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MoonDragon's Health & Wellness
DOG BITES
(Cat or Animal Bites)




BASIC INFORMATION
"For Informational Use Only"
For more detailed information contact your health care provider
about options that may be available for your specific situation.


DESCRIPTION

dog bite A bite or scratch from a dog (or cat or any animal) that breaks the skin poses the danger of infection, especially if the wound is deep. Any bite also carries the risk of rabies. Most household pets have been immunized against rabies, but the possibility of infection still exists. It is also possible to contract a tetanus infection from an animal bite. The microbe that causes tetanus, Clostridum tetani, lives in the top layers of soil, and in the intestinal tracts of cows and horses. It easily infects wounds that result in reduced oxygen flow in the tissue, particularly crushing and puncture wounds.

A dog (or animal bite) can be nothing more than a minor graze, or it can be so severe as to be life threatening. Children are at most risk from dog bites, and children under 5 years of age are victim of the most severe attacks - many of them requiring hospitalization.

DOG BITE INCIDENCE

Each year approximately 4 million Americans are bitten by dogs, and about 800,000 of these persons (44 percent of whom are younger than 14 years) present for medical treatment. More than one dozen fatalities related to dog bites occur each year in this country; most of these victims are children. Although most dog bite attacks are not provoked, there are several measures that adults and children can take to decrease the possibility of being bitten. Family health care providers can educate parents and children on ways to prevent dog bites, but, when dog bites do occur, the health care provider must be knowledgeable about how to treat the bites effectively.

More than one dozen fatalities related to dog bites occur each year in this country; most of these victims are children.

As of 1994, an estimated 34 million American households owned at least one dog, accounting for a canine population in the United States in excess of 55 million. Most dogs never bite a human; however, under certain circumstances, any dog is capable of inflicting harm. The most common victims of dog bites are children, especially in incidents that prove fatal. Almost one half of all reported cases of dog bites involve an animal owned by the victim's family or the victim's neighbors. Most victims are involved in normal, non-provoking activities before the dog attacks. For example, neonatal deaths resulting from a dog bite most often involve a sleeping baby.

Several dog breeds have been identified for their role in fatal dog bite attacks, including pit bull breeds, malamutes, chows, Rottweilers, huskies, German shepherds and wolf hybrids. From 1979 to 1988, pit bull breeds accounted for more than 41 percent of dog bite­related fatalities, three times as many as German shepherds.

IS A RABIES SHOT NEEDED?

Probably not. Rabies is uncommon in dogs and cats in the United States. If a dog or cat that bit you appeared to be healthy at the time of the bite, it's unlikely that the animal had rabies. However, it's a good idea to take some precautions if you are bitten by a dog or cat. If the bite is from a wild animal or a pet that has become feral, the risk increases.

If you know the owner of the dog or cat that bit you, ask for the pet's vaccination record (record of shots). An animal that appears healthy and has been vaccinated should still be quarantined (kept away from people and other animals) for 10 days to make sure it doesn't start showing signs of rabies. If the animal gets sick during the 10-day period, a veterinarian will test it for rabies. If the animal does have rabies, you will need to get a series of rabies shots (see below).

If the animal is a stray, or you cannot find the owner of the dog or cat that bit you, call the animal control agency or health department in your area. They will try to find the animal so it can be tested for rabies.

If the animal control agency or health department cannot find the animal that bit you, if the animal shows signs of rabies after the bite, or if a test shows that the animal has rabies, your health care provider will probably want you to get a series of rabies shots (also called post-exposure prophylaxis). You need to get the first shot as soon as possible after the bite occurs. After you receive the first shot, your health care provider will give you 5 more shots over a 28-day period.




TREATMENT


Dog bite on hand


HOME-CARE RECOMMENDATIONS FOR ANIMAL BITES

SUPERFICIAL BITES

For superficial bites from a familiar household pet who is immunized and in good health:
  • If you have been bitten by a dog, the first thing you should do is remove the animal's saliva from the wound. Wash the wound area thoroughly with warm water, then add soap and water under pressure from a faucet for at least five minutes more, but do not scrub, as this may bruise the tissue. Rinse the wound a few minutes more with plain water. Apply an antiseptic lotion or cream.


  • Dog bite - cleaning the wound


  • Watch for signs of infection at the site, such as increased redness or pain, swelling, drainage, or if the person develops a fever. Call your health care provider right away if any of these symptoms occur.

DEEP BITES OR PUNCTURE WOUNDS

For deeper bites or puncture wounds from any animal, or for any bite from a strange animal:
  • If the bite or scratch is bleeding, apply pressure to the injured part with a clean bandage or towel to stop the bleeding.


  • Wash the wound with soap and water under pressure from a faucet for at least five minutes, but do not scrub, as this may bruise the tissue.


  • Dry the wound and cover it with a sterile gauze dressing for 24 hours or until seen by your health care provider. Do not use tape or butterfly bandages to close the wound, as this could trap harmful bacteria in the wound.


