Animal Bites – Help, the neighbor’s dog bit me!

shutterstock_54807220Quite a few patients come to the urgent care and see me for an animal bite.  Usually it’s a dog or cat bite, but sometimes I’ve seen patients who’ve been bit by a squirrel or raccoon and then there’s the rare person who is worried that a bat might have bit them.  In the US, two to five million people get bit each year and children are bitten much more often than adults.

Most people worry about the possibility of rabies, although an infection in the skin is much more common.  Bites on the hands can be serious because the skin surface is close to underlying bones and joints.

Dog bites:  Most dog bites are to boys between the ages of 5-9 years old, and the most common areas to be bit are on the head and neck for the younger children.  The right hand is the most frequent site of injury for older children and adults.  The complications of the bite range in severity from tearing away a body part to deep open cuts, crush injuries, to minor scratches.   In Washington State, we have not had a rabies case from a dog bite in many years and do not routinely give rabies treatments for individuals bitten by a dog unless it is known to have rabies infection.

Cat bites:  Claws or teeth can cause wounds from cats.  67% of cat bites are on the arms or hands and scratches are most often on the face.  Puncture wounds that are deep from a cat bite is concerning because bacteria from the cat’s mouth can go deep into the wound and cause infection to the underlying bones or joints.  Infections from cat bites generally cause increased redness to the skin, swelling and pain as early as 12-24 hours after the bite and progress quickly.

Rodent bites:  Rats are the most common rodents that cause bites, but squirrels, hamsters, rabbits and guinea pigs are generally all treated the same way as cat bites.

Other bites:  Bites from raccoons, skunks, fox, coyote or bats should be evaluated right away even if the bite is small and does not look like it’s infected.  These animals can carry rabies and medications are generally given to prevent rabies infection in individuals who are bit by these types of animals.

Treatment:  The first step is to clean the wound with soap and lots of water.  In the event of bleeding, gauze pads can be applied and pressure used to stop the bleeding once the wounds have been washed.

When to seek medical care:

1)   The bleeding has not stopped after applying pressure for 15 minutes

2)   There is a broken bone or serious injury such as large or deep laceration

3)   The bite victim has medical problems such as diabetes, cancer, HIV or takes medication that weaken the immune system

4)   The animal is from one of the animals listed above which have a high risk of rabies

Antibiotics:  Skin infections are the most common complication of an animal bite.  High-risk wounds such as on the face, or involving the bone or a joint are usually treated with an antibiotic.  Many experts also recommend antibiotics to treat people bitten by cats because of the high risk of infection from cat bites.  Most of the time oral antibiotics such as Augmentin are given to treat animal bites however in severe bites with infections that are already present, we will use IV antibiotics.

Tetanus immunization:  Tetanus is a serious, and potentially life threatening infection that can be transmitted by animal or human bite.  If the last vaccine was greater than 5 years ago, the patient should receive a tetanus vaccine.

Sutures (aka stiches):  Wounds on the face are usually closed to avoid developing a scar however due to the risk of infection, some bites may not be sutured immediately.  They may be flushed with a sterile solution and left open for 72 hours after injury and watched closely for signs of infection.

Infected bite wound:  If bite wounds are not treated appropriately right after the injury, an infection may develop.  Surgical treatment and antibiotics may be required at that point.

For more information on animal associated hazards, a useful resource is the centers for disease control article: http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/animal-associated-hazards.htm

This document is for informational purposes only, and should not be considered medical advice for any individual patient.  If you have questions please contact your medical provider.

 

I hope that you have found this information useful.  Wishing you the best of health,

Scott Rennie, DO

Blog: https://doctorrennie.wordpress.com

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