The Revision Guide for Student Nurses (Part I)

Abscesses, Ulcers & Haematomas - Answers

ANSWERS

  1. What is an abscess?
    A localised inflammatory reaction with a necrotic, pus-filled centre.
  2. What are the 2 terms that describe the presence of pus?
    • Purulent.
    • Suppurative.
  3. What does pus consist of?
    Liquefied dead tissue mixed with large numbers of dead or dying polymorphonuclear leukocytes.
  4. List 8 clinical signs or symptoms that may be present in a cat suffering from an abscess caused by a bite.
    • Swelling/inflammation.
    • Bite marks.
    • Hair loss.
    • Odour.
    • Pyrexia.
    • Anorexia.
    • Pain/aggression.
    • Leukocytosis initially followed by a monocytosis after about 4-5 days.
  5. Why do bite wounds commonly lead to abscess formation?
    Due to the large amount of bacteria present in the oral cavity. Cats in particular carry Pastuerella multocida, which can be particularly nasty.
  6. Describe the equipment that you would prepare for the treatment of a "ripe" cat bite abscess (not including any premedicant or anaesthetic equipment).
    • Protective gloves, apron and mask.
    • Clippers.
    • Water-soluble lubricating gel to protect the wound whilst clipping.
    • Skin antiseptic such as chlorhexidine.
    • Cotton wool.
    • Size 15 scalpel blade for lancing.
    • Syringe for flushing.
    • Absorbent material to collect the expressed pus.
    • Swab in charcoal transport medium (if culture and sensitivity is required).
    • Clinical waste sack into which infected material is disposed of.
    • Injectable antibiotic and analgesic with suitable sized needles and syringes.
  7. What is meant by a "cold" abscess?
    An abscess that is characterised by a thick fibrous wall enclosing granulation tissue.
  8. Why might a cold abscess develop?
    A cold abscess may develop as a result of chronic infection due to inadequate drainage or the failure to remove the inciting cause. It may also occur in deep tissue where there is no route for drainage.
  9. Describe how a cold abscess is treated.
    Complete surgical excision.
  10. What species do cold abscesses commonly affect?
    These can occur in all species, but are particularly common in rabbits. Rabbit abscesses develop largely in the head area and are often associated with dental problems.
  11. What is an ulcer?
    Local excavation of the surface of an organ or tissue resulting from the sloughing of necrotic tissue.
  12. Give 4 sites of the body where an ulcer might develop and give a possible cause of each.
    • The cornea of the eye - cat scratch.
    • The oral cavity - feline herpes virus.
    • The stomach - reaction to NSAIDs.
    • The skin - bed sores in long-term hospitalised animals.
  13. What is the correct term used to describe a "bed sore"?
    Decubitus ulcer.
  14. What is a rodent ulcer?
    An erosive lesion most commonly affecting the upper lip in cats. Also known as eosinophilic granuloma.
  15. What is a haematoma?
    A swelling caused by extravasated blood; result of injury to the blood vessels or a clotting disorder.
  16. Briefly describe 3 possible treatments of an aural haematoma?
    • Drainage via needle and syringe followed by injection of a steroid such as Voren into the pinna (this can usually be done consciously).
    • Drainage via an incision made with a scalpel blade under general anaesthetic.
    • Drainage via either of the methods described above followed by the suturing of buttons to the pinna to help prevent recurrence.
  17. What is the name of the type of bandage often used to prevent patient mutilation following treatment of an aural haematoma?
    A figure of 8 head bandage.
  18. What is the most common cause of aural haematomas in dogs?
    A dog may shake its head as a result of an ear infection such as otitis externa. The resultant trauma then can lead to the formation of a haematoma, particularly if the dog hits its head whilst it is shaking.