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An immature canine was attacked by another dog in a kennel facility and sustained multiple wounds to the lateral right forelimb and cranial right lateral thoracic region. General surgical and antimicrobial therapies were instituted immediately. The patient battled with recurrent infections and subsequent delayed healing. After approximately 35 days from the initial injury, the patient became acutely lame and febrile. The persistently open wounds were cultured and returned positive for Salmonella spp. Within the following days, the patient became painful, and the lameness progressed significantly. Radiographs confirmed pathologic humeral fracture, and the patient was referred for specialty evaluation. Zoonotic preventative protocols were adopted at the specialty facility upon arrival. Complete forequarter limb amputation was curative in this patient., An immature canine was attacked by another dog in a kennel facility and sustained multiple wounds to the lateral right forelimb and cranial right lateral thoracic region. The patient battled with recurrent infections and subsequent delayed healing and after approximately 35 days from the initial injury, the patient became acutely mildly lame and febrile. Open wounds and draining tracts were cultured and returned positive for Salmonella spp.; within the following days, the patient became painful, and the lameness progressed significantly, with radiographic confirmation of a pathologic humeral fracture.

Background: Dog-to-dog bite wounds are a common veterinary emergency presentation: despite this, there is insufficient information to guide veterinarians on appropriate empirical antimicrobial management. Objectives: Investigate the effectiveness of amoxicillin–clavulanic acid with and without enrofloxacin in the treatment of moderate grade dog bite wounds (DBW). To describe common pathogens and their antimicrobial susceptibility patterns. Materials and methods: In a single-centre parallel group pragmatic trial, 50 dogs presenting with moderate grade DBW were prospectively randomised to receive amoxicillin–clavulanic acid (group A) or amoxicillin–clavulanic acid and enrofloxacin (group B). Swabs were taken for culture and susceptibility testing at admission. Stabilisation, wound care and surgical debridement were performed at the discretion of admitting clinicians. The primary outcome was complication due to infection at 10 days, with Bayesian inference used to estimate the difference in proportions between treatment groups. Results: Of the 24 dogs in treatment group A, 1 required the addition of enrofloxacin at re-examination. None of the 26 dogs in group B required alteration of antimicrobial coverage. The difference in complication rate due to infection between treatment groups was 4.2%. Twenty-one different organisms were identified: Staphylococcus pseudintermedius, Neisseria spp., Pasteurella multocida and P. canis were the most common. Over 90% of gram-negative and gram-positive isolates were susceptible to amoxicillin–clavulanic acid. Ninety-six percent of gram-negative and 86% of gram-positive isolates were susceptible to enrofloxacin. Conclusion and clinical significance: Amoxicillin–clavulanic acid is an appropriate empirical antimicrobial choice for moderate DBW in South East Queensland. Reduced empirical enrofloxacin use will promote antimicrobial stewardship and potentially antimicrobial resistance.

Objective To report the successful treatment of septic nonunion in two dogs with large segmental defects secondary to long-bone fractures by using a novel human placenta-derived matrix (hPM) as adjunct to fixation. Animals One 3-kg 9-year-old neutered male Yorkshire terrier with a distal antebrachial fracture and one 6-kg 4-year-old spayed female miniature pinscher with a distal humeral fracture. Study design Short case series. Methods Both dogs presented for septic nonunion after internal fixation of Gustilo type II open diaphyseal fractures from dog bite injuries. During revision, debridement of nonviable bone resulted in segmental defects of 32% and 20% of the bone length for the antebrachial and humeral fractures, respectively. The antebrachial fracture was stabilized with a circular external fixator, and the humeral fracture was stabilized with biaxial bone plating. The fracture sites were not collapsed, and full length was maintained with the fixation. Autogenous cancellous bone graft and canine demineralized bone allograft were packed into the defects, and hPM was injected into the graft sites after closure. Results Radiographic union was documented at 8 weeks and 6 weeks for the antebrachial and humeral fractures, respectively. Both dogs became fully weight bearing on the affected limbs and returned to full activity. Conclusion Augmenting fixation with grafts and hPM led to a relatively rapid union in both dogs reported here.

Objective: To describe the current practice of prophylactic antibiotic prescribing for patients presenting to the ED with a dog bite, and compare management against existing guidelines. Methods: We performed a descriptive retrospective study on all consecutive patients who presented to one tertiary teaching hospital and one regional district hospital in Southeast Queensland between 1 July 2017 and 30 June 2018 with a presentation of a dog bite. Data on demographics and management were collected from the electronic medical record using a standardised data collection tool. Risk factors supporting prophylaxis were taken from the electronic Therapeutic Guidelines. Results: Of the 336 patients included for analysis, 299 received antibiotics, of which 23 were for established infection. A total of 276 (82% of overall cohort) received a prescription for prophylactic antibiotics, either in hospital (ED or admitting ward) and/or on discharge. Of the 178 patients who received prophylactic antibiotics in hospital, 91 (51.1%) received intravenous antibiotics. Of the patients who presented to ED without a previously established infection 271 (86.6%) received prophylactic antibiotics on discharge. Over one quarter (27.5%) of patients who were given prophylactic antibiotics did not meet any high‐risk factors as outlined in guidelines. Conclusion: Prophylactic antibiotics are extensively used for patients with dog bites. There is scope to rationalise antibiotic use and route of antibiotic administration in patients with dog bites.

