What is Animal Bites?
About one percent of all visits to the emergency room each year in the United States result from animal bites. These injuries can range from minor surface wounds to serious, life-threatening wounds that can alter one’s appearance. Even seemingly small wounds can become infected, so it’s important to have all bite wounds checked out for possible complications. In this context, we will primarily focus on bites from dogs and cats, as they make up the majority of bite wounds treated in the emergency room. In fact, when combined with human bites, these account for over 95% of all bite injuries seen in emergency settings.
What Causes Animal Bites?
In the United States, pet cats and dogs are responsible for almost all of the bites that land people in the emergency room. The most usual issue after a bite is an infection in the wound. Bites from any kind of animal can cause infections because they carry a mix of different types of bacteria that can live with or without air, including something called Pasteurella, Staph, and Strep which are most common in the mouths of dogs and cats.
Cat bites and scratches can also potentially give you a type of infection caused by a bacteria called Bartonella. Additionally, dog bites can be particularly dangerous for people with weakened immune systems, particularly those without a functioning spleen. They could potentially develop a severe infection called Capnocytophaga sepsis.
Risk Factors and Frequency for Animal Bites
Dog bites are the most common type of animal bite, accounting for 60% to 90% of all cases, while cat bites make up 5% to 20%. Children are often bitten on the head, face, and neck due to their larger heads and shorter heights, while adults typically experience bites on their hands and arms.
Dog bites mainly occur in men and children, and usually from dogs they are familiar with. These bites often occur without provocation. On the other hand, cat bites are most common in women and adults, and these usually happen when the cat is provoked.
Less severe bites, especially cat bites – which are often puncture wounds because of their teeth – might not be noticed immediately. Often, the person only seeks treatment when an infection starts to show, which can complicate the treatment process.
Signs and Symptoms of Animal Bites
When a patient comes in with an animal bite, doctors need to gather specific details and thoroughly examine the wound. Initially, they need to understand the context of the incident. This includes things like when and where it happened, the type of animal involved, and whether the patient has had any symptoms like fever, redness at the site of the bite, swelling, warmth, or pus discharge. If the patient’s condition is stable, doctors will numb the area and assess the bite to see if it has caused any potential damage to the underlying tissues or if any foreign bodies, like teeth, may be lodged in the wound.
After numbing, doctors will check for any issues with the nerves or blood vessels near the wound. The patient’s comfort during this examination is crucial as pain or fear may interfere with their cooperation. It’s also essential for doctors to know if the patient has any conditions that could weaken their immune system. This could include being on certain medications (like those used to treat organ transplant patients or rheumatic diseases), or having specific illnesses (like diabetes, HIV/AIDS, or sickle cell disease).
Testing for Animal Bites
If you have experienced a trauma, the first thing doctors do is to make sure your airway is clear, that you’re breathing adequately, and that your blood circulation is functioning properly. If you’re losing blood, the bleeding needs to be stopped. If it’s from a vein, applying direct pressure should do the trick. However, if it’s from an artery, which can be more serious, you may need to be treated by specialist doctors.
The next step is to check your wounds for anything that may have gotten into it during the injury. This could be things like bits of teeth, animal claws, dirt, or plant pieces. The doctor will also need to examine whether the injury has affected structures under your skin. This could include muscles, nerves, and bones that may have been injured in the trauma. While doing this, you might be asked to move the affected area in different ways to see if there are any injuries to these underlying parts.
Treatment Options for Animal Bites
When someone is bitten by a dog, the wound should be thoroughly cleaned, and doctors may need to check if the patient’s vaccinations for tetanus are up to date. Prior to cleaning or treating the wound, the patient should be given pain relief. In uncomplicated cases, the patient is offered education on the risks and benefits of stitching the wound or letting it heal naturally. The final decision whether to stitch or not is made jointly with the doctor. However, if the patient comes to the doctor some time after the bite occurred, the risks associated with stitching the wound mostly surpass the aesthetic benefits.
If the wound is stitched, the patient would typically be sent home with a week’s worth of a type of antibiotic called amoxicillin-clavulanate.
In more serious cases, such as deep wounds from a cat bite, the wound is irrigated (cleaned with a particular solution) under local anesthesia (numbing in the area of the wound) and is usually left open. The patient is sent home with a week’s supply of the antibiotic amoxicillin-clavulanate and will be given detailed instructions on how to take care of the wound at home.
Certain types of bites, like those on the hands or feet, in individuals with weakened immune systems, or those that already show signs of infection or are deep puncture wounds, are usually treated with the antibiotic amoxicillin-clavulanate. If a patient is allergic to penicillin, other antibiotics can be used like doxycycline or trimethoprim-sulfamethoxazole, along with another type of antibiotic called metronidazole or clindamycin. Patients who have widespread infection around the bite or signs of infection spreading throughout their body should be treated with a wide range of intravenous (IV) antibiotics given through a vein, and may need to be admitted to the hospital for further treatment.
What else can Animal Bites be?
When diagnosing issues related to animal bites, doctors usually look into other possibilities before making a final diagnosis. These possibilities include:
- Cellulitis: a common skin infection caused by bacteria
- Cervical spine fracture evaluation: assessment of possible neck bone damage
- Emergency treatment of rabies: urgent care for a dangerous viral disease caused by the bite of an infected animal
- Hand infections: infections that specifically affect the hand
- Human bites: wounds and infections from being bitten by another person
- Neck trauma: any injury to the neck region
- Osteomyelitis in emergency medicine: a severe bone infection, generally treated during emergency care
- Tetanus: a bacterial infection that can happen through a wound like an animal bite
What to expect with Animal Bites
Generally, the outlook is very good for most animal bites. However, it’s important to know that each year, an average of 30 to 50 people do unfortunately pass away due to injuries from dog bites.
Possible Complications When Diagnosed with Animal Bites
Animal bites can lead to a range of complications, including:
- Cellulitis, which is a skin infection
- Tenosynovitis, or inflammation surrounding a tendon
- Endocarditis, a heart infection
- Osteomyelitis, or bone infection
- Abscess or a pocket of pus
- Meningitis, an infection of the fluid and membranes covering the brain and spinal cord
- Tendon rupture, which is a tear in the fibrous tissue connecting muscle to bone
- Nerve injury, damage that affects your brain’s communication with your body
- Post-traumatic stress disorder (PTSD), a mental health condition triggered by a terrifying event
- Rabies, a deadly virus spread to people from the saliva of infected animals
Recovery from Animal Bites
If you have been bitten by an animal, it is imperative that you seek medical attention within 48 to 72 hours after initial treatment. This is to make sure that an infection is not developing from the bite. It’s also key that the animal which bit you is moved to a different location, away from your home.
Preventing Animal Bites
Patients are advised to make sure their tetanus vaccination is up-to-date. A tetanus vaccination helps to protect against a serious bacterial disease that affects the nervous system and can lead to muscle stiffness and spasms. Regularly updating this vaccination is a critical part to staying healthy and protected.
