Feline How-To Manual: Basic Nursing 101 ~ Pawprints and Purrs, Inc.

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Any health care links located here are NOT to replace a veterinarian visit; please take your cat to a vet immediately at any sign of odd behavior or any symptoms of illness or injury. Call your vet and describe your cat's symptoms with any of your concerns about the cat's well-being. Your veterinarian may discover changes in your cat's health that you have overlooked. It is always better to err on the side of caution.

Basic Nursing 101

Compressing Wounds and Injuries

Compressing is one of the oldest and most universally practiced forms of medicine. Historically, it has involved the application of heat or cold, and sometimes salts, solutions, herbs, poultices, or other medicaments by way of cloth pads to the surface of the skin. The effectiveness of these substances has been judged largely on the basis of folklore and time-honored home remedies rather than on scientific fact. However, contemporary medicine does use compressing and in its simplest form, it provides excellent relief from pain and infection and promotes rapid wound healing.

Hot compressing is employed in the treatment of infected wounds. It stimulates blood flow to the affected area, bringing in antibiotics, antiinflammatory and analgesic medications through the circulation. Compressing promotes drainage of infected wounds. The warmth alone often provides excellent pain relief. Most cats will recognize this particular benefit after the first application and will relax and seem to enjoy the experience. Moist hot compresses clean the wound. Epsom salts and antiseptics added to the compressing solutions in appropriate amounts can inhibit infection and encourage rapid wound healing.

Before compressing your cat's wound, have everything you need assembled and ready for use. Pure warm water directly from the faucet or in a pan is entirely adequate. Some vets request that you add to the water a small but specific amount of surgical solution or epsom salts. Occasionally he may want you to use a sterile prepared solution. In this case, warm the solution 3 or 4 seconds in a microwave oven or in a pan of hot water. Use a soft, clean face cloth or a short stack of gauze sponges. The cloth should be wet but not dripping and should be as warm as can be comfortably tolerated. Remember that inflamed, injured tissue is more sensitive to heat than your hands and can scald easily.

Do this procedure next to a sink so you will have more control over the cat while working at waist level. Take advantage of the running water to rinse out the cloth thoroughly. Not every cat tolerates the sound of running water. You may find this task most easily accomplished by holding the cat on your lap. Hold the damp cloth on the wound for a total of about 10 minutes. As you pull away the cloth from the wound, the surface debris will stick to the cloth. Rinse the cloth as often as necessary to keep it warm and clean.

Dry, hot compressing can give the same benefits as hot moist compressing - increased circulation and pain relief - if you place a warm wet cloth inside a plastic bag before applying it to the skin. This technique is usually used to reduce the swelling associated with surgical incisions, which should always remain dry.

Cold compressing is used within the first hour of a traumatic orthopedic injury to reduce swelling. It can also be very effective in controlling bleeding. Except in an emergency, cold compression should not be used without the recommendation of a veterinarian. Put some crushed ice in a small plastic bag and wrap it in several layers of toweling to prevent freezing the skin. Gently place the compress on the affected part. Repeat as recommended by your vet.

Flushing Wounds

The practice of wound flushing is controversial. Some veterinarins believe that the solutions used for flushing are toxic to tissues and will delay wound healing. By flushing wounds, you could also introduce other germs into the wound and set up the possibility of a more severe and persistent infection. Flushing wounds can help to rinse pus and debris from an area while instilling an antiseptic solution that kills bacteria. Saline (salt) water, peroxide, and a variety of surgical antiseptics are commonly used for this purpose. Saline has the advantage of being nontoxic; however, it has little germ-killing ability. Peroxide has a great visual effect and mechanically removes pus and debris, but it is very toxic to tissues and should be used only when diluted and on the recommendation of your veterinarian.

