Could this dog be Cujo?

May 18, 2008 8:50 PM

I was sort of bitten by a dog tonight. I'm morbidly afraid of shots. How necessary is it that I see a doctor?

As I went into a grocery store tonight in the Financial District of New York, I noticed two dogs tethered outside. Being the foolish animal-lover I am, I bent over and offered my hand for a sniff. One of the dogs snapped at me and got my hand.

I have four teeth marks. One of them is barely noticeable. The other three are not deep. It's not like they're flowing blood or anything. There was no blood at all at first, and then after a few minutes there were little dots of blood at each of the other three points on the hand. But like I said, it's not like it was a lot of blood or anything. Really, I'm not even sure if it was blood, given the fact it didn't go anywhere. It was definitely an extremely shallow bite and it's not like it requires stitches or anything.

In a move that was stupider than reaching for the dog, I didn't try to find the owner in the store. I think I felt guilty or something. Anyway, the dog was gone by the time I left the store.

Last thing to consider is that I'm a 24-year old, extraordinarily healthy male, but I have a considerable fear of shots. I really really really want to avoid dealing with this if I can get away with it.

I know there are few of you who can give medical advice. But can anyone give advice on how likely it is, given those circumstances, that I might have been infected? Does anybody have experience getting the vaccine? I've heard it's extremely painful. Is that true? If I see a doctor, are they going to force me to get the shots?

posted by soonertbone to health (28 comments total)

It is unfortunately not uncommon for an animal bite/scratch to heal up without incidence, only to turn into a raging infection requiring serious surgery weeks later. Go to a doctor asap. Likely, you'll be given a prophylactic course of antibiotics.
posted by phunniemee at 9:00 PM on May 18 [1 favorite]

I'm gonna say you are fine, the dog is almost surely vaccinated. I got my hand about taken off a couple years ago, blood everywhere, blinding pain, and I was way back in some wooded park.
The money I spent the next day to calm my fears was wasted.
Unless it's wild animal, if ye in the states, I'd be inclined to not fret.
Run the bite under warm water for 10-15 mins, wash it with peroxide, and, if you bandage, do it very loosely.
As for qualifications, I don't even know CPR.
which, really, I should do smt about

on preview, seeing what phunniemee says, perhaps you should take the middle road and call yr doc. I don't think a ER visit tonight is in order, but err on the side of caution and all...that's what I did after all.
posted by dawson at 9:04 PM on May 18

next time, ensure rabies vaccination. it sounds very probable, as any domesticated dog is extremely unlikely to have it, but you should make every effort to ensure it. It is 100% fatal, or thereabouts.
Other than that, just wash it and keep an eye on it like any other wound.
posted by alkupe at 9:06 PM on May 18

Do you really want to bet your life on the chances that you won't get rabies? Chances are you won't get rabies, especially since the bite was provoked (that is, you reached over to pet the dog, the dog didn't bite you with no provocation). Go see a doctor and see what he/she says. If you knew the dog and about its vaccination history it would be a different story but even a small chance of rabies is worth taking a shot for. You'll feel much more peace of mind after you get the shot. I'm not exactly a fan of shots myself so I can understand your anxiety over it, but this is one case where you shouldn't fool around.
posted by peacheater at 9:07 PM on May 18

No one, including a doctor, can force you to get a shot you don't want to get. Go to the doctor. If the doctor recommends a shot, ask if there are alternatives. Push back. Then decide whether you want to take the shot. No one can make you. And the doctor may not recommend a shot, or he or she may be able to recommend a less invasive alternative, such as pills or topical treatments, if treatment is even warranted. But at least you'll have real information about what is medically recommended in your particular case, instead of just us internet yahoos speculating, before you decide whether or not to get a shot.
posted by decathecting at 9:08 PM on May 18

If you go to the doctor, they will not force you to get shots. They may [or may not, I don't know] argue in favor of shots, but that's the worst that could happen. You will have the option of saying no the shots unless a) you are a child, or b) you are declared mentally incompetent.

If you actually did get rabies - highly unlikely - then you would be in for a far worse time than just getting shots. Likely there would be many shots involved, along with IVs, pain, and other craziness. So if the doctor does recommend shots, you will then have the opportunity to weigh this possibility against the immediate costs. (of course you know this, I'm just spelling it out in case it helps).
posted by amtho at 9:10 PM on May 18

for a frame of reference, here's me about 3 hours after the bite, the bleeding is good for you of course, but at this rate for 5 hours seemed excessive. Moments after washing the thing would flow again. I was able to find out the next day the dog had been inoculated.
posted by dawson at 9:11 PM on May 18

I've been vaccinated for rabies, it's a course of three shots over three months. The shots were in my shoulder, and no more painful than any other shot. There may be different requirements if you have already been at risk of infection however.

On the positive side, my travel health guidebook tells me that rabies can be prevented by scrubbing a shallow wound with hot soapy water. I presume you did that anyway, right?
posted by nomis at 9:12 PM on May 18

Oh my goodness, Dawson. Mine's nothing like that.

