I think we can all learn from the mistakes of others and so I’m going to share a little story with you about something I had happen to me as a neophyte veterinarian. It’s a story I’m not too proud of but I’ll share it anyway. As a new graduate right out of vet school, I went to work in a practice where I was the sole night shift veterinarian (our practice stayed open until 10 pm which helped the working folks out a lot).
I used to see a lot of cat fight wounds in that practice. Cats have a lot of bacteria in their mouths, especially Pasteurella bacteria. And so when a cat bites another cat during a fight, the needle sharp canine teeth make small puncture wounds and the Pasteurella and other bacteria are deposited underneath the skin. The puncture wound then seals up fast but the bacteria multiply and an abscess forms (which is a pocket or collection of pus). Sometimes these cat abscesses that form are quite large. They are commonly found at the base of the tail, and the head and neck area but can be found anywhere on the cat’s body. They are very painful (I learned just how painful abscesses are when I fell on concrete and abraded my knee and had to go to the doctor for a penicillin injection the next morning when I woke up and literally couldn’t walk because the wound had abscessed).
Symptoms of a cat fight abscess are:
- a high fever
- poor appetite or the cat not wanting to eat at all
- a soft lump which is usually very painful to the cat
- a bad smell (which is usually due to necrotic skin around the abscess)
- actually seeing pus draining from the abscess (often pinkish brown in color)
To treat these abscesses, the pus pocket needs to be incised, drained, flushed out and usually a drain tube is installed. Sometimes necrotic skin has to be excised (debrided) and suturing done. Antibiotics are given for several days to kill out the infection. If you just drain the pus without a drain tube you can have problems with the abscess just continuing to re-form. Trust me when I say these abscesses can be very nasty and foul smelling. Lancing an abscess can fill a room in just minutes with the putrid odor of pus and necrotic tissue. It can be nauseating even to those with the strongest of stomachs.
Repairing a cat fight wound abscess is considered “dirty surgery” in vet med (as opposed to sterile surgery). In sterile surgery, such as a spay, where you’re going into the sterile abdomen, we always wore sterile caps, masks, gowns, and gloves and in vet school, we also wore shoe covers. The instrument pack was sterilized in an autoclave as were all drapes, sponges, etc.
But a cat abscess is considered a dirty surgery and we usually didn’t bother wearing a cap, mask, sterile gloves, etc. because the surgical field is already considered infected/contaminated. I did usually wear gloves because I sure didn’t want to be touching all that pus with my bare hands, but they were not sterilized gloves. We also didn’t perform our “dirty” surgeries in the surgical suite but in the prep room, so as not to contaminate the surgery suite.
When I was a newly practicing veterinarian, I had a cat fight abscess come in one evening. The patient was an unneutered tom cat and this ole boy had a history of fights. This particular abscess which was on his right side was huge (as big as the palm of my hand) and Tom was lethargic and not eating. His temperature was 104.6. Tom was a sick boy and he needed his abscess drained and flushed and a drain tube put in. Lancing of the abscess usually brings that temperature down immediately (and that is why many cats feel much better and will start eating again when their abscess ruptures at home on their own… that is, until they seal up again). I gave him an injection of antibiotics and then we sedated him (abscesses as I said are very painful and most cats aren’t going to tolerate the drainage and flushing when they are awake).
Since Tom’s surgery was a dirty surgery, I had a pair of non sterile gloves on but no mask. After shaving the surgical site and a quick prep of the wound, I picked up a scalpel blade and incised the large abscess and WOOSH! Bloody pus came shooting up from the abscess like a geyser right into my lips and face. The smell was horrid and filled the room immediately with a putrid odor. It was sickening. I immediately ran to the sink and started washing my face and lips with soapy water.
How stupid and careless I had been to not have had a mask on! Up until that point, I had always worn a mask for the animal’s safety and protection, but not for my own safety and protection. Thankfully I had my mouth closed when I incised the monster abscess and the foul pus did not go into my mouth or eyes. I was lucky.
You might be saying that it’s different with coronavirus but really it’s the same principle:
While wearing a mask, you are both protecting YOURSELF as well as OTHERS.
I learned that lesson the hard way. And I’ve thought of it many, many times in the past few weeks as the great face mask wearing debate rages on.
It’s like this little diagram that my sons and I have laughed at but it’s actually a great illustration! It’s known as the pee meme. Maybe you’ve seen it. I think it’s great!
Needless to say after getting foul smelling, nasty, bloody pus sprayed into my face, this neophyte veterinarian learned a valuable lesson and one I never forgot. I always, always wore a face mask with any dirty surgery I did after that, and often one with an eye shield.