Should I worry about this bite?

April 6, 2009 1:08 PM

Cat bite that broke the skin: Should I worry yet?

I was bitten by a cat about 5 hours ago. It was a hard bite and broke the skin. There was some bleeding, and it didn't stop right away after I washed it and put a band-aid on it. (The cat was vaccinated for rabies last year, so I don't have to worry about rabies. I have a recent tetanus shot as well.) I'm starting to get worried, though, especially because I've been Googling "cat bite infection"... The bitten finger is painful/sore, looks a tiny bit swollen, and most worrying of all, feels noticeably warmer than my other fingers on that hand (which are freezing because it's cold here today). Should I just keep an eye on it? Call the doctor? (I have health insurance and I filled out an accident report at work, where it happened.) For those of you who have been bitten by cats and developed infections, what happened leading up to that?

posted by trillian to pets & animals (19 answers total)

I would say to keep an eye on it but don't get bent out of shape on it yet. If the local area starts to really swell up , then yes that can be an issue and go seek treatment. If on the other hand it's only a little bit swollen and sore/painful (you've been bitten, of course it hurts ;)), just keep it clean and take care of it like any other wound. The warmer thing could actually be confirmation bias on your part and not actually real. You have been googling cat bite infection after all and some of that is quite scary sounding. Anecdotally, which is not the same as hard data, but nevertheless here it is, I can recall in my lifetime getting bitten more than a few times with no lasting ill effects, and not requiring treatment by a doctor.

The only person I've ever known who needed actual professional medical treatment for a cat bite was my brother in law. They have 8 cats, and getting scratches/minor bites is not an entirely uncommon occurrence in their household.

Anyway, two of their cats were having quite the fight so he stepped in and grabbed the instigator, who twisted around in his grip and bit him hard on the knuckle to the point that the cat's fang actually penetrated the knuckle. That's apparently a time for concern (bone penetration) as his hand swelled up like a balloon and he required a course of strong antibiotics to fend it off.
posted by barc0001 at 1:19 PM on April 6, 2009

I've had infected cat bites (from my own cat, no less). It takes a day or two for the infection to show up. It'll get swollen and very painful -- much more painful than a wound of that size should be.

Any scratch/wound/cut/bite/scrape would feel warmer and look redder than undamaged tissue. That means your body is healing the area. Don't worry yourself into a funk over it.

For now, put some antibiotic gel on it, keep it covered with a band-aid, and call the doc in a couple days if it seems to be getting infected. It'll be easily treated with antibiotics at that point. Again, don't start worrying that you're going to lose your hand.

And stop Googling.
posted by mudpuppie at 1:21 PM on April 6, 2009

Five hours is too soon for in infection to have set in. The warmth is probably due to increased blood flow as part of your body's response to begin healing. I'm assuming that you washed the site thoroughly, applied some sort of antiseptic, and dressed the wound.
posted by longsleeves at 1:21 PM on April 6, 2009

I am not your doctor; you are not my patient; this is not medical advice, only education. No one on the Internets can properly assess you without a full history and physical exam. The signs/symptoms you are describing could be either very normal or very abnormal, no way to tell without seeing you in person.

Cat bites are highly prone to infection and usually require antibiotics and can often cause a rapid cellulitis (skin/soft tissue infection);
bites on the finger/hand can lead to serious complications due to the hand's anatomy and highly important functions, sometimes requiring IV antibiotics or hospital admission;
Cat bites are typically puncture wounds, making them hard to clean and sometimes a part of the tooth can get broken off inside the bite, requiring xrays.

Patients should speak with their doctor immediately, or if unable, head to the Emergency Department for evaluation and treatment.

On preview:
Five hours is too soon for in infection to have set in.
This is true of most infections, but absolutely incorrect in the setting of cat bites.
posted by gramcracker at 1:25 PM on April 6, 2009

My boyfriend went to urgent care a few weeks ago for a dog bite on his hand; the doctor that saw him said that in his experience, about 20% of dog bites lead to infection, while about 80% of cat bites do. He said that an antibiotic ointment is often enough, but when in doubt, you should see a doctor and get a prescription.
posted by scody at 1:25 PM on April 6, 2009

You really should clean and dress it properly. If you do that then you probably have nothing to worry about. IANAD.

Clean it out as best you can with water and some alcohol if you have it. Then put some antibiotic ointment on it and band aid it. You might get infected but you're probably ok. I've been bitten and scratched by cats dozens of times, and the worst that happened was a little infection if I didn't clean it and put Neosporin. If something unusual happens, you should see your doc though.
posted by brenton at 1:45 PM on April 6, 2009

Yeah, cat bites are nasty. I'd have it looked at ASAP. Ignore those who tell you to sit and wait, infection from a cat bite will set it very quickly and mess your hand up something fierce. I love cats, but even if one of mine bit me I wouldn't fuck around.

I'd hit up the doctor, as soon as convenient.
posted by InsanePenguin at 1:46 PM on April 6, 2009

My cat has bitten me quite a few times (in a loving, supportive way) and it has never, ever occurred to me to seek medical advice. That said, I did once get digusting and very painful blood poisoning from a small thorn I stood on while cutting the lawn. If there's a lesson here, I don't know what it is.
posted by rhymer at 1:50 PM on April 6, 2009

In my experience of rough play with cats, scratches and bites, even if they were meant in play, hurt like a bitch regardless of whether they are going to be infected or not. Bleeding is nature's way of cleaning out a wound, so bleeding is good for you (clearly as long as it's not out of control, right).

