Sinus infection photos

[Garden Peas]

More lab reports:









-Kathy

Well that's a scary list for sure! Neither one of those cases had the pseudomonas as anything more than "intermediate" to enrofloxacin, and resistant to nearly anything we commonly use.

Oddly, the second case was susceptible to Neomycin -- I don't think we've ever discussed that medicine here -- and it jumped out at me because I happened to notice a bottle of Neomycin on the shelf as I was cruising the vet supply store today picking up stuff for my neighbor's peahen. Also odd that it was susceptible to dimethox, but not susceptible to the trimethoprim/sulphamethoxazole, since the TMPS is sort of a souped-up version -- I guess it goes to show how narrow the effectiveness can be sometimes.

I don't know if Neomycin is something we might think about for these stubborn cases, but heavens, those cases would have been a complete nightmare without lab studies.

Hugs, @WestKnollAmy , sounds like you are just having an awful time of it trying to pull these little guys through

Here's hoping the Baytril gets there quickly, and that it works!

You really might try another round of Tylan while you are waiting, if it holds the line at all, it might buy you some time.

 

[casportpony]

Quote: I had a Dr. look at those, and she thought that perhaps there was an error on the sulfa one... Neomycin and Gentamicin are two that I'm looking into... both can be purchased OTC for pigs, but I have seen some pretty serious warning about using gentamicin... I think it should be used only as as last resort when amikacin doesn't work. What that say to me is that try whatever, but before trying gentamicin, consult with a vet!

-Kathy

 

[casportpony]

http://www.jefferspet.com/products/neomycin-oral-solution-pint
http://www.jefferspet.com/products/gentamicin-piglet-inj-250ml

-Kathy

 

[Garden Peas]

I had a Dr. look at those, and she thought that perhaps there was an error on the sulfa one... Neomycin and Gentamicin are two that I'm looking into... both can be purchased OTC for pigs, but I have seen some pretty serious warning about using gentamicin... I think it should be used only as as last resort when amikacin doesn't work. What that say to me is that try whatever, but before trying gentamicin, consult with a vet!

-Kathy

Yeah, that would make more sense, if the lab wrote the wrong thing under the sulphamethoxazole and should have put "resistant" there... Wow, that is just not good news with that level of resistance. Were these from necropsies?

And what on earth is "Amikacin???"

 

[allbirds4me]

Neighbor's hen is making great progress!

He's been giving her baytril IM 2x day at the 10 mg/kg rate. The gagging has stopped and she is looking much better.

The lump has gone down a little. It is softer than it was, and a bit smaller.

I just took over some Vetericin eye wash as well as a Neilmed sinus rinse bottle, some rinse packets and a 20 ml syringe with a regular dosing tip (no needle!). We mixed up some sinus rinse with warm (not hot!) water and washed the dried discharge off the hen's beak. I used the syringe to gently flow a little warm sinus rinse into the nostrils and to irrigate the roof of the hen's mouth in the slit area. We were careful to keep her from drowning!

A fairly big plug/chunk of black gunk came out of the left sinus, yaay! I couldn't get the swelling part to squeeze out -- didn't want to rupture anything by squeezing too hard. It's soft enough that I think we are making progress on it and it won't need to be cut out.

Then I took the Vetericin eye wash and rinsed the eye. I waited for the hen to blink it all around, and repeated a few times. Tried to push on the swelling again, no luck with that.

Finished up with a little more rinsing with the warm nasal rinse solution.

Hen left, mildly insulted, but obviously feeling MUCH better than a couple days ago

Neighbor is really happy -- he thought she was dying before we started treatment.

Thanks for the good advice everybody!

" A fairly big plug/chunk of black gunk came out of the left sinus, yaay! "

Where did it exude from if you did not poke a hole or make a small incision ?
So glad it's making progress and interesting thread !

 

[Garden Peas]

" A fairly big plug/chunk of black gunk came out of the left sinus, yaay! "

Where did it exude from if you did not poke a hole or make a small incision ?
So glad it's making progress and interesting thread !

Hmmm, guess I could have worded that better, and I wish I had taken a photo. I probably should have said "nostril" in that sentence.

