The Sonoma County Gazette: Community News Magazine
Sonoma County Gazette
| more

Photo Gallery

Family Pet Animal Care - January 2015 - Tools


Family Pet Animal Care - January 2015 - Tools

by Dr. Michael Trapani

Once in a while we have a spectacularly difficult case. This is the story of “Toolbag” AKA “Tools” the Cat. Warning! Graphic Content! Do not read this while eating!

It’s rare to see a living animal that has been injured as badly as poor little Tools. Tools is an orange and white domestic shorthair cat. He’s about 5 years old and quite the little character.

We have no idea how Tools was injured. He sustained a full thickness skin laceration at his waistline that extends half way around his body. The wound is about an inch and a half deep – all the way down to the muscle (Tools was a pretty “prosperous” kitty before all this). To complicate matters, Tools somehow managed to strip the skin back almost to his hips.

It gets worse. Tools hid out for three or four days after his injury. He chose a space full of mouse droppings to shelter and managed to pack hundreds of mouse poops into his wound, creating a truly horrendous infection. Even though he searched for days, Tools’ owner was only able to locate him by the smell of his wound. Miraculously, Tools was still alive.Family Pet Animal Care - January 2015 - Tools

When we first examined Tools it was clear that he was in deep, deep trouble. His body temperature was eight degrees below normal. Large sections of Tools’ tummy skin had died and his abdominal fat layer was green and rancid, a condition that can only be described as “wet gangrene.”  The wound was filthy and stank so badly that the exam room was permeated with the stench of decaying flesh. Despite this, Tools was purring. He’s a remarkably smart cat who understood perfectly what a mess he was in and how much he needed help. Tools appreciated the care – from the very beginning.

After a period of stabilization, Tools went into surgery. His wound was cleaned and a huge section of dead skin and tissue - nearly one pound of his 11 pounds body weight - was removed. Even this was not enough and dead skin had to be left in place in order to close the wound. It was critical that Tools’ wound be closed in order to help moderate the huge fluid loss he had from his massive injury. Needless to say, Tools was started on an extreme antibiotic regimen, IV fluid therapy, and lots and lots of pain relievers.

Tools’ first hurdle was infection control and management of his fluid balance. He did well in the hospital, but after a couple of days the effects of severe inflammation set in. Tools developed SIRS (Systemic Inflammatory Response to Stress). This condition occurs in many patients with massive injuries or infections. Tools’ injury required him to dissolve and absorb huge amounts of dead and injured tissue, causing him to become anemic, become immunosuppressed, and to leak protein from his blood vessels. Tools spent 10 days in the hospital before he was able to get along without constant IV fluids.  His wounds were healing, but as dead tissue separated from the living, healing tissue beneath, the first temporary wound closure re-opened, necessitating a series of surgical wound debridements (to remove dead tissue) and incremental closures (to stretch the skin and decrease fluid losses from open wounds). By the time things settled down, Tools had lost at least 20% of his skin, creating a 5-inch wide open wound from his mid-chest to his groin.

We also struggled with diarrhea (made worse by the extreme antibiotic therapy Tools required) and poor appetite (another SIRS problem), but Tools remained a happy, grateful kitty that purred whenever he was handled. Tools walked around the hospital whenever he was let out, rubbing against any available ankle. He ate better every day and his drug and fluid therapy were incrementally decreased as he grew more able to care for himself. Even the diarrhea settled down - much to the relief of both Tools and my staff!

Tools’ long journey to recovery is far from over. His current hurdle is to close his wounds through skin contraction and finally, by scarring. Massive though it is, Tools’ wound is healing nicely (cats are really, really good at re-growing skin). He wears a kitty suit that keeps his open wounds covered and bathed with a specialized wound dressing. We change his bandage twice a week and expect him to complete the task of re-growing his skin in 3 to 4 weeks. When it’s all over, Tools will probably have only a smooth, hairless scar on his tummy.

Tools’ daddy really loves his cat and has done everything possible to save him – through 17 days of hospitalization - and Tools, the brilliant kitty that he is, seems to understand perfectly how much he is loved and cared for. Indeed, Tools seems to have undergone a personality change since his near-death experience. He is more outgoing with people and much more affectionate and demonstrative. What a great cat!

My staff and I have enjoyed caring for Tools. It isn’t every day that we have an opportunity to work at our highest level of capability. Taking care of Tools, and watching his progress as he moved from near death to recovery, has been extremely gratifying. Tools is our little Christmas miracle!