  • Keep the injury elevated above the level of the heart to slow swelling and prevent infection.


  • Call your health care professional for guidance in reporting the attack and to determine whether additional treatment, such as stitches (sutures) or antibiotics, a tetanus booster, or rabies vaccination is needed. This is especially important for bites on the face, or for bites that cause deeper puncture wounds of the skin.


  • Report the incident to the proper authority in your community (animal control or police). If possible, locate the animal that inflicted the wound. If you know who the dog's owner is, inquire as to the animal's vaccination status. If the dog is unfamiliar, try to have someone confine it if possible so that its health can be checked and it can be placed under observation. Some animals need to be captured, confined, and observed for rabies. Do not try to capture the animal yourself; instead contact the nearest animal warden or animal control office in your area.


  • If the animal cannot be found, or if the animal was a high-risk species (skunk or bat), or the animal attack was unprovoked, the victim may need a series of rabies shots.


  • Apply antibiotic ointment to the area 2 times every day until the bite heals or follow instructions given by your health care provider.


  • Call your health care provider for any flu-like symptoms such as a fever, headache, malaise, decreased appetite, or swollen glands following an animal bite.

MoonDragon's Health & Wellness: Cuts, Scrapes & Wounds





HERBAL RECOMMENDATIONS

  • Echinacea, Goldenseal, Pau D'Arco, and Red Clover, taken in tea form, are good for dog bites. Goldenseal extract can also be applied directly on the affected area. This is a natural antibiotic that helps to fight infection. Caution: Do not take Goldenseal internally on a daily basis for more than one week at a time, and do not use it during pregnancy. If you have a history of cardiovascular disease, diabetes, or glaucoma, use it only under supervision.

    See Nutritional Supplements located on this page for more recommendations to aid in a fast recovery.

    MoonDragon's Health & Wellness: Cuts, Scrapes & Wounds





    CONSIDERATIONS

  • Your health care provider may prescribe an oral antibiotic to prevent infection. If so, make sure that you take acidophilus to replace the "friendly" bacteria that antibiotics destroy. Your health care provider will also likely recommend you have a tetanus booster shot if you have not had one in 6 years or more.


  • In most states, dog bite incidents must be reported to the local health department, and the dog must then be kept under observation for any signs of rabies:
    • Viciousness.
    • Paralysis.
    • Growling.
    • Foaming at the mouth.
    • Sensitivity to noise and light.
    • Agitation.

    Rabies is an RNA-type of virus that, once established in the human central nervous system, is invariably fatal. If the animal cannot be located and rabies ruled out, a serious of rabies injections will be necessary. These have been highly unpleasant to the person receiving them. The series of injections available today is not longer so painful, not are injections given in the stomach, as in the past. However, It is best to try very hard to locate the animal if at all possible and have it quarantined.




    Dog with rabies


    DESCRIPTION OF RABIES

    Rabies is a viral infection of certain warm-blooded animals and is caused by a virus in the Rhabdoviridae family. It attacks the nervous system and, once symptoms develop, it is 100 percent fatal in animals, if left untreated. In North America, rabies occurs primarily in skunks, raccoons, foxes, and bats. In some areas, these wild animals infect domestic cats, dogs, and livestock. In the United States, cats are more likely than dogs to be rabid. Generally, rabies is rare in small rodents such as beavers, chipmunks, squirrels, rats, mice, or hamsters. Rabies is also rare in rabbits. In the mid-Atlantic states, where rabies is increasing in raccoons, woodchucks can also be rabid.

    Other animals with rabies risk


    Between 40,000 and 70,000 people die of rabies worldwide each year, with a further 10 million receiving treatment after being exposed to animals suspected of having rabies. Detecting, preventing and controlling the disease in the United States costs more than $300 million a year.


    RABIES TRANSMISSION

    The rabies virus enters the body through a cut or scratch, or through mucous membranes (such as the lining of the mouth and eyes), and travels to the central nervous system. Once the infection is established in the brain, the virus travels down the nerves from the brain and multiplies in different organs.

    The salivary glands and organs are most important in the spread of rabies from one animal to another. When an infected animal bites another animal, the rabies virus is transmitted through the infected animal's saliva. Scratches by claws of rabid animals are also dangerous because these animals lick their claws. Other rare means of infection are through entering a cave polluted by infected bats or through receiving organ transplants from a person carrying the rabies virus.


    RABIES SYMPTOMS

    The incubation in humans from the time of exposure to the onset of illness can range anywhere from five days to more than a year depending on the severity and location of the bite, the amount of virus present and the strain of the virus, although the average incubation period is about two months (typical 30-50 days). The following are the most common symptoms of rabies. However, each individual may experience symptoms differently. Symptoms may include:

    RABIES: STAGE 1
    • Initial period of vague symptoms, lasting 2-10 days.
    • Vague symptoms may include:
      • Fever.
      • Headache.
      • Malaise and lethargy.
      • Decreased appetite.
      • Vomiting.

    • Pain, itching or numbness and tingling at the site of the wound.

