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Overview and controversies in the medical management of pit viper envenomation in the dog.
J Vet Emerg Crit Care (San Antonio). 2011 Oct; 21(5):461-70.JV

Abstract

OBJECTIVE

To provide a review and update on the medical management of pit viper envenomation in dogs.

ETIOLOGY

Pit viper snake (Crotalidae) envenomation in dogs is a common emergency in the United States. At least 50 enzymes contribute to snake venom potency that causes soft tissue damage, vasculotoxicity, coagulopathy, cytotoxicity, and necrosis.

DIAGNOSIS

Snakebite envenomation may be identified by fang puncture wounds but primarily as a focal site with a rapid onset of severe swelling, hemorrhage, pain, and potentially necrosis. Crotalid venom causes hematologic abnormalities, local tissue damage, hypotension, and occasionally neurological impairment. The most marked hematologic abnormalities include thrombocytopenia, hemolytic anemia, and various forms of coagulopathy, including defibrination without disseminated intravascular coagulation (in North America), summarized as a venom-induced coagulopathy.

THERAPY

The mainstay of treatment includes intravenous crystalloid fluid therapy, antivenom, and analgesic medications. Currently available antivenom products include a mixed polyvalent Antivenin (Crotalidae) Polyvalent (ACP(a)), and Crotalinae polyvalent immune Fab (Crofab(b)). There are products from Mexico and Costa Rica that have limited availability, a similar imported Fab product (Antivipmyn(c)), and a polyspecific antivenom (Polyvet-ICP(d)), respectively. Glucocorticoids, nonsteroidal antiinflammatory drugs (NSAIDs) and antihistamines are not included in the majority of recommended treatment protocols by world authorities; however, there are some reports that describe their use. Antimicrobial therapy and blood products are used only when clinically indicated. There is a vaccine available, but at present, it is of unknown efficacy because of a lack of documented scientific information.

PROGNOSIS

Mortality from North American crotalid envenomation is generally rare and is influenced by several variables, including the amount of venom injected, the size and species of snake, the size of the victim, the location of the bite, time elapsed until treatment, and the therapy initiated. Mortality rates range from 1% to 30%.

Authors+Show Affiliations

Department of Small Animal Clinical Sciences, University of Florida Small Animal Hospital, Gainesville, FL 32610, USA.No affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

22316194

Citation

Armentano, Robert A., and Michael Schaer. "Overview and Controversies in the Medical Management of Pit Viper Envenomation in the Dog." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 21, no. 5, 2011, pp. 461-70.
Armentano RA, Schaer M. Overview and controversies in the medical management of pit viper envenomation in the dog. J Vet Emerg Crit Care (San Antonio). 2011;21(5):461-70.
Armentano, R. A., & Schaer, M. (2011). Overview and controversies in the medical management of pit viper envenomation in the dog. Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 21(5), 461-70. https://doi.org/10.1111/j.1476-4431.2011.00677.x
Armentano RA, Schaer M. Overview and Controversies in the Medical Management of Pit Viper Envenomation in the Dog. J Vet Emerg Crit Care (San Antonio). 2011;21(5):461-70. PubMed PMID: 22316194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Overview and controversies in the medical management of pit viper envenomation in the dog. AU - Armentano,Robert A, AU - Schaer,Michael, PY - 2012/2/10/entrez PY - 2012/2/10/pubmed PY - 2012/6/21/medline SP - 461 EP - 70 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 21 IS - 5 N2 - OBJECTIVE: To provide a review and update on the medical management of pit viper envenomation in dogs. ETIOLOGY: Pit viper snake (Crotalidae) envenomation in dogs is a common emergency in the United States. At least 50 enzymes contribute to snake venom potency that causes soft tissue damage, vasculotoxicity, coagulopathy, cytotoxicity, and necrosis. DIAGNOSIS: Snakebite envenomation may be identified by fang puncture wounds but primarily as a focal site with a rapid onset of severe swelling, hemorrhage, pain, and potentially necrosis. Crotalid venom causes hematologic abnormalities, local tissue damage, hypotension, and occasionally neurological impairment. The most marked hematologic abnormalities include thrombocytopenia, hemolytic anemia, and various forms of coagulopathy, including defibrination without disseminated intravascular coagulation (in North America), summarized as a venom-induced coagulopathy. THERAPY: The mainstay of treatment includes intravenous crystalloid fluid therapy, antivenom, and analgesic medications. Currently available antivenom products include a mixed polyvalent Antivenin (Crotalidae) Polyvalent (ACP(a)), and Crotalinae polyvalent immune Fab (Crofab(b)). There are products from Mexico and Costa Rica that have limited availability, a similar imported Fab product (Antivipmyn(c)), and a polyspecific antivenom (Polyvet-ICP(d)), respectively. Glucocorticoids, nonsteroidal antiinflammatory drugs (NSAIDs) and antihistamines are not included in the majority of recommended treatment protocols by world authorities; however, there are some reports that describe their use. Antimicrobial therapy and blood products are used only when clinically indicated. There is a vaccine available, but at present, it is of unknown efficacy because of a lack of documented scientific information. PROGNOSIS: Mortality from North American crotalid envenomation is generally rare and is influenced by several variables, including the amount of venom injected, the size and species of snake, the size of the victim, the location of the bite, time elapsed until treatment, and the therapy initiated. Mortality rates range from 1% to 30%. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/22316194/Overview_and_controversies_in_the_medical_management_of_pit_viper_envenomation_in_the_dog_ L2 - https://doi.org/10.1111/j.1476-4431.2011.00677.x DB - PRIME DP - Unbound Medicine ER -