Keep your eye on it. Hot and red is not good, but expect it to hurt. I mean, it's meant to. That's a furry, purring predator there. Those teeth are not for eating zucchini. If it was a deep bite meant to hurt you, I'd be more likely to go to the MD sooner rather than later versus if I just got in the way of a play-bite, simply due to the fact that the former would be far worse than the latter.
posted by Medieval Maven at 1:54 PM on April 6, 2009

Please keep a close eye on it. If there is a defined area that's redder/more swollen than the surrounding area, use a Sharpie to draw its outlines. If the redness/swelling begins to move past the marked area, get it checked by a doctor ASAP.

IANAD, but on vacation last year one of the friends we were with had to go to an urgent care because the scratch from his cat was getting bad. He knew to do this because another friend with us is a nurse practitioner and when she looked at his hand, she was all "Yup. Going to the doctor now." Cellulitis - especially in your hand - is not something to mess around with.

(Or, what gramcracker said.)
posted by rtha at 1:56 PM on April 6, 2009

I faced almost this same dilemma just a few weeks ago. I was bitten on the leg, not the hand, but with multiple puncture wounds plus scratches. The bites weren't seriously deep, nothing that required stitches, but they also bled a lot. And were very painful. I probably pulled up the same things that you have on google and became concerned. Then I talked to some friends with cat bite experience, most people said not to worry, just to clean them well and keep on eye on them.

But then I thought, "well crap, I have health insurance for a reason. Fuck it, I'm going to the doctor." I went and, though the doc agreed that the bites weren't deep, he said that it was not a bad call to come in and prescribed me two antibiotics: one for a broad range of bacteria and one specifically intended to avoid MRSA infection. Who knows if I would have gotten an infection, but I'm happy with my choice to get it looked at.
posted by otolith at 2:02 PM on April 6, 2009

I was bitten by my cat at about lunchtime one day, washed it immediately and well, and bandaged it. About three hours later the area round the bite was a little bit swollen, red, and noticeably warm to the touch. A couple of hours after that the spots around the actual puncture marks were noticeably raised and it was hot, and the skin felt stretched and painful. I dressed it and went out to a comedy show and dinner.

Partway through the show (being now about seven or eight hours after the bite) I became aware that the bite was leaking fluid; the bandage felt wet. Partway through dinner I visited the bathroom and discovered to my horror that the wounds were leaking clear, unpleasant-smelling fluid. It was painful and very hot. The doctors wanted me to go in every day for five days so they could check its progress, and I was on antibiotics and anti-inflammatories.

At this point, if you're going to get infected, it has already started. I would be visiting the doctor now, but if you don't want to do that, keep an eye on it and keep washing it. If it starts to smell bad, get thee to the doctor.

And incidentally, the doctor told me that cat bites are worse than dog bites, but that human bites are the nastiest of all. That surprised me.
posted by andraste at 2:04 PM on April 6, 2009

Draw around the edges of the reddened area with a pen right now. If the red spreads past the pen line, go to the doc for antibiotics right away.

Even mild cat bites from indoor cats tend to get kind of gross and infecty in my experience. Peroxide is my cleaning agent of choice for small playful bites, to help carry the cat spit up & out of the puncture.
posted by pseudostrabismus at 3:15 PM on April 6, 2009

Go in and get antibiotics.
My daughter (a veterinarian) had a severe cat bite in her right thumb that, even with intial antibiotics, eventually led to her missing 3 months of work, getting daily infusions for a couple of weeks and losing about 3/8" off the tip of that thumb. A problem with fingers is that the circulation isn't as good as you approach the tips.
This probably is not going to happen, but don't assume it's all good.
posted by css28 at 6:14 PM on April 6, 2009

I had a nasty nasty cat bite on my leg once and I still have the pictures of the spreading infection and pen lines. Fortunately it got cleared up by a super-heavy oral dose of antibiotics but let me tell you, I'm glad it was just on the side of my leg and not in my hand. Given that yours is on your hand, for the love of god, go get antibiotics if you haven't yet... To add another anecdote, one of my coworkers had his arm in a sling for a while from a cat bite he got on his hand that took a couple of months to turn from a lingering infection into something more serious.
posted by ch1x0r at 6:59 PM on April 6, 2009

I was bitten to the bone by my cat about 10 years ago, and my hand swelled up like a grapefruit before I finally went to the doctor (about 2 hours is all it took.)

Apparently, I had some sort of reaction to the cat's saliva. The nurses at the emergency room all had a lot of fun ridiculing me.
posted by bradth27 at 7:21 PM on April 6, 2009

Leave it 24 hours, then hie thee too a doctor if it's puffy and/or weeping.

I had a horrible cat bite a few years ago that I washed well and felt fine about, but it turned bad by the time that I woke up the next day. My hand looked like a bloody football and had the nastiest goop seeping out of it. A tetanus shot and 2 weeks of hardcore antibiotics later, I was fine (though I still despise that bastard animal).
posted by rhinny at 3:26 AM on April 7, 2009

My mother had a similiar situation as css28's daughter. After being bitten by one of their cats, she had immediately washed the bite with betadine and dressed it with antibac cream and sterile dressings and went to her GP the next day for oral antibiotics. Even with all that done, she still ended up losing the bone from the 2nd knuckle up in her ring finger, 5 weeks inpatient at a specialized hand clinic, discharged with a port and I hung IV antibiotics twice a day for 2 more months afterwards. She had a total of 4 surgeries and her finger is all wonky now.

So, y'know-go see someone asap.
posted by hollygoheavy at 6:02 PM on April 9, 2009

This turned out fine, luckily. The next day I was at work, my boss made me go get it checked out (and I didn't have to pay for it myself). The doctor looked at it, thought it seemed OK, and said to keep an eye on it -- and gave me a list of infection signs. It got much better pretty quickly, so I was lucky. Another person at my work got bitten by a cat around the same time as me, and hers sounded much worse than mine. Thank you for all the advice.
posted by trillian at 6:51 PM on April 21, 2009