    RABIES: STAGE 2
    • Excessive salivation. Patients often develop difficulty in swallowing (sometimes referred to as "foaming at the mouth" due to the inability to swallow saliva - even the sight of water may terrify the patient (hydrophobia).


    • Some patients become neurological signs such as insomnia, agitation (anxiety) and disorientation (confusion), while others become paralyzed.
      • Furious Rabies causes the animal to foam and drool at the mouth. Animals behave unpredictably and may become vicious, snap at imaginary objects and attack without warning. The animal becomes progressively uncoordinated, paralyzed and usually dies in 4 to 5 days.


      • Dumb Rabies causes early paralysis, followed by drooling and death. Animals with dumb rabies remain quiet and only bite when provoked. They are unable to eat, but will frequently try to drink water.

    • Immediate death, or coma resulting in death from other complications, may result. Death usually occurs within days of the onset of symptoms.

    RABIES SYMPTOMS & DIAGNOSIS

    The symptoms of rabies may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

    DIAGNOSIS OF RABIES

    In animals, the direct fluorescent antibody test (dFA) is most frequently used to detect rabies. Within a few hours, diagnostic laboratories can determine whether an animal is rabid and provide this information to medical professionals. These results may save a person from undergoing treatment if the animal is not rabid.

    In humans, a number of tests are necessary to confirm or rule out rabies, as no single test can be used to rule out the disease with certainty. Tests are performed on samples of serum, saliva, and spinal fluid. Skin biopsies may also be taken from the nape of the neck.

    TREATMENT FOR RABIES

    Unfortunately, there is no known, effective treatment for rabies once symptoms of the disease occur. However, there is an effective new vaccine which provides immunity to rabies when administered after an exposure. It may also be used for protection before an exposure occurs, for persons such as veterinarians and animal handlers.

    The only hope for those bitten by a rabid animal is a course of vaccination before symptoms appear. Treatment requires prompt cleaning and disinfection of the bite site and a course of six injections over a month; one injection contains antibodies to fight the virus, the others are vaccinations to ensure long-term protection against the disease.






    MEDICAL MANAGEMENT OF DOG BITES

    INITIAL ASSESSMENT

    After confirming that the victim is medically stable, health care providers should begin a primary assessment by taking a patient history. Several medical conditions place a patient at high risk of wound and rabies virus infection from a dog bite. Information that can help determine the patient's risk of infection includes the time of the injury, whether the animal was provoked, and the general health, immunization status and current location of the animal. In some locations, notification of animal control or local law enforcement may be necessary. Also, the patient's tetanus immunization status, current medications and allergies must be noted in the record. During the physical examination, the measurement and classification of the wound (laceration, puncture, crushing or avulsion), and the range of motion of the affected and adjacent areas should be documented. Nerve, vascular and motor function, including pertinent negative findings, should be recorded. Diagrams and photographs are useful, especially in cases with irregular wounds or signs of infection, and in cases that may involve litigation, such as a wound inflicted by an unleashed dog.



    Medical Conditions
    Associated with a High Risk of Infection
    After a Dog Bite


    Chronic Disease
    Chronic Edema of the Extremity
    Diabetes Mellitus
    Immunosuppression
    Liver Dysfunction
    Previous Mastectomy
    Prosthetic Valve or Joint
    Splenectomy
    Systemic Lupus Erythematosus


    Timely and copious irrigation with normal saline or Ringer's lactate solution may reduce the rate of infection markedly. Injection of the tissue with irrigant solution should be avoided, because this can spread the infection. Necrotic or devitalized tissues should be removed, but care must be taken not to debride so much tissue as to cause problems with wound closure and appearance. Baseline radiographs (x-rays) may be obtained, especially with puncture wounds near a joint or bone.

    The role of wound closure remains controversial. Puncture wounds, wounds that appear clinically infected and wounds more than 24 hours old may have a better outcome with delayed primary closure or healing by secondary intention. Some health care providers close wounds that are less than eight hours old and wounds located on the face. The success of closing facial wounds can probably be attributed to the enhanced blood supply to the face and the lack of dependent edema. Plastic surgery, general surgery or maxillofacial surgery may be necessary for deep wounds or those requiring significant debridement and closure. Cultures are usually not helpful unless the wound appears infected or is unresponsive to appropriate antibiotic therapy. When a culture is necessary, aerobic and anaerobic cultures should be obtained and observed for a minimum of 7 to 10 days to allow for slow-growing pathogens. Orthopedic consultation should be considered for wounds that directly involve joints or other bony structures.

    ANTIBIOTIC TREATMENT

    Only 15 to 20 percent of dog bite wounds become infected. Crush injuries, puncture wounds and hand wounds are more likely to become infected than scratches or tears. Most infected dog bite wounds yield polymicrobial organisms. Pasteurella multocida and Staphylococcus aureus are the most common aerobic organisms, occurring in 20 to 30 percent of infected dog bite wounds. Other possible aerobic pathogens include Streptococcus species, Corynebacterium species, Eikenella corrodens and Capnocytophaga canimorsus (formerly known as DF-2). Anaerobic organisms, including Bacteroides fragilis, Fusobacterium species and Veillonella parvula, have also been implicated in infected dog bites. One review article identified 28 species of aerobic organisms and 12 species of anaerobic organisms isolated from dog bite wounds.

