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dog bite PLEASE DO NOT QUOTE update at post 97


Pen
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Ds14 was bitten by a loose dog yesterday. I don't want to put a lot of detail for safety reasons, and will probably come back and delete this. But I would appreciate ideas and suggestions. ...  Again, PLEASE DO NOT QUOTE. Thanks.

 

UPDATE And replies to some of your questions that are in posts after this.

 

1) The situation was reported to law enforcement and to Animal Control (on their voice mail since they were closed or at least not answering phone--maybe someone went in to take care of impounded animals--over the holiday weekend. You don't need to convince me to report this, since that was already done the evening before I originally posted here.

 

2) However, and something I'd appreciate more thoughts on at this time, I have to fill out a paper form on the incident, which includes a part for description of incident, and I could use ideas on how to word things so as to achieve getting the dog in more control so that this does not happen again to my ds or to anyone else who might be passing on the road in front of where the dog lives. I do not want to ask for the dog to be euthanized. Possibly the owners would do that--I once had a too aggressive dog that I euthanized, but it was my decision and traumatic enough with a loved dog. I do not want to cause a greater problem than there is now with regard to the humans at the house where the dog is. 

 

3) In answer to some questions, we are in the Pacific Northwest. A state epidemiologist I was finally able to speak with told me that the rabies risk is very low: "low" as in for our whole large state there has not been even one rabid raccoon found in the last 50 years, one rabid dog in 50 years, which had been brought in from another country where rabies incidence is high. Had ds been bitten by a bat, the decision of what to do would have been different. But the risks of death by car accident to drive to where PEP could be started are significantly higher than the risk of death from rabies from a dog bite. Here. This is what I learned for my own area and situation. Please do not apply this to some other situation or area where it could be far different. 

 

4) ds started by taking care of his own wound washing while I was on phone trying to figure things out--however as a 14 yo what he did was not long enough or thorough enough, so I redid it. I am fine with him taking care of the wound if he wants to do so at this point--but his idea of clean, and my idea of clean have a gap between them, and this is not a situation where I want him to learn the hard way and have infection set in. He normally does take care of his own cuts and scrapes, but a dog bite is not one to mess around with.  Adding: also it is in a hard spot to take care of himself, since it is awkward to reach that part of his leg and see it well and contortions to get it more accessible and visible were painful due to bruising. --That seems to be changing now and I noticed he was sitting on his knees with his rear down toward where the injury is... so contortions to do things should now be easier for him, but otoh doing things that expose it to dirt would also be easier.

 

5) ... Yes, the issue in the quote below is the main one right now. 

 

 

creekland

Posted Today, 03:43 AM

Personally, I still see more of an issue from letting an aggressive dog remain that close to you.  Dogs who bite and aren't well trained often keep biting and can up the ante next time.  The first time they are practicing.  They learn and get bolder if not really held to task with obedience training.  This was not an unprovoked attack in that dog's eyes (why rabies isn't really a major concern).  Someone was invading his/her territory.  They successfully defended it.  They didn't even start with a little nip, but a full blown bite.  Now they know they can do it again.  Who invades it next time?  A younger kid?  An older person?  That's scary with a far greater risk IMO.

 

 

 

 

Edited by Pen
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Animal control should have an emergency number, the police would know it if it isn't listed somewhere. The county health department may also be able to help. 

 

Did you talk to police?

 

Personally I would probably take him to the ER today and get the first two shots for rabies--immunoglobulin and the first vaccine shot. The series has been shortened, I think it's just three more vaccine shots after that. The immunoglobulin shot isn't fun but the vaccines aren't bad at all, we had to do the whole series with one of mine last year and the vaccines were not painful.

 

Rabies is not something to play around with.

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i would call his doctor (or service) and let them know what happened.  They may still want you to get the bite looked at by Urgent Care (and then Urgent Care will also report the bite I believe). After the holiday weekend I suspect the police/animal control will be trying to track down the stray dog to impound it = you did at least notify the police, right?  I googled it and looks like you have up to ten days to start the rabies shots. BUT - can you be sure they catch the correct dog?  Will you son recognize it?   My maternal gut instinct is to go to Urgent Care or ER and if they want to start the rabies shot, go with it. Rabies you do not want to mess around.

 

My dermatologist says that airing a wound is not a good idea, best to cover it with a bandage and use Vaseline, not Neosporin or any other antibiotic, on the wound.

Edited by JFSinIL
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The CDC advice is here:

 

http://www.cdc.gov/rabies/exposure/

 

It looks like they will have to keep the dog under observation for 10 days.

