By Erik Smith, MD – physician at Sheridan Memorial Hospital’s Emergency Department
For whatever reason, there has been a surge in patients seeking care for dog and cat bite injuries in the emergency department over recent weeks. Maybe it is the weather. Maybe it is the solar eclipse. Perhaps there is an organized movement to expand the doggie swimming days at Kendrick Park. Regardless, many of these kind creatures are coming after the hands that feed them and inspiring this review of prevention and treatment for animal bites.
Not-so-nice doggie
Domestic animal bites can range from mild to severe, and can even be fatal. Here are a few alarming statistics:
- 5 million dog bites are reported yearly in the U.S. (J Injury Epidemiology)
- 43 U.S. deaths per year are attributed to dog attacks (CDC)
- There are over 17,000 dog bite insurance claims yearly (Insurance Information Institute)
- The average insurance claim for a dog bite is $64,000 (Forbes)
Dogs and cats tend to bite when they feel threatened, however playful bites and herding instincts can also play a role. Dog bites are reported more than cat bites, but cat bites have a much higher rate of infection. The closest body part to the threatened animal will be their target. For adults, arms and legs will most often receive the bite. For children and toddlers, unfortunately, this tends to be the face. Bites to the lower face can result in major soft tissue injury, requiring extensive repair efforts.
Prevention
If you are a pet owner, it is important to control what you are able to before a bite occurs. This includes keeping rabies vaccinations up-to-date, securing fencing and socializing your animals. If you are a parent or grandparent, teach your children to ask for permission when petting animals, avoid animals that are feeding, and to never take toys from them. Do not leave children, especially toddlers, unattended around animals. If chased or bitten by an aggressive dog, yell directly at them and make threatening motions to challenge them to retreat. A short stick or pole can be very effective in preventing a bite by an aggressive dog.
Breaking up dog fights is a very common cause of bites. This often results in multiple bites to several locations. It is difficult to watch fights without intervening, however, keeping hands out of the scrum can help prevent significant injury. A gloved hand or stick could offer valuable protection.
What to do if bitten
If bitten by another individual’s animal, attempt to verify rabies vaccination status. This will be helpful to medical staff in determining risk for the deadly disease. If this is a stray or runaway animal, involve animal control.
If bleeding occurs, hold pressure to the wound. Early rinsing with tap water and gentle soap is a very important step to avoiding infection.
Do I need to go to a clinic or Emergency Department?
Evaluation by medical staff is advised if there is anything beyond minimal penetration of the skin or any concern for rabies exposure.
Treatment typically involves five items:
- Infection prevention. The wound will be cleaned, irrigated and dressed. Antibiotics are often prescribed to prevent bacterial infection.
- Injury repair. The wound will be assessed for depth and severity. Many wounds benefit from some type of closure (surgical tape, sutures, etc). Fractures typically require immobilization. Very deep or complex wounds may require surgery or more aggressive antibiotic treatment.
- Rabies prevention. Rabies is a rare disease that is universally fatal (99%). If there is uncertainty regarding the biting animal’s vaccination status (and certainly if the animal has rabies), a human vaccination series is given. Fortunately, this is very effective at preventing any progression to rabies disease if given early after exposure.
- Tetanus prevention. Any open wound can be a source of Clostridium tetani infection, leading to tetanus disease. Booster shots for tetanus prevention are given every 10 years, however for wounds (such as animal bites), a booster is given if the most recent vaccination period is greater than 5 years.
- Assistance with documenting/reporting. Animal bites often require involvement of outside agencies for which clinical staff can assist. This includes formal documentation of the event and injury, animal control reporting for at-large animals or ongoing safety concerns, workers’ compensation documentation and state rabies testing assistance.
Hopefully the animals you share your house and neighborhood with are loving creatures that would never think of inflicting harm on anything but mice and dog toys. Chances are, however, at some point we all will end up too close to the business end of a scared or aggressive animal.
Learn more about our Emergency Department and services by following the link: https://www.sheridanhospital.org/medical-services/emergency/