Here's one of the "before" photos again:



Do you see on the photo above the place where the opening into the hen's left nostril should be? It's caked with brown grossness. As I washed the gunk off the beak using nasal saline solution and a paper towel, that caked stuff loosened up. I kept rinsing and wiping, and a big plug of black crud came out, which opened up that left nostril passageway. It wasn't just a surface crust -- there was stuff that was inside the nostril that came out as I wiped the crud away, down the beak from the nostril. Using the nasal saline solution and the syringe helped soften it up and then a big chunk came out at once -- like a gunky black little cork

Now that nostril is clear.

Ya know, you just do NOT forget to wash your hands after doing THIS job

Sorry I wasn't more clear when I was writing ....

 

[casportpony]

Read this:
Quote:
Source:
http://www.exoticpetvet.net/avian/anatomy.html

-Kathy

 

[allbirds4me]

Quote:
ok, so the gunk did not come out of the sinus itself ( which in itself is the big problem here ) that's what I was wondering about.
Not trying to be a smart a$%, just trying to figure out if you really got to the root of the problem is all.
Couldn't imagine where the gunk went without it being lanced ?
Don't be surprised.... again..not trying to be a smart alec, if this rears it's ugly head again but hopefully I'm wrong about that.
Good job so far !

P.S.

Wear latex gloves , big help !

 

[casportpony]

Quote:
ok, so the gunk did not come out of the sinus itself ( which in itself is the big problem here ) that's what I was wondering about.
Not trying to be a smart a$%, just trying to figure out if you really got to the root of the problem is all.
Couldn't imagine where the gunk went without it being lanced ?
Don't be surprised.... again..not trying to be a smart alec, if this rears it's ugly head again but hopefully I'm wrong about that.
Good job so far !

P.S.

Wear latex gloves , big help !

When the area between the beak and the eye is pressed, fluid and or debris will sometimes exit the choanal slit. That is how I was able to get this out:


That was lodged somewhere in the sinuses, but it came out of the choanal slit when pressure was applied here:


Make sense?

-Kathy

 

[Garden Peas]

ok, so the gunk did not come out of the sinus itself ( which in itself is the big problem here ) that's what I was wondering about.
Not trying to be a smart a$%, just trying to figure out if you really got to the root of the problem is all.
Couldn't imagine where the gunk went without it being lanced ?
Don't be surprised.... again..not trying to be a smart alec, if this rears it's ugly head again but hopefully I'm wrong about that.
Good job so far !

P.S.

Wear latex gloves , big help !

Hello, I never said it was over. I said there is still some swelling in the sinus area in front of the eye (that ball shape on the photos), but softer and more flexible. The bird is on day 3 of a 5 day course of Baytril, which will hopefully kill the infectious agent (whatever bacteria is causing the illness). Getting the nostril open and irrigated is a key step in getting the sinuses cleared out. If the pus inside has not hardened or become encysted, the body can break down and remove some of it. Rinsing from the direction of the eyeball will help too. The nostril is one end of the passageway into the sinus. That gunk starts in the sinus and/or nasal passageway (the whole area gets infected), but when it is plugged up, nothing can drain. Then it backs up and the swelling starts and gradually gets worse.

So opening up the whole passageway is part of the physical treatment to allow stuff out. Irrigating the now re-opened passageway with nasal saline rinse also helps move stuff out.

Treating with antibiotics to kill the infection was also necessary, and has made a hugely visible difference in the demeanor of the bird. It's not gagging or gasping anymore.

If all we did was wash gunk out & off, of course it would come back. If all we did was treat with antibiotic, but no cleaning, rinsing, then we leave the bird at risk for recurrence. Even if we had removed a huge plug from inside the sinus itself, it would not "cure" the bird without using the antibiotic to kill the infection, or if we left the nostril or nasal passage plugged. It's a multi-part treatment effort.

The bird's owner is going to continue rinsing/irrigating the sinus region (imagine a tunnel from the nostril to behind the eye) with nasal saline rinse, and rinsing the eye with sterile eye wash, and will finish the course of antibiotics. Given the progress so far, I am optimistic the bird will make a full recovery.

Fortunately, this was caught early enough that it most likely will not need to be artificially drained via surgery. The sinus has openings into the eye socket and out the nostril where gunk can go, just like normal drainage from the fluids that are normally there. If the goo inside hasn't hardened, it's likely it will clear with the irrigation and the body's own ability to remove goo. You don't always have to have external drainage or surgery when you have a human sinus infection or ear infection, as long as the infection gets killed and the passages open up.

Right now, I think it's a matter of following through with treatment. The good news is the bird is doing very well and making lots of progress.