Atypical Mycobacterial Panniculitis

Hello VETS: atypical mycobacterial panniculitis suspected and treating for such in a 4-6 week old kitten. Tested negative for FIV/Felv. Finishing 2nd week of Baytril & 1st week of doxycycline- which has show much improvement. Looking for more information on quality of life for her- expectations an adopter may have (I foster for New Hope Pet New Hope Pet Rescue). If this infection resolves- will she still struggle with this issue for the rest of her life? Initial culture result was NEGATIVE! Which is insane. Progression from intake (8/18), to present in photos are available. 

Hello!  It sounds as though your vet may be on the way to diagnosing and treating a Mycobacterium infection, although obviously I don't have much information about the diagnosis of the case such as why this was suspected, what tests have been done, which country you are in or the full extent of the signs. There are several different types of Mycobacterial disease, including TB in cattle which most people will have heard of.  I have found a factsheet by veterinary expert Professor Danielle Gunn-Moore, written in 2014, stating that Cutaneous Tuberculosis caused by M Microti or M Bovis typically responds well to treatment in the first instance, even if it has reached the lungs, but that the prognosis should always be stated as guarded because relapses occur in more than 60% of cases.  She also explains that transfer to people would be very unusual (suggesting 6 cases in 150 years), although you would need to take advice from your vet (who will perhaps seek advice from the Professor) about this on your behalf.  I hear your frustration that none of this information tells you what will happen to this little stray;  it seems likely that it cannot be predicted which cats will go on to relapse.  I hope that something here helps.  The following page from the University of Edinburgh is also potentially very useful: https://www.ed.ac.uk/vet/services/small-animals/information-about-cat-tb

Hello!  One of the frustrating things about veterinary medicine is that we cannot state what will happen to any one patient, only talk about it in percentage likelihoods.  It seems likely that your kitten could do very well, but that at some point, after some time of good quality life, just over 60% cases of the cutaneous form will relapse.  I understand that this puts you in a difficult position as to how to decide where you want to go from here.  Professor Gunn-Moore, an expert in this subject, offers advice to vets who contact her about cases and may be a good person to speak to if they have any more technical questions about the disease itself.  You might ,for example, want to ask about spread, which I am not clear about, although it appears that spread to humans may be unusual.  However,  when it comes to the ethical decision at the heart of this, you can only do what feels best for yourself and your cat with the best information that you have at the time.   Wishing you both all the best.