Animal Bites

What is it?

Animals bite people when the animal is frightened or feels threatened. Children are so curious and friendly that they often get too close to an animal too quickly. The animal then may feel threatened and bite or snap at the child. Younger children often get too close to an animal’s food dish, which can make the animal angry or protective. Older children sometimes tease animals to the point that the animal bites them out of fear or frustration. Wild animals also bite people for many of the same reasons. Both tame and wild animals often bite if a person feeds them by hand. Animal bites can range from small scratches, to deep punctures or massive injuries with loss of tissue and occasionally even amputations.

Infections are the biggest immediate concern with animal bites. Scars or injuries that prevent normal activities are later concerns. Some large animal attacks can cause severe injuries or even death.

The most dangerous infection we worry about in animal bites is rabies. Rabies is very rare in the United States, but it is almost always fatal. Rabies is still quite common in developing countries. Fortunately, good wound care and prompt medical attention can prevent rabies infection from developing. If your child was bitten by any wild animal, discuss the need for rabies shots with your doctor. Rodents such as chipmunks and squirrels almost never give rabies to people. Your doctor may have chosen not to give a rabies shot if your child was bitten by a small rodent. Bats are not rodents, and very often carry rabies. Most doctors recommend rabies shots for any bat bite or even contact with a bat. With domestic animals such as pets, rabies is much less common. Most health departments do not recommend rabies shots if there is a clear written record that the animal’s rabies shots are up to date, or if the animal can be watched reliably for a week after the bite.

Rabies shots today are much less painful and complicated than they used to be. Do not be afraid of the rabies shots if your doctor recommends them – they are life-saving.

Other infections are much more common than rabies. These infections are usually caused by germs that live in the animal’s mouth or on the child’s skin. Infections are more common with deep, penetrating bites than they are with open bites. That means that a bite that looks small and has little bleeding may be much more likely to become infected than a larger, uglier bite. In the long run, an infection can be more dangerous and cause more scarring than the bite injury itself. Of the common pet bites, cat bites are the most likely to become infected because they tend to be deep and closed.

Parents and children are usually very concerned about scars, especially if an animal bite is on any part of the child’s face. Any cut will produce a scar, but fortunately there is a good blood supply to the face. That makes facial wounds heal well and infections less likely. Because of the lower risk of infection, doctors can also put stitches in bites on the face that would not be stitched on other parts of the body. Remember that infections are more dangerous than scars. Stitching a dirty wound like a bite can make an infection more likely. For this reason doctors often choose not to stitch an animal bite wound, even if there is a risk of a scar forming. Most children’s skin heals very well, and scars are often smaller than one thinks at first. You may want to read our Aftercare Instruction on Lacerations for additional information.

How do we treat it?

The first step in treating any animal bite is to slow down any major bleeding and then to clean the wound. You probably did both of those things before taking your child to the doctor. Simple soap and water is the best thing to put on any open cut – do not use hydrogen peroxide, iodine, or alcohol. These are painful, can cause damage to skin, and are not very effective at killing germs. If you or your child have frequent contact with wild animals or other animals that are at high risk for rabies, you may want to purchase a topical scrub containing chlorhexidine (klor-hex-ah-deen). These are available over-the-counter under the brand names Betasept®, Calgon Vesta®, Dyna-Hex®, Hibiclens®, Hibistat®, and Spectrum-4®. Use these products as you would soap immediately following the bite, and follow up right away with your doctor.

If your doctor decided that your child needs rabies shots, be sure to follow up with the whole series on schedule. Rabies shots are given on the day of the bite, then at 3, 7, 14, and 28 days later. If possible, be sure that the biting animal is quarantined in a place where it can be closely watched for ten days. If the animal behaves in unusual ways, let the Animal Control authorities know right away.

If your doctor put stitches in the bite wound, follow the doctor’s instructions carefully. This usually means keeping the stitches and wound clean, covered, and moist with an antibiotic ointment such as polysporin. Change the dressing once a day. You can clean the closed wound gently with soap and water after the first 24 hours. Some doctors recommend using peroxide on a cotton swab to rub gently along the line of stitches. The bubbling of the peroxide may help to remove dried blood and crust that forms. After cleaning, apply more antibiotic ointment and cover the wound again with a bandage or an "occlusive" pad such as Telfa®.

If the doctor did not put stitches in the wound, keep it covered with antibiotic ointment and a dry sterile dressing. Your doctor will give you his or her personal recommendations about the best choices for dressings. Many doctors today recommend an "occlusive" dressing such as Telfa® pads. Clean the wound once or twice daily as directed by your doctor. Do not use peroxide or antiseptic cleaners such as povidone-iodine (Betadine®) or chlorhexidine (Hibiclens®) on open tissue, unless there is a high risk of rabies.

Your doctor may have recommended antibiotics for your child. Most simple dog bite wounds do not require antibiotics to prevent infection, unless stitches were put in. All cat bites and all wounds with stitches should be treated with oral antibiotics (you can read our Aftercare Instruction on Administering Oral Medications). Any infected cat bite to the hand usually requires intravenous antibiotic treatment. If your doctor gave you a prescription for antibiotics, please be sure to give your child every dose for the full length of time recommended, even if there is no sign of infection. Your doctor may also want to update your child’s tetanus shot, depending on the status.

Check the wound and the area around it several times a day for signs of infection:

• Redness that spreads more than ¼ of an inch (about ½ cm) away from the wound edges (a small amount of redness just along the wound edges is normal)
• Pus coming from the wound
• Pain that continues for more than one day or gets worse over time
• Swelling of the tissue more than ¼ inch (about ½ cm) away from the wound, or a feeling that there is liquid underneath the skin
• A foul smell from the wound (the old dressing may smell musty, but the wound itself should not produce any noticeable smell)

Please call your doctor right away if any of these things develop. Signs of more serious infection are:

• Fever
• Chills
• A red streak along the skin leading from the wound towards the body

Please bring your child to the doctor or an emergency room if any of these develop.

If the biting animal was a pet, the question always comes up whether to keep the animal or not. A general rule is that an animal that has bitten a person once will do it again. This is true even if the animal was just defending itself. Most doctors as well as animal advocates recommend that biting animals not live where young children are around – the risk is just too great. If the animal belongs to your family, see if you can give it to a friend or relative who does not have young children. If not, give it to a shelter. If the animal does not belong to you, and the owners refuse to move or control the animal, be sure your child knows that s/he must never go to that animal’s home again without an adult present at all times.

Animal shelters welcome animals with a history of biting. They will do everything possible to get the animal into a new environment that is safe for everyone. Sadly, many animals are destroyed each year because they have a history of biting more than one person. These bites could often have been prevented by moving the animal to a more controlled environment.

While most animal bites are the result of a misunderstanding between child and animal, occasionally a child or teenager will "provoke" an animal and get bitten. A child who habitually teases, provokes, or hurts animals may have serious emotional or psychological problems that need attention. If you notice this kind of behavior in your child or adolescent, especially if it happens in combination with other violent or destructive behaviors, please arrange to see your doctor right away.