Monday, June 6, 2011

Well, ain't that a kick (bite) in the head...?

This afternoon, I was presented with a fiesty little ball of fur. "Macy" is a 3 month old kitten. She was outside with her owners this afternoon on the back deck. She disappeared for about 20 minutes, and the owners had no idea where she'd gone. When she came back, her right eye was swollen shut, she had massive swelling around the eye, and there was blood dripping from it. Macy was crouched, painful, and meowing loudly. They rushed her to us.

When she initially presented, I suspected some sort of blunt trauma - hit by a car, picked up by a dog, dropped from a decent height, or the like. Still, the eye looked suspicious - unusual.

Macy was a handful, and it took some sedation before we could clip around her eye. What I found surprised me. She appeared to have puncture wounds over her eye. As in - snakebite fang puncture wounds. I wasn't convinced. Cats are usually smarter than that and won't play with snakes. We see snakebites in dogs ALL the time, but in cats, it's a rarity.

We drew blood for a sample and examined it under the microscope. Sure enough, almost of her red blood cells were irregular and spiky. This is called echinocytosis and is a result of the snake's venom on the cells. They change shape from smooth and oval to round and "spiky." It's a classic sign of envenomation. Still, I was NOT convinced. A cat snakebite to the EYE? And the cat wasn't dead? It seemed unlikely.

So, we made an official blood smear to count kitty's platelets. Snake venom can and often does cause a profound thrombocytopenia (decreased platelet count). Macy had 14,000 platelets to her name. She should have had 200,000-500,000. The evidence was mounting. It was clinched when within 1 hour of presentation, Macy's face had swollen to 3 times the size it was when she came in. There was moderate bruising and necrosis of the skin around the eye.

I spoke with the owner, giving her a very guarded prognosis for Macy's recovery. Such a small animal with such a serious could not end happily. Kittens are not meant to withstand snake venom! That's the whole point.

Macy however seemed determined to prove me wrong. When I left this evening, she was rolling around her cage, trying to play with her IV line, purring, and eating her face off. That was one happy kitten on narcotics! I'm hoping she continues to do so well. Keep your fingers crossed for 2.5 pound Macy kitten.


Karen Whiddon said...

Will keep fingers crossed. Please keep us posted on the kitten's progress!

Fledgling said...

Delurking to say thanks for all the useful info you write about. That fact about the echinocytosis is so useful to know. I wish my toxicology professors had taught us that--they weren't the most qualified. But we took the final today, so at least I don't have to think about it for awhile, lol.

The Homeless Parrot said...

Kitten is doing well and went home.

Fledgling: I think we learned about it in ClinPath, but I had forgotten by the time I graduated. The best way to examine is to do a fresh prep - 1 drop blood, 1 drop saline, cover slip, examine immediately. It's very profound. Of course, the absence of echinocytes does not rule out a snakebite - not all cats/dogs develop it.