Anal Sac Abscess Aftercare

[sierramist]

Hey everyone, my cat suffered an anal sac abscess this week. Today it was lanced, drained, and irrigated. He was given Onsior and Clavamox, some subqand we were told to use hot compresses multiple times a day and he was placed in a cone.

So far, we’ve had some good developments, like his fever came down and he finally felt like eating again. But he couldn’t handle the cone at all, so my husband and I just spent the afternoon taking turns watching him. But we can’t do that all night (or can we?), so we got an inflatable cone for small dogs and it’s better but now he won’t move in it!

The bigger problem: he was running around earlier without it and dropped two gooey poo pieces on the floor, not even realizing he did it. Does this make him temporarily incontinent or something? In addition, he hasn’t tried to use the litter box at all. He’s on diuretics and usually pees a lot, so especially with the subq he should have peed by now, 8+ hours later. It’s really worrying me.

Also, now he has a little poo on his butt, and he can’t clean himself. I tried cleaning it up a little without touching the wound, but honestly it’s kind of a mess back there. I have him sitting on towels and everything is leaky and gross.

If anyone has gone through this experience before and has tips or advice, I’d sure appreciate it! This whole thing really stinks — literally!
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Update -
Oh gosh, guys. This is a mess (again, literally). He’s continuing to have diarrhea where he sits, I think he peed also. He suddenly isn’t using the litterbox. I’ve been up all night with him.

I don’t know if it’s the stress from this ordeal, because of pain, or what. Wondering if the diarrhea could be from coming off of two days of Metronidazole due to misdiagnosis.

But the poo is continuously on his butt. He’s desperate to clean it and I can’t let him. I’ve tried cleaning with a warm washcloth but I can’t get it all.

He’s going to be obsessed with getting to that area, so much so that when I take his cone off to eat, he won’t do anything but dive straight into the area.

Should we go back to the ER? Let them clean the wound? He’s on the antibiotics but having poo it around can’t be okay, right?

He’s so stressed now when he was doing better earlier. Even shivering. If we can get him clean and the diarrhea under control I think it would help tremendously. I can’t live with my cat on a towel on my lap, pooing/peeing himself, for days.

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Another update: talked with the vet and they said to stay the course, it will be gross before it gets better, to do the hot compresses and wipe just his anus if needed.

I’m going to pick up some s. boulardii to help with the diarrhea. It’s been a while since I’ve used it. Is this the right one?

https://www.vitaminshoppe.com/p/jar...oulardii-mos-5-billion-90-veggie-caps/jf-7266

The good news is that he finally peed in the box this morning and is eating pretty well. Currently snoozing on me very soundly. He’s 1000% more at ease without the cone, but I can’t watch him every second and really really need sleep.

 

[FeebysOwner]

Hi. Sorry no one has responded to your post yet. Also, sorry you and your little guy are going through this. It does sound like things are improving slightly already, so that is good! I searched this site and was surprised that I found nothing specific regarding aftercare. I do know one of the staff - mrsgreenjeens has dealt with this with one of her cats, so tagging her here to see if she can help you any. She might know of others who have dealt with it as well.

The s. boulardii brand you noted looks to be one of the ones I have seen mentioned on this web site, so I think you are on the right track by getting it. It can help with diarrhea overall, and especially if some of that is being caused by the antibiotic (which wouldn't surprise me).

Make sure you tell the vet about his shivering too. And keep us posted - hopefully with news of ongoing improvement!

 

[silent meowlook]

Hi. Is he on pain medications other than the Onsior? I would talk to your vet about getting him something like buprenorphine to take. He is probably very painful as there are so many nerves in that area.
Keep him confined. He shouldn’t have the run of the house like that. He will also feel safer confined.
Use shredded paper instead of cat litter because litter will clump and cause more of a mess.

 

[mrsgreenjeens]

One of my cats had an anal gland abcess, and we were also told to do WARM compresses several times a day, plus were given a cream to actually put on the open wound, along with antibiotics. No pain meds were given. No cone either. I asked about her licking off the cream, and they said try to keep her from licking it for a few minutes, then let her be. So a much different experience. Our Vet wasn't concerned with her licking the area.