Key Clinical Message These two cases highlight some of the many challenges encountered when handling dog bite and rabies exposure. They also provide examples of the many barriers, and while highlighting only two individuals, they are likely representative of large numbers of the over 59 000 people that die every year from this preventable disease.

This study aimed to examine the habits of dog walking in Japan using an internet survey of insured dog owners. About 96.4% of the respondents (n = 1,151) reported that they would take their dogs for a walk and they most frequently walk their dogs once or twice a day (75.9%) for 30 min to 1 hr (83.1%). The probability of a companion dog having contact with other dogs during dog walking was estimated to be 0.83 (95% confidence interval [CI]: 0.81-0.85), and the associated daily contact rate was estimated using log-normal distribution with a mean of 2.73 (95% CI: 2.42-3.11) and a standard deviation (SD) of 6.39 (95% CI: 5.18-7.84). Multiple linear regression revealed that the contact rate is mainly influenced by the social behaviour of the owner and to a lesser degree by his/her demographic characteristics including the area of residence, the breed size of dog and the age of the owner. In addition, ten Likert items measured on a 5-point scale were designed to assess the practices towards potential cases of rabies among dog owners. The respondents (n = 972) achieved a mean score of 2.99 (out of a full score of 4) with a SD of 0.90 in responding to situations related to dog bite incidents and injury from stray cat scratches during dog walking. They achieved a higher score in responding to situations related to sighting a stray or wild animal during dog walking and situations related to non-specific clinical signs of rabies and bite injuries from stray dogs or wild animals during dog walking with a mean of 3.70 (SD = 0.58) and 3.84 (SD = 0.34), respectively. The level of best practice was also proved to be significantly associated with the demographic characteristics of the dog owner.

Key Clinical Message This manuscript aims at creating awareness especially to livestock farmers and veterinarians/clinicians that rabies occurs in livestock species. Furthermore, clinicians should note that the viral load in dog bite cases by rabid dog can be reduced by vigorous washing and disinfection which may ultimately delay the clinical manifestation of rabies.

Dog bite injuries are common sources of morbidity with an estimated incidence of 4.5 million bites per year with over 350,000 requiring treatment in the emergency room. Children under the age of 14 are most likely to be affected with a peak age of 5-9 years old. We report a case of a 24-month-old female who sustained a large composite facial avulsion injury from a pit bull dog bite. The avulsed tissue involved a substantial portion of the patient's mid-face, including the entire soft tissue of the nose, upper lip, part of the left cheek, and left oral commissure. Artery-only microvascular replantation was performed because no recipient vein could be identified from the facial defect. Medicinal leech therapy was used for eight days postoperatively to prevent venous congestion. The patient experienced significant blood loss due to leech therapy and required nearly 29 L of blood product replacement. At the last follow up of 8 months postoperatively, the patient was recovering well with significant improvement in function and cosmesis of the mid-face. This case describes a successful artery-only replantation of an avulsive bite injury to the face of a young child. Despite the technical difficulty of cases such as this one, microvascular replantation should be attempted because when successful it provides a superior cosmetic and functional result to other reconstructive techniques.

Key Clinical Message This study reports a case of an 8-year-old boy who suffered from a dog bite injury to the nose. The amputated nasal tissue measured approximately 1.0 × 1.5 cm and included part of the tip, alar, and soft triangle subunits. Both ends of an artery of less than 0.5 mm were found, and replantation was performed. Chemical leeching was performed postoperatively. At 5-year follow-up, a good aesthetic result was achieved.

A nine-year-old, male, neutered Tibetan terrier was evaluated for unilateral otitis externa associated with the history of a dog bite injury to the pinna five years prior. Examination findings of the left ear included severe inflammation, abundant purulent exudate and a polypoid mass, obscuring view of the horizontal ear canal and tympanic membrane. CT scan confirmed the visualised mass location and confinement to the ear canal. Aerobic otic culture revealed abundant colonies of Staphylococcus pseudintermedius and Corynebacterium species. Histopathology was consistent with a fibrous polyp. Otitis externa treatment provided minimal relief following mass removal, and the patient was re-examined. A transparent plastic foreign body lodged within the horizontal canal was identified and removed. The item was recognised as a cap used for packaging of topical treatments prescribed at the time of the original traumatic injury. All clinical signs resolved following removal of the foreign body and oral anti-inflammatory therapy.

