Tuesday, June 26, 2007

Cat -- How to stitch up a very big anal wound?

I am using the Google Docs & Spreadsheets for the first time to document this case. Pictures are at www.toapayohvets.
Be Kind To Pets educational story is to share my veterinary experiences with younger vets in other parts of the world as most veterinary surgical books are too brief on the overall management of the case of a large oval anal wound in a cat.

Jun 26, 2007 3.17 pm

What to do with such a large infected oval wound near the anus? The cat had licked out the fatty tissues under the skin. A big gap of 0.5 cm deep. She had stopped pooping. How to close such a big gap successfully?

1. Ideally, put the cat on antibiotics for a few days. Was the wound. But the wound is large.
2. The cat was fat, at 5.5 kg. Would she be able to survive the injectable general anaesthetic?
3. Anaesthesize the cat using xylazine and ketamine.
4. Clip the hairs, wash the areas. Syringe in 6% hydrogen peroxide.
5. Debride --- cut off dead skin edges and remove dead tissues from inside.
6. Relieve anal sacs of oil. Greyish brown oil seen from left gland. Right gland must have had ruptured resulting in a big hole.
7. Trim edges of wound --- convert to diamond shaped wound.
8. Undermine tissues to get loose skin.
9. Cut lowest end to extend the wound. Z-shaped wounds sutured.
10. Avoid anal sphincter (near the anal ring).
11. Elizabeth collar size 10.
12. Best to ward cat for 10 days but owner wants her home.
13. Warn the owner to confine the cat and if she runs around the home, she may rub stitches off.

14. In 14 days, wound will heal and stitches to be removed.






The owner did not return for stitch removal as she was a nurse in a hospital and I presumed everything was all right with the wound healing.

Friday, June 1, 2007

1. The cat of the night escapes the dog catcher but not his mistress?

"How did your cat survive being exterminated since I saw him with a leg bite wound 2 years ago?" I asked the slimmest young girl with a white head scarf and big-frame spectacles. "Now he has a big lump like a ping-pong ball below his left armpit. It would likely be a cat bite or scratch abscess. There is usually a big muscular tom-cat involved in territory control. Your neutered cat would not be so strong to fight back. Was he permitted to wander the concrete jungles of Singapore?"

"Yes," the girl said. "He will meow so loudly if he was not permitted to go out. So, he goes out in the evening or at 2 a.m."

"For how long?"

"Around 5 hours and he would come home."

The cat had lost some appetite. His rectal temperature was normal. The lump was hard --- an abscess which had not ripened yet.



"I expected your cat not to be involved in cat fights since he was neutered by a vet since I last saw him," I deduced from his left ear tip being cut off a slice. Cats with left ear tips cut off indicated that they are neutered and released into the community. "He would not be as aggressive as the dominant cats after being neutered."

"He was trapped by the Cat Welfare Society and brought to be neutered by the vet last year. We thought he had disappeared for a few days."

"Why not keep the cat at home?" I asked.

"Too noisy," she said. "We keep him at home during the day time."

"A free and roving lifestyle has its risks. I am surprised that this beautiful and gentle cat was not captured by the dog catchers or killed by cat haters. In the past 3 years there was reportedly a team of dog catchers using nets to scoop up the stray cats at food courts and take them away whether they had clipped ears or not." Stray cats with clipped ears were previously not impounded but times have had changed after the outbreak of SARS (severe acute respiratory syndrome) in 2003 and vocal complaints.

"I took pictures of one of the teams netting the cats," the lady said. "Suddenly, a big burly muscular man rushed at me with hands outstretched and shouting at me. I had to run away fast."

"Was he a dog catcher? It cannot be happening in Singapore. Those people you saw could be the outsourced contractors?" I guessed.

"I did not stay to find out," the lady laughed. "I don't want him to know where I live."

I have never witnessed any dog catching team in action. Back to the cat. I asked my assistant to grip the scruff of his neck well. In that way, no tranquiliser was needed as the cat would not suffer pain. This gentlemanly cat did not feel any pain as he was fussed over by the 3 ladies.

I inserted the 20G a needle into the abscess and aspirated out 0.5 ml of greenish yellow pus from the lump.



"The pus smelt of rotten meat," I sniffed at the syringe opening after removing the needle. "This abscess has not ripened yet and more pus will form." .

I continued, "In around 3 days' time, the abscess would ripen and then I could lance it to drain away the pus and debri inside. Sometimes, with antibiotics, it would shrink. We have to wait and see. It is too early to cut the lump."

Would there be another 2.5 years before I see this cat again? After all, he is a stray cat. Anytime he would be impounded. But since he is a cat of the night, he is less likely to be caught. But there are still cat traps around.

The lady who loved cats left with her mother and a sister. An Indian boy of 12 years old cycled to the surgery with a stray kitten with a bluish swollen bluish belly most likely due to being kicked by naughty boys. "My mother asked how much you would charge for treatment of this stray kitten," the boy said.

"I would pay for the treatment," the slim lady said as she put a $50 note down and left the surgery with her mother and sister. "Bill me if this kitten required further payment."

Follow up:
The kitten did not survive the serious injury but the black and white cat recovered at home on antibiotics and after I had aspirated 0.5 ml of the pus from his armpit.