how to treat an abcess? ... and the cost of surgery

[ChrisK]

We were just starting to think it time to have Skittles' tumors removed when up pops a new growth on her jaw. Is it an abcess or another tumor? We don't know. The vet took a look and said he couldn't be sure, and didn't want to try poking it with a needle to find out because he's had bad experiences with infections from doing that kind of thing. So he suggested he'd want to put Skittles under (isoflorane) and open up the area. If it's an abcess, he'd clean it out and then remove the other tumors. If it's a tumor, he'd remove it or debulk it, etc.

I left the office thinking okay... let's just get the surgery done because we were going to have the tumors removed anyway, so this one surgery will do it all.

Then I got home and read the estimate the vet gave me for the surgery. If it takes 20 minutes he wants $468 +tax. If it takes 40 minutes, he wants $765 + tax.

This guy is the best in town, as far as I know, but OMG! I feel like I'm being taken advantage of. The vet we used to use before this one never charged over $200 for lumpectomies. .. that said... the vet we used to go to also had limited knowledge of rats, and now as our girls are in their later years, and have a number of health issues, we decided that they really need someone who knows more about rats.

I'm thinking of maybe two other options. The first is to try talking the vet down some in price.

The second is trying antibiotics for a while -- if it's an abcess, that should get rid of it I think.. ??

Does anyone have experience with abcesses? How are they usually diagnosed and treated?

 

[xxchelle]

Holy sh.... that's CRAZY.

My vet did the same thing with my Azzie. She had a lump behind her ear, and he suggested we gas her and cut it open. Same as your vet said, if it was an abscess he'd clean it and if it was a tumor he'd remove it. I actually got to go back and watch the surgery, it was cool. It took all of 10 minutes, and it turned out to be an abscess. The entire visit plus meds (she was on antibiotics and pain meds afterwards) was $85. Granted, that's with my rescue discount, but still, I don't save THAT much...

 

[victoria]

Is she in pain?

 

[ChrisK]

I don't think she's in pain. When the vet manipulated her growth, she didn't squeek or anything.

 

[jorats]

That is a lot of money. Did you have a bad experience with the other vet? Could you go back to him to get his opinion and estimate?

 

[Katy]

Most vet clinics will provide an estimate that breaks down the cost and they always give a low and high range estimate. Most likely it will be the low end (unless the tumour is attached to structures that will require extreme care to remove which takes more time in surgery). Unfortunately it is the vets time and expertise, as well as the vet techs and vet assistants time which is usually the most costly factor for any surgery (vet techs monitor the patient carefully during anesthesia). However, perhaps the vet is also quoting pain medications and antibiotics as well? Check your quote- if you already have the meds, then the cost could be lowered. They might also be quoting lab fees as some vets will send away samples to see what type of tumour/infection it is. Again check the estimate- it should say there.

I don't know much about abscesses in rats, but I do know that in cats and dogs they usually will run a fever and the area where the abscess is will be warm to touch and PAINFULL. Again, this is only going by my experience in dogs and cats ( and I am not a vet) but the vet will usually lance and clean the abscess and then send the pet home on some form antibiotics. They might even take a same of the pus and send it to the lab- this way they can correctly identify the type of bacteria and give the most appropriate antibiotics.

I don't believe that your vet is intentionally taking advantage of you, but the unfortunate truth is it is still a business. I work at a vet clinic as an assistant and its hard to tell people how much things can cost. But believe me, I still want to get paid for my time (I make barely over minimum wage).

 

[victoria]

I think Chris realizes a good vet will cost money, but the estimate is quite high when compared to others in the same city or even some more experienced vets in Toronto, a bigger city with a higher cost of living in the same province. Some of the variations in prices are hard to justify.

I believe vets and support staff should get fairly compensated for their time, I recognize that is not always the case for support staff. But there has to be a balance that also makes vet care accessible. When I was living in Toronto, my vet quoted me $997-1394 for a lump removal (plus an exam, meds, and taxes). I had had lumps removed before (I lived in a different city at the time) but at a third of the price and cried and wondered how I was going to pay for that, plus rent, plus my student loan payments. I ended up switching vets, to one that was much better and had a better rapport with my rats, and paid $300 for the surgery, exam, and to open a file, including tax. (I had gotten meds from my old vet prior to switching, so I didn't need those and it did turn out to be a much easier surgery than expexted.) Now that I have had many more lumps removed at a few vets, I still cannot justify the insane quote I got for Lizzie's lump.

 

[ChrisK]

That is a lot of money. Did you have a bad experience with the other vet? Could you go back to him to get his opinion and estimate?

