I was recently awakened in the middle of the night by the blood curdling screams of two cats in my back yard having a spirited row over territory. All I could think was there were two cats who were going to have abscesses in about 4-5 days.
Cat bite abscesses are probably the most common survivable affliction I see in cats that go outside. Owners are often quite certain that their cat doesn’t ever leave the yard and their sweet baby would never get in a fight with another cat, yet somehow their cat is sitting in front of me (again) with a 104 degree fever and a bulge under his right ear that looks like he is growing a second head. The fact of the matter is that any cat that goes outside will eventually encounter another cat, and both cats will invariably be infuriated at the uninvited visitor in their territory. In cat world a fight is the only possible course of action in that situation.
Cats generally bite each other around the head, neck, ears, and front legs when they are going mano a mano, but they aren’t above throwing in a cheap shot and chomping down around the base of the tail of someone who is running away. Those pointy teeth are like bacteria laden hypodermic needles that slide though the skin and deposit a generous dose of all sorts of nasty mouth germs into tissue that is now damaged by the crushing forces associated with the bite. Often the pointy teeth slide right back out of the skin leaving no obvious mark.
It takes several days for the bacterial inocculation to brew into an ever expanding pocket of infection--an abscess. Often the skin will stretch like a slowly filling water balloon, but it isn’t water that comes out when that balloon bursts.
When an abscess is discovered before it bursts the best thing to do is to sedate the cat, open up the pus pocket, and flush it out. If the abscess has already burst and left a foul smelling, bloody mess on the middle of your favorite couch then we often proceed directly to step two which is antibiotics and pain medication.
To be honest, if absolutely nothing is done to most abscesses they will usually work through their natural process of bursting and healing and nothing drastic is likely to happen to the cat. However, abscesses are very, very painful and the cat will suffer unnecessarily for many days if no treatment is offered.
Often after an abscess has opened there is a good sized raw-looking open wound left. It seems obvious to many people that we should want to sew it up, but sewing up abscesses just traps the infectious junk inside. That pink tissue is actually normal healing tissue coming in to do its job. It has a big blood supply to carry in healing materials and carry out damaged tissue so it looks very tender, but it has very little nerve supply, so it isn’t painful to touch. It can be hard to stare at a nasty-looking wound and just leave it alone, but that is often the best course in this situation. Topical treatments are generally unnecessary and can actually be counterproductive. Hydrogen peroxide in particular has very close to zero antibiotic activity, it stings, and it damages healing tissue, thus delaying wound healing. The best place for hydrogen peroxide in any first aid kit is in the trash.
Abscesses are problem enough from cat fights, but another serious problem that cannot be resolved is Feline Immunodefficiency Virus--FIV. The virus is spread by bite wounds, and a significant number of feral cats in this community carry the virus. FIV is incurable, and leads to potential lifetime health issues that sometimes become serious enough to be fatal.
The bright side to all of this is that there is an easy trick to almost completely eliminate the possibility of either abscesses or FIV infection happening to our pet cats. Simply make your cat an indoor only cat. You may deprive your veterinarian of a little business, but your couch will thank you for it.