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Published: Tuesday, January 29, 2013, 12:01 a.m.

Cat bites require medical attention

With sleepy eyes and a comically kinked tail, Sammy does not look like a dangerous character. But Sammy put me in the hospital for four days.
As I lay in that bed, hour after hour, hooked up to an intravenous cocktail of antibiotics, I had plenty of time to rue the stupidity that put me there.
Sammy bit me. Although I didn't take it seriously at the time, a bite from a small cat can be a big problem, thanks to the nature of the bite itself and the kinds of bacteria carried by cats and people. For some people, in fact, it can be deadly.
Up to 50 percent of cat bites become infected, said Princy N. Kumar, head of the infectious-diseases division at MedStar Georgetown University Hospital. But, like me, many people don't take the injury seriously enough.
"People underestimate" the danger, Kumar said, and don't realize they should get a bite looked at right away. "They don't realize, being bitten by a cat, you've got a 1-in-2 chance of getting infected."
After I was bitten, I washed the wound well (after shrieking and dropping the cat), put some ice on it and kept it elevated for a while. I figured the swelling would be gone by morning.
The next day, my arm was puffy and I couldn't move my fingers well. My wrist felt hot to the touch. I tried more ice and elevation.
That was my second mistake: minimizing the problem and treating the bite myself. A significant cat bite always requires medical intervention,
"If you got a really bad bite, you should get prophylactic antibiotics," Kumar said. A light nip is not a problem, she said, but seek help if the cat has really sunk its teeth in -- "if you see a puncture wound and blood coming out of it."
Unlike dogs, which tend to deliver superficial, crushing bites that don't penetrate far into tissue, cats inflict puncture wounds with their long teeth, which inject bacteria from the cat's mouth and the environment deep into tissue.
My third mistake, related closely to my second, was dithering once I recognized that my bite was not getting better.
Three days after my encounter, my right arm looked like a stuffed sausage. It hurt, and I couldn't use the fingers at all.
Still, I felt a bit foolish slinking into the Georgetown emergency room -- there were some really sick people there that day. I sat sheepishly waiting to be given a prescription and dismissed.
When the doctor told me I'd have to stay at the hospital, I thought I had misunderstood.
And no food tonight, the doctor added, because they might have to operate tomorrow.
Cat bites tend to cause bone infections, I learned, not only because of the depth of the injury but also because most bites occur on the hands, where the bones and joints are accessible. In those cases, the wound must be cleaned out surgically.
My X-ray didn't show a bone infection, thankfully, so I got to skip the operating room. Instead, I got two strong IV antibiotics, vancomycin for staph and strep, and Unasyn for Pasteurella and other bacteria.
My arm was still a little swollen when I was finally allowed to go home with a round of oral antibiotics. It took several more days until I felt completely well and there was no sign of swelling in my wrist and hand.
Luckily, I'm generally healthy. I don't have medical conditions that can turn a cat bite into a deadly attack. People with underlying liver disease, for instance, are at risk of infection from another type of bacteria sometimes found in cat and dog bites; this is also an issue for people who don't have a properly functioning spleen. Such people are in danger of deadly septic shock, Kumar said.

Avoid cat bites
Redirected aggression: If your cat is in a fight do not touch him. He's likely to go after you.
To break up a fight: Distract the cats. Spray water at the aggressor, clap your hands loudly or, indoors, drop a pillow on the floor next to the cats. Or try shaking a bag of treats or opening a can of food. As a last resort, toss a thick blanket over one of them, but only if you can keep your hands out of harm's way.
Play aggression: Your cat bites and scratches while playing with you. This is a sign that the cat is not getting enough play time. They need play every day, especially kittens. Use a wand or other toy. If your cat does bite during play, yell "ouch" and walk away. He'll learn that biting ends the fun.
Overstimulation: Your cat tries to bite when being petted. It means he's getting too worked up. Look for a twitching tail and ears folded back and stop immediately. Stand up to dump him, walk away and leave him alone for a while. And stay away from a cat's tummy.
Fear aggression: Never corner a cat. Look for signals such as hissing, spitting, growling, crouching, ears flattening. Even rolling on his side can be a sign that he's defensive.
Status-related aggression: You move your cat off the counter and he swats you. Try passive means, such as leaving pans of water on the counter, or creating an alternative, such as giving him a high perch nearby.
Unprovoked aggression: Take him to a veterinarian. A wide range of health problems, from neurological issues to painful arthritis, can cause bad behavior.
Marie Joyce
Special to The Washington Post
Story tags » Health treatmentAnimal attacks

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