Medical Moment: Treating Animal Bites

01 Aug Medical Moment: Treating Animal Bites

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Dr. Paul Koelliker

Dr. Paul Koelliker answers this week’s question: How do I treat an animal bite?

Animal bites are common complaints at Emergency Departments. They can range from mild abrasions/bruising that require no treatment to life threatening injuries.

Care for animal bites include: wound care and closure, antibiotic prophylaxis to prevent or treat bacterial infections, and treatment to prevent viral infections (rabies, tetanus and rarely, viruses in the Herpes family).

Wound care should begin at the time of the bite. If possible any wounds should be cleansed as thoroughly as possible with clean water. Avoid placing hydrogen peroxide or betadine solutions directly into deep wounds. At the Emergency Department, wounds that need more thorough care will be addressed often after the administration of local anesthetics.

Deep contaminated wounds, older wounds or wounds that appear infection prone are often not initially closed. Primary closure of acute animal bites increases the risk of infection. Sometimes animal bites are closed initially after copious cleansing and debridement (cutting away the crushed/damaged tissue that increases infection risk).

Antibiotics are frequently prescribed after animal bites with a penetrating component. Antibiotics should be taken as directed until finished, unless a side effect develops.

People who are immunocompromised (those who are undergoing cancer chemotherapy, or diagnosed with AIDS, etc) are at higher risk of developing a severe infection, as are patients who have had their spleen removed.

Rabies can develop only from the bite of an animal that has been infected with rabies. Bats, foxes, and skunks are animals whose bites carry a high risk of rabies. A bite from one of these animals usually requires rabies shots (immunoglobulin). Rabies is almost uniformly fatal, and post bite prophylaxis is strongly recommended.

Dogs and cats can carry and transmit rabies if they are not immunized and are bitten by an infected animal. Transmission from dogs and cats to humans is uncommon largely due to immunization of pets.

Tetanus immunization status is checked and a Tetanus booster is administered if not up to date. Monkey bites carry the risk of transmitting a virus in the Herpes family and antiviral medication is warranted.

Animal bites are required by law to be reported to the police. The police/animal control will observe the animal to look for signs of rabies infection and check the animal’s immunization records. If possible, it is important to locate the owner or the offending animal and get contact information so the police may investigate more efficiently.

Editor’s note: The Telluride Medical Center is the only 24-hour emergency facility within 65 miles.

 As a mountain town in a challenging, remote environment, a thriving medical center is vital to our community’s health.

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