Dog & Cat Bites - Everything You Need To Know - Dr. Nabil Ebraheim

Dr. Ebraheim’s educational animated video information about dog and cat bites.

Dog bites are the most common animal bite in America. Dog bites have a lower rate of infection than cat bites. Dog bites will cause infection in about 2%-5% of cases. Cat bites will cause infection in about 30%-50% of cases.
Dogs have very prominent teeth with powerful jaws and strong bite pressure. When large dogs attack, they tend to go towards the head and neck. Suspect that the animal is infected if the animal attack is unprovoked and the animal is showing bizarre behavior.
Other causes of unprovoked attacks may include:
• Approaching the animal’s young
• The animal is protecting their territory
• Approaching the animal while it is eating
• Attempting to separate a fight between multiple animals
When a dog bites, the bite tears, avulses, and crushes soft tissue which can be treated by cleaning it in the emergency room and local wound case plus some antibiotics.
In some cases (rare) the crush is so severe that compartment syndrome may develop and the patient may need a fasciotomy. The dog is usually known to the victim in about 90% of the cases. Most dogs will revert back to their normal friendly behavior after an attack. There are more dog bites than cat bites, or even human bites.
Females are bitten more by cats. Males are bitten more by dogs. Animal bites are common in children. Dog bites cause structural damage.
Cat and dog bites affect the upper extremity more often than the lower extremity. There is delayed presentation. Usually the injury and the care is underestimated.
Bacteria associated with the bite
• Dog
o 50% mixed infection
o Mix of aerobic and anaerobic organisms
o The average is about six organisms
• Cat
o Higher rate of infection
o Has small, sharp teeth (needle-like) that can puncture and cause deep wounds that can penetrate the joint and the flexor tendon sheath
o The puncture wounds sometimes seal up immediately, becoming unnoticed or underestimated (not obvious).
o It may take longer to initiate the treatment
What causes infection in both dog and cat bites?
• Delayed treatment more than 12 hours
• Older age
• Crush or puncture wound
• Host condition such as:
o Diabetes
o Immunosuppressed patients
• In general, the bacteria for both dogs and cats is polymicrobial with more than one anaerobe
The most common bacteria isolated from both dog and cat bites is pasteurella. Pasteurella bacteria takes about a week to grow! Pasteurella is present in about 50% of dog bite infections. Pasteurella is present in about 80% of cat bite infections.
Common Bacteria in Dog bites
• Pasteurella
• Streptococci
• Staphylococci
• Neisseria
• Corynebacterium
• Anaerobes
Common Bacteria in Cat bites
• Pasteurella
• Streptococci
• Staphylococci
• Moraxella
• Corynebacterium
• Neisseria
Treatment
• If the patient is seen early:
o Do irrigation in the emergency room
o Give tetanus toxoid vaccine
o Splint
o Give antibiotics
o Do local wound care and observation
If the treatment is delayed, the patient may have infection such as an abscess, septic arthritis, tenosynovitis, or osteomyelitis. The patient will need to go to surgery for incision and drainage. You can suture the wound primarily in facial wounds because this area is very rich in blood supply. Do secondary wound closure in most of the wounds. Augmentin is the antibiotic that is commonly used for dog and cat bites. All cat bites should be covered with Augmentin regardless of the wound. The use of iodine or soap may reduce the development of rabies if the animal is suspected to be infected. If the patient is suspected to have rabies, then the patient will be given vaccination and immunoglobulin.
Cat scratch disease is different! It is an infection that is transmitted by a cat’s scratch. The lesion is small (less than 1 cm). It is self-limited caused by exposure to Bartonella Henselae bacteria. The patient may have swollen or draining lymph nodes. They may also have fever, fatigue or a headache. Swollen, tender lymph nodes could be confused with a tumor. Treatment will include antibiotics, no biopsy is needed.

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