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Retrospective evaluation of neurotoxic rattlesnake envenomation in dogs and cats: 34 cases (2005-2010).
J Vet Emerg Crit Care (San Antonio). 2012 Aug; 22(4):460-9.JV

Abstract

OBJECTIVE

To describe common physical examination findings, clinicopathologic changes, treatment, and outcome in patients with evidence of neurotoxicity secondary to rattlesnake envenomation.

DESIGN

Retrospective multicenter study (2005-2010).

SETTING

Three private veterinary referral centers.

ANIMALS

Thirty-four client-owned cats and dogs with evidence of neurotoxicity secondary to rattlesnake envenomation.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Patient signalment, approximate time between envenomation and presentation for veterinary evaluation, physical examination and clinicopathologic findings, treatments, serial neurologic assessment, duration of hospitalization, and outcome were recorded. Signs of neurotoxicity such as ataxia, postural deficits, muscle fasciculations, paresis, paralysis, or seizures were required for inclusion into the study. The incidence of neurotoxicity amongst the general population treated with antivenin for rattlesnake envenomation in this study was 5.4%. Crotalidae Polyvalent Immune Fab(b) and veterinary approved Antivenin (Crotalidae) Polyvalent(a) were both used in this study. There was no statistically significant difference between type of antivenin or number of vials of antivenin administered and neurologic status, length of hospitalization (LOH), or survival. Hypokalemia was a frequently identified complication, but the presence of hypokalemia did not have a statistically significant association with LOH or survival. Four of the 34 patients (11.8%) required positive pressure ventilation for signs consistent with respiratory paralysis; 2 of these patients survived to discharge. Overall mortality rate was 17.6%. Survival was not significantly different between dogs and cats. However, cats had a significantly longer LOH when compared with dogs (median LOH 3.5 d for cats, 2 d for dogs). Cats appear to be overrepresented in the subset of envenomated patients with neurotoxicity.

CONCLUSION

Although the incidence of neurotoxicity secondary to rattlesnake envenomation may be relatively low, patients can have rapid progression of their clinical signs and a higher mortality rate, necessitating timely and appropriate treatment. Patients treated for neurotoxicity secondary to envenomation appear to have a fair to good prognosis.

Authors+Show Affiliations

Veterinary Specialty Hospital of San Diego, San Diego, CA 92121, USA. tracy.julius@vshsd.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22805363

Citation

Julius, Tracy M., et al. "Retrospective Evaluation of Neurotoxic Rattlesnake Envenomation in Dogs and Cats: 34 Cases (2005-2010)." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 22, no. 4, 2012, pp. 460-9.
Julius TM, Kaelble MK, Leech EB, et al. Retrospective evaluation of neurotoxic rattlesnake envenomation in dogs and cats: 34 cases (2005-2010). J Vet Emerg Crit Care (San Antonio). 2012;22(4):460-9.
Julius, T. M., Kaelble, M. K., Leech, E. B., Boyle, K. L., Strandberg, E. J., & Clare, M. C. (2012). Retrospective evaluation of neurotoxic rattlesnake envenomation in dogs and cats: 34 cases (2005-2010). Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 22(4), 460-9. https://doi.org/10.1111/j.1476-4431.2012.00775.x
Julius TM, et al. Retrospective Evaluation of Neurotoxic Rattlesnake Envenomation in Dogs and Cats: 34 Cases (2005-2010). J Vet Emerg Crit Care (San Antonio). 2012;22(4):460-9. PubMed PMID: 22805363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective evaluation of neurotoxic rattlesnake envenomation in dogs and cats: 34 cases (2005-2010). AU - Julius,Tracy M, AU - Kaelble,Monika K, AU - Leech,Elizabeth B, AU - Boyle,Kimberly L, AU - Strandberg,Erika J, AU - Clare,Monica C, Y1 - 2012/07/16/ PY - 2011/05/03/received PY - 2012/06/03/accepted PY - 2012/7/19/entrez PY - 2012/7/19/pubmed PY - 2013/1/25/medline SP - 460 EP - 9 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 22 IS - 4 N2 - OBJECTIVE: To describe common physical examination findings, clinicopathologic changes, treatment, and outcome in patients with evidence of neurotoxicity secondary to rattlesnake envenomation. DESIGN: Retrospective multicenter study (2005-2010). SETTING: Three private veterinary referral centers. ANIMALS: Thirty-four client-owned cats and dogs with evidence of neurotoxicity secondary to rattlesnake envenomation. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Patient signalment, approximate time between envenomation and presentation for veterinary evaluation, physical examination and clinicopathologic findings, treatments, serial neurologic assessment, duration of hospitalization, and outcome were recorded. Signs of neurotoxicity such as ataxia, postural deficits, muscle fasciculations, paresis, paralysis, or seizures were required for inclusion into the study. The incidence of neurotoxicity amongst the general population treated with antivenin for rattlesnake envenomation in this study was 5.4%. Crotalidae Polyvalent Immune Fab(b) and veterinary approved Antivenin (Crotalidae) Polyvalent(a) were both used in this study. There was no statistically significant difference between type of antivenin or number of vials of antivenin administered and neurologic status, length of hospitalization (LOH), or survival. Hypokalemia was a frequently identified complication, but the presence of hypokalemia did not have a statistically significant association with LOH or survival. Four of the 34 patients (11.8%) required positive pressure ventilation for signs consistent with respiratory paralysis; 2 of these patients survived to discharge. Overall mortality rate was 17.6%. Survival was not significantly different between dogs and cats. However, cats had a significantly longer LOH when compared with dogs (median LOH 3.5 d for cats, 2 d for dogs). Cats appear to be overrepresented in the subset of envenomated patients with neurotoxicity. CONCLUSION: Although the incidence of neurotoxicity secondary to rattlesnake envenomation may be relatively low, patients can have rapid progression of their clinical signs and a higher mortality rate, necessitating timely and appropriate treatment. Patients treated for neurotoxicity secondary to envenomation appear to have a fair to good prognosis. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/22805363/Retrospective_evaluation_of_neurotoxic_rattlesnake_envenomation_in_dogs_and_cats:_34_cases__2005_2010__ L2 - https://doi.org/10.1111/j.1476-4431.2012.00775.x DB - PRIME DP - Unbound Medicine ER -