“No matter how much cats fight, there always seem to be plenty of kittens.” At least, (rumor has it) so said Abraham Lincoln. OK, Abe, maybe so, but there are also a helluva lot of cats running around with nasty infected wounds. Take my friend, Distraction. He’s a scrappy old boy who, despite being neutered, constantly gets into altercations with other neighborhood cats. Here’s what happens. Dis has a disagreement with Dat Other Cat, who then bites Dis. Let’s pause while you go look closely at your cat’s mouth. See those four canine teeth, the upper and lower fangs? See how pointy and sharp they are? Like needles. When Dat bites, those fangs sink in easily, injecting bacteria-laden saliva under the skin.
Cats carry some pretty nasty bugs in their mouths, including pasteurella, staphylococcus, and streptococcus, and those fangs are designed to penetrate deep into any designated target. People who get chomped by a cat often learn this the hard way. A three-year study at the Mayo Clinic found that one-third of human patients with cat bites to the hand had to be hospitalized, and two-thirds of those needed surgery. Bites to the hand are especially dangerous because of the increased risk of bacteria being introduced into joints or tendons. Although the tiny surface puncture wounds heal over quickly, inside, things fester. Within a day or so, what looked like a negligible injury can turn into a hot, red, swollen, painful lesion requiring serious medical attention.
The same thing happens to cats. Perhaps you hear the scuffle outside. Dis comes home; you look him over. You don’t find any wounds, or maybe just small pinprick holes from his opponent’s teeth, but it looks minor. You don’t realize that the damage underneath is greater than you think. When Dat Other Cat bit Dis, he pulled the skin, causing it to separate from the underlying tissues. This is particularly easy to do in cats, whose skin is sort of loose and movable — so different from ours. A subcutaneous pocket is created, called “dead space,” where fluid can accumulate. Soon Dis doesn’t feel well. His appetite lessens. He may be feverish. Perhaps you notice a swelling. The most commonly areas affected are legs, face around the cheeks and ears, and the back. Technically called a subcutaneous abscess, it’s a big, soft pocket of pus made up of bacteria, white blood cells, and necrotic tissue.
Abscesses are frequent sequels to cat fights, and a common reason kitties end up at their veterinarians. The fur at the site of the initial bite often cakes over with dried blood and pus. It may feel like a stiff, dried paintbrush tip. If you grab and pull it off, the wound may open, allowing the abscess to start draining. It also may provoke Dis to bite or scratch you, as abscesses are painful, so if you try this, use due caution. If the abscess isn’t drained, swelling will continue to increase as more and more pus builds up inside. The overlying skin starts to die, and eventually ruptures, letting loose a torrent of yellow, green, brown, white, or red purulent material. In other words, pus. In other words, gross.
Treatment of cat-fight wounds depends on at what stage you head for the vet. Ideally, bring Distraction in as soon as you know he has been bitten; then prophylactic antibiotics can prevent an abscess from even starting. If you arrive when there is already a pus pocket, but it isn’t draining, your veterinarian may lance it right in the exam room, using local anesthetic or even just a quick poke with a small scalpel blade. Or your veterinarian may advise surgical placement of a rubber drain. This may require general anesthesia. If the abscess has ruptured on its own, there may be a large open wound and/or areas of dead skin that would benefit from surgical debridement.
I used to recommend surgery on most of these, until the time I admitted a patient with just such a ruptured abscess. She had eaten a large meal right before arriving, and I didn’t want to risk anesthesia on an animal with a stomach full of food. “I’ll start antibiotics now and fast her overnight,” I told the owners. “We’ll do surgery in the morning.” The next day when I took her out of her cage, the wound had already shrunk to half its original size. I canceled surgery and sent her home with 10 more days of antibiotics. (Nowadays, we also have long-acting injectable antibiotics that can make treatment much easier for cat owners who find it hard to give their fur babies pills.) Since that case, I often try conservative medical treatment before rushing into surgery, but there are still situations where surgery is indicated.
Another important aspect of cat-bite wounds is observing rabies protocols and laws. Regulations vary depending on vaccination status of both biter and victim. If you can definitively identify the attacking cat, then Dat Other Cat is home-quarantined for 10 days. As long as Dat shows no signs of illness during that period, there are no concerns about rabies. But all too often, no one knows who bit Dis. We call that a “bite wound of unknown origin.” In that case, the rabies protocol depends on the victim’s rabies vaccination status. If current, then he gets a rabies booster and 45-day home quarantine. If not, then it is six months of home quarantine, with rabies vaccination given at the five-month mark. Of course, keeping Distraction indoors would eliminate the risk of cat bites altogether, but the discussion of the pros and cons of indoor versus outdoor kitties is fodder for another day. As long as Distraction and Dat Other Cat roam the great outdoors, fights happen. In the words of poet Jean Burden, in “A Celebration of Cats,” “Prowling his own quiet backyard or asleep by the fire, he is still only a whisker away from the wilds.”