Retrobulbar abscess

[Scoobstersmom]

I know it's a long shot, but you all seem to know just about everything about dogs, so I thought I'd throw it out there. Is anyone familiar with or have you dealt with a retrobulbar abscess? Not my yorkie - but his toy poodle sister - was diagnosed with this last week.

She is 14 years old, blind, nearly deaf and has a serious respiratory illness so she is not a candidate for surgery to have the abscess drained, and I know that is the front line treatment for this kind of abscess. Last week her right eye and the whole upper right side of her face was grossly swollen, but after about five days on some strong antibiotics, a draining tract in her eye finally opened up and the abscess has drained now. Except for looking like she has a heck of a shiner from the bruising when the swelling went down she looks pretty normal now, but I am scared to death of this thing. From what I have read on the internet, it is unusual for these things to open up and drain on their own, and if it's not completely drained it could come back. I'm just wondering if any of you have had experience with healing one of these things without surgery? Her eye vet wants to keep her on the antibiotics for another four weeks to make sure the infection clears completely and is optimistic that we have it under control now, but I'm still worried and having nightmares about it.

Diana and the Scoobster

[Marhcarter]

Ok, as I have said before, I am a people nurse, not a doggie nurse, but my experiences with abscesses is that if they are draining on their own, this is good. Sometimes gentle irrigation of the abscess with sterile saline through the draining tract can be done by the provider (vet) to loosen/remove any remaining pus. Did the vet rule out a dental issue or dental abscess as the cause? My concern with recurrence would be that the original source of the infection is treated or removed. You said she has a serious respiratory infection. Does he think it came from the sinuses? Would possibly adding a med to keep the sinuses open like a decongestant help avoid reinfection? Hopefully the full course of antibiotics will take care of all of the infection, but an ultrasound of the affected area after the antibiotics are completed could be an easy, noninvasive way to assess if further treatment with antibiotics is needed. Just tossing out ideas here.

[Scoobstersmom]

Marilyn, thanks for your ideas. She doesn't have a respiratory infection, she has a respiratory disease. Chronic allergic bronchitis. She was diagnosed about three years ago, and at the time our vet told us that most dogs don't live more than a year or so after diagnosis. We went after it pretty aggressively - she is on daily low dose pred and a steroid inhaler - and she stabilized pretty quickly. Her bronchitis hasn't gotten any worse and as long as she takes her meds and uses her inhaler, she is fine. A year after the CAB diagnosis, she was hit with glaucoma in her left eye and had enucleation surgery. She did not do well with the anesthesia, but eventually she did wake up and we decided right then that there wouldn't be any more anesthesia for her. A year after the enucleation, glaucoma hit her right eye. Because she couldn't do anesthesia, when the pressure got too high, she had an ablation with gentamicin while wide awake. Such a brave little girl. So that's the history.

The vet does think the infection probably came from seasonal allergies. Possibly sinus or irritation in the eye. Vet said it could have even come from a bump on the head in the eye area, and that's certainly possible, since she's blind. When the allergies are really bad we do give her an antihistamine but they have a tendency to raise eye pressure so we don't do it often. I've been taking her in every other day for them to irrigate the eye really well, the drain tract has stayed open but nothing is finally coming out now. We're also doing warm compresses four times every day, irrigating the eye at home four times per day, and using an antibiotic cream in her eye, as well as oral antibiotics. Because she can't handle any sedation and the area has been so painful, the eye vet has held off on trying to do an ultrasound or anything like that, but said that once she's pain free we may do that. The thing that concerns me is that our vet said it's very unusual for these things to open up and drain on their own?

She looks really good now. The swelling is down, and all she has is a little bruising, she's eating, active and her personality is back to normal. But I don't want to get a false sense of security either.

Diana and the Scoobster

[107barney]

I dealt with something worse - and everyone thought it was a retrobulbat abcess. A CT scan was needed and it pinpointed the location of the infection so a drainage on the mouth could be made. Your vet is right that these dont usually drain on their own. Usually retrobbar abcesses occur due to a tooth problem. As for anesthesia, protocols can be modified if you're at a speciality hospital that deals with high risk cases. My dog as I said didn't have an abscess -- his salivary gland leaked. Because everyone thought it was an abscess I learned all about them and it is very scary.