It's as though I was pricked with a tiny safety pin in three spots. And I think even then I would bleed more if I were pricked.

Still, I think I'm going to go to ER just to be on the safe side. You all are right--it's not worth taking the chance.

Thanks for the quick advice, all. :-(
posted by soonertbone at 9:16 PM on May 18

good luck, man.
posted by dawson at 9:17 PM on May 18

Last time I was bitten by a neighbourhood dog (imagine dawson's wound on my calf, through a perfectly good set of work pants) I went to see my GP, who told me that though rabies was a very unlikely prospect in Australia, I was overdue for a tetanus shot.
Soonertbone, I share your morbid apprehension about needles to the ludicrous point that I feel more repelled by any given scene in ER or Scrubs than, say, the opening battle in Saving Private Ryan. Let me reassure you that the tetanus shot wasn't so bad, a quick jab and a bit of a bruise, which I self-medicated with a consolation cold beer.
posted by Fiasco da Gama at 9:27 PM on May 18

Dog bites are not nearly as infectious as housecat bites; I ignore my cat's bites to my face and hands all the time (he's feisty!) and haven't gotten a serious infection yet.
posted by nicwolff at 9:30 PM on May 18

Let us know if you're ok! Good luck, dude.
posted by phunniemee at 9:41 PM on May 18

Yes, if you can't track down the dog, you must see a doc. Infection is a concern of course, but you don't want to mess with any chance of rabies. It's not likely, of course, but it's also not something to fool around with because it's, you know, fatal.

I was mauled by a dog as a teen, and had to go through the rabies shots, which at that time was 14 shots in the stomach, one per day for 2 weeks. It's not nearly as traumatic these days. I think it's 3 shots, a few days apart. I have no idea if your "sort of bite" would be as much of a concern as my "mauled and bitten on my arm and back." But do please let a doctor make that decision. Good luck!
posted by Fuzzy Skinner at 9:45 PM on May 18

Last summer, the wife of the man interested in buying our van put her hand through our chainlink fence to pet our Jack Russel (right next to the 'beware of dog' sign!). He nipped her pretty good and it bled all the way to the hospital. The doctor told us that they dont usually stitch up a dog bite if they can avoid it, because the high amount of germs in a dogs mouth can cause a nasty infection if the wound is closed. They allowed her to bleed for awhile, then cleaned the boo-boo the best they could before dressing it and sending her home with a prescription for antibiotics. No tetnus was needed because she was current.
The best thing you can do is keep the bite clean and open. Hydrogen peroxide it as much as you can stand and you should be fine.
posted by Acacia at 10:10 PM on May 18

They won't give you a rabies shot unless you were bit in a place close to Mexica. They will clean out your wound and give you a dose of antibiotics, which will take care of your biggest risk--infection.
posted by Packy_1962 at 10:11 PM on May 18

Thanks again everybody.

Update: I went to the emergency room. They put yellow stuff on my hand and gave me a tetanus shot.

They ballparked my estimated cost at $1500. I'm sincerely hoping the lady didn't know what she was talking about. Apparently my AskMefi question should have been "Where can I find cheap medical care in NYC?"
posted by soonertbone at 10:35 PM on May 18

They ballparked my estimated cost at $1500.

I'm sorry, what? Is that what they quoted you for getting a Betadine swab and tetanus shot? (Sorry, I know this isn't really related to the question but I'm actually interested to know.)
posted by turgid dahlia at 10:48 PM on May 18

in my experience too, i only have bad news for you. I was raised to believe that any animal bite *requires* a doctor visit. Three people in my family have been bitten by dogs over the years. Every one saw the doctor (it was *incomprehensible* in my family to think that they would not), and every one had to get rabies shots (because, what i gathered at the doctors office was, that it was *incomprehensible* for the doctor to not give those shots as a precaution.

The reason why this is all so *required* of you, has to do not with the *chance* that you might have rabies, but rather, it has to do with the *severity* of rabies IF you have it. If it develops, you're a goner. Really.

Think of it this way: What if you stepped on a random hypodermic needle lying on the sidewalk?
Would you consider the possibility of tetanus or HIV?
Same thing here. Its not the "chances" of it. Its the fact that getting either one will be *brutal*. Thats why you'd go to the doctor.

And more bad news: rabies shots are notoriously more painful than regular shots. And they hurt for *days* afterwards. And oh, back when my family members were bit, they were still administring the shots in the *stomach*. Yes, they'll give you the shot in your stomach.

Sucks, huh? Well, it still beats a horrifying death, doesnt it? Yes, it does. Good luck! ;)
posted by jak68 at 10:54 PM on May 18

They ballparked my estimated cost at $1500.
That's sorta what I was alluding to in my first post. But, like you, I needed to know. And really, it's worth the peace of mind after all is said and done. But I bet I won't go to ER next time I'm bitten, if, God forbid, I am. :)
posted by dawson at 11:08 PM on May 18

They ballparked my estimated cost at $1500.

