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Help! I live on an isolated reserve in Northern Manitoba as

a nurse. Tonight I am...
Help! I live on an isolated reserve in Northern Manitoba as a nurse. Tonight I am also the vet and I need help. A patient of mine had his little poodle/terrier mix bit on the face by another dog 2-3 days ago and now it is sick.
He says it hasn't eaten for 3 days and that there is a cut on it's lip. The dog is so furry and is anxious so it won't let me look well enough to actually visualize a cut however there can be nothing extensive as I haven't seen any laceration. I can see clotted blood under the Left lip and yellow discharge from the Left eye. I can also SMELL what is definitely the sweet familiar smell of infection that I know so well in people.
As a nurse I have access to so medications including antibiotics. So my questions are:
- Would you recommend an antibiotic? and if so which human ones are safe in dogs? I have access to Amoxil, Cephalexin, Septra 200/40mg/5ml, Amoxi/Clav and Azithromycin. (The dog weighs approximately 8 pounds)
- I know how to give a sub cutaneous infusion to a dog - should I? if so what would you recommend?
- What do you recommend for the draining Left eye? I do have access to erythromycin eye ointment...
- Is there anything else you would advise?

Thankyou!
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Answered in 19 minutes by:
8/20/2013
Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 10,708
Experience: I have been a practicing veterinarian for over 30 years.
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Hi Rachael, I'm Dr. Deb. I will do my best to assist you today.

 

I'm so sorry for these problems with Joey but it's good that you're available to help and so knowledgeable.

 

1. Yes, I would definitely recommend an antibiotic. Clavamox or Cephalexin are excellent choices for a bite wound.

The dose of Clavamox for an 8 lb dog would be 62.5 mg twice a day.

The dose of Cephalexin would be 150 mg twice a day.

You probably know to give antibiotics with food, is possible.

I usually give oral antibiotics for 10-14 days or longer if needed.

I feel obligated to tell you that it would be illegal for me to advise you to use a drug for Joey which was prescribed for another dog or for a human but I can tell you dosages as I just mentioned of acceptable drugs which would be useful in this context.

 

2. Subcutaneous injections are not usually needed for bite wounds since improvement is usually seen fairly quickly once oral ones are started.

 

3. Erythromycin eye ointment is also a good choice but make sure that it doesn't have any steroid in it since this could worsen the situation if the cornea has been scratched or injured. Dosage would be 3-4 times a day for at least 7-10 days.

 

4. If you have access to topical Atropine, this would also be advisable. Dose would be twice a day for 2-3 days and then discontinue if the eye shows significant improvement. This drug would help with pain and spasm control if the cornea has been scratched. The pupil will dilate and will remain so for about 12-24 hours after the drug has been stopped...which you may already know.

 

5. You could give Aspirin at a dose of 10 mg/lb twice a day for inflammation and pain control. The dose for an 8 lb dog would be 81 mg twice a day. Give with food to avoid stomach upset.

 

6. Do the best you can to clean the area of the bite wound; I'd recommend dilute betadine or iodine to the color of weak tea. Trimming as much hair as possible is good as well, if he will let you.

 

If he's drinking water, then you might mix canned food with water in a blender to see if he will "drink" his meals. You could also offer human baby food but avoid those with onion or garlic in them.

 

You could take his temperature although I suspect that it might be elevated reflecting the infection he has. Normal is between 100 and 102. 5

 

 

I hope this helps and that Joey will feel better soon. Deb

 

 

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Customer reply replied 4 years ago


Thank you Deb!


 


I am hoping so too. Right now I am worried about dehydration and sepsis. He still has a bit of energy but he is pretty lethargic. I will get him the Cephalexin right away. I was also thinking to give him some plain yogurt by mouth

Rachael:

You're welcome:)

I suspect that he has an abscess in his mouth if you can't actually visually see any external injuries.

The lethargy is most likely secondary to the fever he's running because of infection.

