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Pit vipers are the largest group of venomous snakes in the United States and are involved in an estimated 150,000 bites annually of dogs and cats. The severity of any pit viper bite is related to the volume and toxicity of the venom injected as well as the location of the bite, which may influence the rate of venom uptake. The toxicity of rattlesna...
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Context 1
... severity of any pit viper bite is related to the volume and toxicity of the venom injected as well as to the location of the bite, which may influence the rate of venom uptake. Generally, the toxicity of pit viper venoms ranges in descending order from the rattlesnakes to the water moccasins and then to the copperheads (Table 1). The toxicity of rattlesnake venom varies widely. ...Similar publications
Acute renal failure (ARF) is the main cause of death following snake bites by Bothrops species. In this study, we investigated the morphologic and functional renal disturbances caused by Bothrops moojeni venom in rats. Renal function was assessed based on creatinine and lithium clearances and on histologic examination of renal tissue 5 hr after the...
Patient: Male, 53-year-old
Final Diagnosis: Snakebite envenomation
Symptoms: Pain • swelling
Medication: —
Clinical Procedure: Antivenom administration • Point of care ultrasound (POCUS)
Specialty: Critical Care Medicine • Radiology • Toxicology
Objective
Challenging differential diagnosis
Background
There are few reports of crotaline envenomatio...
Using venom for predation often leads to the evolution of resistance in prey. Understanding individual variation in venom resistance is key to unlocking basic mechanisms by which antagonistic coevolution can sustain variation in traits under selection. For prey, the opposing challenges of predator avoidance and resource acquisition often lead to co...
Envenomations by exotic snakes occur from zoological collections and private individual collectors. Antivenoms to these snakes may not be readily available. The objective of this study is to determine the efficacy of North American crotalid antivenin in treating mice envenomated with venom of the African viper Bitis gabonica (Gaboon viper). The sub...
Background
Each year, 3,800 cases of snakebite envenomation are reported in Mexico, resulting in 35 fatalities. The only scientifically validated treatment for snakebites in Mexico is the use of antivenoms. Currently, two antivenoms are available in the market, with one in the developmental phase. These antivenoms, produced in horses, consist of F(...
Citations
... En cambio, no existen cifras oficiales acerca del número de mascotas que sufren un accidente ofídico (intoxicación por la inoculación de veneno por parte de una serpiente venenosa) en el territorio mexicano, sin embargo, Peterson [5] estimó que en los Estados Unidos ocurren cerca de 150,000 mordeduras a perros y gatos por año. En México se estima que el 69.8% de los hogares tienen alguna mascota, destacando a los caninos que suman 43.8 millones y felinos con 16.2 millones, por lo que estos accidentes podrían ser habituales sin un registro confiable [6]. ...
... Debido a la persistencia de la inflamación, se opta por aplicar a las 23:00 h una cuarta dosis de 5ml de faboterápico Birmex, reservando el resto para 12 h después; constantes registradas: FC de 80 lmp, FR de 30 rpm y T de 37.7 °C. El 8 de septiembre, a las 9:00 h se administraron 0.01 mg/kg de buprenorfina, el examen físico mostró una marcada edematización hacia el cuello y la región braquio-pectoral, que por efecto gravitatorio podría implicar el avance hacia tejido que previamente no estaba en contacto, por lo tanto, se decidió utilizar el diurético furosemida con una dosis de 2 mg/kg a la par de una quinta dosis de 5 El 11 de septiembre se presentó a su revisión, con constantes de FC 135 lpm, FR 35 rpm y una T de 38.8 °C, con buena actitud, sin ninguna alteración en el examen físico. Los propietarios refieren que los días 9 y 10 de septiembre presentó buen ánimo y se alimentó de manera normal. ...
... An enzyme in the diamondback rattlesnake venom, known as protease H, induces widespread bleeding. Five distinct proteolytic toxins from the western diamondback rattlesnake venom cause bleeding by disrupting laminin in band A within the basement membrane [15][16][17][18]. Additionally, snake venoms, including those from the Crotalus genus, primarily consist of proteins (approximately 95% of venom dry weight) with potential pharmacological properties, making them potential targets for various pharmacological studies [19,20]. ...
