Animal bites can sometimes result in severe infections and some people are at higher risk than others.

Are you at risk? And do you know what to do if you are bitten?
The information and recommendations here will help you avoid serious problems.

 I’ve always heard that dogs’ mouths are cleaner than humans. Is this true?
 What are the particular dangers from animal bites?
 Which is worse, dog bites or cat bites?
 What kinds of infections can develop?
 How do I know if I am at risk for infection following an animal bite?
 What should I do if I am bitten?

I’ve always heard that dogs’ mouths are cleaner than humans. Is this true?
Neither dogs nor cats nor humans have mouths that can even remotely be considered clean. All are filled
with bacteria, many of which can cause disease if they enter broken skin. Over 130 disease-causing
microbes have been isolated from dog and cat bite wounds. 1 Animals’ saliva is also heavily contaminated
with bacteria, so a bite may not even be necessary to cause infection; if you have a cut or scratch and
allow a pet to lick it, you could be setting yourself up for trouble.

What are the particular dangers from animal bites?

Bites to the hand, whether from cats or dogs, are potentially dangerous because of the structure of the
hand. There are many bones, tendons, and joints in the hand and there is less blood circulation in these
areas. This makes it harder for the body to fight infection in the hand. Infections that develop in the hand
may lead to severe complications, such as osteomyelitis or septic arthritis.

In small children, bites to the face, neck, or head are extremely hazardous. Because their small stature
often puts their heads near dogs’ mouths, children are often bitten in these areas. Dog bites can cause
fractures of the face and skull and lead to brain and nervous system infections. Dog bites cause, on
average, about 15-20 fatalities a year in the United States. Most of these victims are infants and young
children.

Which is worse, dog bites or cat bites?

Dogs have strong jaws—large dogs can exert more than 450 pounds of pressure per square inch—and
their teeth are relatively dull. So the wounds caused by dogs are usually crushing of the tissue bitten and
lacerations or tearing of the skin rather than puncture wounds. Most dog bites do not penetrate deeply
enough to get bacteria into bones, tendons, or joints, but they often do a lot of damage just from the
trauma of the bite. Tissue that has been crushed, however, such as may occur with a bite to the hand, is
particularly susceptible to infection.

Cats’ teeth are thin and sharp, so the wounds they cause are more likely to be puncture wounds. These
wounds can reach into joints and bones and introduce bacteria deeply into the tissue. Puncture wounds
are very difficult to clean, so a lot of bacteria may be left in the wound. Also, most cat bites are to the
hand, which makes infection more likely.

Dog bites often do more outright damage, but only 3 to 18 percent become infected. In contrast, cat bites
may appear more trivial, but up to 80 percent of cat bites may become infected if proper care is not taken.

What kinds of infections can develop?

Many infection-causing bacteria have been isolated from dog and cat bite wounds. The four we discuss
here are probably the most significant.

Pasteurellosis.
The most common bite-associated infection is caused by a bacterium called Pasteurella. Most cats and
dogs—even healthy ones—naturally carry this organism in their mouths. When an animal bites a person
(or another animal), these bacteria can enter the wound and start an infection. The first signs of
pasteurellosis usually occur within 2 to 12 hours of the bite and include pain, reddening, and swelling of
the area around the site of the bite. Pasteurellosis can progress quickly, spreading toward the body from
the bitten area. It is important that you seek medical care immediately if these symptoms occur.
Untreated, this infection can lead to severe complications. Bites to the hand need special attention; if
pasteurellosis develops in the tissues of the hand, the bacteria can infect tendons or even bones and
sometimes cause permanent damage if appropriate medical care is not administered promptly.

Streptococcal and Staphylococcal Infections.

These bacteria can cause infections similar to those caused by Pasteurella. Redness and painful swelling
occur at or near the site of the bite and progress toward the body. As with pasteurellosis, you should seek
prompt medical care if these symptoms develop.

Capnocytophaga Infection.
This is a very rare infection, but we mention it here because it is so dangerous if it develops. There is no
common name for this infection, which is caused by the bacterium Capnocytophaga canimorsus. Most of
the people who have become infected were bitten by dogs; in many instances the bite wounds
themselves were tiny and would not have ordinarily called for any special medical care. But
Capnocytophaga can cause septicemia, or blood poisoning, particularly in people whose immune
systems are compromised by some underlying condition (see box below). Up to 30 percent of people who
have developed this septicemia have died. People who have had their spleens removed are at special
risk for this infection. Early symptoms may include nausea, headache, muscle aches, and tiny reddened
patches on the skin.

If you have any of the risk factors listed below, particularly if you have had your spleen removed, it is very
important that you take proper immediate care of any animal bite wound and promptly seek medical
advice.