As far as the diarrhea, I'm suspecting it's caused from the antibiotic she is on. If you have a regular Vet, give them a call and let them know what is happening and see if they might prescribe a different antibiotic (and ask how necessary the cone really is). I know at least two of the cats I have had in the past could not take Clavamox because of the side effects (not diarrhea), and another one currently gets diarrhea with any antibiotic he's prescribed, but some are worse than others. Giving them with food helps, and using FortiFlora with them also helps with our guy. Hopefully using the S. Boulardi will help your little one.

 

[sierramist]

Thanks everyone. Our biggest issue right now is the pooing problem. I have him mostly laying on me on a towel between mealtimes and hopeful potty breaks and he’ll just suddenly produce some poo, initially runny though the last time had more of a form to it. So then we have to clean him up as well as we can, change towels (the washing machine has been going all day) and start over.

He’s been in the litter box a couple more times but comes back out. Maybe it is just the pain making him not want to go willingly. He also hasn’t peed since this morning which is unusual. How long can he hold it?!

Because of this and the butt scooting he pretty much has to be watched constantly so he’s not disturbing the wound. This is not sustainable! I got his first dose of the s. Boullardi in a little earlier, so hopefully it helps.

I’m planning to call our normal vet tomorrow and pick their brain. This seems unusual to me so I’m worried something else is going on.

 

[FeebysOwner]

I know it is not much, but maybe buy some disposable pee pads to lay on top of the towel, just to lessen the laundry issue??

Perhaps, check with the vet about a cream like mrsgreenjeens mentioned, to help with healing - and it might also make it easier to wipe 'stuff' off of his little behind?

He will most likely pee when he absolutely has to - but I don't blame you for wanting to check with the vet about whether or not his overall current state can be considered 'typical' or 'normal'.

 

[sierramist]

Great idea, we’re getting pee pads now.

I just don’t know how to live like this. I’ve probably slept less than 8 hours over three days, barely ate.

Theoretically I could put him in a kennel with a cone overnight but he’ll poo all over himself and fret and struggle all night trying to clean himself up, not just leaving a mess for us but likely opening his wound further. It looks like it’s gaping more today.

Vet recommended putting him back on Metronidizole which was prescribed before we discovered the abscess and just thought he had diarrhea. Between that, the painkiller (only one day left btw), the antibiotic, the probiotic we’re throwing a lot at this guy which I’m sure is taxing his system, on top of all the other meds he takes for his seizure and heart conditions. But at the same time, surely something in there should be working to get him feeling better and back in the litter box, right?

And maybe it just takes time. But again, I cannot sustain this routine and be a functional person with a full time job. I just don’t know what to do.

 

[FeebysOwner]

Metronidazole is also an antibiotic, so I am not sure what the point is in giving him two antibiotics at the same time. You might want to ask for more pain killers too.

It may not have been long enough for all of the 'stuff' he is on to yet make a difference. If he is willing to sleep on/with you, maybe he would sleep beside you (on the pee pads and a towel)? Not saying that makes for a full night's sleep, but if he can drift off for a while, maybe you can too.

Keep pestering the vet about his progress - and if they bring up Metro again ask why they would want him on 2 antibiotics at the same time. Make them explain how that is going to be beneficial. Wish I knew what else to suggest.

 

[sierramist]

Well, the next chapter in this saga is that he ran to the litterbox, which initially excited me, but only did it to hide, sit in it, and try to lick his wound! Omfg.

I grabbed him as soon as I could but he got litter around (in?) his open wound. Clay, not clumping, but I know that’s not ideal. I called the emergency vet for help with my sweetest but now growling at me poo-and-litter covered fur child. Not very helpful. We were initially going to go in again, have them clean/check the wound and potentially keep him overnight. BUT they were totally backed up when we got there, and I couldn’t handle a 2+ hour late night wait with a distressed cat in a carrier on one hour sleep.

So we came back home and I attempted to clean it myself by running a little water over his butt area, which they recommended. Got most of it off but I feel like some little pieces may have gotten near or even in the opening. How horrible is this?

We decided to without food for the evening/night, and he’s drinking pretty well. Continuing emergency dosing of the s. Boulardii. I set myself up with him on the couch for the night and tried to get a little sleep. He had two more bouts of diarrhea (pee pads helped a ton!) and I just finished cleaning up. Took his soft cone off and let him clean himself near the wound but not directly on it. No diarrhea for the last few hours or so, but he’s probably pretty empty too.

