Bite wound
Bite wound
A bite wound is tissue damage caused by teeth with bruises, puncture and often deep pocket formations under seemingly small skin openings. It is often contaminatedContaminated describes something that has been polluted by harmful microorganisms, chemicals, or other dangerous substances. In veterinary medicine, this can affect food, water, toys, or the environment. with bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. and can lead to abscesses, wound infections or tissue necrosisNecrosis is the Death of tissue in a living organism, caused by factors such as injury, infection, or lack of blood supply. Necrotic tissue can cause Inflammatory conditions and further health problems.. Bites to the neck, chest, abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen. and near joints are particularly critical.
Bite wounds in dogs and cats are one of the most common types of traumatic injuries in small animal medicine. These injuries are caused by the penetrationPenetration describes the entry or permeation of a substance or organism into a body or material. In medicine, it can refer to the penetration of microorganisms into tissues or the insertion of instruments into the body. of an animal’s teeth into the skin and underlying tissue of another animal. Characteristic of bite wounds is their complex nature: While often only small puncture wounds are visible on the skin surface, significant tissue damage can be hidden underneath. The teeth of dogs and cats act like injection needles that transport bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. deep into the tissue. In dogs, the combination of bruising and puncture leads to more extensive tissue damage, while in cats the needle-like teeth cause deep but narrow wounds. These differences are crucial for the assessment and treatment of bite wounds. Bite wounds near joints, in the thorax / chestThe thorax / chest is the upper part of the trunk, surrounded by the ribs, sternum, and spine. It protects vital organs such as the heart and lungs. or abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen., and in the area of the head and neck are particularly dangerous, as vital structures can be affected here.
Causes
The causes of bite wounds are varied and depend heavily on the social context and environment of the animals. In dogs, bite wounds often result from dominance fights, territorial disputes, or resource conflicts over food, toys, or attention. The possible bite wounds depend on the overall situation, such as the authority of the owner, whether the dogs are on a leash, etc. Furthermore, they depend on the number of dogs involved, the size of the biting dog, its aggressiveness, and the bite force of a dog.
Bite force is measured in PSI (pounds per square inch). It ranges from 195 (Malinois) to 740 (Kangal) PSI in large dogs. For example, the German Shepherd Dog is said to have a bite force of 220 PSI.
In contrast, a human has a bite force of 120 to 130 PSI.
The aggressiveness, i.e. how long a dog only threatens when irritated and when it starts to bite, was investigated by the American Temperament Test Society and listed on their website https://atts.org. The Bearded Collie had the highest irritation threshold and the French Bulldog had the lowest.
However, the irritation threshold in dogs is not only due to breed-related but also to a large extent to individual differences.
In cats, bite wounds occur mainly during territorial fights, especially in unneutered male cats. Lack of socialization, fear, or pain can also lead to biting incidents in both types of animals. In multi-pet households, sudden tensions can arise between previously compatible animals, often triggered by an animal’s illness or changes in group dynamics. Bite wounds from wild animals such as foxes or martens, which can bring additional risks of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease., should not be underestimated.
Symptoms
Bite wound in dog/cat
Typical Symptoms:
- Punctiform skin lesions, pain, swelling
- Hematoma, lameness, licking at wound
- In cats, often “small hole – big problem” (deep infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease.)
Alarm signs:
- Severely bleeding wound, circulatory signs
- Bites to the neck/chest (thorax / chestThe thorax / chest is the upper part of the trunk, surrounded by the ribs, sternum, and spine. It protects vital organs such as the heart and lungs.)/abdomen (abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen.) carry the risk of organ damage and air entering the chest (pneumothorax).
- Shortness of breath after a bite → possible chest problem
- Fever, apathyApathy refers to a state of indifference and reduced interest or lack of emotional involvement in activities or events that would normally arouse interest., increasing swelling/heat/pus
- “Crackling” skin, i.e. air under the skin (subcutaneousSubcutaneous means "under the skin." In medicine, it refers to the administration of drugs or the placement of implants directly under the skin. emphysemaEmphysema is a chronic lung disease characterized by over-expansion of the air spaces distal to the terminal bronchioles, accompanied by destruction of the alveolar walls. This leads to breathing difficulties and reduced oxygen uptake.), severe pain
Escalation/course:
- 12–48 h after bite frequently: Abscess formation (cat)
- Rapidly increasing swelling/pain, foul odor → severe infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease./necrosis possible
- Lameness increases after 24 h → deep tissue involvement/wound near joint
Bite injuries can be trivial or life-threatening for your pet.
