An Up to Date Guideline for Management and Prevention of Dog and Cat Bite – A Literature Review

Main Article Content

M. M. Hosain
M. T. Mohamed
A. Siddiqui


Background: The prevalence of animal bites is high, of which the vast majority are from cats’ and dogs’. There is a wide variation in severity of such bites from mild to lethal. The evidence in the literature with respect to management does not provide a solid ground on which such cases could be managed. Dog and Cat bites are more common and can have dramatic consequences especially for children.

Objective: This project is to identify current evidence in the literature on epidemiology, management and prevention of dog and cat bites. This review is aimed at clinicians who deal with dog and cat bites. The basic principles of wound management and indications for use of antimicrobials, tetanus and rabies prophylaxis as well as preventive education are the primary focus of this article to help the clinicians. This aims at updating the management of patients who sustain a dog or a cat bite.

Materials and Methods: A literature review on the management of animal bites was performed. UK NICE guidelines, University of Texas bites management guidelines, WHO rabies prophylaxis protocol, UK Green Book and infectious diseases text books also reviewed.

Results: The available data in the literature suggest that appropriate wound management is the most important factor for prevention of infection in dog and cat bites. Antibiotic prophylaxis should only be given in high-risk wounds and primary closure should be performed in low-risk wounds.

Conclusions: Proper assessment and wound care are the prime consideration for dog and cat bites management.

Dog bites, cat bites, dog and cat bites, animal bites, management, education

Article Details

How to Cite
Hosain, M. M., Mohamed, M. T., & Siddiqui, A. (2021). An Up to Date Guideline for Management and Prevention of Dog and Cat Bite – A Literature Review. Journal of Advances in Medicine and Medical Research, 33(3), 28-38.
Original Research Article


Bykowski MR, Shakir S, Naran S, Smith DM, Goldstein JA, Grunwaldt L, Saladino RA, Losee JE. Pediatric dog bite prevention: Are we barking up the wrong tree or just not barking loud enough? Pediatr Emerg Care. 2019;35(9):618-623.
DOI: 10.1097/PEC.0000000000001132
PMID: 28398940.

Gates MC, Walker J, Zito S, Dale A. A survey of opinions towards dog and cat management policy issues in New Zealand. N Z Vet J. 2019;67(6):315-322.
DOI: 10.1080/00480169.2019.1645627
Epub 2019 Aug 4.
PMID: 31319780.

Evgeniou E, Markeson D, Iyer S, Armstrong A. The management of animal bites in the United kingdom. Eplasty. 2013;13:e27.
PMID: 23837110;
PMCID: PMC3681434.

Centers for Disease Control and Prevention (CDC). Nonfatal dog bite-related injuries treated in hospital emergency departments--United States, 2001. MMWR Morb Mortal Wkly Rep. 2003;52(26):605-10.
PMID: 12844076.

Jaindl M, Oberleitner G, Endler G, Thallinger C, Kovar FM. Management of bite wounds in children and adults-an analysis of over 5000 cases at a level I trauma centre. Wien Klin Wochenschr. 2016;128(9-10):367-75.
DOI: 10.1007/s00508-015-0900-x.
Epub 2015 Dec 11.
PMID: 26659907.

Hurt JB, Maday KR. Management and treatment of animal bites. JAAPA. 2018;31(4):27-31.
DOI: 10.1097/
PMID: 30973531.

Long B, April MD, Koyfman A. Dog bites are an indication for routine antibiotic therapy. Ann Emerg Med. 2020;76(1):85-86.
DOI: 10.1016/j.annemergmed.2020.02.011
PMID: 32591126.

Park JW, Kim DK, Jung JY, Lee SU, Chang I, Kwak YH, Hwang S. Dog-bite injuries in Korea and risk factors for significant dog-bite injuries: A 6-year cross-sectional study. PLoS One. 2019;14(2):e0210541.
DOI: 10.1371/journal.pone.0210541
PMID: 30789915;
PMCID: PMC6383883.

Chaudhry MA, Macnamara AF, Clark S. Is the management of dog bite wounds evidence based? A postal survey and review of the literature. European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine. 2004;11(6):313-317.
DOI: 10.1097/00063110-200412000-00003

Ellis R, Ellis C. Dog and cat bites. Am Fam Physician. 2014;90(4):239-43.
PMID: 25250997.

