Puffy Paw: One Manifestation of Cat Bite Abscess

Leave it to my cat Larry to provide blog fodder.

Out of the blue this week he limped across the driveway toward me, left front foot puffed up like a marshmallow. While all my cats have the opportunity to play outside, Larry has only recently ventured out into the yard. The gusto with which he flings himself up and down trees, pursues pretend prey, and dashes from imagined peril is delightful. Of course, cats that live outdoors face a number of real dangers as well: vehicular trauma, predators, disease from fleas and other external parasites, injury or illness from other cats.* Before I even examined him, differential diagnoses flooded my mind with trauma and infection at the top of the list. Did his paw get stepped on, run over, caught in something? Did he get bit by a fellow cat or some other animal? Are there broken bones?

Although his left front foot was nearly three times the size of his right, close examination of Larry's limb was surprisingly boring. I braced myself for biting, scratching and loud complaint as I palpated the swollen area. Nothing. Well, it clearly wasn't broken. I looked for breaks in the skin, blood or pus discharge, redness and hairloss. Nothing. I checked Larry's temperature. Normal.

An animal's history and signalment are often as important to reaching diagnosis as physical and laboratory findings, and in this case prompted my treatment. Larry is a young feisty male neutered cat. Lately he has been picking loud obnoxious fights with his housemates Cheeks and Jimi Happy. I felt a few bumps under the fur on his injured leg which raised my suspicion of puncture wounds (e.g., a bite), and I bet if I had shaved his leg I would have found some signs of injury. In another 12-24 hours, Larry probably would have a fever, noticeable pain, redness and foul discharge as the probable cat bite abscess progressed.

In this photo taken several hours after antibiotic injection,
Larry's left paw has residual swelling between the toes and
behind the large metacarpal pad.

An injection of a long-lasting antibiotic ideal for this type of infection was all it took in this case. Just as rapidly as his foot swelled up Larry's infection responded to antibiotic treatment. By the next morning Larry was walking normally and his foot appeared normal!

Cat bite abscesses are a common problem in outdoor cats, but I have seen a number of infected bite wounds in strictly indoor cats as well. Even play-biting between friendly housemates can result in an abscess requiring varying levels of treatment. I'll never forget the female kitty with a huge worrisome mass on her back. The owners were afraid she had some sort of cancer, but when I touched the large lump a weak spot in the skin broke open and foul smelling pus and blood spewed forth. What a delightful finding! (Really, we veterinarians live for this stuff!) I squeezed out as much of the bacteria-filled pus as possible, cleaned the wounds and administered an antibiotic. Like Larry, in a few days, she was as good as new! There is really nothing quite as satisfying to treat as a cat bite abscess.


*Yes, I know that allowing cats to roam outdoors is politically incorrect nowadays. As a farm girl, cat lover and veterinarian I believe an indoor/outdoor lifestyle is ideal for most cats' psychological health and well-being. While there are risks to life in the big wide open, sedentary indoor cats also face insidious risks to their health and well-being: obesity-linked diabetes mellitus, behavioral and medical urinary tract disease, and other stress-related problems (some of which result in relinquishment to shelters and/or euthanasia). I am not recommending tossing your strictly indoor kitty outside  -- the outside world can be intimidating and couch potato cats are especially vulnerable to danger if not accustomed to being outdoors. Exercise, proper nutrition and mental stimulation can and should be implemented in households of strictly indoor cats -- it's just that the humans must do more of the work! Pet cats that do spend time outdoors absolutely must be spayed/neutered to control cat overpopulation and prevent sexually-transmitted illnesses. They should also be kept current on all vaccinations, intestinal deworming and flea/tick preventatives. 

When Cats Attack!

Admitting to a struggle with a bit of writer's block on Facebook, I received several immediate and interesting questions and suggestions. Yet I can't get the following image out of my head and feel I should find a way to make it work.

The other day my toddler son--enamored of our cats as most toddlers are--grasped Cheeks by the armpits, hoisted her up and buried his face in her soft belly fur. Usually a very tolerant feline, Cheeks sort of freaked out at this! She wrapped her limbs around my son's head and held on for dear life as he blindly stumbled about in a panic. We rescued the cat from the boy (and vice versa), relieved to find not the slightest injury to either.

Cats being predatory and often aloof animals, it's easy for me to joke that if we humans were smaller or if they were much bigger, our cat companions would probably pounce on us like mice and toy with us a while before enjoying us for a snack. I have been observed more than once by a pint-sized feline with a chillingly calculating stare.

Mountain Lion

Domestic Short Hair

Some cats actually do lie in wait for their humans, leaping at unsuspecting legs, biting and clawing without provocation. Fortunately, this sort of excessive "play" behavior is the exception to the rule. Many more cats, like Cheeks, tolerate innumerable indignities without complaint (think kitties wearing bonnets being carted around in baby buggies). I have been absolutely shocked by the restraint demonstrated by some cats in situations that would make a less conscientious feline tear a person to shreds. Years ago during a bath, my cat Abe locked his front paws (with piercing claws out) around my arm in an effort to stop me and yowled in protest. Amazingly, he did not make a scratch!

When cats do lose control of their weapons--either in play or fury--the results to people can be disasterous. Cat Scratch Fever ain't just a kickin' Nugent tune. More than one veterinary professional has wound up in a hospital bed on IV antibiotics after a decent cat bite or scratch. It's like a game of Russion roulette. I've been bitten repeatedly--once so hard it bruised my thumbnail for months--and although each bite hurt like heck the wound healed without intervention beyond an initial thorough scrubbing. But I remain vigilent for myself, my kids and my clients because a simple little scratch can send you to the ER.

Cats biting cats can produce nasty cat bite abscesses, too. I know it's gross (it's a vet thing), but there is nothing more satisfying than draining an explosive, stinky cat bite abscess. With the pressure relieved, the cat feels better and the wound generally responds well to a short course of oral antibiotics. This type of injury is typically seen in unneutered outdoor male cats, but I've seen plenty of indoor female cats suddenly sicken from an abscess produced by a housemate's wrath.

The moral of this story is to wash thoroughly even an innocent scratch or nip and be grateful for your cat's unusual restraint during times of insult and injury!