Surgical solutions such as povidone-iodine (Betadine) or chlorhexidine diacetate (Nolvasan) kill a broad spectrum of germs. Povidone-iodine is not an effective antiseptic in the presence of blood and pus. When used, povidone-iodine should be diluted to the color of weak tea. Chlorhexidine diacetate should be diluted to 0.75 percent. Follow your veterinarian's instructions for diluting the flush solutions. Full-strength Betadine and other povidone-iodine solutions are less effective than diluted ones; both are toxic to living tissues unless properly diluted.

Your veterinarian will provide you with the appropriate flushing solution and syringe if he feels it is a necessary part of wound management. Be sure to keep any diluting containers and syringes scrupulously clean with hot, soapy water and rinse well. Store these supplies in a clean, dry place. Wash your hands thoroughly before and after the procedure.

To flush an open wound properly, use a large volume of appropriately diluted solution and a high jet pressure from the syringe. Expect the solution to splatter as you force the solution through the syringe as quickly as possible. The jet pressure acts to lift debris and bacteria off the surface of the wound. This is more effective, less damaging, and less painful than merely wiping the surface with gauze.

An abscess is a pocket of pus and damaged tissue under the skin. It develops as a result of puncture wounds, usually from the bite of another cat. Abscesses usually rupture and drain to the outside through a small opening. Sometimes they become progressively larger, undermining large areas of skin. Abscesses tend to drain very poorly unless they rupture through a large opening or are lanced. It is often necessary to place one or more drains through the abscess. Drains are usually of several types: soft rubber Penrose drains, antibiotic impregnated gauze, or cloth drains called umbilical tape. The latter two look a lot like shoe laces tied through the skin. Penrose drains are usually sutured in place.

Drains permit the accumulation of pus and other debris to flow to the exterior from pockets under the skin and thus allow healing. Without good drainage, infections tend to fester and recur.

The solution used for flushing closed wounds should be at or slightly warmer than body temperature. When flushing wounds with drains, the syringe is filled and the tip inserted under the skin where the drain exits. The contents of the syringe are squirted under the skin and into the pocket. The flushing solution will run out the openings in the skin, bringing with it puss and sloughing tissue. This process is repeated several times until the solution becomes clear. Note that you do not flush solutions through the center of a Penrose drain as they do not have holes. The drains themselves are removed by your vet after two or three days.

The exact volume of flushing solution used is not important. These solutions should be slightly warm to the touch. Remember that damaged tissue is much more sensitive to burns.

Therapeutic Baths

Because most cats have a natural aversion to water, you may need assistance in giving your cat a bath - one person to hold him and one person to lather and rinse. Before beginning, insert a piece of cotton into each ear canal to absorb the water that will inevitably get inside. Instill a small amount of neutral eye ointment (get this from your veterinarian) into both eyes to protect them from soapy run-off. The best place to give a bath at home is in the kitchen sink where you will be working at waist level in a good size basin. Have a couple of clean bath towels ready for your wet feline when it's all over.

Follow the instructions on the shampoo or other solution unless otherwise instructed by your vet. Most medicated and insecticidal shampoos require contact with the skin and coat for several minutes for maximum benefit, so watch the clock. Use a face cloth to rinse around the head to help prevent soap from getting into the eyes. To rinse, use a small saucepan, bowl, or sprayer attachment on the sink. Spend a lot of time rinsing, and pay close attention to rinsing under the legs and tummy where soap tends to collect. Soap residues are one of the most common causes of skin irritations. The medicated and insecticidal shampoos dispensed by your veterinarian are formulated to be extremely rinsable, and are superior and safer to over-the-counter preparations.

When rinsing is complete, dry your cat thoroughly, using several towels and a blow dryer if your cat will tolerate it. Don't forget to remove the cottom from each ear canal. A soft wire brush called a slicker brush will remove the loose hair. Remember, too, that inflamed skin is very sensitive to heat and cold and your cat can be more easily burned by bath water or a dryer.

