I am sorry to hear about Bobbie. It is good that this is looking better.
My name is Rebecca. I am a veterinarinan, and I will do my best to help.
What was seen on the CT scan? Why do they want to do a US FNA?
The saw what they believe to be a retrobulbar abscess
Most dogs do tolerate a long term course of antibiotics. I would put him on a probiotic if you are going to continue the Clavamox. I like the ones made for dogs, like Proviable, Fortiflora and Benebac. The one made for humans called Culturelle is also supposed to be good.
chest CT was free on neoplasia as was the head CT
A retrobulbar abscess usually requires draining.
Often, no matter how long the dog is on antibiotics, when you stop, the infection comes back.
Good that the chest was clear.
But seeing how he does on antibioitics is not the wrong way to do. Once in awhile a dog gets better on antibiotics alone.
I see, so even if the inflamation has dramatically subsided it is too deep in the tissue? I thought the FNA was just for cytology and to relive pressure?
Abscesses, by definition, are walled off. Almost always there is a "nidus" of infection that hides and lurks and almost always comes back. The antibiotics do not penetrate the wall that the body makes to surround the infection.
I usually lance these so they can drain. That, along with a course of antibioitics, usually takes care of the problem.
The CT says there is no true cavitation though, it says abscess is moderately suspected
Otherwise, the infection could move into the ears, sinuses, or even the brain.
Do you think this needs to be done ASAP?
I have suspected these, poked a hole in the mouth behind where the eye is, and that gives the infection a place to drain down with gravity
If this were my dog, I would do it in the next few days or so.
Not an emergency, but not something I would let go too long.
I understand, will he stay on the clavamox post FNA? I just would not like to do it to soon. He has now been sedated 3 days in a row (he needed deep because of the pain from the pressure)
I thought for the retro-orbital FNA with US they go from the dorsal aspect with the fine needle, rather than ventral?
Yes, I would keep him on the Clavamox for a week or so after.
If they are still trying to get a definitive diagnosis, that might be the approach. But if you want to drain one of these, you have to let it drain ventrally; it won't drain "uphill".
If the antibiotics are working, the abscess might be much smaller now. The US would show it best.
But we would still have to take him in again for the ventral approach?
after the initial FNA, or can they do everything right there?
That would be a question for them. If they see an abscess, why not drain it right then, using the US to guide the needle?
I would think they could.
Ok, so you think 3 or 5 days would be too long?
of waiting before we do the procedure
Too long to wait? No, that should be fine.
Yes, that should be fine.
ok, but even if he is back to full form, you would still recommend it?
It is just not clear form the diagnosis whther it is cellulitis/inflamation or a true abscess
It would not be wrong to see how he does on antibiotics. If after stopping, his eye starts to look red or get swollen again, you know what you have to do..
If it is not clear that it is an abscess, then waiting sounds reasonable to me, especially since it sounds like he is looking a lot better.
OK, many thanks for your help
You are welcome!
Is there anything else I can help with or answer?
That is all for now, you were most helpful
You are welcome.
KIndly rate my answer, but only if all your questions have been answered.
I hope he continues to improve.
will do, thanks again
Try again; I had hit the wrong button!