Yahoo Lifestyle Why a little cat bite can trigger a big health emergency
I was cat-sitting recently, in exchange for a free place to stay, when the white-and-gray cat lunged at my hand and bit it - ouch! - one evening before bed.
The bite left a small puncture wound below my left thumb, and it stung as I washed it and slathered it in antibiotic ointment. (My pride stung, too; animals usually love me.) I was sure I’d be fine, so the next afternoon when my hand turned red and swollen, I told myself I was imagining things; it was nothing.
But within an hour, a thick red line was traveling up my arm, almost to my elbow. I hurried to a nearby hospital emergency room, where they said that, without treatment, the infection was potentially life-threatening and that I might need surgery.
For a tiny cat bite?
“A cat bite is indeed an emergency,” said Julien Gaillard, head of the orthopedic and trauma surgery unit at the American Hospital of Paris, near where I was cat-sitting, and the doctor who treated me. “It can quickly lead to a serious infection within six to 12 hours after the bite.”
As a lifelong pet owner - or pet parent, as I think of myself - I was surprised I didn’t know this.
“Cat bites look very benign,” said Jacques H. Hacquebord, chief of the division of hand surgery at NYU Langone Health. “They just look like these little puncture wounds. But their teeth are so sharp; they’re like little needles, with the tip of it being bacteria.” And when you’re bitten by a cat, the pin-size wound tends to seal up quickly, trapping the bacteria and making the tissue beneath the skin a “fertile” ground for infection, Gaillard said.
In one study by the Mayo Clinic, 1 in 3 cat bites to the hand required hospitalization and some required surgery to clean the wound. In comparison, almost all dog bite ER patients are treated and sent home, even though the bacteria Pasteurella multocida is usually the culprit in both.
“Although dog bites occur far more commonly than cat bites, they less commonly become infected” due to the dog’s blunt teeth, which won’t create the same sort of puncture wound, Gaillard said.
Armed with oral antibiotics provided by the ER, I was spared surgery because I had no nerve damage (which would have been signaled by a tingling sensation), and also because the cat had bitten into my muscle, not a joint or tendon sheath. The latter would probably have required, in addition to the antibiotics, surgical irrigation and removal of dead or infected tissue to flush out the bacteria and help the wound heal.
Hacquebord said that, because joints and tendon sheaths don’t have the same amount of blood flow as muscle, it’s hard for your body to get antibiotics to those areas, where hand bite wounds inflicted by cats are often located. “The infection can go into all these nooks and crannies and then fester,” he said.
My wound healed after two follow-up appointments and three weeks of antibiotics. Because I have an autoimmune disorder and take a biologic medication that weakens my immune system, Gaillard said I would need additional monitoring and ordered an extra week of meds (for the total of three weeks). Babies and senior patients are also at risk of complications, such as a worsening of the infection that could lead to blood poisoning, and anyone not up-to-date on their tetanus shot (I thankfully was) will need one.
So, if you get bitten by a cat, how quickly do you need to get to a doctor - and what should you do in the meantime? The Mayo Clinic recommends that you immediately wash the wound with soap and water, apply an antibiotic ointment, and cover the wound with a clean bandage.
“Each case being unique, there is no consensus on management,” Gaillard said, adding that he recommends that patients visit a doctor as soon as possible - and within 24 hours at the latest. “The wound must be evaluated, at least cleaned, and, most often, antibiotic treatment initiated.”
Hacquebord said that cat bite patients may monitor their wound for the first 24 hours, but they must be prepared to act immediately if they see cause for concern, such as the red line going up my arm, a sure sign of infection setting in. “These things can accelerate really quickly,” he said.
If you’re bitten by a feral cat - meaning one living on the street or outdoors and unsocialized - in Western Europe or the United States, follow the same advice. You probably don’t need to worry about rabies: “The risk of rabies is so incredibly small” in these areas, Hacquebord said. But if you’re bitten in a country where rabies is endemic, immediately see a doctor and seek guidance from local health officials.
Swelling, redness, pain and tingling - in addition to that red line - are all signs that the infection is progressing. If ignored, it could progress to sepsis - the body’s extreme response to an infection, which can lead to shock, organ failure and death and is a true medical emergency, Hacquebord said. To avoid that, “you need to go to the emergency room, and you need to go to the emergency room soon,” he added, noting that if the wound continues to worsen after you are given antibiotics and leave the doctor or hospital, you need to return to the ER, and you might be admitted for IV antibiotics.
It’s worth nothing that a dog bite requires a trip to the emergency room if you’re bleeding heavily, but otherwise, patients should wash the wound thoroughly and monitor it for signs of infection, according to Hacquebord. “But your threshold for being concerned is much, much lower,” he said, since the wound is not likely to be as deep as the puncture of a cat bite.
After my treatment, I wondered why the cat, who had been friendly and welcoming, had bitten me in the first place. He followed me around, rubbed against my shins and even greeted me at the door. Just before he bit me, I’d given him a gentle pet on the head, as I had the previous four nights.
“If the cat is not interacting with you, don’t assume he wants to interact with you,” said Carlo Siracusa, an associate professor at the University of Pennsylvania School of Veterinary Medicine, who studies animal behavior. He explained that cats, like humans, may enjoy social interaction but consider it “rude” if it lasts too long. “When these interactions are prolonged, many times they perceive aggression,” he said. “It means that cats are getting nervous about it.”
My interactions had been very short, I pointed out. “But also there was a history at that point,” Siracusa added. For the cat, “the first day, it was [probably] like, ‘Well, you know, I’m not happy about it, but I take it.’ The second day is like, ‘Here we go again.’ Because then there is what we call an anticipatory anxiety.”
On the other hand, Siracusa noted (perhaps to soothe my bruised pride), it’s possible that a noise outside on the patio had made the cat nervous and I should have let him be. Despite a recent study showing that cats have nearly 300 facial expressions (far more than a dog), their body language can still be hard for humans to read.
“It’s always safest to wait for the cat to come to you, then you put your finger out, and most cats will come up and sniff you and rub against you,” said Katherine Houpt, professor emeritus at Cornell University College of Veterinary Medicine, who studies domestic animal welfare. “If they do that, it’s probably safe to pet them.”
Houpt said the biggest mistake people make is petting a cat in “the wrong place, or too many times in the right place.”
The cheeks are a favorite spot for felines, but belly, legs and tail are off limits, according to Houpt. And if you see a tail lashing back and forth, flattened ears or dilated pupils, step away, Houpt warned. “Rolling” their skin - think of it like a muscle twitch - can also be a sign they’re overstimulated and you should back off, Siracusa said.
Cats set boundaries even with their “preferred associates,” the term behaviorists use for a cat’s favorite person or animal - so don’t feel too offended if you’re the victim of a frustrated feline. Siracusa adopted a cat who’s bitten him, but that doesn’t make him care for her any less.
“Just the fact that cats decide to stay close to us, that should make us feel happy and honored,” he said.
The morning after the cat bit me, he was back to his normal, friendly self. I held no grudge - after all, he was just being a cat. But I was more careful about how and where I pet him.
“They have a lot of receptors, especially around their mouth and cheeks, but also in their body that make them very sensitive to touch. So, many times, they just get overstimulated,” Siracusa said. “Mother Nature makes them very sensitive.”
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