Cat Scratch Disease will ruin your day

(0/10 do not recommend)

Content warning: photos containing blood and wounds from a cat. No gore.

I've been scratched and bitten by cats a lot. Maybe you have too.

But did you know, like my girlfriend did, that cat scratches and bites are actually really dangerous?

Did you know, like my girlfriend does, that you should probably go to Emerg right away if you have a bad scratch or bite?

This is a story of how I didn't die because I listened to my girlfriend.

The sound of a cat absolutely losing his shit has become a little too commonplace over the past weeks. Unfortunately, it is our cat, Bozo. (Don't come at me for his name; I didn't choose it but I also cannot deny that it is apt.) Bozo is an eight year old grey domestic short hair cat – male, indoor (with escape tendencies), fixed. This information may not be relevant to you, but it was relevant to the district health unit, so I thought I'd include it for posterity.

Every other night since it started getting warm out, a random ghostly pale orange cat has come by the window to visit Bozo. Bozo isn't a fan of visitors (it's genetic), so he encourages the cat to mosey on, but no moseying occurs. Bozo isn't great at de-escalation, so within moments there's a screaming shit-fight in the window about two feet from my head. The window is open approximately one centimetre less than the widest part of a cat skull. Through the screen, they scream and hiss and lunge at each other, and I have to close the window.

I pick up our cat with one arm, and with the other, I close the window. I always make sure all his toes and tails are out of the way before I do this, because he is pretty desperate to get that fucking outdoor cat. But this time, Bozo bites me. And bites me good. And scratches me, but not as good.

It's not even light out yet.

The window is now closed. Bozo has run out of the room, and I'm definitely bleeding. I clamp a hand over the wound and think about how I can get back into bed without too much of a mess.

There is a mess. Kai is following me around with cleaning supplies cleaning up my blood, and I swear I'm having deja vu. Is this our life?

It's Thursday, so we go to the Farmer's Market: my mom, Kai, and me. Kai has put bandaids all over my punctures, so I figure I'm good. Her unsubtle suggestions that we visit Emerg are escalating. I'm bleeding through my shirt and it's not a good look, nor is it appropriate to expose people to an open wound (nor to expose an open wound to people).

This is fine…

I don't really believe Kai that cat bites are That Bad, so I look it up, and she is her favourite thing: correct.

So I have to do her least favourite thing, which is go to Emerg based on the experiences and knowledge of people on the internet and not because she told me to.

Listen, I love Emerg. I'm Canadian, it's free, I get to see my favourite nurses, it's a great place to people watch and catch up on a book. And there are two different types of Emerg visits:

1. Is it “this?” Y/N

2. What is it?

Number one is obviously my favourite. A couple months ago, I sat in the car for too many hours and pulled something (yeah, you can pull things by not moving as well as by moving). But the pain also really felt like what my Cancer Associated Thrombosis felt like, which was one of the first warning signs of my cancer. So I couldn't relax, I had other symptoms, and I needed to rule out a blood clot.

There's a blood test for that called D-Dimer. It will tell you, conclusively, whether you have blood clotting. I brought the book Our Wives Under The Sea by Julia Armfield. The doctor did the blood test and when it came back negative, I could tell he was gearing up to do more testing, but I slung my bag over my shoulder and said TYVM and left, because he had ruled out the problem I cared about, so whatever was wrong with me wasn't my problem. Or something like that. I was in and out in two hours.

Number two is the worst type of Emerg visit, and I've had a lot of these. Where you have a lot of pain but you aren't sure why. Luckily, I've had cancer, so I get treated less like a drug-seeker than I used to before I had a life-threatening illness. But it is still a huge ordeal to submit to the questioning and testing that goes along with 'it hurts and I don't know why', and I do prefer to wait for an appointment with my Nurse Practitioner while I die rather than go to Emerg.

Thankfully, this was a Number One type visit, and you can feel the relief from staff all the way from triage to doctor.

