Insect Stings, Spiders, and Scorpions
Because cats are predators and are curious by nature, they tend to be at risk from small poisonous creatures. The stings of bees, wasps, yellow jackets, and ants cause painful swelling at the site of the sting. Cats tend to get stung about the face and on the paws. Swelling may include the face and neck, or be localized to the area of the sting. If a cat is stung many times, he could go into shock as the result of absorbed toxins. Rarely, a hypersensitivity reaction (anaphylactic shock) can occur if the cat was exposed in the past (see page 13).
The stings of black widow and brown recluse spiders and tarantulas are toxic to animals. The first sign is sharp pain at the sting site. Later, the cat may develop excitability, chills, fever, and labored breathing. Shock and seizures may occur, with early paralysis from black widow bites. Most cats will die. There is antivenin if it can be obtained from your veterinarian in time. Brown recluse spider bites cause two syndromes. One is a cutaneous form with a localized blister and pain. Eventually, a bull’s-eye lesion may be noted. Over a week or two, the involved skin will die and ulcerate, leaving a wound that may take months to heal. The second, visceral form is accompanied by fever, painful joints, and possibly vomiting and seizures. Cats may develop blood disorders and kidney failure. This form is much rarer and is often fatal.
Tarantula bites are usually not serious, but the barbed hairs they drop can be irritating to skin and mucous membranes. The stings of centipedes and scorpions cause a local reaction and, at times, severe illness. These bites heal slowly. Poisonous scorpions are found only in southern Arizona (two species). A young kitten or small cat is at greater risk due to his small size.
TREATING STINGS AND BITES
1. Identify the insect or animal, if possible. 2. Remove an embedded stinger with tweezers, or scrape it out with a credit card. (Only bees leave their stingers behind.) 3. Make a paste of baking soda and apply it directly to the sting. 4. Apply ice packs to relieve swelling and pain. 5. Apply Calamine lotion and Cortaid to relieve itching if needed, but cover the area with a loose bandage so the cat will not lick off the medication. If the cat exhibits signs of generalized toxicity or anaphylaxis (restlessness, agitation, face scratching, drooling, vomiting, diarrhea, difficulty breathing, collapse, or seizures), transport him immediately to the nearest veterinary facility. If your cat is known to have reactions to bee stings, ask your veterinarian about keeping an EpiPen kit available and what dose to use for your cat. The EpiPen kits are special prepackaged kits of injectable epinephrine for counteracting anaphylactic shock. Epinephrine has a short expiration date, so check frequently to be sure your kit is not outdated.
Snake and Lizard Bites
Poisonous and nonpoisonous snakes are widely distributed throughout North America. Cats may come into contact with snakes while hunting or out of curiosity. In general, bites of nonpoisonous snakes do not cause swelling or pain. They show teeth marks in the shape of a horseshoe (no fang marks). Ninety percent of snake bites in cats involve the head and legs. Body bites from poisonous snakes usually are lethal.
In the United States there are four poisonous varieties: cottonmouths (also called water moccasins), rattlesnakes, copperheads, and coral snakes. The diagnosis of poison snake bite is made by the appearance of the bite, the behavior of the animal bitten, and identification of the species of snake. (Kill it first, if possible.)
PIT VIPERS (RATTLESNAKES, COTTONMOUTHS, AND COPPERHEADS)
You can identify these species by their large size (4 to 8 feet, 1.2 to 2.4 m long), triangular heads, pits below and between the eyes, elliptical pupils, rough scales, and the presence of retractable fangs in the upper jaw. The bite: You may see one or two bleeding puncture wounds in the skin; these are fang marks. You may have to search the haircoat and skin carefully at first to find the punctures. Signs of local reaction appear quickly and include sudden severe swelling, redness, and hemorrhages in the skin. The pain is immediate and severe.
Note that 25 percent of poisonous snake bites lack venom and thus do not produce a local reaction. While absence of local swelling and pain is a good sign, it does not guarantee the cat won’t become sick. Severe venom poisoning has been known to occur without a local reaction.
