Hello! Thanks for using JustAnswer.com, I'm Dr. Dan and I'll try to help you.
How was the mass diagnosed? Just by feel, was a needle stuck in it? was an ultrasound done on it?
no, x-ray and ultrasound, 3 ml of purulent material were drawn and analysis showed that it has intracellular bacteria
I am afraid of surgery - it is recommended to have surgery
Is this causing your dog breathing or swallowing problems?
How is his appetite and activity level?
no, no problems breathing, appetite is OK, activity level is reducing every day, is not interested in treats (it is not like him), making kind of "grouling sound sometimes when is breathing
I started to give him antibiotics today
I just want to find out if the surgery is the best option
what will happen if we don't go for surgery?
I think you are right to be nervous about surgery, I think personally i would give the antibiotics a few days before rushing to surgery it is certainly possible that if there is no foreign body that this can be resolved medically. If there is a foreign body then the antibiotics will help shink the size of the abcess making surgery easier. As long as he is not having breathing or swallowing problems I'd give the antiboitcs a few days. If it is not improving then I'd much more strongly consider surgery. Another way to determine if surgery is needed is to have an ultrasound done. If the wall of the abcess is thick then surgery will be needed or the problem has a high probability of continuously returning or worsening. If the wall is thin then antibiotics are much more likel to solve the problem. The other technique to improve the odds of medical therapy working is to have a culture done of the pus to make sure we are using the right antibiotics.
they said that the culture will be ready in about 3 days, but recommend surgery within 72 hours they didn't say anything re. thickness of the walls (ultrasound was done), except "well encapsulated cavitary mass" it is just over his epiglottis
and Clavomox is prescribed for now
I guess given the location I'd see if it responds to meds first then go into surgery. Give the meds a chance we can always do surgery later. The only thing that would change this is if he worsens on the clavamox, not improves. We should know in a couple of days.
what is the probability of rapture happening it cqan lethal sinc
since it is near his trachea can it be lethal?
The probably of rupture is pretty good since many abcesses need to drain. Usually they are not lethal as the body tries to do this on purpose. The only way this would be lethal is if it damages one of the great vessels. I would think that would be unusual. If it drains to the outside of his skin then it's beneficial. It is unlikely to drain into the trachea unless the doctors told you that the ultrasound suggested the trachea was part of the abcess
is it possible to drain to outside of the skin? how ? (I am medically illiterate")
Sure the body will want to reject the abcess material and often will try to find a way to open a whole in the skin to drain out the pus using gravity.
the doctor said that is is over his air passages just above trachea (so I envision if it above it can drain INTO it am I wrong?
Only if the wall of the trachea is involved. Think of a waterballoon (abcess) over a garden hose (trachea) if the water ballon breaks the water won't get into the garden hose unless the garden hose is damaged as well.
It sounds to me like the other doctors did not go into why exactly they want to do surgery so bad. I would find out from them what exact reason (probably linked to the ultrasound) make them want to do surgery so bad instead of giving the meds a chance to work
that is my question as well, they don't know whether is a foreign matter there or a puncture and keep saying me that if we use only antibiotics it will come back and they did say that we need ST scan to figure out how to do surgery correct because of location in such a difficult place
I'd say given that advice I would certainly give the medication time to work. If the problem is not going away or returns then I think CT and surgery is appropriate. Given the location I'd probably wait on surgery personally.
How long usually does it take for abscess of this size (4.5 cm) to dissolve?
and thank you
1-3 weeks if using the proper antibiotics the culture will help with deciding the proper antibiotic...
and you are welcome
what need to be avoided during this process? intensive exercise? what else
and what is during the antibiotic treatment he 'll have issues/ difficulty breathing?
and with rapture - if it doesn't drain outside of skin, but inside and go to his lungs?
I would say avoid strenuous exercise and make sure he is getting his antibiotics,
If he has issues with breathing or swallowing then he'll need to be seen by the vet right away ... determine the reason for the difficulty breathing or swallowing and correct the problem.
If it doesn't drain outside the skin it will drain between layers of muscle and connective tissue. Unless it damages the trachea there is almost no way for it to get into the lungs.
thanks you and I'll contact you again