I'm sorry, what? Is that what they quoted you for getting a Betadine swab and tetanus shot?

In the emergency room. Sounds about right to me. Emergency room care is frikkin' expensive.
posted by Justinian at 11:09 PM on May 18

Guys, presumably the estimated $1500 is for more than a tetanus shot, but also the rabies protocol...

A tetanus shot and some betadine or something similar for a dog bit ran me under $500 at a US emergency room with (effectively) no insurance.
posted by needs more cowbell at 11:13 PM on May 18

Jeez, people. The CDC declared in 2007 that canine rabies was eliminated in the United States. That doesn't means that no dog has rabies, but that dogs aren't infecting each other; a dog can still get rabies if bitten by another animal. But it means that the chance a random apartment-dwelling dog on Wall Street is infected is vanishingly minimal.

Yes, rabies is fatal if you get it but essentially no one gets it by being bit by a dog in the US; in fact, there were just four rabies deaths in the US in 2007, all from bat bites.
posted by nicwolff at 11:38 PM on May 18 [5 favorites]

One more note from me and I'll hush, I just felt my last comment was a bit too 'I told you so!' You did the best thing, and not only did you buy peace of mind, but that shot is good for something like ten years. So treat yourself to a few beers and don't stop loving animals and just let it go...over and done.
posted by dawson at 11:41 PM on May 18 [1 favorite]

I'm in the UK so rabies isn't an issue (as it almost certainly isn't in US cities) but I'm with nicwolff here. My cat bites and scratches me all the time when we're play fighting and often draws blood. It has never occurred to me to seek medical help.
posted by rhymer at 4:08 AM on May 19

My cat bites and scratches me all the time when we're play fighting and often draws blood. It has never occurred to me to seek medical help.

Let's just clarify here: Your own pet does not equal a strange animal whom you have no clue about.

If your cat bit you, you wouldn't worry about it. My cat has scratched and bitten me as well. But if your cat started acting weird and foaming at the mouth, you would get to the doc. Being bitten by a dog that you can't then track down does have a risk. No, it's not a high risk, but a risk nonetheless.

My daughter was once bitten by the neighbor's dog. They let the thing run free all the time. The bite broke the skin. They gave her a tetanus shot and had to quarantine the dog to make sure it didn't show signs of rabies. If the dog had shown any symptoms, my daughter would have had rabies shots immediately.
posted by Fuzzy Skinner at 6:18 AM on May 19

My very basic rule for going to the doctor for dog bites is this: "Can I see a lot of fat, a tendon, or bone?" If so, I am off to the doctor, if not, I just wash it.

I just want to reiterate what Nicwolf said in that our rabies vaccination program has been amazingly successful in the US and the CDC has said it is virtually eliminated. A rabies bite is also only capable of transmitting rabies if the disease has made it sway to the animals brain and its in that mad, foaming phase.

Also, next time poster, look for one of those UrgiCare kind of places. I got bit by a dog last year. His tooth caught just right in my finger that when I jerked my hand away, it peeled back my skin exposing a bright white layer of ligament! Yay. Anyway, I got it to stop bleeding and went to the clinic. I got xrays to make sure the bone wasn't damaged, a tetanus shot, and some stitches for about $250. I love that place. The PA there looks like a normalized Amy Winehouse and wears funky pink tracksuits.
posted by stormygrey at 8:04 AM on May 19

Just for posterity, the standard of care in my community is that all dog bites that penetrate the dermal layer (i.e. a millimeter or so depth in the skin) should start oral antibiotic prophylaxis within 8 hours. Actually, the most important thing you could do to prevent infection is to wash the wound with lots and lots of clean running water and *perhaps* an antiseptic scrub. The same thing goes for cat bites. Scratches are a different issue, generally they can be treated like ordinary cuts unless there are signs of illness (cat scratch fever is a real illness).

A tetanus booster is recommended but (I am told) the immunity from tetanus shots is very long lasting and the every 10 year booster schedule was created in the interest of being over-cautious. Tetanus is rare, it's not any more common from a dog bite that a rusty nail injury, but it's really really bad when it happens so get your tetanus boosters people.

Unless someone has seen the dog behaving rabidly, the possibility of catching rabies from a bite from a dog with unknown rabies status is infinitesimal. Given the complex regimen of rabies shots, the cost of the shots, the pain associated with them, the potential for serious adverse reactions, and the limited nationwide supply, it's really irresponsible to give rabies shots for most cases like this.

Anecdotally, hand infections from dog and cat bites are common and *nasty.* They pus out, lots of times they require surgical drainage, and they require long courses of antibiotics. I am the most conservative, cavalier doctor you will ever meet and I will tell you, you don't want to mess around with dog and cat bites.

$1500?! Jesus motherloving christ! Our bill for a visit like this would be about $100, which we'd collect about $70 and I might see $25.

*starts googling how to open private emergency room*
posted by Slarty Bartfast at 9:56 AM on May 19