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Elapid snake envenomation in horses: 52 cases (2006-2016).
Equine Vet J. 2018 Mar; 50(2):196-201.EV

Abstract

BACKGROUND

Snake envenomation is a cause of morbidity and mortality in domestic animals worldwide. The clinical features of crotalid snake (pit viper) envenomation are widely reported and well described in horses but elapid snake envenomation is poorly characterised.

OBJECTIVES

To describe the presentation, clinical and laboratory findings, treatment and outcome of horses with a diagnosis of elapid snake envenomation in Australia.

STUDY DESIGN

Retrospective case series.

METHODS

Medical records of horses with a diagnosis of elapid snake envenomation (2006-2016) at several university and private veterinary practices were reviewed. Inclusion criteria comprised one or more of the following: 1) observed snakebite, 2) positive snake venom detection kit (SVDK) result, 3) appropriate clinical response to treatment with antivenom or 4) supportive post-mortem findings.

RESULTS

Fifty-two cases met the inclusion criteria. Most cases (94%) demonstrated clinical signs of neurotoxicity, characterised by generalised neuromuscular weakness. Associated neurologic signs included staggering gait, muscle fasciculations, recumbency, mydriasis, ptosis and tongue paresis. Concurrent clinically important conditions included rhabdomyolysis (50%) and haemolysis (19%). Of 18 urine samples evaluated with a SVDK, only three (17%) were positive. Overall survival was favourable (86%) among 49 horses who received antivenom. Eighteen surviving horses (43%) required more than one vial of antivenom.

MAIN LIMITATIONS

Possible cases within the searchable database were not included if horses died acutely or responded to symptomatic treatment without receiving antivenom.

CONCLUSIONS

Elapid snake envenomation is primarily a syndrome of neuromuscular weakness. Supportive anamnesis or an obvious bite site is rarely encountered. In endemic areas, this diagnosis should be considered for horses with generalised neuromuscular weakness, altered mentation, rhabdomyolysis and/or haemolysis; especially during spring and summer months. Diagnostic suspicion is best confirmed by response to treatment with antivenom.

Authors+Show Affiliations

Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Victoria, Australia.Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Victoria, Australia.Scone Equine Hospital, Scone, New South Wales, Australia.School of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, Western Australia, Australia.School of Veterinary Science, The University of Queensland, Gatton, Queensland, Australia.School of Animal and Veterinary Sciences, The University of Adelaide, Roseworthy, South Australia, Australia.Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Victoria, Australia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28787774

Citation

Bamford, N J., et al. "Elapid Snake Envenomation in Horses: 52 Cases (2006-2016)." Equine Veterinary Journal, vol. 50, no. 2, 2018, pp. 196-201.
Bamford NJ, Sprinkle SB, Cudmore LA, et al. Elapid snake envenomation in horses: 52 cases (2006-2016). Equine Vet J. 2018;50(2):196-201.
Bamford, N. J., Sprinkle, S. B., Cudmore, L. A., Cullimore, A. M., van Eps, A. W., Verdegaal, E. J. M. M., & Tennent-Brown, B. S. (2018). Elapid snake envenomation in horses: 52 cases (2006-2016). Equine Veterinary Journal, 50(2), 196-201. https://doi.org/10.1111/evj.12735
Bamford NJ, et al. Elapid Snake Envenomation in Horses: 52 Cases (2006-2016). Equine Vet J. 2018;50(2):196-201. PubMed PMID: 28787774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elapid snake envenomation in horses: 52 cases (2006-2016). AU - Bamford,N J, AU - Sprinkle,S B, AU - Cudmore,L A, AU - Cullimore,A M, AU - van Eps,A W, AU - Verdegaal,E J M M, AU - Tennent-Brown,B S, Y1 - 2017/09/06/ PY - 2017/05/07/received PY - 2017/08/02/accepted PY - 2017/8/9/pubmed PY - 2018/8/18/medline PY - 2017/8/9/entrez KW - antivenom KW - haemolysis KW - horse KW - neurotoxicity KW - rhabdomyolysis KW - snakebite SP - 196 EP - 201 JF - Equine veterinary journal JO - Equine Vet. J. VL - 50 IS - 2 N2 - BACKGROUND: Snake envenomation is a cause of morbidity and mortality in domestic animals worldwide. The clinical features of crotalid snake (pit viper) envenomation are widely reported and well described in horses but elapid snake envenomation is poorly characterised. OBJECTIVES: To describe the presentation, clinical and laboratory findings, treatment and outcome of horses with a diagnosis of elapid snake envenomation in Australia. STUDY DESIGN: Retrospective case series. METHODS: Medical records of horses with a diagnosis of elapid snake envenomation (2006-2016) at several university and private veterinary practices were reviewed. Inclusion criteria comprised one or more of the following: 1) observed snakebite, 2) positive snake venom detection kit (SVDK) result, 3) appropriate clinical response to treatment with antivenom or 4) supportive post-mortem findings. RESULTS: Fifty-two cases met the inclusion criteria. Most cases (94%) demonstrated clinical signs of neurotoxicity, characterised by generalised neuromuscular weakness. Associated neurologic signs included staggering gait, muscle fasciculations, recumbency, mydriasis, ptosis and tongue paresis. Concurrent clinically important conditions included rhabdomyolysis (50%) and haemolysis (19%). Of 18 urine samples evaluated with a SVDK, only three (17%) were positive. Overall survival was favourable (86%) among 49 horses who received antivenom. Eighteen surviving horses (43%) required more than one vial of antivenom. MAIN LIMITATIONS: Possible cases within the searchable database were not included if horses died acutely or responded to symptomatic treatment without receiving antivenom. CONCLUSIONS: Elapid snake envenomation is primarily a syndrome of neuromuscular weakness. Supportive anamnesis or an obvious bite site is rarely encountered. In endemic areas, this diagnosis should be considered for horses with generalised neuromuscular weakness, altered mentation, rhabdomyolysis and/or haemolysis; especially during spring and summer months. Diagnostic suspicion is best confirmed by response to treatment with antivenom. SN - 2042-3306 UR - https://www.unboundmedicine.com/medline/citation/28787774/Elapid_snake_envenomation_in_horses:_52_cases__2006_2016__ L2 - https://doi.org/10.1111/evj.12735 DB - PRIME DP - Unbound Medicine ER -