Thursday , March 06, 2014 - 10:08 AM
With sleepy eyes and a comically kinked tail, Sammy does not look like a dangerous character. But Sammy put me in the hospital.
For four days.
As I lay in that bed, hour after hour, hooked up to an intravenous cocktail of antibiotics, I had plenty of time to rue the stupidity that put me there.
Sammy bit me. Although I didn’t take it seriously at the time, a bite from a small cat can be a big problem, thanks to the nature of the bite itself and the kinds of bacteria carried by cats and people. For some people, in fact, it can be deadly.
“A cat bite is nothing to trivialize,” said Nancy Peterson, cat programs manager at the Humane Society of the United States.
Up to 50 percent of cat bites become infected, said Princy N. Kumar, head of the infectious-diseases division at MedStar Georgetown University Hospital. But, like me, many people don’t take the injury seriously enough.
“People underestimate” the danger, Kumar said, and don’t realize they should get a bite looked at right away. “They don’t realize, being bitten by a cat, you’ve got a 1-in-2 chance of getting infected.”
My first mistake was getting in the middle of a fight.
Sammy, a street cat who had just joined our family, did not like established resident Blue. When I heard a blood-curdling yowl from the spare bedroom late one night, I decided to remove one of the combatants.
When I reached down to pick him up him, Sammy wrapped his legs around my right arm and plunged his teeth into my wrist. Deep-red, venous blood ran out of two puncture wounds, and the area began to swell. I washed the wound well (after shrieking and dropping the cat), put some ice on it and kept it elevated for a while. I figured the swelling would be gone by morning.
The next day, my arm was puffy and I couldn’t move my fingers well. My wrist felt hot to the touch. I tried more ice and elevation.
That was my second mistake: minimizing the problem and treating the bite myself. A significant cat bite always requires medical intervention,
“If you got a really bad bite, you should get prophylactic antibiotics,” Kumar said. A light nip is not a problem, she said, but seek help if the cat has really sunk its teeth in — “if you see a puncture wound and blood coming out of it.”
Unlike dogs, which tend to deliver superficial, crushing bites that don’t penetrate far into tissue, cats inflict puncture wounds with their long teeth, which inject bacteria from the cat’s mouth and the environment deep into tissue.
And, Peterson said, “cats have a pretty potent bacteria.” While cats have a variety of microbes living in their mouths, the real trouble comes from Pasteurella multocida, a bacterium that can cause bad infections. One study found that 90 percent of domestic cats are carriers. Dogs also carry this bacteria, first isolated by Louis Pasteur and named after him, but the infection rate from their bites doesn’t come close to cats’ 50 percent. (Pasteurella is not the microbe that causes cat scratch disease, which is usually transmitted by kitten scratches and nips, and in most people causes only swollen lymph nodes, not severe local infection.)
We humans also carry germs on our skin, such as staphylococcus and streptococcus, which can be picked up by the animal’s teeth and added to the bacterial stew injected by the bite.
Apparently, quite a few people end up in my situation, though there aren’t any great statistics on how many people get bad wounds from their cats. A study by New York’s public health department found that 13 percent of emergency room visits for animal bites were due to cats.
“It’s not an uncommon problem,” said Kumar, who sees about five or six cases a year that require hospitalization.
A lesson learned
My third mistake, related closely to my second, was dithering once I recognized that my bite was not getting better.
Three days after my encounter, my right arm looked like a stuffed sausage. It hurt, and I couldn’t use the fingers at all. Still, I felt a bit foolish slinking into the Georgetown emergency room — there were some really sick people there that day. I sat sheepishly waiting to be given a prescription and dismissed.
When the doctor told me I’d have to stay at the hospital, I thought I had misunderstood.
And no food tonight, the doctor added, because they might have to operate tomorrow.
Cat bites tend to cause bone infections, I learned, not only because of the depth of the injury but also because most bites occur on the hands, where the bones and joints are accessible. In those cases, the wound must be cleaned out surgically.
My X-ray didn’t show a bone infection, thankfully, so I got to skip the operating room. Instead, I got two strong IV antibiotics, vancomycin for staph and strep, and Unasyn for Pasteurella and other bacteria. I spent the four days and three nights trying not to bother the nurses too much and trundling my IV contraption down the hall to the snack machine just for something to do. My arm was still a little swollen when I was finally allowed to go home with a round of oral antibiotics. The bill for my stay and treatment was $15,524, paid for by my insurance.
It took several more days until I felt completely well and there was no sign of swelling in my wrist and hand.
Luckily, I’m generally healthy. I don’t have medical conditions that can turn a cat bite into a deadly attack. People with underlying liver disease, for instance, are at risk of infection from another type of bacteria sometimes found in cat and dog bites; this is also an issue for people who don’t have a properly functioning spleen. Such people are in danger of deadly septic shock, Kumar said.
Everyone asks me if we still have Sammy. We do. And he still doesn’t get along with Blue.
But I, at least, have learned something. Now, if a fight erupts, I grab a spray bottle of water and keep my body out of the way.
Joyce is a Washington-based health and science writer.
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