Fighting Wound

*URGENT* (TW // Graphic) Dear Vets, I am reaching out for advice regarding a 3-4 year old cat back home. It was a stray and the cats can be pretty aggressive so he got bit by either a cat or a dog. He got bit in May but my aunt decided to take him in and get him treated in December. Nobody was able to catch him so he has been outdoors with the open wounded which caused it to get infected. He has been tested FIV positive so the wound has not been healing and has only been getting worse. As of now, the vet recommended an immune support, fucidin or fucicort, antibiotic ciprofloxacin and manuka honey directly on the wound. I would really appreciate hearing your recommendations and opinions whether there are any other effective treatments or what should be done. Thank you

Hello!   - And what a horrible wound.  I don't envy your vet the challenge you describe.  First, all bite wounds are badly infected from the off.  Imagine spikes covered in bacteria and plunge them into tissue, applying a level of pressure that also crushes the tissues.  Such is a bite wound (the spikes being teeth).  Most healthy animals would not have the immune system to deal with that level of infection while also mending the wound.  This one sounds as though it has been festering for a while.  The owner of the leg has spent their time outside (as opposed to resting) and further, turns out to have a virus that affects the efficiency of the immune system.    I suspect that this may take a very long time to heal if indeed healing were actually going to be possible (ask your vet about the prognosis).  You are not painting a picture of a cat that likes to be housed indoors while this healing happens.   I therefore wonder about the possibilities of removing the leg - although perhaps the patient would still need to be housed or hospitalized in order to give the surgical wound chance to heal.  Has neoplasia (cancer) been ruled out at this time?  It occurs to me that whatever the diagnosis, if you and your vet feel that there is no chance of taking care of even that surgical wound, then you may be considering euthanasia.   Indeed, there is no obvious 'right' or 'easy' answer here and the solution may be to look at the various possibilities (amputation vs try to repair vs euthanasia vs anything else your vet, who has after all examined the cat, has thought of), and asking any questions of your vet that you need to (don't forget to ask for reasonable predictions of overall cost).  What outcome would your vet predict in each scenario?  What would the likely quality of life be like, for how long, in each case?  This may not be a case of picking the best course of action, but selecting the one that is least unappealing.  A specialist or other colleague may offer a second opinion if required.  Wishing the three of you - cat, vet and yourself - all the best.

So to be more clear about this, you questions to your vet could be:    a) what do you think will happen from here if the current treatment is continued?   b) what other options are available?  c) which would you choose in this situation?   d) would a referral vet offer anything any different?     I think that this would be a good conversation to start with.

There is no clear-cut "right" or "easy" answer in this situation. Instead, you should consider your options (amputation vs. repair vs. euthanasia vs. anything else your vet, who has examined the cat after all, has considered), and ask your vet any questions you may have (don't forget to ask for reasonable predictions of overall cost). In each case, what result would your veterinarian anticipate?