Cat bites in humans....

RE: Cat bites in humans....

Bob Russell — Mon, 19 Sep 2016 11:08:19 GMT

I would write to the practice involved. The nurse is absolutely wrong giving this advice! Early antibiotics can make a world of difference!

Even dog bites benefit from amox/clav at an early stage despite the injury often involving more bruising than infection.

It is a sad state of affairs that we still need to dish out VDS bite advice forms!

RE: Cat bites in humans....

Thomas Johnson — Mon, 19 Sep 2016 09:32:11 GMT

[quote user="Martin Atkinson"]I also have these forms to hand out, medics seem more concerned with tetanus, which is a very unlikely infection from a cat bite, than septicaemia. [/quote]

I've often wondered why doctors are so concerned about tetanus from animal bites, and the NICE guidelines back this up:

"Although tetanus after animal bites is rare, all guidelines in common use advise tetanus prophylaxis"

RE: Cat bites in humans....

Martin Atkinson — Mon, 19 Sep 2016 09:13:47 GMT

[quote user="Dagmar Steele"]not sure how easy those big synulox bullets would go down![/quote]Noroclav 500 mg are a lot easier to swallow, no different from Augmentin!

[quote user="Stephen Courtney"]Also the clavulanic acid dose in synulox is different to that in augmentin, so not ideal.[/quote]It is the same 4:1, just Augmentin are 625mg (500/125) combined ingredients whereas the veterinary stuff is 500mg (400/100) the dose is just pro-rata.

[quote user="Jill Butterworth"]Also, I give this form and stern instructions to any client who gets bitten, including the dire warnings of the possibility of rejection of implants...[/quote]I also have these forms to hand out, medics seem more concerned with tetanus, which is a very unlikely infection from a cat bite, than septicaemia.

RE: Cat bites in humans....

Jill Butterworth — Mon, 19 Sep 2016 08:47:34 GMT

Oh heck...download the VDS form and take it with you to the doctors, it tells them exactly why and (and with which) antibiotics you SHOULD treat cat bites with antibiotics.

Over the years, I have had two nurses hospitalised with 24 hours after ignoring my instructions to do this, some individuals can become septicaemic quite easily.

Also, I give this form and stern instructions to any client who gets bitten, including the dire warnings of the possibility of rejection of implants...

RE: Cat bites in humans....

Stephen Courtney — Sun, 18 Sep 2016 21:45:20 GMT

they do taste awful - and they are very hard to swallow. I know from experience back in the day when I was more cavalier...wouldn't do it now, mainly because if things went tits up and I was in trouble, it would leave me exposed in all sorts of ways, including ignoring a fairly comprehensive practice manual which forbids any helping of ones' self to the medication we stock.

Also the clavulanic acid dose in synulox is different to that in augmentin, so not ideal.

My final reason for no longer self treating is a respect issue - I'm not a doctor and havent been impressed in the past to find a medically qualified client deciding to DIY their pet's health, so it would be hypocritical of me to do the reverse.

RE: Cat bites in humans....

Dagmar Steele — Sun, 18 Sep 2016 20:55:02 GMT

[quote user="cathal rafferty"]

As for Martin's comment, not sure how easy those big synulox bullets would go down!

[/quote]

I have been told ;-) they taste awful but it is possible....

RE: Cat bites in humans....

Rachel Brown — Sun, 18 Sep 2016 20:47:11 GMT

[quote user="Eilidh Corr"]

https://drive.google.com/file/d/0B6d3c_U5HhzBQWpkSTVlUGtRSG8/view?usp=drivesdk

Hope this works.

[/quote]

many thanks for that.

Rachel

RE: Cat bites in humans....

cathal rafferty — Sun, 18 Sep 2016 20:39:09 GMT

Except in this case you're not trying to save time, you're trying to save your fingers!

I've no problem waiting a few hours for an x-ray if I know the problem is worsened by the delay. As for Martin's comment, not sure how easy those big synulox bullets would go down!

RE: Cat bites in humans....

Michael Woodhouse — Sun, 18 Sep 2016 19:36:37 GMT

If you ring and speak to our local GPs they will put them up over the phone. Don't even need to be seen. It's nice speaking professional to professional. They usually ask what I want.

RE: Cat bites in humans....

Noweia — Sun, 18 Sep 2016 17:44:18 GMT

[quote user="cathal rafferty"]

Why do people bother with the doctor? We have augmentin on the shelf for staff if they're bitten. There's doing what you're meant to and there's just delaying the enevitable. if the risk is losing fingers etc let the complaint of self-prescription come...

[/quote]

For the same reason that someone got prosecuted for by trying to save time and and NHS money by x-raying their own foot to see if it was broken!

RE: Cat bites in humans....

Eilidh Corr — Sun, 18 Sep 2016 13:45:41 GMT

https://drive.google.com/file/d/0B6d3c_U5HhzBQWpkSTVlUGtRSG8/view?usp=drivesdk

Hope this works.

RE: Cat bites in humans....

Martin Atkinson — Sun, 18 Sep 2016 13:35:35 GMT

[quote user="cathal rafferty"]

[/quote]I can't understand how it took 10 replies to the OP to get here. But why Augmentin, what's wrong with Synulox/Noroclav etc just as illegal. Of course I wouldn't admit to it myself!

