Facial skin abscess

History

Buckingham is a rat from the London agouti rescue. The rats from this rescue have proved to be exceptionally prone to abscesses, but these are always shallow and don't tend to affect underlying structures. Those that have been cultured have grown e.coli. I have found that these abscesses generally ripen, burst and heal without intervention, save cleaning them up with they burst. However, when Buckingham's latest abscess affected his face I took him straight to the vet as facial abscesses can be very difficult to treat.

Medical treatment

Buckingham was prescribed Antirobe (and Metacam) and this was given with difficulty (it tastes foul) for a week, by which time a lot of the facial swelling had gone and the abscess was coming to a head. At this point it was clear that it was a superficial skin abscess as normal and I stopped the Antirobe because of the trauma of administering it.

These pictures were taken near the beginning of treatment showing the generalised swelling and porphyrin staining:
  

This is before abscess is ready to burst, but the generalised swelling is reduced and the abscess is very prominent. You can just see the darkened area where the overlying skin is beginning to scab and die:
  

Outcome

Approximately 2 weeks later the dead layer of skin over the abscess finally gave way and Buckingham was left with a raw open crater on the side of his cheek/nose. It was only at this point that I did any cleaning of the area. The dead skin had separated in the main but was still attached and flapping about on the side of his face. Using a dilute solution of warm Hibiscrub I gently loosened the remaining skin and cleaned the area.

Buckingham also has an ongoing foot injury (from his time in the Dungeon) and this became swollen and infected at about the same time as the abscess burst. He restarted antibiotics: baytril and cephalexin, plus metacam for pain. However, even without the foot injury he would still have needed antibiotics as the area was initially wet and open. At this point he had a check up at the vet, just to be sure she thought everything would heal normally.

These pictures are taken a day or two after the abscess broke open:

This last photo shows the progress 10 days after the abscess opened up. It has needed no further cleaning or attention other than continued antibiotics. Buckingham, dropped the metacam after about 3 days when his swollen foot went down and his face seemed much more comfortable. He moved onto just cephalexin after about a week, and would have stopped that too had his foot fully returned to normal.

I should stress that facial abscesses are rarely this uncomplicated and are often related to other structures around the skull. Most need more aggressive intervention and offer a less optomistic prognosis.