    Treatment with prophylactic antibiotics for three to seven days is appropriate for dog bite wounds, unless the risk of infection is low or the wound is superficial. If frank cellulitis is evident, a 10- to 14-day course of treatment is more appropriate. Amoxicillin-clavulanate potassium (Augmentin) is the antibiotic of choice for a dog bite. For patients who are allergic to penicillin, doxycycline (Vibramycin) is an acceptable alternative, except for children younger than eight years and pregnant women. Erythromycin can also be used, but the risk of treatment failure is greater because of antimicrobial resistance. Other acceptable combinations include clindamycin (Cleocin) and a fluoroquinolone in adults or clindamycin and trimethoprim-sulfamethoxazole (Bactrim, Septra) in children. When compliance is a concern, daily intramuscular injections of ceftriaxone (Rocephin) are appropriate.

    Occasionally, outpatient treatment of infection fails and the patient needs to be hospitalized and treated intravenously with antibiotics. Reasons for hospitalization include systemic signs of infection; fever or chills; severe or rapidly spreading cellulitis or advancement of cellulitis past one joint; and involvement of a bone, joint, tendon or nerve.

    Consultation with a maxillofacial or plastic surgeon may be required if the patient has a facial or other highly visible wound. For patients hospitalized with cellulitis or abscess formation in an extremity, surgical consultation should be considered immediately because of the risk of worsening infection and tissue damage. Depending on community practices and the location of the injury, general orthopedic surgery, hand surgery or general surgery consultation may be appropriate. Tetanus immunization and tetanus immune globulin should be administered, if appropriate. Recommendations for tetanus prophylaxis are given above.

    ACIP Recommendation Summary
    Tetanus Prophylaxis in Routine Wound Management

      Clean, minor wounds All other wounds*
    History of adsorbed tetanus toxoid (doses) Td† TIG Td† TIG
    Unknown or less than three Yes No Yes Yes
    Three or more‡ No§ No No|| No
    ACIP = Advisory Committee on Immunization Practices
    DTP = diphtheria tetanus and pertussis
    Td = tetanus and diphtheria toxoids adsorbed (adult)
    TIG = tetanus immune globulin (Hyper-Tet).
    * - Including, but not limited to, wounds contaminated with dirt, feces, soil or saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns and frostbite.
    † - For children younger than seven years, DTP (dT, if pertussis vaccine is contraindicated) is preferred to tetanus toxoid alone. For persons seven years or older, Td is preferred to tetanus toxoid alone. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP) may be used instead of DTP for the fourth and fifth doses.
    ‡ - If only three doses of fluid toxoid have been received, then a fourth dose of toxoid, preferably an adsorbed toxoid, should be given to complete the series.
    § - Yes, if it has been more than 10 years since the last dose.
    || Yes, if it has been more than five years since the last dose. (More frequent boosters are not needed and can accentuate side effects.)


    From Diphtheria, tetanus, and pertussis: recommendations for vaccine use and other preventive measures. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1991;40:21.


    ASSESSING THE RISK OF RABIES

    The patient's risk of infection with rabies virus must be addressed immediately. Because of the serious risk to the public of a rabid animal on the loose, it is important to document the conditions surrounding the attack. As a result of widespread vaccination of dogs against rabies in the United States, the most common source of the rabies virus is now wild animals, specifically raccoons, skunks and bats. Nonetheless, there are still reported cases of rabies virus associated with a dog bite. Patients with a bite from a non-provoked dog should be considered at higher risk for rabies infection than patients with a bite from a provoked dog. If the dog owner is reliable and can confirm that the animal's vaccination against rabies virus is current, the dog may be observed at the owner's home. Observation by a veterinarian is appropriate when the vaccination status of the animal is unknown. If the animal cannot be quarantined for 10 days, the dog bite victim should receive rabies immunization.

    Rabies immunization should begin within 48 hours after the bite, but it can be subsequently discontinued if the animal is shown to be free of rabies virus. Rabies immunization consists of an active immune response with a vaccine and a passive immune response with rabies immune globulin (RIG). Guidelines for rabies immunization are given below.

