Non-healing skin lesion - Update Feb 16/12

[lilspaz68]

Picture from today - it's hard to get a good shot because he's squirmy!

It looks virtually the same as it has for almost two months now...

You could try to excise it but if it's not bothering him, not really growing, I would just leave it. Just consider it one of those lumpy/bumpies that rats sometimes get.

 

[Maple]

"lumpy/bumpies".............. :laugh4: Spaz you have a great way of describing rattie issues. Always creates a well needed chuckle.

:hugs: for you Joanne, it actually looks better in the second set of pictures.

 

[Joanne]

Today Hotch had his lesion excised. We are sending half for culture, and half for pathology. The area has gotten slowly larger. Nothing seems to be working so I decided we just really need to know what we are up against. I took some pics while he was under the anaesthetic. I tried to pick the most in-focus pic to show what the tissue looks like. It was bleeding a little at the time.

Pre shave:

Close up:

Post shave:

The biopsies will get sent off on Monday. I don't know how long it will take to get the results back.
So now we wait.....

 

[jorats]

When you look at it that way, it dooesnt seem so bad, almost looks like a hot spot.
It will be interesting to know what's going on with that.

 

[Joanne]

When you look at the close up, I can see white striations on a red background. This reminds me of a condition we see intraorally called Lichen Planus. That is an auto-immune problem. If it is auto-immune, then I guess Prednisone would be the drug of choice. More speculation, I know...

 

[*Rebel_Angel*]

Poor doll! Keep us posted!

 

[Joanne]

So the biopsy came back and the diagnosis was ulcerative dermatitis. I didn't have a chance to speak to the vet so I haven't discussed it yet with her. I am hoping they gave a bit more information with the report. We are still waiting on the culture. Hopefully it will give us a definitive treatment plan. He seems to be healing OK. He didn't chew the sutures out yet. It's been 7 days since the biopsy.

 

[jorats]

Well that doesn't sound so bad... hopefully there's a drug out there that can help treat the lesions.

 

[mamarat]

It's good to finally know what it is. Sending healing vibes to your sweetie.

 

[Joanne]

From the pathology report:

"Final Diagnosis:
Ulcerative dermatitis, locally - extensive, severe

Comments:
The lesions in this case are characteristic of staphylococcal ulcerative dermatitis of rats. The incidence of ulcerative dermatitis may vary from 1-2% to over 20% in certain populations of Sprague-Dawley and other strains of rats. It is reported to occur more frequently in males. The lesions are associated with coagulase-positive Staphylococccus aureus infection with trauma/persistent irritation appearing to be important contributing factors in the perpetuation of the lesions. The typical gross appearance is of irregular, circumscribed red ulcerative skin lesions with associated hair loss. They are most commonly found over the shoulder/dorsal neck area, rib cage, submandibular regions, ears and head."

Still waiting for the culture report. I am really hoping this is not MRSA!!! ETA: (Methicillin resistant Staph Aureus)

 

[Joanne]

Well, the thing that I had been banking on, the culture, came back "no growth".
What the heck am I supposed to do now?!
He has a long incision where the spot was excised. All of it is healing except at the very top he has a new, painful, angry, red ulcerated area! Arrrgh!
I just can't get this boy healed up.
I was thinking of treating this as MRSA, and going with Vancomycin.
BUT, I cannot find a description of using this drug with rats, or a dosage.
Another alternative antibiotic mentioned was Clindamycin.
Once again, no dosing schedule in the Rat Guide, although there is one in the "Rat Health Care" by Ducommun.
My edition is 2008 - can someone check the current edition and see if there is a dosage for Vancomycin or if the Clindamycin is the same?
It's listed as 5-10 mg/lb BID
I just want to get my boy back to health...

 

[jorats]

What does your vet recommend? Does he have any idea? What would be done on a dog? I can't recall but did you try prednisone?

 

[hopefloats]

My dog has a spot, just one that she gnaws. It gets kinda nasty looking. Not as horrible as that but still. They gave her some meds for skin disorder. Cephalexin, cleared it right up. It comes back but a few days on the meds and it is gone. He told me some animals get a infection type in the hair follicles. I dont know if it is used on rats. My dog is prone to skin irritations. I know there are other meds that are better for skin problems.

I know they have over the counter meds for hot spots, I never used them but it anything is worth a try, as long as it is safe LOL.

Can rats be diabetic? I know diabetics have a hard time with sores and healing.

 

[Dazzle87]

Isn't Bactrim (SMZ TMP) used to treat MRSA?

Also, I apologize if I missed it, but did you test for fungus or treat for it? I had a somewhat similar situation with tests that came back negative, I finally tried an antifungal and it cleared up the skin problem.

 

[Joanne]

Isn't Bactrim (SMZ TMP) used to treat MRSA?

Also, I apologize if I missed it, but did you test for fungus or treat for it? I had a somewhat similar situation with tests that came back negative, I finally tried an antifungal and it cleared up the skin problem.

I tried a topical antifungal near the beginning with no improvement.
I just checked and Bactrim is used to treat MRSA. I will look into trying this drug.

What does your vet recommend? Does he have any idea? What would be done on a dog? I can't recall but did you try prednisone?

I didn't try Prednisone yet. The pathology report said it was consistent with Staphlococcus Aureus infection, so I guess I'm kind of hesitant to try it and feel like I should try a different antibiotic first.
I don't know why the culture didn't grow. Different reasons could be:
1. The culture medium was expired or the tube was handled in such a way as to let the microbes die.
2. The disinfection of the skin surface pre-excision was too effective.
3. There were no microbes to grow.

We went to the vet's Friday and removed his sutures. There was only a small spot there at that time. In two days it has increased in size significantly. I haven't contacted my vet yet as I just noted the increased lesion size this afternoon.

My dog has a spot, just one that she gnaws. It gets kinda nasty looking. Not as horrible as that but still. They gave her some meds for skin disorder. Cephalexin, cleared it right up.

Thanks! That's another drug to try. I'll have to ask the vet which drug she would suggest next...

 

[Joanne]

Update:
So eventually the skin incision healed without any more treatment, and last week I was looking at him and felt his belly and thought "AT LAST!!! Everything has finally healed, I can't feel a single spot or scab!"
Wouldn't you know it, a couple of days later he has a lesion that looks almost exactly like the lesion in October.
O.M.G.!!!!!!!!! Arrrrrrgh! I give up!

 

[SQ]

:sad3:

If meds made a difference before, I hope they do so again

 

[Joanne]

:sad3:

If meds made a difference before, I hope they do so again

They didn't. The spot was surgically removed...

 

[jorats]

That's so very strange. I'd probably leave it alone. Is it in the very same spot?

 

[lilspaz68]

Maybe try different meds than before? That must be a horrible sight to see yet again...I know I would've lost my mind if Selene had showsn up with pyoderma again. *pulls hair*