Swollen tongue knawed, loss of blood, abscess

Question

Lucy1  

Lucy2   Hello!
   So, about 3 weeks ago I noticed a lump on my rat Lucy's lower jaw.  I have your rat first aid book and read about tumors vs. abscesses and after a few days it got soft inside and I realized it was an abscess.  I was worried about it since it was on the face, so I started giving her amoxicillin 2x a day, dosing like your book says, and doing hot moist compresses.  It came to a head (on the underside of her chin, center of the swelling), turned black and crusty like you described, then opened up.  I irrigated it with the 10 to 1 water/hydrogen peroxide mix and rubbed the crater with a little neosporin.  I realized at this time her actual jaw bone was exposed when I tried to wipe away the "pus" with the q-tip and it wouldn't wipe away and was hard.  

    I saw in your first aid book to give Clindamycin for tooth or bone infections, and since it seemed possible she had a tooth abscess and her bone was now exposed to the outside of her body, I rounded some up and started her on 7 mg 2x a day in addition to the amoxicillin. And twice a day I irrigated the wound and applied neosporin. I also provided her with lots of different soft foods and changed her bedding more frequently. I noticed she was eating much less and not really drinking much.  
  
   She seemed to be doing better for about a week, the wound was slowly closing in from the outside in and a healthy pink color. Two days ago I went to get her from the cage and noticed her cheek was swelling up on the side that had the abscess and her eye was all watery.  I wondered if it was another abscess popping up despite the antibiotics. The swelling in her cheek doesn't seem to be increasing since then though, in fact it seems a little less.  Still slightly swollen though.

   Then yesterday, when I went to get her out, she was COVERED in blood...all over her hands, head, down her stomach to her feet.  Everywhere.  Her bedding was soaked with it.  I took her out and cleaned her up and changed her bedding.  I tried to find the source of the bleeding and realized she was gnawing her tongue to hamburger. I remembered then noticing that her tongue had been pressing into her front teeth and had been dark purple each time I cleaned her jaw wound. I'm not sure if that meant it was swollen? I didn't realize it was abnormal at the time though because I'm not sure what a normal rat tongue is supposed to look like. I don't know if she's been able to properly grind her teeth with the problems going on. Maybe they are getting too long.  I'm not sure how long that would take.  

    I put her back in her cage, and when I checked on her again later that day, she had been bleeding heavily again.  She seemed super weak and tired and wouldn't take any water or food.  I noticed the tip of her tail felt really squishy and cold.  I didn't give her her antibiotics yesterday or today because I didn't want to force them into her injured tongue. She hates them and I have to fight her to give her them and I wasn't even sure if she was going to survive the night.

  She hasn't bled more today, and the tongue actually looks a little better (from what I can tell anyway, she's fighting me pretty bad when I try to look) but she's having a really hard time eating and drinking. I tried to force some food and water in her mouth with a syringe and she fought me hard and was super stressed.  I gave her a small bowl of water besides the bottle so she had options and several different kinds of foods in her cage.  I haven't noticed her trying to drink out of the bowl though.  She did try to take some food from me, (coconut oil and banana mush) but struggled to eat it.  I think her tongue being messed up is preventing her from eating properly?

  She's lost a lot of weight during this whole ordeal, and is now pretty skinny.  (She was super healthy before all this started.)  She seems dehydrated too, with her skin standing up when I pinch between her shoulder blades.  She's constantly grinding her teeth and bringing her paws together like she wants to clean her face, over and over.  I can tell she's unhappy, but I'm not sure what to do for her.  I live in an area with no vet. (Small town Alaska) If I want to get her to a vet I will need to put her on a plane to fly her to Juneau, if the planes even fly (if it's cloudy tomorrow, they won't.) She's about 2 years old.  I'll attach a few pictures (if she'll let me take them) so you can try to see her wound and swelling and tongue.  Any advice or insight would be appreciated.  

Thank you!

P.S.  So I "burritoed" her to get some pictures and got a closer look myself in the process.  Her tongue looks much better...it's not purple anymore, and it seems to have healed from last night (it seriously looked like hamburger on the side of it last night..totally chewed up. In her abscess crater, the white part that is closest to her mouth is the bone..it's still exposed. (Or I assume it's bone anyway, it's hard and not pus.) The hole was about twice that big and deep when it first started.

Answer
Hi Brittney,
You have been doing really well so far!  Good job. I'm wondering if there might be cancer involved, which is the case with most instances of abscesses on the face that don't heal well. That would probably explain the swelling of her tongue. I think maybe the best thing for her at this point would be euthanasia.

If you don't want to do that yet, you could try giving her ibuprofen to help with the pain and inflammation in her mouth and jaw area. However, it can be hard to get rats to take it even when their mouth isn't sore and they are fine with taking medications. So, unfortunately, I think the kindest thing for her might be euthanasia.  I'm sorry.
Deb