    Rabies Immunization Guidelines
    VACCINATION STATUS TREATMENT REGIMEN*
    Not previously vaccinated RIG Administer 20 IU per kg body weight. If anatomically feasible, the full dose should be infiltrated around the wound(s) and any remaining volume should be administered IM at an anatomic site distant from vaccine administration. Also, RIG should not be administered in the same syringe as vaccine. Because RIG may partially suppress active production of antibody, no more than the recommended dose should be given.
      Vaccine HDCV, RVA, or PCEC 1 mL, IM (deltoid area†), once daily on days 0‡, 3, 7, 14 and 28
    Previously vaccinated§ RIG RIG should not be administered.
      Vaccine HDCV, RVA, or PCEC 1.0 mL, IM (deltoid area†), once daily on days 0‡ and 3
    RIG = Rabies Immune Globulin
    IU = Immunizing Unit
    IM = Intra-muscularly
    HDCV = Human Diploid Cell Vaccine
    RVA = Rabies Vaccine Adsorbed
    PCEC = Purified Chick Embryo Cell Vaccine
    * - These regimens apply to all age groups, including children.
    † - The deltoid area is the only acceptable site of vaccination for adults and older children. For younger children, the outer aspect of the thigh may be used. Vaccine should never be administered in the gluteal area.
    ‡ - Day 0 is the day the first dose of vaccine is administered.
    § - Any person with a history of pre-exposure vaccination with HDCV, RVA or PCEC, prior post-exposure prophylaxis with HDCV, RVA or PCEC, or previous vaccination with any other type of rabies vaccine and a documented history of antibody response to the prior vaccination.


    Reprinted from Human rabies prevention - United States, 1999. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1999;48(RR-1):1-21 [Published erratum appears in MMWR Morb Mortal Wkly Rep 1999;48:16].


    FOLLOW-UP MEDICAL CARE

    Patients who have been bitten by a dog should be instructed to elevate and immobilize the involved area. Most bite wounds should be reexamined in 24 to 48 hours, especially bites to the hands.





    CONSIDERATIONS

    FAMILIES CONSIDERING GETTING A DOG

    When families are considering getting a dog as a pet, they need to keep in mind that dogs can play an important role in family life. As the canine population grows, so does the need for guidance to prevent dog bites. Prevention can begin with information from primary care professionals and veterinarians. Because a large percentage of dog bite victims are younger than 14 years, it is appropriate to begin prevention education with children and parents. Families acquiring a pet should consider their home environment and be told that a dog younger than four months is preferred. An older dog should not be introduced into a household with children because the dog's behavior cannot be predicted. Prospective dog owners should obtain breed-specific information before getting a new dog.

    Some breeds of dogs are more likely to attack despite training. Other breeds seem to be accepted more as "family dogs". Families should be educated to avoid "humanizing" their dog (e.g., allowing it to sleep on the furniture and to beg for food at the dinner table) and treating the dog as a child or a substitute for a mate. This type of behavior makes it more difficult for the animal to distinguish between animal and master and may increase the risk of the dog biting.



    Dog bite threat


    Breed-Specific Aggressiveness

    AGGRESSIVE DOGS (Higher Attack Rates)
    (Alphabetical Order)


    Bull Terrier
    Cocker Spaniel
    Chow Chow
    Collie
    Doberman Pinscher
    German Shepherd
    Great Dane
    Pit Bull
    Rottweiler
    Siberian Husky
    LESS AGGRESSIVE DOGS ("Family dogs")
    (Alphabetical Order)


    Boxer
    Dalmatian
    English Setter
    English Springer
    Golden Retriever
    Irish Setter
    Labrador Retriever
    Spaniel


    PREVENTING DOG & CAT BITES

    Being safe around animals, even your own pets, can help reduce the risk of animal bites. Some general guidelines for avoiding animal bites and rabies include the following:
    • Never leave a young child alone with a pet.
    • Do not try to separate fighting animals.
    • Avoid sick animals and strange animals that you do not know.
    • Leave animals alone while they are eating.
    • Keep pets on a leash when in public.
    • Select your family pet carefully.
    • Do not approach or play with wild animals of any kind, and be aware that domestic animals may also be infected with the rabies virus.
    • Supervise pets so they do not come into contact with wild animals. Call your local animal control agency to remove any stray animals.
    • Be sure to keep your pet's vaccinations (shots) up-to-date. This is especially important if they are outdoor or outdoor/indoor pets. A pet (such as a cat) that never goes outdoors and is strictly an indoor pet, is at a lower risk of transmitting a serious infection since exposure to an infecting agent, such as rabies, is minimal. However, cat scratches, even from a kitten can carry "cat scratch disease," a bacterial infection.

    BEHAVIOR TO PREVENT A BITE

    Measures for preventing dog bites are given above. Dogs have a tendency to chase a moving object. Therefore, children need to learn to avoid running and screaming in the presence of a dog. Dogs should not be greeted by presenting an outstretched hand. Do not pet a dog without letting it sniff you first. Hugging and "kissing" a dog express a sense of submission to the animal, which is confusing because the animal is used to viewing humans as being in charge. This confusion may lead to more aggressive behavior by the animal.

    Educate children and adults to remain calm when threatened by a dog. Direct eye contact should be avoided because the dog may interpret that as aggression. Standing still ("like a tree") with feet together, fists folded under the neck, and arms placed against the chest is recommended. If knocked to the ground by a dog, recommendations include lying face down and becoming still "like a log," with legs together and fists behind the neck with forearms covering the ears. If a dog perceives no movement, it will most likely lose interest and go away.

