“The greatness and moral development of a nation is judged by the way it treats animals,” says Gandhi.  There are so many neglected, thrown out dogs or cats around.  And these animals are so unprotected, helpless and miserable that… Unfortunately, they can harm people unintentionally.
In the pediatric surgeon’s journal, I’ll tell you about cat and dog bites, what to do and how to avoid them.  But first, in our country, which is far from justice today, let me remind you of a saying of Hz. Ali: “A predatory and gluttonous animal is better than a judge who is far from justice.”
Did you know that according to statistics, there are 2-5 million animal bites a year in North America, and 1% of annual emergency visits are due to this reason?
90% of bite cases are also dog bites, and the most common victims are children; especially boys aged 5-9 years.  Cats are responsible for the remaining bite injuries. However, this time the victim is not children but, as we might guess, adult women.
Let me immediately highlight an important difference between cat and dog bites.
The incidence of infection after cat bites is much higher than after dog bites.  While only 7% of infections are seen in dog bites, this rate is almost half in cat bites.  However, no matter which animal bites, the risk of infection increases in cases of low immune system, hand-foot bites, bites from operated or diseased areas, deep-pierced or crushed bites, and late visits to a doctor.
Dog bites are more common in the head and neck area in young children, while limbs are bitten in older children and adults.  Cat bites, on the other hand, are mostly seen on the hands, and since cats’ teeth are thin, pointed, and long, they can penetrate deeper and cause serious infections.
While signs of infection may appear up to 24 hours after dog bites, infection can occur in as little as 12 hours after cat bites.  These infections can be in the form of superficial infections such as cellulitis or deep infections where joints, bones and tendons are involved.
You can immediately tell that the infection has developed.  The severity of the pain begins to increase gradually, systemic signs of infection such as fever appear, redness and swelling around the wound increase, and even a crackling sound can be felt when you press on it due to the formation of air under the skin.
If our patient comes with the findings I have explained, we first take a sample for the culture from the wound.  There is no need for routine culture of bite injuries unless we are considering infection.  If we do not think that foreign objects such as teeth are left inside and there is no deep and crushing bite that can damage joints and bones, we do not need to do imaging.
What to do in cat and dog bites?
What you need to do is to wash the wound with plenty of soap and water, if possible, and to apply an antiseptic solution such as betadine, if available.  If there is bleeding, stop the bleeding by applying pressure on it.  Then you need to go to the nearest hospital so that we can do the dressing.
In general, if it is a superficial wound, we can close the open wound with stitches, but we prefer the tissue to heal itself, especially in deep bites, cat bites, hand-foot bites, that is, in cases where infection development is much higher.  But facial bites may require stitches in any case.
We always start antibiotics for all our patients.  Although, in a study, it was revealed that preventive antibiotics only work in hand bites, but the general approach is to give them to all bites.
Another reason to see a doctor is to get vaccinated.  Bite injuries can cause tetanus.  We make sure to vaccinate every patient for tetanus.  For superficial bites by a known animal, rabies vaccination can be expected if the animal is close at hand, if you wash it well with soap and water.  But otherwise, it is absolutely necessary to vaccinate against rabies.  Your doctor will direct you anyway.
Also, a very important issue that you should not forget after everything is over is that your child may develop post-traumatic stress.  You must get the necessary help.
Best not to get bitten.  What to do?  As someone who has been with animals for years, let me give you a few tips on what to do if you come across a dog trying to attack you.
Dogs are sensitive to movement, and they all have a chase instinct.  So don’t panic and run.  You can’t run faster than a dog anyway.  Stand still, sideways if possible, and don’t make eye contact.  If you have an object, such as a water bottle, distract them to somewhere else.  If you have a bag in your hand, put it on the ground between you and the dog, it will perceive it as a barrier.  If he continues to bark, give orders such as “no” or “get out” in a loud voice without shouting.
Whatever you do, you will try to cause the least injury if he attacks with a snarl.  You cannot escape.  You can climb to a higher place.  You will fist your hands to protect your fingers.  You can try to hit him in the nose, neck, throat.  You will scream and ask for help.  You must protect your neck and face.  If it’s a small dog, you can put your weight on it and try to press it on its neck.
What I said was for you.  If you see a dog barking and running, you can simply tell your child not to run, not to be afraid.
It’s best not to pet unfamiliar dogs until you’re sure they’re friendly.  If they are owned, be sure to get permission from the owners first.  Do not try to pet a dog that is eating or sleeping.
But do not leave a dog without love, who comes to you by wagging its tail, lying in front of you or trying to make you like it by opening its belly.
Remember, love multiplies when shared.  It is good for both you and him.
I’ll talk about cat-scratch disease in the next episode.
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And stay happy.
Prof. Dr. Egemen Eroğlu
October 2022