Enemas

As some cats get older, they lose the ability to empty their bowels effectively. Such cats are more than constipated, they are obstipated. Impacted feces causes severe distension of the colon. These cats are in pain and seriously ill. The condition is managed in a variety of ways, including manipulating the amount of fiber in the diet, laxatives, regularly scheduled enemas, and sometimes surgery. Never give your cat an enema unless your veterinarian has instructed you to do so, and only after he demonstrates the procedure.

You need two people to give an enema properly and safely. Your vet will provide you with an enema solution specifically made for animals, or you may be instructed to use a specific recipe with warm water and an empty human enema bottle such as a Fleets. Under no circumstances should you use a human enema solution in a cat. They are very high in phosphorus and are extremely toxic to cats.

Most people recognize that a veterinary hospital is better equipped to manage giving an enema and its after effects. Still, you may need to take care of this at home if you have a special needs cat. The best place is to work in the bathtub. One person should restrain your cat by holding onto the scruff. The person working at the other end of the cat should lubricate the catheter tip of the enema bottle with a small amount of petroleum jelly or K-Y jelly and gently insert it into the rectum as you would a thermometer. Insert the catheter tip to its fullest extent. If you cannot because of fecal impaction, stop and contact your vet. Slowly and gently express the contents of the enema bottle into the colon and withdraw the nozzle. It's a good idea to have a litterbox right there by the tub, as most cats head right for it. If you have a large dog crate, put your cat in there with the box. It may take 30 minutes or so before you see results.

Cleaning Eyes and Nose

Remove the crusty debris that accumulates around the eyes of cats and kittens with upper respiratory infections with a soft cotton ball and either boric acid eyewash or a sterile, preservative-free (aerosol spray) saline solution made for soft contact lenses. You and your cat should not use the same bottle of saline to prevent one of you from giving the other an eye infection. The use of saline solutions to plain tap water is because the latter is not balanced and can be irritating. Do not spray saline directly into your cat's eyes.

Use a very wet cotton pad or soft cloth to clean your cat's nose of mucus and crusts that accumulate with respiratory infections. For very heavily dried-on debris, soften the crust by applying a small amount of antibiotic ointment, K-Y jelly, or petroleum jelly, and wait a few minutes before wiping it off. Repeat as often as needed to keep the nose clean, since your cat won't eat if he can't smell food.

Cleaning and Flushing Ears

Your cat's ear canals are proportionately longer than your own and are L-shaped, angling inward. The horizontal portion of the canal tends to accumulate debris and pus if it is infected. Medications put into the ear may be ineffective unless these materials are periodically removed.

Your vet will provide you with an appropriate ear cleaning solution. The solution will either be premixed, or you will need to mix it yourself in a small bowl. You will also need a smal bulb or ear cleaning syringe from the drugstore. You will also need some cotton, a small towel, and a few cotton swabs. If the ears are sore and itchy, you will probably need an assistant.

Working at waist level on a good solid surface, hold the tip of your cat's ear and examine the opening to the ear canal. Your cat will find this procedure less objectionable if the solution is slightly warm. Using the bulb syringe, instill sufficient solution to fill and overfill the ear canal so that the solution spills back out of the ear. This is going to tickle your cat and you, as the solution trickles down his neck and probably down your arm. While still holding onto the ear, gently massage the base of the canal to break up debris, working it upwards towards the opening. Besides the tickling, the sound of the ear canal being filled and the squishing sound as you massage will annoy your cat the most.

Using several pieces of cotton and your finger, wipe out the ear. You can use cotton swabs in the nooks and crannies, but do not insert them into the canal. This will only pack debris into the base. Repeat the process until the cotton stays reasonably clean. Then medicate the ear as directed.

