infection in cat

Hi
I adopted a 3 legged cat on may 2 who was perfectly fine. The next week his suture not area was open and clear puss was coming out. on the 18th he had a hole, in the armpit of the leg that was amputated (the vet from the shelter i got him from left a stub). The vet said it was punctre, i said i thought it was an abcess that poped since i didn't see anything he could hurt himself on, and i was home all day and didn't hear him meow). On the 19th he had an operation to fix the hole, where they went in and cleaned it up, they also gave him an antibiotic shot and put him on clindymicin 1 tablet every 12 hours. I took him back to the vet on 22nd and there was a fair amount of puss but not that much. On the 26th there was much more puss, at least one stich was out and the vet switched the antibiotic to orbax 1/2 tablet every 24 hours. I took him back on the 29th and there was still puss, she cleaned it up a little and put in antibiotic cream. I just checked the bandage and it's still infected, plus he has the runs, which i know is a side effect of orbax.

She says the next step is to test or Feline luek and fip. He's already been tested for luek twice and both were negative. So i don't see a a point in testing him again, is there?

Also when he had his surgery they recommended blood test's that i declined because of the cost, when he first came into the shelter they said his blood levels where out of whack, but they tested him the week before I adopted him i think and they were normal (not sure if they tested or not, the lady said they did), would his blood levels being out of whack be a reason why the infection isn't clearing up? If that could be a reason i'll get the tests done again, but if it's not realted to that then i'll save on that cost.

She also said that it was unfortunate that we didn't get a culture before he was on the antibiotics because now she wouldn't get an accurate reading. How long would he have to be off of the antibiotics before he would have an acurate culture?

Someone I know says there's this laser light therapy, does anyone know how well it works, and how much it costs? http://www.lumenphoton.com/overview.htm

Is there any antibiotics that cover other bacteria or are stronger than clindamycin and orbax? Like Albon, Amoxicillian, Antirode, Baytril, Cephalexin, Clavamox, Doxycycline, Metronidazole, Primor, Tetracycline or Zeniquin. Which is the best one that covers the most bacteria, covers bacteria that the other's don't?

I'm really hoping that I can get the infection cleared up and don't have to go to another surgery or costly things, I will if i can afford to however, I mean he's my pet even though i just adopted him and i love him, but i might not be able to afford much more and my parents and no one else i know is in a position to help me presently, though my vet seems has a payment plan so i could have procedure's done then pay for them later.

Any other adivce would be greatly appreiciated, thank you for your time in reading this
Laura

What it sounds like to me is that the "wound" is not able to drain, and is becoming a breeding ground for bacteria.

I'm really not sure on the antibiotic strengths, but I do know that there are certain antibiotics for certain types of bacteria. Gram Negative vs Gram Positive.

The antibiotics are supportive only, they require that his immune system is working at it's best capacity.

If he's been double tested for FeLV and FIV and was negative, then I don't see a need to retest again. However if there is an underlying problem with his bloodwork, it will definately be a contributing factor to his inability to heal.

I'm not sure on antibiotics throwing off blood work, but it would make sense for certain measurements. What I would suggest would be calling a second vet and seeing if they would be willing to give you a second opinion.

Also, were you instructed to clean and change the wound and bandages?

Spotz

Originally Posted by Spotz

What it sounds like to me is that the "wound" is not able to drain, and is becoming a breeding ground for bacteria.

I'm really not sure on the antibiotic strengths, but I do know that there are certain antibiotics for certain types of bacteria. Gram Negative vs Gram Positive.

The antibiotics are supportive only, they require that his immune system is working at it's best capacity.

If he's been double tested for FeLV and FIV and was negative, then I don't see a need to retest again. However if there is an underlying problem with his bloodwork, it will definately be a contributing factor to his inability to heal.

I'm not sure on antibiotics throwing off blood work, but it would make sense for certain measurements. What I would suggest would be calling a second vet and seeing if they would be willing to give you a second opinion.

Also, were you instructed to clean and change the wound and bandages?

Spotz

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i wasn't instructed to clean the wound at all. in fact i changed it myself after the one they put on fell off( he's really hard to get the bandage to stay on properly though so it's not there fault, he was bandaged better the next times i've brought him in), i used sterile bandages though that i got from the drug store.

he went in on the 18th with the hole, on the 19th they operated and i took him home, they said to come back on the 26th to have it looked at, i took him on the 22nd though to have them change the bandage. I then took him back on the 26th to have him checked, then on the 29th again for them to change the bandage, and then i have an appointment for tuesday to change the bandage.

