Cat Bite: A Small Wound That Runs Deep

Key takeaways

The danger of a cat bite lies in how undangerous it looks. According to MedlinePlus, a cat's teeth are longer and sharper so they make a deeper puncture, and cat bites are less common but carry a higher risk of infection.
According to CDC, about 20–80% of reported cat bites and scratches become infected. So do not decide for yourself that your own hole is a small one.
Two things, in this order: rinse the wound under running water with soap, washing for longer than you think is enough; then be seen today. According to CDC, call a doctor straight away after being bitten by a dog or a cat, even if you feel perfectly well.
Go to emergency care now if bleeding will not stop even with gauze pressed on it, if the wound is deep or wide, if red streaks run away from it, if the bite is on the head, face or neck, or if the bitten person has a fever with vomiting, headache or confusion.
And there is one sign that arrives late, particular to cat wounds: according to CDC, cat-scratch disease causes large, painful swollen glands appearing 1–3 weeks after contact with a cat. By then the wound has healed and nobody is thinking about it any more.

A cat bite usually leaves just one or two holes the size of a pinprick, barely any bleeding, and within a few minutes the opening has already closed over. That is precisely where it gets taken lightly. According to MedlinePlus, a cat's teeth are longer and sharper so they make a deeper puncture, and the risk of infection is higher. Two things to do today: wash it really thoroughly, then be seen.

Recognising it: a small hole, but a deep way in

People who are seen late usually did not take cat bites lightly — they concluded for themselves that their own wound was nothing much. According to CDC, about 20–80% of reported cat bites and scratches become infected.

A small hole with a deep way in: water running over the opening does not mean it has been washed to the bottom, and the wound can look healed while the deep part is still sealed in
A scratch counts too, and so does saliva licked onto skin that is already grazed: according to CDC, an infected cat that bites or licks an open wound on a person can pass on Bartonella bacteria
Where it is matters more than how big it is: according to MedlinePlus, a bite on the neck, head, face, hand, finger or foot is a reason to contact a doctor straight away
Kittens and stray cats are more of a worry: according to CDC, stray cats are more likely to carry Bartonella bacteria than pet cats, and CDC advises avoiding being scratched, bitten or licked by kittens or unfamiliar cats
According to CDC, the risk of serious infection is higher in people whose immune system is weakened by cancer, diabetes or HIV, people on chemotherapy, people without a spleen and people with alcohol dependence

What to do straight away

None of the steps below needs a prescription.

If it is bleeding, press a piece of gauze or a clean dry cloth onto the bleeding point and hold it firmly — do that first.
Rinse the wound under running water with soap and wash for a long time — for an animal bite that may have exposed you to rabies, CDC specifies washing for 15 minutes.
Cover it with clean gauze. According to MedlinePlus, you may apply an antibacterial ointment before covering it — but that does not take the place of the appointment.
Be seen today, saying clearly that a cat bit you, where the wound is, and which cat it was.
Note the time of the bite and whose cat it was or whether it was unfamiliar; if the cat has an owner, ask them for proof of rabies vaccination.
According to CDC, if the cat becomes ill or dies soon after the bite, have a vet examine it; report the bite to your local health authority.

What you must NOT do

Do not use “our own cat, it lives indoors, it is probably fine” as a reason to skip the appointment. According to CDC, be seen when you do not know whether the cat has been vaccinated against rabies
Do not stitch it yourself and do not seal the opening shut; do not cut it open wider, do not suck blood from it with your mouth
Do not apply leaves, medicinal powders, toothpaste, oil or grease to the wound
Do not wait to see whether the wound swells before deciding: according to CDC, call a doctor straight away after being bitten by a dog or a cat, even if you feel perfectly well
Do not buy medicine to take yourself and treat that as the end of it — whether antibiotics are needed is the doctor's decision after looking at the wound

Cat-scratch disease: glands that swell up weeks later

This part is particular to cat wounds. According to CDC, the bacterium Bartonella henselae causes cat-scratch disease; people catch it from being scratched by a pet cat or a stray cat, kittens especially. The signs arrive late, so people usually do not connect them with the cat:

A mild fever
Large, painful swollen glands appearing 1–3 weeks after contact with a cat — usually the glands nearest the bite or the scratch
A papule or a pustule right at the site of the scratch
According to CDC, this illness is more common in children under 15; rarely, the infection can reach the eyes, the liver, the spleen, the brain, the bones or the heart valves

There is one more watching window, an earlier one. According to CDC, within 14 days of being bitten by a dog or a cat, contact a doctor straight away if there are blisters around the wound, discharge of pus, fever, vomiting, diarrhoea, headache or confusion.

