Seventeen Bites

 D. E. Larsen, DVM

Mrs. Wilson was standing by the exam table holding her cat, Fluffy, in her arms. Fluffy was an average-sized female cat with long gray hair and striking blue eyes.

“What’s up with Fluffy this morning, Mrs. Wilson?” I asked.

“She has been sick for several days,” Mrs. Wilson said. “She hasn’t eaten a bit for at least two days, and this morning she started vomiting. I am sick with worry.”

“Let’s set her on the table, and I will get a look at her,” I said.

“Can you get a blanket for her,” Mrs. Wilson said. “Fluffy is used to soft surfaces, and that table looks cold and hard.”

Joleen retrieved a soft kennel mat and placed it on the table. Then she pried Fluffy from Mrs. Wilson’s arms. 

“She will be safer on the table if I hold her,” Joleen said as she directed Mrs. Wilson to a chair.

I petted Fluffy, and she did not respond to the attention. Opening her mouth, her oral membranes were dry, with some whitish mucus at the corners of her mouth. I picked up the skin on her back over her shoulder blades. It almost stood up on its own, slowly sliding back to a normal position.

Palpating Fluffy’s abdomen revealed a painful bladder. I squeezed the bladder slightly, and Fluffy cried a bit and deposited a few drops of bloody urine on the exam table. Mrs. Wilson was out of her chair and at the table to comfort Fluffy.

“We need to get some blood and urine out of Fluffy,” I said. “She obviously is very dehydrated. It might be wise to keep her overnight for some IV fluids and any other needed treatment.”

“I am not going to leave Fluffy overnight, Doctor Larsen,” Mrs. Wilson said.

“This could be a serious illness,” I said. “Treating her as an outpatient could be difficult and threaten her life.”

“If Fluffy is going to die, she is going to die at home,” Mrs. Wilson said. “I can leave her for a few hours while you do your blood work and treatments, but she is not going to be left here overnight.”

“Let me get a look at these couple of drops of urine real quick,” I said. “I just want to see if the kidneys are working.”

The urine had many red blood cells, white blood cells, and some crystals. The good thing was the concentration was very high, so we probably had functional kidneys.

“Okay, Mrs. Wilson, we can try to work within your limitations,” I said. “It looks like Fluffy is probably not in kidney failure. But she does have a serious urinary tract infection. We will do some blood work to make sure my initial assessment is accurate and get some urine for a urine culture. For her dehydration, we will give some fluids by subcutaneous injection. That is less than ideal but may be functional. It will leave a large squishy lump on her back, and her elbows will be baggy this evening. Then we can recheck her in the morning.”

We kept Fluffy and started by drawing blood and getting some urine from her bladder with a needle poke.

Her blood and urine showed a significant urinary tract infection, and we started a urine culture. 

In the cat, lower urinary tract disease is usually caused by diet-related issues and is seldom complicated by infection. Fluffy’s prognosis was pretty favorable with antibiotics, fluids, and a special diet.

Joleen had the treatment table set up to give Fluffy some subcutaneous fluids. We gave Fluffy an injection of amoxicillin in her kennel and then moved her to the treatment table for her fluids.

I commonly treated cats with fluids administered under their skin. It was a fast procedure and generally well tolerated by the cat. It was satisfactory in mild disease, but I would have preferred to have Fluffy on an IV due to the degree of dehydration. 

I stuck a sixteen gauge needle into the skin on her back, and Joleen started the fluids. I stood holding Fluffy by the nape of her neck, and Joleen was applying some pressure to the bag of fluids. We made some idle conversation as Joleen watched the fluids in the bag.

“How much do you want to give her?” Joleen asked.

Suddenly, Fluffy exploded!

Like is visualized in cartoons, Fluffy made circles around and around my arm, starting at my wrist, and in a brief second, she was at my shoulder. I managed to grab her and return her to the table.

“Are you okay?” Joleen asked.

“I think so,” I said. “I think she just scratched me.”

“I don’t think so,” Joleen said. “I think those are bite marks.”

We examined my right arm and my right side. Many bite wounds were evident on my arm and the side of my chest.

“I guess I better get a doctor to look at these,” I said. “The only animal that has ever put me in the hospital was a cat.”

I took a couple of cephalexin capsules and headed for the doctor’s office. They counted seventeen bites on my arm and my side.

“Do you think you should flush these wounds?” I asked the doctor. 

“I’ll have the nurse scrub these really well, and we will get you started on some Augmentin,” the doctor said. “That will be more effective than the cephalexin that you took. I think that should take care of things for you.”

I was cleaned up and returned to the office just in time to send Fluffy home.

“I hope Fluffy was okay for you, Doctor Larsen,” Mrs. Wilson said.

“Well, actually, she objected to the subQ fluids a bit,” I said. “In fact, she bit me seventeen times on my arm and the side of my chest.”

I held up my arm for her inspection.

“Oh my, Fluffy, did that mean man upset you?” Mrs. Wilson asked Fluffy as she reached into the kennel to console her.

“Well, we will be a little more cautious with Fluffy in the future,” I said. “We should recheck her in the morning. If things are improved, we will repeat the fluids and antibiotic injection and set you up with medication for home. And we will need to get her on a special diet for a time.”

“Whatever you say, Doctor,” Mrs. Wilson said. “We just want our little Fluffy to be well.”

“Well, if you remember, I wanted to keep her on an IV overnight,” I said. “This treatment is our second choice, and hopefully, it will work out okay.”

“Yes, I remember, but Fluffy will be much happier at home tonight,” Mrs. Wilson said.

***

Fluffy was much improved in the morning. We repeated the fluids, but this time we had Fluffy restrained in a cat bag. The urine culture showed an E. coli infection in the urinary bladder.

Fluffy went on the heal and returned to her old self. But she remained on my naughty list.

My wounds healed uneventfully.

Photo by Cocoparisienne/Pixabay