I would take him to another vet but i can't afford it as all my money has gone toward paying this vet and i don't get paid for another 2 weeks, which then i could, but that won't help me now. And i can't borrow money from anyone either, as no one in my family has the cash to spare. I may be able to take him to another vet later this week though if i can get money from my sister, thing is i don't think they will do payment plans for me since i'd be a new client and don't even have a credit card, i may take him though i'm not sure.

I know that Tetracycline and those related tend to have one of the broadest spectrums of effectiveness against both gram negative and gram positive bacteria, vs. amoxicillin, which is a derivative from penicillin, which is only effective against gram positive bacteria, although the amoxicillin is semi-synthetic which allows for a greater spectrum. Please note that there are a lot of antibiotic resistant bacteria out there, and it may take more than one try to find one that is effective against this particular infection. And I'm sure that your vet mentioned this, and you probably already knew this beforehand, but please please please administer the drug as instructed and give it until it is completely gone. Failing to do so only encourages the production of MORE resistant bacteria, and they will be resistant to the antibiotic that your baby was on. Don't be afraid to ask your vet a bizillion questions, as it seems there's been complications and I'm sure you have a ton to ask! Plus they are the experts and should have the best judgement as far as what antibiotics should fit the bill at this time. Good luck and keep us posted! You are an angel for taking this poor little kitty in!

Originally Posted by Lauralai

i wasn't instructed to clean the wound at all. in fact i changed it myself after the one they put on fell off( he's really hard to get the bandage to stay on properly though so it's not there fault, he was bandaged better the next times i've brought him in), i used sterile bandages though that i got from the drug store.

he went in on the 18th with the hole, on the 19th they operated and i took him home, they said to come back on the 26th to have it looked at, i took him on the 22nd though to have them change the bandage. I then took him back on the 26th to have him checked, then on the 29th again for them to change the bandage, and then i have an appointment for tuesday to change the bandage.

I would take him to another vet but i can't afford it as all my money has gone toward paying this vet and i don't get paid for another 2 weeks, which then i could, but that won't help me now. And i can't borrow money from anyone either, as no one in my family has the cash to spare. I may be able to take him to another vet later this week though if i can get money from my sister, thing is i don't think they will do payment plans for me since i'd be a new client and don't even have a credit card, i may take him though i'm not sure.

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I would just call another vet and ask if you could do a phone consultation. All likelyhood you're vet is doing everything right. Every vet I've ever trusted, was usually open to simple things like this.

I would also call your vet and ask for specific instructions for changing and dressing the wound. This could be a big contributor to prolonging the problem.

Please keep us posted...we all like helping, and hate to see any animal or owner suffer.

Spotz

Originally Posted by bossinova

...Don't be afraid to ask your vet a bizillion questions, as it seems there's been complications and I'm sure you have a ton to ask! Plus they are the experts and should have the best judgement as far as what antibiotics should fit the bill at this time. Good luck and keep us posted! You are an angel for taking this poor little kitty in!

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I fully agree

Spotz

I just read your second posting, and would like to offer a few words of encouragement. My kitty was very ill and I couldn't afford to spend any money, either. I called around to all the local vets, and found one that would take payments. We were new to their office, and I don't have a credit card, either. Please don't feel discouraged. If you have the time, do the research, and it very well may pay off. Try to stay away from chain clinics, such as Banfield (in Petsmarts, don't know if you have any there or not), for they have higher-ups that are only concerned with the dollars and they are completely inflexable with any sort of payment plans (know this from experience ). I'm not badmouthing them, just merely saying you may have better luck with smaller, private offices.
Let us know what you can find.
What state are you in?
Oh, I see now, Florida....
Dang it, I'm of no assistance to you, I'm way in Washington!
Good luck to you! And make sure to love on your little boy.

Originally Posted by bossinova

I just read your second posting, and would like to offer a few words of encouragement. My kitty was very ill and I couldn't afford to spend any money, either. I called around to all the local vets, and found one that would take payments. We were new to their office, and I don't have a credit card, either. Please don't feel discouraged. If you have the time, do the research, and it very well may pay off. Try to stay away from chain clinics, such as Banfield (in Petsmarts, don't know if you have any there or not), for they have higher-ups that are only concerned with the dollars and they are completely inflexable with any sort of payment plans (know this from experience

). I'm not badmouthing them, just merely saying you may have better luck with smaller, private offices.
Let us know what you can find.
What state are you in?
Oh, I see now, Florida....

Dang it, I'm of no assistance to you, I'm way in Washington!
Good luck to you! And make sure to love on your little boy.