Crotalus snakebites induce various toxicological effects, encompassing neurological, myotoxic, and cytotoxic symptoms, with potentially fatal outcomes. Investigating venom toxicity is essential for public health, and developing new tools allows for these effects to be studied more comprehensively. The research goals include the elucidation of the physiological consequences of venom exposure and the assessment of toxicity using animal models. Chicken embryos serve as valuable models for assessing venom toxicity through the chick embryotoxicity screening test (CHEST) and the chick chorioallantoic membrane (CAM) assay, particularly useful for evaluating vascular impacts. C. adamanteus venom application resulted in higher embryotoxicity and morphological abnormalities, such as Siamese twins. The CAM assay demonstrated the hemorrhagic effects of venom, varying with venom type and concentration. The irritant potential of both venom types was classified as slight or moderate depending on their concentration. Additionally, acetylcholinesterase (AChE) activity was performed to receive information about organ toxicity. The results show that both venoms induced changes in the whole embryo, heart, and liver weights, but the C. adamanteus venom was identified as more toxic. Specific venom concentrations affected AChE activity in embryonic tissues. These findings underscore the embryotoxic and vasoactive properties of Crotalus venoms, providing valuable insights into their mechanisms of toxicity and potential applications in biomedicine.
... 5 Hemocoagulation failure: venom-induced consumption coagulopathy (VICC), most frequently with defibrination and consequent potential bleeding and organ hematoma forms, is one of the snakebites envenoming manifestations. 6 Worldwide, VICC occurs due to bites by vipers, most Australasian elapid snakes, and a few species of colubrid. 7 VICC results from the combined effects of toxins, which include phospholipase A2, snake venom serine protease, and snake venom metalloprotease. ...
Key Clinical Message
Splenic hematoma secondary to snake bite is a potential complication due to snake envenomation and poses a significant risk to the health of the patients. Although relatively rare, this complication once diagnosed, should be initiated with timely anti‐venom administration and supportive care. Clinicians must be aware of any signs of hematological abnormalities in snakebite patients, as the development of splenic hematoma can have serious implications for patient outcomes. Awareness of this potential complication and multidisciplinary collaboration among medical teams are crucial to ensuring effective management and optimal patient care in these clinical scenarios. Understanding this concern can improve patient prognosis and advance the overall approach to snakebite management in healthcare settings.
... Snakebites have long been treated with antivenin, but the therapeutic approach in terms of ideal supportive care remains up for debate. Snakes are known to harbour bacteria in their oral cavity, including Salmonella, Pseudomonas aeruginosa, Proteus spp., coagulase-negative Staphylococcus spp., Clostridium spp., and Bacteroides fragilis (Peterson, 2006). Consequently, many veterinary references recommend the use of antimicrobials following envenomation to prevent wound contamination. ...
PICO question In dogs with snakebites does the use of antimicrobials compared to no antimicrobials reduce incidence of wound infection? Clinical bottom line Category of research Treatment. Number and type of study designs reviewed Seven case series. Strength of evidence Weak. Outcomes reported Three studies looked at the incidence of wound infection in envenomated dogs, three compared antimicrobial use to mortality and one compared other outcomes, such as time in hospital. The incidence of wound infection was low in the studies and overall antimicrobials seemed to have no significant effect on outcomes such as survival or wound infection. Therefore, the routine use of antimicrobials for snakebite treatment is not supported by the results, however further studies are required to provide conclusive evidence. Conclusion There is currently insufficient evidence from literature to either support or reject the use of antimicrobials in the treatment of snakebites. How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
... According to the World Health Organization (WHO), 5.4 million snakebites occur annually in people, of which 2.7 million are venomous, with 81,000-138,000 deaths [1]. An estimated 150,000 animals, primarily dogs and cats, are bitten by snakes in the United States annually [3]. Although mortality in humans after snakebites in the United States is low (0.06%), the reported canine mortality rates range from 1% to 30% [4,5]. ...
... Although no relationship between echinocytosis and mamushi envenomation has been reported, echinocytosis appears to be a reasonably good marker in dogs because the venom of this snake also contains phospholipase A2. Thrombocytopenia and acute kidney injury are common conditions following hemorrhagic envenomation in both humans and dogs [2,3,5,21,23,28,29]. However, in our study, the mean platelet counts were within the reference ranges, and only two dogs had acute kidney injury. ...
... Regarding pain control, opioid agonists, especially fentanyl, are usually recommended because they can provide excellent short-term analgesia. And morphine should be used with caution owing to the risk of histamine release [3,23]. However, tramadol was used most frequently in the present study, possibly due to its non-narcotic properties and the fact that it is legally available and widely used in the Korean veterinary community. ...
Background:
Snakebites remain a devastating and life-threatening environmental hazard. While the management of snakebites has been well described in humans, few clinical data and guidelines exist for dogs, especially in Korea.
Objectives:
This retrospective study evaluated the clinical features of 70 dogs with snakebite wounds in Korea.
Methods:
The medical records of 72 dogs that presented to three animal hospitals from June 2008 to July 2021 were reviewed; among these, 70 dogs that met the inclusion criteria were enrolled. Their signalment, history, clinical signs, physical examination, blood analysis, treatment, and prognosis were also evaluated.