How do I know if I am at risk for infection?

Anyone who is bitten by a cat or a dog and who does not take proper care of the wound is at risk of
developing infection.

But some people are at increased risk.

 Are you over 50 years of age?

 Do you have diabetes, circulatory problems, liver disease, alcoholism, or HIV/AIDS?
 Have you had a mastectomy or organ transplant?
 Are you taking chemotherapy or long-term steroids?
 Have you had your spleen removed?

If you answered “yes” to any of these questions, you may be more likely to develop a serious
infection than other people. You should take special care to avoid being bitten or scratched by
any animal.

What should I do if I am bitten?

Immediately and thoroughly wash the wound with plenty of soap and warm water. The idea is to remove
as much dirt and saliva—and therefore, bacteria—as possible. It may hurt to scrub a wound, but an
infection will hurt a lot more. Scrub it well and run water over it for several minutes to make sure it is clean
and all soap is rinsed out. It is a good idea to follow the washing with an antiseptic solution, such as
iodine or other disinfectant, but always wash with soap and water first. Apply antibiotic ointment and cover
the wound with gauze or a bandage. If the wound is severe, or if you have any of the risk factors listed
above, seek medical advice at once. Your doctor may want you to take antibiotics to prevent infection
from developing. If you have not had a recent tetanus booster, you may be advised to take one. And if
you are bitten by a wild or stray animal that could have rabies, you may need to begin anti-rabies
treatment. (See What You Should Know About Rabies Prevention).

If you have had your spleen removed, you should be aware that the potential for fatal infection exists,
even from seemingly minor wounds. Some experts recommend that people without spleens should
completely avoid contact with cats and dogs. This is an issue you and your doctor should discuss in
detail.

For most people, however, the benefits of companion animals outweigh the risk. If you have any of the
risk factors shown in the box above, you should do everything possible to avoid being bitten or scratched
by dogs or cats. If wounds do occur, you should clean them promptly and thoroughly and seek medical
advice. A little care and common sense can go a long way in preventing bite-associated infections.

Bites & Stings

For Bites

Signs & Symptoms

 Swelling. Redness. Pain. Itching.

 Bleeding.
 Tissue loss, if the wound is severe.
 Skin rash. With Lyme disease, a red bull's eye rash with a white center around the bite
occurs. Fatigue, fever, and joint pain may also occur.
 Lockjaw. This is a painful, persistent stiffness of the jaw due to a toxin. Tetanus shots can
prevent this. (See Immunization Schedule.)
 Allergic reaction, such as with insect bites. (See Signs & Symptoms of Allergies.)

Causes

 Dog, cat, and human bites are the most common animal bites in the U.S.
 Black widow and brown recluse spider bites can cause severe reactions.
 Deer tick bites can cause Lyme disease, a bacterial infection.
 Less common, but more dangerous, are bites from skunks, raccoons, bats, and other animals
that live in the wild. These animals can have rabies. This is a serious viral infection. It can be
fatal. Most house pets are vaccinated for rabies. It's unlikely they carry the virus.

Deer tick on scalp.

 Mosquito bites can cause West Nile virus if the mosquito is infected with it.
 Snake bites can be fatal if the bite is from a poisonous snake (e.g., rattlesnakes, cotton
mouths, copperheads, and coral snakes).
 Shark bites are a potential problem when swimming in shark-infested waters.

Treatment

Self-care can be used for dog and cat bites that cause scratches on the skin and for insect bites
that do not cause a severe allergic reaction. All human bites that break the skin should be
checked by a doctor due to the high risk for infection. A series of rabies shots can prevent the
spread of rabies to humans. The shots should begin soon after a bite from an infected animal.
Antivenom can be given for poisonous snake bites at emergency medical facilities. It should be
given within 4 hours of the bite.

For Stings

Signs & Symptoms

 Quick, sharp pain.

 Swelling, itching, and redness at the sting site. These can occur beyond the sting site.
 Raised bump (with or without pus).
 Signs of a severe allergic reaction.

Causes

 Insect stings.
 Marine animals that sting include jellyfish, Portuguese Man-of-War, and sea nettles.

Treatment
Self-care treats mild reactions to stings. A severe allergic reaction needs immediate care.
Symptoms of a severe allergic reaction usually happen soon after or within an hour of the sting.
Persons with a severe allergic reaction to a sting in the past should carry an emergency kit,
prescribed by a doctor. A medical alert tag should be worn to let others know of the allergy.
Persons who have had severe reactions to bee or wasp stings should ask their doctors about
allergy shots.

Questions to Ask

Are any of these problems present?

