Insect Sting
Insect stings are a common problem for our pets, which in most cases are harmless but can become life-threatening in certain situations. An insect sting is defined as the penetration of an insect’s stinger or mouthparts into the animal’s skin, often injecting toxins or irritating substances. For dogs and cats, stings from bees, wasps, hornets, bumblebees, as well as bites from ants, mosquitoes, and horseflies are particularly relevant. The animal’s reaction to these stings varies greatly and depends on various factors: the insect species, the amount of venom injected, the location of the sting, and the individual sensitivity of the animal. While most stings only cause local reactions, some animals can develop allergic reactions, which in the worst case can lead to anaphylactic shock. Stings in the respiratory tract area are particularly dangerous, as swelling here can lead to life-threatening complications.
Causes
Insect stings from bees, wasps, hornets or ant bites etc. on the skin are usually harmless and don’t require treatment (Fig.).
The occurring symptoms such as itching and swelling subside on their own.
In rare cases, an allergic reaction can occur (see —>Anaphylaxis) and have dramatic consequences.
A sting in the throat area may also require treatment due to the resulting swelling.
Supplement
The causes of insect stings in pets are diverse and depend heavily on the animals’ behavior and environmental conditions. Insect stings occur particularly frequently in the warm season when insects are more active. The various insect species cause different reactions:
Bee stings are characterized by leaving behind the stinger with an attached venom sac. The venom contains enzymes, peptides, and biogenic amines that cause pain and inflammatory reactions. Bees typically only sting in self-defense.
Wasp stings can occur multiple times as wasps don’t lose their stinger. Their venom contains similar components to bee venom, but in a different composition. Wasps are particularly attracted to sweets and meat and can react more aggressively than bees.
Hornet stings contain a higher venom concentration and can therefore cause stronger reactions. However, hornets are less aggressive than often assumed and usually only sting when directly threatened.
Mosquito bites lead to local reactions due to saliva release and can, in rare cases, transmit pathogens. Mosquitoes are particularly active near water bodies and at dusk.
Tick bites are a special case as they remain attached longer and can transmit various pathogens such as Borrelia or Anaplasma in addition to causing local reactions.
The curious behavior of many dogs and cats, especially sniffing and chasing insects, significantly increases the risk of stings in the facial and mouth area.
Symptoms
Stings in the respiratory tract and mouth area require much more caution.
If one or more of these symptoms occur, take your pet to a veterinarian as soon as possible:
- Coughing
- Swelling in the facial area
- Breathing difficulties
- Increased heart rate
- Vomiting
The symptoms after an insect sting vary depending on the insect species, sting location, and individual reaction of the animal. Typical local reactions include redness, swelling, warmth, and pain at the sting site. These symptoms usually develop within a few minutes after the sting and can last for several hours to days. Affected animals often lick or scratch the sting site, which can lead to secondary infections.
Stings in the head and neck area are particularly dangerous. Swelling here can quickly lead to breathing difficulties. Stings in the mouth or throat area can cause life-threatening swelling that obstructs the airways. Symptoms such as drooling, gagging, coughing, or shortness of breath are warning signs and require immediate veterinary assistance.
In case of allergic reactions, systemic symptoms can occur that affect the whole body. These typically develop within 20 minutes after the sting and include:
- Extensive swelling that extends beyond the sting site
- Urticaria (hives) with wheal formation
- Vomiting and diarrhea
- Restlessness or lethargy
- Increased heart rate and respiratory rate
- Pale mucous membranes
- Collapse or unconsciousness
Anaphylactic shock represents the most severe form of allergic reaction and can be fatal without prompt treatment. Animals with known insect venom allergies have an increased risk of severe reactions to subsequent stings.
First Aid
- Removing the stinger and lightly cooling the affected skin area are usually sufficient.
- Observe your pet for the next 30 minutes.
- Prevent your pet from scratching intensively to avoid causing a wound and subsequent infection.
Diagnosis
The diagnosis of an insect sting is primarily based on clinical examination and anamnesis. Pet owners often report observing their animal’s contact with insects or notice typical behavioral changes such as sudden howling, yelping, or frantic licking of a specific body part. During the clinical examination, the veterinarian looks for characteristic signs such as local swelling, redness, or a visible stinger.
In bee stings, the remaining stinger with attached venom sac can often be identified. This should be carefully removed, ideally by sideways scraping with a credit card or similar flat object to avoid further squeezing of the venom sac.
