When we hear about someone being bitten by an animal, most of us giggle because we imagine a nip on the finger by a cute kitten.  In reality, animal bites are potentially a very serious medical condition that accounts for a significant amount of morbidity.  Animal bites are among the most ancient afflictions of mankind.  The true incidence of bite wounds is not certain, since many victims do not seek medical attention.  An estimated 1.5 million bites occur each year, most common are dog bites with cats in second place.  They occur most often in the warm summer months.  Male victims outnumber females, with the greatest risk to persons under the age of 30, most involve the extremities. Children, due to their small size, are more likely to suffer bites on the face and upper lip.  Eighty per cent of dog and cat bites result from pets known to the person.

Animal bite fatalities are quite rare although as many as 15 fatal dog bites occur in this country each year, most of these are children under the age or 10.  Although the vast majority of animal bites are not life-threatening, they may be severe enough to require urgent intervention.  Large animals may generate up to 450 lbs/inch of pressure in their jaws.  This pressure can easily crush the throat, lacerate major vessels, and fracture bones, including the skull of small children.  Soft tissue damage can range from simple abrasion and scratches to massive avulsion of skin, muscle, and nerves, and blood loss may be enough to cause shock.  Dog bites tend to cause tearing and crushing injuries.  Swelling and necrotic tissue in the area of the bite makes the wound more susceptible to infection caused by organisms from the dogs mouth into the wound.  Interestingly, infections in dog bites occur in only about 4% of bites, wounds from cats, which have long slender teeth, are much more prone to infection because the organisms are injected deep within a small wound.  Wounds to the arm or legs are more likely to become infected than the face.  This is because the face has a far richer blood supply.

Dogs saliva includes an average of 64 different types of organisms.  Cat bites are much simpler, although cause many more problems.  Redness at the wound with red streaks often develop within 24 hours.  Once infection occurs following a cat bite, as many as 25% of patients require hospital admission for cleaning the site and IV antibiotics.  Cat scratches and bites can also produce “cat-scratch disease” in which a tender, raised dimple occurs at the site.  Localized swelling of the lymph nodes in the area develop after a 3-10 day incubation period.  Symptoms generally resolve quickly with the treatment of antibiotics. 

Treatment of bites include control of bleeding, clean the area of the bite with a nonirritating soap solution, cleaning away dirt, and cover with a clean dry dressing.  Medical literature involving animal bites revolves around the choice of antibiotics to be used.  This leads some to think antibiotics are the most important treatment.  In fact, meticulous local wound care has been shown to be much more effective in preventing infection.  A current tetanus should be provided or a tetanus shot given.  There is much controversy whether to suture of not, leave that to the physician to decide.  Rabies is always a concern.  While rabies is a very rare disease in this country, it is increasing in the animal population in many areas.  This increase is even found in quite heavily populated suburban regions of the county. 

Animal bites are a significant problem, the risk of infection can be high and the cosmetic problem cannot be overlooked. In most states, reporting animal bites to local health department agencies is mandatory.  Be careful and be safe, seek medical attention if you are bitten.