Animal Bites: First Aid and When to Get Treatment

First aid for an animal bite

1. Get to safety away from the animal.
2. Wash the wound with soap and running water for 5 to 15 minutes. This greatly reduces the risk of infection and rabies.
3. Stop bleeding with firm pressure using a clean cloth.
4. Apply a clean dressing. Do not close the wound tightly with tape or strips.
5. Raise the bitten limb to reduce swelling.
6. Get information about the animal: owner details, vaccination status, and whether it can be observed.
7. Seek medical care if the bite meets any of the criteria above.

Dog bites vs cat bites

Cat bites look small but inject bacteria deep into tendon sheaths and joints. Infection can start within 12 to 24 hours.

Children are bitten most often, usually by a dog they know, and are more likely to be bitten on the face, head and neck.

What the doctor will do

• Examine the wound for depth, damage to tendons, nerves, blood vessels, joints and bones
• Irrigate the wound thoroughly and remove dead tissue
• Decide about closure: many face wounds are stitched because of cosmetic importance and good blood supply. Puncture wounds, hand wounds and older wounds are usually left open to reduce infection risk
• X-ray if a tooth fragment, fracture or joint penetration is possible
• Prescribe preventive antibiotics for high-risk bites
• Update tetanus protection
• Assess rabies risk

Who gets preventive antibiotics

A 3 to 5 day course, usually amoxicillin-clavulanate, is recommended by IDSA for:

• cat bites
• bites to the hand, face, genitals or near a joint
• deep puncture wounds
• crush injuries and wounds needing closure
• people with diabetes, liver disease, no spleen or weak immunity

Alternatives are used for penicillin allergy.

Signs of an infected bite

Watch for these over the next few days:

• increasing redness, swelling and warmth around the wound
• worsening pain or throbbing
• pus or discharge
• red streaks spreading from the wound
• swollen lymph nodes
• fever or chills
• stiffness or pain moving a nearby joint or finger

An infected bite may need IV antibiotics or surgery, especially on the hand. See cellulitis and infection of an open wound.

Tetanus

Get a tetanus booster if it has been more than 5 years since your last dose, because bites are considered dirty wounds. If you never completed the primary series, you may also need tetanus immune globulin. See tetanus.

Rabies

Rabies is a virus spread through the saliva of infected mammals. Once symptoms start, it is almost always fatal, but it is completely preventable with prompt treatment after exposure.

Animals that carry rabies risk

• High risk in the US: bats, raccoons, skunks, foxes, coyotes
• Dogs, cats and ferrets: low risk if vaccinated and observable. Unvaccinated or stray animals, and dogs in many countries abroad, are higher risk
• Low risk: squirrels, rabbits, hamsters, mice, rats and other small rodents rarely carry rabies

Bat bites can be tiny and unnoticed. Waking up with a bat in the room, or finding one near a child or someone who cannot report a bite, counts as a possible exposure.

Post-exposure prophylaxis (PEP)

For people not previously vaccinated, PEP is:

• rabies immune globulin injected into and around the wound on day 0
• rabies vaccine in 4 doses over 2 weeks (day 0, 3, 7 and 14), with a fifth dose for people with weak immunity

A healthy dog, cat or ferret that bites can be observed for 10 days. If it stays healthy, it could not have transmitted rabies at the time of the bite.

Preventing animal bites

• never leave young children alone with a dog, even a familiar one
• teach children not to approach unfamiliar animals, and not to disturb animals eating, sleeping or caring for young
• do not handle wild animals or bats. Call animal control
• vaccinate pets against rabies
• when traveling, avoid feeding or petting street dogs and monkeys, and consider pre-exposure rabies vaccination for high-risk trips

Frequently asked questions

What should I do immediately after an animal bite?

Wash the wound with soap and running water for 5 to 15 minutes, press to stop bleeding, and cover it with a clean dressing. Then get medical advice, especially for cat bites, deep bites, hand or face bites, and any bite from a wild animal or unknown pet.

Do I need antibiotics after a dog bite?

Not always. Preventive antibiotics are recommended for deep punctures, bites to the hand, face, genitals or joints, wounds that need closing, and people with diabetes, liver disease, no spleen or a weak immune system. Cat bites almost always warrant antibiotics.

Do I need a tetanus shot after an animal bite?

Get a tetanus booster if your last dose was more than 5 years ago, since bites are considered dirty wounds. If you never completed the childhood tetanus series, you may also need tetanus immune globulin.

When do I need rabies shots after a bite?

You need rabies post-exposure prophylaxis after bites or scratches from bats, raccoons, skunks, foxes and other wild carnivores, and after bites from dogs, cats or ferrets that are unvaccinated, sick, or cannot be observed for 10 days. Bites abroad often need rabies shots.

How soon does an animal bite infection start?

Cat bite infections can begin within 12 to 24 hours. Dog bite infections usually appear within 1 to 3 days. Increasing redness, swelling, pain, pus, red streaks or fever means you need medical care promptly.