They are characterized by bruises and lacerations and often bleed very heavily (Fig.).
They are always associated with the entry of germs, and sometimes hair and other foreign bodies, into the wound.
They often reach very deep, without you always noticing it from the outside.
Cat bites may look inconspicuous, but they can also penetrate very deeply. They have a very high risk of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease..
Bruises and lacerations of the tissue in the deeper layers can also be dangerous, even if hardly anything is visible from the outside.
Bites can penetrate the chest, abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity, joints, a bone, or other sensitive structures such as the eyes, sinuses, etc., and lead to purulentPurulent refers to pus or the production of pus, which may indicate a bacterial infection. Purulent inflammatory conditions are often painful and may have significant swelling and redness. inflammatory conditions there.
Bite injuries should therefore always be treated by a veterinarian.
First Aid
- Cut the hair around the wound.
- Thoroughly wash superficial wounds with fresh tap water and soap and remove any visible foreign bodies. There are different recommendations for this, but tap water is almost sterile.
- If you are not sure whether the chest, abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. cavity, joints or similarly sensitive structures have been injured, do not wash out the wound.
- Cover the wound with a bandage that is as sterile and light as possible. Do not tie it too tightly and loosen it again after a certain time.
- Do not apply any ointments.
- If possible, think about the legal consequences on site and, if necessary, register the contact details of the owner of the dog involved.
Diagnosis
The diagnosisA diagnosis is the identification of a disease or condition by its symptoms and/or results from diagnostic tests. It is the first step in the management and treatment of patients. of bite wounds begins with a thorough medical historyThe medical history is the systematic collection of a patient's medical history through questioning. It includes information about previous illnesses, treatments, allergies, and lifestyle habits. and clinical examination. The veterinarian first asks about the course of the incident, if it was observed, as well as the time of the injury, as this is crucial for the treatment strategy. During the clinical examination, the extent of the visible injuries is assessed, whereby the fur in the area of the wound must be shaved in order to recognize all lesions. PalpationPalpation is an examination method in which the condition of body tissues is assessed by feeling them with the hands. It is used to identify swelling, pain, or other abnormalities. of the surrounding tissue is particularly important in order to identify swelling, emphysemaEmphysema is a chronic lung disease characterized by over-expansion of the air spaces distal to the terminal bronchioles, accompanied by destruction of the alveolar walls. This leads to breathing difficulties and reduced oxygen uptake. or crepitation. In the case of deep or complex bite wounds, imaging procedures such as X-rayX-ray is an imaging technique that uses X-rays to create images of the inside of the body. It is often used to diagnose bone fractures, lung diseases, and other conditions., ultrasoundUltrasound refers to sound waves that are above the hearing threshold of the human ear. In medicine, ultrasound is used for diagnostic imaging procedures to visualize internal organs, tissues, and blood flow. or, in special cases, CT or MRI may be necessary to detect foreign bodies, air pockets or organ injuries. Laboratory tests such as blood count and inflammatory parameters help to assess the systemic condition of the animal. In the case of infected wounds, a bacteriological examination with antibiogram is useful in order to identify the pathogens involved and to initiate targeted antibiotic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.. The most common pathogens in bite wounds are Pasteurella multocida (especially in cat bites), Staphylococcus spp., Streptococcus spp. and anaerobicAnaerobic describes life forms or processes that occur in the absence of oxygen. In veterinary medicine, this often refers to anaerobic bacteria that thrive in low-oxygen environments and can cause infections. bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. such as Bacteroides and Fusobacterium.
Further veterinary measures
See a veterinarian the same day.
Teeth and saliva are not sterile. There is a high risk of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease..
