Dog Bite [Long and Boring]

Medical issues, doctors, dentists, opticians and hospitals in Hua Hin and Thailand.
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Ratsima
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Dog Bite [Long and Boring]

Post by Ratsima »

Last week I was cycling across the earthen dam of a reservoir (อ่างเก็บน้ำห้วยตะแปด) just east of the entrance of the Springfield golf course. I stopped to take a photo of an amusing sign when I was suddenly surrounded by a pack of barking dogs. I'm not afraid of dogs and am usually pretty good at showing them that I'm not a threat. After taking the photo I knelt down and slowly managed to start petting and scratching a few of them. A big Black Lab was especially friendly. After a few minutes most of the dogs left, but the Lab and a few others stayed for more attention.

I got up to leave and started peddling up a rather steep hill. Suddenly, all the dogs followed in attack mode. I didn't think much of it until the formerly-friendly Black Lab jumped up and big a hunk out of my knee. I was really shocked. I've lived in Asia for nearly 40 years and have been running and cycling daily and never have I had a dog draw blood.

At that point I'm about 15K from home. I figure it's time to get back, clean the wound and head to the hospital for a Rabies shot. So, I peddled back, showered, scrubbed the wound with a brush, got the bleeding stopped and cycled 9K to the Cha Am hospital. The place was jammed, so I settled in for a long wait, but was pleasantly surprised by the speed of the care and the organization of the place.

Now my Thai is pretty poor, but I did manage to tell them I wanted a Rabies shot (ฉีดวัคซีนพิษสุนัขบ้า is what I said). The intake lady asked to see the bite, had me fill out an intake form (in English) and directed me to the emergency room where a nice nurse insisted on cleaning the wound again and applying a dressing. She did the injection and then I was required to see a doctor for medicine. I said I didn't want any, but that was ignored. The doctor, very young, wanted to prescribe an antibiotic and something for the pain. I declined both.
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Then it's time to pay. Not having a prescription proved problematic. Who leaves a Thai medical facility without a bag full of different colored pills, the function of which is generally unknown? The doctor finally had to come out and explain to the cashier that there was no medicine — ไม่มียา.

Anyway, I managed to pay. The bill came to almost 2000 baht, including the shot (900 baht), the emergency room care and the doctor consult. I was given a small appointment slip giving the dates for the next four shots. (You get a total of five.)

All in all, I was quite impressed. Although the hospital was busy, I never had to wait long and was in and out of there in much less than an hour. I didn't even get past the second page of the Bangkok Post.

On Saturday I went back for the second shot. The OPD was closed and the place was empty. In and out in ten minutes. 900 baht for the jab.

By the time the third shot was due I was back in Korat. I went to the small health center near my house. It was completely empty. Not a single patient. Everyone was very kind and helpful and chatty. (My Thai would improve if only I needed medical care more often.) I did manage to complete the Thai language registration form which they seemed to like.

I got the shot and tried to pay, but the cashier said, "Free service". Not bad.

This was my first personal encounter with public health facilities in Thailand. For my rather minor problem they performed admirably and efficiently.

YMMV
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Re: Dog Bite [Long and Boring]

Post by Dannie Boy »

I live just outside of Cha Am so use the hospital there whenever I need minor treatment and so far, my experience has also been very good, particularly for acupuncture that I've needed for a couple of sports injuries.
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Re: Dog Bite [Long and Boring]

Post by J.J.B. »

FWIW you should have accepted the antibiotics. They would have been prescribed for prophylactic treatment since you had a puncture wound. The bacterial soup in a wild dog's mouth could pose any number of potential risks, especially when embedded into an ideal and anaerobic growth medium, like your leg.

It seems you've not had any ill-effects, which is fortunate, although getting rid of a bacterial soft tissue infection is no fun. It's the same preventative decision you took with the rabies shot, since you don't know whether the dog had rabies or not, and could have been very unpleasant. Nevertheless, I trust you have a full and rapid recovery.
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Ratsima
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Re: Dog Bite [Long and Boring]

Post by Ratsima »

If the dog had actually sunk a canine into my leg I probably would have accepted antibiotics. Although the wound was big, it was superficial. I had thoroughly debrided it with a scrub brush, cleaned it with detergent and applied a topical antibiotic. I figured the chance of infection was low and that proved to be correct. If there had been any sign of infection I would have gone back in.

