What to do if a cat bites or scratches you

 

Five minutes into bringing my latest litter of foster kittens into my house and I got bitten.

 

The little monster I’d been cuddling had only been playing, but a tiny tooth slipped across my thumbnail into that little groove beside it, and I saw a droplet of blood.

 

It hardly seemed like an emergency, but any cat bite, no matter how small, is an emergency. Within two hours I had my first course of antibiotics in hand. I ended up needing a second course.

 

If you’ve been bitten by a cat, any cat, including your own well-loved, vetted, and vaccinated cat, you need medical attention. Period. This is not a “wait-and-see” situation.

 

All cat bites are dangerous. Cat scratches can be dangerous, too. We’ll talk about all of that.

 

Bitten by a cat? Call your doctor or go to urgent care

 

Cats are biting all the time, apparently. Sure, people get bitten by their dogs, pet rats, and parrots. Some people get bitten by bats, skunks, and raccoons, and even wolves and bobcats, too. (Don’t ask.)  

 

But a lot of animal bites are from cats: 5-15% of all bites to humans are the work of cats.[1] Naughty, naughty cats.

 

But just because cat bites are extremely common, doesn’t mean they’re boring. Cat bites are the opposite of boring. Within three to six hours of a cat bite, you can develop cellulitis or an abscess.[2]

 

So, if you have been bitten by a cat, don’t wait until Monday. Don’t wait until after work. Don’t wait to see if it gets worse. Just go to your doctor, to urgent care, or to an emergency room.

 

Why are cat bites so dangerous?

 

 

When a cat bites, it’s like someone sucked a bunch of deadly bacteria into a syringe and then used a hypodermic needle to inject it directly into your body.

 

A cat’s tooth is narrow and sharp, like a needle, and is covered in a mélange of bacteria, including this beauty: Pasteurella multocida. Studies show that a large percentage of infected cat bites (20-80%) contain P. multocida[3] so there’s a good chance your cat bite will have some in there.

 

But that’s not the only bacteria of concern in a cat’s mouth. Bartonella henselae, which comes from a bite from an infected flea or flea poop, are in cats’ mouths and under their claws. Staphylococcus and Streptococcus frequently join the bacterium party, too.

 

(Read about flea infestations in cats in this post.)

 

I’ll explain what P. multocida and friends can do to your flesh in a second.

 

But it’s not just cat-mouth bacterium that get injected when a cat bites. Anything that was on your skin when that tooth penetrated gets pushed under the surface, too.

 

And then, because the hole a cat’s tooth makes in your skin is so tiny, it quickly seals over, trapping the bacteria where you don’t want it to be.

 

What damage does an untreated cat bite cause?

 

Certain cat-mouth bacteria, like P. multocida, are anaerobic,[4] meaning they flourish in an environment without oxygen,[5] just like that sealed-over cat bite.

 

As the bacteria begin to multiply, they can spread into the surrounding tissues, causing cellulitis.[6] Cellulitis is an infection that spreads within the deeper layers of skin.[7]

 

Another route for these rogue bacteria is your bloodstream, a condition called septicemia, which you might know as “blood poisoning” or sepsis. The bacteria travel through the bloodstream to other tissues and organs, wreaking havoc as they go.

 

If septicemia from a cat bite progresses unchecked, it can lead to septic shock, in which blood pressure drops, damaging organs and leading, potentially, to death.[8]

 

A cat bite could turn into necrotizing fasciitis, which is when bacteria become “flesh-eating.” Septicemia from a cat bite could cause inflammation in the bones (osteomyelitis), heart (endocarditis), brain and spinal cord (meningitis), and belly (peritonitis).[9]

 

Cat bites have been known to cause deep-vein blood clots, arthritis, and even a thing called subcutaneous emphysema, in which gas bubbles form under the skin.[10]

 

There are cases in the scientific literature of people dying from bites from their own cats, even with treatment.[11]

 

A cat bite can cause especially severe damage to your hand

 According to one study, 85% of cat bites occur on the hand or wrist.[12] No surprise. What body part are you using to pet that adorable little stray?

 

Why is the hand particularly vulnerable?

 

That tiny cat tooth can pierce one of the many joints in the hand, or the membrane around a tendon. Those tight, closed-off spaces are perfect for growing certain bacteria. Infections can cause permanent damage to the hand, including loss of mobility.[13]

 

The Journal of Hand Surgery found that nearly a third of people who visited the famed Mayo Clinic for a cat bite to the hand ended up being hospitalized, and two-thirds of those folks ended up getting surgery. Surgery was necessary to flush bacteria out of the wound, and to cut away infected tissues.[14]

 

Several of the patients enrolled in the study didn’t get better after one surgery and needed to go under the knife a second time.[15]

 

Who is most at risk from a cat bite?

