How to Handle a Cat Scratch

Cats are playful and unpredictable animals, sometimes even aggressive. If you interact with cats often, you may occasionally get scratched. Cats have sharp claws for self-defense, and these scratches can sometimes be quite deep. Proper care for a cat scratch will help you avoid complications from the injury.

Identify the Cat. It's important to gather information about the cat that scratched you. If it’s your pet or a friend’s cat, you can treat the injury yourself, provided it isn’t too severe, and you have full details about the cat:

• The cat is up to date on its vaccinations.
• The cat is in good health.
• The cat primarily stays indoors.

Seek medical attention if you're unsure about the cat that scratched you. Unknown cats may not have been vaccinated, so you might need preventive treatment for bacterial infections, tetanus, or rabies. This is especially important if the scratch includes a bite (which carries up to an 80% risk of infection), as you'll need to visit a doctor for medical care.

Assess the injury. The appropriate treatment depends on the severity of the wound. While all cat scratches can be painful, the depth of the injury will indicate whether it is serious or not.

• Shallow scratches that affect only the outermost layer of skin and cause slight bleeding can be considered surface wounds.
• Deeper scratches that pierce through multiple skin layers and bleed significantly are considered more serious.

Decide on the proper treatment. Superficial scratches from a pet cat can generally be treated at home. However, scratches from a stray cat or serious (deep) wounds from a pet cat should be evaluated by a healthcare professional.

Wash your hands. Before treating the scratched area, make sure your hands are clean and sterile. Use soap and warm (or comfortably hot) water to wash your hands for at least 20 seconds. Be sure to clean between your fingers and under your nails. Rinse thoroughly with clean water afterward.

Rinse the wound. Use tap water to rinse the cat scratch and the surrounding skin. Avoid using hot water as it may cause increased bleeding.

Clean the scratched area. Use soap to thoroughly clean the affected skin. Make sure to wash both the wound and the surrounding area (for example, if the scratch is on your arm, wash the entire arm rather than just the scratch itself). After soaping, rinse thoroughly with clean water.

• Do not scrub the scratched area, as this could cause further damage (bruising) to the tissue.

Apply ointment to the scratch. You should treat the cat scratch with an antiseptic ointment. A common option is Neosporin, which contains neomycin, an antibiotic that helps heal cuts effectively.

• You can apply the antibiotic ointment up to three times a day.
• Bacitracin is a good alternative for those allergic to regular antibiotic ointments.
• Antibiotics are not necessary if the scratch is from your own pet cat.

Do not cover the wound. Superficial scratches from a pet cat can be treated at home, so there is no need to cover the wound. Keep it clean during the healing process, but allow the wound to be exposed to fresh air.

Medical treatment. Deeper wounds may bleed heavily and require antibiotics to prevent infection, even if the cat that scratched you is fully vaccinated. Typically, you will be prescribed Augment 875/125 mg, to be taken twice a day for 7 to 10 days.

• Before receiving medical care, you may need to provide basic first aid at home.
• You should definitely visit a doctor after following these initial steps to treat the wound.

Stop the bleeding. If the wound is bleeding heavily, apply a clean cloth to the injury and press firmly. Hold it in place until the bleeding subsides. You may also need to elevate the injured area above the level of your head.

Clean the injured area. After thoroughly washing your hands, gently clean the injured skin with soap and rinse it with clean water. Avoid scrubbing as this could cause the wound to start bleeding again.

Pat the wound dry. Use a clean towel to gently dry the wound and the surrounding skin completely.

Cover the wound. Deeper wounds should be covered with a band-aid, butterfly bandages, or clean gauze.

• If the wound is wide, bring the edges of the injury together and apply a butterfly bandage, which helps close the wound. If necessary, you can use several butterfly bandages to close the wound and aid in healing.
• If band-aids are unavailable, you can use gauze and secure it with medical tape.

Avoiding infections. Some cat scratches and most cat bites can lead to infections. Cleaning the wound thoroughly and applying an antibiotic ointment like Neosporin or Bacitracin can significantly reduce the risk of infection. Infected wounds will require antibiotics. Signs of infection include:

• Severe pain, swelling, redness, or warmth around the wound
• Red streaks extending from the wound
• Discharge coming from the wound
• High fever

Preventing cat scratch disease. Cat scratch disease is the most common illness transmitted by cats, caused by the bacterium Bartonella henselae. Cats, particularly kittens and those with fleas, act as the primary carriers. Around 40% of cats carry the bacteria at any given time, but they show no signs of illness.

• Some cats with the disease may develop heart problems, mouth ulcers, or eye infections.
• The first sign of cat scratch disease in humans is usually a small, swollen bump at the site of the scratch or bite, accompanied by swollen lymph nodes in the armpit, groin, or neck. This is followed by fever, fatigue, red eyes, joint pain, and sore throat.
• Cat scratch disease can cause serious complications affecting the eyes, brain, liver, or spleen.
• People with weakened immune systems are at higher risk for severe complications or even death from cat scratch fever.
• Diagnosis typically involves a blood test for B. henselae, but it can also be diagnosed using bacterial culture, histopathology, or PCR. The disease is treated with antibiotics like azithromycin, rifampin, gentamicin, ciprofloxacin, clarithromycin, or bactrim.

Determine if you have ringworm. Ringworm is a fungal infection characterized by round, raised, scaly patches on the skin.

• Itching is common with ringworm.
• It can be treated with antifungal ointments like miconazole or clotrimazole.

Assess the risk of toxoplasmosis infection. Toxoplasmosis is a parasitic infection that is found in cats and transmitted through their feces. You can contract the Toxoplasma gondii parasite from a cat scratch, especially if the cat's claws have come into contact with feces.

• Infected individuals may experience fever, body aches, and swollen lymph nodes. Severe cases can lead to brain, eye, or lung damage and can be particularly dangerous for pregnant women. Pregnant women should avoid handling cat litter or cat feces during pregnancy.
• Toxoplasmosis is treated with antiparasitic medications such as pyrimethamine.

Be aware of symptoms from other illnesses. Cats can carry harmful pathogens that may be life-threatening. Contact a doctor immediately if you have been scratched by a cat and experience any of the following symptoms:

• Fever
• Swelling in the head or neck
• Red, itchy, or scaly patches on the skin
• Severe headaches, dizziness, or lightheadedness

Don’t punish the cat for scratching you. Scratching is a natural defensive behavior in cats. Punishing a cat for scratching could make it more aggressive in the future.

Trim your cat’s claws. You can use regular nail clippers to trim your cat’s claws. Trimming their claws once a week can help reduce the damage caused by scratching.

Avoid rough play. Avoid engaging in rough play with both adult cats and kittens. Such play can encourage them to scratch and bite you and others.

Taking care of an adult cat. Most cats outgrow the bad habit of biting and scratching when they transition from adolescence to adulthood, typically between the ages of 1 to 2 years. If your skin is sensitive to scratches from a cat or if you lack strong immunity, it might be a good idea to adopt an adult cat rather than a kitten.