Results:
Of 70 dog owners, 35 (50%) witnessed the bite, with a mean time between bite and hospital presentation of 9.7 ± 4.1 h in 58 dogs. Blood smears were evaluated in 45 dogs, of which 28 (62%) showed echinocytosis. Anemia and acute kidney injury were found in 21 (29%) and 2 dogs (3%), respectively. A total of 37 dogs (53%) were hospitalized, 5 (7%) of which died.
Conclusions:
The most significant finding was the high prevalence of echinocytosis. The data from this retrospective study could inform the management of dogs bitten by snakes in Korea.
... 18,19 Coagulation panels may also show increased prothrombin times and activated partial thromboplastin times, especially in cases of severe envenomation. 20,21 In the current report, the CBC and plasma biochemistry panels were relatively unremarkable. Although hematologic changes are well documented among human, canine, and feline cases of rattlesnake envenomation, they are unknown in avian species. ...
Envenomation in avian species can result in death, with few cases of successful treatment described. A juvenile, wild-caught, intact female red-tailed hawk (Buteo jamaicensis) used in falconry was presented for emergency evaluation after being bitten by a Northern Pacific rattlesnake (Crotalus oreganus) approximately 2 hours before presentation. On presentation, the bird was quiet, alert, and responsive, with moderate swelling and discomfort of the digits on the right foot. Complete blood count (CBC) and plasma biochemistry abnormalities included a regenerative left shift, severe lymphopenia, and a moderate hypoproteinemia characterized by moderate hypoalbuminemia. Analgesic and antibiotic medications were administered during hospitalization. In addition, 5 mL of VenomVet was administered intravenously with crystalloid fluids over 60 minutes; no adverse effects were noted secondary to infusion. Improvement in the swelling was observed immediately after antivenom administration and nearly resolved within 12 hours. Complete resolution of digital swelling with no discomfort on palpation of that foot was observed 1 week after initial presentation. Blood collected at the 1 week reexamination was submitted for a CBC and plasma biochemistry panel. The results of the CBC revealed a reduced regenerative left shift, increased heterophil count, and a moderate monocytosis; the lymphopenia was resolved. A mild hypoalbuminemia still persisted. Ten months after presentation, the bird was reported to be doing well with no changes in function of the right foot and subsequently released from captivity.
... However, there are no official reports on snake bites in veterinary medicine in South Korea. In North America, snake bites in dogs and cats are approximately 30-fold the number of human cases [4,5]. Contrarily, almost equal numbers of snake bites in humans and companion animals have been reported in Australia [6]. ...
Snake envenomation may lead to venom-induced consumptive coagulopathy (VICC), usually diagnosed by classical coagulation tests (CCTs), such as prothrombin time (PT) and activated partial thromboplastin time (aPTT). However, the results of CCTs are frequently normal in the initial stages, which may delay anti-venom treatments. Thromboelastography (TEG) is a point-of-care and real-time diagnostic tool that enables a comprehensive assessment of the coagulation process. This in vitro study aimed to determine concentration-dependent changes in canine blood caused by Gloydius ussuriensis (G. ussuriensis) envenomation using TEG and CCTs. Lyophilized G. ussuriensis venom was reconstructed using mouse intravenous lethal dose 50 (LD50iv) and serially diluted to 25% LD50iv, 50% LD50iv, and 75% LD50iv to reproduce VICC at different concentrations. Normal saline was used for the control. We compared TEG values of the reaction time (R), kinetic time (K), rate of clot formation (α-angle), maximum amplitude (MA), fibrinolysis at 30 min (LY30), and global strength of the clot (G) with those of PT, aPTT, fibrinogen, and platelet counts (PLTs). Most TEG parameters, except R and LY30, demonstrated statistically significant changes compared with the control at all concentrations. CCTs, except PLTs, revealed significant changes at ≥50% LD50iv. Thus, TEG could be a useful diagnostic strategy for early VICC and preventing treatment delay.
... It is usually based on the severity of the clinical signs and the experience of the clinician managing each case.2 The average human dose of Fab antivenom in the United States is reported between 10 and 12 vials, but cumulative doses up to 75 vials have been described in the literature.1,33 One report suggests that amount of antivenom per kilogram of body weight may be a more useful assessment of dosing in veterinary patients, because there is such variability in size relative to human patients.2 ...
Objectives
To describe the clinicopathological characteristics of dogs that develop acute kidney injury (AKI) secondary to pit viper envenomation, and to describe the association between development of AKI and clinical course and outcome.
Design
Retrospective study.
Setting
University teaching hospital.
Animals
Client‐owned dogs treated with at least 1 vial of antivenom following pit viper envenomation and that had at least 2 plasma creatinine concentrations measured during the course of hospitalization.
Interventions
None.