In Nepal, most dogs are free to roam and may transmit diseases to humans and animals. These dogs often suffer from malnutrition and lack basic health care. Minimal information is available about their demographics and about public attitudes concerning dogs and diseases. We carried out a study in Chitwan District (central Nepal), to collect baseline data on free-roaming owned dog demographics, assess knowledge, attitudes and practices of dog owners concerning dogs and rabies, evaluate rabies vaccination coverage and anthelmintic treatment of dogs, measure dogs' response to rabies vaccination and assess dog health through body condition scores and parasites. We conducted household interviews with owners of free-roaming female dogs (n = 60) and administered dogs with rabies vaccination and anthelmintics. Dog owners regularly fed free-roaming dogs but provided minimal health care; 42% of respondents did not claim ownership of the dog for which they provided care. We collected skin, faecal and blood samples for parasite identification and for measuring rabies virus-specific antibodies. Ninety-two per cent of dog owners were aware of the routes of rabies virus transmission, but only 35% described the correct post-exposure prophylaxis (PEP) following a dog bite. Twenty-seven per cent of the dogs had measurable rabies virus-specific antibody titres and 14% had received anthelmintics in the previous year. Following rabies vaccination, 97% of dogs maintained an adequate antibody titre for ≥6 months. Most dogs appeared healthy, although haemoprotozoans, endoparasites and ectoparasites were identified in 12%, 73% and 40% of the dogs, respectively. Poor skin condition and parasite load were associated. Seventy-four per cent of the females had litters in 1 year (mean litter size = 4.5). Births occurred between September and February; we estimated 60% mortality in puppies. We concluded that vaccination coverage, PEP awareness and anthelmintic treatment should be emphasized in educational programmes focussed on animal welfare, veterinary and public health.

Community awareness regarding rabies and treatment seeking behaviours are critical both for the prevention and control of the disease in human and animals. We conducted a study to explore people's awareness about rabies, their attitudes towards dogs and practices associated with treating dog bites in Satkhira Sadar, a south‐western sub‐district of Bangladesh. Of the total 3200 households (HHs) surveyed, the majority of the respondents have heard about rabies (73%) and there was a high level of awareness that dog bite is the main cause of rabies (86%), and that rabies can be prevented by vaccination (85%). However, 59% of the dog bite victims first seek treatment from traditional healers instead of visiting the hospitals, 29% received the rabies vaccine, 2% practiced proper wound washing with soap and water, while 4.8% have not taken any measures. None of the victims have received rabies immunoglobulin (RIG). Of the respondents, 5.2% reported a history of dog bite in at least one family member, and 11.8% reported a history of dog bite in domestic animals during the previous year. The HHs having a higher number of family members (OR: 1.13, 95% CI: 1.07–1.2), having a pet dog (OR: 2.1, 95% CI: 1.4–3.2) and caring or feeding a community dog (OR: 2.1, 95% CI: 1.4–2.9) showed an increased risk of getting a dog bite. Among the bite victims, 3.6% (n = 6) humans and 15.8% (n = 60) animals died. As a measure for dog population management (DPM), 56% preferred sterilization while the rest preferred killing of dogs. The current treatment seeking behaviours of the respondents should be improved through additional education and awareness programme and better availability for the provision of post‐exposure prophylaxis in Bangladesh. We recommend scaling up national mass dog vaccination and DPM to reduce the burden of rabies cases and dog bites in Bangladesh.

Free-roaming dog populations are a global concern for animal and human health including transmission of infectious disease (e.g. rabies, distemper and parasites), dog bite injuries/mortalities, animal welfare and adverse effects on wildlife. In Saskatchewan (SK), Canada, veterinary care is difficult to access in the remote and sparsely inhabited northern half of the province, where the population is predominately Indigenous. Even where veterinary clinics are readily available, there are important barriers such as cost, lack of transportation, unique cultural perspectives on dog husbandry and perceived need for veterinary care. We report the effects of introducing a community action plan designed to improve animal and human health, increase animal health literacy and benefit community well-being in two Indigenous communities where a dog-related child fatality recently occurred. Initial door-to-door dog demographic surveys indicated that most dogs were sexually intact (92% of 382 dogs), and few had ever been vaccinated (6%) or dewormed (6%). Approximately three animal-related injuries requiring medical care were reported in the communities per 1000 persons per year (95% CL: 1.6-6.6), and approximately 86% of 145 environmentally collected dog faecal samples contained parasites, far above levels reported in other urban or rural settings in SK. Following two subsidized spay/neuter clinics and active rehoming of dogs, parasite levels in dog faeces decreased significantly (P < 0.001), and important changes were observed in the dog demographic profile. This project demonstrates the importance of engaging people using familiar, local resources and taking a community specific approach. As well, it highlights the value of integrated, cross-jurisdictional cooperation, utilizing the resources of university researchers, veterinary personnel, public health, environmental health and community-based advocates to work together to solve complex issues in One Health. On-going surveillance on dog bites, parasite levels and dog demographics are needed to measure the long-term sustainability of benefits to dog, human and wildlife health.