The differential diagnosis includes other causes of acute swelling and allergic reactions such as contact allergies, foreign bodies, bite injuries, or reactions to medications. In unclear cases or severe systemic reactions, further diagnostic measures may be necessary:
- Blood tests to assess inflammatory parameters
- Allergy diagnostics using serological tests (IgE determination)
- In case of suspected secondary infections: bacteriological examinations
- In case of respiratory distress: X-rays of the thorax to assess the airways
For animals with recurrent allergic reactions, an allergological assessment may be useful to detect specific sensitizations and possibly initiate desensitization therapy.
Further veterinary measures
Further measures, if not already taken, are to remove the bee stinger with the venom reservoir.
If the stings with subsequent swelling are in areas where they can impede breathing, anti-swelling medication should be given.
The veterinarian is familiar with the classification of the severity of an allergic (anaphylactic) reaction and will accordingly initiate appropriate measures (—> Allergic Reaction (Anaphylaxis).
Supplement
The treatment of insect stings depends on the severity of the symptoms and ranges from simple first aid measures to intensive medical care. For uncomplicated local reactions, often no specific treatment is necessary. The following therapeutic measures are used depending on the severity:
For bee stings, the stinger should first be carefully removed, ideally by sliding it off sideways to avoid further squeezing of the venom sac. The sting site can then be cooled to reduce swelling and pain. Cold compresses should be applied for 10-15 minutes and repeated if necessary.
For moderate local reactions, antihistamines can be used to reduce itching and swelling. Commonly used active ingredients are diphenhydramine, cetirizine, or chlorpheniramine in veterinary-adjusted dosages. However, these should only be administered after consultation with the veterinarian.
For stronger inflammatory reactions, corticosteroids such as prednisolone or dexamethasone may be used. These have a strong anti-inflammatory effect and can be life-saving in allergic reactions. The dosage and duration of use are determined individually by the veterinarian.
For severe allergic reactions or anaphylactic shock, emergency therapy is required:
- Adrenaline (epinephrine) to stabilize circulation and reduce bronchial constriction
- Intravenous fluid therapy for circulatory stabilization
- High-dose corticosteroids
- Oxygen administration for respiratory distress
- Intubation and ventilation for severe airway obstruction
For stings in the mouth or throat area with swelling that may affect the airways, immediate veterinary treatment is essential. In some cases, temporary tracheotomy may be necessary to ensure breathing.
In case of secondary infections at the sting site, antibiotic therapy may be required. The choice of antibiotic is ideally made based on an antibiogram.
Prognosis and aftercare
The prognosis for insect stings is excellent in most cases. Local reactions usually subside within 24-48 hours without lasting damage. For uncomplicated stings, no special aftercare is required, except for monitoring the sting site for signs of secondary infection.
In animals that have shown an allergic reaction, the prognosis depends on the severity of the reaction and the speed of treatment. An anaphylactic shock treated in time has a good prognosis, while delayed treatment can lead to permanent organ damage or death. Animals with known insect venom allergies should be monitored closely and pet owners should be aware of potential insect contacts.
Aftercare for severe reactions includes close monitoring of the animal for signs of renewed deterioration. After an anaphylactic reaction, the animal is often monitored in-patient for 24-48 hours, as biphasic reactions can occur where symptoms reappear after apparent improvement.
For animals with known insect venom allergies, the veterinarian may prescribe an emergency kit with antihistamines and, if necessary, an adrenaline auto-injector, and train the owner in their use. Additionally, desensitization therapy (specific immunotherapy) may be considered to reduce the allergic reaction in the long term.
For the future, it is important to take preventive measures to avoid further stings. This includes avoiding areas with high insect activity, especially during the summer months, as well as using pet-friendly insect repellents after consulting with the veterinarian.
Summary
Insect stings in dogs and cats are common events that in most cases are accompanied by mild local reactions and do not require specific treatment. Symptoms range from local swelling and redness to life-threatening allergic reactions. Stings in the respiratory tract area are particularly dangerous, as swelling can lead to respiratory distress.
First aid measures include carefully removing bee stingers, cooling the sting site, and observing the animal for signs of an allergic reaction. In severe reactions, immediate veterinary treatment is essential, which may include antihistamines, corticosteroids, and adrenaline in case of anaphylactic shock.
The prognosis is good with timely treatment, however, animals with known insect venom allergies should be particularly protected. Preventive measures such as avoiding areas with high insect activity and using suitable repellents can reduce the risk of future stings.
Pet owners should know the symptoms of an allergic reaction and when veterinary help is needed. With the right knowledge and quick action, even severe reactions to insect stings can be successfully treated.
