Saturday, November 28, 2015

Cat Abscess: What to do when they aren't healing.

This is Chaussette.

She came in to see me because she was "lethargic, not eating, not playful, or acting like herself, and she was much more vocal than normal."

To me these were all very important clues that she was not feeling well, and particularly I thought the vocalization was her very smart way of demanding help and attention. Those cats are very very smart and will tell you there is a problem if you just listen and pay attention.

Always listen to your cat!

So began my exam of Chaussette; Even though her weight was normal, her mucous membranes were normal, she was walking fine, could open her mouth normally, and seemed to look normal, she had a fever (104.8 F, normal high end is 102.5 F) and a large mass on the left side of her neck. The big clue was the big mass on her neck.

She was also an inside cat.

The mass on her neck was painful to the touch and had a tiny area of a scab.

Chaussete had what I find most commonly on cats with no other history of trauma, no access to poisons or toxins, and a hard mass.  With the careful prick of a needle she had puss under that hard mass. She had an abscess. An abscess is an infection that has buried itself under the skin, or within the body. It is significant because it can be harder for the body to fight on its own and remain hidden from our view.

For those of you at home.. If your cat is not acting normally check them over from top to bottom, nose to tail. Let your hands be your eyes. If your cat has a mass it is important to see your vet. I do not ever recommend that you lance or open up the infection on your own. Here's why; It might not be infection. Don't poke without knowing your anatomy and worst possible scenarios.

Even after I was pretty sure it was an abscess I did not lance the wound and I did not open it up. Why? Well, I know people want to pierce an infection to let stuff out,,but,, it might also be allowing stuff in,, and the wound was very large. Too large for me to do much with while she was awake and in obvious discomfort due to a big festering wound on her neck.

Here is where a good discussion with your vet can make a big difference!

Chaussette's options were;
  1. Gold Standard; Bloodwork done to assess degree of infection, organ function. Costs range from about $25 (PCV), to $300 USD for full CBC and chemistry. Chaussette was a young healthy cat. This step was not going to change our treatment plan (infection  needs to be addressed). 
  2. Silver Standard; Placing a drain under general anethesia. Pre-operative blood work is recommended. General anesthesia cost $100, drain placement $40, pain medications and antibiotics about $40-$60.
  3. Bronze; Try an antibiotic to see if that is all that she needs to heal her wound. 

Chaussette's mom wanted to try an antibiotic first. I discussed that it might work, but, I was a bit worried that based on the size of the wound it might not be enough? She elected to try a 7 day injectable antibiotic. I gave it a 50:50 chance. We talked about monitoring at home and the next step should the wound not resolve. 
Chaussette's initial treatment plan included;
1. Examination $50
2. SubQ Fluids $25
3. Injectable Antibiotic $50 (7 day dose).
4. Injectable NSAID $13

About a week later Chaussettes' mom called. She wasn't eating again and the bump was still there.

OK, time for Plan B. (Every prudent vet has a Plan B. Further, every vet talks about Plan B before it is needed!).

Chaussette was given subcuticular (sub q) fluids and injectable non-steroidal anti-inflammatory to help with the fever. We also started her on a different antibiotic. Any cat with a high fever is reluctant, if not down right adamant, about NOT eating. 

Whenever it is possible I provide as much of the immediate treatment plan as possible in the hospital. It might cost a little extra (you can always ask your vet about the cost differences), but, it gets those cats feeling better much quicker, and it can be awfully difficult, as well as down right dangerous, to pill a cat who is cranky because they do not feel good. It is especially difficult in Chaussette's case because her wound is on the side of her  face and it will be hard to not touch it when you are trying to open her mouth to pill her.

I gave Chaussette

The next day Chaussette went under general anesthesia and had a drain placed. The drain is a small flexible piece of rubber tubing that extends from the top of the wound to the bottom. The plastic tube (called a Penrose drain) stays in place with suture at either end. The drain allows us to flush an antibiotic solution under the skin to eradicate and kill the infection that has been hiding out under the skin. I usually put an e-collar, sweater, or bandage very loosely over the surgical area so the cat won't be able to scratch, lick, or pull it out. The worst thing that can happen is that a pet

Cost of treatment plan number 2;
1. Re-check appointment $30
2. Sub Q fluids (to get break her fever and get her comfortable for surgery the next day) $25
3. NSAID $12
4. Injectable Antibiotic, different and (stronger than first) $10 (one day dose).
5. Anesthesia $125
6. Drain Placement $75
7. E-collar $8
8. Daily oral antibiotics, 10 day course $32

The drain was removed about a week later and Chaussette abscess is now finally resolved.

Important tips for drains;
  • We use the drain to flush a medical grade surgical solution around the plastic tubing.
  • An e-collar is used so that Chaussette won't pull her drain out.
  • The drainage should considerably subside over 24-48 hours. It should be gone by day 5.
  • The drain must be removed within 2 weeks time or the plastic degrades in the body.
  • Drains should only be used when the infection has abscessed and doe snot respond to conventional methods.
  • Keep the area clean and dry. These patients MUST be kept inside and under close supervision.
If you have a pet question you can find me, and a whole bunch of really talented helpful pet people at Pawbly is free for all to use and open to anyone who loves and cares about pets and animals.

If you want to discuss your pets case with me you can find me at Jarrettsville Veterinary Center in Jarrettsville Maryland. 

I am also on Twitter @FreePetAdvice, and I have lots of helpful videos on my YouTube channel.


  1. Thanks for the post! Very interesting information. My cat Midnight suffered from a similar infection. I was worried sick about her for weeks because I noticed how much weight she was losing from her lose of appetite. Once my vet explained to me what was going on I started to feel a little better.

    1. Hello Samantha,
      If any cat is sick and losing weight I would be very worried. I'm glad to hear that she is better now.

  2. This is a very helpful post . Chester was taken in for an abscess removal surgery and he is at day 2 recovery. his abscess was also on his neck but a little higher than chaussettes... closer to his jaw. he has a drain put in . it is supposed to come off in 5 days.. I'm counting down the days as my chester looks very depressed about having to wear the e-collar. i believe the incision to remove his abscess was quite long as he has stitches, apart from the drain. I'm assuming he will continue to wear the cone after he gets the drain removed because of the stitches? also, i noticed that in your treatment plan #2, which is what i chose at the animal hospital i took chester too, you did not include a price for pain medication. is that common? chester did not receive any pain meds to take home, instead 2 different antibiotics to be taken every 12 hours: Clindamycin liquid and clavamox drops . I was told the pain injection chester received only lasts 2-3 days.. what about the 5-4 days after that? he will still have his drain in place.. will that not hurt him once the pain meds wear off? thanks in advance..