It would take a lot for him to become septic to the point where we'd become really concerned.

 

Yogurt is ok although some dogs are lactose intolerant.

 

If you have access to lactated ringers or Norm-R fluids, you could give him some subcutaneously between his shoulder blades. I'd probably give him 100 cc's twice a day. If the fluids "pool" around his shoulders, then you'll know that he's not really that dehydrated and you might only give once a day.

 

Hopefully, the antibiotics will kick in within a day or so and your supportive care will then be unnecessary.

I hope you'll keep me posted about him. Even after you've rated (if you
do, of course), we can still continue to communicate. I can also send you a
follow up email in a few days to which you can respond when you have the time
to do so.

 

Good luck:) Deb

Dr. Deb
Dr. Deb, Dog Veterinarian
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Customer reply replied 4 years ago


Thanks so much! Deb, I would really appreciate that! :)


 

Rachael:
I'll look forward to chatting with you at that time....hopefully, you'll have good news to share:) Take care, Deb
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Rachael

I just wanted to thank you for the rating; it's greatly appreciated.

Kindly ignore the request for additional information. Regards, Deb

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Customer reply replied 4 years ago


Hi Dr. Deb!


 


I hope you don't mind if I ask some more about Joey.


The first day and yesterday he did drink a few meals really well and we've managed to get 4 doses of the Cephalexin into him. I have noticed the infection smell has markedly decreased but he is still clearly in pain. Every once in a while if he tries to drink or I try to give him meds he screams in pain like he's dying and hold's his head to the side. Then he stands there and salivates for a few minutes before looking up and wagging his tail and moving on.


 


My coworker pointed out that I should be worried about Rabies. Now it's all I can think about! Bit by another dog, salivating, and now not wanting to eat or drink on his own. He does still swallow the meds and to my knowledge there have never been any confirmed Rabies in this community, but we are in the northern forest... :(


 


My questions are now this:


How long would it take the Keflex to really work for this little guy?


And how worried should I be about the possibility of Rabies vs. Just an injury? He hasn't bitten, but I have gotten his saliva all over my hands and they have a couple open scratches from the garden...


 


I know usually we just watch the dog for 10 days but I have to leave the community tomorrow so I don't really have the 10 day window...


 


Any advice?


 


 


Thanks again! Rachel


 

Rachael:
I had a follow up email scheduled for you today so no worries about additional questions about Joey. By the way, you may still receive it even after I cancel it (a computer glitch sort of thing).

1. I usually expect to see some improvement from bite wounds or an abscess within a few days but definitely by seven days. Poodle mixes are notorious for over reacting to injuries... I'm not saying that he's not hurting but they do tend to be less stoic than some of the larger breeds.
Have you tried giving him Aspirin since he's eating? This may help if you don't have access to something like Tramadol.

2. For him to be showing signs of Rabies now, he would have had to been infected anywhere from 3 weeks to 6 months ago. If he's been kept up to date on his rabies vaccinations, then he should be fine: I've never seen a vaccine break with this vaccine (although I suppose it's possible) and he should be protected even if he was exposed to a rabid animal.
This LINK discusses a time line which you may find helpful.
Rabies would not be high on my list of possible explanations for his signs but if he hasn't been vaccinated and there's possible previous exposure for him, then I would advise you to discuss this with your physician.


Personally, I doubt Rabies is a real concern. He was attacked and developed an infection secondary to injuries sustained during the attack. He's improving but hasn't been on antibiotics quite long enough for 100% improvement yet.

 

3. If possible, the rabies vaccine status of the other dog should be ascertained. If this dog hasn't been vaccinated and neither has Joey, then he needs to be quarantined for 6 months, although local and state regulations may vary about this. A local vet or the state vet can be contacted for specifics.

If the other dog was vaccinated, then there's no worry about rabies being transmitted to Joey from him.