Except for the coral snake, all poisonous species in North America are pit vipers. Note the elliptical pupil, the pit below the eye, the large fangs, and the characteristic bite.
The cat’s behavior: Signs of envenomation may take several hours to appear because of variables such as time of the year, species of the snake, toxicity of the venom, amount injected, location of the bite, and size and health of the cat. The amount of venom injected bears no relationship to the size of the snake. The first signs are extreme restlessness, panting, drooling, and weakness. These are followed by diarrhea, depressed breathing, collapse, sometimes seizures, shock, and death in severe cases.
CORAL SNAKES
Identify this snake by its rather small size (less than 3 feet, .9 m long), small head with black nose, and brightly colored alternating bands (red, yellow and black) fully encircling the body. The fangs in the upper jaw are not retractable.
The bite: There is less severe redness and swelling at the site of the bite, but the pain may range from mild to excruciating, depending on whether venom was injected. Look for the fang marks.
The cat’s behavior: Coral snake venom is a neurotoxin, meaning it affects the nerves and causes weakness and paralysis. Signs include vomiting, diarrhea, urinary incontinence, paralysis, convulsions, and coma. Some cats will survive.
This cat with a poisonous snake bite shows an extensive face wound after loss of devitalized tissue.
LIZARDS
Two species of poisonous lizard are found in the United States, both in southwestern states. They are the Gila monster and the Mexican bearded lizard. The bite of these lizards could potentially be fatal to a cat. If the lizard has a firm hold on the cat, pry open the lizard’s jaws with pliers and remove the cat from the lizard.
TREATING SNAKE AND LIZARD BITES
First identify the snake or lizard and look at the bite. If the animal is not poisonous, clean and dress the wound as described in the section on Wounds (below). If it appears the cat has been bitten by a poisonous snake or lizard and if you are within 30 minutes of a veterinary hospital, proceed at once to the veterinary hospital. If you are unable to get help within 30 minutes, follow these steps, then go to the nearest veterinarian.
Keep the cat quiet. Venom spreads rapidly if the cat is active. Excitement, exercise, and struggling increase the rate of absorption. Carry the cat. If the bite is on the leg, apply a constricting bandage (a handkerchief or a strip of cloth) between the bite and the cat’s heart. You should be able to get a finger beneath the bandage; loosen the bandage for five minutes every hour.
Do not wash the wound, because this will increase venom absorption.
Do not apply ice, because this does not slow absorption and can damage tissue.
Do not make cuts over the wound and/or attempt to suck out the venom. This is never successful and you could absorb venom. Proceed to the veterinary hospital. Veterinary treatment involves respiratory and circulatory support, antihistamines, intravenous fluids, and speciesspecific antivenin. The earlier the antivenin is given, the better the results. Because signs of envenomation are often delayed, all cats who have been bitten by a poisonous snake or lizard—even those who don’t show signs—should be hospitalized and observed for 24 hours.
Wounds
The two most important goals in treating wounds are to stop the bleeding and to prevent infection. Wounds are painful, so be prepared to restrain the cat before treating the wound (see Handling and Restraint, page 2).
CONTROLLING BLEEDING
Bleeding may be arterial (bright red blood will spurt out) or venous (dark red blood will ooze out), or sometimes both. Do not wipe a wound that has stopped bleeding, as this will dislodge the clot. Similarly, don’t pour hydrogen peroxide on a fresh wound. Peroxide dissolves clots and starts a fresh round of bleeding. It may also damage the tissues and delay healing. The two methods used to control bleeding in an emergency situation are a pressure dressing and a tourniquet.
Pressure Dressing
The most effective and safest method for controlling bleeding is to apply pressure directly to the wound. Take several sterile gauze squares (or, in an emergency, use any clean cloth such as a thickly folded pad of clothing) and place it over the wound. Apply direct pressure for 5 to 10 minutes. Leave the dressing in place and bandage snugly. If material for bandaging is not available, hold the pack in place until help arrives.