When you must go to hospital

Call 115 (the emergency number in Vietnam) or go to emergency care NOW if: bleeding will not stop even with gauze pressed on firmly · the wound is deep or wide, gaping open, with flesh or bone visible underneath · red streaks run away from the wound · the wound is on the head, the face or the neck · there are several bites at once · after the bite there is a fever with vomiting, headache or confusion · the bitten person is faint, weak or pale. BE SEEN THE SAME DAY, do not wait until tomorrow, for every other cat bite — including a tiny hole that did not bleed, including a vaccinated house cat. Go sooner still if: the wound is on a hand, a finger or a foot · the wound is red, hot, swollen, oozing or smelling unpleasant · you do not know whether the cat has been vaccinated against rabies, or the cat is unwell · your last tetanus injection was a long time ago · you are in one of the higher-risk groups above.

According to MedlinePlus, every bite that breaks the skin should be seen by a doctor within 24 hours. Your part is to be seen; do not grade the levels yourself and then stay home.

What has to happen at a medical facility

Put plainly: rabies vaccine and rabies immune globulin, and any tetanus injection, are given at a medical facility rather than at home — and what gets injected is the doctor's decision after looking at the wound and hearing your account of the cat. Stitching, if it is needed, happens there too. With a sign from the box above, go in first and call afterwards.

What we can do sits around the wound: a remote consultation by video call so you can show a doctor the wound and find out whether this case needs to be seen; a doctor coming to the house to take your history and examine you, and saying clearly which cases must go into hospital; and, once a medical facility has dealt with it, a nurse changing dressings, removing stitches and following the healing as prescribed.

Sources: CDC and MedlinePlus, together with the public guidance of NHS for the parts stated above. This article passes that on and does not replace being examined. Citing CDC here does not imply that CDC endorses Y Te Xanh or our services.

Need personalised advice for your loved one? Call our hotline 094 368 81 15 (24/7) — calling to ask a question or to book costs nothing. GreenCare has doctors who come to examine, nurses who carry out doctor's orders (injections, infusions, dressing changes), remote consultation by video call, and a review of the medicines you are taking; an in-depth remote consultation, or any one after the first, is a paid service. For children we take examination and acute care only — not long-term care at home, and not newborns or expectant mothers. We confirm we have staff in your area and provide transparent pricing before we begin.

Sources

CDC — About Rabies
NHS — Animal and human bites

Frequently asked questions

My cat lives indoors and the bite was tiny. Do I need to be seen?

You should still go. According to CDC, call a doctor straight away after being bitten by a dog or a cat, even if you feel perfectly well — because the issue here is not only rabies prevention but infection. CDC also puts “you do not know whether the cat has been vaccinated against rabies” among the reasons to be seen, so if the cat has an owner, ask them for proof of vaccination and bring it. That is information the doctor uses to assess the risk, not something for you to reach your own conclusion with.

It is only two pinprick holes, it did not bleed, and I have washed it. Is that enough?

Not yet, and this is exactly the kind of wound most easily overlooked. The tiny opening seals itself, so water running over the outside struggles to reach the deep part. Washing with water and soap is still the right thing and well worth doing — for a wound that may have exposed you to rabies, CDC specifies washing for 15 minutes — but it does not replace the appointment, which is where a doctor settles the three things you cannot settle at home: rabies prevention, tetanus prevention, and whether the wound needs antibiotics.

Is a bite on the hand different from one on the leg or the body?

It is, and in the more worrying direction. According to MedlinePlus, a bite on the neck, head, face, hand, finger or foot is a reason to contact a doctor straight away, and a bite on the head, face, neck, hand or foot is on the list of reasons to go to an emergency department; NHS likewise sets the hand, the foot, the face and the head apart. So with a bite on a hand or a finger, do not wait, even when the hole is very small. Be seen and say exactly where the wound is and whether the finger still moves normally.

A cat bit me over a week ago and now there is a painful swollen gland in my armpit. What is it?

That is a reason to be seen, and say clearly that a cat bit or scratched you some weeks ago — do not describe the swollen gland on its own and leave the cat out. According to CDC, cat-scratch disease, caused by the bacterium Bartonella henselae, gives a mild fever and large, painful swollen glands appearing 1–3 weeks after contact with a cat, usually the glands nearest the bite or the scratch. This is work for a doctor, not for hot compresses or squeezing the gland.

Can a nurse come to the house to stitch a cat bite or give the rabies injection?

No. Stitching a wound and giving rabies vaccine or immune globulin are all done at a medical facility, where there are the means to monitor and manage a reaction. What we can do is what comes before and after: a remote consultation by video call so you can show a doctor the wound; a doctor coming to the house to take your history and examine you; and then a nurse changing dressings, removing stitches and following the healing as prescribed once a medical facility has dealt with it. With a sign from the red-flag box, go in first and call afterwards.