Next steps for cat bite puncture wound

February 17, 2020 9:04 PM

My cat and I were in our yard when an unleashed pitbull charged us out of nowhere. In the ensuing mayhem, my cat bit my ankle and gave me a deep puncture wound in the muscly area between Achilles tendon and shin bone. I went to urgent care and got amoxicillin, but the area has swelled quite a bit and hurts. What are the next steps?

The cat is fine, thankfully, though traumatized. A million curses on people who don't control their large dogs.

My ankle is swollen as though i have a moderate sprained ankle. It hurts about as much as a sprained ankle as well and i have very limited range of motion flexing my foot up and down. Is this normal for a serious puncture wound or is something worse happening? I don't have chills or anything like that.

How long should the antibiotic take to start working? I took it about 5 hours ago.

I plan to call the urgent care back in the morning if it's any worse. Im reading horror stories of cat bites requiring hospitalization and surgery.

Lastly, my job requires a lot of walking. I can't fit my foot in a shoe. I went to work today after the incident this morning but am now wondering if this is a reasonable cause to call off work tomorrow. I guess i could get a crutch.

Basically given the traumatic experience fol lo owed by the condition my foot is in, im having trouble thinking of reasonable next steps. Help?

posted by cat friend to Health & Fitness (16 answers total)

Best answer: I would say call in sick tomorrow for sure!

Cat bites are notorious for infection. Google the symptoms- I’m not a doctor but the basics I’ve learned are:

- Outline the red area around the wound with a clean pen. Take photos regularly and compare them. If the red area keeps spreading outside the pen marks, especially in a streak going up your leg, that’s a major sign of worsening infection so go to the hospital.

- “Angry” looking red skin- bright colour, hot, shiny, or majorly swollen - is a bad sign, go to the hospital.

- Monitor your temperature. If you get a fever it means it’s a worsening infection, go to the hospital. Ditto headaches and general joint pains.

- For a foot injury, if you get pain in the groin, it would suggest your lymph nodes are getting involved - in that case go to the hospital

Hope you feel better soon! Puncture wounds are very prone to infection and cat spit is really unfriendly to humans, so when you combine them you have a wound that needs really careful monitoring and aggressive treatment. Err on the side of caution if you have any worsening symptoms at all.

This is a big enough deal to take it really easy for a couple days, be gentle with your body! Hope you feel better soon!
posted by nouvelle-personne at 9:15 PM on February 17, 2020 [20 favorites]

Best answer: Yep - definitely take the day off tomorrow. Elevate your foot and put ice on it if that makes it feel better. The antibiotics will take a while to kick in, usually it's about 24 hours. But I think you're safe to wait until tomorrow to call the urgent care back unless you get a fever tonight.
posted by dawkins_7 at 9:31 PM on February 17, 2020

you should probably get a tetanus shot.
posted by H21 at 9:35 PM on February 17, 2020

Best answer: If the oral antibiotics aren't effective, you may end up needing IV antibiotics, which you can get at urgent care or the ER if the redness or pain increase. Stay on top of it and don't walk around on the injured ankle. Cats' teeth are little needles that implant bacteria deep under your skin, bless 'em. Hopefully the current medication will do the trick.
posted by Scram at 9:55 PM on February 17, 2020

I had a friend who had several days in the hospital fighting off infection after a deep accidental cat bite. Be very careful
posted by emjaybee at 10:25 PM on February 17, 2020

I have also had a friend hospitalized with a small cat bite puncture. It was awful. What nouvelle-personne said, and really someone healthy should be monitoring you in case you get really sick really quickly.
posted by clew at 10:57 PM on February 17, 2020 [3 favorites]

Go to the ER if it's not noticeably better in the morning. Cellulitis isn't for messing around with.
posted by spindrifter at 2:57 AM on February 18, 2020 [4 favorites]

Best answer: Go ahead and book an appointment with a doctor for today. I got bit badly by a dog and everyone in ER and plastic surgeon told me the same thing, "You're lucky it wasn't a cat." Their bites, as a rule, create infections. It's going to require active medical monitoring over the next 3-4 days to keep the infection under control and start healing.
posted by caveatz at 5:41 AM on February 18, 2020 [5 favorites]

Best answer: The last time my cat bit me it was on the foot and it got very infected. I waited about a day to go get oral antibiotics because I didn't take it seriously at first and it was already too infected by then. I was bitten on the top of my foot which swelled up so much that I wore sandals for weeks. I ended up going back to the urgent care after a few days and got IV antibiotics which seemed to kick the last of the infection. The doc told me she should have sent me to the ER for it and that I had to go if I wasn't better after the IV, but fortunately that did it. So if you don't see quick improvement I would definitely go back for stronger treatment, I wish I had taken it more seriously at the time.
posted by possibilityleft at 6:22 AM on February 18, 2020 [4 favorites]

Response by poster: Thank you everyone. A cat bite seems like it should be so innocuous but clearly is not. I did call off sick from work and plan to keep it elevated. The pain is a little less severe today which has me hopeful. Thank you for the outlining the red area suggestion, i am doing that. If anything seems to worsen today im heading right back in to the dr. Especially since it's my Achilles tendon i dont want to mess around.
posted by cat friend at 6:37 AM on February 18, 2020 [2 favorites]

Response by poster: And fortunately i am up to date on tetanus, but that is also a good suggestion.
posted by cat friend at 6:39 AM on February 18, 2020 [2 favorites]

I just had this happen to me last spring, though the bite was just above my ankle (and one on my arm). I went to the ER right away, and the doctor walked in and said, "Well, that's going to get infected." I took the first antibiotic immediately, and the doctor had me come back to the ER two days later for a recheck. I was very careful to follow all advice, and it healed pretty well.

The only thing that I would add to all of the advice above is that the ER doctor told me (IAMNAD of course, so take advice from your doctor over this second-hand info) to take warm/hot baths and to massage the area around the bite. This gets the blood to that area to help your immune system do its thing. From what I read when I was worrying about the wound is that the problem with cat bites is that the long pointy teeth can push bacteria deep into the body, and it can end up around the tendons where your immune system isn't well suited to fight. So, the warm water and massage helps to keep things circulating allowing your immune system to do what it can.

It felt silly to go to the ER twice, but with what I had read it was definitely a better safe than sorry.
posted by past unusual at 7:11 AM on February 18, 2020 [1 favorite]

I spent several days in ICU because of a cat bite, after receiving an antibiotic shot six hours after the bite. Six hours later I was in ER. I would have died or lost my hand had I not sought immediate treatment. Please go in if this is not ACTIVELY getting better.
posted by 2soxy4mypuppet at 8:16 AM on February 18, 2020 [3 favorites]

I agree with the above advice to have a friend check in on you - perhaps every 4-6 hours. I had an infection take an unexpectedly bad turn once and it went from “I’m fine” to “I’m shaking and can’t lift my arm” within 2 hours. Glad to hear you’re taking it seriously! Get well soon!
posted by nouvelle-personne at 11:37 AM on February 18, 2020

I had a cat bite which seemed minor at the and, after days of antbiotic IVs, ended up with the tip if my pinky amputated.
Dont wait around at home, nmonitoring your swellings instead go to the ER now. One of the symptoms was lethargy, loss of judgement. Cat bites cannot be treated at home.
posted by 15L06 at 1:29 PM on February 18, 2020 [1 favorite]

Did you get more treatment? How’s the foot?
posted by clew at 10:48 PM on February 20, 2020