Watch for signs of swelling of the limb below the pressure pack (see Foot and Leg Bandages, page 52). This indicates impaired circulation. If you see these signs, the bandage must be loosened or removed. Consider adding more bulk to the pack and apply a second bandage over the first. Transport the cat to a veterinary hospital.
Tourniquet
Tourniquets can be used on the extremities and tail to control arterial bleeding that can’t be controlled with a pressure pack. Tourniquets should never be used if bleeding can be controlled by direct pressure. Always place the tourniquet above the wound (between the wound and the heart).
A suitable tourniquet can be made from a piece of cloth, belt, or length of gauze. Loop the tourniquet around the limb, then tighten it by hand or with a stick inserted beneath the loop. Twist the loop until the bleeding stops. If you see the end of the artery, you might attempt to pick it up with a pair of tweezers and tie it off with a piece of cotton thread. When possible, this should be left to a trained practitioner.
A tourniquet should be loosened every 10 minutes to prevent tissue hypoxia and to check for persistent bleeding. If bleeding has stopped, apply a pressure bandage as described in the previous section. If bleeding continues, let the blood flow for 30 seconds and then retighten the tourniquet for another 10 minutes.
PUNCTUREWOUNDS
Puncture wounds are caused by bites and pointed objects. Animal bites, in particular, are heavily contaminated with bacteria. There may be bleeding. There may also be bruising, particularly if the cat was picked up in the teeth of a bigger animal and shaken. Puncture wounds are often concealed by the cat’s coat and may easily be overlooked until an abscess develops a few days later. Treating a puncture wound requires a veterinarian. It involves surgically enlarging the skin opening to provide drainage, after which the area is irrigated with a dilute antiseptic surgical solution. These wounds should not be closed. With all animal bites, keep in mind the possibility of rabies. If your cat is bitten by an animal of unknown vaccination status or a wild animal, a rabies booster may be recommended.
Bites from other cats very often lead to abscesses. Antibiotics are frequently prescribed for bite wounds and wounds that are heavily contaminated, such as puncture wounds.
TREATINGWOUNDS
Nearly all animal wounds are contaminated with dirt and bacteria. Proper care and handling will reduce the risk of tetanus and prevent many infections. Before handling a wound, make sure your hands and instruments are clean.
An infected wound near the base of the tail from a cat fight. Because of the bacteria in cats’ mouths, bites from other cats often lead to infection and abscess. The five steps in wound care are as follows: 1. Skin preparation 2. Wound irrigation 3. Debridement 4. Wound closure 5. Bandaging Skin Preparation Remove the original pressure dressing and cleanse the area around the wound with a surgical scrub solution. The most commonly used solutions are Betadine (povidone-iodine) and Nolvasan (chlorhexidine diacetate). Both products are extremely irritating to exposed tissue in the concentrations provided in the stock solutions (Betadine 10 percent, chlorhexidine 2 percent), so be very careful that the solution does not get in the wound while scrubbing the skin around it. Dilute the solution to a weak tea color for Betadine or a pale blue color for Nolvasan.
After the scrub, start at the edges of the wound and clip the cat’s coat back far enough to prevent any long hairs from getting into the wound. Three-percent hydrogen peroxide, often recommended as a wound cleanser, has little value as an antiseptic and is extremely toxic to tissues. Do not use it on a wound, as it can damage tissues and delay healing.
Wound Irrigation
The purpose of irrigation is to remove dirt and bacteria. The gentlest and most effective method of wound cleansing is by lavage, which involves irrigating the wound with large amounts of fluid until the tissues are clean and glistening. Do not vigorously cleanse the wound using a brush or gauze pad because this causes bleeding and traumatizes the exposed tissue.
Tap water is an acceptable and convenient irrigating solution. Tap water has a negligible bacterial count and is known to cause less tissue reaction than sterile or distilled water.
