The 10-year-old female stray cat has a gigantic swollen face. Pt 1/2
Channel: Dr David Sing
Date: 2019-03-04

THE CAT WITH THE LARGE FACIAL ABSCESS – PARTS 1 AND 2.

MAR 4, 2019. Part 1/2 is this video is also shown in this video. The care-giver contacted me at 10 am. He used to keep over 20 stray cats in a kennel place in Pasir Ris kennels some 20 years ago. Now he has this cat and another two cats in his factory shop in Ang Mo Kio. 

This cat lived in the factory unit but roamed freely within the factory surroundings according to him and had never been sick for over 10 years. "How long has the cat has a swollen face?" I asked him. "3-4 days," he said. That was an explosive ballooning of the cat's right facial area in just 3-4 days. The bad odour of rotten eggs wafted up when I incised the abscess. It indicated a flesh-eating gas-forming bacterial infection. 

What to do? 

The cat was anaesthesized. Xylazine 0.01 ml + Ketamine 0.1 ml IM. Isoflurane gas and oxygen via gas mask topped-up the anaesthesia when needed. The swelling was lanced with a scalpel blade. Foul smelly thick brownish red pus flowed out of the cut (See also P2/2 video). I used 3% hydrogen peroxide as an antiseptic after releasing the pus into the kidney dish. 

Then I used copious amounts of normal saline to irrigate and clean up the inner part of the skin wound. Blood test showed very high numbers of white blood cells and neutrophils indicating a severe bacterial infection. Prompt treatment by the owner saved this cat's life as the infection spread rapidly within 3 days. 

The cat did not have fever or become emaciated, showing that the owner did seek early veterinary intervention. The old cat woke up fast from anaesthesia as the dosage given was very low. The risk of dying on the operating table is very high in old pets, hence the use of isoflurane gas top up was the safest procedure rather than a higher dose of injectable sedatives. She went home with oral antibiotics and painkillers. 

UPDATE: 
MAR 9, 2019. No complaint from the care-giver. The cat had fully recovered and was eating as normal. He still wandered freely in the factory premises. Cat facial abscesses are due to cat fights. This cat was neutered. In general, it is best to neuter the male cat and keep the cat at the factory shop/home to prevent cat fights during wanderings. 

This cat recovered fully after two weeks. 

UPDATES IN 2022:: 
https://2010vets.blogspot.com/2022/07/4138-what-happened-to-calico-cat-with.html

Pt 2/2 is at:  
https://www.youtube.com/watch?v=0p6UnO0xX8Q
Video - Part 2 shows surgical treatment - lance and drain the abscess, dental scaling and extraction of the decayed lower right premolar tooth. Flea and deworming treatment were advised. WARNING. Part 2/2 contains surgical procedures on treatment of the malar abscess in this cat. Viewer discretion is advised.

P.S.
The upper right jaw has no more malar tooth when I examined the mouth during treatment. This infected upper 3rd premolar tooth in this jaw had decayed and dropped off before treatment. The bacterial infection of its roots would have spread upwards to the face over a short period of 3-4 days to form the gigantic facial abscess, also known as malar or carnassial tooth abscess.