 

While everyone should seek medical attention for a cat bite, some people are more at risk than others of ending up with a severe infection.

 

Children, elderly individuals, sick people, people taking medications which suppress their immune systems, or who have a condition which weakens their immune system are at greatest risk of having a severe complication from a cat bite.

 

Should I worry about rabies if a cat bites me?

 

If you have been bitten by an unvaccinated cat, you should take the risk of rabies seriously. Rabies is typically fatal once you develop symptoms. Consequently, your medical professional might recommend an anti-rabies prophylactic vaccine as a matter of course.

 

That being said, the risk of contracting rabies from a cat is vanishingly small. There has not been a single confirmed case of a human catching rabies from a cat in 40 years. This is because cats tend to avoid the kind of wildlife that carry rabies, and because cat prey animals (chipmunks, squirrels, and mice) rarely have the disease.[16]

 

In the United States, there are only one to three cases of human rabies per year, and those have not been from cats in many, many decades.[17]

 

What is the first thing you do first if you are bitten by a cat?

 

First, call your medical professional and make an appointment to be seen immediately. Tell them you were bitten by a cat to create a justified sense of urgency.

 

While you’re waiting, clean the wound. Flush it out under running water. You can then gently clean the wound with isopropyl alcohol,[18] or a gentle salt solution: one teaspoon of salt in two cups of water.

 

How does salt water help? In the presence of salt water, the liquid (and any bacteria it contains) in your damaged cells moves out, through a process called osmosis. So, salt water acts as a sort of vacuum cleaner.[19]

 

Don’t apply plain, dry salt, however. Salt is a jagged crystal that could damage the wound further. Salt needs to be dissolved in water.

 

Don’t scrub the wound or use strong disinfectants. These could also damage the wounded tissue and make healing more difficult.[20]

 

What can I expect my physician to do if I’m bitten by a cat?

 

Your physician will likely clean your wound further. She may recommend a tetanus booster or rabies prophylaxis treatment. She will likely prescribe antibiotics.

 

Follow all medical instructions to the letter.

 

What should I look for after medical treatment for a cat bite?

 

A cat bite ain’t over ‘til it’s over.

 

Even if you washed the wound, saw your doctor, and started antibiotics immediately, your cat bite could still get infected. If you have any of these symptoms, call your doctor or go to the emergency room:

 

• Fever
• Flu-like symptoms
• Increasing pain
• Swelling around the wound
• A widening circle of redness around the wound
• Red streaks emanating from the wound
• An increase in skin warmth around the wound
• Development of pus

 

What happens to a cat who has bitten someone?

 

Laws around animal bites vary widely. Depending upon the jurisdiction in which the bite occurs, there may be some discretion on the part of local animal control and veterinarians about how to handle a cat who has bitten. 

 

In some jurisdictions, a physician is required to file an animal-bite report with the local department of health, and there may be a quarantine period for the cat who did the biting. The quarantine period might vary depending upon whether there is proof of a current rabies vaccine or not. [21]

 

If the animal is a stray, local animal control might be required to hold the animal for a short period of time to allow an owner to come forward. An unclaimed cat could be euthanized for rabies testing (animals must be deceased to test for rabies.)[22]

 

Are cat scratches as dangerous as cat bites?

 

Cat scratches can be dangerous. Afterall, a cat claw has the ability to puncture skin like a tooth.

 

Cat claws can also contain many of the same bacteria found in a cat’s mouth, including our old friend P. multocida.[23]

 

But one of the more serious risks of a cat scratch, however, is a disease called, appropriately enough, cat-scratch disease (CSD). CSD is caused by B. henselae, a bacteria carried by fleas. About 40% of cats will carry B. henselae at some point in their lives.[24]

 

CSD symptoms can show up anytime between about three to 14 days after a scratch. These include:

 

• Fever
• Fatigue
• Decreased appetite
• Swelling at the lymph nodes
• Pain and redness
• A small blister at the scratch site

 

If you develop any of these symptoms after a cat scratch, contact your healthcare provider for advice.

 

About 500 people with CSD end up being hospitalized every year. If the disease is untreated, it can progress to some pretty serious (but rare) medical problems, from enlargement of the spleen to inflammation of the membranes around the brain (encephalitis).[25]

 

What should I do if my cat scratches me badly enough to draw blood?

 

Unless you are in a high-risk group (see above), a cat scratch does not usually require emergency medical care.

 

Clean any cat-scratch wounds immediately after receiving them and watch for worsening symptoms. If you develop a fever, if the scratch wound isn’t healing or is getting worse, or if you have severe pain, contact a healthcare provider.

