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> Cats wound infection and abscesses|
|Wound infection and abscesses |
Wounds and their frequent sequelae, abscesses, are the most
common skin problems seen in cats who are allowed outdoors. Whether or
not your cat needs to see a veterinarian for wound care depends a lot on
the kind of wound it is. Short, clean lacerations (cuts) or cuts that do not
completely penetrate the skin and most abrasions (scrapes) usually need
only to be washed thoroughly with mild soap and rinsed with large volumes
of warm, clean water. After thorough washing these injuries should be
examined daily for signs of infection. Larger cuts (about one-half-inch long
or longer) and punctures usually need veterinary attention.
How wounds heal
Wound healing is essentially the same process whether it occurs by
primary or secondary intention. The wound fills with a clot. The wound
edges contract, reducing the wound in size. White blood cells called
macrophages enter the wound and remove dead tissue and foreign
material. Blood vessels and connective tissue cells enter the wound,
followed by nerve fibers and lymphatic cells. At the same time this is
happening, skin cells move in to close the surface opening, and finally the
wound is healed. Wounds that are allowed to heal without apposing
(bringing together) their edges heal by secondary intention. Healing by
primary intention is more rapid. Your veterinarian tries to achieve primary
intention healing by suturing larger wounds closed. Suturing clean wounds
closed also helps prevent them from becoming infected while they are
healing. Wounds, however, which are likely to become infected cannot be
sutured closed or must be sutured only with special care. Puncture wounds
—most commonly bite wounds or claw wounds—are among the most
frequently seen wounds on cats that fall into this category.
Puncture wounds need special attention
Bite wounds and claw wounds require special attention not only
because they are likely to become infected (which interferes with healing),
but also because if the body’s defenses (white blood cells and lymph
nodes) are unable to overcome the bacteria, infection may spread from the
original wound to the bloodstream. This may result in a septicemia
(bacterial toxins in the blood) or a bacteremia (actual bacteria in the blood)
and can sometimes eventually lead to death. Although puncture wounds
are difficult to wash, you should make an attempt to clean them thoroughly
whenever you notice any on your cat. Flushing a mild disinfectant into the
wound under light pressure (with a eyedropper, turkey baster, or syringe) is
one of the best home remedies because this action tends to wash debris
out of the wound. Disinfectants that are used in veterinary hospitals and
that you can buy there or in drugstores include 0.001% to 1% povidoneiodine
(the more dilute solutions are actually more potent disinfectants and
less damaging to healthy tissue), 0.55% chlorhexidine, and 0.125% to
0.5% sodium hypochlorite (one fourth to full strength Dakin’s solution),
which can be made by diluting household bleach 1:10 to 1:40 with water.
Flushing with hydrogen peroxide, once thought to be an effective wound
treatment, has fallen into disfavor due to its weak antibacterial properties.
Its foaming action is impressive but is best reserved for flushing debris or
blood clots from a wound. If used, the concentration of hydrogen peroxide
should never be more than 3%. Do not instill oil-based antibiotic wound
ointments or those containing the local anesthetic benzocaine into the
wound cavity as oily products may interfere with healing. Any benzocaine
absorbed through the skin is toxic to red blood cells. If possible, antibiotics
should be administered by a veterinarian from the start of treatment (within
twenty-four hours of the bite) since bite wounds are so prone to infection.
The biting cat (or other animal) should be investigated regarding the status
of its rabies immunization.
An abscess is a localized collection of pus in a cavity caused by the
death and destruction of body tissues. Abscesses are the most common
type of infection occurring in improperly treated bite or claw wounds. They
usually cause swelling under the skin at the wound site and sometimes
signs of pain, but often go unnoticed until they begin to drain sticky white,
yellow to yellow-green, or blood-tinged pus. Abscesses are frequently
found on the head (cheeks, ears), legs and feet, and on the tail (near its
base). They occur much less frequently in the tissues behind the eye
(retrobulbar abscess) causing swelling, protrusion of the eye, and signs of
pain particularly when attempts are made to open the mouth. Veterinarians
treat abscesses by opening them surgically under anesthesia and by
removing all visibly dead and infected tissue (débridement). Antibiotics
are administered, and you are usually instructed to clean the wound daily at
home. You can often tell when an abscess that is not draining is formed
and ready to open by feeling it with your finger. If you can feel a soft spot or
if the swelling feels fluid filled under the skin, it is ready to lance.
Sometimes your veterinarian will advise you to put warm packs on an
inflamed and infected area that is not yet abscessed. This helps localize
the infection so effective drainage can be provided. By transiently
increasing the blood supply to the area, hot packs may help antibiotics get
into the infection, preventing abscessation in some instances. You may
want to try this without a veterinarian’s advice on an infected, diffuse
swelling (cellulitis) that has not yet abscessed if your cat does not have a
fever and seems fairly normal except for the signs of inflammation.
Home treatment for abscesses
If your cat has a well-localized abscess that has burst or is covered by
a scab that can be removed and has no fever, you may be able to get the
abscess to heal with home treatment alone. You must pull off the scab if the
abscess is not yet draining, then determine how extensive the abscess is.
Any abscess in which you can’t reach to the full extent of the pocket
probably won’t heal but will spread or recur and need a veterinarian’s
attention. Determine the extent of the pocket by wrapping your gloved
finger in a sterile gauze pad and probing the wound thoroughly. Be gentle,
but be sure to clean out all pus and loose tissue and to probe to the
wound’s farthest reaches. A small abscess can be cleaned and probed
with a cotton-tipped swab. Clean the abscess thoroughly with a
disinfectant once or twice a day. If the opening of the wound is large
enough, you can pour the disinfectant solution directly into it. A syringe
(bulb or hypodermic type) or eye dropper can be used to flush the solution
into smaller wounds. The disinfectant can be applied to a gauze pad which
is used to wipe the wound or to a cotton-tipped swab which can be
inserted into very small wounds.
Cleaning an abscess
Some cats find these procedures uncomfortable, so be alert to avoid
injury to yourself if the cat bites or scratches to show his or her displeasure.
Clean the wound until visible tissue is free of debris and/or until the solution
runs clear. Repeat the cleaning once or twice a day until debris no longer
accumulates in the wound.
Veterinary help with abscesses
If your cat has a fever or any other signs of illness accompanying an
abscess or wound, do not attempt home treatment without the help of a
veterinarian. Fever and/or other general signs of illness indicate that the
problem is a more serious infection that the body’s defenses have not
been able to localize. Improperly treated wounds can be responsible for
serious and expensive complications—among them bone infections,
recurrent abscesses, and bacterial infections of internal organs such as
liver, heart, and lungs.
Other kinds of abscesses
Another type of abscess in cats is the tooth root abscess caused by
an infected tooth, usually found in a neglected mouth. This kind of infection
may cause swelling on the face; the swelling may come and go. Treatment
usually requires that the infected tooth be removed to prevent recurrent
abscessation. So see your veterinarian if you suspect this problem.
Foreign bodies not removed from a wound can also cause a recurring
abscess. Plant awns (wild barley “foxtails”) often cause this type of
abscess between the toes or in the genital area of dogs. They are much
less common in cats, but these abscesses must be probed by an expert
until the foreign object is found and removed or they will not heal. If you are
lucky at home, a foreign body abscess will open and, by expressing
(squeezing out) the contents, you will be able to pop out the foreign body.
Infected anal glands frequently abscess.