Wound that won’t close?

[scienceofcats]

Lola has a small lesion on her chin for about a week and a half now (which I mentioned in my other thread here), and I’m back to square one now. Feeling frustrated and stressed out... if anyone can offer advice on what I can do differently, I’m all ears.

The wound started as a lesion seeping semi-purulent serous fluid (pink/yellow colour) and was maybe 3-4 mm wide if I had to guess. It’s on the bottom centre of her chin, pretty close to her mouth. The vet prescribed Isaderm (fusidic acid + betamethasone), a dual antibiotic/anti inflammatory cream. She also suggested using a cone, which I tried at first, but Lola was absolutely miserable in it, so I switched it out to a plush inflatable donut I got from the pet store that’s supposed to serve as an alternative.

She’s been wearing that and getting her cream twice a day for a week, and it was starting to heal really nicely. But last night is started to look a lot more inflamed (see picture, taken last night), and this morning it’s started seeping pinkish fluid again. I’m worried she’s found a way to scratch it despite the donut (although I’ve never seen her succeed at scratching it while I’m around). If that’s the case, she might’ve reopened it by scratching.

I’m suspicious that it might be because the donut is a bit looser now - she’s been aggressively scratching at it since day 1, and now it won’t stay fully inflated. I think she made a small puncture in it. For now, I’ve got the cone back on her, but I cut the excess plastic off so it’s not quite as huge on her head. She still hates it. I’ll try to get another donut today, but I’ve got my reservations about it’s effectiveness.

Is it possible to bandage a cat (in addition to using the donut)? Especially to keep her from rubbing the cream off, which she does regardless of the donut or the cone? Good idea, or bad idea? I was kind of wondering if you could use one of these, to add another barrier to keep it clean and undisturbed. Also, should I stick with the antibiotic cream, or would oral antibiotics be a better idea? I know very little about skin infections and wound closure in cats.

Here’s that picture from last night. It was still dry then, but looked much worse than it did the day before. The missing hair is just because the vet clipped that area to keep it cleaner.

 

[Larry and Kitties]

Could be chin acne. It can be caused by plastic bowl and other things. My Wiggles developed, soon after he arrived in my home, chin acne that looked similar to your photo. I cleaned the are twice daily first with Povidone iodine I got from a drug store, that did not seem to do much good so I then tried chlorhexidine wound solution and then even a human acne med. It finally went away and was seemed to be due to Wiggles licking/chewing various plastic bags he found in his room.

 

[jt and trouble (GA)]

I'm surprised your Vet didnt give the oral antibiotics along with the cream. I'd start them asap.

 

[scienceofcats]

The thing about oral antibiotics that concerns me, though, is that they give her diarrhea, and that will lead to dehydration. She’s had issues with ketone levels recently, which are strongly affected by hydration, and that makes me nervous.

Are the adhesives on human bandages safe for cats? The more I think about it, the more I think that would solve the problem of keeping the medicine on it and preventing rubbing on the donut.

 

[Deb & Wink]

Duct tape to fix the possible hole in the donut. Put the cone back on Lola, put the inflated donut under water, squeeze the donut to push out some air and look for air bubbles. Keep working your way around the donut, to try and find the leak. Once found, mark quickly with something. Dry the "donut", attach duct tape to the leaky spot. Or use some of that rubber patch they make for inflatable bike tires, if you have some. Duct tape, most everyone has in their "tool chest."

Skin infections often respond to topical antibiotics. Sounds like they were working fine, until she scratched at her chin.
Yes, Lola hates the cone, but if she can reach around the donut to scratch at her chin, you may need to put the cone back on her.

Sorry.

 

[jt and trouble (GA)]

The thing about oral antibiotics that concerns me, though, is that they give her diarrhea, and that will lead to dehydration. She’s had issues with ketone levels recently, which are strongly affected by hydration, and that makes me nervous.

Are the adhesives on human bandages safe for cats? The more I think about it, the more I think that would solve the problem of keeping the medicine on it and preventing rubbing on the donut.

Sorry I wasnt aware.

 

[Deb & Wink]

Are the adhesives on human bandages safe for cats? The more I think about it, the more I think that would solve the problem of keeping the medicine on it and preventing rubbing on the donut.

Not sure if they are safe. I think they would have a hard time, sticking to the fur and all, and Lola might just scratch or rub off the human bandage.

Some of those human bandages, the waterproof ones or the fabric type ones, can leave some sticky stuff behind on human skin. Would think they would do the same on the cat's fur or on the skin around her chin.

I always have to use a trace of vegetable oil on my skin, then rub gently but thoroughly, to get the sticky stuff off. Like on the thumb currently bandaged.

 

[Judy and Freckles]

I know we have used a rolled up towel as a doughnut around a dog's neck. I'm not sure how it would work for a cat but it may be worth a try.

 

[scienceofcats]

Sorry I wasnt aware.

Oh don’t worry about it, no harm done!

It was a good suggestion, and it’s possible I’ll have to go down that road anyway if this doesn’t clear up in the next several days. Hopefully it closes up soon~

I think they would have a hard time, sticking to the fur and all, and Lola might just scratch or rub off the human bandage.

You were right - the circular band-aids wouldn’t stick, so that’s out. I bought another donut for now - this one is slightly different in that it feels sturdier, but same general design. I’ve fixed the old one, so I have a backup in case she punctures the new one.

I also tried to ‘soften’ it by padding the donut with gauze, but she soaks it when she drinks, so I can’t do that. I will try to cover up the rough seams etc. with waterproof bandaging tape so that at least those won’t be able to rub.

Skin infections often respond to topical antibiotics. Sounds like they were working fine, until she scratched at her chin.
Yes, Lola hates the cone, but if she can reach around the donut to scratch at her chin, you may need to put the cone back on her.

I don’t think that’s what’s happening, or at least not when the donut is fully inflated (as the new one is now). I worry that she’s rubbing her chin on it to try to itch it, and I wonder if that’s how she managed to open it up again. Same problem happens with the plastic cone - I tried it again, and she presses/grinds her face right into it. What I did notice when I tried the cone again was that she won’t drink with it - I watched her for quite a while, and she would attempt to have a drink, but she couldn’t figure out how to comfortably do it with the cone, and after a couple of tries she would just give up. I really don’t want to be doing anything that’s going to discourage her from drinking enough, considering her recently ketone scare.

It’s dried up considerably from this morning. Here’s a photo taken with flash, same as the other one, for comparison. Attached is also a photo without flash with more natural lighting that more accurately shows what it really looks like.

Oh, also, one other thing I’m doing differently. I read that applying too much cream can actually have the opposite effect because it makes kitty want to rub at it. So I’ve started applying thin layers of cream with cotton swabs instead of straight out of the tube.

 

[Lisa and Witn (GA)]

Also, trim her nails. That may help keep her from puncturing the collar again.

 

[Judy and Freckles]

Also, trim her nails.

or nail caps

 

[scienceofcats]

Yeah, a nail trim is probably in order. Problem solved though! I fixed the original clear plastic cone by cutting a really big amount of plastic off of it. It’s now short enough that it doesn’t impede her vision or ability to eat and drink, but still stops her from being able to reach her chin with her feet. She seems pretty happy with it!

 

[Judy and Freckles]

purrrrrfect!