Dog bite: brief overview
- What to do in case of a dog bite? First aid: Clean, disinfect and close the wound (e.g. with a plaster). Press a germ-free, sterile material (e.g. sterile compress) onto a heavily bleeding bite wound and apply a pressure bandage if necessary.
- Dog bite risks: severe skin and muscle injuries, nerve injuries (sometimes with subsequent sensory disturbances), vascular injuries (sometimes with dangerous blood loss), bone injuries, wound infection, formation of unsightly scars.
- When to see a doctor? In principle, every bite wound should be examined by a doctor and treated if necessary (especially in case of heavy bleeding).
Attention!
- Even small bite wounds can become infected. In the worst case, a life-threatening tetanus or rabies infection develops!
- In case of a heavily bleeding dog bite wound, you should consult a doctor or call the emergency doctor as soon as possible after the initial treatment!
Dog bite: What to do?
If you irritate or frighten a dog (unintentionally), it can snap quickly. Sometimes only the skin is superficially scratched. However, with its rounded teeth and powerful jaw muscles, a dog can also inflict severe tissue injuries on the victim.
Generally, the following first aid measures are recommended for a bite wound of a lighter nature:
- Clean the wound: clean the bite wound carefully but thoroughly with lukewarm water and soap as soon as it stops bleeding profusely.
- Disinfect wound: Use an appropriate wound disinfectant to disinfect the dog bite wound, if available.
- Cover wound: For a small bite wound, a band-aid will suffice. A larger bite wound, on the other hand, should be covered with a sterile pad or gauze compress.
- Off to the doctor!
In case of a bite wound with heavy bleeding, you must initiate these first aid measures:
- Stop bleeding: Press a soft material that is as germ-free as possible (e.g. sterile compress) onto the bite wound or into the wound.
- Apply a pressure bandage if the bleeding is particularly severe.
- Take the patient to a doctor immediately or alert the emergency services (112) – especially if the bleeding cannot be stopped!
Dog bite: Risks
A dog bite carries various risks: On the one hand, much tissue may have been injured, such as muscles, nerves, blood vessels and bones. Second, invading germs (especially from dog saliva) can cause a wound infection.
Tissue damage
A dog bite can cause varying degrees of tissue damage. In mild cases, often only the superficial layer of skin (epidermis) is injured.
In addition, a deep dog bite can injure nerves, blood vessels and sometimes even bones, in addition to skin and muscle tissue. Nerve injuries can result in nerve failures (sensory disturbances). This can mean, for example, that the sensation of touch in the affected area will not be as good in the future as it was before.
In the case of vascular injuries, escaping blood can accumulate in a barely stretchable muscle pulley (= group of muscles surrounded by fascia). The area swells and is very painful. Doctors refer to this as compartment syndrome. As a further consequence, muscle weakness and nerve deficits can develop.
In infants and small children, a dog bite often has particularly bad consequences: The animal can bite or tear off entire body parts (e.g., ears, hands or even the entire head) even more easily in them than in older children and adults.
Dog bite infection
Bacteria from the skin flora of the bitten person as well as environmental bacteria can also infect the bite wound. However, this happens less frequently than a wound infection caused by bacteria from the dog’s saliva.
You can recognize an infected bite wound by swelling and redness that spreads around the wound.
According to research, five to 25 percent of all dog bites result in a wound infection. On a case-by-case basis, the likelihood of a dog bite wound infection depends on several factors. These include:
- The type and degree of contamination of the bite wound.
- extent of tissue destruction
- the individual patient profile, e.g. increased risk of infection in young children, the elderly and weakened immune systems (e.g. as a result of diabetes, HIV, cancer or cortisone treatment)
- affected body region (dog bites on the hands, feet, face and genitals particularly often lead to wound infection)
Some wound infections remain localized. However, it can also happen that the pathogens spread to other tissues and organs. Possible consequences are then, for example:
- Phlegmon: This is the spread of the inflammation to the surrounding tissue.
- Abscess: accumulation of pus in a cavity caused by the inflammation-related melting of tissue
- Joint empyema: collection of pus in the joint space (due to spread of the dog bite infection to an adjacent joint)
- Inflammation of an entire joint (arthritis): However, this rarely happens with a dog bite infection.
- sporadic spread of the infection to other organs, which can lead, for example, to bone marrow inflammation (osteomyelitis), meningitis or pus accumulation in the liver, lungs or brain.
Dog bite: When to see a doctor?
In the case of a dog bite wound, a visit to the doctor is always advisable. Even if the dog has left only small wounds in the skin with its pointed teeth, these can reach very deep, which increases the risk of wound infection.
This is because germs from the dog’s saliva can penetrate deep into the tissue and cause inflammation, while the wound edges of the small entry point quickly stick together in the upper layers of the skin, making further wound care seemingly unnecessary.
Therefore, small bite wounds are generally more dangerous than large bite wounds, which often bleed profusely and close more slowly.
A visit to the doctor is also advisable for a dog bite because the patient may need a vaccination against tetanus or rabies. These vaccinations should be administered as soon as possible because both diseases can become life-threatening.