The veterinarian can assess the type of injury. Sometimes they are relatively trivial injuries where local treatment and antibiotic care as well as pain medication are sufficient.
However, a large proportion of bite wounds require surgical treatment under general anesthesia, as bruises have led to dead tissue in the depth or injuries to joints, tendons and ligaments.
In addition to appropriate care, the veterinarian will also keep an eye on the risk of tetanus.
Also, keep in mind that rabies is still widespread among animals in some countries.
The therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. of bite wounds requires a multi-stage approach that depends on the severity, location and time of presentation. In fresh bite wounds (less than 6-8 hours old), a primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. surgical treatment should be aimed for. After induction of general anesthesiaGeneral anesthesia is a medical procedure that induces unconsciousness and eliminates pain during surgical procedures. It involves the use of anesthetics to temporarily shut down the body's overall perception., thorough wound cleaning with sterile saline or diluted antiseptic solution is performed first. Debridement, i.e. the removal of devitalized tissue, is a crucial step to prevent infections. In deep bite wounds, drains are inserted to drain wound secretions and avoid dead spaces. The decision on a primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. wound closure or an open wound treatment depends on the degree of contaminationContamination refers to the pollution of surfaces, objects, water, food, or air with harmful microorganisms, chemicals, or other hazardous substances., the time elapsed since the injury and the location. In general, the more contaminatedContaminated describes something that has been polluted by harmful microorganisms, chemicals, or other dangerous substances. In veterinary medicine, this can affect food, water, toys, or the environment. the wound and the more time has passed since the injury, the more likely a delayed wound care (delayed primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. closure) or secondary wound healingWound healing is the natural process of repairing tissue damage, occurring in phases including inflammation, tissue regeneration, and wound contraction, to restore tissue integrity. is indicated. Antibiotic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. is almost always necessary for bite wounds and should be broad-spectrum, with good efficacy against gram-positive, gram-negative, and anaerobicAnaerobic describes life forms or processes that occur in the absence of oxygen. In veterinary medicine, this often refers to anaerobic bacteria that thrive in low-oxygen environments and can cause infections. bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease.. Commonly used antibiotics are amoxicillin-clavulanic acid, clindamycin in combination with fluoroquinolones, or third-generation cephalosporins. The pain therapy / analgesic therapyPain therapy / analgesic therapy includes methods and medications to relieve Pain in animals. The goal is to improve well-being and increase the quality of life of animals with acute or chronic Pain. is carried out using non-steroidalNon-steroidal refers to medications or substances that are not steroids and often have anti-inflammatory, analgesic, or antipyretic effects. They are used in dogs and cats to treat Pain and Inflammatory conditions. anti-inflammatory drugsAnti-inflammatory drugs are medications that reduce inflammation. They can be divided into nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids and are used in dogs and cats to reduce Inflammatory conditions and Pain. (NSAIDsNSAID (non-steroidal anti-inflammatory drug) stands for non-steroidal anti-inflammatory drugs, a class of medications used to relieve pain, reduce inflammatory conditions, and lower fever without using steroidal agents. They are a commonly used pain reliever in veterinary medicine.) or, in the case of severe pain, using opioids. In already abscessed bite wounds, an incision, drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing. and flushing is required, followed by antibiotic treatment.
Prognosis and aftercare
The prognosis for bite wounds depends largely on the location, the extent of tissue damage, the timing of treatment and the general health of the animal. With early and adequate care, the prognosisThe prognosis is the prediction of the likely course and outcome of a disease based on the general state of health, the nature of the disease, and the response to treatment. It can provide information on how a disease is expected to develop. for superficial bite wounds is generally good. Complications are more common with delayed treatment, in immunosuppressed animals, or in injuries to critical areas such as joints, thorax / chestThe thorax / chest is the upper part of the trunk, surrounded by the ribs, sternum, and spine. It protects vital organs such as the heart and lungs. or abdomenThe abdomen, also known as the abdominal cavity, is the part of the body located between the rib cage and the pelvis. It houses several important organs, including the stomach, liver, kidneys, intestines, and spleen.. Aftercare plays a crucial role in the success of healing. Regular wound checks are necessary to detect signs of infections or healing disorders early. The dressing should be changed every 1–3 days depending on the condition of the wound. Antibiotic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. is usually continued for 7–14 days, or longer for severe infections. A neck brace or body suit is often necessary to prevent self-traumatization. The animal’s activity should be restricted during the healing phase so as not to impair wound healingWound healing is the natural process of repairing tissue damage, occurring in phases including inflammation, tissue regeneration, and wound contraction, to restore tissue integrity.. During aftercare, attention should also be paid to possible late effects such as scar tissue formation, restricted movement or chronicChronic refers to a condition or disease that is long-lasting or permanent. Chronic diseases often develop slowly and can lead to persistent or recurring health problems over time. pain. In some cases, physiotherapeutic measures may be necessary to restore full functionality.
