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Carl Pastor
couldn’t figure out where the foul smell was coming from. BeeJay, his
4-year old longhaired cat, always took pride in her spotless appearance,
grooming enthusiastically at every opportunity. Lately, however,
something wasn’t right. Normally playful and energetic, these last
three days found BeeJay very quiet, apathetic toward food, and
disinterested in going out in the yard. And there was that unpleasant
odor that she mysteriously acquired. Determined to find the source of
the odor, Carl gave BeeJay his own physical exam. Her teeth were fine,
and her fur looked spotless. As he attempted to examine her rear end,
however, BeeJay let cried and tried to run away. “I retrieved her, to
finish checking her out”, said Carl, “and when I touched near her tail,
and she cried again, and my hand was covered with some really awful
smelling pus”.
Welcome to the
world of cat bite abscesses.
Cat fights, and
their resultant injuries, are a common reason for veterinary visits.
Although cats living together indoor occasionally fight over territory
or for owner attention, it rarely leads to serious injury. Cats that
encounter other cats outdoors, however, are more likely to fight,
usually over territory.
Cats’ teeth are
sharp, and when they bite, puncture wounds are produced. There is a
tremendous amount of bacteria in cats’ mouths. The puncture wounds seal
over quickly, and bacteria injected into the skin become trapped. The
bone marrow sends out many white blood cells to help fight this
infection. The white blood cells and bacteria accumulate to form a
painful pocket of pus just beneath the skin. This collection of pus is
an abscess. Abscesses are common in cats, owing to the tough, elastic
nature of feline skin, which readily seals over contaminated puncture
wounds, allowing for pus to accumulate beneath the skin.
Dr. Mitchell
Crystal is a board-certified veterinary internist at North Florida
Veterinary Specialists in Jacksonville. Dr. Crystal warns that trauma
and infection are not the only concern regarding cat bite injuries. “Cat
bites have the potential to transmit several life threatening infectious
diseases to other cats”, notes Dr. Crystal. “Examples of these include
the feline leukemia (FeLV) and feline immunodeficiency (FIV) virus,
Bartonellosis, and rabies. Some of these, such as Bartonellosis and
rabies, have zoonotic potential – they are transmissible to humans”.
The diagnosis of
an abscess is based on history and physical examination findings. The
majority of abscesses are seen in cats that go outdoors, like BeeJay.
Intact males are at higher risk than neutered males or females, as
they’re more likely to roam and fight over territory. Typically, a cat
that has been bitten appears fine after the encounter. Over the next 2
– 4 days, bacteria deposited in the wound begin to multiply, and cats
develop a fever, become lethargic, and often stop eating. Many cats are
taken to the veterinarian at this stage, where the abscess appears as
either a firm or soft painful swelling. In most cases, puncture wounds
or small lacerations may be present, and the
area may feel
warm. If not discovered in this early stage, the abscess will continue
to swell, burrowing through tissues and accumulating more pus. The
abscess may then burst through the overlying skin, releasing creamy
yellow or brownish, often malodorous pus. Overlying hair may become
matted with dried discharge. Common locations for abscesses are the face
and neck, tail, back, and legs, although any part of the body can be
bitten during a fight. If a bite wound occurs in a location that does
not have much loose skin, such as a leg, the infection can dissect its
way through the tissues, causing diffuse swelling instead of a discrete
collection of pus. This diffuse swelling is called cellulitis.
The goal of
treatment is to prevent further contamination by cleaning the wound,
removing dead tissue, and treating for infection. The earlier that
treatment is instituted, the better the chances of the wound healing
without complication. Dr. Gary Norsworthy is a board certified feline
specialist and owner of Alamo Feline Health Center, in San Antonio. Dr.
Norsworthy has treated hundreds of catfight abscesses, and has even
authored a chapter on these types of injuries in a veterinary textbook,
“The Feline Patient”. “In most cases, the cat is anesthetized so an
incision can be made into the abscess”, says Dr. Norsworthy. “The wound
is then flushed with an antibacterial solution to further remove pus and
other debris”. If detected and addressed at an early stage, lancing and
flushing (plus antibiotics) may be all that is required. If discovered
at a later stage, where significant tissue damage has occurred beneath
the skin, the veterinarian may need to debride the wound (i.e. remove
dead or compromised tissue). In some cases, the veterinarian may find
it necessary to insert a drain (a piece of soft rubber tubing
that exits at the lowest point of the wound) to allow any future
accumulation of fluid or pus to escape. After debriding, if the wound
is large, sutures may be required to partially close it, however, most
wounds are left open to drain and heal on their own. Very large skin
defects may require some type of reconstructive skin surgery after the
infection has resolved. BeeJay’s abscess had already burst through the
skin, leaving a small hole just to the left of her tail base. The wound
was cleansed, but placement of a drain wasn’t necessary. “It was kinda
gross looking”, said Carl, “but she felt much better afterward”.
Indeed, once an abscess is opened up so that pus can drain, most cats
immediately begin feeling better.
Antibiotic
treatment, therefore, is an important part of abscess therapy “because
oral bacteria are literally injected below the skin during the biting
process”, says Dr. Gary Norsworthy, and nearly all of these wounds are
infected. Penicillin derivatives are the antibiotics of choice. Pus
that has a particularly putrid smell, like that present in BeeJay’s
wound, is usually indicates that anaerobic bacteria – bacteria that
thrive in environments where oxygen is low or absent – are involved in
the infection, and antibiotics known to be effective against anaerobes
should be administered. A short course is typically all that is
required. “Antibiotics are given for 5-10 days”, says Dr. Norsworthy.
Occasionally, some bite wound infections do not respond to initial
antibiotic therapy, and a bacterial culture and sensitivity test may be
required to determine which specific bacteria are infecting the wound
and which antibiotics are most effective.
The prognosis for
a properly treated abscess is excellent, however, cats that engage in
frequent fights are at high risk for contracting serious illnesses, such
as FeLV and FIV. Cats who contract these viruses may then spread them
to other cats in future encounters. Cats with FeLV or FIV also have
weakened defenses against infection, and may have difficulty defeating
an infection if bitten by other cats. Outdoor cats should be regularly
tested for these viruses. Although the majority of cats will test
positive within several weeks of being bitten by an infected cat, a cat
that tests negative should be retested no sooner than 90 days after
exposure, to rule out false negative results obtained during incubation
of the virus.
Cats that go
outdoors should also be current on their vaccinations, especially rabies
and FeLV. A vaccine against FIV was introduced several years ago and is
gaining popularity, although there is still some controversy regarding
its usage. Administration of the vaccine causes cats to test “positive”
when tested for FIV, and there is currently no way to determine if a cat
that tests positive is infected, immune, or both. Once a test is
developed that can distinguish between vaccinated and infected cats, the
FIV is certain to gain more widespread acceptance.
The best
prevention is to keep all cats indoors and prevent them from roaming and
fighting. All cats should be neutered, to reduce roaming and aggressive
tendencies. A good sturdy fence can be helpful in preventing cats that
insist on going outdoors from getting into fights with cats outside
their property. “BeeJay is an indoor cat now”, says Carl. “I love her
too much to take chances”.
Sidebar 1: Signs of an abscess
Lethargy
Poor or absent appetite
Visible puncture wounds
Swelling or lump on skin
Limping (if bitten on a leg)
Pain or resentment when picked up or touched
Fever
Swollen lymph nodes
Updated 2/9/06 |
