Persistant Abscess?

My problem is with my older kitty, Spot. He's 10+ years old and has hyperthyroidism (which is being treated with methimazole). My current problem is that he has an abscess. This is the second abscess in the three months I've had him. He is indoors only, so either my other cat bit him or he scratched himself. The first abscess was on his side, so I could see how my other cat could have caused it, but this one is on his head, near his eye. When we treated the first abscess with antibiotics, he immediately began having diarrhea. We switched antibiotics several times, but the diarrhea persisted. It took about three weeks for it to go away, and the abscess eventually healed.

Needless to say, my vet was very reluctant to use antibiotics for this abscess. I was told to put warm compresses on his head and flush the area with saline. When that didn't help, a different vet did give me antibiotics. He got diarrhea (of course) and the abscess seemed to get a little better. When I brought him back to have it checked, my normal vet reopened the abscess and told me to continue with the warm compresses and saline. I thought it was just about healed, but then it started to swell again. This time, the abscess was bigger, so the vet opened it and put a drain in to keep it open. I'm taking him back to the vet tomorrow to have it rechecked, though it doesn't look any better, but I'm wondering if his poor little head will ever heal.

Does anyone have experience with stubborn abscesses? This one has been a problem for at least three weeks now, and I'm running out of ideas.

It is probably time to do a culture on the drainage to make sure he is being treated with the correct antibiotic. And ask about getting acidophilus or lactobacillus supplements for him to replace the bacteria in his gut. And the other thing that sometimes helps the diarrhea is to put him on a high fiber food, like Iams Hairball or Prescription r/d. I wouldn't ordinarily recommend dry food or these brands, but sometimes they do the trick in stubborn diarrhea. Becky

He isn't on any antibiotics right now because of the fear of the diarrhea coming back (this is more my vet's fear than mine). When he had the diarrhea the first time, we did switch him over to a high fiber food, Purina OM, and we had him taking BeneBac once per day. The second time he had the diarrhea, I couldn't find the BeneBac, so I gave him a little bit of yogurt. The diarrhea didn't clear up until a week or so after the last dose of antibiotics. Currently his stools are normal, and he's back on a normal food (Precise). But the abscess persists and keep draining all kinds of disgusting goo. My vet mentioned that we may have to give him injectable antibiotics, but I'm not thrilled with the thought of giving him daily injections on top of the daily pills.

My other concern is that the vet mentioned another cat who kept getting abscesses. It turned out that cat had lymphoma. I'm wondering if there might be some kind of underlying immune system problem.

That would be a concern. Has he been tested for FeLV? Injectable antibiotics may help. Actually, there are long lasting ones that don't need to be given daily. I am not sure how long they last in cats, though. Also, Zithromax is taken orally for five days and lasts ten in the system, so it can be used for intolerant cats. But really, you need to get the draingage cultured so that you don't waste your time on antibiotics that are not the right ones. Also, there aren't enough bacteria in yogurt to really do the trick. The Bene-bac or getting lactobacillus capsules at the health food store are much better. Becky

He was tested for all of the major diseases when I found him (before I let him roam with my other baby), and he came up negative except for the hyperthyroidism. I will talk with the vet tomorrow about doing a culture if we need to do the antibiotics again. Maybe, if I'm lucky, she'll think he's starting to get better but with my luck, I doubt it.

Getting the correct antibiotic for this bacteria is vital. Some bacteria are also getting resistant to antiobiotics so the antibiotic that might once have worked fine doesn't work as well and the underlying bacteria is never completely eradicated. It sounds like this could be a factor in your kitty's returning abcess. The drain will help to prevent the pus from building up, and a culture will help ensure you get the best antibiotic to do the job. I have had injectible ones that only needed to be repeated every 2nd day so perhaps this might help him with his reactions to the a/b as well. Good luck.

Kathryn

I agree with all the advice that has been given so far. A culture is a great idea. Also a complete dental exam with xrays should be done. Abscesses on the face can sometimes be a result of a tooth root abcess, and these will not go away until the tooth has been dealt with.

I took him in this morning, so I figured I'd give an update. I was wrong about how long he's had this abscess. It's been a month and a half, not three weeks (how time flies!). I asked the vet about getting a culture. She cleaned up his head and forgot to get one, so I'm taking him back tomorrow morning to have that done. It takes three days for the culture to grow, so with the holidays, we won't be able to start antibiotics until Sunday. In the meantime, I'm going to continue with the warm compresses and the saline flushes. We also decided to give him vitamin supplements to help boost his immune system.