If possible, add chlorhexidine solution or Betadine solution to the tap water for antibacterial activity. Chlorhexidine has the greater residual antiseptic effect, but either antiseptic solution (not soap solutions) is satisfactory when correctly diluted. To dilute chlorhexidine, add 25 ml of the 2 percent stock solution to 2 quarts (2 l) of water, making a 0.05 percent irrigating solution. To dilute Betadine, add 10 ml of the 10 percent stock solution to 2 quarts (2 l) of water to make a 0.2 percent irrigating solution.
The effectiveness of the irrigation is related to the volume and pressure of the fluid used. A bulb syringe is a low-pressure system. It is least effective and requires more fluid to achieve satisfactory irrigation. A large plastic syringe removes a moderate amount of dirt and bacteria. A home Waterpik unit (used by people to clean their teeth) or a commercial lavage unit that provides a high-pressure stream of fluid is the most effective.
A garden hose with a pressure nozzle for the initial lavage, or a kitchen sink spray unit, followed by one of the methods just described to deliver the antiseptic, is a good alternative. You want to flush and clean the wound, not force dirt deeper into the tissues. Angle your flow of liquid to accomplish that and let the fluid pool to bring debris to the surface.
Debridement
Debridement means removing dying tissue and any remaining foreign matter using tissue forceps (tweezers) and scissors or a scalpel. Debridement requires experience to determine the difference between normal and devitalized tissue, and instruments to control bleeding and close the wound. Accordingly, wounds that require debridement and closure should be treated by a veterinarian.
Wound Closure
Fresh lacerations on the lips, face, eyelids, and ears are best sutured or stapled to prevent infection, minimize scarring, and speed recovery. Lacerations longer than half an inch (1.25 cm) on the body and extremities probably should be closed, but small lacerations may not need to be. The exception is small V-shaped lacerations, which almost always heal best if sutured. Wounds contaminated by dirt and debris are quite likely to become infected if they are closed at the time of injury. These wounds should be left open or sutured around a drain that can be used for through and through irrigation. Similarly, wounds older than 12 hours should not be closed without drainage. Suturing or stapling should be avoided if the wound appears to be infected (is red, swollen, or has a surface discharge). Your veterinarian may decide to close a wound that has been left open for several days and has developed a bed of clean tissue. Wounds that are clean after several days are resistant to infection and usually can be closed without negative consequences. Suturing such a wound is called delayed primary closure. The length of time sutures or staples should remain in place depends on the wound’s location and other characteristics. Most sutures and staples can be removed after 10 to 14 days.
Bandaging
Bandaging protects the wound from dirt and contaminants. It also restricts movement, compresses skin flaps, eliminates pockets of serum, keeps the edges of the wound from pulling apart, and prevents the cat from biting and licking at the wound. Bandaging is most effective for wounds to the extremities. Dressings over draining or infected wounds must be changed once or twice a day. The bandage should be bulky enough to absorb the drainage without soaking through.
Bandages are more difficult to apply to cats than to dogs and, once applied, are more difficult to keep in place. Cats who do not tolerate bandages and continually remove them may be helped by mild sedation. As an alternative, an Elizabethan collar or a BiteNot collar may be helpful. Wounds about the head and those draining pus are best left open to help drainage and ease of treatment.
When a cat claws and macerates a wound or continually scratches at a skin condition, treatment can be facilitated by bandaging his back feet or securing baby socks over the paws, and clipping his nails. Bandaging is made much easier when a cat is gently but firmly restrained, as discussed on page 2. The bandaging equipment you will need is listed in the Home Emergency and Medical Kit (page 1).
Foot and Leg Bandages
To bandage a foot, place several sterile gauze pads over the wound. Pull apart a cotton ball and insert small bits between the cat’s toes. Hold in place with adhesive tape looped around the bottom of the foot and back across the top until the foot is snugly wrapped.
