Cat Bite Management and Rabies Prevention

Immediate Wound Management

The Centers for Disease Control and Prevention recommends thoroughly washing and flushing all bite wounds immediately with soap and water for approximately 15 minutes to reduce infection risk and potential rabies transmission 1, 2
Irrigate with povidone-iodine solution after soap and water cleansing, as this virucidal agent further reduces rabies risk 1, 2
Examine the wound carefully for depth, tendon involvement, bone involvement, or joint penetration 2, 3

The Centers for Disease Control and Prevention recommends assessing tetanus immunization status and administering tetanus prophylaxis as indicated 1, 4
Administer tetanus toxoid to patients with unknown or incomplete tetanus immunization 3

If the cat is healthy, available for 10-day observation, and properly vaccinated, confine and observe the cat for 10 days without initiating prophylaxis 1, 4, 3
Initiate immediate rabies post-exposure prophylaxis if the cat is stray or unwanted, cannot be confined for observation, dies or develops illness before completing the 10-day observation period, or shows signs suggestive of rabies during observation 1, 4
The World Health Organization recommends a rabies post-exposure prophylaxis regimen consisting of Rabies Immune Globulin and a 4-5 dose vaccine series for previously unvaccinated persons 1, 3

Unprovoked attacks are more likely to indicate rabies than provoked attacks, according to the Centers for Disease Control and Prevention 1, 4, 3
More cats than dogs are reported rabid in the United States, with the majority associated with raccoon rabies epizootics in the eastern US 1, 4

Never delay wound cleansing, as thorough wound cleansing alone has been shown to markedly reduce rabies likelihood in animal studies 1, 3
Do not exceed the recommended Rabies Immune Globulin dose, as excess can suppress active antibody production 3
Do not initiate unnecessary post-exposure prophylaxis for healthy domestic cats that can be observed for 10 days 3

Infectious complications include septic arthritis, osteomyelitis, subcutaneous abscess, tendonitis, and bacteremia caused by Pasteurella species, Staphylococci, and anaerobes 3