Last week I visited Noisette at home. Noisette is an eight-year-old female calico cat, originally from France, weighing all of eight kilos. For her frame, she is overweight.

A peculiar characteristic of Noisette is that she cannot stand being touched unless by her owners. Any demonstration of affection must happen within the secure environment of her home and with no one else there. If Noisette’s owners have guests at home, she refuses to be cuddled or held.

When they phoned, Noisette’s owners were very anxious. About 10 months ago, Noisette needed to have a huge skin tumour removed from her belly. That procedure had gone very well. Now, her owners told me their cat could barely walk and that when she did, her pain and distress were obvious.

What was also very worrying was that for the last two days, Noisette would eat and drink only if they took it to her. Her reluctance to move was so bad that they had to pick her up and place her in her litter tray when the need arose. They were terrified that another tumour was growing somewhere in her body.

Just as her owners had portrayed, I found Noisette crouched with her feet tucked under her body, head fixed, looking straight. Very uncharacteristically, she made no attempt whatsoever to run away as I entered the house.

And where she would normally struggle and protest vociferously if I made any attempt to touch her, this time she actually let me pick her up off the floor. Noisette, truly, was in a bad way. We gently placed the cat on the table. An examination of the belly area confirmed that all was well there. So something other than that was bothering her. I extended my examination to the rest of her body and soon found a swelling about the size of a squash ball situated beneath the skin right in between her shoulder blades. No wonder she was in such excruciating pain.

The only reason why such a large swelling was not immediately apparent was due to her excessive weight masking the growth. This time, however, I had better news for Noisette’s owners. What she had was an abscess.

Imagine the skin to be the border of a country. When a foreign body or bacteria manages to get under the skin, the body reacts by becoming inflamed. A type of white blood cell called macrophage will inform another type of white cell called neutrophil of the intrusion.

Abscesses can form in any soft tissue of the body

Just like an army sent out to attack the enemy that has invaded its border, the neutrophils react by rushing in troops of cells towards the assigned site. The body achieves this by dilating the blood vessels around the area. This dilation becomes outwardly visible as an increase in redness and swelling. The neutrophils and bacteria then commence battle.

The neutrophils release proteins to try and kill the bacteria and the bacteria releases toxins to try and kill the neutrophils. As the battle under the skin rages, the soup of dead bacteria, dead neutrophils as well as the proteins and toxins they churn out becomes what we refer to as pus.

The pus may be of a purulent or mucopurulent type, depending on the type of bacteria involved. Mucopurulent pus is thicker, has a greenish tinge, is smellier than the purulent type and is usually an indicator that the infection is more serious.

This is the type of infection that Noisette had. The abscess came about because Noisette’s body was defending itself from the infection.

To protect itself from the dangerous substances contained within the pus, the body defends itself by isolating the soup of bacteria and by-products in a fibrous capsule which ultimately forms the abscess.

The body will continue using the macrophages to try and clean up the mess. Very importantly, it tries to achieve this by forcing the bacteria upward towards the fragile surface of the skin when it becomes easier to rupture and drain out the bacteria.

That draining of pus would normally provide considerable relief from pain and infection. But when the invading bacteria have the upper hand, the abscess just continues to grow and grow.

Abscesses can form in any soft tissue of the body, such as the gums, liver, lungs, kidneys and also in many other locations. The most visible are those just under the skin. Causes of abscesses also differ immensely. The most typical come from a penetrating wound such as that inflicted by a dog or cat bite, or foreign body that has worked its way under the skin.

Abscesses from tooth or gum decay are also quite common. Liver abscesses could form from an infected umbilical cord.

Anal gland abscesses do occur occasionally when these are not regularly emptied or treated. When superficial, diagnosis is straightforward. Abscesses on internal organs that affect diagnosis can be more challenging.

Treatment for an abscess may or may not be necessary, and can also vary depending on the location, dimension and level of discomfort it is causing. It would also depend on whether it has already ruptured or not. If it has already ruptured, the treatment may just consist of cleaning it out with a disinfectant solution.

If not, your veterinarian may decide to shave and clean the affected skin area and lance it to remove and drain the pus inside. This may have to be done under heavy sedation or anaesthesia.

Noisette had all the symptoms of suffering from a painful abscess. Antibiotics and painkillers were administered as a start, and arrangements made for a clinic appointment later in the day to lance the abscess.

But it seemed that all Noisette needed was just that little bit of help to kickstart her body’s fight against the infection.

Within hours she was asking her owners for food and water. And within a couple of days the abscess had shrunk considerably.

Noisette was back to her usual self and would not let me anywhere near her on my next visit.

thisweekwiththevet@gmail.com

Dr Martin Debattista is a veterinary surgeon.