If you own a dog, there are a few early symptoms of rabies you need to know about, and most of them are easy to miss. Early rabies rarely looks like the snarling, foaming dog of the movies. It usually starts as a quiet change in behavior that could pass for a dozen other problems.
So the signs alone are a poor guide. Two questions matter more: could your dog have been exposed (a bite or scratch from wildlife, a stray, or an animal of unknown vaccine status), and is its rabies vaccine current? If there was a possible exposure, call your veterinarian and your local health department the same day, even if your dog seems perfectly normal.
What is rabies?
Rabies is a viral disease that can infect any mammal, including dogs, cats, livestock, and people. The virus attacks the central nervous system (the brain and spinal cord), and once neurological signs appear, the disease is fatal. It spreads almost always through the saliva of an infected animal, usually by a bite. A scratch, or saliva getting into a fresh wound or onto the eyes, nose, or mouth, can also transmit it (Merck Veterinary Manual).
Airborne spread is extremely rare (laboratories, caves packed with bats). Outside the body the virus is fragile and quickly damaged by heat and sunlight.
Where rabies comes from in the US
In the United States, wildlife accounts for more than 90% of reported animal rabies cases, mainly bats, raccoons, skunks, and foxes (CDC). A bat bite can be so small that it leaves no obvious mark, so any contact with a bat, or a bat found where a person or pet was sleeping, is worth reporting.
The dog-to-dog strain (the "canine variant") has been eliminated from the US, but dogs still catch rabies from wildlife, and imported dogs can bring the canine variant back. Among domestic animals, cats are now reported rabid far more often than dogs: in 2021, US surveillance found 216 rabid cats and 36 rabid dogs.
How long before signs appear
The time between the bite and the first signs is the incubation period. In dogs and other domestic animals it is usually about 3 to 12 weeks, rarely longer than 6 months, while the virus travels slowly along the nerves to the brain and then to the salivary glands. That long, silent stretch is why a bite from a few weeks ago still matters.
Early symptoms: the prodromal stage
Rabies is often described in three stages: prodromal, furious, and paralytic. Real dogs don't follow the script. A dog may show one, two, or all three.
The prodromal stage is a short lead-in that lasts about 1 to 3 days. The most reliable early sign is a sudden change in temperament (Merck Veterinary Manual):
- an outgoing dog becomes withdrawn or anxious and seeks solitude
- a calm or shy dog becomes irritable, restless, or snappy
- an aggressive dog suddenly turns unusually affectionate
- the dog loses its appetite
None of these signs is specific to rabies, and foaming at the mouth is often absent early on. Other neurological diseases, including canine distemper, can cause similar behavior changes and seizures. What should raise the alarm is a sudden behavior change in a dog that is unvaccinated or overdue and could have met a wild or unknown animal.
The furious stage
Many dogs show little or none of this stage and go straight to paralysis. When it does happen, the dog overreacts to sights and sounds, becomes irritable and restless, and may bite at the slightest provocation. Affected dogs may roam, swallow stones and other odd objects (pica), lose coordination, and have seizures. Some die during a seizure.
The paralytic stage
The paralytic stage can follow either of the earlier stages. Paralysis starts in the throat and jaw muscles: the lower jaw often drops, the dog can't swallow, and saliva drools or foams from the mouth. Owners often think something is stuck in the dog's throat.
Do not reach into the mouth of a drooling dog with a slack jaw to look for a bone or stick. That is exactly how owners expose themselves to rabies. Keep your hands out, keep people and other pets away, and call your veterinarian. Drooling has plenty of other causes (see our guide to hypersalivation in dogs), but drooling plus trouble swallowing plus a behavior change calls for a phone call before anyone touches the dog.
The paralysis then spreads through the body, followed by coma and death.
You may have heard that rabid dogs are afraid of water. Fear of water (hydrophobia) is a sign in people, not in dogs. A rabid dog may stop drinking because its throat is paralyzed, not because it fears water.
How vets confirm rabies
No test confirms rabies in a living animal. Rabies is confirmed by testing brain tissue after death, using a lab method called direct fluorescent antibody (DFA) testing at a designated public health or diagnostic laboratory (NASPHV Compendium).