Brushing Your Cat's Teeth

Good oral hygiene for cats may sound ridiculous to you and you may argue that "Wild cats never brush their teeth and they do just fine." True, but consider this: In nature, a cat's diet consists of whole, small animals. Crunching on little bones serves to scrape the teeth and keep them healthy. Feral cats die at a younger age from hunger, infectious diseases, and accidents, and therefore don't live long enough to develop the severe dental problems seen so frequently in well-cared for house cats. With modern vaccines, improved nutrition, and regular health care, it is not unusual for a cat to live 15 to 20 years. And that is ample time to develop cavities and severe periodontal disease.

In fact, cavities are extremely common in cats and can cause a great deal of low-grade mouth pain that goes on unnoticed by an owner, until those teeth are loose and decayed. Once a process destructive to the periodonal ligament that holds the teeth in the jaw begins, it continues until the teeth loosen, fracture, and fall out. As in humans, some cats develop tooth and gum problems more readily than others. When the cavaties are filled and the diseased teeth are removed, the cat returns to eating and acting normally.

Other known risk factors for feline dental disease are the feline leukemia virus and feline immunodeficiency virus. Severe disease of the teeth and gums can alert your veterinarian to test for these diseases. Your vet examines your cat's mouth during his annual physical examination, assesses the need for professional scaling and polishing, and gives you pointers on home care. Your home care will only be effective after your cat's teeth have been professionally cleaned and any existing infection is under control.

Use a cotton swab, small child's toothbrush, or a specially manufactured pet toothbrush to brush your cat's teeth. Usually the cotton swab is the least objectionable to the cat. Moisten the swab or brush with a veterinary dentifrice, peroxide, water from a water-packed can of tuna, or an oral-antiseptic prepared for animals. Do not use human toothpaste or mouthwash as they may burn or upset your cat's stomach if swallowed.

Moisten the swab and THEN go get your cat. Put him on the kitchen table or counter facing away from you so he can't back up. Hold his head in your hand as you would to give him a pill. No need to open his mouth, just slide the swab into the corner and gently rub the teeth and gums along the back, sides, and front. You do not need to brush the inside or occlusive (grinding) surfaces of the teeth.

With a little practice, the whole process takes about 30 seconds. Daily brushing is best; if this isn't possible, try for at least three times a week. To mimic the natural teeth cleaning action of the feral cat, offer your cat cooked chicken necks once or twice a week. He will crunch up these neck bones safely and scrape his teeth in the process. Cooking softens the bones and makes passage through the gastrointestinal tract safer. Do not feed other chicken bones, which may fragment into dangerous splinters. Do not feed raw chicken, which may cause salmonella food poisoning.

Not all cats will eat chicken necks. The best oral hygiene begins when a cat is still a young kitten. That way he becomes accustomed to having his teeth brushed. Many older cats can and do adapt to routine home dental care. And you can take comfort in the fact that your veterinarian does not ask you to floss your cat's teeth.

How-to Articles in This Series:

Article   1: How to Choose a Vet
Article   2: Hospital Admission of Your Cat
Article   3: Preventive Care: Vaccinations, Serologic Testing, Spaying & Neutering
Article   4: Preventative Care - Dental Care, Flea Control, and Grooming
Article   5: Cooperation - Restraint Procedures and Trimming Claws
Article   6: Keeping Records
Article   7: Care in the Sick Room
Article   8: Keeping Watch - Your Cat's Vital Signs
Article   9: Nutrition for the Cat
Article 10: Feeding the Cat - Including Newborn Kitten Feeding
Article 11: Medications and Prescriptions
Article 12: Basic Nursing 101
Article 13: Managing Bandages and Splints
Article 14: Before and After Surgery and Dentistry
Article 15: Pregnancy and Delivery
Article 16: Euthanasia

Page URL: http://www.sniksnak.com/cathealth/howto12.html

Resource References:
Caring for Your Sick Cat Carol Himsel Daly, DVM and veterinary consultant
Cat Doctor, Mark Evans, B Vet Med MRVCS
Cornell Book of Cats, Cornell Feline Health Center, Cornell University