 


I hope this helps. Deb

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Customer reply replied 4 years ago
Thanks once again Dr. Deb. :)
I can guarantee neither dog has any vaccinations and the attacking dog was shot by it's owner. As I said there are no vets available to this community unfortunately.
I have been giving hom ASA regularly at the 81mg dosage you suggested and yesterday even a little more.
I didnt know about poodles being a little over reactive. It's good to know because it breaks my heart to hear him crying and see him shaking and cowering.

I am so grateful for all your help!!
Rachel:
OMG!!! The owner shot his dog??? I know it happens but I prefer not to know about it, if you know what I mean.
Legally, this dog should have been evaluated for rabies if this was an unprovoked attack.
I know you're probably helpless to do much about this now but it sounds like the wild west out there!

Please keep me posted about this situation. Hopefully, Joey will show continued improvement each day. Deb

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Customer reply replied 4 years ago


I'm sorry to upset you, but yes, it is true.


It is far more like the wild west out here than you can imagine! We have packs of wild dogs that wander around town, I have found dens of puppies under tree roots in the forest, and this winter people even had to keep their dogs in doors because the wolves were eating them!


Sometimes my life is crazy! :P but if I can help a little, I do what I can.

Rachel,
Goodness, it sounds so desperate!!!
I live in MA, very near the NH border and very backwoodsy (for these parts anyway). I know there are farmers around here that take care of their sick animals in less than what I would consider humane ways but it really bothers me when I hear about such things.

Your situation sounds dire, indeed! I imagine what little you can do to help is appreciated. Deb
Dr. Deb
Dr. Deb, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 10,708
Experience: I have been a practicing veterinarian for over 30 years.
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Customer reply replied 4 years ago


Oh dear!!


I tried feeding him some cottage cheese and he was excited when he started but after a few seconds the shrieking started and now there is this awful grinding/rubbery sound coming from his vibrating jaw! :(


 


I palpated his mandible when he arrived and I couldn't feel an obvious break. Is there anything else that might explain this?


 


 

Rachel:
I suppose he could have a TMJ (temporal mandibular joint) problem depending on how he was grabbed by the other dog or another possibility would be retrobulbar cellulitis or abscess. Both of these can be pretty painful especially when the mouth is opened.

For retrobulbar cellulitis, you can try to push the eye back into the sockets. It's usually painful when you do this. Sometimes these dogs will respond to oral antibiotics but many of them need to have the abscess lanced from inside their mouths under anesthesia.

And, feel along the back of his jaw. Does he seem painful when you palpate there? TMJ problems are also going to be tough to deal with since most of them require anesthesia and x-rays to diagnose. If he's luxated the joint, he shouldn't be able to close his mouth.

He could have a fractured mandible that wouldn't be obvious without an x-ray. These can heal but can take some time to do so. If he can use his tongue, then he can drink his meals for a while until it heals.

Deb
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Customer reply replied 4 years ago


Yes, he does whimper when I palpate the back of his jaw - but not the crazy screaming he sometimes does. He can close his mouth and use his tongue so I will instruct his owner to give regular ASA, Keflex and liquid meals for 2 weeks and hopefully everything else will heal itself up...


 


Poor Joey! :(

Rachel:
Poor Joey, indeed!
Well, you've done the absolute best that you can. Hopefully, he'll heal with time and drugs.
I'm sure you will stay in touch with them so that you can then stay in touch with me:)
I'd love to know how he makes out. Deb
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Customer reply replied 4 years ago


Hello Dr. Deb!


 


I just wanted to let you know that I spoke with Joey's owner the other day who said he seems to be doing very well and is almost back to his normal self. He said that he is eating and barking and playing so it seems that we are going to have a happy ending after all. Thanks again for all your help! Hope all is well with you. Have a great day!


 


Rachel

Rachel:

What wonderful news; thanks so much for sharing it with me:)

I love a happy ending as well!

All is well here and hope all remains well with you.

Enjoy your day, Deb
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