    INCIDENCE REPORTING

    If you or someone you know is bitten by an animal, remember these facts to report to your healthcare provider:
    • Location of the accident.
    • Type of animal involved (domestic pet or wild animal).
    • Type of exposure (cut, scratch, licking of open wound).
    • Part of the body involved.
    • Number of exposures.
    • Whether or not the animal has been immunized against rabies.
    • Whether or not the animal is sick or well - if "sick," what symptoms were present in the animal.
    • whether or not the animal is available for testing or quarantine.





    NUTRITIONAL SUPPLEMENTS

    Unless otherwise specified, the following recommended doses are for adults over the age of 18. For a child between 12 and 17 years, reduce the dose to 3/4 the recommended dose. For a child between 6 and 12 years old, use 1/2 the recommended dose, and for a child under 6, use 1/4 the recommended dose.

    NUTRIENTS
    Supplement Suggested Dosage Comments
    Very Important
    Vitamin C With Bioflavonoids 4,000-10,000 mg daily, in divided doses for 1 week, then reduce to 3,000 mg daily. Fights infection. Important for repair of collagen and connective tissue.
    Vitamin C Liquid w/ Rose Hips & Bioflavonoids, Kosher, Natural Citrus Flavor, Dynamic Health, 1000 mg, 16 fl. oz.,
    Ester C With Bioflavonoids, Nature's Way, 1000 mg, 90 Tabs,
    Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Vcaps,
    The Right C, Nature's Way, 1000 mg, 120 Tabs
    Important
    Proteolytic Enzymes
    Or
    Infla-Zyme Forte
    As directed on label, 3 times daily. Take between meals, on an empty stomach. Acts as an anti-inflammatory.
    MetabolicZyme (Hypoallergenic), Allergy Research Group / Nutricology, 900 Tabs,
    Plant Enzymes, NOW Foods, Vegetarian, 120 VCaps,
    Enzymes, All Complete, 250 mg, 90 Caps
    Helpful
    Colloidal Silver As directed on label. To reduce the danger of infection. Can be taken internally or placed on a sterile bandage covering the wound.
    Colloidal Silver Liquid, SilvaSolution, 10 ppm, 16 fl. oz.,
    Colloidal Silver Liquid, SilvaSolution, Super Strength Pro 50, 8 fl. oz.
    Garlic (Kyolic) 2 capsules 3 times daily. Acts as a natural antibiotic. Kills bacteria and parasites. Enhances immunity.
    Garlic Oil Tincture, Alcohol Free, Nature's Way, 1 fl. oz.,
    Garlic Bulb Cloves, Garlic Supplement, Nature's Way, 580 mg, 100 Caps,
    Odorless Garlic Supplement, NOW Foods, 50 mg, 250 SoftGels,
    Garlic Supplement, Kwai, Triple Concentrated, 180 Tabs,
    Every Day Garlic Supplement, Kwai, 30 Tabs,
    Garlic Tincture, 100% Organic, 2 fl. oz.,
    Aged Garlic Extract, Cardiovascular Formula 100, Wakunaga Kyolic Supplements, 300 Caps,
    Kyolic Liquid Aged Garlic Extract, Cardiovascular, Vegetarian, Wakunaga Kyolic, 4 fl. oz.,
    Kyolic Aged Garlic Extract, One-A-Day, Vegetarian, 1000 mg, Wakunaga Kyolic, 30 Caps,
    Aged Garlic Extract, Cholesterol Formula 104, Wakunaga Kyolic, 200 Caps
    L-Cysteine
    And
    L-Methionine
    500 mg of each daily for two weeks. Take on an empty stomach. Take with water or juice. Do not take with milk. Take with 50 mg vitamin B-6 and 100 mg vitamin C for better absorption. Powerful detoxifying agents.
    L-Cysteine Structural Support, With Vitamin B-6 & C, Vegetarian, NOW Foods, 500 mg, 100 Tabs,
    L-Methionine, 500 mg, Plus B-6, 10 mg, 100 Caps
    ViraPlex
    (Enzymatic Therapy)
    As directed on label. Aids in healing and fights infection.
    Vitamin A 25,000 IU daily. If you are pregnant, do not exceed 10,000 IU daily. Powerful antioxidants that aid the immune system and assist healing of the skin.
    Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels
    Plus
    Natural Beta-Carotene
    Or
    Carotenoid Complex (Betatene)
    25,000 IU daily.

