This manuscript describes the extended clinical abnormalities that can occur in severe snake envenomation and the clinical signs associated with antivenom hypersensitivity in a 3 yr old dog. Treatment consisted of IV fluid therapy, analgesics, a vasopressor, cardiac antiarrhythmia drugs, and polyvalent pit viper antivenom. Following initial response to treatment, relapse of clinical signs occurred. Most interesting was the recrudescence of clinical signs on day 7 that may have been caused by the release of deposited venom during surgical debridement of necrotic skin. The resulting extensive clinical signs required multiple vials of antivenom (22 vials over a 7 day period). Both F(ab′)2 antivenom and antivenin (Crotalidae) polyvalent were used in this dog because of availability logistics. It is thought that this large amount of antivenom resulted in type I (anaphylaxis) and type III hypersensitivity (serum sickness) reactions. The dog made a complete clinical recovery. This description of extended, fluctuating clinical abnormalities that were associated with envenomation together with the development of hypersensitivity reactions that were presumably secondary to antivenom administration is information that can be useful for the management of patients afflicted with severe pit viper envenomation.
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September/October 2015
Case Reports|
September 01 2015
Severe Pit Viper Envenomation with Extended Clinical Signs and Treatment Complications in a Dog
Michael Schaer, DVM, DACVIM, DACVECC;
Michael Schaer, DVM, DACVIM, DACVECC
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
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Gareth J. Buckley, MA, VetMB, MRCVS, DACVECC;
Gareth J. Buckley, MA, VetMB, MRCVS, DACVECC
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
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Bobbi J. Conner, DVM, DACVECC;
Bobbi J. Conner, DVM, DACVECC
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
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Laura C. Cuddy, MS, MVB;
Laura C. Cuddy, MS, MVB
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
*Laura C. Cuddy's updated credentials since article acceptance are MS, MVB, DACVS.
**Laura C. Cuddy's present affiliation is University College Dublin, Dublin, Ireland.
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Alessio Vigani, PhD, DVM, DACVA;
Alessio Vigani, PhD, DVM, DACVA
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
†Alessio Vigani's updated credentials since article acceptance are PhD, DVM, DACVA, DACVECC.
††Alessio Vigani's present affiliation is North Carolina State University, Raleigh, NC.
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Allison E. Vansickle, DVM;
Allison E. Vansickle, DVM
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
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James G. Coisman, DVM;
James G. Coisman, DVM
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
§James G. Coisman's updated credentials since article acceptance are DVM, DACVS.
§§James G. Coisman's present affiliation is United States Army, Fort Belvoir, VA.
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Deanna R. DeVuyst, DVM;
Deanna R. DeVuyst, DVM
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
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Carsten Bandt, DVM, DACVECC
Carsten Bandt, DVM, DACVECC
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL (M.S., G.B., B.C., L.C., A.V., A.E.V., J.C., C.B.); and Lake Veterinary Clinic, Mt. Dora, FL (D.D.).
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J Am Anim Hosp Assoc (2015) 51 (5): 329–337.
Citation
Michael Schaer, Gareth J. Buckley, Bobbi J. Conner, Laura C. Cuddy, Alessio Vigani, Allison E. Vansickle, James G. Coisman, Deanna R. DeVuyst, Carsten Bandt; Severe Pit Viper Envenomation with Extended Clinical Signs and Treatment Complications in a Dog. J Am Anim Hosp Assoc 1 September 2015; 51 (5): 329–337. doi: https://doi.org/10.5326/JAAHA-MS-6234
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