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Bite Wounds and Rabies Protocols

By Alyssa Blaustein, VMD
angell.org/emergency
MSPCA-Angell West
781-902-8400

 

It is very stressful when your pet gets into an altercation with another animal. Unfortunately, bite wounds resulting from dog fights or wild animal encounters are commonly seen veterinary emergencies. A veterinarian will best determine what kind of medical attention your pet needs to address his/her injuries, but there are also rabies protocols that need to be followed based on the type of animal encountered.

Bite wounds can be much worse than they appear on the surface. Small puncture wounds can often be the tip of the iceberg. Biting animals often have very strong jaws that can penetrate/tear the skin surface, in addition to crushing underlying structures and tearing skin or muscle away from the underlying tissue. Crushing can cause severe swelling, tissue death, and bone fractures. The worst cases often occur when smaller pets are attacked by much larger animals.

Evaluation and repair of these wounds often requires heavy sedation or anesthesia. If relatively minor, your general practitioner or emergency veterinarian may be able to handle treatment on an outpatient basis. The wounds will likely be shaved, thoroughly cleaned, flushed out, and explored. This allows as much of the contamination and dead tissue to be removed as possible. Some wounds will be left open to drain, while others will be closed in a staged process. If there is significant pocketing underneath the skin where it is no longer attached to the underlying tissue, a soft rubber drain may need to be placed. If the wound is severe or if there is penetration into your pet’s chest or abdominal cavity, your pet may need to be hospitalized and a board certified surgeon may need to become involved. Blood work and imaging may be recommended to confirm and evaluate the extent of internal damage. Bite wounds can be fatal if there is significant blood loss, inflammation, infection/sepsis, or damage to vital organs.

Bite wounds are at risk of becoming infected due to the heavy bacterial load of animal mouths and compromised surrounding tissue. Even if a wound appears minor, it is important to have your pet evaluated as soon as possible because prolonged time without treatment allows bacteria more time to proliferate in the affected area. Even with proper wound management and antibiotic treatment, it is still possible for tissue to become infected. If this occurs or if tissue dies, additional surgery may be necessary. Your veterinarian may also want to culture the wound to guide appropriate antibiotic therapy. After your pet’s wound is repaired, close monitoring is important. As mentioned above, tissues that initially appear healthy can change. It is often necessary to strictly rest your pet, give pain/anti-inflammatory medications in addition to antibiotics, and return to your veterinarian for drain removal (usually after 3-5 days) and/or suture removal (usually after 10-14 days).

Bite wounds can also transmit viral diseases from one animal to another. Cats are at risk of acquiring Feline Leukemia Virus (FeLV) or Feline Immunodeficiency Virus (FIV) from other cats that carry these diseases. Both dogs and cats are at risk of getting rabies from a variety of mammals. For this reason, and since humans are also at risk of acquiring rabies, there are strict rabies laws that we must follow. Rabies laws vary from state to state; the following discussion refers to Massachusetts rabies laws.

A bite wound before (left) and after (right) treatment.

Upon presentation to the emergency room, your veterinarian will often have you fill out a “Notice of Possible Exposure to rabies” form. This will include information about the encounter, your pet, and the animal encountered (if known). If the biting animal is an owned pet dog, cat, or ferret, it is important to get their information, as well as whether the pet has been previously vaccinated for rabies. If the biting pet is available for quarantine, he/she will need to be placed under strict confinement on the owner’s property for 10 days. If the biting animal is normal after 10 days, no additional action is required. If the biting animal begins to show signs consistent with rabies, rabies testing is required. If the animal tests positive, your pet should then receive a rabies vaccine booster and be strictly confined for 45 days. If your pet has never been vaccinated for rabies and is bitten by an animal that is identified and available for quarantine, they should be vaccinated regardless.

No post exposure confinement or vaccination is necessary if the biting pet is a guinea pig, rabbit, gerbil, or hamster that is housed exclusively indoors.

If your pet is bitten by an owned animal that is not available for quarantine or by an unknown wild animal, he/she should immediately receive a rabies booster (as long as they have not been vaccinated within 28 days) and be strictly confined on your property for 45 days (versus for 4 months if your pet has not been vaccinated for rabies before). Additional recommendations are based on the type of wild animal encountered. If it is a species at high risk of carrying rabies (such as bats, raccoons, skunks, foxes, coyotes, bobcats, or woodchucks), the wild animal should be tested if possible and post exposure treatment should be initiated. If it is a species at low risk of carrying rabies (such as squirrels, chipmunks, mice/rats, or rabbits), no post-exposure treatment is necessary.

If you are concerned your animal has been bitten, evaluation by a veterinarian is recommended regardless of the circumstances.

In any case where your pet has sustained a bite wound from a domestic animal of unknown rabies vaccination status, or from any wild animal, precautions should be taken to protect yourself and other humans from potential rabies exposure. This includes wearing gloves if you are touching the wound area or removing saliva or blood, not touching the wound area if possible, and notifying your health professional if you have experienced possible exposure to rabies.

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