10/10 Tigger URI better-eye v. swollen

[Tigger's Friend]

Good Morning All!

Tigger's URi is better, but swelling is unchanged (gooseberry size) Reg. vet wants me to call if eye swelling isn't better by today. I'd love some help with vet questions & how to proceed. To re-cap:

Tigger got URI Thursday 10/3. (accidentally vet's fault & they're treating him for free). Rx Azithromycin AB & fluids

Friday eve. enucleated (removed) eye socket swollen (marble size)

Saturday not-reg. vet said was prob. mucus & advised histamine. Vet also checked mouth- good. Gave Zyrtex + AB + Fluids + steam.

Sunday Tigger develops 104 fever, not v. interested in food. AB + Fluids + Zyrtex

Monday - Tigger's fever down. Eating well. Eye specialist won't see Tigger w/ active URI - says swelling is prob. a retrobulbar abscess / dental infection. OK'd reg. vet to sample fluid & recommends skull & dental xrays to confirm cause of swelling.

Reg. vet not want to do x-rays / anesthetize while Tigger's uri active -thinks x-ray won't pick up cause. Checks mouth - good - most teeth gone fr. stomatitis. Soft swelling under skin, not behind skull - good. Fluid sample - cells are mucus w/ sm. bacteria - not pus/abscess - good. Sample causes 1 blood drop on outside of Tigger's eye seam. Vet rxs new AB, clindamycin. If no improvement in 72 hours, recheck, possibly to sedate & drain. Gave Fluids, no zyrtec.

Monday night & Tuesday: Swelling increases to double - triple size (gooseberry). Tigger's uri symptoms worsen, but no fever & eating well, just miserable. Reg vet believes sample caused hematoma in socket - lots of small blood vessels there. Advised to wait unless develops fever / not eating. AB + fluids + steam.

Wednesday - No change in swelling. Eating, feeling better. BG still elevated

Thursday - No change in swelling. Eating, URI better. BG @ 462 - close to all time high.

Will need to see vet.
:?: 1) If need to sedate to drain - will that affect Tigger's BG / insulin situation?
:?: 2) Should I increase or hold Tigger's dose (7 cycles) at this point? He's still high & level
:?: 3) How long would it take a large hematoma to drain on its own?
:?: 4) Should I wait to drain swelling yet since it got worse after the sample - will it likely re-fill with whatever fluid filled it?
:?: 5) It's possible a root portion remains in gums from removed teeth - tho' vet saw no inflammation there, it's possible there's an infection. Should I insist on a dental / skull xray before draining even tho' Tigger's still sick & immunity weak? (vet has already offered to do a dental xray for free as a learning exercise when they get their new dental machine & Tigger's better)


Also, I'll call the specialist who removed the eye to see if she will do a phone consult. My questions are:
:?: 1) If Tigger's URi caused tearing / mucus accumulation in the enucleated eye socket, will it drain into the sinuses or is the cavity sealed off?
:?: 2) When eye is removed, is there any tissue / membrane remaining that could be affected by URI & cause tearing or swelling?
:?: 3) does she believe sample could have caused a large hematoma
:?: 4) is drainage the best course of action or is it best to wait if there is no fever?

Any other suggestions??? I'm trying not to seem like a crazy cat lady, but Tigger seems to always have horrible things happen to him - I'm worried this will affect his FD healing process, as well as his general immunity.

Thanks for all your help, sorry this is so long - I'm really trying to understand & help Tigger get over this & heal. I'd go crazy without this forum!!!

 

[BJM]

Re: 10/10 Tigger URI better-eye v. swollen -dose & sedation

My thoughts on some of your questions; reminder, I'm not a vet.

:?: 1) If need to sedate to drain - will that affect Tigger's BG / insulin situation?
They usually want to hold food when doing sedation; sometimes they want a half dose of insulin, sometimes none.

:?: 2) Should I increase or hold Tigger's dose (7 cycles) at this point? He's still high & level
The high glucose may not be helping if there is infection; I'd be inclined to increase.

:?: 3) How long would it take a large hematoma to drain on its own?
I'm sorry, I do not know.

:?: 4) Should I wait to drain swelling yet since it got worse after the sample - will it likely re-fill with whatever fluid filled it?
My thinking is that a pocket of whatever it is, is a pocket that could feed infection. There may be something that needs to be ablated to prevent further build up of whatever it is.

:?: 5) It's possible a root portion remains in gums from removed teeth - tho' vet saw no inflammation there, it's possible there's an infection. Should I insist on a dental / skull xray before draining even tho' Tigger's still sick & immunity weak? (vet has already offered to do a dental xray for free as a learning exercise when they get their new dental machine & Tigger's better)
If he's weak in general, waiting for him to get stronger may be prudent.

 

[Tigger's Friend]

Re: 10/10 Tigger URI better-eye v. swollen -dose & sedation

Thanks, BJM,

I really value your opinion & appreciate the time you spent reading all the info. Your input makes sense, especially draining the swelling since it could be an infection time-bomb. I'll plan on a slight insulin dose increase tomorrow, too, depending upon what the vet's instructions'll be re. sedation. It makes sense, too to wait on the x-ray - especially since there's no fever, but he's still on AB.

Thanks again, from Tigger, too.

 

[Wendy&Tiggy(GA)]

Re: 10/10 Tigger URI better-eye v. swollen -dose & sedation

Hey you know you posted on the health board right? Obviously thats fine but i know you normally post on TR.

Stress and any infection will spike his blood glucose. Plus his BG is currently higher than the TR protocol likes to see so I would be inclined to increase and try 1.75 again, but bear in mind you may need to reduce once the infection clears. But you are testing enough to notice if his BG drops again.

Wendy

 

[Tigger's Friend]

Re: 10/10 Tigger URI better-eye v. swollen -dose & sedation

Thanks, Wendy, I'll increase Tigger's dose as soon as I can once he's through surgery issues.

I posted on Health to get input before I spoke with the vet. I posted Tigger's regular in Lantus. We're scheduled for exploratory tomorrow. Fasting & .5u dose in AM; Tigger's never gone through anesthesia on insulin so I'm pretty scared, & not sure how to handle evening dose. I assume an increase is out at least for tomorrow. I also guess we'll figure out the PM dose once we get through the exploratory & see how Tigger's doing.

 

[BJM]

Normal dose tonight; dose as instructed in the morning.