Chey, you raised a couple of interesting points that I would like to respond to. I am a Pediatrician and NOT a vet, so discount my ramblings accordingly.

While it is true that some antibiotics cross placentas and get into milk in nursing humans, they all have different lipid and water solubilities. The level in babies is generally well below mom's level. In some drugs, the toxic levels for moms could be reached before getting to a level that would be adequate for the baby. Others might actually concentrate in the milk in high levels. I wouldn't count on the mother's milk to deliver adequate treatment levels in the joeys. Data such as which ones get into milk at what levels is extremely important and interesting to us in human endeavors, but unfortunately good data about this doesn't always exist. I can't imagine glider data is out there about antibiotic levels in glider milk. Prior to OOP date that may be all you have, but once OOP and able to directly feed the joey a defined adequate dose, put your money there.

Another comment about boosting up the dose when first OOP to "catch up" is interesting. Seems tempting, but maybe ill-advised. In preemies, their kidneys, liver, and drug detoxification and clearing systems handle meds at different rates than adults -usually slower. Clearance rates of your body taking meds out of the system is key to picking the size of the dose and the interval at which it is given. For a human baby, we would cut back on both until older, not increase them. Again, your vet can best direct such matters.

Baytril is a fluoroquinolone. We don't give fluoroquinolones to children under 18 years of age. Some rat and puppy studies showed it did bad things to developing cartilage in joints. It's a great drug for many things, and we seem to be successfully using it in gliders including young joeys without known harmful effects, but it would be one antibiotic that I would have a theoretical concern about in a pregnant, undelivered female. Be sure and ask your vet. Amoxicillin on the other hand we use throughout human pregnancy without seeing untoward effects. Sulfa (trimethoprim-sulfamethoxazole)is another no-no in a baby under two months of age. Same concern during pregnancy.

One other comment I didn't explain well in a previous post in this thread. A mixed culture is often garbage information. Any wound that has been draining for a month undoubtedly has many micro-organism that have come to grow in this wet, non-normal environment. Many things we might culture there might not have anything to do with the original infection. They are just opportunists setting up shop in an easy place to survive, perhaps much easier than dry, normal fur. So, cultures need to be interpreted very carefully. If one grows a single bug in high quantity, and it makes sense, (that germ typically grows there), then you've got a winner. When lots of things are growing, and they are in low colony count, and they are screwy germs to be in that location, watch out! You can easily be led astray, but feeling good because it's "culture proven."

To Judie, with these not yet OOP joeys, I might suggest the following strategy as food for thought to discuss with the vet. I have taken certain liberties extrapolating from what we do with babies whose moms have known exposure to Group B strep, and how we treat them, as well as figuring in the unique problems of treating Morganella, (a bummer of a bug). It might require a sophisticated lab to do the culture identification for morganella.

This germ makes a lot of sense for this wet fur infection. It likes perinatal transmissions, it likes immunocompromised hosts such as the very young, it is resistant to many antibiotics, it can do wound and skin stuff when conditions are right, and it is frequently brought out after being unsuccessfully treated with beta-lactam antibiotics, like ampicillin (=amoxicillin).

If the parents are culture positive or known to have had some prior Morganella exposure, what would your vet think of empirically treating the newly OOP joeys with Baytril for 2-3 weeks ASAP. I know a previous set did not get better on Baytril, but it still has a good track record with this germ and if brought under control early, we might get lucky. Besides, baytril is easy, plan B is not. If they emerge looking healthy and stay healthy after the 3 weeks of med, then watch. If along the way they get sick or develop the dreaded wet fur crud, change them to combination therapy.

Combination therapy is more difficult. IV meds (Medication right in a vein) seems beyond reason. IM (shots in the muscle) might be worth considering, but not ideal. Oral and topical look like the goal meds.

