Dr. Scott, MD
Treating Dog Bites
Valerie Scott, MD
The CDC reported that an estimated 4.7 million dog bites occur every year in the United States. Some of these bites are not very severe but around 800,000 require medical attention.
The majority of non-fatal dog bites were inflicted upon family members or guests on the families' property. The incidence of being a victim of a dog bite is highest in males less than 12 years old followed by female children in that same age group.
Dogs tend to bite children in the head or neck areas whereas for adults the injuries occur in the arm and hand areas most frequently.
It is very difficult to find unbiased information as to the breeds which bite most frequently. For example, very small breeds might bite their owners but not cause enough damage to be reported. Whereas, a larger breed has the capacity to inflict much more damage and therefore the bites will be reported. Also, the popularity of a certain breed will also inflate the bite statistics.
In primary care, we often see patients who have been bitten by their own dog or one owned by a friend. I would recommend seeking medical advise for any dog bite that substantially breaks the skin. This is because there is a risk of infection after the bite and antibiotics are often required.
That being said if the injury is very minimal and not a puncture wound you can care for it yourself by washing the wound with soap and water. Hydrogen peroxide is no longer recommended for wound care. Nor is applying alcohol directly to the wound. After cleaning the wound apply antibacterial ointment and cover with a bandage. Monitor the wound for signs of infection. These include systemic fever, and or redness, warmth or pus at the site of the injury. If any of these symptoms occur you should be seen by your physician.
"If the wound is too big to handle at home, you should be evaluated by a physician. The site is dictated by the timing and also the severity of the wound. For the more serious wounds such as finger amputations the ER is the best bet."
Your family doctor can handle many of the injuries. I recommend calling and asking the receptionist if it is possible for the more minor injuries to be handled there. It is best to not wait >12 hours to have these injuries addressed so you might need to go to an urgent care for after hours evaluation.
When we evaluate your wound initially, we look to see if there is damage to the nerves or blood vessels. This kind of damage might require referral to a surgical specialist. If the nerves and vessels are OK, we will cleaned the wound and evaluate for repair.
In general we avoid stitches if at all possible because of the increased risk of infection. If stitches are placed they are usually done very loosely to allow drainage if needed. Most often you will be given a short prescription of an antibiotic to prevent infection and instruction of the signs and symptoms of infection.
We will also update your tetanus shot if needed. The last aspect that the physician will do is ask you to complete a DHEC animal bite form. People are often hesitant to complete this form because of concern over legal ramifications to the dog or it's owner. This is actually only used by the health department to prevent rabies infection so there is no need to worry.
Rabies is a viral infection which can be transmitted to humans from several species of animal. Fortunately, it is not commonly transmitted by dogs but it is a possibility. Rabies can be prevented by administering the rabies specific immunoglobulin within 30 days of exposure. If this is not done, there is no treatment for rabies and most people will die from it. So you see why completing the form is so important.
Once the form is completed the health department will contact the dog's vet and determine if the immunoglobulin is needed. Until recently the immunoglobulin was offered free of charge through the health department. Budget cuts have eliminated this service but the immunoglobulin is available.
The health department can guide you to the proper source for the medication. It is a shot but it is not given into the abdomen as it was years ago. And often times the health department will recommend having the vaccine series against rabies.
Most importantly, we should focus on preventing dog bites. We must remember that all dogs are capable of biting and we should respect them. Most importantly, all children should be taught how to behave around dogs.
The American Humane Association has produced a dog-bite prevention program geared for children ages 4-7. It is entitled American HumaneKIDS: Kids Interacting with Dogs Safely. Their website address is www.americanhumane.org. I invite you to review this and use it to teach your kids or grandkids how to behave around a dog.
About Dr. Scott
Dr. Scott is a board certified Family Physician & graduate of Emory University Medical College in Atlanta. She trained here at MUSC. Currently, she is in practice at Mt. Pleasant Family Practice.
She is owned by 3 dogs- an Australian shepherd/ lab mix, a Pomeranian/ American Eskimo mix and a full blooded pug.; 4 grown children and 2 grand children.
Her professional interests include keeping healthy people healthy and helping others get to the healthy state.