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Actually i'm on Ontario, Canada, i just joined so i have not changed my profile or looked into it at all. thanks for the advice though, my vet is fairly expensive too though, so i'll phone around tomorrow and see if any will allow payment plans, i know my vet has to have half of it up front before they will do a payment plan, i was lucky that they let me do a payment plan as i had less than half, but i've gone there for a few years. I mean it was 600ish for the surgery to fix the little hole, and 15 now every bandage change. it is $75
for every 10 minutes in the operating room and it only took 10 minutes, plus IV and all that added up to 600ish, and that's not including the 142 for blood test's i declined and 22 to obtain the blood from him. but i didn't know what else to do.

I completely feel and relate to your financial situation. It's stressful, because you really very badly want to do the absolute best for your kitty, and those bills get so high so fast! I also didn't have anybody to go to and ask for that kind of money. My parents would probably have a hernia if they knew how much I spent on my little man, just to have to put him down in the end Not that that is what will be the final outcome of this story! My boy had FIP, and there was no other humane choice for him. Your little man, however, has tons of hope and options. You just may have to dig around a little to find someone who's willing to fight this battle with you.

You're doing fine...Lauralai.

Spotz

here's the run down on the bill it's in canadian money, but still fairly pricy i think

consult 48.95
clindamycin 25.20
ward, nursing, doctor's care 85
antibiotic injection 35
pain relief 15
anesthesia induction fee 92
sterile surgical pack 40
suture material 15
surgery 75
progress exam 36
IV catherization 58
admin fee for payment plan 25

grand total 550.15 plus 40 for orbax and bandage change and another 16, and then another on tuesday and whatever else he might need since the infection isn't clearing up

oh and the hole was only 1 cm round, the vet said puncture, i said abcess that popped, since i think that's what it was, she didn't believe me i don't think, and now she know's i was right
he's worse now then when i brought him in, i mean the hole opened up again, and now it's infected, which it wasn't in the first place.
he's itchy though where the hole is, so maybe it's healing

i'm off to bed now though

Lauralai,

What was the nature of the injury that required the amputation, and which limb...foreleg or hindleg?

What blood testing was done prior to the amputation that prompted your vet to say it was "out-of-whack", what chemistry levels exactly were out of normal range? (i.e., liver or kidney function, etc), or was she simply relying on a CBC? (which does not include chemistry profile). An infection was probably already present directly prior to the amputation surgery, which would have thrown off the CBC, not necessarily chemistry values. A CBC will also show infection.

I'm confused as to why your vet said the first blood test results were not normal, then told you the second testing was normal, then requested yet another profile (which you declined). I'm also questioning why, if she already tested for FELV TWICE, why she would recommend a third time if the two earlier tests were negative. Only going by your posts, but seems like you have one confused vet and perhaps she is really inexperienced. Was she the vet who actually performed the amputation?

As for antibiotics, what she should have done, directly prior to, and during recovery, was administer Pen-G, a penicillin given twice daily until released from the 'clinic'. Then she should have followed with oral amoxicillin for you to take home, for approx 7-10 days, request a recheck at that time, then follow with an extended course for another 7 days if necessary (i.e., if evidence of infection were still obvious, wound slow to heal, indication of high temperature upon exam, etc)

She should also have sent home with you explicit instructions on proper wound care, and once she was aware that the wound had opened and infection was present, she should have sent wound cleaning flush home with you, such as Nolvasan, a surgical scrub you can use to gently cleanse the wound on a daily basis. Combined with the amoxi, that should have kept the infection from worsening.

I understand you are limited with your finances right now, but you and your kitty would really benefit to see a new vet. If you have had to have one or more "surgeries" to cleanse this wound, there's something amiss with your current vet's approach to wound care and monitorization/followup care. Was this wound necrotic in any way? Did your vet have to remove any necrotic tissue surrounding the wound, or was a puncture wound all it was and only required cleaning/flushing?

How old is your kitty, and has he suffered any other signs of illness, such as lethargy, fever, inappetance, vomiting, etc since the initial surgery? If so, it's possible this infection has turned systemic and will require further investigation with bloodwork. If however, no signs of illness have accompanied the wound problem, then an agressive approach with wound cleaning and proper antibiotics should be effective. (again, I would recommend amoxicillin)..............................Traci

Lauralai,

What was the nature of the injury that required the amputation, and which limb...foreleg or hindleg?