    As directed on label.
    Powerful antioxidants that aid the immune system and assist healing of the skin.
    Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels,
    Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
    Plus
    Vitamin E
    200-400 IU daily. A powerful antioxidant that aid the immune system and assist healing of the skin.
    Ester E Natural Vitamin E, California Natural, 400 IU, 60 Softgels,
    Vitamin E, 400 IU, 100% Natural, NOW Foods, 100 Gels,
    Vitamin E-1000, NOW Foods, 1000 IU, 100 Gels,
    Vitamin E, d-alpha-tocopherol, 400 IU, 100 Softgels
    Vitamin B Complex 50 mg of each B vitamin daily, with meals 3 times daily (amounts of individual vitamins in a complex will vary). B vitamins work best when taken together. Aids in tissue oxidation and antibody production.
    Ultimate B (Vitamin B Complex), Nature's Secret, 60 Tabs,
    Vitamin B-100 Complex, w/ Coenzyme B-2, Nature's Way, 631 mg, 100 Caps





    DOG BITE SUPPLEMENTS & PRODUCTS

    Supplements and products for dog bites, cuts, lacerations, punctures, abrasions, crushing wounds and fractured bones caused by canine attack.

    Amino 1000 Complete, NOW Foods, 120 Caps

    Amino 1000 Complete contains a balanced blend of 20 essential and non-essential amino acids.
    Arnica Cream (Arnica Montana), Homeopathic First Aid Cream, 100% Organic, 1 oz.

    Nelson's Arnica Cream is a healing and soothing homeopathic remedy for the relief of bruises and sore muscles.
    Australian Tea Tree Oil, First Aid Handbook, 2nd Edition, By Cynthia Olsen

    For nearly a century, Australian tea tree oil has been proven clinically effective for over 100 various skin conditions.
    Bach Rescue Remedy Flower Essence Cream, 50 g

    Bach Rescue Remedy Cream Flower Essence Cream base that can be used for any stress or trauma to your skin. Safe and natural. A great addition to your herbal first aid kit.
    Bach Rescue Remedy Spray, 20 ml

    Bach Rescue Remedy Spray is for times to help balance the emotions, relieve stress and reduce fear and nervousness.
    Black Ointment, All Natural, Nature's Way, 2 oz.

    Nature's Way Black Ointment is a time tested herbal formula made with herbs traditionally used to dry and draw external wounds. This is an excellent herbal wound care product.
    Burt's Bees Natural Remedy Kit, All Natural

    Burt's Bees Natural Remedy Kit is perfect for relieving the discomfort of minor skin irritations, burns, bruises, stings and scrapes. Included is Poison ivy soap, lip balm, hand salve, comfrey ointment, gardener's soap, natural peppermint breath drops and lemongrass insect repellant.
    Calendula Gel, Califlora (Relief For First Aid & Sunburn), Homeopathic, Boericke & Tafel, 2.75 oz.

    Califlora Calendula Gel is the ideal pain reliever for a wide variety of skin conditions including sunburns.
    Colloidal Silver Liquid, SilvaSolution, 10 ppm, 16 fl. oz.

    Colloidal Silver is a potent yet non-toxic natural food supplement that has shown to support the immune system during the cold and flu season.
    Comfrey Leaf Ointment, Nature's Way, 2 oz.

    Comfrey Leaf Ointment is a 100% all natural, mild scented, herbal ointment.
    Complete Book of Essential Oils & Aromatherapy By Valerie Ann Wormwood

    Destined to be THE classic reference book on Aromatherapy, it offers over 600 original recipes in practical, understandable form.
    Enzymes, All Complete, 250 mg, 90 Caps

    All Complete Enzymes, dietary supplement, is an important combination of critical enzymes that help support normal digestive function, cholesterol levels, fat metabolism and more, all in one convenient tablet.
    Nature's Antiseptics Tea Tree Oil & Grapefruit Seed Extract, CJ Puotinen, Paperback

    Nature's Warfare, this book covers tea tree oil and grapefruit see extract use in safely destroying viruses, bacteria, molds, yeasts and parasites that want to live in us and on us.
    Nutribiotic First Aid Skin Spray W/ Grapefruit Seed Extract & Tea Tree Oil, 4 fl. oz.

    Grapefruit Seed Extract acts as a broad spectrum antiseptic and antibiotic. Keeps the wound clean and helps to speed healing with Grapefruit Seed Extract & Tea Tree Oil.
    NutriBiotic Skin Ointment W/ Grapefruit Seed Extract & Lysine, 0.5 oz.

    NutriBiotic Skin Ointment with GSE can be used topically for such things as scrapes, scratches and cuts. NutriBiotic Skin Ointment with GSE can also be used on the lips and in the mouth on cold sores and canker sores.
    Smart Medicine for a Healthier Child: A Practical A-to-Z Reference to Natural & Conventional Treatments for Infants & Children

    Here's a practical A-to-Z reference guide to children's health. This source offers the best perspectives of both alternative care and conventional medicine for the most common childhood disorders and their treatments.
    Spices To The Rescue, By Hanna Kroeger

    Spices To The Rescue is first aid from your kitchen with suggestions that are very practical for everyday use, the kind of advice your grandmother would give you.
    Stress Relief Kit, Bach, 0.7 oz. Spray & 1.7 oz. Cream

    Rescue Remedy, is a natural stress reliever that many folks keep on hand at home and in travel kits.
    Tea Tree Antiseptic Cream, 4 oz.

