Animal Bite

Symptoms

DEFINITION

• Bite or claw wound from a pet, farm or wild animal

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General Information

• Animal bites usually need to be seen by a physician because all bites are contaminated with saliva and are prone to wound infection.
• If any redness develops around the wound 1-4 days after an animal bite, this usually means that the bite has become infected.
• Bites on the hands are at increased risk of complications.

Types of Wounds

• Bruising: There is no break in the skin. No risk of infection.
• Abrasion or Scratch: Low risk of infection. Antibiotic therapy to prevent infection is not needed.
• Laceration: Intermediate risk of infection. Wound cleansing and irrigation can help prevent infection by washing out the bacteria from the wound. Sometimes debridement of the wound edges is needed. Antibiotic therapy to prevent infection may be needed.
• Puncture Wound: Intermediate risk of infection. Puncture wounds from cat bites are especially prone to getting infected; many physicians will prescribe antibiotics for cat bites to try to prevent infection.

Types of Animal Bites

• Bites from Rabies-Prone Wild Animals: Rabies is a fatal disease.  Bites or scratches from a bat, skunk, raccoon, fox, coyote, or other carnivores are especially dangerous. These animals can transmit rabies even if they have no symptoms. Bats have transmitted rabies without a detectable bite mark (MMWR Recomm Rep. 2008 May 23;57(RR-3):1-28.).
• Small Wild Animal Bites: Rabits and small rodents (such as squirrels, mice, rats,  and chipmunks) rarely become infected with rabies and have not been known to transmit it to humans. These bites can sometimes get infected.
• Large Pet Animal Bites: Most bites from pets are from dogs or cats. Bites from domestic animals such as horses can be handled using these guidelines. The main risk from pet bites is serious wound infection. Cat bites become infected more often than dog bites. Claw wounds from cats are treated the same as bite wounds, since the claws may be contaminated with saliva. Bites from pet pigs or primates also have a high rate of wound infection. Bites on the hands or feet have a higher risk of infection than bites to other parts of the body.
• Small Indoor Pet Animal Bites: Small indoor pets (gerbils, hamsters, guinea pigs, white mice, rats, etc.) are at no risk for rabies. Puncture wounds from these small animals also don't need to be seen. There is only a small risk for developing a wound infection. (Reason: the wound infection rate is low because the bites often don't penetrate the dermis)

Wild Animals at risk for RABIES

• Bat, skunk, raccoon, fox, coyote
• Any other large wild animal

Pet animals at higher risk for RABIES

• Outdoor pets who are stray, sick or unvaccinated AND living in communities where rabies occurs in pets. You should check with your local Public Health Department about the risk for rabies in your community.
• Dogs and cats in developing countries.
• Unprovoked bite.

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FIRST AID Advice for Bleeding: Apply direct pressure to the entire wound with a clean cloth.

FIRST AID Advice for all Bites and Scratches: Wash all bite wounds and scratches with soap and warm water.

Should I Call?

WHEN TO CALL YOUR DOCTOR

Call 911 Now (you may need an ambulance) If

• Major bleeding that can't be stopped (see First Aid)

Call Your Doctor Now (night or day) If

• You think you have a serious injury
• Bleeding doesn't stop after 10 minutes of direct pressure (continue pressure until seen by a physician)
• Any break in skin (e.g., cut, puncture or scratch) caused by a wild animal
• Any break in skin (e.g., cut, puncture or scratch) caused by a monkey
• Any break in skin (e.g., cut, puncture or scratch) caused by an animal that may carry rabies
• Any  break in skin (e.g., cut, puncture or scratch) caused by pet animal (e.g., dog, cat) a wild animal
  EXCEPTION: superficial scratches that don't go through the skin or tiny puncture wound
• Puncture wound (holes through skin) caused by a cat (teeth or claws)
• NOTE: For all new bites, see First Aid
• Bite looks infected (redness, swelling, warmth, tender to touch, or red streaks)

