Introduction
Cat scratches can be dangerous because cats carry bacteria under their claws and in their mouths that can cause infection in humans. While most cat scratches are minor, they can lead to more serious conditions like cat scratch disease, cat scratch fever, or cellulitis. It’s important to take proper precautions if you get scratched by a cat to prevent complications. This guide provides an overview of first aid, signs of infection to watch for, when to see a doctor, treatment options, and tips to avoid cat scratches.
According to research published in PMC, the estimated annual incidence of cat scratch disease in the United States for people under 65 years old is 4.7 cases per 100,000 population (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038427/). While the risk is low, it’s important to monitor any cat scratch carefully.
Assess the Wound
If you’ve been scratched by a cat, the first step is to closely examine the wound. Carefully look at the scratch and take note of the size, depth, and location [1]. Even small scratches can introduce bacteria deep under the skin. Check to see if the scratch is superficial or if it has penetrated deeper.
Look to see if any skin is pinched or hanging – this would indicate a deeper scratch. Examine if the wound is actively bleeding or just superficial without much blood. Bleeding wounds need prompt care. Also note if the scratch is located over any joints, tendons, or other sensitive body parts. Sensitive areas are more prone to complications if infected.
Carefully observing the wound helps determine the severity and how to best treat it. Minor superficial scratches may just need cleaning and observation. Deeper penetrating scratches require urgent medical care to prevent infection.
Clean the Scratch
It’s important to properly clean a cat scratch wound to prevent infection. The first step is to wash the wound with mild soap and warm water. Gently clean around the scratch to remove any dirt, bacteria or debris 1. Be sure to clean the wound for at least 5 minutes. Thoroughly rinsing is key.
After washing, pat the area dry with a clean towel. Then apply an antibiotic ointment, like Neosporin, to the scratch. The ointment helps keep the wound moist and prevents scabbing. It also contains antibiotics to fight off infection. Cover the ointment with a bandage to keep it clean. Reapply the ointment and change the bandage daily until the scratch heals.
Watch for Infection
Cat scratches, even minor ones, can become infected if bacteria gets introduced into the wound [1]. Here are signs of infection to look out for:
- Redness, swelling, or pus around the scratch
- Warmth or hotness around the wound
- Increased pain or tenderness
- Fever, chills, fatigue, or flu-like symptoms
An infected cat scratch often looks worse than the initial wound. The skin around the scratch may become red, swollen and painful. There may be pus or other drainage coming from the scratch. Some people also develop a fever, headache, or generally sick feeling if the scratch becomes infected.
If you notice any of these infection signs, it’s important to see your doctor for evaluation and treatment. Left untreated, the infection can spread more extensively in the skin (cellulitis) or even the bloodstream (sepsis), which requires intravenous antibiotics.
When to See a Doctor
You should see a doctor for a cat scratch wound if it is deep or shows signs of infection. According to Ask My Cats, deep puncture wounds from cat scratches can embed bacteria deeply into the skin and cause more serious infections. Signs of infection include redness, swelling, warmth, increasing pain, red streaks, pus, or fever. Seek medical care promptly if the wound shows these signs of infection.
You may also need to see a doctor for cat scratches if you are immune compromised. People with weakened immune systems, such as those with HIV/AIDS, cancer, diabetes, or those taking immunosuppressant medications have a higher risk of developing deeper infections from cat scratches. For these individuals, it is recommended to consult a doctor even for minor cat scratches to assess the risks and get proper treatment.
Tetanus Shot
Getting a tetanus shot may be recommended if you are scratched by a cat, especially if you are not up to date on your tetanus immunizations.
Tetanus, also known as lockjaw, is a serious illness caused by a bacterial toxin that affects the nervous system, leading to painful tightening of the muscles. It can be fatal if the breathing muscles are affected.
The bacteria that cause tetanus, Clostridium tetani, are present in soil, dust, and animal feces. When skin is punctured or wounded, the bacteria can enter the body.
Cats may have small amounts of C. tetani bacteria in their mouths that can enter through a scratch. So if your tetanus vaccine is not up to date, your doctor may recommend getting a tetanus booster shot within 48 hours of the injury.
Adults should get a tetanus booster every 10 years. So if it’s been longer than that since your last shot, getting a booster soon after a cat scratch provides an extra level of protection against tetanus.