Dog bite: examinations by the doctor
First of all, the doctor will take the patient’s medical history (anamnesis) in a conversation with the patient or the parents (in the case of children with a dog bite). Possible questions are:
- Where and when were you (or your child) bitten?
- Has the appearance of the wound changed since the dog bite? If so, how (swelling, redness, pus formation, etc.)?
- Has there been or is there a fever?
- Are there any other symptoms such as numbness in the area of the bite wound or movement problems of the affected body part?
- Are there any pre-existing conditions (such as diabetes)?
- Are you (or your child) taking any medications (e.g., cortisone or other preparations that suppress the immune system)?
If it is not your own dog, you should obtain such information from the dog’s owner if possible and pass it on to the doctor.
Physical examination
After the anamnesis interview, a physical examination follows: the doctor will closely examine the dog bite wound. He will look at how much tissue has been injured, how badly the wound is contaminated and whether there are signs of inflammation (such as swelling, redness, hyperthermia, pus formation).
He may take photographs of the dog bite wound (for documentation).
In the case of a dog bite to the arm or leg, the doctor will also check the mobility of the affected limb (such as the elbow or knee joint). Muscle strength, reflexes as well as the sense of touch of the skin (sensitivity) are also tested. In this way, any damage to muscles, tendons or nerves can be detected.
Blood test
For example, in dog bite inflammation, various inflammatory parameters are elevated in the blood such as white blood cells (leukocytes) and C-reactive protein (CRP).
Dog bite wound swab
The doctor takes a swab from the bite wound or obtains samples of the wound secretion for more detailed analysis in the laboratory. There, one checks whether possible pathogens of a dog bite infection can be cultured in the sample material. If so, the doctor can then prescribe the patient a suitable medication against the germs.
Imaging
If there is a suspicion that bone tissue was also injured in the dog bite, an X-ray examination can provide clarity. In the case of a dog bite to the face or skull, the doctor will usually order a computed tomography (CT) scan or magnetic resonance imaging (MRI).
Dog bite: Treatment by the doctor
Medical treatment of a dog bite wound depends on which part of the body the animal bit and how extensive the injury is. General measures of wound care are:
- Cleaning of the bite wound (e.g. with a 1% organoiodine solution)
- Wound irrigation with saline solution
- Debridement (excision of torn, crushed and dead wound tissue)
- Primary wound care: direct wound closure with plaster, tissue adhesive, staples or suture. This is done for uncomplicated bite wounds that are no more than a few hours old.
- Secondary wound care: The dog bite wound initially remains open (sometimes for days) and is cleaned several times before it is finally closed (e.g., by suturing). This is necessary for large and/or gaping wounds as well as infected wounds.
- If necessary, immobilization of the injured body part (especially in case of wound infection).
In some cases, the physician will give the patient antibiotics to prevent bacterial wound infection. This may be appropriate, for example, in the case of fresh, deep bite wounds as well as bite wounds in critical body regions (hands, feet, areas near joints, face, genitals).
Patients with an increased risk of infection (such as diabetics) and those with implants (e.g. artificial heart valves) often receive antibiotics as a preventive measure after a dog bite.
If a bacterial wound infection already exists, antibiotics are used in all cases.
A tetanus vaccination is administered by the doctor after a dog bite in case of missing vaccination protection (e.g. last tetanus shot too long ago) or unknown vaccination status.
A rabies vaccination is necessary if an infection cannot be ruled out (e.g. in case of a bite by a feral dog, a bite by a domestic dog that behaves unusually trustingly or aggressively – rabies suspected!).
Prevent dog bite
- Never leave a child alone with a dog, even if it is the otherwise well-behaved pet dog. Even out of play, the dog may suddenly perceive the child as a threat and bite.
- Watch for warning signs from the dog such as the animal backing away, raising its flews and baring its teeth, growling, flattened ears, ruffled fur, tail raised or tucked.
- Do not disturb the dog while it is eating or sleeping! If you take food away from a feeding dog or touch a sleeping dog suddenly (and roughly), it may snap.
- Be especially careful when handling mother dogs and their puppies.
- Do not separate dogs that are scuffling with each other. Otherwise, you run the risk of becoming involved in the fight and being injured.
- Avoid making loud noises (such as yelling) around the dog. The animal may perceive loud noises as a threat and then snap.
- You should only touch or pet strange dogs if the owner has allowed it (he knows his animal best). Also, always let the dog sniff you before touching it.
If a strange dog approaches you without an owner, you should heed the following rules to avoid risking a dog bite:
- Keep calm and stand still!
- Do not panic and do not shout!
- Do not stare at the dog (especially not directly into the eyes)!
- Say “No!” or “Go home!” or similar in a low voice.
- In the best case, stand sideways to the animal – direct confrontations could provoke the animal to a dog bite.
- Wait for the dog to lose interest and walk away!
Educate your child about proper dog handling, too! They are particularly likely to suffer a dog bite, especially in critical regions such as the head and neck.
