and she was angry! I'll still try to send a photo of Machu, but I do think we are over the worst of it! Maybe instead of sending a puffy-eyed pic of machu, I will send a cute one of Machu & Picchu <img src="/ubbthreads/images/graemlins/muchlove.gif" alt="" /> <img src="/ubbthreads/images/graemlins/muchlove.gif" alt="" />

Thanks for the detailed and positive update. So glad to hear Machu is on the road to recovery.

Can you get more info than "Strep"? There are many members of the Strep family. Strep viridans are a bunch of wimpy germs that live in the mouth. They usually don't cause much trouble, but can be resistance problems when they go aggressive somewhere else.

Strep pneumonia in many species are frequent stinkers for upper respiratory infections. In my patients, it is the number one cause of sinus infection and ear infection. Clavamox is more than enough to treat it IF you are getting it in the right area and draining.

"Strep" isn't enough info. Did they culture? If so, what was identified? What were the resistance levels? Lab reports? ??

First, it can be the tiniest of scratches (you could probably never even see it) that can cause this...all it takes is a break in the skin enough to allow bacteria to enter. If the abscess is draining, that is good-keep it draining, even if the vet has to keep reopening it until significant improvement is noted.

Not to cause a problem here, but I now have 3 vets with my Riker and Chronos(and his recurrent facial infections) that all agree with each other. The only difference is his infections, despite the facial swelling and eye bulging, are so diffused within the tissue it can't drain, nor a sample be taken.

The most effective combo (and my newest vet has seen several of these type infections and agrees with this also)*Riker* has been Clindamycin and Metronidazole for a period of two to three months, both meds twice daily, to cover gram positives, negatives, and anaerobics. Sometimes longer is better and in these it seems to be the case-any shorter treatment has not worked on Riker's infections. Argue if you will, but shorter treatments did not clear the infections-we have been dealing with this for two years.

I also have one with an anal gland abscess *Chronos*-he is on Clindamycin, Baytril, and Metronidazole, all twice daily. Meds to be continued until the abscess is GONE. In the meantime, we express the infection (gently) on a daily basis, and rinse with a 50/50 peroxide and water solution once daily. If any of the abscess remains, it will come back. He is also on long term meds until the infection is cleared. My vets' feelings are that even if you identify one, another may not show up so we treat for the entire spectrum.

Your vet will need to prescribe dosages and monitor progress. You can call if you like as well..H-435-783-6097 or Cell-435-640-9438, any time. Keep us updated on your little one. I'm only offering this as someone who has dealt with these in gliders for years now, and offering what we found thru trial and error to be the most effective treatment that gives the glider the best chance of recovery.

What I mean by 'long term' is a course of two to three months on medication.

Thanks for the info, appreciated as always!!! <img src="/ubbthreads/images/graemlins/thanx.gif" alt="" />
I am taking Machu to the vet again in the morning, just for a check up on his eye goop, make sure no drops are needed... I keep wiping it away, and I don't see any discoloration, so I think he will be fine. I am also going to get a copy of his file, just so I have the x-rays on me (came out normal, so I figure good to have a pic of his "normal" skull on file) and also to get the exact list of Strp bateria found... so I know, and so I also have this on file, incase (hope not!!) it happens again. I read the post before and that's why I figured I might have to keep Machu on meds longer... at least until this is 100% gone! I will list the exact lab results as soon as I get them! <img src="/ubbthreads/images/graemlins/cool.gif" alt="" />

Jen has been through a tough road with her guy's facial infections, and has great first hand experience. With appropriate respect for what she has been through, I would suggest a different perspective that I also believe to be true:

Using three different antibiotics does not mean that the infection was so severe it required three different ones to clear. In a usual situation it is one germ that does not require three different ones to get better. Because Riker was naughty enough not to drain or wall off a nice pus pocket to lance and culture, thus recovering germs to culture and identify, they are dealing with the situation without good guiding information. Since there is no information to select the appropriate antibiotic, one has to resort to either guessing and switching when there is no improvement or treating multiple possibilities with multiple meds. That sometimes becomes the default treatment because no other better option was available.

But doing that in general breaks many tenements of good infectious disease management. For Riker's specific situation it may be the best option, but that should not be the knee-jerk response to every facial infection or abscess. If one can get a culture, do it and use the result to select the one best narrow spectrum antibiotic that the germ is sensitive to. If a short-term treatment works, use short term. If you get unlucky enough to have a pet be as contrary about their germs as Riker has been, then do what you have to do. But one should not come away with the conclusion that the best treatment for facial abscess (or any abscess) is multiple meds for long term treatments.

Your pet may give up an organism. They may drain and heal without much med at all. They might clear in short order. Not every situation will play out as stubborn as Jen's gem.

And keep in mind - the antibiotic versus bacteria fight has little to do with the animal except for the incredibly important immune system help. The animal is often the arena in which the battle takes place, but the fight is about whether that medication can harm life-sustaining processes within that bacterium. Each infection is a unique germ, with its individual resistance tendencies, and individual location which may be easy or hard to get antibiotics levels into.

Schlep is correct. All I have to go on are my two and experience, and what they have responded to or not. Less and we got nowhere...hence the multiple meds to cover all the bases, and long term. I was asked to post on this thread, and all I have to offer is my own experience. Keep us updated on the little one!

Jen -
I am going to try to send you an article that was sent to me from OZ awhile back - a few think it could possible help - please show your veterinarians & post article here
for others (I am unsure how to post it here)

"Use of Antibiotic impregnated polymethylmethacrylate beads"
- This has been used with bennets wallaby, dogs, horses, & black bear - beads would have to very very tiny!