 

Here there is a link to a map by county with the number of dogs tested for rabies and the number found to be infected. The probability is linked to the number of wild animals with rabies.

 

http://www.cdc.gov/rabies/exposure/animals/domestic.html

 

http://www.cdc.gov/rabies/resources/publications/2014-surveillance/2014-cats-and-dogs.html#dogs

 

Personally I would at least call my doctor for advice.

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Second ER or at least doctor. Plus they are obligated to report the bite and so animal control will follow up and quarantine the dog. I was bitten once by a pit mix. It was very painful and did take a long time to heal. I had to follow up with my doctor after the ER visit because of risk of infection. Luckily the dog that bit me was up to date on its shots. But if there had been the slightest doubt than I absolutely would have had the rabies series.

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I agree rabies is not something to mess with. There are other issues that can occur with a dog bite, too. This does not sound superficial with the level of your concern. I would take him to the ER. I realize that stinks but better right now than 2-3 days from now when it would be much harder to help him and may require a more extensive procedure.

 

And I agree, normally there is an emergency after hours number for animal control that at least the police should have access to. You might try.

Edited by OneStepAtATime
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Not to mention puncture wounds can get infected pretty badly and very quickly, I'd go into the ER as well. Mom sorry you're dealing with this and hope your in heals quickly.

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He doesn't need to be staying in bed.  He really doesn't.  But, he really should be seen by ER or Urgent Care for rabies shots.  I would definitely report to police, since you sort of know the house that the dog is associated with.   I can see cancelling swimming, but I'm not sure why anything else would need to be cancelled? 

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The thing about rabies is that it's life threatening.

And you have to start the shots quickly or they won't work.

I would not wait around.  Call your doctor's off hours line, and if you don't reach them in, say, an hour, go to the ER.

Plus, if there is a dog that has bitten someone, he has crossed a serious line, and the authorities need to get involved.

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About whether to go to urgent care or ER -- you should know that only ERs have the rabies shots. It's the law.

 

The ER is probably the only place that has the immunoglobulin shot, so that is where you have to go first. For the rest of the vaccine series we had the option of ordering it from a pharmacy and having our regular dr. administer it or of getting it at the county health department. 

 

Some ER's charge an ER fee for every single visit even just the next in a vaccine series, so checking into other options is good. Other ER's will let you finish up the series through their hospital outpatient clinic without charging again for an  ER visit. It's the usual messed up healthcare stuff.

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I'm very lax about stuff and rarely take the kids in to the ER... but I would go now. I know it's rotten to go on a holiday, but it's rabies. Take him. Get the shots.

 

And then, also, it's documented and your options with the bad neighbors are expanded as well.

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The thing about rabies is that it's life threatening.

And you have to start the shots quickly or they won't work.

I would not wait around.  Call your doctor's off hours line, and if you don't reach them in, say, an hour, go to the ER.

Plus, if there is a dog that has bitten someone, he has crossed a serious line, and the authorities need to get involved.

 

Not just life threatening, it is essentially 100% lethal once a person contracts it. 

 

This is not one to take chances with.

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I'd be taking my guy to Urgent Care and reporting the bite.  I would then expect the dog to be tested if anything at all is suspicious about it.  This requires killing the dog, but that wouldn't bother me at all.  I don't want an aggressive dog around.

 

IF rabies is big in your area, then I'd potentially be concerned about it to the point of pursuing shots, but honestly, it mainly sounds like an aggressive dog issue to me.

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The ER is probably the only place that has the immunoglobulin shot, so that is where you have to go first. For the rest of the vaccine series we had the option of ordering it from a pharmacy and having our regular dr. administer it or of getting it at the county health department. 

 

Some ER's charge an ER fee for every single visit even just the next in a vaccine series, so checking into other options is good. Other ER's will let you finish up the series through their hospital outpatient clinic without charging again for an  ER visit. It's the usual messed up healthcare stuff.

 

Yes, I did mean the immune globulin specifically is in the care of the ER...in my state, the health department and PCPs may not administer the vaccine, either, which is a change from the past.

 

(I'm talking as if I know all about it -- which I don't quite LOL -- because one of my children went through this last month! Raccoon, not dog.)

 

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because one of my children went through this last month! Raccoon, not dog.)

 

 

With any wild animal - or even a cat - I'd agree with the Rabies bit because those critters don't (usually) attack people without provocation.  

 

But to me, this just seems like an unsocialized dog - unless rabies is big in the area.

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With any wild animal - or even a cat - I'd agree with the Rabies bit because those critters don't (usually) attack people without provocation.  

 

But to me, this just seems like an unsocialized dog - unless rabies is big in the area.

