A dog bite puncture wound is something that requires attention considering the high risks for infection. Dog bite puncture wounds indeed can be more of a problem compared to dog bite lacerations. You want to therefore take action fast. While at a first glance a dog bite puncture wound may appear as something not much worrisome, in reality there may be significant damage and dangers brewing right underneath the skin's surface. Your best bet is to see your vet sooner than later so to properly clean the wound and prevent disconcerting complications.
Critical Dog Bite Puncture Wounds
Some dog bite puncture wounds can be particularly dangerous because of their location. If you own a small dog who was attacked by a larger dog, you need to be aware of these dangers. The most critical areas are dog bite puncture wounds affecting the dog's neck, thorax and abdominal cavity.
Bites located in the dog's head and neck area may lead to respiratory issues due to damage to the dog's larynx and trachea. Affected dogs may suffer from acute laryngeal paralysis causing trouble breathing and a characteristic stridor as a result should the dog's laryngeal nerve be damaged. Dog bites affecting the dog's jugular vein are of course worrisome as they can lead to troublesome bleeding.
Dog bite puncture wounds located in the thorax may puncture a dog's lungs and risk leading to life-threatening conditions such as pneumothorax, hemothorax or pyothorax.
A dog bite puncture wound to the abdominal cavity instead may penetrate into the dog's peritoneal cavity, potentially causing herniation of abdominal contents, damage to internal organs such as the liver, gallbladder, urinary tract or spleen, organ perforation and internal bleeding.
Concerning are also dog bites that are bleeding extensively or with blood spurting rhythmically out with every heartbeat as it happens with wounds affecting an artery. In these case of excess bleeding, it is important to stop the bleeding by applying pressure to the wound with a clean cloth or towel for about 3 minutes straight (without lifting it up and looking!) until the bleeding stops. If this doesn't work, there are chances that there is a severed artery that needs to be clamped with hemostats by an emergency vet, explains veterinarian Dr. Peter.
Dogs receiving serious, deep and penetrating bite wounds should be monitored for signs of shock such as pale gums, lethargy, weakness, weak pulse and low blood pressure.
"Significant trauma to vital structures of the neck, thorax and abdominal cavity may not be immediately apparent at first glance. A bite-wound patient can also progress from being "stable" to "crashing" in a remarkably short time."~ Tara Britt, VMD, Christopher Thacher, DVM, DACVS
Less- Critical Dog's Bite Puncture Wounds
Of course, not all dog bite puncture wounds are as critical as the ones described above, however, all dog bite puncture wounds can potentially become infected which leads to complications.
The main problem with dog bite puncture wounds is the fact that they allow bacteria to be inoculated into a dog's deep tissues which may lead to infections and the formation of abscesses (pockets of infection). The bacteria responsible for causing such complicating infections comes from bacteria residing in the dogs' mouths.
While it helps to clean up the wound using warm soapy water and antibacterial products such as betadine solution/chlorhexidineand antibiotic ointment, this takes care only of the exterior layer of skin. Such products therefore fail to address the risk for infection caused by bacteria inoculated deep under the dog's skin.
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A full skin thickness dog bite puncture wound risks turning into an abscess if a systemic antibiotic isn't administered within 48 hours, warns veterinarian Dr. Michael Salkin.
"Until you can get any bitten dog in to see a vet (hopefully within 24 hours), the most helpful thing would be for you to apply a warm compress to the area... Hold the warm, damp washcloth to the swollen area for 10 minutes, rewarming it every 2 minutes or so. The goal is to keep those puncture holes OPEN as the bacteria don't like oxygen. If you let the holes scab over, then the bacteria will grow."~Dr. Fiona
Signs of Trouble
As already mentioned, a dog bite puncture wound is very likely to become infected. Bacteria are inoculated deep inside, and since the entry wounds formed by the teeth are small, they tend to quickly scab over, leaving the bacteria trapped below there. It doesn't help the fact that bacteria thrive in warm, moist places where there is little oxygen present. Bacteria therefore multiply, and soon an infection sets in.
Signs suggestive of a possible infection are inflammation (which causes redness and swelling) and the presence of pus. As the body attempts to fight the infection a large army of white blood cells are sent to the area leading to the formation of a big pocket of pus and bacteria, which is medically known as an "abscess."
The abscess grows bigger and bigger until it ruptures and the pus pours out. This helps relieve the pressure temporarily, but soon the area scabs over again and the process restarts, explains veterinarian Dr. Fiona.
A dog who becomes lethargic after receiving a bite is also a warning sign that an infection is setting in. Affected dogs may also be running a fever. These are likely signs that the infection is spreading under the skin and may possibly even be reaching the bloodstream. See your vet immediately.
At the Vet's Office
If your dog has a bite puncture wound, it is important to see the vet. Your vet will likely explore the wound evaluating how deep it is. This is often done with the dog awake but if there is pain or the dog is fractious, your dog may require mild sedation or general anesthesia.
Your vet will likely clip the fur around the wound to allow more air (remember, bacteria thrive in low-oxygen) and will clean it. If there are puncture wounds that are deep, your vet may have to open them up further. In some cases, a drain may be needed.
Your vet may provide intravenous administration of antibiotics. The earlier the wound is treated, usually the better. Early administration of antibiotics (within 12-24 hours) prevents the bacteria from multiplying and forming an abscess.
For abscesses that are already formed, antibiotics usually do not work too well on their own. To heal completely, the abscesses often must be opened with the use of warm compresses or by a veterinarian making an incision (lancing) and draining it. Left untreated, an abscess may get worse and spread to further tissues under the skin and even into the bloodstream.
For complicated cases, where antibiotics do not seem to work well, a culture and sensitivity test may be needed so to determine exactly what bacteria are causing trouble and choose the best antibiotic to use.