Danic I just found this thread but I went through the same thing with my twinkie awhile back. My vet did lance it open and I had to give her clavamox and keep it cleaned 2 times a day with a moist qtip. Her eye did clear up in about 10 days and now she is just fine.
I was told it prolly happened by her cage mate while they were sleeping when Cookie scratched her by accident with her claw. SO just keep it clean and keep an eye on her.

let me see if i can find the pic of twinkies eye..... Ok here it is.

Yes, that's what Machu looked like! <img src="/ubbthreads/images/graemlins/wink.gif" alt="" /> I will try to attach his picture I just took right now. His eye looked even better today!! <img src="/ubbthreads/images/graemlins/yelclap.gif" alt="" /> no goop in the eye to have to wipe away tonight either!!! I can actually see his eye again... looks more clear and bright like it used to before this horrible nightmare began! <img src="/ubbthreads/images/graemlins/multi.gif" alt="" /> He is on Clavamox only now, and almost done with the perscription. He will see the vet again next week as a follow up... I'm hoping he'll get his clean bill of health! <img src="/ubbthreads/images/graemlins/party.gif" alt="" /> I think when this last bit of swelling goes down, his eye globe will look big and normal again. I think he's happy to be seeing normal again too! Easier to find those treats! <img src="/ubbthreads/images/graemlins/cloud9.gif" alt="" />

ok, I'm a dork... I can't get the pics to upload... too big. I have to figure out how to attach a smaller photo file, <img src="/ubbthreads/images/graemlins/nixweiss.gif" alt="" /> then you can see Machu!

I am glad my pic could help you out Danic. Also glad your baby is doing better. Just remember to keep it cleaned everyday and soon enough you wont even remember it was there.
This has not happened to Twinkie since so I am going ot believe it was a scratch.

Danic...if you can email me the pic, I'd be more than happy to resize and attach. Hoping things are still going well for your little one. I know how scary this type infection can be...having been there. Lots of hugs. <img src="/ubbthreads/images/graemlins/hug2.gif" alt="" />

Pockets...PM sent

Yup! machu is just about back to 100% normal!! <img src="/ubbthreads/images/graemlins/yelclap.gif" alt="" /> His eye is looking great and he only has a couple days left on the antibiotics. <img src="/ubbthreads/images/graemlins/multi.gif" alt="" /> I am trying to email pics to get help posting them... Then I had email issues too <img src="/ubbthreads/images/graemlins/shakehead.gif" alt="" />... so hopefully you get my emails. I was wishing I had taken more photos during machu's infection... so maybe I could help out future glider parents. <img src="/ubbthreads/images/graemlins/help.gif" alt="" /> The photo of Twinkie was so helpful... I felt Machu would recover when I saw Twinkie had looked the same and was all better! <img src="/ubbthreads/images/graemlins/agree.gif" alt="" /> But I took these the other day, when the swelling had gone down considerably!! Now he looks almost 100% normal! I still thought it would be nice to post so you could see Machu. <img src="/ubbthreads/images/graemlins/littleglider.gif" alt="" /> Thanks again to everyone at GC forum! It was greatly appreciated!! <img src="/ubbthreads/images/graemlins/heartpump.gif" alt="" /> <img src="/ubbthreads/images/graemlins/thanx.gif" alt="" /> <img src="/ubbthreads/images/graemlins/hug2.gif" alt="" />

Looks like I was able to finally get a pic attached on that last message! I am not really a technical genius <img src="/ubbthreads/images/graemlins/smirk.gif" alt="" /> but that's one picture of Machu as his eye swelling had gone down considerably!

Hopefully we can get this licked! My vet says that it's another medical cluster, she has 3 other cases right now, and hadn't had any in about a year prior to this.

I wanted to write back (sorry it took me so long <img src="/ubbthreads/images/graemlins/blush.gif" alt="" />) but to include the specific info as a reference for any future "swollen cheek" cases that might come along.
The aerobic culture came back as a moderate growth of "Alpha Hemolytic Streptococci". We started him out on Baytril, but the Clavamox seemed to work better on this bacteria. Machu has recovered 100% <img src="/ubbthreads/images/graemlins/yelclap.gif" alt="" />and his eye is back to normal. His xrays were normal, no bone affected, so this was an isolated cheek tissue infection. Still not sure why it happened <img src="/ubbthreads/images/graemlins/nixweiss.gif" alt="" />... I'm guessing he scratched the inside of his cheek somehow. Thank goodness he is better. I am keeping this info in his file, just incase it ever happens again. My mom will be babysitting for two weeks in a couple days!!! ...she is hoping things go smoothly. She is their grandmother and has babysat before, but after this incident with Machu, she is more afraid of anything going wrong while I am away. But I will give her the GC info (along with my vet info of course) so she has good contacts while I am away from my sugar babies!! <img src="/ubbthreads/images/graemlins/thumb.gif" alt="" />Thanks again for such a great resource at GC! <img src="/ubbthreads/images/graemlins/thanx.gif" alt="" />

Thanks for the upbeat update! So glad to hear Machu has fully recovered. <img src="/ubbthreads/images/graemlins/yelclap.gif" alt="" />

<img src="/ubbthreads/images/graemlins/multi.gif" alt="" />So happy to hear this great news. Thank you for posting an update. This info is great to have and save incase someone else has a similar problem. Thank You <img src="/ubbthreads/images/graemlins/smile.gif" alt="" />

That is truely wonderful news Danic, congradulations you two! Good luck to your mum!