The other vet did a good job with surgeries. The only problem there was he's got limited knowledge of rats, and as our girls are getting older, he doesn't have the knowledge/experience. We were using both vets at the same time for a while, until the more experienced guy, who just gave us the high quote for surgery, threw a hissy fit. Told me it's not good for my pets to bring them to different vets, they need consistent care, etc. So, I understood his point, and figured at this stage, the girls were getting older now, and needed the experience, so we decided just to go to the more experienced/expensive vet. For regular check ups, it's not that big a price difference. But for surgery....

I could probably go back to the other vet for something like this. My only concern is that he uses staples for surgeries, and with the possible abcess located close to her jaw/neck that'd be trouble waiting to happen..

Timing being so close to the holidays, I really feel the time pressure. Probably I should at least try having a phone conversation with the other vet though..

 

[ChrisK]

I think Chris realizes a good vet will cost money, but the estimate is quite high when compared to others in the same city or even some more experienced vets in Toronto, a bigger city with a higher cost of living in the same province. Some of the variations in prices are hard to justify.

Exactly.

I believe vets and support staff should get fairly compensated for their time, I recognize that is not always the case for support staff. But there has to be a balance that also makes vet care accessible. When I was living in Toronto, my vet quoted me $997-1394 for a lump removal (plus an exam, meds, and taxes). I had had lumps removed before (I lived in a different city at the time) but at a third of the price and cried and wondered how I was going to pay for that, plus rent, plus my student loan payments. I ended up switching vets, to one that was much better and had a better rapport with my rats, and paid $300 for the surgery, exam, and to open a file, including tax. (I had gotten meds from my old vet prior to switching, so I didn't need those and it did turn out to be a much easier surgery than expexted.) Now that I have had many more lumps removed at a few vets, I still cannot justify the insane quote I got for Lizzie's lump.

Wow! That's a huge difference! My old vet charged less than $200 for a lump removal, and did a good job. But I don't trust him so much with the more complex issues of my rat's health. I think we need the pricier/more experienced vet for that kind of stuff. But the more experienced guy has issues with me using another vet's services, and typically I wouldn't put up with an attitude like his, but I've gone to a number of vets in town and have found that either they don't know much and don't charge much or they know a larger/varying amount more about rats and charge more. At least the expensive guy is someone I trust when it comes to caring for my rats.

Unfortunately, between yesterday's appointment for Skittles and tonight's appointment for Lollipop, if we get the surgery and he charges the higher quote, that'd cost $1000 this week! I don't have that kind of money!

I'm thinking I'll ask tonight if he can give us a price break on the surgery. If he says no, maybe I'll take the antibiotics and try that route for her while I look yet again for another vet.

I'm just concerned about the time because this lump seems to have come out of no where and gotten big fast. It looks horrible to me, but I'm the skweemish sort. I don't know how much time we've got to sort this out and get it taken care of..

 

[SQ]

If it is an abscess, it would need to be left open ... they need to heal from the inside out.
Is she on antibiotics? That is important for many abscesses.

You can tray warm compressed on it several times a day. If it is an abscess, that will help to bring it to a head.
Abscesses around the face are very dangerous, especially if they get into the gum or bone.
In my experience, facial abscesses are often associated with a tumour.

Christmas will be here soon and vets will be closed for Christmas and then New Years.
A bad time for surgery but if it isan abscess, you need to get it taken care of soon.

 

[Joanne]

The estimate does seem excessive. I too would look at the breakdown and see where most of the money would be going. If it's a tumor and they want to send it to pathology, that could be $150 right there. Stuff like that would be nice to know, but maybe not essential. It's hard when it's the one vet you feel safest with...

 

My vet dose not charge for time, only the procedure.
I just got Hannah Spayed & 3 tumors removed, I'll let you know the damage when I go to get her.

 

[ChrisK]

If it is an abscess, it would need to be left open ... they need to heal from the inside out.
Is she on antibiotics? That is important for many abscesses.

You can tray warm compressed on it several times a day. If it is an abscess, that will help to bring it to a head.
Abscesses around the face are very dangerous, especially if they get into the gum or bone.
In my experience, facial abscesses are often associated with a tumour.

Christmas will be here soon and vets will be closed for Christmas and then New Years.
A bad time for surgery but if it is an abscess, you need to get it taken care of soon.

She's not on antibiotics yet because we tentatively scheduled her for surgery Thursday (that was before I saw the estimated cost), and the vet said it's not enough time for antibiotics to do much good, but that she'd get them after the surgery. However, we're going back there tonight with my other rattie, so I can always request baytril then. The bulge is still getting bigger, so I don't want to wait long.

My great stress over this is the timing. As you say... it's almost Christmas and soon everyone is closed. If I get the surgery done Thursday, that means her recovery is while everyone is closed, so if anything happens we'll have to go to an emergency room somewhere.. ughh... But if we don't have it done, we may end up in an emergency room anyway...