Call Your Doctor Within 24 Hours (between 9 am and 4 pm) If

• You think you need to be seen
• Your last tetanus shot was more than 10 years ago
• Suspicious bat exposure (e.g., bat found in same room as sleeping adult) and no bite mark

Self Care at Home If

• Tiny puncture wound or superficial scratches (EXCEPTION: cat puncture wound)
• Bite that didn't break the skin (e.g., just a bruise)

Care at Home

HOME CARE ADVICE FOR MINOR ANIMAL BITE

Minor Cuts and Scratches and Puncture Wounds

1. Bleeding: For any bleeding, apply continuous pressure for 10 minutes.
2. Cleansing: Wash all wounds immediately with soap and water for 5 minutes. Scrub the wound enough to make it re-bleed a little. Also, flush vigorously under a faucet for a few minutes (Reason: can prevent many wound infections).
3. Antibiotic Ointment: Apply an antibiotic ointment (e.g., Neosporin, Bacitracin) to the bite 3 times a day for three days.
4. Cleansing: Wash all wounds immediately with soap and water for 5 minutes. Scrub the wound enough to make it re-bleed a little. Also, flush vigorously under a faucet for a few minutes (Reason: can prevent many wound infections).
5. Call Your Doctor If:
   • Wound begins to look infected (redness, swelling, warmth, tender to touch, or red streaks)
   • You become worse

Minor Bruises

1. Treating Bruises

   • Cold Pack for First 48 Hours: For bruises or swelling, apply a cold pack or an ice bag (wrapped in a moist towel) to the area for 20 minutes. Repeat in 1 hour, then as needed for the first 48 hours after the injury (Reason: to reduce the bruising, swelling, and pain).

   • Local Heat After 48 Hours: After 48 hours apply a warm moist washcloth or heating pad for 10 minutes three times a day to help absorb the blood.

2. Pain Medication:

   • For pain relief, take acetaminophen or ibuprofen.

   • Acetaminophen (e.g., Tylenol): The dose is 650 mg by mouth every 4 hours or 1000 mg by mouth every 6 hours. Maximum dose per day = 4000 mg.

   • Ibuprofen (e.g., Motrin, Advil): The dose is 400 mg by mouth every 6 hours or 600 mg by mouth every 8 hours.

   • People who are over 65 Years of age: Acetaminophen is generally considered safer than ibuprofen. Acetaminophen dosing interval should be increased to every 8 hours because of reduced liver metabolism. Maximum dose per day = 3000 mg.

   • CAUTION: Do not take ibuprofen if you have stomach problems, kidney disease, are pregnant, or have been told by your doctor to avoid this type of anti-inflammatory drug. Do not take ibuprofen for more than 7 days without consulting your doctor.

   • CAUTION: Do not take acetaminophen if you have liver disease.

   • Read the package instructions thoroughly on all medications that you take. 

3. Expected Course: Bruises should fade away over 7-14 days

And remember, contact your doctor if you develop any of the "Call Your Doctor" symptoms.

Photo Example

Laceration - Arm (Dog Bite)

This laceration near the right elbow was caused by a dog bite. The laceration is gaping open.

This laceration needs medical evaluation and copious wound irrigation. Sutures may or may not be used, depending on the judgment of the treating physician. A clean wound like this from a knife would be sutured closed. But an animal bite carries a higher risk of infection and this will need to be considered by both physician and patient.

First Aid Care Advice:

• Apply direct pressure for 10 minutes to stop any bleeding.
• Wash the wound with soap and water
• Cover the wound with a sterile gauze or a clean cloth until seen.

Scratches from a Cat

The photo shows 3-4 parallel scratches on the wrist caused by a cat.

First Aid Care Advice:

• Wash the scratches with soap and water.
• Apply an antibiotic ointment twice daily.
• Watch closely for signs of infection, especially the first 1-3 days.