Summary
Bite wounds in dogs and cats are complex traumas that can have serious consequences despite often inconspicuous external appearances. The special feature lies in the combination of mechanical tissue damage and bacterial contaminationContamination refers to the pollution of surfaces, objects, water, food, or air with harmful microorganisms, chemicals, or other hazardous substances.. Dog bites typically cause bruises and lacerations with more extensive tissue damage, while cat bites, due to their needle-like teeth, create deep but narrow puncture wounds that carry a particularly high risk of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease.. The therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. includes surgical wound care, antibiotic treatment and adequate pain management. Decisive for the success of the treatment are the time of care, the thorough wound cleaning and the professional debridement. Aftercare with regular wound checks and consistent medication are essential for uncomplicated healing. Particular attention is required for bite wounds near joints, in the thorax / chestThe thorax / chest is the upper part of the trunk, surrounded by the ribs, sternum, and spine. It protects vital organs such as the heart and lungs. or abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. area, and in the head and neck area. With early veterinary care and consistent aftercare, most bite wounds can be treated successfully and heal without permanent damage.
Outlook on current research
Research into bite wounds in small animals is constantly evolving. Current studies focus on optimizing antimicrobialAn antimicrobial substance is an agent that serves to inhibit the growth of microorganisms such as bacteria, viruses, fungi, and protozoa, or to kill them. Antimicrobials are frequently used to treat infections. therapies in the face of increasing antibiotic resistanceResistance refers to the ability of microorganisms to withstand the effects of antibiotics, antifungals, or other antimicrobial drugs. Resistance can also refer to the body's ability to be insensitive to diseases or toxins.. Local wound dressings with antimicrobialAn antimicrobial substance is an agent that serves to inhibit the growth of microorganisms such as bacteria, viruses, fungi, and protozoa, or to kill them. Antimicrobials are frequently used to treat infections. properties, such as silver- or honey-containing preparations, are being investigated, which could be an alternative or supplement to systemic antibiotic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions.. In the field of wound healingWound healing is the natural process of repairing tissue damage, occurring in phases including inflammation, tissue regeneration, and wound contraction, to restore tissue integrity., regenerative therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. approaches are gaining in importance. The use of Platelet-Rich PlasmaPlasma is the liquid part of blood in which blood cells are suspended. It contains water, salts, proteins, and other substances and serves as a transport medium for nutrients, hormones, and waste products. (PRP) or stem cell therapies shows promising results in the treatment of complicated wounds and could also be used for severe bite wounds in the future. New imaging techniques such as high-resolution ultrasound and special MRI sequences improve diagnostics, especially in the assessment of soft tissue damage and the early detection of infections. Intensive research is also being carried out in the field of behavioral medicine in order to better understand risk factors for biting incidents and to develop preventive measures. The development of standardized protocols for the initialInitial means beginning or at the start. In medicine, it can refer to the first symptoms of a disease or the first phase of a treatment process. care and aftercare of bite wounds is another important field of research that should contribute to improving treatment outcomes.
Frequently asked questions (FAQs)
- Why are cat bites often more dangerous than dog bites, even though they appear smaller?
Cat teeth are needle-like and leave deep but narrow puncture wounds that quickly close on the surface. This traps bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. deep in the tissue, where they can multiply under low-oxygen conditions. In addition, cat saliva contains particularly aggressive bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. such as Pasteurella multocida. - When should I take my pet to the vet after a bite wound?
