Thursday, July 1, 2010

Case of the Week: Clawed

Clawed is a five-year-old domestic shorthair that does go outside regularly. He arrived at the clinic with some soft swelling and yellow fluid drainage from his side. Usually when a cat that goes outdoors comes into the clinic with these symptoms, Dr. Karnia suspects an abscess due to a recent cat bite. In such a case, we clip the fur around the infected area and then flush the wound with a surgical disinfectant. With this treatment and a course of antibiotics, the cat usually heals quickly.

However, from his first visit, the swelling on Clawed's side made Dr. Karnia suspicious that there might be something more going on than just a bite wound abscess. He had had some drainage from the side of his chest for a few days. There was a solid swelling under his skin two inches across and extending along the whole left side of his chest. At the center of this solid swelling was a soft section with a cloudy brown fluid inside it.

We put Clawed under anesthesia in order to drain and flush the wound. The fluid was sent to the lab for a culture to ensure we were giving him the correct antibiotics. No bacteria grew on the culture but the lab did see some light fungal growth. Clawed did very well on the antibiotics but the drainage never completely resolved. When Clawed was brought back for a progress exam, blood was sent in for fungal testing. The results showed that he had Coccidiomycosis, also known as Valley Fever.

Coccidioides is a fungal organism that is endemic to the dry southwestern U.S. The usual route of infection is by inhalation into the lungs. The fungus can then spread to other parts of the body. The infection can cause fever, weight loss, and decreased appetite. Cats are relatively resistant to infection compared to dogs and humans. The most common sign of Valley Fever in cats is an abscess or draining lesion in the skin. Anti-fungal medications, such as fluconazole, are usually effective but may need to be given for several months or even years.

We expect Clawed to do well on the anti-fungal medications, and will report on his progress as his treatment continues.

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