SURGERY Section of Surgery, Veterinary Teaching Hospital, Koret School of Veterinary Medicine. The Hebrew University of Jerusalem, Israel Dog Bite Wounds in Dogs and Cats: a Retrospective Study of 196 Cases M. H. SHAMIR 1,3 , S. LEISNER 1 , E. KLEMENT 2 , E. GONEN 1 and D. E. JOHNSTON 1 Addresses of authors: 1 Section of Surgery, Veterinary Teaching Hospital, Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Israel, PO Box 12, Rehovot 76100, Israel; 2 Department of Epidemiology, Sackler Faculty of Medicine, Tel Aviv University, Israel; 3 Corresponding author: E-mail: shamir@agri.huji.ac.il With 2 tables and one figure Received for publication December 19, 2000 Summary The age, type, etc., time of injury, body areas injured, treatment modalities and mortality rates were reviewed in 185 dogs and 11 cats that were bitten by dogs. Male dogs were more frequently bitten than females, and small dogs (£ 10 kg) were not only the most common victims but also were more likely to suffer multiple injuries. Mortality occurred only in cases with thoracic or abdominal injuries. Exploratory thoracotomy, performed in some of the cases presented with penetrating thoracic injury, did not prove to alter prognosis. Cats are not as frequently bitten as dogs, and are often younger than the mean age of cats in the overall hospital population. Introduction Bite wounds are one of the most common reasons for admission of dogs and cats to veterinary clinics. The true incidence of dog and cat bites is unknown (Kelly et al., 1992; Holt and Griffin, 2000), but a survey of 1000 urban trauma cases showed that bite wounds were the third most common cause of trauma in dogs (10% of all dog trauma cases), and the second most common cause in cats (15% of all cat trauma cases) (Kolata et al., 1974). In people, in the United States, animal bite wounds account for approximately 1% of the emergency room visits (Douglas, 1975; Goldstein and Rich- wald, 1987; Underman, 1987; Cowell and Penwick, 1989); of these, bites by dogs are responsible for approximately two- thirds of the cases (Douglas, 1975). Dog bite wounds can range from minor to extremely complex wounds (Neal and Key, 1976). This kind of injury has several unique characteristics that distinguish it from other traumatic injuries. The initial skin lesion appearance in many cases is deceptive since most damage occurs to deeper tissues and organs. This is possible due to the loose skin and subcutaneous tissues of dogs and cats that enables the biting dogs’ teeth to move quite freely and hence tear and avulse a large amount of muscles, vasculature and internal organs, leaving minimal damage to the skin itself (Neal and Key, 1976; McKeirnan et al., 1984; Cowell and Penwick, 1989; Swaim and Henderson, 1997; Davidson, 1998a; Holt and Griffin, 2000). This, accompanied by the great pressure that can be generated between the jaws of the biting dog (up to 450 psi), can result in a potentially severe bruising and crushing of tissues (Neal and Key, 1976; Cowell and Penwick, 1989; Swaim and Henderson, 1997). Bite wounds that penetrate the skin are considered contaminated to the depth of the wound with either the biting dog’s oral bacteria, the victim’s resident skin bacteria or soil organisms. After the bite, devitalized tissues, dead space and serum accumulation provide a good medium for growing inoculated bacteria (Neal and Key, 1976; Harari, 1993; Swaim and Henderson, 1997). Another factor affecting the injury is the relative sizes of the attacker and the victim; toy or miniature dog breeds and cats are often just ‘bite size’ for a large dog, with the victim being picked up around the head, neck, thorax or abdomen and shaken by the attacker (Neal and Key, 1976; Swaim and Henderson, 1997). No standard protocol is available for the treatment of bite wounds in dogs and cats. The principles of overall wound care and adequate de´bridement are widely accepted, but several issues including exploratory surgery in cases of thoracic bite wounds or prophylactic antibiotics remain controversial (Douglas, 1975; Zook et al., 1980; Fleisher and Boenning, 1981; Cowell and Penwick, 1989). Surgical de´bridement to remove any devitalized fat and muscle as well as copious lavage are recommended (Neal and Key, 1976; Harari, 1993; Shahar et al., 1997; Swaim and Henderson, 1997). Pressure irrigation (at least 500 ml saline per wound at a pressure of 300 mmHg or 8 psi) for removal of debris, bacteria and dislodgement of devitalized fat is strongly emphasized in human and veterinary medicine (Zook et al., 1980; Waldron and Trevor, 1993). In cases of crushing or penetrating abdominal injuries immediate surgical intervention is recom- mended as soon as the patient is stabilized (Neal and Key, 1976; Cowell and Penwick, 1989; Harari, 1993; Davidson, 1998a; Holt and Griffin, 2000). The treatment strategy of penetrating thoracic bite wounds is still controversial. Some authors recommend mandatory surgical intervention (Neal and Key, 1976; McKeirnan et al., 1984; Harari, 1993; Shahar et al., 1997; Holt and Griffin, 2000), whereas others suggest more conservative way of treatment (Cowell and Penwick, U. S. Copyright Clearance Center Code Statement: 0931–184X/2002/4902–0107 $15.00/0 www.blackwell.de/synergy J. Vet. Med. A 49, 107–112 (2002) Ó 2002 Blackwell Wissenschafts-Verlag, Berlin ISSN 0931–184X