Measurements and Main Results
Sixty‐three dogs met the inclusion criteria. One was excluded due chronic kidney disease, and 6 were excluded due to nonsteroidal anti‐inflammatory drug administration. Of the 56 dogs included in the study, 16 developed AKI (29%). Dogs with AKI received a significantly higher dose of antivenom, 8.7 ± 6.8 total vials versus dogs in the non‐AKI group that received 4.2 ± 2.6 vials (P = 0.006). Dogs in the AKI group were significantly more tachycardic (P = 0.028), hypotensive (P = 0.002), had a higher shock index (P = 0.012), and were more likely to receive transfusions with packed red blood cells (P = 0.042) than dogs in the non‐AKI group. No significant association was identified between the development of AKI and length of hospitalization. The only factors that were significantly associated with degree of severity of AKI included the receipt of blood transfusion (P = 0.006) and number of vials of antivenom administered (P = 0.03). The development of AKI was significantly associated with outcome (P < 0.001), with 5 of 16 (31%) dogs in the AKI group surviving to discharge, 7 of 16 (44%) dying, and 4 of 16 (25%) being euthanized versus 39 of 40 (98%) surviving to discharge in the non‐AKI group and 1 of 40 (2%) dying in hospital.
Conclusion
Development of AKI in dogs following pit viper envenomation carries an increased risk of mortality that is associated with severity of shock at presentation and increased doses of antivenom administration.
... Pit vipers inhabit Asia, North America, Europe, and Africa [1]. Envenomation through a pit viper bite is frequently reported, and it can lead to critical illnesses [1,2]. ...
... Pit vipers inhabit Asia, North America, Europe, and Africa [1]. Envenomation through a pit viper bite is frequently reported, and it can lead to critical illnesses [1,2]. Venom-induced consumption coagulopathy (VICC) is a central issue following a pit viper bite because it can be lethal [2]. ...
... Venom-induced consumption coagulopathy (VICC) is a central issue following a pit viper bite because it can be lethal [2]. However, it is currently difficult to characterize coagulopathy and identify specific treatment because of the complex pathophysiology of coagulopathy following a pit viper bite [1]. ...
Pit viper venom commonly causes venom-induced consumptive coagulopathy (VICC), which can be complicated by life-threatening hemorrhage. VICC has a complex pathophysiology affecting multiple steps of the coagulation pathway. Early detection of VICC is challenging because conventional blood tests such as prothrombin time (PT) and activated partial thromboplastin time (aPTT) are unreliable for early-stage monitoring of VICC progress. As the effects on the coagulation cascade may differ, even in the same species, the traditional coagulation pathways cannot fully explain the mechanisms involved in VICC or may be too slow to have any clinical utility. Antivenom should be promptly administered to neutralize the lethal toxins, although its efficacy remains controversial. Transfusion, including fresh frozen plasma, cryoprecipitate, and specific clotting factors, has also been performed in patients with bleeding. The effectiveness of viscoelastic monitoring in the treatment of VICC remains poorly understood. The development of VICC can be clarified using thromboelastography (TEG), which shows the procoagulant and anticoagulant effects of snake venom. Therefore, we believe that TEG may be able to be used to guide hemostatic resuscitation in victims of VICC. Here, we aim to discuss the advantages of TEG by comparing it with traditional coagulation tests and propose potential treatment options for VICC.
... Indeed, although statistics are hard to find, dogs are subjected to rattlesnake bites in significant numbers. In the United States, it is estimated that about 150,000 dogs and cats are victims of pit vipers annually (Peterson, 2006). In just a 2-year period in Maricopa County, Arizona, there were 272 reported cases of dog envenomation by rattlesnakes (Witsil, Wells, Woods, & Rao, 2015). ...
Although the rattling of rattlesnakes (Crotalus and Sistrurus) is widely accepted as being aposematic, the hypothesis that rattling deters approach from the snake's potentially dangerous adversaries has not been well tested. In a controlled study using rattling recorded from captive rattlesnakes (C. oreganus helleri) and a variety of comparison sounds or no‐sound controls, domestic dogs (Canis familiaris) showed no hesitation to approach camouflaged speakers projecting the recorded rattles. The dogs were equally likely to approach speakers projecting rattling as they were to approach speakers playing control sounds, or speakers that were silent. Furthermore, the dogs spent no less time in front of the speakers projecting the rattles than they did in front of speakers projecting control sounds or no sound. The dogs' reactions may not be representative of other species with whom rattlesnakes come into contact, but the data suggest a need for some circumspection about the role of rattling in the rattlesnake's defensive repertoire. Our results also suggest that dogs may be vulnerable to envenomation because they fail to react to the sound of rattling with avoidance. Although rattlesnake rattles are assumed to be aposematic, we found that domestic dogs are no less likely to approach the source of playbacks of rattlesnake rattles than they are to control sounds or silence.