AIM: To describe the characteristics, circumstances and consequences of dog bite injuries in children in order to inform the discourse concerning preventative approaches. METHOD: A retrospective review of children presenting to the emergency department (ED) of the Women's and Children's Hospital (WCH) in South Australia between the years 2009 and 2011 was performed. RESULTS: A total of 277 children presented to the WCH with dog bite injuries between 2009 and 2011. Of those, 141(51.0%) were referred for admission. Injury rates were highest in those aged 0-4, declining thereafter with age. In the 0-4 year age group, 89.5% of children presented after being bitten by a familiar dog with 92.5% occurring at home. The head/neck region constituted the most common location for injuries. We found that 67.5% of dog bite injuries were provoked and occurred between the child and a familiar dog (78.0%). Dogs from the bull terrier group (20.0%) and Jack Russell Terriers (11.0%) were the two most documented breeds. Almost half of the children presenting during the specified timeframe required at least one operation under a general anaesthetic. Two children were referred to a psychologist for management of post-traumatic stress. CONCLUSION: Dog bite injuries are common in children and often require admission for inpatient care. This presents as a significant public health burden. For this reason, prevention initiatives need to be implemented on an ongoing basis. Language: en

The objectives of this study were to determine the rate of animal bite incidents occurring in the human population of a local health department, and to determine the proportion of these canines and felines that were not up to date on their rabies vaccination at the time the incident occurred. Data were obtained from animal bite incidents reported to Wellington-Dufferin-Guelph Public Health during 2010 and 2011. Descriptive statistics of 718 eligible reports revealed the average rate of animal biting was 1.55 bites per 1000 residents per year. Approximately 54% of these animals were vaccinated against rabies, 32% were not up to date with their rabies vaccination, and the remaining 14.5% were of unknown status. The unit of analysis was the municipality, and the four outcomes of interest were: (i) number of animal bite incidents per 1000 residents, (ii) number of dog bite incidents per 1000 residents, (iii) proportion of animals involved in bite incidents that were not up to date with their rabies vaccination, and (iv) proportion of dogs that were not up to date. Associations between the outcomes and selected demographic variables were investigated using regression analysis. The number of veterinary clinics per 10,000 residents, and whether the municipality was urban or rural were identified as significant predictors for the number of animal bites per 1000 residents, and the number of dog bites. There were no significant predictors for the proportion of unvaccinated animals or dogs. Spatial clustering and the location of spatial clusters were assessed using the empirical Bayes index and spatial scan test. This analysis identified five municipalities within the health department that have a high rate of biting incidents and a high proportion of animals that were not up to date on their rabies vaccination. Such municipalities are ideal for targeted educational campaigns regarding the importance of vaccination in pets.

AIM: Dog bites are common injuries in children. A large percentage of these dog bites affect the upper extremity. There is little information describing the results of treatment of upper extremity injuries in children. METHODS: We retrospectively reviewed the medical records for all children less than 19 years old who presented to the emergency department in our level one trauma centre because of dog bites from 2005 to 2011. RESULTS: During the study period, there were 254 paediatric emergency department visits for animal bites, among these there were 118 dog bites, two were excluded because of inadequate documentation leaving 116 patients; 26 of them (22.4%) had bites to the upper extremity. Among the 26 children with dog bites to the upper extremity, 6 (23.1%) were admitted to the hospital for surgery (four patients) or parenteral antibiotics (two patients). Among the four surgeries, two were for extensive laceration and two were for abscess debridement. Of the 41 who presented with bites to the lower extremities, none were admitted to the hospital (P = 0.002). Compared with those who presented the same day they were injured, the relative risk of hospitalization or surgery in patients who presented 1 and 2 days after their injury was 3.5 and 7.0, respectively. CONCLUSION: Dog bites at the upper extremity are more prone to require surgical intervention and develop infection than those at the lower extremity, and delayed presentation of these injuries is associated with higher incidence of developing infection. Language: en

The impact of dog bites on human health has been extensively documented in the literature and risk factor analysis has been very useful in the search for causal mechanisms of dog bite accidents, by identifying human-, dog- and context-related risk factors. In this way, epidemiological studies have contributed to a better understanding of specific triggers of dog bites in a given context (Reisner and others 2007, Gilchrist and others 2008, Rezac and others 2015) and have helped to tailor more adequate prevention strategies; that is, for a household setting and a familiar dog (Meints and De Keuster 2009, Schwebel and others 2012, Dixon and others 2013, Shen and others 2016), or for a human-dog encounter in public places with an unfamiliar dog (Chapman and others 2000, Hornisberger 2015, Lakestani and Donaldson 2015). At the same time, a number of conclusions proved to be a major point of disagreement between studies worldwide, especially those relating to the dog’s characteristics, the dog-owning household, and also to the type of education and training methods used. Even though decades of research have stressed the importance of avoiding interpretation bias in studies (Parrish and others 1959, Overall and Love 2001, Cornelissen and Hopster 2010), the frequent lack of …