[Marhcarter]

Originally Posted by 107barney

: Usually retrobbar abcesses occur due to a tooth problem.*

Yeah, this is what I found when I researched, too. I'm glad your baby is doing well. Sounds like he had a heck of a time, too.

@scoobstersmom: I am glad she is doing better and it sounds like you are doing everything you can to help this clear up without putting this poor girl through any more trauma or anesthesia. I hope that the infection clears up completely since anesthetising her for drainage of a dental or salivary abscess doesn't sound feasable or like something you want to risk at this time. Poor baby, sounds like she has been through a lot. Since she is looking better, eating and acting fine, I would just continue current treatment as recommended by the vet, keep a close eye out for recurrence, and enjoy her during this time that she has left, be it months or years. Many owners, when faced with problems like this would just have the dog put down, and that's a shame. It sounds like she still has quite a bit of life and love left in her. She is very lucky to have such a good mommy who takes such good care of her.

[kimp5]

just a question. How does one use an inhaler on a dog? Do you use a whole piece over the nose/mouth?
Hope your baby is ok soon//

[Patti]

I had a yorkie years ago with an abscess. His was caused by a bad tooth. I forget which one but one tooth on each side can do this. I didn't know about Zorro's until one morning he yelped and ran off the bed. I looked at him and he had a hole under his eye with stuff draining out. I took him to his vet and after being on an antibiotic for a few days they removed the tooth and the one on the other side just as a precaution. If it happens again maybe a specialty clinic could put him under a light sedation and remove the tooth, if that is the cause. They have a lot of high tech equipment to help with high risk animals. I will keep her in my prayers that she has no reoccurence.

[Scoobstersmom]

Originally Posted by kimp5

just a question. How does one use an inhaler on a dog? Do you use a whole piece over the nose/mouth?
Hope your baby is ok soon//

Ha Ha! Yes, I thought the same thing. How on earth would you train a dog to use an inhaler? There is a device called "Aero-Dawg" which I bought from my vet, but petmeds also carries them. The inhaler fits in one end of the chamber, and there is a little mask on the other end that fits over the dog's nose. We trained our dog with tiny pieces of chicken. One puff, one chicken treat. She does not mind the inhaler at all. She uses Flovent, which is a human inhaler. Steroids by inhalation cause much less in the way of side effects. We order her inhalers from a Canadian website so they are reasonably priced at $30 each. She's been using an inhaler for about 3 years now.

Diana

[Scoobstersmom]

Originally Posted by Patti

I had a yorkie years ago with an abscess. His was caused by a bad tooth. I forget which one but one tooth on each side can do this. I didn't know about Zorro's until one morning he yelped and ran off the bed. I looked at him and he had a hole under his eye with stuff draining out. I took him to his vet and after being on an antibiotic for a few days they removed the tooth and the one on the other side just as a precaution. If it happens again maybe a specialty clinic could put him under a light sedation and remove the tooth, if that is the cause. They have a lot of high tech equipment to help with high risk animals. I will keep her in my prayers that she has no reoccurence.

I know that these abscesses are generally caused by a tooth, but they've looked as much as they can with her and can't find an issue with a tooth. The vet said if caused by a tooth, the swelling is generally under the eye, and hers was more above the eye and on the bridge of her nose. The vet at this point is saying she thinks it was most likely caused by infection in her sinus from allergies. I just have to hope she's right. We do have her at a specialty clinic. They are really concerned about anesthesia with her and she nearly did not make it after enucleation surgery a couple of years ago. When glaucoma hit her second eye, they would not remove her eye because of that. She had a procedure where they went in with a needle, removed most of the contents of her eyeball and filled the eyeball with something to kill the remaining cells. The procedure is called chemical ablation and is also usually done under anesthesia. Our eye specialist had never done one on an awake dog. Peaches was her first. They gave her some kind of drop in the eye to numb it and voila - she sat right there and let them do it. But they never would have even tried it if they thought she could make it through anesthesia.

Believe me, I wish she could have anesthesia so we could drain this thing and get it over with.

Diana and the Scoobster

[Scoobstersmom]

Originally Posted by Marhcarter

Yeah, this is what I found when I researched, too. I'm glad your baby is doing well. Sounds like he had a heck of a time, too.

