I have seen some nasty infections from dog and cat bites in my years of practice. In 2001, more than 350,000 people were treated in US hospital emergency departments for non-fatal dog-bite-related injuries. It is important to know how to handle a dog or cat bite and when to seek help.
In the U.S. dog and cat bites comprise roughly 1% of emergency room visits annually with similar numbers reported in Europe. Dog bites cost over $1 billion per year in the USA. Roughly 60% of animal bites are related to dogs, with 10–20% attributed to cats. Cat bites are more common in women and the elderly while most dog bites occur in people less than 20 years old.
Risk of a dog bite is highest in young boys aged 5–9 years likely because children might be more likely to provoke a bite by simple play, teasing, or abuse. Due to a child’s height they often have bites to the face, neck, or head.
Cat bites are most likely to involve the hands and face, but are less destructive and life threatening. However, cats' narrow sharp teeth cause deeper puncture wounds than dogs, and tend to carry a higher risk of infection and abscess. It is important to know that patients who show up at the doctor or emergency room more than 8 hours after a bite injury often have infected wounds, with cat bites progressing to infection more rapidly than dog bites.
Most bite infections from dogs and cats contain a mix of bacteria from both the skin of the patient and the mouth of the animal. Dog and cat bites are taken seriously because severe infections related to dog and cat bites can occur in about 20% of all cases. Bacteria can enter the bloodstream, and in bites to the hands more serious joint and tissue infections can occur.
By contrast with other sites, 30–40% of hand bites become infected. Again, cat bites are more likely to penetrate deeply leaving only a small skin opening from which fluids can drain. Therefore deeper abscesses and infections in the bone (osteomyelitis) are more common with cat bites.
Treatment of the immediate injury is the best place to start. Deep wounds are at greater risk for abscess formation so I suggest you seek out medical help for prompt and generous irrigation with tap water or normal saline. While this may sound gross, careful probing for embedded teeth or fragments and cutting away dead tissues is crucial.
In the case of bites to the hand, orthopedic specialist involvement may be necessary along with elevation, immobilization, and hand physical therapy. A plastic surgeon should be called in for most head and neck bites. Interestingly, because of great blood supply, face wounds can be associated with a lower risk of infection but are of more concern for cosmetic reasons.
Here is a summary of the management and treatment of dog and cat bites, and your doctor’s office or emergency room will help guide you through it:
• Normal saline irrigation with high pressure jet from syringe
• Cut away any dead tissue and remove any foreign bodies
• X-ray if there may be a fracture
• Unless the bite is on the face, closure with sutures is not usually indicated
• Antibiotics are usually advised unless the bite is very superficial and easily cleaned (Augmentin is a good first line antibiotic and add Clindamycin or Bactrim if MRSA is a concern).
• Tetanus booster if you are not up to date
Let us know your experience.
There are two means of refuge from the misery of life - music and cats.
- Albert Schweitzer