Antibiotics
Antibiotics may be prescribed if the scratch becomes infected. Cat scratches can introduce bacteria deep into the skin, leading to infections like cellulitis or abscesses. Common antibiotics used include amoxicillin-clavulanate (Augmentin), doxycycline, azithromycin, cephalexin, or clindamycin. If there are signs of infection like increasing redness, warmth, swelling, or pus, promptly see a doctor for evaluation and possible antibiotics (Source).
Another concern with cat scratches is cat scratch disease, an infection caused by Bartonella henselae bacteria. About 40% of cats carry this bacteria in their blood. Symptoms include fever, headache, poor appetite, and lymph node swelling near the scratch. Cat scratch disease is usually self-limiting in people with healthy immune systems, but antibiotics can be used in more severe cases. Typical antibiotics include azithromycin, ciprofloxacin, trimethoprim-sulfamethoxazole, rifampin, or gentamicin (Source).
Home Care
Proper at-home care is crucial for minor cat scratches to prevent infection and promote healing. Here are some tips for caring for a cat scratch at home:
Keep the wound clean and dry. Gently wash the scratched area with mild soap and water 2-3 times a day. Be sure to rinse thoroughly and pat dry with a clean towel. Avoid soaking the wound.
Elevate the limb if possible to minimize swelling and throbbing. Prop up the scratched arm or leg on a pillow when sitting or lying down.
Take over-the-counter pain relievers as needed. Medications like acetaminophen, ibuprofen, or naproxen can help relieve pain and inflammation. Be sure to follow dosage instructions.
Apply antibiotic ointment 2-3 times per day after cleaning. This helps prevent infection. Neosporin or Bacitracin are good options. Do not use ointment if allergic.
Cover with a sterile bandage. This protects the scratch from irritants while allowing air flow to promote healing. Change bandages daily.
Avoid scratching, picking or irritating the wound. This can disturb scab formation and introduce bacteria.
Monitor for signs of infection like increasing redness, swelling, oozing, foul odor, streaking redness, fever or chills. Seek medical care promptly if these occur.
With proper at-home care, most minor cat scratches heal within 1-2 weeks. Deeper scratches or those showing signs of infection should be evaluated by a medical provider.
Prevention
The best way to avoid cat scratches is to prevent them in the first place. Here are some tips for avoiding scratches:
Play gently with cats. Try not to play too roughly with your cat or engage in games that encourage scratching and biting. Use cat toys on strings or laser pointers to keep play at a distance.
Trim your cat’s nails regularly to keep them blunt. Ask your vet to demonstrate the proper technique. Trim just the sharp tip of each nail.
Provide scratching posts, cardboard scratchers, and cat trees. These give cats an appropriate place to scratch and climb.
Avoid petting sensitive areas like the belly, back, and base of the tail. These areas can trigger an aggressive reaction.
Do not startle a sleeping cat. Approach slowly and let them wake up on their own.
Read your cat’s body language. If the tail is swishing, ears are back, or they are hissing/growling, leave them alone.
Consider caps or covers for your cat’s claws if they persistently scratch furniture or people. These blunt the claws so scratches do little damage.
Adopt calmer adult cats rather than rambunctious kittens if looking for a cat less prone to scratching.
Always supervise interactions between small children and cats. Children may accidentally hurt or startle a cat.
According to this source, understanding feline instincts and providing appropriate outlets for scratching are key prevention measures.
When to Seek Emergency Care
In most cases, cat scratches and bites heal on their own with basic first aid and care at home. However, you should seek emergency medical care if you experience any of the following symptoms:
- Difficulty breathing – A cat scratch or bite that becomes infected can sometimes lead to lymph node swelling and difficulty breathing. Seek immediate medical care if you have trouble breathing after a cat scratch.
- Severe swelling – Significant swelling around the scratch or red streaks traveling from the wound can indicate a serious infection. Go to an emergency room right away if you notice severe swelling that continues to get worse.
- High fever – A high fever over 101°F in adults or 100.4°F in children, especially if it persists for more than 24 hours, could signal an infection or serious illness. Seek emergency care for a high fever along with a cat scratch or bite.
These symptoms indicate your condition may be progressing to a serious infection that requires urgent treatment. Don’t wait to see if the symptoms improve on their own. Go to the nearest emergency room or call 911 if you experience difficulty breathing, severe swelling, or a high fever after a cat scratch, bite or exposure to cat saliva through an open wound.
Sources:
https://www.cdc.gov/healthypets/diseases/cat-scratch.html
https://www.hopkinsmedicine.org/health/conditions-and-diseases/cat-scratch-disease