First of all, frequent baths to drop the bacterial load. Then what else to add? Since daily injections of an aminoglycoside is a tough thing to accomplish, might reserve this for those that really appear systemically ill. If it just looks like wet fur but otherwise eating and playing, there is an aminoglycoside in the triple antibiotic ointment to be applied topically. The bacitracin in the triple antibiotic ointment may also help prevent secondary invaders like staph and strep. Most of the extended spectrum drugs with activity against morganella are IV only, and no oral form exists. One last thing to add to our substitute for baytril might be chloramphenicol. It has activity against Morganella, has an oral form, and should be dirt cheap. 50mg/kg twice a day orally would be about right. It has a rare effect in humans which picks off their bone marrow and causes them to quit making blood. They told me in school it is bad form to fix an infection and knock off the patient along the way. But this reaction is rare. We quit the drug because safer, effective IV meds were developed. But this might be a very reasonable drug to add to or substitute for baytril if it proves resistant. And since we already are experiencing bad outcomes with current attempts used to date, we don't have an unacceptable risk/benefit ratio. That should give us a couple of effective meds to put in the regimen and see how we do. Just a thought to run by your vet, who ultimately should make the call. Hope some of this is helpful.

I still have not heard back on the culture results. I bathed Aphrodite's joeys for a last time, their fur seems to be getting softer, it is no longer wet or matted. Athena's female joey has wet fur again and the male still has a little wetness near his cloacae. I have pretty much ruined one of Aphrodite's joeys temperaments because the joey refused to lick the medication by herself. I had to force feed it to her. She hates me and is becoming mean. The other joey took the medication without the need of forcing it. She has remained inquisitive and tame.

Ushuaia

Chris, hopefully, once you no longer have to force feed the meds, you can work with her and regain her trust, I've got several that I have to force feed them their meds and we do ok when that's over. Or as long as I'm not giving them meds. Something you might try if they will eat mealies is to inject the meds in a mealie or other favorite treat, then watch to make sure they are eating the entire treat. Maybe even mix it up in a little bit of gliderade. Hopefully this will soon be behind you, you can look back and tell yourself, we got thru it! It sounds like even if she isn't the sweetest glider, she's lucky to be alive! You've done awesome!
Chey <img src="/ubbthreads/images/graemlins/wave.gif" alt="" />

Ushuaia - one of ours laps up med, the other is a royal pain. We put the dose in a little bit of Hawaiian Delight. They love that. They only get supper after finishing the little pile of med-loaded Hawaiian Delight. Probably not great nutrition, but it keeps us friends. It sounds like you are doing a great job of saving these little guys lives. I've enjoyed reading your saga and have learned something from it. Thanks, and Congratulations.

You can also put the meds in the end of the straw. Not only does it become a game, glider's will do anything to get that yummy out of a straw. (you may have to mix it with babyfood or yogurt though).

Karin

Update:

Aphrodities joeys are still dry, their fur is soft again and they appear to be recovering.

Athena's female joey is still wet and losing hair on her underside, while the male has only slight wetness near his cloacae.

The vet said that the lab has gotten extensive growth of a gram negative bacteria and is working on identifying it. I should have the full report of the analysis in a few days.

Ushuaia

I am so sorry Chris. I hope this nightmare is over soon for you. At least one pair seem to have recovered. Few more days...to wait and then perhaps the proper meds can be given and the second pair of babies will be on their way to wellness again.

Hang in there.

Update:

The results of the bacteria culture is back. My joeys have Klebsiella and Strep. Strep is a result of lower immunity due to the Klebsiella and is scant growth. Klebsiella can cause Mastitis (a mammary infection) which is why my female joeys show greater symptoms than my male joey. This strain is susceptible to 8 different medications. Amoxicillin is partially effective against this strain, which is why Aphrodite's joeys appear to have recovered. My vet has prescribed Clavamax for 14 days. I am going to pick up the medication tonight.

Klebsiella is a bacteria found in the environment such as on wood chips or wood. It can also be carried in by new gliders. I do not use wood chips but rather corn cob bedding. I have no wood in my cages. I did get my cinnamon gliders from a breeder in "Irving Texas". My vet feels that this was contracted from these cinnamons. I got my cinnamons 7-30-03 and my joeys first infected were born on 8-25-03. The symptoms stared in about 9-30-03. It is very possible that these joeys were infected through their mothers milk and that accounts for the delay in symptoms. I will keep the board updated as to their progress. Now that the bacteria has been identified and the source discovered, I am well on the way to overcoming this and preventing any reoccurrences.