Background: Dog bites represent a significant health concern leading to a variety of consequences. Nursing students should be appropriately educated in order to manage and help prevent such injuries. Aim: This paper is the first to report the lifetime experience and characteristics of dog bites among Greek nursing students and their knowledge in managing the above injuries. Methods: A cross-sectional quantitative study was performed using an anonymous questionnaire distributed to first and fourth year nursing students from April though June 2009. A knowledge score based on key questions was set on a scale from 0 to 7, to assess their competence on bite injuries management. Results: Of 237 nursing students recruited, 56 (23.6%) had experienced a dog bite. Men outnumbered women as dog bite victims [n = 15 (39.5%) vs. n = 41 (20.6%), P = 0.012]. Mean age at the attack was 11.1 (standard deviation = 5.6) years and legs sustained the majority of injuries (n = 31; 55.4%). Most bites (n = 39; 69.9%) involved a dog known to the victim, were provoked (n = 30; 53.6%) and occurred in a public place (n = 35; 62.5%). Ten (17.9%) of the victims sustained a moderate or severe injury. The majority (67.9%) of students answered correctly to less than or equal to three out of seven key knowledge questions. After multiple linear regression analysis, previous educational course attendance was the only factor associated with increased score (b = 0.48, standard deviation = 0.17, 95% confidence interval = 0.12-0.84, P = 0.009). Conclusions: Dog bites were common and presented characteristic patterns among nursing students, but knowledge in their management was suboptimal. Improved education should be provided during undergraduate studies. Language: en

Dog bites represent lesions commonly found in Hospital Emergency Clinic. This type of lesion may cause severe harm to patients, but it rarely affects the underlying bone structure causes facial fracture. This study aims to illustrate a rare clinical case in which a pediatric patient presented a comminuted fracture in the mandible which evolved into a unilateral avulsion of the mandibular condyle, body fractures as well as a mandibular ramus and hemiface that had been deformed, with multiple lacerations and loss of soft-tissue mass. Intermaxillary fixation was performed using the Ivy method, followed by internal rigid fixation using miniplates and screws in attempt to reconstruct the child's mandible. After 2 years of follow-up, a satisfactory esthetics and functional results could be observed. Language: en

Three dogs were presented for the management of disease processes resulting in large skin defects over the dorsal lumbosacral region. One had severe dog bite wounds, one had a large burn sustained from a heating pad and one had a large myxosarcoma in the region. In each case, the extent and location of the resulting skin defect were assessed as factors likely to prevent reconstruction using simple tension-relieving techniques alone or in combination with established reconstructive techniques, such as axial pattern flaps or skin stretching devices. Bilateral skin fold rotation-advancement flaps (SFRAFs) based on the flank folds were mobilised dorsally and allowed complete wound closure in two dogs and subtotal closure in the other dog. All wounds healed without major complications and an acceptable cosmetic outcome was achieved in each case. Minor flap debridement was required in two dogs. The use of bilateral SFRAFs is a useful technique alone or in combination with other reconstructive techniques for the closure of large dorsal lumbosacral skin defects when existing techniques are not sufficient. Small flank folds, such as those of obese dogs, may yield unexpectedly large SFRAFs.

Dog bites to the face are common in children and often involve amputation of the lip or cheek resulting in a devastating facial injury. When feasible, replantation of the amputated lip segment provides the optimal cosmetic outcome. Here, we present the case of a partial upper lip replantation with delayed inset as a new treatment option. Revascularization of the central upper lip segment was enabled by anastomosis to a single labial artery. Inset compression at the time of initial closure caused arterial insufficiency. Therefore, a delayed, sequential inset was performed over the following 2 weeks resulting in an esthetically and functionally successful replantation. A comprehensive review of the literature on published lip replantation techniques is also provided and discussed. We add delayed inset to the armamentarium of the microsurgeon when faced with these difficult injuries. © 2009 Wiley-Liss, Inc. Microsurgery, 2009.

Dog bite injury is a common reason for presentation to emergency departments. However the nature of this problem in Australia has not been closely studied and a number of unresolved questions remain regarding management options. This prospective study of 101 cases was undertaken to collect demographic information about victims and assailants, to describe the spectrum of injury seen and to report outcome following a standard management protocol. In common with other studies, young males were bitten most frequently, usually by German Shepherds, Heelers and Terriers. Nearly half (48%) of the facial injuries occurred in children under 10 years old. The infection rate in this study, using wound cleansing and prophylactic penicillin in all cases, was only 4%. Wound swabs on presentation were unhelpful. Controversies still exist regarding wound closure and the use of prophylactic antibiotics.

Objectives 1) Demonstrate patterns of dog bite injury to the head and neck in children. 2) Identify treatment outcomes of dog bite injuries to the head and neck. Study Design Case series with chart review. Subjects and Methods Children aged 0 to 19 years, treated for head and neck dog bites at our tertiary care children's hospital (1999-2007), were included. Demographics, dog breed and ownership, seasonal incidence, wound location, characteristics, management, and complications were recorded. Results Eighty-four children, aged 10 months to 19 years (mean, 6.19 years) underwent primary repair of head and neck dog bite injuries. The cheek (34%) and lips (21%) were involved most commonly. Average wound length was 7.15 cm. Dog bite incidence peaked during summer months. Infection occurred in 10.7 percent. Pulsed dye laser was used to improve cosmesis. Conclusions Children are vulnerable to head and neck dog bite injuries. Wound healing is excellent despite a contaminated wound. Infections occur infrequently. Pulsed dye laser improves cosmesis.