Benson LS, Edwards SL, Schiff AP, Williams CS, Visotsky JL. Dog and cat bites to the hand: Treatment and cost assessment. J Hand Surg Am. 2006;31(3):468-73.
DOI: 10.1016/j.jhsa.2005.12.011
PMID: 16516744.

Goldstein EJ. Bite wounds and infection. Clin Infect Dis. 1992;14(3):633-8.
DOI: 10.1093/clinids/14.3.633
PMID: 1562653.

Sabhaney V, Goldman RD. Child health update. Management of dog bites in children. Can Fam Physician. 2012;58(10):1094-6, e548-50.
PMID: 23064918;
PMCID: PMC3470506.

Kisaka S, Makumbi FE, Majalija S, Bangirana A, Thumbi SM. Epidemiology and preclinical management of dog bites among humans in Wakiso and Kampala districts, Uganda: Implications for prevention of dog bites and rabies. PLoS One. 2020;15(9):e0239090.
DOI: 10.1371/journal.pone.0239090
PMID: 32956373;
PMCID: PMC7505423.

Aziz H, Rhee P, Pandit V, Tang A, Gries L, Joseph B. The current concepts in management of animal (dog, cat, snake, scorpion) and human bite wounds. J Trauma Acute Care Surg. 2015;78(3):641-8.
DOI: 10.1097/TA.0000000000000531
PMID: 25710440.

University of Texas, School of Nursing Family Nurse Practitioner Program. Management of cat and dog bite wounds. Austin (TX): University of Texas, School of Nursing. 2013;31.

Morgan M, Palmer J. Dog bites. BMJ. 2007;334(7590):413-7.
DOI: 10.1136/bmj.39105.659919.BE
PMID: 17322257;
PMCID: PMC1804160.

Abrahamian FM, Goldstein EJ. Microbiology of animal bite wound infections. Clin Microbiol Rev. 2011;24(2): 231-46.
DOI: 10.1128/CMR.00041-10
PMID: 21482724;
PMCID: PMC3122494.

NICE Guideline. Bites, Human and animal, Clinical Knowledge Summaries. NICE>CKS>Health topics A to Z>Bites - human and animal>Management>Scenario: Managing a Cat or Dog Bite; 2020.

Bula-Rudas FJ, Olcott JL. Human and Animal Bites. Pediatr Rev. 2018;39(10): 490-500.
DOI: 10.1542/pir.2017-0212
PMID: 30275032.

Philipsen TE, Molderez C, Gys T. Cat and dog bites. What to do? Guidelines for the treatment of cat and dog bites in humans. Acta Chir Belg. 2006;106(6):692-5.
DOI: 10.1080/00015458.2006.11679983
PMID: 17290697.

Mitnovetski S, Kimble F. Cat bites of the hand. ANZ J Surg. 2004;74(10):859-62.
DOI: 10.1111/j.1445-1433.2004.03189.x
PMID: 15456433.

Maimaris C, Quinton DN. Dog-bite lacerations: A controlled trial of primary wound closure. Arch Emerg Med. 1988;5(3):156-61.
DOI: 10.1136/emj.5.3.156
PMID: 3178974;
PMCID: PMC1285519.

Callaham ML. Treatment of common dog bites: Infection risk factors. JACEP. 1978;7(3):83-7.
DOI: 10.1016/s0361-1124(78)80063-x
PMID: 633680.

Paschos NK, Makris EA, Gantsos A, Georgoulis AD. Primary closure versus non-closure of dog bite wounds. A randomised controlled trial. Injury. 2014;45(1):237-40.
DOI: 10.1016/j.injury.2013.07.010
Epub 2013 Aug 2.
PMID: 23916901.

Rui-Feng C, Li-Song H, Ji-Bo Z, Yi-Qing J, Yu-Jie L, Yi S. Negative pressure wound therapy for serious dog bites of extremities: A prospective randomized trial. Am J Emerg Med. 2016;34(6):1006-10.
DOI: 10.1016/j.ajem.2016.02.043
Epub 2016 Feb 20.
PMID: 26964825.

Malahias M, Jordan D, Hughes O, Khan WS, Hindocha S. Bite injuries to the hand: Microbiology, virology and management. Open Orthop J. 2014;8:157-61.
DOI: 10.2174/1874325001408010157
PMID: 25067969;
PMCID: PMC4110396.

