Let's see if I can gross you out

[If you have a sensitive stomach,

you might want to skip today's post.]

A client brought in a new-found kitten today with a sore on its neck. I was excited before I even saw the patient, because a sore on the neck of a kitten in summer usually means one of my favorite summer time conditions: Cuterebra!

But, I am getting ahead of myself. Let's go back to the beginning and that moist, icky sore on the neck of an 8 week old kitten.

Is it an abscess? A bite wound? No, it's not.

Look closely at the hole. See the little white thing sticking out, with a dark ring in the center?Here, I'll point it out to you.

A close-up (Forgive the fuzzy focus - I was using the little point and shoot belonging to the office, not my Canon Rebel.)

What could it be?

It is a spiracle, the breathing apparatus of a warble, the larval form of the Cuterebra fly, which is a member of the botfly family. Similar botflies include the ox warble that causes "grubby back" in cattle, the stomach bot in horses, and the nasal bot of sheep.

Cuterebra primarily infest rabbits, although cats, and occasionally dogs, may be victims. The female fly lays its eggs on plants along paths frequented by rabbits. When the rabbit passes by, the eggs hatch instantly and the larvae crawl onto the host's fur. They enter the body through natural openings, (nose, mouth, anus, etc.) and migrate under the skin. They usually end up in the neck area, although I have found them on other body parts.

The larva cuts a breathing port through the host's skin and attaches its spiracles. These respiratory openings, it should be noted, are at the butt end of the grub, not the head end like you might expect. Not pertinent to treatment, just a fun factoid I like to share.

The developing organism sets up a strong inflammatory reaction in the rabbit or cat, leading to moist, painful wounds like we see here. A warble wound may resemble a standard cat bite abscess but for one thing: if you observe the opening carefully, you can see the movement of the larva at the breathing port.

That's where I come in. Rather than allowing the warble to finish its life cycle, enlarge its breathing port and drop to the ground to complete its metamorphosis to an adult fly, I swoop in to remove the little bugger. Just a small nick to enlarge the hole, and I can grasp the butt of the warble and slowly, carefully extract it.

(Please excuse the Band-Aid. A slip with a dental elevator earlier in the day gouged my thumb.)

TA-DAH! Victory!

Here's an even better shot, complete with a centimeter ruler for scale.

Astute readers will note that the warble itself sustained an injury during the extraction process. This is the first warble I have ruptured during removal, and luckily, it happened after that part of the larva was out of the kitten's body. If a warble is ruptured under the skin, it could set up an anaphylactoid reaction that might prove fatal. For that reason, warbles should not be casually squeezed out of the hole, but removed delicately.

After the minor surgery, we cleaned up the kitty's neck and gave her an antibiotic injection. The wound is not sutured, but allowed to close on its own. Once healed, in 7 to 10 days, she'll be as good as new.

Update, Aug. 2:

Three days after warble removal, look how much better the wound looks.Even the kitty is happy about the outcome.