For leg wounds, begin by wrapping the foot as just described. Then cover the wound with several sterile gauze pads and hold in place with strips of adhesive tape. On top, pad the entire leg with plenty of cotton so the dressing won’t become too tight and interfere with circulation. Wrap the leg first with roll gauze, firmly but not too tightly, then wrap the leg with elastic tape or bandage, as shown in the photographs on page 53. Your veterinarian or a veterinary technician can show you the best way to bandage an individual wound. Veterinary wraps, such as VetWrap, work well, but you need practice to have the right amount of tension so you don’t cut off circulation. Flex the knee and foot several times to be sure the bandage is not too tight and that there is good movement at the joints.
Wrap the tape around the leg at the top, but do not overlap it because you want the tape to stick to the cat’s hair. This technique keeps the dressing from sliding up and down, which often happens when only a roll gauze bandage is used without tape at the top. When a dressing is to be left in place for some time, check every few hours to be sure the foot is not swelling. Over the next few hours, check the toes for coolness and observe the feet for swelling. Swelling of the leg below a bandage will be seen in the toes. When the toes are swollen, the nails are spread apart instead of being side by side. If this swelling is not treated by removing the bandage, the foot becomes cold and loses feeling. If there is any question about the sensation or circulation to the foot, loosen the dressing. Cats will frequently attempt to lick, bite or remove dressings that are too tight and uncomfortable.
You may need to put a plastic baggie over the wound bandage when the cat goes to the litter box, to prevent litter from getting up inside the bandage. A cat with a bandage should not be allowed outside. Bandages over clean, healing wounds can be changed every two days, but should be inspected three or four times a day for signs of constriction, limb swelling, slippage, drainage, or soiling. If there are signs of any of these problems, replace the bandage.
Wounds on the foot or leg may be covered with a splint as well as a bandage. The splint minimizes movement of the area and speeds healing.
To apply a foot bandage, start by covering the injured area with several layers of gauze.
Hold the gauze in place with adhesive tape looped around the bottom of the foot and back across the top. Tape loosely to allow for good circulation.
Many-Tailed Bandage
This bandage is used to protect the skin of the abdomen, flanks, or back from scratching and biting and to hold dressings in place. It is made by taking a rectangular piece of linen and cutting the sides to make tails. Tie the tails together over the back to hold the bandage in place.
Ear Bandage
These dressings are difficult to apply. Most ear injuries can be left open. To protect the ears from scratching, use an Elizabethan or a BiteNot collar.
Eye Bandage
Your veterinarian may prescribe an eye bandage as part of the treatment of an eye ailment. Place a sterile gauze square over the affected eye and hold it in place by taping around the head with 1-inch-wide (25-mm) adhesive. Be careful not to wind the tape too tight. Apply the dressing so that the ears are free. You may need to change the dressing from time to time to apply medication to the eye. Many cats will need to wear an Elizabethan or a BiteNot collar to prevent them from removing the bandage.
A many-tailed bandage may be used to keep kittens from nursing if the mother’s breasts are infected.
HOMEWOUND CARE
Small, open wounds can be treated at home without sutures or staples. Medicate the area twice a day with a topical antibiotic ointment such as triple antibiotic. The wound can be left open or covered with a dressing. Make sure the cat is not licking or chewing at the wound. You may need to use a wound covering such as a sock, or put an Elizabethan or a BiteNot collar on the cat. Infected wounds that are draining pus require the application of moist sterile compresses. A number of topical antiseptics are effective in treating superficial wound infections. They include chlorhexidine, Betadine (diluted as described in Wound Irrigation, page 50), Furacin (both the topical cream and the 0.2 percent solution), 1 percent Silvadene cream, and topical antibiotics containing bacitracin, neomycin, and polymyxin B (triple antibiotic). Apply the topical antibiotic directly to the wound or place it on a gauze pad and dab the wound.
Change the dressing once or twice a day to facilitate pus drainage. Again, try to keep the cat from licking or grooming off the medication. Distracting the cat with play or food may give the medication time to be absorbed.
To make an eye bandage, wrap a gauze roll around the eye. A pad may be placed beneath the gauze. Secure with tape. The ears should be free.
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