Talan DA, Citron DM, Abrahamian FM, Moran GJ, Goldstein EJ. Bacteriologic analysis of infected dog and cat bites. Emergency Medicine Animal Bite Infection Study Group. N Engl J Med. 1999;340(2):85-92.
DOI: 10.1056/NEJM199901143400202
PMID: 9887159.

Babovic N, Cayci C, Carlsen BT. Cat bite infections of the hand: Assessment of morbidity and predictors of severe infection. J Hand Surg Am. 2014;39(2):286-90.
DOI: 10.1016/j.jhsa.2013.11.003
PMID: 24480688.

Kwo S, Agarwal JP, Meletiou S. Current treatment of cat bites to the hand and wrist. J Hand Surg Am. 2011;36(1):152-3.
DOI: 10.1016/j.jhsa.2009.10.008
Epub 2009 Dec 14.
PMID: 20006917.

Dire DJ, Hogan DE, Riggs MW. A prospective evaluation of risk factors for infections from dog-bite wounds. Acad Emerg Med. 1994;1(3):258-66.
DOI: 10.1111/j.1553-2712.1994.tb02442.x
PMID: 7621206.

Garcia VF. Animal bites and Pasturella infections. Pediatr Rev. 1997;18(4):127-30.
DOI: 10.1542/pir.18-4-127
PMID: 9100448.

Quinn JV, McDermott D, Rossi J, Stein J, Kramer N. Randomized controlled trial of prophylactic antibiotics for dog bites with refined cost model. West J Emerg Med. 2010;11(5):435-41.
PMID: 21293762;
PMCID: PMC3027435.

Capellan O, Hollander JE. Management of lacerations in the emergency department. Emerg Med Clin North Am. 2003;21(1):205-31.
DOI: 10.1016/s0733-8627(02)00087-1
PMID: 12630738.

Saul D, Dresing K. Chirurgische Behandlung von Bissverletzungen [Surgical treatment of bites]. Oper Orthop Traumatol. German. 2018;30(5):321-341.
DOI: 10.1007/s00064-018-0563-7
Epub 2018 Sep 12.
PMID: 30209521.

Medeiros I, Saconato H. Antibiotic prophylaxis for mammalian bites. Cochrane Database Syst Rev. 2001;(2):CD001738.
DOI: 10.1002/14651858.CD001738
PMID: 11406003.

Tabaka ME, Quinn JV, Kohn MA, Polevoi SK. Predictors of infection from dog bite wounds: which patients may benefit from prophylactic antibiotics? Emerg Med J. 2015;32(11):860-3.
DOI: 10.1136/emermed-2014-204378
Epub 2015 Jan 29.
PMID: 25634096.

Chávez-Serna E, Andrade-Delgado L, Martínez-Wagner R, Altamirano-Arcos C, Espino-Gaucín I, Nahas-Combina L. Experience in the management of acute wounds by dog bite in a hospital of third level of plastic and reconstructive surgery in Mexico. Cir Cir. English. 2019;87(5):528-539.
DOI: 10.24875/CIRU.19000678
PMID: 31448798.

Kall S, Vogt PM. Chirurgische Therapie von Infektionen der Hand--Teil I [Surgical therapy for hand infections. Part I]. Chirurg. German. 2005;76(6):615-25, quiz 626-7.
DOI: 10.1007/s00104-005-1043-9
PMID: 15928956.

Søe NH, Jensen NV, Dahlin L, Johansen HK. Håndens akutte infektioner [Acute infections of the hand]. Ugeskr Laeger. Danish. 2009;171(14):1189-93.
PMID: 19338739.

Stahl JP, Gautret P, Ribadeau-Dumas F, Strady C, Le Moal G, Souala F, Maslin J, Fremont B, Bourhy H. Update on human rabies in a dog- and fox-rabies-free country. Med Mal Infect. 2014;44(7):292-301.
DOI: 10.1016/j.medmal.2014.05.002
Epub 2014 Jul 8.
PMID: 25011930.

Duperrex O, Blackhall K, Burri M, Jeannot E. Education of children and adolescents for the prevention of dog bite injuries. Cochrane Database Syst Rev. 2009;(2):CD004726.
DOI: 10.1002/14651858.CD004726.pub2.
PMID: 19370606.

Shen J, Pang S, Schwebel DC. A randomized trial evaluating child dog-bite prevention in rural China through video-based testimonials. Health Psychol. 2016;35(5):454-64.
DOI: 10.1037/hea0000273.
Epub 2015 Nov 2.
PMID: 26523353;
PMCID: PMC4833565.