    This tea tree cream has a soothing and cooling effect on inflamed skin. It can be used as diaper change lotion.
    Tea Tree Cream, Antiseptic, 1 Gallon

    Tea tree cream has a soothing and cooling effect on inflamed skin. It can be massaged into sore joints for relief from discomfort.
    Tea Tree Oil (Melaleuca Alternifolia), 100% Pure Oil, 2 fl. oz.

    Tea Tree Oil can be used for general first aid uses such as cuts, burns, abrasions, insect bites, bee stings, rashes, impetigo, boils, sinus problems, sore throat, thrush, fingernail and toenail infections.
    Tea Tree Oil Bulk (Melaleuca Alternifolia), 100% Pure Oil, 32 fl. oz.

    Bulk Tea Tree Oil can be used for so many things including cuts, burns, abrasions, insect bites, bee stings, rashes, impetigo, boils, sinus problems, sore throat, thrush, fingernail and toenail infections.
    Travel or Home First Aid Kit

    The Travel or Home First Aid Kit has all the internal and topical products from Nutribiotic you will need for your travel or home first aid needs.
    Unker's Pain & Itch Roll-On Stick, All Natural, 0.25 oz.

    With any cut, abrasion, rash or bite, wash the area with one of the Unker's all natural soaps, then apply the Pain & Itch roll on.
    Vitamin A, 100% Natural, Nature's Way, 10,000 IU, 100 Softgels

    Nature's Way vitamin A is 100% natural from fish liver oil. It contains no artificial ingredients or preservatives.
    Vitamin C 500 With Bioflavonoids, Nature's Way, 100% Natural, 500 mg, 250 Caps

    Vitamin C 500 With Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.
    Vitamin C 1000 With Bioflavonoids, Nature's Way, 100% Natural, 1000 mg, 250 Caps

    Nature's Way Vitamin C with Bioflavonoids provides antioxidant protection for many of the body's important enzyme systems.





  • Herbal Remedies: Dog Bite Information


  • Herbal Remedies: Dog Bite Supplements & Products




  • NOTIFY YOUR HEALTH CARE PROVIDER IF...

  • You or a family member has been bitten by a dog on your hand, foot or head, or you have a bite that is deep or gaping. Your health care provider will:
    • Examine the wound for possible nerve or tendon damage, or bone injury and signs of infection.
    • Clean the wound with special solution and remove any damaged tissue.
    • Use stitches to close a bite wound, but often the wound is left open to heal, so the risk of infection is lowered.
    • Prescribe an antibiotic to prevent infection.
    • May have you do a follow up visit in a few days.
    • If your injury is severe, of if the infection has not gotten better even though you are taking antibiotics, you may be referred to a specialist and/or go to the hospital and get antibiotics intravenously and/or other further treatment.

  • You have diabetes, liver or lung disease, cancer, acquired immunodeficiency syndrome (AIDS), or another condition that could weaken your ability to fight infection.


  • You have a fever above 101°F, swelling, redness, warmth, increased tenderness, oozing of pus, or other signs of infection.


  • You have bleeding that does not stop after 15 minutes of pressure or you think you may have a broken bone, nerve damage or other serious injury.


  • Your last tetanus vaccination was more than 5 years ago. If so, you may need a booster shot.


  • You are unable to find the dog that bit you and you feel you need to be examined.


  • You have any unexpected or unusual symptoms. Some people may have sensitivity, allergies, or other health conditions which would prevent them from using certain medications, herbs, supplements or other treatments. Some medications may produce side effects.





  • HELPFUL ONLINE LINKS

  • Dog Bite Law: Information about dog bites, victims, etc.
  • Humane Society: Staying Dog Bite Free
  • AVMA: Dog Owner Brochures - Dog Bite Prevention & Rabies
  • DogLaw.HugPug.com: Dog Law & Dog Bites
  • American Kennel Club: Tips To Prevent Dog Bites
  • DogGoneSafe: A Non-Profit Resource of Dog Bite Prevention & Education
  • USPS: Dog Bite Awareness - The U.S. Postal Service
  • KidsHealth: Dogs and Preventing Dog Bites - Kid's Tutorial




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    HELPFUL PRODUCTS & FURTHER EDUCATION

  • Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
    -- by Phyllis A. Balch, James F. Balch - 2nd Edition

  • Prescription for Nutritional Healing: The A-To-Z Guide To Supplements
    -- by Phyllis A. Balch, James F. Balch - 4th Edition

  • Prescription for Herbal Healing: The A-To-Z Reference To Common Disorders
    -- by Phyllis A. Balch

  • The Complete Guide to Natural Healing



    If you see a suggested Amazon product "not there" as indicated by an orange box with the Amazon logo, this only means the specific product link has been changed by Amazon.com. Use the "click here" icon on the orange box and it will bring you to Amazon.com and you can do a search for a specific product using keywords and a new list of available products and prices will show. Their product and resource links are constantly changing and being upgraded. Many times there are more than one link to a specific product. Prices will vary between product distributors so it pays to shop around and do price comparisons.

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