I'm not a big fan of oral antibiotics and haven't taken any for at least three decades. They are horribly overprescribed in Thailand. I decline to be a part of that.

I realize there are differences of opinion on this, but I think I made the right decision in this case.
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Re: Dog Bite [Long and Boring]

Post by Ginjaninja »

Thanks for the informative post Ratsima. Useful information.
Whilst out running I'm finding the dogs increasingly aggressive and reading the relavent posts on this forum is increasing my paranoia.. Perhaps the dogs are sensing my increased awareness...!?
Contemplating something light, maybe plastic that looks like a stick to carry with me before maybe the inevitable happens.
Cheers,
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Re: Dog Bite [Long and Boring]

Post by bsdk1960 »

When I'm out cycling I have a wirelock that's open and lay over my stear,so it's availible very easy.
One time I have to hit a dog that have chased me many time,and he never come bag again.
I really love dogs, and don't won't to hurt them,but I don't won't them to bite me, so up to them.
I'm sure that the dog can feel if your affraid of them,but I realize that it must be like being afraid of other thing,not easy to get rid off.

:cheers: :cheers:
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Re: Dog Bite [Long and Boring]

Post by robcar »

I walk every morning and always carry my 'dog stick'. I have only had to threaten with it a couple of times.
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Re: Dog Bite [Long and Boring]

Post by Homer »

Ginjaninja wrote:Contemplating something light, maybe plastic that looks like a stick to carry with me before maybe the inevitable happens.
I use the plastic handle from my plumbers helper, AKA toiler plunger, AKA poo pump.
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Re: Dog Bite [Long and Boring]

Post by Ratsima »

Ginjaninja wrote:Thanks for the informative post Ratsima. Useful information.
Whilst out running I'm finding the dogs increasingly aggressive and reading the relavent posts on this forum is increasing my paranoia.. Perhaps the dogs are sensing my increased awareness...
You know, since getting back here to Korat, I've noticed the same thing; increasingly aggressive behavior by dogs. I figured it was all in my head due to the recent bite. Fear pouring out my pores….
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Re: Dog Bite [Long and Boring]

Post by Ratsima »

Bit of drama today. It's the day for the fourth rabies shot but I'm also traveling from Korat to Phuket for a five day dive trip.

I get to the Korat clinic early, but the doctor doesn't show. I give up.

Luckily, the medical clinic at Don Mueang has the vaccine so I get the 4th jab there. Now for a few days of diving.

BTW, the clinic doctor advised me to "keep the wound dry". Oops!
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Re: Dog Bite [Long and Boring]

Post by Homer »

There is 1 'gotcha' for rabies vaccine following bites. The WHO and CDC recommended schedule for post-bite shots is days 0, 3, 7, and 14. If one gets treatment on day zero, prevention of rabies is virtually 100%. Prevention rate drops with number of days after exposure. Something to think about when near dogs and away from quality health care is how many days are you from such care - and will they have the vaccine in stock?
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Re: Dog Bite [Long and Boring]

Post by Ratsima »

Dive trip done. Only downside was the persistence of Cleaner Wrasse getting at the wound.
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Re: Dog Bite [Long and Boring]

Post by STEVE G »

I had a similar experience of a dog bite and the full course of injections a couple of years ago. Just out of interest, does that course of jabs give you any protection from the disease into the future or do you need to do it every time you get bitten?
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Re: Dog Bite [Long and Boring]

Post by Ratsima »

What I understand is that if you get bit again you need a shorter course (3?), but you still need some jabs.
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Re: Dog Bite [Long and Boring]

Post by redzonerocker »

STEVE G wrote:I had a similar experience of a dog bite and the full course of injections a couple of years ago. Just out of interest, does that course of jabs give you any protection from the disease into the future or do you need to do it every time you get bitten?
If you have the initial vaccination jabs, you have to have them reinforced to maintain protection after one year and approx three years after that, and so on.
As Thailand and the surrounding nations are in the 'high risk' category for rabies, well worth noting considering the dog populations, especially strays.

As your bite was a couple of years ago, I would suggest you get another course of jabs if you were to get bitten again.
Hopefully you won't. :D :cheers:
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