Approximately four to five million animal bite wounds are reported in the USA each year. Domestic companion animals inflict the majority of these wounds. Although canine bites far outnumber feline bites, unlike the dog, the cat's bite is worse than its bark; 20-80% of all cat bites will become infected, compared with only 3-18% of dog bite wounds. Pasteurella multocida is the most commonly cultured bacterium from infected cat bite wounds. Anyone seeking medical attention for a cat-inflicted bite wound is given prophylactic/empiric penicillin or a derivative to prevent Pasteurella infection (provided they are not allergic to penicillins). In an effort to establish a carriage rate of P. multocida in the domestic feline, bacterial samples from the gingival margins of domestic northern Ohio cats (n=409) were cultured. Isolates were tested for antibiotic sensitivity as prophylactic/empiric use of penicillin and its derivatives could potentially give rise to antibiotic resistance in P. multocida. The high carriage rate (approximately 90%) of P. multocida observed was found to be independent of physiological and behavioural variables including age, breed, food type, gingival scale, lifestyle and sex. High antibiotic susceptibility percentages were observed for benzylpenicillin, amoxicillin-clavulanate, cefazolin, and azithromycin (100%, 100%, 98.37% and 94.02%, respectively) in P. multocida isolates. The high prevalence of P. multocida in the feline oral cavity indicates that prophylactic/empiric antibiotic therapy is still an appropriate response to cat bite wounds. Additionally, the susceptibility of P. multocida to penicillin and its derivatives indicates that they remain reliable choices for preventing and treating P. multocida infections.

Information was obtained by telephone interview from 100 dog owners whose dog had bitten a person, and from 134 victims of bites by a dog not owned by the victim. Three-quarters of the victims were female and aged from 21 to 60 years. The majority of the dogs were owned, male, two to six years old, over 10 kg in bodyweight and belonged to the popular breeds: collies, cocker/springer spaniels, terrier breeds, Jack Russell terriers, German shepherd dogs, golden retrievers and crossbreeds. The numbers of bites by the different breeds indicated that those that inflicted the most bites were the popular breeds rather than the breeds with any greater propensity to bite. Most attacks were rapid single bites and in 50 per cent of the cases, neither the owner nor the victim was able to identify any signal of the dog's intention to bite. Overall, 21 per cent of the incidents were rated as 'serious' and 2 per cent as 'life threatening'. One fifth of the dogs were euthanased as a result of the incident. Half the incidents required professional medical assistance for the victim. Almost half the incidents took place while the victim was walking or passing close to the dog's territory, or while the victim was interacting with the dog at home.

BACKGROUND: Mammalian bites are a common presentation in emergency and primary healthcare facilities across the world. The World Health Organization recommends postponing the suturing of a bite wound but this has not been evaluated through a systematic review. OBJECTIVES: To assess the effects of primary closure compared with delayed closure or no closure for mammalian bite wounds. SEARCH METHODS: In July 2019 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In‐Process & Other Non‐Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta‐analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials which compared primary closure with delayed or no closure for traumatic wounds due to mammalian bite. DATA COLLECTION AND ANALYSIS: Two review authors independently screened titles, abstracts and full‐text publications, applied the inclusion criteria, and extracted data. We pooled data using a random‐effects model, as appropriate. We used the Cochrane 'Risk of bias' tool and assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We found three trials (878 participants) that compared primary closure with no closure for dog bites and one trial (120 participants) that compared primary closure with delayed closure. No other mammalian bite studies were identified. The trials were from the UK (one trial), Greece (one trial) and China (two trials). Overall, participants from both sexes and all age groups were represented. We are uncertain whether primary closure improves the proportion of wounds which are infection‐free compared with no closure, as the certainty of evidence for this outcome was judged to be very low (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.97 to 1.05; 2 studies, 782 participants; I(2) = 0%). We downgraded the evidence by one level for high risk of bias and two levels for imprecision. There is no clinically important difference in cosmesis (acceptable physical/cosmetic appearance) of dog bite wounds when primary closure is compared with no closure (mean difference (MD) ‐1.31, 95% CI ‐2.03 to ‐0.59; 1 study, 182 participants). The certainty of evidence for this outcome was judged to be moderate (we downgraded our assessment by one level for imprecision). We are uncertain whether primary closure improves the proportion of dog bite wounds that are infection‐free compared with delayed closure, as the evidence for this outcome was judged to be very low (RR 0.98, 95% CI 0.90 to 1.07; 1 study, 120 participants; I(2) = 0%). We downgraded the evidence by one level for high risk of bias and two levels for imprecision. None of the four trials reported any adverse outcomes such as death or rabies but they were, in any case, unlikely to have been large enough to have satisfactory power to provide precise estimates for these. Important outcomes like time to complete wound healing, proportion of wounds healed, and length of hospital stay were not evaluated. AUTHORS' CONCLUSIONS: All the studies we identified concerned dog bites. There is no high‐certainty evidence to support or refute existing recommendations concerning primary closure for dog bites. The potential benefits and harms of primary closure compared with delayed or no closure for mammalian bites remain uncertain and more robust trials are needed.