Many owners, when faced with problems like this would just have the dog put down, and that's a shame. It sounds like she still has quite a bit of life and love left in her. She is very lucky to have such a good mommy who takes such good care of her.

I do have a line in the sand with her. It is pain and suffering that I can't fix. She's almost 15, blind, almost deaf, and has the lung condition. I was very close to that line last week, as she was in a lot of pain. I am very glad she's done so well with this, and as long as she's still enjoying life we will fight to keep her going as long as we can. We've had her since she was nine weeks old, and she has been a faithful and loyal little companion so we owe her that. But we also owe her not to let her suffer either. It is very hard to know when to draw the line. We have two senior dogs, both 14 and both with health problems, so I think about it a lot and hope I have the courage to keep their best interest in the forefront when making decisions.

Diana and the Scoobster

[Marhcarter]

Originally Posted by Scoobstersmom

I do have a line in the sand with her. It is pain and suffering that I can't fix. She's almost 15, blind, almost deaf, and has the lung condition. I was very close to that line last week, as she was in a lot of pain. I am very glad she's done so well with this, and as long as she's still enjoying life we will fight to keep her going as long as we can. We've had her since she was nine weeks old, and she has been a faithful and loyal little companion so we owe her that. But we also owe her not to let her suffer either. It is very hard to know when to draw the line. We have two senior dogs, both 14 and both with health problems, so I think about it a lot and hope I have the courage to keep their best interest in the forefront when making decisions.

Diana and the Scoobster

Putting down my 13 year old lab mix humane society rescue almost 10 years ago was the hardest thing I have ever done. We got him at 9 weeks, also. He is buried in the backyard and I can't fathom selling this house ever because of that. It took us 5 years to get another dog and we went tiny this time so we wouldn't compare. OMG, I am more attached to Huey than I was to Homer-dog. Homer was in so much pain from arthritis (because we were terrible parents and let him get fat) that he could no longer get up and down the 5 steps to go outside to potty unless I juiced him with a steroid injection every few weeks. When he quit eating and went from 90lbs to 65, we knew it was time. I still cry thinking about it, so I know how hard it is when you finally reach that line in the sand and have to do something about it. Prayers for your little poodle to enjoy what time she has left, and you to enjoy it with her.

[Scoobstersmom]

Originally Posted by Marhcarter

Putting down my 13 year old lab mix humane society rescue almost 10 years ago was the hardest thing I have ever done. We got him at 9 weeks, also. He is buried in the backyard and I can't fathom selling this house ever because of that. It took us 5 years to get another dog and we went tiny this time so we wouldn't compare. OMG, I am more attached to Huey than I was to Homer-dog. Homer was in so much pain from arthritis (because we were terrible parents and let him get fat) that he could no longer get up and down the 5 steps to go outside to potty unless I juiced him with a steroid injection every few weeks. When he quit eating and went from 90lbs to 65, we knew it was time. I still cry thinking about it, so I know how hard it is when you finally reach that line in the sand and have to do something about it. Prayers for your little poodle to enjoy what time she has left, and you to enjoy it with her.

Thirteen years is a long life for a lab, so I think you did a pretty good job.

And that's really all that any of us can do, is the best we can. It's such a hard choice though. (((Hugs)))

At the moment I can tell Miss Peaches is doing quite well, as she is getting a little obstinate about all these eye washes. I hated it when she was compliant enough to let me do it without putting up a fight for the muzzle!

Diana and the Scoobster

[107barney]

What is a CAB diagnosis?

[Marhcarter]

Originally Posted by 107barney

What is a CAB diagnosis?

Chronic allergic bronchitis. Very similar to COPD in a human.

[Marhcarter]

Originally Posted by Scoobstersmom

Thirteen years is a long life for a lab, so I think you did a pretty good job.

And that's really all that any of us can do, is the best we can. It's such a hard choice though. (((Hugs)))

At the moment I can tell Miss Peaches is doing quite well, as she is getting a little obstinate about all these eye washes. I hated it when she was compliant enough to let me do it without putting up a fight for the muzzle!

Diana and the Scoobster

It is like sick kiddos in the ER. If they dont fight, something is bad wrong.