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Ambulatory electrocardiography and serum cardiac troponin I measurement in 21 dogs envenomated by the European adder (Vipera berus).
J Vet Intern Med. 2020 Jul; 34(4):1369-1378.JV

Abstract

BACKGROUND

Envenomation by the European adder (Vipera berus) is common in dogs in Europe. Cardiac arrhythmias occur but clinical studies of envenomated dogs are limited.

OBJECTIVES

To describe arrhythmias in dogs within 48 hours of envenomation, and investigate associations between arrhythmia grade, serum troponin I (cTnI), and snakebite severity score (SS score).

ANIMALS

Twenty-one client-owned dogs bitten by V berus.

METHODS

Prospective cohort study of envenomated dogs. Ambulatory electrocardiograms were recorded from presentation to 48 hours after snakebite, and arrhythmias graded 0 to 3 based on frequency and severity. Serum cTnI was measured at presentation, 12 hours, 24 hours, 36 hours, and 14 days after bite. An SS score of 1 to 3 was recorded at admission and based on clinical examination.

RESULTS

All dogs survived. Twelve dogs (57%) developed arrhythmias, all of which were ventricular in origin. Severe complex ventricular arrhythmias (VAs) were observed in 6 dogs (29%). Eighty-one percent of dogs (n = 17) had increased cTnI concentrations at 1 or more time points. Dogs that developed arrhythmias had significantly higher concentrations of cTnI at 12 hours (1.67 [0.04-32.68] versus 0.03 [0.01-0.052]; P = .002), 24 hours (1.88 [0.2-14.23] versus 0.06 [0.01-2.06]; P = .009), and 36 hours (3.7 [0.02-16.62] versus 0.06 [0.01-1.33]; P = .006) after bite compared to those that did not. Contingency table analysis showed that SS score was not significantly associated with arrhythmia grade (P = .9).

CONCLUSIONS AND CLINICAL IMPORTANCE

Myocardial cell injury, reflected by increased cTnI concentrations and VAs, is common after V berus envenomation in dogs. Prolonged electrocardiography monitoring is advised, particularly where cTnI is increased.

Authors+Show Affiliations

Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway.The Norwegian Medicines Agency, Oslo, Norway.HeartVets Exeter, City Vets, Exeter, UK.Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway.Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway.Faculty of Veterinary Medicine, Department of Companion Animal Clinical Sciences, Norwegian University of Life Sciences, Oslo, Norway.Faculty of Veterinary Medicine, Department of Basic Sciences and Aquatic Medicine, Norwegian University of Life Sciences, Oslo, Norway.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32557821

Citation

Harjen, Hannah J., et al. "Ambulatory Electrocardiography and Serum Cardiac Troponin I Measurement in 21 Dogs Envenomated By the European Adder (Vipera Berus)." Journal of Veterinary Internal Medicine, vol. 34, no. 4, 2020, pp. 1369-1378.
Harjen HJ, Bjelland AA, Harris J, et al. Ambulatory electrocardiography and serum cardiac troponin I measurement in 21 dogs envenomated by the European adder (Vipera berus). J Vet Intern Med. 2020;34(4):1369-1378.
Harjen, H. J., Bjelland, A. A., Harris, J., Grøn, T. K., Anfinsen, K. P., Moldal, E. R., & Rørtveit, R. (2020). Ambulatory electrocardiography and serum cardiac troponin I measurement in 21 dogs envenomated by the European adder (Vipera berus). Journal of Veterinary Internal Medicine, 34(4), 1369-1378. https://doi.org/10.1111/jvim.15817
Harjen HJ, et al. Ambulatory Electrocardiography and Serum Cardiac Troponin I Measurement in 21 Dogs Envenomated By the European Adder (Vipera Berus). J Vet Intern Med. 2020;34(4):1369-1378. PubMed PMID: 32557821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ambulatory electrocardiography and serum cardiac troponin I measurement in 21 dogs envenomated by the European adder (Vipera berus). AU - Harjen,Hannah J, AU - Bjelland,Annelin A, AU - Harris,Joanne, AU - Grøn,Tone K, AU - Anfinsen,Kristin P, AU - Moldal,Elena R, AU - Rørtveit,Runa, Y1 - 2020/06/18/ PY - 2019/12/04/received PY - 2020/05/05/revised PY - 2020/05/11/accepted PY - 2020/6/20/pubmed PY - 2021/3/11/medline PY - 2020/6/20/entrez KW - ECG KW - Holter monitoring KW - adder KW - ambulatory ECG KW - arrhythmia KW - cTnI KW - canine KW - common adder KW - envenomation KW - myocardial injury KW - snake bite KW - troponin KW - ventricular arrhythmia SP - 1369 EP - 1378 JF - Journal of veterinary internal medicine JO - J Vet Intern Med VL - 34 IS - 4 N2 - BACKGROUND: Envenomation by the European adder (Vipera berus) is common in dogs in Europe. Cardiac arrhythmias occur but clinical studies of envenomated dogs are limited. OBJECTIVES: To describe arrhythmias in dogs within 48 hours of envenomation, and investigate associations between arrhythmia grade, serum troponin I (cTnI), and snakebite severity score (SS score). ANIMALS: Twenty-one client-owned dogs bitten by V berus. METHODS: Prospective cohort study of envenomated dogs. Ambulatory electrocardiograms were recorded from presentation to 48 hours after snakebite, and arrhythmias graded 0 to 3 based on frequency and severity. Serum cTnI was measured at presentation, 12 hours, 24 hours, 36 hours, and 14 days after bite. An SS score of 1 to 3 was recorded at admission and based on clinical examination. RESULTS: All dogs survived. Twelve dogs (57%) developed arrhythmias, all of which were ventricular in origin. Severe complex ventricular arrhythmias (VAs) were observed in 6 dogs (29%). Eighty-one percent of dogs (n = 17) had increased cTnI concentrations at 1 or more time points. Dogs that developed arrhythmias had significantly higher concentrations of cTnI at 12 hours (1.67 [0.04-32.68] versus 0.03 [0.01-0.052]; P = .002), 24 hours (1.88 [0.2-14.23] versus 0.06 [0.01-2.06]; P = .009), and 36 hours (3.7 [0.02-16.62] versus 0.06 [0.01-1.33]; P = .006) after bite compared to those that did not. Contingency table analysis showed that SS score was not significantly associated with arrhythmia grade (P = .9). CONCLUSIONS AND CLINICAL IMPORTANCE: Myocardial cell injury, reflected by increased cTnI concentrations and VAs, is common after V berus envenomation in dogs. Prolonged electrocardiography monitoring is advised, particularly where cTnI is increased. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/32557821/Ambulatory_electrocardiography_and_serum_cardiac_troponin_I_measurement_in_21_dogs_envenomated_by_the_European_adder__Vipera_berus__ DB - PRIME DP - Unbound Medicine ER -