Every bite wound should be examined by a veterinarian, ideally within the first 6-8 hours. Even small wounds can become infected or reach deeper than is externally visible. - Can I treat a bite wound myself?
First aid such as careful cleaning with water is useful, but does not replace veterinary treatment. Do not use home remedies or disinfectants without veterinary instructions. - Why are bite wounds often not sutured?
Bite wounds are contaminatedContaminated describes something that has been polluted by harmful microorganisms, chemicals, or other dangerous substances. In veterinary medicine, this can affect food, water, toys, or the environment. wounds with a high risk of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease.. A primaryPrimary refers to the first or original cause of a disease or condition, as opposed to secondary causes or symptoms that develop from it. closure would trap bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. and increase the risk of infectionAn infection is the colonization and multiplication of pathogens such as bacteria, viruses, fungi, or parasites in an organism, which often, but not always, leads to a disease.. Therefore, they are often left open or provided with drainageDrainage refers to the removal of fluid from body cavities, Wounds, or inflamed areas, often using a tube or other device. It is used to prevent infection and promote healing.. - How long does it take for a bite wound to heal?
The healing time varies depending on the severity and location between one and several weeks. Superficial wounds heal faster, while deep or infected wounds take longer. - Why is antibiotic therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. almost always necessary for bite wounds?
The saliva of animals contains numerous potentially pathogenic bacteriaBacteria are microscopic, single-celled organisms that exist in almost every environment on Earth. Some types of bacteria are beneficial or even essential to life, while others can cause disease. that enter deep into the tissue through the bite. Prophylactic antibiotics prevent serious infections. - What complications can occur with bite wounds?
Possible complications are abscess formation, sepsisSepsis is a life-threatening condition caused by the body's overwhelming response to an infection, which can lead to damage to its own tissues and organ failure., osteomyelitis, arthritisArthritis is an inflammation of the joints that can cause pain, swelling, stiffness, and limited mobility. There are many forms of arthritis, including rheumatoid arthritis and osteoarthritis., pneumothorax (in the case of thorax / chestThe thorax / chest is the upper part of the trunk, surrounded by the ribs, sternum, and spine. It protects vital organs such as the heart and lungs. injuries), peritonitis (in the case of abdominalThe term "abdominal" refers to anything that concerns the belly or the abdomen. It is an adjectival expression used to describe the location, symptoms, or conditions that occur in the abdominal area. injuries) and, in rare cases, tetanus. - Can my pet live normally with other animals again after a bite wound?
After complete healing, this is usually possible, but traumatic experiences can lead to behavioral changes. A gradual, controlled reintroduction and, if necessary, behavioral therapyTherapy refers to the treatment of diseases or disorders with the aim of alleviating symptoms, promoting healing, or improving quality of life. Therapies can be medicinal, surgical, or through other medical interventions. support are recommended.
Literature
- Cray M, Berent LM, Weese JS. Treatment of Bite Wounds in Dogs and Cats. Journal of the American Animal Hospital Association. 2021;57(5):227-236.
- Jha S, Gupta P, Al-Sudani T, et al. Microbiology and antimicrobial susceptibility in dog and cat bite wounds: A systematic review. PLoS ONE. 2023;18(1):e0280577.
- Kagan R, Mickelson M. Bite Wound Infections. Veterinary Clinics of North America: Small Animal Practice. 2022;52(4):927-941.
- Nolff MC, Albert R, Reese S, Meyer-Lindenberg A. Comparison of negative pressure wound therapy and silver-coated foam dressings in open wound treatment in dogs: A prospective controlled clinical trial. Veterinary and Comparative Orthopaedics and Traumatology. 2018;31(4):229-238.
- Pratesi A, Grieco G, Morabito S, et al. Prevalence of methicillin-resistant staphylococci isolated from the oral cavity of dogs and cats and genetic characterization of methicillin-resistant Staphylococcus pseudintermedius strains. Journal of Veterinary Diagnostic Investigation. 2021;33(5):910-917.