 Signs of a severe allergic reaction. {Note: Before emergency care, use emergency kit as
directed.}
 Signs of shock.
 The bite severely mangled the skin and/or causes severe bleeding. {Note: See First Aid For
Severe Bleeding.}

Was the bite from an animal that lives in the wild or a pet that has not been immunized against
rabies?
Was the bite or sting from a poisonous snake, spider, etc. or do any of these problems occur?

 Fainting. Feeling lightheaded.

 Confusion.
 Seizures.
 Feeling restless or dizzy.
 Breathing problems.
 Painful cramps and muscle stiffness in the abdomen, shoulders, chest, and/or back.
 Fever. Chills. Heavy sweating.
 Nausea. Vomiting.

(Note: Give first aid as needed.)

Was the bite over a joint and does it cause painful movement?

Do you have a fever, pus, or increased swelling and/or redness 24 or more hours after the animal
bite?
Self-Care / First Aid

For Poisonous Snake Bites Before Medical Care

 Carefully move the person away from the snake. Calm the person. Have him or her rest.
Moving about can help spread the venom.
 Gently wash the bite area with soap and water. Keep the limb of the bite site level with the
heart (or just below this). Apply a splint to the limb of the bite site to keep it from moving.
 Being careful, note, if you can, the shape of the snakes eyes, pupils, and head, the colors it is,
and if it has rattles.
 Don't try to kill the snake, cut the fang mark, or suck out the venom.
 Don't apply a tourniquet, a bandage, or ice to the bite.

For Non-Poisonous Snake Bites

 Gently wash the site with soap and water.

 Treat the bite as a minor wound. (See For Minor Cuts and Scrapes.)
 If you notice signs of an infection, call your doctor.

For Poisonous Spider Bites Until Emergency Care Arrives

 Perform rescue breathing, if needed. (See Rescue Breath.)

 If you can, keep the bitten area lower than the level of the heart.
 Calm the person and keep him or her warm.
 Gently clean the site of the bite with soap and water or rubbing alcohol.
 Put an ice pack over the bite site for pain relief.
 If you can, catch the spider in a closed container to show what kind it is.

For Poisonous Spider and Scorpion Bites Before Medical Care

 Do rescue breathing, if needed.

 If you can, keep the bitten area lower than the level of the heart.
 Calm the victim and keep him or her warm.
 Gently clean the site of the bite with soap and water or rubbing alcohol.
 Put an ice pack over the bite site to relieve pain.
 If you can, catch the spider in a closed container to show the doctor.
 Get emergency care!

For Human Bites Before Medical Care

 Wash the wound area with soap and water for at least 5 minutes. Don't scrub hard. Rinse with
running water or with an antiseptic solution, such as Betadine.
 Cover the wound area with sterile gauze. Tape only the ends of the gauze in place. Then get
medical care.

For Deer Tick Bites

 Remove any ticks found on the skin. Use tweezers to grasp the tick(s) as close to the skin as
you can. Firmly, but gently begin rotating the head part in a counterclockwise manner until the
whole headpiece comes out. Or, pull gently and carefully in a steady upward motion at the point
where the tick's mouthpart enters the skin. Try not to crush the tick. The secretions released may
spread disease.
 After you remove the ticks, wash the wound area and your hands with soap and water. Apply
rubbing alcohol to help disinfect the area.
 Use an ice pack over the bite area to relieve pain.
 Save one tick in a closed jar with rubbing alcohol to show the doctor.

For Dog and Cat Bites

 Wash the bite area right away with soap and warm water for 5 minutes. If the bite is deep,
flush the wound with water for 10 minutes. Dry the wound with a clean towel. Then get medical
care.
 If the wound is swollen, apply ice wrapped in a towel for 10 minutes.
 Get a tetanus shot, if needed.
 If the bite hurts, take an over-the-counter (OTC) medicine for pain.
 Report the incident to the animal control department. If a pet's immunizations are not current,
arrange with the animal control department for the pet to be observed for the next 10 days to
check for rabies.
 Observe the wound for a few days. Look for signs of infection. Often, cat bite wounds need
an antibiotic.
Stingray.

For a Stingray Bite

 Remove the person from the water.

 Apply a local pressure bandage for a wound that bleeds a lot.
 Immerse the wound area in hot water for 30 to 90 minutes. Make sure the water is not hot
enough to burn the skin.
 Scrub the wound area well with soap and water.
 Unless the wound is a slight one in only one limb, get medical help right away.

For Stings from Jellyfish or Sea Nettles, etc.