Ushuaia

Ushuaia , I'm glad you have been able to identify the causative organism for your problems and thus begin to deploy the appropriate treatment to help them mend. Whew! Long but rewarding journey.

I wanted to respond to some comments in your last post that I think could be misinterpreted.
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Klebsiella is a bacteria found in the environment such as on wood chips or wood. It can also be carried in by new gliders. I do not use wood chips but rather corn cob bedding. I have no wood in my cages. I did get my cinnamon gliders from a breeder in "Irving Texas". My vet feels that this was contracted from these cinnamons. ... Now that the bacteria has been identified and the source discovered, I am well on the way to overcoming this and preventing any re-occurrences.

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Klebsiella is part of the normal flora in human and most species' guts. When Klebsiella chooses to be a fool and get in the lungs, one can get pneumonia. When it gets in the urinary tract, one can get a Urinary Tract Infection. If it gets in moms lactating breasts, mastitis. But one doesn't need wood chips, contact with sick critters, or exposure to Typhoid Mary to get an infection with this normally occurring bacteria. It is often with us always, and for a myriad of reasons can set up shop in a weird place and get one sick if conditions are right. In a similar vein, staph and strep are everywhere. They grow on our skin all the time. Strep proctitis is not uncommon in kids, same strep that causes strep throats, only involves the anus. I don't know if there are similar conditions in gliders. There are other strains of strep that live in the GI tract normally, and you may well be right that it added on to the other infection and was only a secondary opportunist.

The thought that female joeys would be more susceptible to a mastitis-transmitted infection than a male joey doesn't sound likely. I'd be interested in any vet's comments. We see human moms get mastitis frequently. Both boys and girls have identical breast tissue at birth. Only after puberty related stimulation do things change. And Klebsiella has no particular predilection for mammary tissue. Engorged, lactating breasts are a different thing altogether. It does seem very plausible that once mastitis or a pouch infection exists in the mom, that joeys' skin and fur thus exposed could be compromised.

If related pedigrees have some immunodeficiency from insufficient genetic diversity or inborn errors of metabolism, then they should keep getting repeated and weird infections. But if this turns out to be what normally happens, the usual case of bad luck when a bad germ in a place that causes trouble, then hopefully they'll stay healthy after finishing treatment. Hope it works out.

I was told by my vet that it was found in wood chips. Male sugar glider do not have a pouch and therefore do not have brests. So it is more likly for a female to appear to have it worse due to the presence of a brest.

Ushuaia

It might be in wood chips. But I bet you can find it in most any mammals' bowel, so I don't think one needs "outside sources" to explain every infection you get.

I guess my other point was just because a female joey has a pouch, I don't expect her to get Klebsiella in her pouch because her mom has mastitis. Their respective breasts are doing very different things.

Good question you ask though. Do male gliders have nipples or any mammary tissue? I'm a boy and I do. My male dog and cat both have nipples too. Does anyone know if male gliders have rudimentary, never-to-be-developed breasts? I assumed yes, but I don't know. Thanks.

You might ask the question more broadly to state:

Do male marsupials have mammary tissue or undeveloped brests?

It is suspicious that right after I took the cinnamons out of quarentee that the jeoys showed signs 3-4 weeks after possible exposure. That short 3-4 week delay might have been the time it took to get the mother to contract it and pass it to her joeys and the joeys to metabolize it to the point of overproduction. My vet gave me the impression that this is not a normal part of their system.

Ushuaia

Update:

Athena's female joey is limp. She has no mobility. I took her to the vet. She has pneumonia. Their is fluid in her lungs. The vet gave her an injection to dissipate the fluid. She is very critical, but stable. She has lasted 6 hours and if she makes it through the night then she will go to the vet again tomorrow, if she dies the I will necropsy her.

Ushuaia

I am so sorry to hear about the baby Chris, I hope she makes it threw the night, my thoughts are with you <img src="/ubbthreads/images/graemlins/heartpump.gif" alt="" />

I'm so sorry. It sounded like you had it beat. Were they able to determine if the Klebsiella strain was sensitive to the Amoxicillin/Clavulanic acid? Hope she does well, or doesn't suffer.