And to top it off, I'll need to take my poor girl with me Christmas eve for an hour ride to my daughter's and then an hour ride back Christmas noonish. That's the last thing I'd ever want to do to a rattie 24hours after surgery. Any suggestions to make this less stressful and keep her warm will be most welcome! (I'll be setting up her full cage once we get there, and her cagemate will be traveling with us too.)

And I hope I've written all this correctly, because today I'm very much beside myself over all this... so I hope this all makes sense!

 

[victoria]

If it is an abscess, it would need to be left open ... they need to heal from the inside out.
Is she on antibiotics? That is important for many abscesses.

You can tray warm compressed on it several times a day. If it is an abscess, that will help to bring it to a head.
Abscesses around the face are very dangerous, especially if they get into the gum or bone.
In my experience, facial abscesses are often associated with a tumour.

Christmas will be here soon and vets will be closed for Christmas and then New Years.
A bad time for surgery but if it isan abscess, you need to get it taken care of soon.

I had an abscess (we thought it was a tumour) surgically removed and it was not left open. If the abscess is completely cleaned out, it can be closed. Antibiotics were given after surgery to make sure it didn't return.

 

[ChrisK]

I just brought Skittles to the other vet this morning. By the time we arrived, it was clearly an abscess, and it had opened some.. some fluid had come out. The vet put a slide against the fluids to verify that it looked as expected for an abscess. He also looked at her teeth, and said that they seem okay, but that because of the proximity of the abscess to her teeth, he'd have to assume that it's related.

He gave me an antibiotic -- metronidazole -- he said it's more targeted toward killing bacteria that might attach to bone. And he said we'll keep an eye on it. If it doesn't clear up, then one course of action would be to have her bottom teeth removed, which would then mean having her upper teeth trimmed regularly, etc.. But, first we try the antibiotic and see if that will do it.

Does this sound correct to use antibiotics for two weeks first? It's my first experience with an abscess, and this being so close to her jaw/face I hear what you're all saying about how potentially serious it could be. Does antibiotics for a week or two first sound reasonable? Or is it too risky to wait that long?

Also, the other vet gave me baytril in a nice flavor that Skittles actually likes. But this vet made a good case for metronidazole as a better option. Does anyone have experience/comments on that too?

Thank you!!!

 

[SQ]

Great that she saw the vet and is on antibiotics.
Many vets will treat with antibiotics first.
That is a good antibiotic but you will likely want her on it for at least 3 weeks if it is helping.
Since the abscess is open, you may want to flush it out and keep it open so it will heal from the inside out.
Hopefully the abcess is only in the tissue and not associated with a tumour.

Removing any of a rat's front teeth is not a simple procedure and not to be taken lightly.
If even a very tiny piece of the root is not removed, the tooth will grow back .... and not always in the same position.

(I am not a vet, just speaking from experience.)

 

[ChrisK]

Since the abscess is open, you may want to flush it out and keep it open so it will heal from the inside out.

it's not fully open. Looks like a pin hole openning. I can clean the outside with warm water. Is there more I can be doing to flush it out?

Hopefully the abcess is only in the tissue and not associated with a tumour.

How will I know if it's associated with a tumor? Is it just a matter of the lump not going away after antibiotics?

Removing any of a rat's front teeth is not a simple procedure and not to be taken lightly.
If even a very tiny piece of the root is not removed, the tooth will grow back .... and not always in the same position.

Yes... I don't think we'll want to go that route really.. I think rather if the abcess persists after antibiotics, we'll get the surgery done and/or try a different route.

 

[Joanne]

You can help keep the abcsess open with warm, moist compresses.

Metronidazole is very different from Baytril - they target different bacteria. Metronidazole targets mainly anaerobic bacteria so works well in bony infections as there is little oxygen there.

Unless you can be absolutely sure that the infection is related to the teeth, I agree with erring on the side of caution and waiting to see if the infection clears up with antibiotics. The consequences of extracting a rat's tooth are much more serious than extracting a human's tooth.

 

[ChrisK]

Got called out of town for a few days due to family illness. Fortunately my husband was able to care for our little girlies at home while I was gone. This morning I got my first good look at Skittles. The area where the abscess was seems back to an almost normal shape and there's no awful odor anymore.. so I think the abscess has now finished draining. However, I've noticed that under her chin, there's an area where there's no hair/fur, and it looks red and kind of rough -- maybe as if scratched? (hope to post photo tonight). I'm just wondering if that's a normal kind of thing when an abscess opens?

Also, note that while I was gone, she was on baytril instead of metronidazole. It was a compromise I had to make so that my husband would actually be able to get her to take some kind of antibiotic. (she takes the baytril easily but the metronidazole is a hard sell.)

 

[jorats]

I'll wait for the pics before commenting. It's good news though that it's looking better.