Dog Bites and PTSD

Cujo PTSD

We are all well aware of the physical damage that occurs with dog bites, particularly in children, who are often bitten in the face and above the shoulders.  We all are able to deftly discuss the risk and benefits of conscious sedation, if necessary, and are comfortable at the various methods of closing wounds.  We are also well versed in determining whether specific wounds require prophylactic antibiotics.  We deal with the physical damage and the physical treatments swiftly and effectively.

But, perhaps we should do more.  While the physical wounds can be repaired, often the emotional damage can be quite disabling and chronic.  Dr. Larry Schmitt has written about this and requests that we keep the potential for evolving PTSD in children who have had dog bites. {Thank you Dr. Schmitt for recommending the topic.}

Dog Bites are Traumatic

  • > 4 million dog bites are reported each year in the US.
  • From 2007 to 2010, 28 to 33 children died due to dog bites each year.
  • Often the dog that attacks is known to the patient, which can actually be more traumatic than an unknown animal.
  • PTSD has been shown to develop in a high percentage of young children attacked by dogs.

PTSD in a child can be subtle and may look like:

  • Excessive anxiety
  • Irritability
  • Decreased school performance
  • Sleep disturbance
  • Reduced creativity
  • Withdrawal
  • Altered appetite
  • Depression
  • Somatizations
  • Pronounced startle response
  • Behavioral problems

Help Repair the Emotional as well as Physical Wounds

  1. Acknowledge that this was a traumatic emotional event.
  2. Help make the family realize the potential for continued emotional distress beyond the initial repair.
  3. Distribute patient educational handouts that will help reinforce the potential for PTSD developing.
  4. Provide list of mental health clinics and resources in your area.
    1. http://www.doggonesafe.com/dog_bite_victim_support
    2. http://helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm
    3. http://aacap.org/

Sample Letter

By helping the family acknowledge the severe emotional as well as physical trauma that was sustained during the dog bite, you can help prevent PTSD from developing into a debilitating condition or even prevent it entirely.

 

Schmitt RL. Dog bites in children: Focus on posttraumatic stress disorder. Contemporary Pediatrics. 2011; July: 38-42.

 

Sean M. Fox
Sean M. Fox

I enjoy taking care of patients and I finding it endlessly rewarding to help train others to do the same. I trained at the Combined Emergency Medicine and Pediatrics residency program at University of Maryland, where I had the tremendous fortune of learning from world renowned educators and clinicians. Now I have the unbelievable honor of working with an unbelievably gifted group of practitioners at Carolinas Medical Center. I strive every day to inspire my residents as much as they inspire me.

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3 Comments

  1. Sadly I have PTSD because I have an image seared into my memory of the Pit bull CRUSHING the slender neck of my shy Amber as she screamed & thrashed.
    I live with that painful memory always…
    Also, ANOTHER PIT BULL jumped over/out of a dog run fence, to charge at me & my last 14-yr-old dog.
    I screamed him down, so he paused long enough for his owner to get to him.

    Even if I could “get over it” people with their Pit bulls won’t stay away from me, & actually BULLY me.

    Why can’t we, at least, get Pit bulls muzzled, to protect the innocent.
    These are NOT simply “bites”. Too many people, pets, etc. are violently murdered by Pits & Pit-mixes each year. The numbers are rising.

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