Outlook on current research
Research in the field of insect venom allergies in pets continues to evolve. Current studies focus on improved diagnostic methods that allow for more precise identification of the triggering insect venoms. Molecular allergy tests that can detect specific components of insect venoms are increasingly being used in veterinary medicine and allow for a more accurate differentiation between cross-reactions and true sensitizations.
In the area of therapy, new protocols for desensitization (specific immunotherapy) are being researched, which should enable more effective and faster hyposensitization. These could improve treatment options for animals with severe insect venom allergies in the future.
Innovative emergency medications with extended duration of action and improved stability are being developed to optimize the initial treatment of allergic reactions. Furthermore, researchers are working on more pet-friendly formulations of antihistamines and corticosteroids with reduced side effect profiles.
Another research focus is on the development of more effective and simultaneously environmentally friendly insect repellents for pets. Natural active ingredients are being investigated for their efficacy and tolerability to find chemical alternatives with lower environmental impact.
Climate change is leading to altered distribution areas of various insect species, which brings new challenges for veterinary medicine. Studies on the spread of new insect species and their potential impacts on pet health are gaining increasing importance.
Frequently asked questions (FAQs)
- How do I recognize if my pet has been stung by a bee or wasp?
With bee stings, the stinger with venom sac often remains stuck in the skin, while wasps retain their stinger and can sting multiple times. Bee stings are often more painful, while wasp stings tend to burn. - Can I give my pet human antihistamines?
Some antihistamines approved for humans can also be used in animals, but only after consultation with the veterinarian and in the correct, species-specific dosage. Some human preparations contain additives that can be toxic to animals. - How do I properly remove a bee stinger?
The stinger should be carefully scraped off sideways with a credit card or similar flat object. Pulling it out with fingers or tweezers can lead to squeezing the venom sac and should be avoided. - When should I take my pet to the veterinarian if it has been stung?
Immediate veterinary help is required for: stings in the mouth or throat area, breathing difficulties, severe swelling, vomiting, diarrhea, weakness, collapse, or known insect venom allergy. - Can my pet develop an allergy to insect stings?
Yes, dogs and cats can develop allergies to insect venom. An allergic reaction can occur after the first sting or only after several stings and can become more severe with each subsequent contact. - How can I protect my pet from insect stings?
Avoid walks in areas with high insect activity, especially during morning and evening hours. Keep away from flowers, trash cans, and fallen fruit. After consulting with the veterinarian, special repellents for animals can be used. - Can insect stings leave scars on my pet?
In most cases, insect stings heal without scarring. However, excessive scratching or licking can lead to secondary infections, which may result in scarring. - Is a hornet sting more dangerous for my pet than a bee sting?
Hornet venom contains a higher concentration of toxins, which can lead to stronger local reactions. However, the danger mainly depends on the individual sensitivity of the animal. - How long does it take for swelling to subside after an insect sting?
For uncomplicated stings, swelling mostly subsides within 24-48 hours. For larger swellings or allergic reactions, it may take longer. - Can my pet die from a single insect sting?
A single insect sting can be fatal in case of a severe allergic reaction (anaphylactic shock) if not treated promptly. For non-allergic animals, single stings are generally not life-threatening, unless they occur in the respiratory tract area and lead to obstruction.
Literature
- Kohn, B. and G. Schwarz: Praktikum der Hundeklinik, Enke, 12th Edition, Stuttgart 2017
- Sigrist, N. (Ed.): Notfallmedizin für Hund und Katze; Sofortmaßnahmen und sichere Aufarbeitung. Stuttgart, Enke Verlag 2017.
- Löwe, G. and Löwe, O. (2021). Emergencies in Dogs and Cats – A Veterinary Guide. Kynos-Verlag. 208 p.
- Mueller RS, Jensen-Jarolim E, Roth-Walter F, Marti E, Janda J, Seida AA, DeBoer D. Allergen immunotherapy in people and dogs with allergies: a comparative review. Journal of Allergy and Clinical Immunology: In Practice. 2018;6(4):1363-1376.
- Saridomichelakis MN, Olivry T. An update on the treatment of canine atopic dermatitis. The Veterinary Journal. 2016;207:29-37.
- Rudloff E, Kirby R. Anaphylaxis and angioedema. In: Silverstein DC, Hopper K, editors. Small Animal Critical Care Medicine. 2nd ed. St. Louis: Elsevier; 2020. p. 807-812.
Bee on a dog’s nose