Nine dogs with panniculitis due to rapidly growing mycobacteria (RGM) were examined over 17 years. Dogs were two to 15 years; five were male, four were female. All were obese or in good condition. Antecedent injury, typically a dog bite or vehicular trauma, could be identified in some patients, while one bitch had hyperadrenocorticism. Infections involved different locations, although the cervicothoracic region, dorsum or flank were most often affected. Patients were systemically well, apart from one dog with pyrexia and two with pain or lameness. Cytology demonstrated pyogranulomatous inflammation, but in only one case was it possible to see acid-fast bacilli (AFB) in smears. Histology demonstrated chronic active pyogranulomatous panniculitis and dermatitis; AFB could be detected in only four specimens. Culture of aspirates or resected tissues demonstrated RGM in all cases, comprising six Mycobacterium smegmatis group and three Mycobacterium fortuitum group isolates. Resection of infected tissues, perioperative injectable antimicrobials and long courses of oral antimicrobials chosen according to susceptibility data generally effected a cure, although some cases recurred.

THE UK dog population is estimated to be 8.5 million, making dogs the most popular pet, sharing the lives of 24 per cent of families in the UK (PFMA 2015). However, decades of dog bite research indicate an important downside to this friendship; dogs are responsible for the majority of animal bites to people, leading to physical and psychological trauma or even fatalities. The incidence of dog bites is estimated to be around 1.5 per cent of the population with children being twice as much at risk compared to other age groups (Gilchrist and others 2008). According to hospital data, most dog bites happen in familiar surroundings involving a familiar dog and a child victim. The known number of dog bites probably reflects only the tip of the iceberg since accurate reporting is lacking (Bernardo and others 2002). However, dogs can bite more than people. Research by Brooks and others (2010) and recently by Moxon and others (2016) address a topic rarely mentioned in dog bite research, namely attacks on working guide dogs for the blind and the visually impaired. In a paper summarised on p 367 in this issue of Veterinary Record , Moxon and others (2016) report 629 dog bite attacks over a 56 month period …

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 (< or = 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.

This report describes two incidental findings of aberrant branches of the radial digital nerves in the middle finger of a 52-year-old man who cut himself with a grinding machine, and in the index finger of a 45-year-old female who sustained a flexor sheath infection following a dog bite. In both patients, two equally sized radial digital nerves were found and both nerves originated from one common digital nerve.

Objective To determine the prognosis and distribution of ischemic injuries caused by inappropriate bandaging of the lower limb in dogs and cats. Study design Retrospective clinical study. Animal population Eleven client-owned animals, including 9 dogs and 2 cats with a history of injuries consistent with incorrect application of a bandage. Methods Medical records for dogs and cats referred to the Queen's Veterinary School Hospital with limb wounds between 1995 and 1999 were reviewed for clinical history and referring veterinary surgeons' reports, indicating that the injury was directly related to the application of a bandage to the limb. Results The indications for bandage application included 2 postoperative cruciate ligament ruptures, 2 lacerations, 3 internal fixations, an onychectomy, a shoulder dislocation, a dog bite, and a tendon strain. None of the patients had other body systems involved or underlying or concurrent diseases. Five different types of bandage were described (support, Robert Jones, pressure, splint, and Velpeau), and no particular age or breed was overrepresented. Of the 11 animals, 5 required full-thickness skin grafts, 3 had to have digits amputated, and 2 required limb amputations. Nine animals survived, but only 4 became fully functional on the affected limb. Conclusions Bandage-related injuries are potentially serious sequelae to a routine procedure. A guarded prognosis should be given when there is loss of deeper structures. Clinical relevance A review of bandaging principles is presented. Method of application, choice of materials, and close monitoring of the bandage are important factors in preventing iatrogenic injury.

Unintentional injury is the leading cause of death and disability among children. This study sought to describe the characteristics of dog bite injuries to aid in promoting healthy environments for children.This descriptive, retrospective study of one hospital's 1997 emergency department records detailed dog bite injuries to children and adolescents and resultant emergency treatment (N = 204).Childrenor = 5 years of age accounted for 49% of the injuries. The biting dog's owner was generally a parent or neighbor. Only 2 children received rabies prophylaxis.Parents and children need information about safe interactions with dogs, including community leash laws and quarantine guidelines. Nurses should know the procedures for reporting dog bite injuries to local health authorities. Interested nurses can find many opportunities to assist with community safety campaigns.

We report a 46-year-old woman who experienced swelling of the right thigh around the wound caused by a dog bite. Physical findings, laboratory findings, imaging studies, and muscle biopsy showed that this was nodular-type muscle sarcoidosis. This is an unusual case of sarcoidosis, and the possibility is discussed that a dog bite may serve as a trauma to trigger sarcoidosis in genetically predisposed individuals.