I know that one of his teeth looked kind of bad on the initial exam three and a half months ago, but the position of this abscess seems a bit off for a tooth problem. This one is above his right eye on his forehead. The problem with actually dealing with his tooth is that he has a heart murmur (probably caused by the hyperthyroidism), and he's old, so I'm reluctant to put him under anesthesia.

I'll update you all when I know more, and thank you for the suggestions.

I took him back in today, and they said that nothing grew in the culture. The vet says that it is a sterile abscess (though I wonder if it's possible nothing was oozing at the time it was swabbed). Since this has been going on for more than a month and a half without any signs of healing properly, it may be a draining tumor. We are going to do a biopsy on Monday. I know that this is the right thing to do, but I'm still worried because they have to put him under anesthesia. It's dangerous for all kitties, especially the older ones, but even more so for one like him, with hyperthyroidism and a heart murmur. I'm hoping he survives the procedure, and I hope that the test shows *SOMETHING*. The worst thing of all is not knowing what is wrong.

A biopsy sounds like a good idea. It will give a better culture, too. And they can look at the cells and see if there are clues to what is going on. It is a quick surgery, more of a sedation than a full blown anesthesia probably. Although they will take the time to clean it out well. He needs to have it done. Keep us posted. Becky

I will post again next Monday or Tuesday, depending on when I hear the results. I will probably have to leave him there overnight, since I don't get home from work until long after the vet's office closes.

Any news? Becky

Nothing yet. I'm trying to figure out how I'm going to remove the food at 8pm (no food 12 hours before surgery) when I don't get home until 10:30pm! I think I need to call someone and see if I can get them over to the house. If I can clean my apartment enough, I may ask my mom to take him home on Monday evening after the surgery so I can be with him that night.

His lump isn't getting any better on its own, though. It seems to be spreading to two areas on his head. Poor guy. He's so good natured about everything, even when I'm messing with his head trying to get it clean.

How about just putting down a half ration in the morning before you go. He will have it all eaten in the earlier part of the day. But my vet says nothing for eight hours, so you will probably be safe, anyway. Poor guy, he sounds like a sweet boy. Becky

I know how awful it is not to have a lead on what is wrong, especially over a chronic problem. Just a note to say I hope you get positive and treatable answers on Monday.

He made it through surgery, so that's a relief. They said he had another pocket of gunk closer to his eye, so they put a drain in that. My mom is going to pick him up for me, so I can see him when I get home. It'll be a few days before we have the biopsy results.

Lets hope it was that pocket that was not allowing it to heal. Thanks for letting us know. Becky

Tests are back...no cancer--Yay! They did an injection of a penicillin-based antibiotic during the surgery, so now poor Spot has diarrhea again. The vet said that either this is a continuation of a previous infection or that there is a ruptured cyst. The two options are to treat with another antibiotic (Baytril) or do surgery again to remove the cyst. For now, I'm giving him Baytril to see if it clears up.

They had put a drain in the pocket right above his eye, and we removed that on Friday morning. The vet told me to keep the incisions open to allow draining. Those things heal so quickly on Spot! They had closed up by Friday night. I've opened them a couple times since then, but nothing is draining. Maybe all the gunk is gone for good (knock on wood)?

Just figured I'd update anyone who may have been following Spot's saga.

Hi - I've been hoping for an update on Spot. What great news!!! Sounds like a wise plan to give the meds a chance to work before resorting to surgery. Hopefully, they'll do the trick.

It's a good sign that Spot heals quickly. I hope this will clear up soon - please let us know!

The reason cats get abcesses so easily is that their skin heals so fast, while infection is still present underneath. Did they do a culture with the tests when they sent the specimen? I wouldn't be surprised if the persistent infection was because until the surgery they hadn't been able to clean out that pocket.
For the diarrhea you could try acidophilus from the health food store for him and put him on a hairball or weight reduction food. These foods are both high in fiber and can really help diarrhea. You can even get r/d from your vet to try, that is what my vet put Elfie on and it cleared up her diarrhea while still on the antibiotics. Becky