Dog and cat bites to the hand: treatment and cost assessment

PURPOSE: To assess the demographic patterns, clinical morbidity, and treatment costs associated with domestic animal bites to the hand.

METHODS: A retrospective review was performed on 111 patients who suffered either a dog or cat bite to the hand. Demographic data were collected for both the patient and the animal involved.

RESULTS: The patient population had suffered 71 dog bites and 40 cat bites. Two scenarios were identified that increased the likelihood of a bite: (1) attempting to separate fighting animals and (2) attempting to aid an injured animal. More than half of the victims (61 of 111) were bitten by an animal with which they were familiar. Bite injuries ranged from relatively minor wounds to major injuries that included open fractures, persistent deep infection including osteomyelitis, nerve laceration, tendon laceration, or tissue loss. Approximately two thirds of patients required hospital admission at least for intravenous antibiotics. Approximately one third of animal bite victims required at least 1 surgical procedure. Thirteen patients required long-term intravenous antibiotics and/or multiple surgeries and incurred medical expenses in excess of dollar 77,000.

CONCLUSIONS: Domestic animal bites to the hand are common injuries that can produce considerable morbidity. Stray animals did not account for the majority of incidents. Bite prevention strategies should focus on careful handling of animals that are fighting or injured. Animal bite wounds often require intravenous antibiotics and hospitalization and the cost of care for deep infections can be enormous. Our patient population was selected from a small geographic area over a relatively short collection period, suggesting that domestic animal bite injuries may represent a major public health issue.

TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic, Level IV.