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Bite Injuries - Animal Bites 

Introduction
Animal bite injuries can cause skin wounds and structural damage to the hand.  Infection and, less commonly, rabies are always a main concern.  Pets are the most common source of bite injures, although they may result from wild animals as well.  Animal bite injuries need prompt careful cleaning.  Hand surgery may be necessary to drain infections or repair injured bones, blood vessels, muscles, tendons, ligaments, and nerves.

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Anatomy
Your hand is composed of many bones that provide structure for your wrist and fingers.  The bones are connected with strong ligament tissues.  Tendons are strong fibers that attach your muscles to your bones and allow movement.  Your hand also contains nerves, blood vessels, and fat.  The skin that covers your hand protects it from the environment.

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Causes
The hand is the most common place for animal bites.  Animal bites can result in skin lacerations, puncture wounds, crushed bones, torn ligaments, tendons, and muscles.  They can injure or damage blood vessels and nerves.  Compounding the physical injuries, several types of infections, including rabies, are transmittable from the animal’s mouth into the hand. 
 
Dogs have rounded teeth and strong jaws that can cause crushing injuries.  Animal bites can break the skin and cause a puncture wound.  Cats have sharp pointed teeth and cause more puncture wounds than dogs. 
 
Infection is a major concern for all bite injuries.  Most infections from animal bites are mixed infections, meaning that a combination of sources including bacteria, virus, fungal, and other germs cause them.  Rabies is a concern, because without timely treatment rabies is fatal.  Most pets in the United States are vaccinated against rabies.  The majority of rabies cases occur from wild animals such as skunks, bats, or raccoons.
 
Pets are a common cause of animal bites.  Dog bites occur most frequently, followed by cat bites.  Stray animals and wild animals also cause bite injuries.  Skunks, raccoons, foxes, bats, rodents, reptiles, and farm animals may bite people if they are sick, provoked, or feel threatened.
 
If an animal bites you or your child, you should try to keep the animal in view and contact your local animal control experts to capture it.  They may quarantine the animal and check it for rabies.  They can also verify the rabies vaccination status of stray pets.

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Symptoms
An animal bite can cause pain and swelling.  It may be difficult for you to move your fingers or wrist if the bones, muscles, tendons, ligaments, or nerves are injured.  You may experience a loss of sensation or tingling in your fingers.
You should inspect your hand for puncture wounds and bleeding.  Signs of infection include warmth, redness, pain, and tenderness.  Drainage of pus can occur with abscess formation.  Infections can also cause a fever, chills and or sweats.
 
You should contact your doctor if you or your child suffers an animal bite.  You should carefully wash the wound with soap and water, unless the area is actively bleeding.  If you experience bleeding apply direct pressure with a clean dry cloth and elevate your hand above the level of your heart.  You should go to your doctor or an emergency department for immediate treatment of bleeding.

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Diagnosis
You should tell your doctor what kind of animal bit you and how you received the bite.  Your doctor will examine your hand and arm.  An X-ray may be ordered if structural damage is suspected.
 
Your doctor will carefully wash and remove any foreign material from your wound.  Your doctor may order a blood test to check for infections.  You may need to get a tetanus shot and antibiotics to help prevent infection. 
 
If rabies is identified or suspected, you will receive a series of vaccinations.  The medication is highly effective if it is received in the first stage of rabies.  As the consequences of rabies are so severe, you should always promptly contact your doctor if you or your child suffers an animal bite.

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Treatment
Animal bites that puncture the skin require careful cleaning.  To avoid infection, wounds are usually kept open, instead of stitched shut.  If you have an infection, you may receive antibiotic medication, antibiotic ointment, or IV antibiotics.  Your wound will be loosely bandaged.  Your doctor will provide you with home care instructions.  It is very important that you attend your follow-up appointments so that your condition can be monitored.

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Surgery
Surgery may be necessary if bones, blood vessels, muscles, tendons, ligaments, or nerves are injured, or if an abscess develops.  The type of surgery that you receive depends on the type and extent of your injury.  You will most likely participate in hand therapy rehabilitation following surgery.  The goal of surgery is to return your hand structure and function to its pre-injured condition.

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Recovery
Recovery from animal bites is an individualized process.  Your recovery will depend on the extent of your injury or infection and the type of treatment you receive.  Your doctor will let you know what to expect.  Attend all of your doctor and hand therapy appointments to ensure the best recovery possible. 

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Prevention
There are several ways that you may be able to prevent animal bites.  Do not approach, pick up, or play with any type of wild animal.  You should not try to separate animals that are fighting.  Avoid animals that appear sick or that are acting odd—call your local animal control service to have the animal picked up.  Do not provoke or tease animals.  Do not approach pets when they are eating. Keep your pet on a leash in public and make sure your pet is vaccinated.  Do not touch other's pets without asking permission of the owner first.  Teach your children about animal bite prevention.

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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on April 13th, 2016. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.