Antibiotics in a Cat Bite Abscess

RE: Antibiotics in a Cat Bite Abscess

Anthony Todd — Thu, 14 Sep 2017 10:09:56 GMT

[quote user="Evelyn Barbour-Hill"]Sigh. What's the point of keeping detailed records if you keep them hopelessly inaccurately? [/quote]

[deep sigh] Crikey, failed again. Don't know how I bumbled through confusing a Cat Bite Abscess, with just a cellulitis. Lucky I didn't confuse it for a tumour....

Should not have written anything and seen it next day when it probably would be a CBA.... No room to write "will be CBA by tomorrow" on a 6X4.

Lucky I gave it good old Lpen [that's long acting penicillin] or it would have been, after ineffective Clam LA [that's Clamoxyl Long Acting] , for the pedants.

RE: Antibiotics in a Cat Bite Abscess

Evelyn Barbour-Hill — Thu, 14 Sep 2017 01:58:22 GMT

[quote user="Anthony Todd"]

CBA is probably a lazy TLA for describing, on a 6x4 record card, in one line, with a recalcitrant ball point, a Cat Bite Abscess, anything from a sore puncture wound to a 20ml pus-filled swelling, but usually the early ones.

[/quote]

Sigh. What's the point of keeping detailed records if you keep them hopelessly inaccurately? A sore puncture wound is not an abscess. Cellulitis and abscess are two very different entities needing very different treatments.

And yes, I'm familiiar with 6x4 record cards, not to mention 4x3 ones and scrutty quarto sheets of lined paper.

RE: Antibiotics in a Cat Bite Abscess

Eilidh Corr — Wed, 13 Sep 2017 20:27:34 GMT

I also think we can't equate a bite to the human hand, with its numerous vital structures, relatively poor blood supply and potential for devastating and debilitating consequences, with a bite to the generous skin and soft tissues of a cat's backside.

RE: Antibiotics in a Cat Bite Abscess

Andrew Kent — Wed, 13 Sep 2017 20:13:20 GMT

I'm not convinced that progression of cat bites in people and the progression of cat bites in cats are the same. Humans seem to get a much deeper tracking response than the focal abscess in a cat.

Andy

RE: Antibiotics in a Cat Bite Abscess

Thomas Johnson — Wed, 13 Sep 2017 18:36:17 GMT

[quote user="Julie Innes"]

I thought cats carried pasteurella in their mouths and so nearly every bite was contaminated? We give owners forms to give to their doctor if they are bitten, recommending antibiosis. A few people I have seen 2 people (client and a nurse) who ended up in hospital with septicaemia after a cat bite, so I think its safer to give some long acting penicillin than risk complications. I have seen a couple of cats lose their tail, and recently one lost a leg, after particularly nasty bites

[/quote]

One of our nurses was bitten on the back of the hand by a cat and developed a tendon sheath infection which needed to be opened up and flushed out. What really annoyed me was that she went straight to the local walk-in centre after it happened, they examined it and said that she needed to go to A&E as she needed i/v antibiotics, and of course it was over 4 hours later by the time our practice manager had driven her there, she'd been seen by a doctor and had the antibiotics prescribed. I suspect that if they'd given her oral antibiotics straight away at the walk-in centre she wouldn't have needed surgery.

RE: Antibiotics in a Cat Bite Abscess

Julie Innes — Wed, 13 Sep 2017 17:59:16 GMT

RE: Antibiotics in a Cat Bite Abscess

Andrew Kent — Wed, 13 Sep 2017 17:57:51 GMT

[quote user="Martin Atkinson"]I am prepared to alter my views on this if you can give me good reasons why I should change this approach.[/quote]

Far be it from me to tell you what to use - as far as I am aware there is no published evidence on this so we are mostly down to anecdote.

Personally I never found amoxi-clav effective for nasty CBA's and had saw better results switching to clindamycin so stuck with it. But I do question why you need something more broad spectrum?

[quote user="Anthony Todd"]Sorry the devil is in the detail, as usual. CBA is probably a lazy TLA for describing, on a 6x4 record card, in one line, with a recalcitrant ball point, a Cat Bite Abscess, anything from a sore puncture wound to a 20ml pus-filled swelling, but usually the early ones.[/quote]

Agree there are CBAs and CBAs - I tended to go for antibiotics in the ones with significant local reaction.

Andy

RE: Antibiotics in a Cat Bite Abscess

Neil Wheadon — Wed, 13 Sep 2017 17:47:52 GMT

Evelyn pointed out a few months ago that antibiotics weren't necessary which set me thinking about this ever since.

The proof for me lies in the numerous CBA's that are presented having burst and looking and smelling clean. (That slightly off red colour) All they need is the scab pulling away when it's loose and a clean up. There are also the zillion cases of CBA's that vets never see. It's rare for a cat to be brought in with a CBA that has gone bad (unless it's cellulitis)

Contra to that is that this year I had a CBA lanced on my thumb and the hospital wanted me in overnight on IV antibiotics.

So anecdotally to me they don't need it, and here we are driven by another post in that you are dealing with client expectation. ' Thanks for bringing in fluffy, that'll be £30 for pulling the scab off'....'What no antibiotics', it's a problem.

Personally I use clindamycin and the 75mg/cat SID dose for 5 days. I use this if antirobe is available as it's easier to give, once a day and it's not a super broad spectrum. I'm afraid and I know I'm not alone to reach for the Convenia if the client can't pill their cat.

I can't recall the last time I saw a case where antibiotics weren't dispensed so it's widespread and all types are used

Neil

RE: Antibiotics in a Cat Bite Abscess

Anthony Todd — Wed, 13 Sep 2017 17:44:05 GMT

[quote user="Martin Atkinson"]

I have always lived by a rule that given the choice between establishing good drainage or antibiotics then the former is preferable however a number of CBAs are difficult to drain, may include cellulitis and the cats are febrile and sick. It would be IMO be negligent to not give antibiotics and I would say that clindamycin is too narrow spectrum so would choose pot amox. I am prepared to alter my views on this if you can give me good reasons why I should change this approach.

[/quote]

Sorry the devil is in the detail, as usual. CBA is probably a lazy TLA for describing, on a 6x4 record card, in one line, with a recalcitrant ball point, a Cat Bite Abscess, anything from a sore puncture wound to a 20ml pus-filled swelling, but usually the early ones.

All I can say is, after many painful cat bite reactions which came back after 2 days or so of Clamoxyl etc. still swollen and painful but came back, nearly normal in 2 days after a shot of narrow spectrum penLA, I always gave said PenLA. 300k units, and never needed to see them again.

Try it, you'll be surprised, I'm sure.

RE: Antibiotics in a Cat Bite Abscess

Martin Atkinson — Wed, 13 Sep 2017 17:18:18 GMT