The triage nurse says, “We can get to the bigger story in a moment, but can you tell me in one sentence what brings you to Emerg today?”

“My cat bit me.” I pause. “There's no bigger story, that's the whole thing.”

I peel back my wet shirt and show her. Blood is pulsing out of the puncture marks, six hours later. I tell her I take baby aspirin daily because of Lynch Syndrome (according to studies, aspirin can reduce the amount of colon polyps that can lead to cancer in Lynch patients). Which explains the bleeding. I do something else Kai can't stand – I try to accurately describe the pain. What I've never understood is why they ask you to rate your pain without asking your reference point. They say, on a scale from one to ten, one being no pain and ten being the worst pain you've ever experienced. But they don't ask what that worst pain was. If I say my wound is a 4 and the worst pain I've ever experienced is an ingrown hair, that's very different than if my worst pain were a degloving.

Anyway, I say a one, because my pain tolerance is high and I've had a lot of it.

If you know anything about Emerg, you know where I've just placed myself in the triage line.

Cat scratch disease is a bacterial infection caused by the bacteria Bartonella henselae. It can, to be succinct, fuck your shit up.

I get an x-ray to make sure there aren't bits of teeth in the bite because it is super deep. I mean, this cat unhinged his staple-remover teeth and chomped, and then PULLED. No teeth left behind in my flesh, thankfully. I'm given a prescription for antibiotics, told what to look out for, have the doctor's terrible bandages changed by an excellent nurse who gave me supplies to change my dressings and sent me home.

Every single person, without fail, from friends to pharmacist, told me a horror story about someone they know who left a cat wound too long and spend weeks in hospital, lost bone to infection, got sepsis. It is a very serious wound! I did not know this!

Little did I know what was to befall me. Here is an excerpt from my journal entry that very night.

“When I got home, though, I was FUCKED UP. First I was freezing, so I lay in bed with a hot water bottle, watching VEEP. I ate leftover pizza but very soon I started to feel very ill like I was going to throw up. Then I was on FIRE and everything hurt, everywhere felt bruised and I would get these goosebumps and they were just agony. Fever of 38.8 degrees. I took tyenol and ibuprofen, benadryl, gravol, cyclobenzaprine, robax, a little bit of anything that would help. Didn't feel like much did. So I just rolled around and cried, cried on the dog, cried by myself.”

Listen, I was miserable. It hurt so much. My arm was on fire, radiating heat. Nothing could touch it. There was immediate bruising, and then a dark red outline about seven inches in diameter and growing. It grew two more inches over the next couple days, and spread almost entirely downward, so I guess gravity? I knocked myself unconscious with sleeping pills that first two nights and rode out the worst of it.

No cat visits in the night, but we did discover that in the melee Bozo lost a toenail, and we saw the screen was all messed up, so we think he got his toe stuck just before I grabbed him (or maybe me grabbing him when he was stuck caused him to lose the nail) and that made him bite me. I feel so bad for the guy because he is obviously just trying to protect the house and I know he didn't mean to hurt me. But the next day, I wanted him to sit with me, so Kai picked him up and handed him to me, but handed him to my right arm, and I started crying because it triggered the event and I got scared. We've been better since it happened, but this was an Event.

I felt like shit for a couple days but the fever was only about 24 hours of it, that and the chills went away with the antibiotics. I have one more day of them. The arm is healing well, the puncture marks are tiny but there is a solid mass inside my arm from the inner trauma to the muscle.

So, in case you are like me and thought cat scratch fever was kind of a joke, don't downplay it – it's really serious and can cause permanent harm and permanent death!

It's made me wonder how many people in the US don't go to the ER because of the cost and because they downplay it (surely I am not the only one), only to end up in a way worse situation as the infection takes hold. I also wondered about a pre-antibiotic world and also a world of antibiotic resistance, where people just die of this. That said, for the drama and the wtf-factor, I would prefer to die that way because I think me dying of cancer would just be predictable and heavy-handed. Gotta think of the plot.

Moral of story: listen to your fucking girlfriend.