  

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Dawn LaFontaine

Dawn LaFontaine is a lifelong animal lover who always seems to have a little pet hair in her keyboard. Her blog, Kitty Contemplations, helps cat guardians better understand and care for the special beings they share their lives and homes with. Her cat-products business, Cat in the Box, sells beautiful, well-made, and award-winning products that she designed to meet the biological needs of cats.

 

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FOOTNOTES

[1] Krebsbach, Dr. Susan. “What to Do If You're Bitten by a Cat.” Preventive Vet, 7 Mar. 2021, https://www.preventivevet.com/cats/what-to-do-if-youre-bitten-by-a-cat.

 

[2] Lloret, Albert, et al. “Pasteurella Multocida Infection in Cats: ABCD Guidelines on Prevention and Management.” International Society of Feline Medicine, American Association of Feline Practitioners, Sage Publications, 27 June 2013. https://orbi.uliege.be/bitstream/2268/187998/1/424%20pub_thiry.pdf

 

[3] ibid.

 

[4] Giordano, Antonio, et al. “Clinical Features and Outcomes of Pasteurella Multocida Infection.” Medicine, Wolters Kluwer Health, Sept. 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616664/.

 

[5] “Anaerobic: Medlineplus Medical Encyclopedia.” MedlinePlus, U.S. National Library of Medicine, https://medlineplus.gov/ency/article/002230.htm.

 

[6] “Wounds-Cat-Bite-Injuries-to-Humans: VCA Animal Hospital.” Vca, https://vcahospitals.com/know-your-pet/wounds-cat-bite-injuries-to-humans.

 

[7] Maitre, Sarah. “Cellulitis: Definition, Etiology, Diagnosis and Treatment.” Journal of Ethics | American Medical Association, American Medical Association, 1 Dec. 2006, https://journalofethics.ama-assn.org/article/cellulitis-definition-etiology-diagnosis-and-treatment/2006-12.

 

[8] “Sepsis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 19 Jan. 2021, https://www.mayoclinic.org/diseases-conditions/sepsis/symptoms-causes/syc-20351214.

 

[9] Lloret.

 

[10] “Cat Bite.” Wikipedia, Wikimedia Foundation, 28 May 2022, https://en.wikipedia.org/wiki/Cat_bite.

 

[11] Blackburn, Julie, et al. “Overwhelming Sepsis after a Cat Bite.” The Canadian Journal of Infectious Diseases & Medical Microbiology = Journal Canadien Des Maladies Infectieuses Et De La Microbiologie Medicale, Pulsus Group Inc, 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3720010/.

 

[12] Perry, Susan. “Cat Bites to the Hand Can Cause Serious Infections, Mayo Study Finds.” MinnPost, 12 Feb. 2014, https://www.minnpost.com/second-opinion/2014/02/cat-bites-hand-can-cause-serious-infections-mayo-study-finds/.

[13] ibid.

 

[14] ibid.

 

[15] ibid.

 

[16] “Cats Are No Rabies Threat.” Alley Cat Allies, https://www.alleycat.org/cats-are-no-rabies-threat/.

 

[17] “Is Rabies in Your State?” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 6 Apr. 2020, https://www.cdc.gov/rabies/location/usa/surveillance/index.html.

 

[18] “Cat Bite.” Wikipedia.

 

[19] Suckling, Lee. “Does Salt Water Really Heal Open Wounds?” Stuff, 19 Apr. 2016, https://www.stuff.co.nz/life-style/79116292/does-salt-water-really-heal-open-wounds.

 

[20] “Wounds-Cat-Bite-Injuries-to-Humans: VCA Animal Hospital.” Vca, https://vcahospitals.com/know-your-pet/wounds-cat-bite-injuries-to-humans.

 

[21] “Cat Bite.” Wikipedia.

 

[22] “CDC - Veterinarians: What to Do with an Animal That Has Bitten a Person - Rabies.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 22 Apr. 2011, https://www.cdc.gov/rabies/specific_groups/veterinarians/person_bitten.html.

 

[23] Nishina M, et al. Pasteurella multocida peritonitis associated with a cat in a peritoneal dialysis patient using an automated cycler device. CEN Case Rep. 2012 Nov;1(2):73-76. doi: 10.1007/s13730-012-0016-3. Epub 2012 Jun 6. PMID: 28509064; PMCID: PMC5411526. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5411526/

 

[24] “Cat Scratch Disease.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 17 Jan. 2020, https://www.cdc.gov/healthypets/diseases/cat-scratch.html.

 

[25] Editorial, PetMD. “How to Treat Cat Scratches at Home.” PetMD, PetMD, 11 Mar. 2022, https://www.petmd.com/cat/general-health/how-treat-cat-scratches-home.