The first ‘UK Dog Bite Prevention Week’ was introduced on June 6 and 7 with a two-day conference hosted by television presenter and dog trainer Victoria Stilwell in association with the University of Lincoln. The event attracted a mix of academic and professional speakers as well as delegates from a wide range of backgrounds. Rachel Orritt, who is researching the perceptions, assessment and management of human-directed aggressive behaviour in dogs at the University of Lincoln, reports on the proceedings

Delegates from around the world met at the University of Lincoln on June 11 and 12 for the third annual UK Dog Bite Prevention and Behaviour conference. The conference, hosted by dog trainer Victoria Stilwell, brings together dog behaviour experts to discuss possible solutions to this public health issue. Rachel Orritt, who has been examining the perceptions, assessment and management of human-directed aggressive behaviour in dogs for her PhD, reports.

Objective: 1) Recognize the operative technique for performing the split orbicularis oris myomucosal flap. 2) Identifiy candidates for repair using split orbicularis myomucosal flap. 3) Understand the utility of the split orbicularis oris myomucosal flap in the repair of complex dog bites of the flap.Method: Case series of full thickness pediatric lip avulsion injuries secondary to dog bites with immediate flap reconstruction. Cases were reviewed from the last 5 years at an academic institution. All procedures were performed by the same surgeon. Outcome measures included pre- and postoperative photographs as well as assessment of patient satisfaction.Results: A total of 3 patients underwent immediate primary repair of complex dog bites of the lip using split orbicularis myomucoal flaps. All patients were admitted postoperatively for IV antibiotic therapy and were discharged within 1 to 2 days on a 7- to 10-day course of augmentin. No patients developed a postoperative wound infection. None of the patients...

I HAVE read with interest the recent correspondence on dog bite prevention and dog bite injury in practice ( VR, February 8, 2014, vol 174, pp 151-152), and various articles highlighting cat and dog behaviour issues in Veterinary Record in recent months. I am delighted that our profession is moving towards an appreciation of why we must take behaviour problems and their prevention seriously. This is because, first, there is little point attending to our patients’ physical health but ignoring …

BACKGROUND: Dog bites can have dramatic consequences for children and adolescents. Educating young people on how to interact with dogs could contribute to reducing dog bite injuries. OBJECTIVES: To determine the effectiveness of educational interventions that target children and adolescents in reducing dog bite injuries and their consequences. SEARCH STRATEGY: We searched the following databases: The Cochrane Injuries Group's Specialised Register, CENTRAL (The Cochrane Library Issue 3, 2008), CAB Abstracts, Zetoc, SIGLE, MEDLINE, EMBASE, ERIC, PsycInfo, SPECTR, CINAHL, National Research Register, LILACs, African Healthline, Science Citation Index, Social Science Citation Index, CurrentClinicalTrials.Gov, Centrewatch, Controlledtrials.com, Vetgate and the WHO database. We checked the bibliographies of relevant reviews and trials and also contacted experts in the field. The searches were carried out to 18 July 2008. SELECTION CRITERIA: We included randomised controlled trials and controlled before-after studies that evaluated the effectiveness of educational interventions, in populations under 20 years old, for preventing dog bites. DATA COLLECTION AND ANALYSIS: Two review authors selected eligible studies based on information from the title and abstract. Two review authors decided on the inclusion of eligible trials and extracted data from the trial reports. We contacted authors of eligible studies to obtain more information. MAIN RESULTS: Two studies met the inclusion criteria. No study looked at our main outcome: dog bite rates. The included studies were randomised controlled trials conducted in kindergarten and primary schools. Their methodology was of moderate quality. One study showed that the intervention group showed less 'inappropriate behaviour' when observed in the presence of a dog after a 30-minute educational intervention. Another study showed an increase in knowledge and in caution after an information programme. AUTHORS' CONCLUSIONS: There is no direct evidence that educational programmes can reduce dog bite rates in children and adolescents. Educating children who are less than 10 years old in school settings could improve their knowledge, attitude and behaviour towards dogs. Educating children and adolescents in settings other than schools should also be evaluated. There is a need for high quality studies that measure dog bite rates as an outcome. To date, evidence does not suggest that educating children and adolescents is effective as a unique public health strategy to reduce dog bite injuries and their consequences.

The patient presentation of septic shock and purpuric rash is commonly attributed to meningococcal septicaemia. We describe a case of similar presentation where initial cultures and antigen testing were negative for meningococcus and the isolation of an unusual organism, Capnocytophaga canimorsus, was only made after obtaining a history of a dog bite and liaison with the microbiology laboratory. The epidemiology and clinical features of Capnocytophaga canimorsus infection is discussed, together with the antibiotic management of dog bites.

Objectives: Demonstrate facial laceration patterns of dog bites to the head & neck area in children. Identify treatment outcomes of dog bite injury repair in the head and neck region. Methodology: We performed a retrospective chart review (1999-2006) of children, age 0-19 years, who were treated at our tertiary care children’s hospital after dog bite injuries to the head and neck. Patient demographics, dog bread and ownership, location of bite injury, seasonal incidence, wound characteristics and management, and complications were recorded. Results: Primary repair of dog bite injuries (

Dangerous dogs and dog bite incidents are rarely out of the news and are a matter of great public interest, but what can be done to tackle this issue and are the dogs really to blame? A debate at the BVA Congress at the London Vet Show discussed the complexities surrounding dog bites and dog behaviour, and looked at possible ways of preventing future incidents. Georgina Mills reports.