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4 Abscess, Cat Bite

Abscess, Cat Bite Client Education
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BASIC INFORMATION
• Associated problems include cellulitis, drain-
○ Cephalexin 22 mg/kg PO q 12h, or
ing tract, necrosis of overlying skin and • Antibiotic therapy is typically initiated.
Definition osteomyelitis of underlying bone (rare). ○ Cefovecin 8 mg/kg SQ once, or
Focal pocket of purulent material located in Fistula formation from bite perforation of ○ Amoxicillin ± clavulanic acid 10-20 mg/
the subcutaneous tissue of a cat due to a bite hollow organ can occur (e.g., rectum). kg PO q 12h
wound from another cat • Resolution of an abscess should occur within
5 days of effective therapy.
Epidemiology DIAGNOSIS • Castration or ovariohysterectomy may
SPECIES, AGE, SEX Diagnostic Overview decrease roaming and aggression.
Cats of any age and either sex (more common Diagnosis relies on history, physical exam find-
in male cats) ings, and results of aspirate cytology. Additional Possible Complications
testing is aimed at identifying the extent and • Progressing cellulitis and necrosis of tissue
RISK FACTORS complications of the abscess and injury. due to inadequate debridement or improper
• Intact male antibiotic use (p. 907)
• Outdoor cat Differential Diagnosis • Dehiscence of surgically closed wound
• Multi-cat household Depends on the site of abscess ○ Avoid primary closure of an infected
• Foreign body abscess wound
CONTAGION AND ZOONOSIS • Penetrating foreign body ○ Inadequate wound debridement
• Feline immunodeficiency virus (FIV): • Anal sac abscess • Non-healing wound
transmission is mainly via bite wounds. • Salivary mucocele ○ High incidence in the axillary and inguinal
• Humans can develop severe cellulitis from regions (pocket wounds)
cat bite wounds. Initial Database ○ Biopsy and culture and susceptibility
• Complete blood count: normal, or changes should be performed (mycobacteria,
GEOGRAPHY AND SEASONALITY consistent with sepsis L-form bacteria may complicate wound
Greater occurrence during warmer months • Radiographs: if distal extremity; osteomyelitis healing).
(roaming cats) possible ○ Consider surgical referral of cats with
• FIV testing: indicated for all cats with bite pocket wounds.
ASSOCIATED DISORDERS wounds, since this is the main route of
• Severe cellulitis transmission for FIV (p. 325). PROGNOSIS & OUTCOME
• Skin necrosis • Fine-needle aspiration and cytologic evalu-
• Osteomyelitis ation of abscess contents: to confirm septic • Excellent if proper therapy provided
inflammation if clinical features alone are • Guarded if cellulitis or tissue necrosis devel-
Clinical Presentation ambiguous ops and/or a non-healing wound develops
HISTORY, CHIEF COMPLAINT
• Painful swelling Advanced or Confirmatory Testing PEARLS & CONSIDERATIONS
• Crusted, dried discharge interpreted as • Bacterial culture and susceptibility: often
matted hair unnecessary with adequate surgical drainage Comments
• Lethargy, inappetence and an otherwise stable patient; considered Do not close bite wounds primarily. Allow them
if the patient is systemically ill (other than to heal by second intention.
PHYSICAL EXAM FINDINGS fever) and/or fails to respond to treatment
• Palpation: abscess may be well-circumscribed • Consider feline leukemia virus serologic Technician Tips
or broad-based and difficult to identify (e.g., testing if not already performed. Perform a wide clip and sterile prep before the
cellulitis) abscess is lanced and drained.
• Fever, dehydration, depression TREATMENT
• Draining tract with purulent material SUGGESTED READING
• Open wound with presence of necrotic tissue Treatment Overview Norsworthy GD, et al: The feline patient, ed 4, Ames,
• Swollen and/or painful subcutis (focal or Drainage of the abscess and antibiotic therapy IA, 2011, Wiley-Blackwell, pp 44-45.
regional) are the cornerstones of treatment and are
successful in the vast majority of cases. AUTHOR: Otto I. Lanz, DVM, DACVS
Etiology and Pathophysiology EDITOR: Elizabeth A. Swanson, DVM, MS, DACVS
• The bite punctures or lacerates skin and Acute General Treatment
underlying tissue. • Surgically lance and drain abscess, flush with
• Bacteria from oral cavity, hair, skin, and sterile saline or lactated Ringer’s solution,
surrounding environment are injected into and establish ongoing drainage. If necrotic
the subcutaneous tissue. tissue present, debride the wound.
○ Pasteurella multocida, Streptococcus, and
Staphylococcus spp. are most common.
○ Anaerobes

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