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The rescue group I got him from found him with an injured foreleg, not sure what happend or how long he was like that, maybe a car, or a trap, it's out in the country so anything is possible. They thought they were going to have to euthansize him but the vet cut the bills in half and they got a large donation to the group so they went through

What blood testing was done prior to the amputation that prompted your vet to say it was "out-of-whack", what chemistry levels exactly were out of normal range? (i.e., liver or kidney function, etc), or was she simply relying on a CBC? (which does not include chemistry profile). An infection was probably already present directly prior to the amputation surgery, which would have thrown off the CBC, not necessarily chemistry values. A CBC will also show infection.

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I'm not sure what exactly they preformed, my current vet knows though since I had the vet that preformed the operation fax the results to my curretn vet. In his health record though is says "Blood levels out of whack, should keep an eye on levels through blood tests regualrily, Blood Cell Count - 14. Given Amino B Plex for low blood levels" Then a few lines later it says "Blood levels normal, Blood Cell count 43"

I'm confused as to why your vet said the first blood test results were not normal, then told you the second testing was normal, then requested yet another profile (which you declined). I'm also questioning why, if she already tested for FELV TWICE, why she would recommend a third time if the two earlier tests were negative. Only going by your posts, but seems like you have one confused vet and perhaps she is really inexperienced. Was she the vet who actually performed the amputation?

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She wasn't the vet that preformed the operation and she's had her own practice for at least 5 years, so I don't think she's that inexperienced. I'm wondering why she wants to test again for FELV when they other vet did the test twice.

As for antibiotics, what she should have done, directly prior to, and during recovery, was administer Pen-G, a penicillin given twice daily until released from the 'clinic'. Then she should have followed with oral amoxicillin for you to take home, for approx 7-10 days, request a recheck at that time, then follow with an extended course for another 7 days if necessary (i.e., if evidence of infection were still obvious, wound slow to heal, indication of high temperature upon exam, etc)

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She gave him one antibiotic injection at least not sure what it is though, and she sent him home on clindamycin, then orbax, is amoxicillin better? If so I will ask her to switch him to that tomorrow as orbax doesn't seem to be working, though I never saw what it was like on saturday, when i looked last night it was still pussing.

She should also have sent home with you explicit instructions on proper wound care, and once she was aware that the wound had opened and infection was present, she should have sent wound cleaning flush home with you, such as Nolvasan, a surgical scrub you can use to gently cleanse the wound on a daily basis. Combined with the amoxi, that should have kept the infection from worsening.

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Tomorrow when i take him for a bandage change i'll bring that up to her, i mean it can't really make it worse, and being in a bandage for 3 days that has puss in it can't be good for the wound.

I understand you are limited with your finances right now, but you and your kitty would really benefit to see a new vet. If you have had to have one or more "surgeries" to cleanse this wound, there's something amiss with your current vet's approach to wound care and monitorization/followup care. Was this wound necrotic in any way? Did your vet have to remove any necrotic tissue surrounding the wound, or was a puncture wound all it was and only required cleaning/flushing?

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I don't think it was necrotic, not sure though, it might have been a puncture wound, i don't think so, i mean i think he did it while trying to squeeze under an end table, i'm not sure if it was the lighting or what but i thought that i saw something on him before he cleaned it, i didn't get a good look though. I managed to catch him a few minutes later and only saw the hole

How old is your kitty, and has he suffered any other signs of illness, such as lethargy, fever, inappetance, vomiting, etc since the initial surgery? If so, it's possible this infection has turned systemic and will require further investigation with bloodwork. If however, no signs of illness have accompanied the wound problem, then an agressive approach with wound cleaning and proper antibiotics should be effective. (again, I would recommend amoxicillin)..............................Traci

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He's 6 months to a year, he has diherrea now, but i think that's a side effect of the orbax, he vomited a few days before the hole, it might have been a fur ball, and hasn't happened again. He's even gained weight since the surgery and is a little big. Not sure on the fever, he's acting like a normal kitty though, so i don't even think it could be the FELV since that effects there immune system right? and if he had it wouldn't he be worse off, like sicker than he is?

So tomorrow i'll ask her to switch him to amoxicillin and ask her for the cleaning stuff, and if that doesn't work i will then think of further steps.

I may take him to another vet later in the week when i get more money, as right now i have no money and i'd need at least the vet consult fee of 50 to walk in the door at the local vets.

thanks for your time
Lauralai

Originally Posted by Lauralai

She wasn't the vet that preformed the operation and she's had her own practice for at least 5 years, so I don't think she's that inexperienced. I'm wondering why she wants to test again for FELV when they other vet did the test twice.

Lauralai

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Hopefully I'm really wrong....but the question quoted above, the only reasonable answer I can come up with is this:


$$$$$

Spotz