Pet Bravery Award 2014 - Henry recovers from severe head injury

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01/06/2015
Henry was first see by vet David Garrett. He presented with a very swollen left eye and a bite wound on the top of his head. Henry was not showing these signs the night before except a weepy eye that had started to develop. 

Henry's owner told us, "I was unaware of any injury as it was not noticeable at all. I did see that he appeared quieter than usual that evening and from his perch on top of the tall fridge I made a mental note to bath his eye as it didn't look quite right. He did not like it being touched which with hindsight was understandable. In the morning however, he was just lying in the upstairs hall and seemed very under the weather."

Day 1.

David admitted Henry for treatment, which started with pain relief.  He had developed a Grade IV heart murmur over the previous few months which was a concern as Henry would need a general anaesthetic to address his injuries.   At some point he would also need some dental attention but this was not an immediate priority.   
The full extent of Henry’s head wounds would not be revealed until he was anaesthetised.   It was clear that there was bone involvement which was very painful.   Critically David’s thorough examination of Henry’s injured eye while anaesthetised, would determine the treatment he would need to save Henry’s eye.   His sight in this eye, was at risk from the injuries he had sustained. 

Routine bloods (haematology, biochemistry and electrolyte blood tests) to check for conditions such as kidney or liver disease would be carried out in normal circumstances especially given Henry’s heart condition and age, being 8 years old. But Henry had a blood and urine test only a few months previous when his owner was concerned about a change of character and weight loss, which coincided with the death of his brother Thomas.

"He is a well mannered little chap with not a scrap of aggression - and a total Mummy's boy.  We had Thomas, a young related Selkirk who died at just over a year from a RTA and Thomas was from the same breeder.  When Tom died suddenly, we were genuinely worried at how badly Henry took it as we did not know they were that close.  Henry became quiet and withdrawn and worryingly depressed.  First time I have ever seen that in any of my cats.  Our nearest neighbour told us that she used to see Henry daily coming past her sitting room French Windows with Thomas about 6 feet behind and watching and copying everything Henry did.  This explains why he felt so lost perhaps.  He has never been the same bouncy little fellow since Tom went sadly.  He lost weight and took to sitting by where we had buried Tom -  which spooked me a tad.  Totally stopped venturing out of the farm area too and has since only gone wherever I go.  The one time he did venture forth of course was when he almost lost his eye."

After Henry was anaethetised, Henry’s chest x-ray showed a mild enlargement of his heart but his lungs appeared normal.   Concerned about the development of congested heart failure, David asked the owner to return Henry to him in 6 weeks to have his heart re-examined as well as the other checks that would be needed post treatment.

David's priority then turned to Henry's head and eye injury.   Henry's eye was damaged and he had developed a haemorrhagic conjunctivitis.   David suspected this damaged to be caused by a cat claw or serious bruising to the eye ball itself.  Treatment for this would require minimal intervention.   To promote healing, his eye was carefully flushed and the first dose of eye ointment administered.   Over the next few days regular examination would be needed to ensure his eye was starting to respond to the medication and show signs of healing.

David then located a deep puncture wound to the left side of his skull, this included tissue and bone damage to the extent where small fragments of bone had to be removed from his nasal sinuses.   There were multiple other bites and scratches confirming a cat fight and further blunt trauma to the left side of his face.   Luckily his jaw bones were unaffected.   These wounds were flushed, debrided and drained under sterile conditions.  A temporary drain was placed to help drain any fluid build up from the wounds, which would otherwise prevent the wounds healing and lead to an infection.   

Henry was very stable during his anaesthetic so it was decided to carry out his required dental work rather than give him another anaesthetic at a later period.  Bacteria is released into the air during dental procedures such as this so his existing wounds, drain and eye were covered for protection.  He had two teeth removed and his remaining teeth descaled and polished.

He recovered well from his anaesthetic.   Once fully awake he was offered a little chicken and rice which he ate.   Henry was regularly assessed for signs of pain and his pain relief medication was tailored to suit this.   His eye medication and prescribed antibiotics were continued.   To protect Henry’s eye and the drain which had been placed in the skin next to his head wounds, the ward nurse secured a buster collar to prevent patient interference.  Henry was hospitalised and stayed in our cat ward overnight.     

Day 2 & 3.
When David examined him the following day, though comfortable, Henry's left eye had swollen further.   He stayed in the ward for another night but when examined the next day he was visibly more comfortable.   The left side of his face remained swollen but this was expected given the degree of his injuries.   He had been eating well and was ready for discharge and was sent home with pain relief, the rest of his antibiotic course and his eye medication. His owner was given extensive advice on caring for Henry while he had his drain in place.   

Day 4.
Henry’s drain was removed.  Discharge was present from the left nostril but this was likely to be caused by the sinus damage.  His eye showed signs of improvement.  But re-examinations would still be necessary.

Day 8.
Henry returned once again for David to examine him.   He showed signs of excellent healing and the swelling had reduced remarkably over the left side of his face.  The swelling in his eye continued to reduce.   He was doing well at home with a healthy appetite.   

Day 12.
Henry had recovered from his traumatic injury.   He had a slightly increased tear production in his left eye and still showed swelling around his eye, but this was mild.   His stitches were removed with instructions to return Henry to him if the owner was concerned in anyway.  David commented,
 ‘Henry recovered remarkably well from his injuries and did not lose his sight, which concerned me when I first examined him.   Continuity of care is important in cases such as these and being able to personally examine Henry in the subsequent days after my procedure allowed small changes to be noted easily,  not to mention the increased bond between patient and vet!’

 

Henry’s owner was delighted with his recovery.   "Henry comes on long country walks with me across the fields along with 5 others in the household.  They all answer to the whistle and appear as soon as they hear it.  When I sit down to read he and the others just lie down around me and wait for the signal to move again.   Our new home here near Rye is surrounded by open fields and woods and again I just have to open a garden gate to walk into safe wide spaces where the 'hiker' cats can explore rabbit burrows and whatever things busy cats have to do.  Henry has had 3 changes of home in his life and probably another early next year as we are not wildly keen on living so far from everything down here!"

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