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This morning, on top of snow in May, I was greeted by the sight of blood and pus on Odin's neck. He's had an approximately 1" sebaceous cyst on the back of his neck for a couple of years now, and today it decided to burst.

I put him up on the grooming table, trimmed away the hair, and expressed tons of nastiness until it seemed to be done draining. That left him with an only slightly raised lump (it was quite large and firm before) and an opening slightly smaller than a pencil eraser.

I cleaned the opening as gently as I could with warm water, and then hydrogen peroxide. After that, I covered it with anitbiotic/antifungal ointment I had from the vet for a different injury a while back, covered it, and wrapped it in gauze.

Since it's Saturday (naturally) during the plague, our usual vet is closed, and many places are closed in general. I called the emergency vet and they were pretty nonchalant: just keep doing what you're doing. Sounds like you've got this! Which is sort of reassuring, but I'm not sure exactly how to best prevent infection at this point, or even whether it's completely cleaned out.

Anyone have experience with these? Any tips for keeping it clean and preventing infection? We're lucky that he can't get to it at all - he can't reach to lick or scratch it on the middle back of his neck--but it's still an open wound and I know that infections closer to the head are more dangerous, so I'd like to avoid that if at all possible!

Thanks in advance!
 

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Sounds like you're doing a good job. I've seen vets do it where they'll take a little syringe of saline and stick the point into the hole of the abscess and totally flush it out from the inside. That would probably be the ideal way to "clean it out." You may see it refill and it may need to be emptied again. Years ago I had one on a mouse that the vet lanced and drained, but then it came back and so I lanced it again at home. It stayed gone after that thankfully. Can't really clean them out too well on a mouse!
 

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Thank you! I know that the vet can do that but I don’t have a needle syringe like theirs here at home. I wonder if I could flush it with saline from a sterilized medicine syringe from CVS? Maybe I’ll try that the next time I change the bandage.
 

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You did a good job in dealing with this surprise. I know you used hydrogen peroxide but its generally not recommended because while it helpful in cleaning a wound, it also damages the skin cells which you want to remain healthy so the body can heal.

while this link isn’t completely approprivate, if you read at the bottom they do suggest flushing the wound with tap water or salt water. I know you are keeping an eye on it and will allow it to continue to drain as needed. I hope you don’t have any additional problems and it heals quickly.

 

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What you did is good.
My suggestion as a nurse:
It’s ok that you cleaned the wound with hydrogen peroxide once, but don’t use it to clean the would again. It’s very harsh and damaging to tissue and especially to a wound that needs to heal.
Clean it with saline from the center of the wound toward the outside. Use either pieces of nonwoven gauze or even just tear apart a paper towel into small pieces. Use a few fresh pieces, one for each swipe.
How deep was the cyst? You likely don’t need to flush it with saline unless it was a deep cyst. If you want you certainly can flush it with saline once. Use a syringe with as wide of an opening at the tip as possible, don’t stick the tip in the wound though. Steady the syringe in one hand so you can very slowly depress the plunger with the other. To prevent too much pressure shooting into the wound. Don’t use those saline wound sprays in a can directly as they spray WAY too hard.
Use the ointment and then cover with a bandage. Clean it twice a day.
Just keep an eye out for infection— heat coming off it, dark pink/redness and swelling of the surrounding skin, or a bad smelling, thick yellowy pus that occurs 48 hours or later.
Once there’s not any drainage when you’re changing the bandage you can leave it open to air. Id still clean it once a day with saline for at least a week.
Is the area possibly able to be rubbed by the collar?
 

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Thank you! I know that the vet can do that but I don’t have a needle syringe like theirs here at home. I wonder if I could flush it with saline from a sterilized medicine syringe from CVS? Maybe I’ll try that the next time I change the bandage.
I am 100% sure that would work. I have seen vets use the same plastic syringes.
 