He DID do a big pee in the box just after the litter ordeal, so that’s good. But I feel like he’s now tired, in pain (he growls if I go near the area), and I’m worrried 1) that the diarrhea will come back if we give food in the morning, 2) about the state of the wound, 3) how to control his pain, 4) dehydration.

I’m planning to call his regular vet’s office in the morning to see if they will see him, check the wound, and anything else we need to do to buff him up while he hopefully begins healing this week. If he could just get the diarrhea resolved or at least go in the box, that would be huge.

Anyway, sorry for the long post. I appreciate everyone’s help. If there’s any advice around all this I’d love to hear it. It’s again a fairly sleepless night, but I love this boy more than anything.

 

[FeebysOwner]

I'm just hoping the vet will have some ideas on how to help - and give you more pain meds for him.

I understand about withholding food, but you really need to let him eat despite the 'end result' (no pun intended). Making him hungry and the related empty stomach - and antibiotics which are already hard on the digestive tract - is just adding to his woes.

I feel for you and really wish he would turn the corner with the loose stools. It would seem, as you said, to help matters quite a bit.

 

[mrsgreenjeens]

With our girl, just to give you some perspective, her wound was about the size of a quarter, but it healed up completely within an 8 day period. I'm guessing it was a combination of the warm compresses, the cream we put on it, and the antibiotics. We weren't even advised to change her litter, so continued to use clumping litter. but she never had diarrhea with it, thank goodness.

Hoping your regular Vet has been able to provide you with some assistance.

 

[sierramist]

So, some developments. We’ve continued the emergency dosing of s. boulardii, and this morning began a diet of mostly poached chicken (which he is LOVING) but as the day went on we gave a little regular food with it and a Churu to get some meds in.

Went to the vet and they were actually pretty pleased with how the wound looked so far, but shaved and cleaned around it a little better. Gave us a few more Onsior to give if we think it’s needed, switched his antibiotic to Covenia as it’s less likely to have the diarrhea effect, and advised to continue with the Metro and boulardii.

Most of the day things were great. He was very sleepy but was finally sleeping comfortably like his usual self — stretching out, rolling on his back, happy. Peed in the box, continued drinking, has some appetite. We decided ourselves not to give the Metro since things were looking up and I was iffy on it anyway.

As for poo, he didn’t go at all from yesterday at midnight… until 1:00 am today. I woke up to him literally plopping a turd on me. It was fairly small and more formed but not totally solid (close to a type 5). But just after then he did more and it got looser and looser until back to runny. An hour later he did some more, almost liquid.

I don’t know if this looks like progress? Or was it just delayed from skipping a meal and him eating a little less overall?

He still has healing to do but I can’t figure out why he isn’t even trying to get to the box. He just lets it come out where he sits.

Should we not have stopped the Metro? Maybe that would have made a difference. Or maybe it just takes more time for the s. boulardii to kick in, and the other antibiotic to get out of his system.

We’ve been giving a quarter of a s. boulardii capsule, put in a #3 capsule, about every 3-4 hours. Is that enough? Am I expecting too much too soon?

In any case, his wound is looking better, but cleaning up his butt again, twice, and getting everything wet is probably not helping. I’m hoping as it heals further and pain subsides he’ll go back in the box, but I’m very worried about it all. At least I got 3 hours of sleep tonight? Ugh.

 

[sierramist]

More developments, ha. So after the 2:00 a.m. poo incident we were good until about 8:30, and it happened again. All runny this time, just leaking out of his bum, no attempt to go to the litter box. Cleaned him up again.

We've been giving the s. boulardii now for about a day and a half — shouldn't we be seeing some effects IF it was going work? I've made a schedule today to make sure and give it every 2 hours, where before we were ranging in the 3-4 hour mark. Not sure it matters. One #3 capsule full each time.

Should we add the Metro back? I discovered it might be contraindicated for seizure disorders, which my boy has, btw. So I'd like to avoid giving it UNLESS it's a proven method to resolve this.

Is it just taking a while for his gut to recover from the Clavamox? We gave the last dose yesterday morning, but then of course also switched to Convenia.

Any other ideas to get him through this quickly? Help!

 

[FeebysOwner]

Glad to hear the vets think the wound is coming along nicely. At least one piece of good news! I take it that they didn't prescribe any kind of cream and/or explain why they don't feel it is necessary? I wonder if using a little bit of Vaseline after each 'clean up' would help for the next cleaning round without impeding healing? Maybe call the vet and ask? I know for skin wounds, my husband's dermatologist has suggested it to help with healing.

