Monday, May 11, 2015

Bite Wounds

Please note: Some images of wounds will be presented in this article

We see a significant number of bite wounds, here at Exclusively Cats. Sometimes, the wounds are on indoor/outdoor cats, other times, we find them on stray or feral cats that are brought in for limping. Occasionally, we are called on to treat bite wounds in indoor-only cats - usually after a fight between housemates that got a little out of hand.

Bite wounds often harbor multiple kinds of bacteria
Sometimes, we see the bite wound when it is fresh, and we can prescribe medications and treatments to decrease pain and inflammation, as well as prevent infection. Other times, we see bite wounds after they have become abscesses. An abscess is a pocket of infection that can develop after a wound. This occurs because the canine teeth create small punctures in the skin that do not bleed much. The sharp, conical tooth acts like a needle, injecting bacteria deep into the skin or muscle. Since the wound does not bleed much, the bacteria remain at the bottom of the wound, and when the injury scabs over, a warm, moist area is left behind, which is a great environment for bacterial growth. As the bacteria grow, white blood cells flock to the area to fight the infection. Eventually, there is too much "stuff" (bacteria, diseased tissue, white blood cells and other inflammatory cells) to fit in the puncture wound and the abscess starts to swell. It may be warm to the touch. As it swells, eventually damaged tissue will fail and the abscess will open to the outside and begin to drain. If antibiotics are not started, the wound will scab over again and the process will start anew. 

A bite wound or abscess can happen anywhere on the body, but common locations are on the legs and feet, especially the hind legs, as many cats will get bitten while running away. Other common places to find these wounds are the head and neck, ears, and tail.

If an abscess or bite wound is not obvious due to moist hairs around the wound, or hair loss, you may notice a strong, unpleasant odor - this foul odor is characteristic of  infection. A cat that does not have other obvious signs of a wound may seem painful to the touch, may lick at an area excessively, or may run a fever. Feverish cats often do not have an appetite, so weight loss or disinterest in food can also be signs of a bite wound or abscess. Depending on the location of the wound, you may also note limping, squinting, ear-flicking or the holding of an ear at a strange angle, a reluctance to lie on one side or the other, restlessness, or discomfort when sitting.

Usually, when we are examining a bite wound, we will find a set of 4 wounds (from all four canines), but not all four wounds will be the same severity - some teeth will puncture further than others. Sometimes only one of the four wounds becomes infected. Most of the time, a wound can be flushed and cleaned while the cat is under anesthesia, and then sutured as needed if the wound is large. Warm compresses twice daily will allow the wound to remain open to drain, which will help the wound heal more quickly and prevent the wound from scabbing over and beginning the process all over again. In some cases, the wound is in a location where it can't drain well, and a drain tube will have to be placed. In other cases, the wound has started to heal, but some of the tissue around the wound is too badly infected to recover. In these
This wound required a 12 day stay in the hospital for intensive wound care
cases, the diseased tissue will need to be surgically removed to allow healthy tissue to replace it. This is called "debriding". In extreme cases, there may be enough badly diseased tissue that needs to be removed that the wound cannot be sutured closed and we must use special bandaging techniques to encourage the wound to heal.

An important thing to remember when dealing with bite wounds is that, aside from bacterial infections, other complications can arise from this situation. A cat that has been bitten by another cat will be at high risk for feline-specific viral diseases that can be transmitted through saliva, such as Feline Immunodeficiency Virus (FIV) and Feline Leukemia Virus (FeLV) (although FeLV is more likely to be transmitted by long term contact between two individual cats than a single bite wound, the fact that a cat has obvious contact with other cats outdoors suggests that a bitten cat should be tested for FeLV out of due diligence).  Additionally, a cat that has been bitten by any other mammal - cat, dog, raccoon, fox, bat, etc. runs the risk of rabies exposure. If the animal that bit your cat is known - for example a neighbor's cat or dog, it is a good idea to ask what that pet's vaccination status is. If the animal that bit your cat is unknown, it is recommended to have your cat re-tested for FeLV and FIV about 2 months after the bite wound occurred. In Michigan, if your cat's rabies vaccine is up to date, the bitten cat should be re-vaccinated and observed carefully for 45 days for any signs of illness. If the bitten cat has not been vaccinated for rabies, or the vaccine has lapsed, the situation becomes more complicated, as the choices outlined by the Michigan Department of Community Health are either immediate euthanasia or strict quarantine for 6 months. This is one of the reasons that we emphasize keeping your cat's rabies vaccine current.

Michigan Department of Community Health Rabies Protocol
For more about bite wounds:
Frequently Asked Questions About Bite Wounds
Abscesses From Bite Wounds
Bite Wound Abscesses in Cats

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