 

Probably so, but just speaking for myself, I wouldn't want to take responsibility for that decision for my kid because the wrong choice leads to a horrible death. It's the ER doctor's job to decide if the immune globulin is needed.

 

Sometimes rabies (in wild animals) doesn't look like a crazed attack. Raccoons, in particular, can act unusually playful and affectionate while in earlier stages of rabies.

 

Edited to add: Our ER doctor said that the decision is based on exposure, not on the patient's analysis of the animal's behavior.

Edited by Tibbie Dunbar
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Probably so, but just speaking for myself, I wouldn't want to take responsibility for that decision for my kid because the wrong choice leads to a horrible death. It's the ER doctor's job to decide if the immune globulin is needed.

 

Sometimes rabies (in wild animals) doesn't look like a crazed attack. Raccoons, in particular, can act unusually playful and affectionate while in earlier stages of rabies.

 

Edited to add: Our ER doctor said that the decision is based on exposure, not on the patient's analysis of the animal's behavior.

 

All true, but in this case the dog can be euthanized and tested to know for certain.  It's an alternative way to know for sure rather than guessing and it gets rid of an aggressive dog.

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Bite was reported on the "emergency" line for animal control by me. The recording says that after hours the Sheriff dept should be called. So I called Sheriff dept and reported it there. They said they'd report it to animal control who however would not be available till Tuesday. (This was last night after it happened.)

 

Ds will recognize the dog, and may also know the dog's name since a person in the house was yelling at it. 

 

Looks like there are 10 more replies. I'm going to post, then read.

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Pros of not going to the ER:

1. You and your son don't have to deal with sitting all day in an ER.

 

Cons:

1.  Your son runs the risk of contracting rabies, a disease that is almost 100% fatal once symptoms start showing.  There is no way to know for certain ahead of time if he has contracted the disease unless the dog is caught and tested.  

2.  A puncture wound from a dog can cause infections that can be quite serious, even if he wasn't exposed to rabies.

3.  Without the medical exam and the dog being reported you may have fewer legal options for protecting your son from future attacks from the animals at that same location.

4.  You will continue to worry and wonder whether he is sick.

 

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Looks like hive consensus at least so far is toward going to ER and getting shots started. I am going to start with more calls because I have heard a This American Life episode where there was a pretty clearly rabid animal bite, but a run around from health authority places each of which said to go somewhere else for rabies treatment. I already feel like I am in a circular situation with animal control referring to Sheriff dept who refers back to animal control.

 

In this case the patient, my ds, says he thinks it is an aggressive dog, not rabid. But it is true that it isn't something I want to be guessing at.  Some options, like the dog being killed and then examined-- could turn the owners aggressive which might not be an improvement unless the dog actually has rabies.

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I would call your primary doctor and talk to them, they may have a better idea of who to call and the procedure in your area. If you can't do that I would go to the ER. If the dog can reliably be monitored for 10 days you don't necessarily have to start rabies vaccine. If the dog cannot reliably be monitored (it can't be found, you are unsure if the people will watch it, etc) then the vaccine should be started. Monitoring the dog is the concern of animal control. They usually won't euthanize the dog unless it shows symptoms during the period of being monitored or it's a very aggressive dog that has bitten before and been reported. 

 

Often for dog bites we do prophylactic antibiotics. They are more likely to get infected than other wounds/cuts. We almost always do antibiotics for cat bites and human bites...dog bites it depends on the bite. But it's worth getting it checked out for that reason even if you don't end up needing to start rabies shots. 

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My dermatologist says that airing a wound is not a good idea, best to cover it with a bandage and use Vaseline, not Neosporin or any other antibiotic, on the wound.

my son's dermatologist gave him the antibiotic ointment to put on the incisions when the dressings were changed. Vaseline is not recommended.

 

if the bite was so serious he needed to rest - and rest again today - go have it checked out.  that isn't a treat it at home even if you knew the rabies status.

Edited by gardenmom5
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It sounds like the dog doesn't live next door and you're not sure who owns it.  So that lessens the chance it can be caught and monitored, unfortunately.

Kid needs ABX, I'd be going.

I'm so sorry that you have to deal with this kind of neighbor.  That's wretched.

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I would take him to ER. I was bit by a stray feral kitten and any bite automatically is reported to the local health department. Local health department, who then involves the state health department if the animal can't be caught or found. The state health department was who made the call whether I should have the shots or not. In my case they started antibiotics and didn't recommend the rabies vaccine since rabies in cats is almost unheard of in our state. 

 

I wouldn't mess around with this. You pay medical bills. DS is a minor. If you say he goes, he goes.