She is still alive. She is eating ensure/pedilite. She seems to have a little more energy. I have chosen a name for her. Kandula. It means stregnth. I will stay up as long as I can and hold her in my hands until the vet opens tomarrow. She is a very strong joey to cling to life by a thread for 12 hours, most other joeys would have died. I hope she lives and has a good quality life.

Ushuaia

I have euthanized Kandula, Athena's female joey. She had neurolgical problems, and would have no good quality of life. In addition her brother is degressing into a worse state and the only hope for him is a necroptsy done on Kandula. She will be sent off tomarrow. I will post the results when I get them. My vet said the bacteria identified in her mothers culture, because I was not able to get fecal samples out of her joeys, might be a secondary outbreak to some other ailment. A necroptsy will shed more light.

Ushuaia

[:"#CC6699"]I am so sorry to hear about your little girl! I for sure thought she would make it! It must have been a tough decision for you and hopefully the brother can hang in there! Best wishes heading your way! <img src="/ubbthreads/images/graemlins/heartpump.gif" alt="" /> [/]

Chris,
Boy this has been a really tough time for you. Hugs, I know you are doing everything humanly possible to save and take care of them.
Hopefully the little boy will make it.
Chey <img src="/ubbthreads/images/graemlins/worried2.gif" alt="" />

I'm so sorry... I hope you find answers and peace. <img src="/ubbthreads/images/graemlins/heartpump.gif" alt="" />

Update:

I have decided upon a name for Athena's sole surviving male joey.

Kutisha (KUH-tee-shah) meaning: tough, formidable. Origin: Swahili; Country: Kenya-Tanzania; Region: East Africa

Kutisha is now moving around his cage freely. I have placed him back with his parents and they are good about taking care of him. He weighs 40.0 grams and just started to eat fresh made BML through an adapted syringe. He is still on the medication and his fur is still a little wet in the mornings but he is gaining weight and with time will make a full recovery. He is very very tame and trusting due to all the attention and feeding I have been giving him.

I have also decided on names for Aphrodite's twin girls.

Kibibi (kee-BEE-bee) meaning: little lady. Origin: Swahili; Country: Kenya-Tanzania; Region: East Africa.

Tisha (TEE-shah) meaning: strong willed. Origin: Swahili; Country: Kenya-Tanzania; Region: East Africa.

Kibibi and Tisha are both doing very well. Both are regrowing hair on their bellies and show no more signs of illness. They will be able to be sold in about one more month once their hair is completely regrown.

Well, things sound like they are finally on the mend. Congratulations for a job well done. <img src="/ubbthreads/images/graemlins/muchlove.gif" alt="" />

it could be that the older ones are immu8ne to the bacteria. <img src="/ubbthreads/images/graemlins/confused.gif" alt="" />

No the older ones were on amoxicillin and have had it for longer. The other treatments I did weakened the bacteria, and the amoxicillin finally killed it. They are older and will have developed a better immune system.

Chris, that's great news!
Chey

The baby male has been off the Clavamax for about three days and the wetness has returned in earnest. The necropsy results will not be back in for a few days to a week. I weighed the male three days ago and he was 40 grams at 8 weeks OOP! I weighed him and today he is 50 grams OOP. I feel the medication interfered with his growth and development. I will wait for the necropsy results before trying any new medications. I need to treat the problem, and not the symptoms. The good news is that he is gaining weight again. I am hoping he will get to 65 grams before he goes back onto medication. He needs the weight to help with his fight. It is a delicate balance between, development, weight gain, and medication. He appears to have a strong fight in him. If he is as strong as his sister was I have no doubts as to his recovery.

Ushuaia

Gosh Chris, you sure have had to deal with alot. <img src="/ubbthreads/images/graemlins/frown.gif" alt="" />
Im so sorry... how awful for the little ones and you.

Hugs to you, and prayers for a super speedy recovery for the little one! <img src="/ubbthreads/images/graemlins/heartpump.gif" alt="" /> Thanks for keeping us posted. Keeping you guys in my thoughts.

Still waiting for the necroptsy results. The male weighs 58.8 grams today. He is still wet.

Ushuaia

Boy, he has gained almost 8.5 grams in 24 hours? Sure he is not retaining fluids or something?LOL

Sure do hope the necropsy report will be back any day now. But then again...not sure when it was sent off. Has it been close to seven days yet?