 Remove the person from the water. Don't touch the sting area with bare hands.
 Rinse the sting area with salt (not fresh) water right away. Don't put ice on the skin. If you
can, put vinegar or rubbing alcohol on the area several times for 30 or more minutes until the
pain is relieved.
 Apply dry or moist heat to the sting area until the pain subsides. You can mix one part
ammonia with 3 parts salt water and apply this to the sting area.
 Wear gloves when you remove stingers. Use a towel to wipe the stingers or the tentacles off.
Use tweezers to lift large tentacles. Don't scrape or rub them.
 To relieve itching, apply OTC calamine lotion or 1% hydrocortisone cream to the affected
area as directed on the label.

Animal Bites Overview

Many different types of animals ranging from dogs and cats to hamsters, raccoons, ferrets, and
squirrels can bite adults and children. Many times, bites are from the family pet

Animal Bites Symptoms

Although most bites need to be checked by a doctor, if you do not seek immediate attention after
the bite has occurred, then watch closely for signs and symptoms of infection. These symptoms
may signal there is infection or debris still in the wound (such as teeth, clothes, or dirt):

 Redness at or around the bite site

 Swelling

 Pus (thick) drainage from the wound

 Increasing pain

 Localized warmth at the bite site

 Red streaks leading away from the bite site

 Fever

When to Seek Medical Care

Most animal bites should be evaluated in a doctor’s office, at a walk-in clinic, or in a hospital’s
Emergency Department for these reasons:

 The risk of infection

 Broken or embedded teeth (cats) or other foreign material in the wound

 Underlying nerve and blood vessel damage

These types of bites pose the highest risk of infection and therefore require prompt evaluation:

 Dog bites - Because of the crushing mechanism of the bite

 Cat bites - Because of the puncture mechanism of the bite

 Wild animal bites (from raccoons, for example) and dog or cat bites (your pets may have
themselves been bitten by stray animals) - Because of the risk of contracting rabies

Certain bite wounds require immediate attention:

 Bite caused by a wild animal or a stray dog or cat

 Possibility of teeth, dirt, or other matter in the wound

 Excessive bleeding

 Weakness or numbness of the area or another area away from the bite
  Any other symptoms or concern that you may have regarding a bite wound

Exams and Tests

The doctor will assess the risk of infection, look for other injuries, and try to minimize any
scarring or deformity from an animal bite.

Inspection: The wound will be thoroughly examined to look for any debris such as dirt, grass,
teeth, clothing, or other objects that may have become embedded into the bite area. Sometimes
the wound will be numbed with lidocaine so it will not hurt while the doctor makes a complete
inspection of the area. This is not always necessary and depends on the extent of the injury.

X-rays: The doctor may order x-rays to look for fractures of bones or to make sure nothing
remains in the wound. Although certain objects such as metal always show up on x-ray, some
objects such as dirt and grass do not always appear. That’s why careful inspection and washing
out the wound are key to proper care. Despite best efforts, there is always a risk that foreign
material will be missed and may be in the wound.

Irrigation: This is very important to preventing infection. Several techniques are used but the
idea is the same. The doctor will spray irrigation solution (usually saline solution) into the wound
with either an irrigation device or a syringe (without the needle) in order to wash out anything
that may contaminate the wound. Despite best efforts and intentions, infections can and still do
occur in animal bites.

Debridement (tissue removal): Dog bites are noted for being crush type injuries. This will
macerate and tear apart the skin and tissue in humans. The result is that skin tears often are not
repairable because of the amount of damage or the significant crushing mechanism. These areas
usually have either no blood supply to them or decreased blood supply and will not survive and
are considered to be dead tissue.

 In some cases, it may be necessary for the doctor to remove or debride the skin. This
involves numbing the wound with lidocaine and then cutting the skin with either small
scissors or a scalpel to remove the tissue.

 This not only will reduce the risk of infection but also will promote quicker healing and
may even allow the doctor to obtain better wound closure.

Closure: Not all animal bites need to be closed with stitches. Some wounds are sutured (stitched)
immediately after they occur (this is referred to as primary closure). Some are repaired a few
days later (referred to as delayed closure). Some animal bites are never sutured.

 Relatively clean wounds or those that can be easily cleansed may be stitched
immediately. Also bites to cosmetic areas (such as the face) are usually sutured
immediately.
 Delayed closure or no closure at all will most likely occur in any wound that is on an arm
or leg because of decreased blood flow and increased risk of infection. Also, delayed
closure is more likely if the wound is heavily contaminated (dirty) or has a significant
amount of tissue damage or crushed tissue. It is important to note that animal bites to the
hand have a very high risk of infection so they are generally not sutured immediately.
Bite wounds to hands are excellent candidates for delayed closure.