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The bite was yesterday?  The dog is not in custody or on ice en route to be checked?  The owner has not appeared on your doorstep with an up-to-date shot record, flowers, pie, and a big apology?

 

You have a very limited time in which rabies shots work after an exposure.  Exposer without shots = horrible death.  I'd be at the ER right the flip now!!

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Yes, I totally agree that he needs to visit a doctor. He Will probably need antibiotics and a tetnus shot in addition to concerns about rabies. The rabies shots are not as bad as they used to be (no longer 20+) shots. I think it is like 3 shots total. My DH was bit by a stray dog a couple of years ago and had to get the rabies shots.

 

The dr will have to report the bit to the appropriate authorities who will go after the dog if possible. Don't expect the local police to know what to do.

 

My DH who is in law enforcement was just dealing with this issue on Friday afternoon. A child was bit by the dog of a family friend. The families were not concerned but the dog owner did not have proof of the dogs vaccinations. After consulting with his supervisor, my DH was told to just write a report and that was it. Well, the dr reported the bite as required (there is no animal control here so I don't know what agency it was reported to) within 30 minutes my DH was contacted by the agency and had to pick up the dog which had already been put down by the owner. Once he had the dog's body, he had to find a place to store it until Tuesday when it can be sent to the state lab for testing. I am leaving out a few details so as not to upset anyone, but the bottom line was that I told him there was absolutely no way that he was leaving a dead dog in my refrigerator over the holiday weekend. Luckily 1 of the 3 vets in this county has a refrigerator big enough to hold it. Intersectingly enough, it cannot be frozen before testing for rabies.

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http://www.ncbi.nlm.nih.gov/pubmed/21247662

 

if you goggle Vaseline vs antibiotic ointment for wound care, about a zillion hits come up basically saying the same thing - use Vaseline over antibiotic.

 

And now we all know, too, ER not Urgent Care if might need rabies shots.  Never knew only ER's had to have at least the first shots on hand.  Good to know.

Edited by JFSinIL
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We'd go to the ER whether he wants to or not, so the incident can be documented and so the doctor can make the determination regarding the rabies immune globulin and series.

Absolutely, for both medical and possible civil case documentation. You don't know what the lasting effects could be at this stage of the game.

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I get that a 14 year old can be very insistent about what what he simply will not do.

But most 14 year olds don't understand that there are situations, like rabies, that they cannot talk their way out of. No do-overs.

 

I like Alice's idea of calling ds's regular doctor (presuming you have one) first. Sometimes doctors can make a call to an ER and things move faster.

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If the dog can reliably be monitored for 10 days you don't necessarily have to start rabies vaccine.

 

I was told by that county health agency that if you haven't been vaccinated before, you really should get the vaccine within 24 hours of exposure, not 10 days. And that if you'd had the preventative vaccine, you still should try to get a booster within 48 hours of exposure.

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Yup, ER, sorry. Dog bites can have NASTY bacteria. If it's as bad as you are making it sound (resting, etc) then he probably needs antibiotics. Get it checked, get on antibiotics, bandage it up, and carry on with life. 

 

Now, regarding rabies, can someone knock on these people's door and ask if the dog has a rabies vaccine? Maybe they can prove it has one and that ends the issue. Or can you call the police to have them check, since animal control is not answering? 

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If anyone is curious, here's the reported cases of rabies in the US, overall, and by species (and where).

 

http://avmajournals.avma.org/doi/pdfplus/10.2460/javma.248.7.777

 

With dogs, the incidences are very, very low.

 

I would totally trust local experts about that risk and whether it's ok for the dog to be monitored rather than tested if I were feeling sympathetic to the dog or its owners.  If rabies is in the area the answer would be totally different than if it isn't.  The owners might even start to rein in their dogs if they begin to see the bigger picture associated with loose aggressive dogs.  One never knows.

Edited by creekland
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Okay. The rabies treatment issue is now laid to rest for a while. I reached a nurse at the emergency room who led me through their protocol questions and told me that they would not start ds on rabies treatment even if I brought him in today. The key factor seemed to be that from assessing rabies pov versus aggressive dog and owner not keeping it under control, an unfenced yard where the dog charged out at passer-by in the circumstances that this happened is considered normal, not rabid behavior from the dog's pov--that it is exercising territorial aggression as it deems normal not understanding that the street is not its territory.  ... Apparently animal control will still do the 10 day rabies watch, but I am supposed to relax and not worry about the rabies aspect of it. I was also passed to a doctor who explained the risks in this area in a reassuring way. But anyway they agreed with my son that it sounds like an aggressive, not rabid, dog. That took a few phone hours, but better than spending the afternoon at hospital only to be sent home with same answers.

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