In the UK about 250,000 people each year go to an emergency department because they have been bitten by a dog. Probably many more bites occur, but people do not see a doctor about them, so it is hard to be sure. Cat bites are less common. Bites are caused most often by the owner's own pet or an animal known to them. Boys get bitten more than girls. Children under the age of 5 are most commonly affected. Some dogs are more dangerous than others. Some that can cause the worst injury, such as pit bull terriers, are illegal to own in the UK.
This leaflet gives a guide as to what you should do following a bite. But the take home message is that all but the most minor bites should probably be assessed and treated by a doctor or nurse - in particular, bites to hands.
Clean the wound
You should clean the wound no matter how small the cut to the skin. There are many germs (bacteria) in animal mouths. Cleaning will reduce the chance of infection. If the wound is small, you can clean it yourself. Just use ordinary tap water. Let it bleed freely, unless the bleeding is very heavy. If the wound is bleeding heavily, use a clean pad, or preferably a sterile dressing, to apply pressure until you can get medical treatment. Wounds that are large, deep, punctured or dirty are best cleaned and assessed by a nurse or doctor.
After cleaning, cover the wound with a sterile, non-sticky dressing.
Consider going to hospital or seeing a doctor
This is for the following reasons:
The wound can be properly assessed and cleaned. If part of the wound has dead or damaged skin then it may need to be trimmed or removed. This is because infection is more likely to develop in dead skin. So, if in doubt, see a doctor or go to your local accident and emergency department.
Do not be surprised if the doctor does not stitch or close up a dog or cat wound immediately. For many bites it is safer to let them heal on their own. For some bites in some parts of the body it is common practice to wait for a few days before closing the wound. This is particularly the case if the wound is more than six hours old. This is to make sure the wound is not infected before closing it up. A wound that becomes infected after it has been stitched or closed up, can cause serious complications. After the wound is cleaned (and trimmed of dead or damaged tissue, where necessary), a sterile dressing is normally applied.
Large, severe or deep bites may require an operation to clean the wound and repair underlying structures that may be damaged, such as tendons.
A short course of antibiotics may be prescribed to prevent infection developing. Antibiotics are prescribed for bite wounds to prevent infection in certain situations. For example, if:
- You have been bitten by a cat. All cat bites are usually treated with antibiotics, as they are much more likely to get infected than dog bites.
- The bite wound is on an arm or leg - especially a hand. These sites are particularly prone to nasty infections that can cause severe damage after a dog or cat bite.
- The wound is large, deep or punctured. A puncture wound may not look large but may go deep into the tissues.
- Your injury needed an operation to clean it out, or repair the damage.
- Your resistance to infection is low. For example, if you are on chemotherapy; have no working spleen; have diabetes; have an immune system problem such as AIDS.
- You have an artificial heart valve (and sometimes, if you have an artificial joint).
Antibiotics will also be prescribed if your wound has already become infected. It might be infected if:
- It is getting more painful rather than improving as time goes by.
- It has become red or swollen.
- It is oozing.
Are you up to date with your tetanus immunisations? If not, you may need a booster dose.
Rabies is a very serious illness passed to humans from some animal bites. At present the UK is free from rabies. However, animal bites (particularly dog bites) that occur abroad have a risk of rabies. When abroad, take seriously even the most tiny of dog bites, or a lick from a dog over a cut or wound. If needed, treatment straight after a bite can prevent rabies from developing. It is important that the treatment should be given quickly, so see a doctor as soon as possible.
What to look out for after a dog or cat bite
The most common complication following a bite is an infection of the wound. See a doctor as soon as possible if the skin surrounding a wound becomes more tender, painful, swollen, or inflamed over the following few days. Rarely, some germs (bacteria) can get into the bloodstream through a wound and cause a serious infection in the body. See a doctor urgently if you become generally unwell with a high temperature (fever), shivers, or other worrying symptoms within a week or so after a dog or cat bite.
Some people, particularly children, may become scared of dogs if they have been bitten. They may get nightmares, or become worried. To try to stop this, talk to them about what happened, and why, and help them learn to interact with pets safely. If they are still having problems, see a doctor.
Dr Tim Kenny
Dr Mary Harding
Prof Cathy Jackson