What is a dog bite?
Dog bites in this case implies that the skin is broken. That is, there is a cut, some bleeding, and it needs to be sutured (sewn).
Quickcare or ER?
The vast majority can be seen in a Quickcare setting. However, it is best not to wait. The sooner a cut can be cleaned thoroughly and sewn up the better.
So if the accident occurs after the clinic is closed, you must go to the ER for treatment. The best time to get sewn is within 6 hours after the accident.
What will your doctor ask?
Your doctor will want to know the location of the bite. Wounds in the face may need a specialist (plastic surgeon).
Your doctor will want to know the severity of the bite. Another way to assess the severity is to know the extent of the bleeding. Uncontrolled bleeding could mean a catastrophe.
After any cut, doctors will ask if tetanus is up to date and if you are allergic to any medications. The knowledge of allergies is important since he will be giving numbing medicine and prescribing antibiotics.
What will your doctor look for?
Then a doctor will look at the bleeding. If an artery was hit, the bleeding will be excessive.
After an injury to a muscle, such as a calf, the doctor has to make sure the muscle is working well. Since the calf moves the foot down (plantar flex), your doctor will make you push your foot down like stepping on the gas pedal.
The wound needs to be explored. What is in it? Are pieces of the dog’s teeth in it? Is it a dirty wound? Did the bite go through pants and now some cloth is stuck inside of it?
What is the doctor thinking?
Some dog bites to the face will need a specialist (Plastic Surgeon).
Your doctor will assess whether he can handle the bite or does it need to be treated at a higher level of care. That is, if the wound is large and bleeding excessively, it will have to be sewn up in the operating room
What is the treatment of dog bites?
Most patients are shaken up after a bite. I like to get their pain under control. A shot of Toradol does take the edge off the pain.Then, local numbing medicine to the wound site hurts initially but then brings great relief.
One routine thing that is asked after all wounds is the last tetanus shot. Should be within 5 years after a wound.
I treat dog bites with antibiotics. My “dog bite antibiotics” are straightforward. If you are not allergic to penicillin, I use Augmentin 500mg three times a day for 7 days. If penicillin allergic, then I prescribe Clindamycin.
About 12 years ago, I tried a weaker and cheaper antibiotic for a dog bite. Two days later, my patient developed a wicked infection. Never again have I swayed from regimen.
Like any laceration, dog bites need to be sewn up. However, there is concern that an infection will occur. So the stitches are placed further from each other than normal. The intention is if infection occurs, then oozing out of pus is more likely.
How long will you be sick?
After a cut is sewn, the routine is to see the doctor in two days. He will look for infection or if the wound is opening up (dehiscense)
Normally, a routine cut from a dog bite heals in 7-10 days. The wound must remain clean and dry. That means, during bathing, it must be covered.
Let me tell you a story
Just hearing a bark automatically perks up our ears. It is an “attention getter.”
Like most of us, our inclination is to stop and run. The postal workers have the same feelings. They don’t want to get bitten. Day-after-day, however, they enter our yards and give us our mail. It is an age-old connection to the outside world that pre-dates telephones, telegraphs, emails, Fed Ex, UPS, Twitter and WhatsApp (to name a few).
Diligently, these workers bring us our goods. The price they pay is facing those pesty little pooches.
Let me tell you about Monica…….She had always wanted to be a school teacher. As a little girl, she had a makeshift classroom in her garage. She used to stay after school to help out her teacher Mrs. Robledo correcting papers using a red pen. But “Life Happens” and Monica found herself as a 20 year old single mom. She “did what she had to do” to provide for her twins. Quitting college was hard. Her family wanted nothing to do with her. So she took a civil service exam and passed easily. Off she went, delivering our packages.
She always tried to avoid the dogs at corner house. After her delivery, she turned around only to get bitten right on the calf muscle.
The stitches were placed. Tetanus was given. Antibiotics were taken. Her wound healed in 7 days as planned.
Without missing a step, she was back delivery our mail and still dreaming of being in the classroom.
I hope this helps
David Reyes MD