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Discussion Starter #8
What you did is good.
My suggestion as a nurse:
It’s ok that you cleaned the wound with hydrogen peroxide once, but don’t use it to clean the would again. It’s very harsh and damaging to tissue and especially to a wound that needs to heal.
Clean it with saline from the center of the wound toward the outside. Use either pieces of nonwoven gauze or even just tear apart a paper towel into small pieces. Use a few fresh pieces, one for each swipe.
How deep was the cyst? You likely don’t need to flush it with saline unless it was a deep cyst. If you want you certainly can flush it with saline once. Use a syringe with as wide of an opening at the tip as possible, don’t stick the tip in the wound though. Steady the syringe in one hand so you can very slowly depress the plunger with the other. To prevent too much pressure shooting into the wound. Don’t use those saline wound sprays in a can directly as they spray WAY too hard.
Use the ointment and then cover with a bandage. Clean it twice a day.
Just keep an eye out for infection— heat coming off it, dark pink/redness and swelling of the surrounding skin, or a bad smelling, thick yellowy pus that occurs 48 hours or later.
Once there’s not any drainage when you’re changing the bandage you can leave it open to air. Id still clean it once a day with saline for at least a week.
Is the area possibly able to be rubbed by the collar?
Thank you! I did know not to use hydrogen peroxide after the initial cleaning, but it’s good advice. I am not sure just how deep it is? It was about an inch around, and a lot of material came out of it, although there wasn’t much noticeable smell, which I thought there would be. I even found a chunk on the upstairs wall—he always shakes there after he gets up in the morning and must have burst it there. Gross, I know.

Anyway, I suppose that, given how much was in there, there’s likely a pocket of some sort left behind. I didn’t explore too deeply because I didn’t want to aggravate it or introduce any bacteria inside.

It doesn’t seem to bother him, and is just weeping slightly now. We’re lucky it’s in a place where he can’t worry it. And no, I don’t think it’s related to his collar. He only wears a collar when we’re out, and it hangs below where the cyst is/was. I don’t know what cause the original insult there.

I’ll do a saline rinse this afternoon/evening and reapply the antibiotic ointment again at that time. I kept it wrapped in gauze all morning, but took it off to let it breath this afternoon. I was planning to only cover it again at bedtime since he often rolls onto his back and rubs against the side of his crate in the night—do you think I should be wrapping it for the rest of the day, too?

Thanks again for your help with this!
 

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You know, nothing really grosses me out, haha!
Glad you knew about the hydrogen peroxide, just wanted to make sure.
It’s ok if you’re not sure how deep it is. If it was just hanging off the surface before it popped then it’s probably not very deep. Of course you don’t want to be putting anything in there to test the depth unless you have sterile q tips, gloves, etc. What you did for the initial cleaning was plenty fine. There will always be some crud left in there even after cleaning.
I would continuously keep it with the antibiotic ointment and bandage for at least a couple days. At this point you don’t need it to air out as it’s very early in the healing process. The bandage will help draw out the drainage and you can also more easily monitor the quality and quantity of the drainage that collects. If you can’t get Odin to keep a bandage on the area all day and night it’s not the end of the world and should be fine.
 

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Discussion Starter #11
So I put a warm, wet compress on it for a while this evening, then did a gentle saline rinse, and coated it in antibiotic ointment again. Cleaning it didn’t seem to bother him at all, thankfully. I’ll add a little more ointment and re-bandage it before bed. Here’s hoping he doesn’t aggravate it overnight! Thank you so much for your help!
 

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He also needs a course of antibiotics. Call the vet. Had this happen with Buck, before COVID-19.
 

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Lola gets sebaceous cysts all the time. Vet recommended contact lens cleaning solution for wound cleansing. It is slightly antibacterial but gentle. Everything you are doing sounds right. Just keep an eye on it. Lola has only had one that needed further attention and had to be surgically removed. Every other healed nicely on its own.
 

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Lola gets sebaceous cysts all the time. Vet recommended contact lens cleaning solution for wound cleansing. It is slightly antibacterial but gentle. Everything you are doing sounds right. Just keep an eye on it. Lola has only had one that needed further attention and had to be surgically removed. Every other healed nicely on its own.
Thank you so much! I am seriously hoping that this stays clean and uninfected, too. Good tip about the contact lens solution; I’ll try to pick some up!
 

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I don't have much to offer-the advice you have given all seem to have good sense. Just wanted you to know that I will be keeping good thoughts and prayers coming your way.
 

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Add contact lens cleaner to the Spoo first aid kit! I’m going to try it. Thank you, Poodlemana!
 

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Generally exactly what porkchop said! Peeves had a sebaceous cyst when he was young. Our vet recommended putting synotic on it, which did reduce its size. Then we would forget about it and it would fill again. Eventually it just ruptured on its own. We cleaned it with first aid wash and left it uncovered since it was on his side and we would have needed yards and yards of co-wrap to keep it securely bandaged. We kept an eye on it for signs of infection/inflammation (which didn't happen) and that was the end of it.
 
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