I think that until the diarrhea is under control, and he heals some more, he isn't going to be much interested in trying to use the litter box. Assuming the capsules are 5bn CFU 250mg), 1/4 of a s. boulardii capsule every few hours seems to be the 'emergency stop diarrhea' dosing that normally takes 24-48 hours to woek, so that sounds like what you were doing. But, going to every 2 hours is also another approach. The guidelines also state that it likely will reduce stool production at first, so perhaps that is what you saw with the extended duration between his poops initially. However, not to burst your bubble, some cats' diarrhea can get worse with this dosing, so be on the lookout for that. If that were to occur, stopping the s. boulardii for a day or so (depending on the severity of the increase in diarrhea) is sufficient before starting back up at half the therapeutic dose, which would be 1/4 capsule twice a day, and building up to the 1/2 capsule twice a day. The thing is every cat is different, so all of this is nothing more than a guideline to use and experimenting is pretty much the only way to determine what works best for your cat.

I can't speak to the Metro as I have never used it and have heard both pro and con stories about it. I do know it seems to be prescribed quite often for cats with diarrhea.

Depending on when you feel up to it, you might try placing him in the litter box shortly after he has used it to pee, just in case he might need to poop and that is enough to prompt him to do so.

 

[sierramist]

Glad to hear the vets think the wound is coming along nicely. At least one piece of good news! I take it that they didn't prescribe any kind of cream and/or explain why they don't feel it is necessary? I wonder if using a little bit of Vaseline after each 'clean up' would help for the next cleaning round without impeding healing? Maybe call the vet and ask? I know for skin wounds, my husband's dermatologist has suggested it to help with healing.

I think that until the diarrhea is under control, and he heals some more, he isn't going to be much interested in trying to use the litter box. Assuming the capsules are 5bn CFU 250mg), 1/4 of a s. boulardii capsule every few hours seems to be the 'emergency stop diarrhea' dosing that normally takes 24-48 hours to woek, so that sounds like what you were doing. But, going to every 2 hours is also another approach. The guidelines also state that it likely will reduce stool production at first, so perhaps that is what you saw with the extended duration between his poops initially. However, not to burst your bubble, some cats' diarrhea can get worse with this dosing, so be on the lookout for that. If that were to occur, stopping the s. boulardii for a day or so (depending on the severity of the increase in diarrhea) is sufficient before starting back up at half the therapeutic dose, which would be 1/4 capsule twice a day, and building up to the 1/2 capsule twice a day. The thing is every cat is different, so all of this is nothing more than a guideline to use and experimenting is pretty much the only way to determine what works best for your cat.

I can't speak to the Metro as I have never used it and have heard both pro and con stories about it. I do know it seems to be prescribed quite often for cats with diarrhea.

Depending on when you feel up to it, you might try placing him in the litter box shortly after he has used it to pee, just in case he might need to poop and that is enough to prompt him to do so.

No, they didn't recommend using any cream or topical, but I did purchase this and began dabbing some on the area today:

Amazon.com

Ugh, I wasn't aware it could actually get worse with the s. boulardii. Is it too soon to change things up? Should I wait another day?

Yeah, we've tried putting him in the box, even during an episode, but he tries to sit or get out.

 

[FeebysOwner]

No, they didn't recommend using any cream or topical, but I did purchase this and began dabbing some on the area today:

Just to be on the safe side, I would tell the vet what you bought and make sure there is no reason not to use it. There probably isn't, but... If they would, by chance, have an issue with it, make them explain why - and, then ask about the Vaseline.

Ugh, I wasn't aware it could actually get worse with the s. boulardii. Is it too soon to change things up? Should I wait another day?

That's part of the judgement process that only you can make. It is not something that happens with all cats, just some cats. I guess the key is to look for the diarrhea to get worse, not just that it doesn't change any - from I understand. These are the guidelines that I have used before, and from where I am noting things to you. These guidelines are related to IBD cats, but I have found data in them on an overall basis that apply to other situations as well. So, the issue about the diarrhea may be related to the IBD condition. The other thing that was mentioned was some cats can be sensitive to yeast-based products. I have not seen such a case on this site, but that doesn't preclude it from being a possibility. There are just so many posts about s. boulardii being helpful, and I am hoping that is true for you as well.
Prebiotics & Probiotics for Cats: Healing Inflammation and gut dysbiosis - Raw Feeding for IBD Cats
Probiotics – IBDKitties

 

[mrsgreenjeens]

I would definitely give the Vet a jingle and let them know the diarrhea is back and get their take on it. I have not only heard that sometimes (not often) probiotics can cause diarrhea, but that sometimes Metro can cause it too, even though it IS very often prescribed for that very issue. When probiotics cause diarrhea, introducing them slowly is the "fix".