RE: Cat bites in humans....

Rachel Brown — Sun, 18 Sep 2016 13:22:44 GMT

That NICE link only works in the UK. Any chance someone could post or link to the PDF?

Thanks

Rachel

RE: Cat bites in humans....

Dagmar Steele — Sat, 17 Sep 2016 22:42:03 GMT

Happened many times when staff got bitten, antibiotics refused, worsened, ended up with surgery and hospitalization. If I get bitten (if teeth get in deep) I put myself on amoxiclav asap. Nonetheless the last time I had to change to Cephalosporine plus Metronidazole as it didn't work and my whole arm was swollen, hand huge as a big purple balloon. Cat bites are pure horror. Nowadays in Germany there is a guideline for GPs on animal bites that states antibiotics are defo needed for cat bites. I provide every employee going to the doc with it, albeit in the meantime it seems most of the GPs did actually read it!

RE: Cat bites in humans....

Elisabeth Knappett — Sat, 17 Sep 2016 22:21:14 GMT

Thanks all for your responses - we too have the printout to give to clients following advice to get bites treated, didn't think to take it with me! The NICE information is very useful, will definitely be included in the polite note I'll be sending to the GP's office this week.

RE: Cat bites in humans....

cathal rafferty — Sat, 17 Sep 2016 22:21:10 GMT

RE: Cat bites in humans....

Sammy82 — Sat, 17 Sep 2016 20:40:53 GMT

Had it once that the nurse and the GP practice who cleaned up my bite asked me if I thought I needed ABs, and when I said yes that's why I am here she asked the doctor who said yes, definitely. My boyfriend had a similar experience with NHS 111, when they advised to definitely see a doctor for his severe stomach cramps, and none of the practices would see him, despite him telling them that 111 said so. Problem was that we had only just moved to the area and not registered with any GP yet. He ended up not seeing anyone and eventually getting better on his own. I am not surprised that A&E is full of those GP cases, I was close to taking him there.

RE: Cat bites in humans....

intelligenteaser — Sat, 17 Sep 2016 19:00:08 GMT

Its so frustrating isn't it. Where I work our practice policy is to go to the doctors (with a leaflet) after a cat bite (and like you say you can usually tell which ones definately need antibioitcs from the immediate swelling and pus within a few hours.) however the doctors won't give anyone an appointment for a cat bite so then 111 is called who tell you that you must head straight to A and E and be seen within the next hour (which of course doesn't happen at A and E esp as you are probably the bottom of the list) so then most of the day (meaning we are a staff member down) or all of someones evening in spent sitting in A and E. I had to ring 111 several years ago as it was a saturday evening and had pus coming out and very swollen thumb that was getting difficult to bend and didnt want to leave it to ringing a doctors on monday wasnt familiar with the area (just on a short contract in the area) so wanted an OOH doctor that might be open on a sunday etc.....and was given the above advice but not only that they offered to get me an ambulance to take me to hospital...it took some persuading them to say that I would be able to drive myself! I think the NHS need to chat amongst themselves, they moan about people wasting emergency resources but the doctors wont give you an appointment but their 111 advice service want to send an ambulance!

RE: Cat bites in humans....

An On MRCVS — Sat, 17 Sep 2016 18:14:28 GMT

I'd insist on antibiotics for a cat bite and in the unlikely event they wouldn't give me any, I'd take some synulox from the practice.

I know people who've lost fingers and people who've had to spend a week in hospital on iv antibiotics after GPs refused them antibiotics for a cat bite. Not really worth messing about with

RE: Cat bites in humans....

Eilidh Corr — Sat, 17 Sep 2016 16:42:10 GMT

Can you tell I've had disagreements with medics about this in the past, including a client being hospitalised after the GP disagreed with my advice to use antibiotics for a hand bite? Considering the very real potential for life-altering outcomes if a bite isn't properly treated, I think we have a responsibility to remind medics of best practice when they're faced with these wounds. In fairness to them, we tend to have much greater experience of treating dog bites than they do

RE: Cat bites in humans....

Eilidh Corr — Sat, 17 Sep 2016 15:26:57 GMT

I have a printout of this in the practice:

http://cks.nice.org.uk/bites-human-and-animal#!scenario:2

RE: Cat bites in humans....

Virginia Campbell — Sat, 17 Sep 2016 15:24:38 GMT

http://cks.nice.org.uk/bites-human-and-animal#!scenario:2

RE: Cat bites in humans....

Rob Loxley — Sat, 17 Sep 2016 14:15:59 GMT

We have a client who is an A&E doctor who suggests amox-clav as first line early treatment - particularly important for people with underlying medical conditions - we had a client with septicaemia after her cat bit her...

RE: Cat bites in humans....

Utlendigur — Sat, 17 Sep 2016 14:11:35 GMT

VDS do an information leaflet - downloadable from their website- to give to clients who've been bitten by cats (eg during consult) for them to take to A&E or their GP, precisely because so many medics don't understand the potential risks of cat bites and just think about tetanus