Once signs appear, rabies cannot be treated. A suspected case is isolated and reported to the local health department, which decides on testing and on follow-up for any people or animals that were exposed.
What happens after a bite or exposure
These rules come from the national Compendium of Animal Rabies Prevention and Control. State and local rules can differ, and your local health department decides how they apply to your dog.
If your dog was bitten or scratched by a wild animal, a stray, or an animal of unknown status:
- Current on rabies vaccine: prompt veterinary care, a rabies booster, and 45 days of observation under the owner's control.
- Never vaccinated: health officials typically recommend euthanasia. If the owner declines, the dog goes into strict quarantine for 4 months and is vaccinated at the start of it.
- Overdue on vaccines: handled case by case by the health department.
If your dog bit a person: a healthy dog that bites someone is confined and observed for 10 days, whether or not it is vaccinated. A dog can shed the virus in its saliva a few days before it shows any signs. If the dog stays healthy for those 10 days, it was not shedding rabies virus when it bit. If signs appear, the health department arranges testing. Our page on dog bite statistics and prevention covers why bites happen.
When to call your vet and health department
Call your veterinarian, and your local health department or animal control, if:
- your dog was bitten or scratched by a wild animal, a stray, or any animal whose vaccine status you don't know, or fought with one and you can't rule out a bite
- your dog has a wound you can't explain
- you find a bat in your home, especially in a room where a pet or person was sleeping
- your unvaccinated or overdue dog suddenly changes in behavior, starts drooling, has trouble swallowing, or becomes weak
- your dog bit someone
Call even if the wound looks minor or your dog seems fine. That is where the incubation period hides the risk.
Vaccination: the best protection
Vaccinating your dog protects your family too. Most US states and many local governments require rabies vaccination for dogs, but the rules vary by state and locality.
The age for the first vaccine and the timing of boosters depend on the licensed vaccine's label and on state and local law, so your veterinarian sets the schedule and keeps the record. Keep the certificate where you can find it fast: after a bite or exposure, proof of current vaccination changes what the health department requires.
Even a fully vaccinated dog should see a vet after any bite, scratch, or wound of unknown origin. Keep dogs leashed or supervised outdoors and away from wildlife and strays, and vaccinate the cats too: they are now the most commonly reported rabid domestic animal in the US. Planning to travel? Ask your vet well ahead, because rules depend on the destination, and the CDC and USDA APHIS set the rules for bringing dogs into the US.
People and rabies
If you are bitten or scratched by an animal that could have rabies, wash the wound right away with soap and water. Then call your doctor and your local health department without waiting for the animal to show signs (CDC).
Your doctor and the health department decide whether you need post-exposure prophylaxis (PEP), treatment that stops the virus before it reaches the nervous system. It can include rabies immune globulin and a course of rabies vaccine. Started in time, it is nearly 100% effective. Once symptoms begin in a person, rabies is almost always fatal. In the US, fewer than 10 people die of rabies each year.
For the veterinary team: people who handle animals at work are advised to have rabies pre-exposure vaccination and to wear protective equipment with a suspect animal (CDC Information for Veterinarians). For the wider picture, see our article on emerging zoonotic diseases.
World Rabies Day: rabies around the world
September 28 is World Rabies Day. Rabies is still a serious public health problem worldwide (WHO):
- Rabies is present on every continent except Antarctica.
- Dogs cause up to 99% of human rabies cases worldwide.
- WHO's latest estimate is about 44,000 human deaths a year, likely an undercount, mostly in Asia and Africa.
- About 40% of people who die of rabies are children under 15.
- The burden falls mostly where dogs are not widely vaccinated.
Sources
- NASPHV: Compendium of Animal Rabies Prevention and Control, 2016
- Merck Veterinary Manual: Rabies in Animals
- WHO: Rabies fact sheet
- CDC: About Rabies
- CDC: Protecting Public Health (rabies)
- CDC: Information for Veterinarians (rabies)
- JAVMA: Rabies surveillance in the United States during 2021
- VCA Animal Hospitals: Rabies in Dogs
- Global Alliance for Rabies Control: World Rabies Day
This article is for general information and is not a substitute for advice from your veterinarian.