I wouldn't worry too much about getting the wound wet, particularly when you are supposed to be applying compresses to it anyway, as those are somewhat wet, aren't they?

 

[sierramist]

Just to be on the safe side, I would tell the vet what you bought and make sure there is no reason not to use it. There probably isn't, but... If they would, by chance, have an issue with it, make them explain why - and, then ask about the Vaseline.

Yes, we asked at our appointment yesterday and I showed them the product. Good to use! The reviews are great, we'll see... Apparently vaseline, if they lick it, can have a laxative effect, so not a good idea for this use.

That's part of the judgement process that only you can make. It is not something that happens with all cats, just some cats. I guess the key is to look for the diarrhea to get worse, not just that it doesn't change any - from I understand. These are the guidelines that I have used before, and from where I am noting things to you. These guidelines are related to IBD cats, but I have found data in them on an overall basis that apply to other situations as well. So, the issue about the diarrhea may be related to the IBD condition. The other thing that was mentioned was some cats can be sensitive to yeast-based products. I have not seen such a case on this site, but that doesn't preclude it from being a possibility. There are just so many posts about s. boulardii being helpful, and I am hoping that is true for you as well.

I would definitely give the Vet a jingle and let them know the diarrhea is back and get their take on it. I have not only heard that sometimes (not often) probiotics can cause diarrhea, but that sometimes Metro can cause it too, even though it IS very often prescribed for that very issue. When probiotics cause diarrhea, introducing them slowly is the "fix".

I get it. It's a trial-and-error thing for sure. I was so hopeful the s. boulardii would be the trick! Perhaps I've given too much, or it's just not going to be the thing for him. We are considering switching to Proviable, which we've used before in a IBD cat and it worked well.

If I call the vet again, they'll just say I should keep him on the Metro. Which I would do if I knew it would help, but I don't feel great giving it to him. How come all these diarrhea "fixes" can also cause diarrhea?

BUT, some good news: No poo since 8:30 this morning. I'm clock watching, hoping for a longer period between bouts, as I'm assuming there will be more. He's also more active, jumping into the window, exploring, currently sleeping in the cat tower — and I'm hoping that means his bum at least feels better, and good enough to go in the litter box.

We're still doing just boiled chicken today and he's going crazy for it, though I'm not sure exactly how much to give him, and know we'll have to reintroduce real cat food soon to keep his diet balanced. Drinking well, and just peed in the box. Let's hope he deposits a poo in there soon!

 

[catsknowme]

Wow - you have been through the wringer, so to speak. I agree with your instincts about the metronidazole (flagyl). It sounds like there has been good improvement! You could ask your vet about trying slippery elm decoction, either topically or internally, because it is very soothing to mucus membranes. However, when used internally, slippery elm 's soothing coating can block absorption of medications so it needs to be separated by 3-4 hours from oral meds.

 

[sierramist]

Wow - you have been through the wringer, so to speak. I agree with your instincts about the metronidazole (flagyl). It sounds like there has been good improvement! You could ask your vet about trying slippery elm decoction, either topically or internally, because it is very soothing to mucus membranes. However, when used internally, slippery elm 's soothing coating can block absorption of medications so it needs to be separated by 3-4 hours from oral meds.

Well, he lasted a couple more hours. Just had another blowout, mostly liquid with a little pudding puddle. Put him in the box twice while it was happening and he popped back out. I think there was maybe a little less this time, and the frequency is improving, but not the consistency. Going by that, I wouldn't think the s. boulardii is making it worse, right?

Another question if anyone knows the answer: is it a bad idea to give both s. boulardii AND Proviable? I know they are two different types of probiotics, but if either could improve the situation and not have risks I'd want to try both.

I'm really not sure what to do at this point. His poor bottom is red and sore, then of course there's the open wound back there. Healing, but every bout of poo sets him back. I'm so sad, he makes little cries when I blot off his butt after an episode.

Is it just going to take time, with small improvements each day? I'm so tired, guys.