European Adder bites in dogs in southern Germany

Summary

Objective

In some regions of Germany dogs are presented to the veterinarian due to a snake bite, especially during the summer. These patients often show multiple clinical and laboratory deviations. Without a significant history diagnosis is commonly difficult. Aim of this retrospective study was to analyze exposure, physical examination and clinical pathology results as well as course and outcome in dogs presented after European adder bites.

Material and methods

Patient history of 15 dogs diagnosed with European adder bites over a 6.5-year-period were evaluated retrospectively. Normality of data distribution was tested by D’Agostino and Pearson omnibus normality test. Data were analyzed by T-test and Wilcoxon-matched-pairs-signed rank-test. P-values < 0.05 were considered significant.

Results

All 15 dogs were presented within 1–48 hours after the snakebite. Most common clinical signs were local swelling and pain. Clinical pathology results on day 1 included haemoconcentration, leukocytosis and coagulopathy. On the second day of hospitalization heart rate and haematocrit declined significantly. Treatment included fluid therapy, antibiotic and antihistaminic drugs, glucocorticosteroids, antivenom and analgesics. One of 15 dogs died on the third day of hospitalization, all others were discharged. Duration of hospitalization was between 1 and 8 days (mean 4.2 ± 1.9 days).

Clinical relevance

Dogs affected by European adder bites most often present with swelling and pain at the site of the bite, most frequently on the head and limbs. Patients require intensive symptomatic therapy including antibiotics and analgesics, if indicated. With adequate therapy survival rate is high. For some patients European adder bites may be lethal.

Keywords

Snakebite - haemoconcentration - coagulopathy - antivenom - prognosis

• Literatur

• 1 Aroch I, Yas-Natan E, Kuzi S, Segev G. Haemostatic abnormalities and clinical findings in Vipera palaestinae-envenomed dogs. Vet J 2010; 185: 180-187.
• 2 Aroch I, Harrus S. Retrospective study of the epidemiological, clinical, haematological and biochemical findings in 109 dogs poisoned by vipera xanthina palestinae . Vet Rec 1999; 144: 532-535.
• 3 Calderon L, Lomonte B, Gutierrez JM, Tarkowski A, Hanson LA. Biological and biochemical activities of Vipera berus (European viper) venom. Toxicon 1993; 31: 743-753.
• 4 Campbell A. Vipera berus berus/European adder. In: Handbook of Poisoning in Dogs and Cats. Campbell A, Chapman M. eds. Oxford: Blackwell; 2000: 254-257.
• 5 Chipaux JP. Epidemiology of snake bites in Europe: A systematic review of the literature. Toxicon 2012; 59: 86-99.
• 6 Goddard A, Schoeman JP, Leisewitz AL, Negel SS, Aroch I. Clinicopathological abnormalities associated with snake envenomation in domestic animals. Vet Clin Pathol 2011; 40: 282-292.
• 7 Grotto L, Jerushalmy Z, de Vries A. Effect of purified Vipera palestinae hemorrhage on blood coagulation and platelet function. Thrombosis et Diathesis Haemorrhagica 1969; 31: 482-495.
• 8 Hrovat A, Schoeman JP, de Laat B, Meyer E, Smets P, Goddard A, Nagel S, Daminet S. Evaluation of snake envenomation-induced renal dysfunction in dogs using early urinary biomarkers of nephrotoxicity. Vet J 2013; 198: 239-244.
• 9 Karlsson-Stiber C, Salmonson M, Persson H. A nationwide study of vipera berus bites during one year – epidemiology and morbidity of 231 cases. Clin Toxicol 2006; 44: 25-30.
• 10 Kängström LE. Snake bite (Vipera berus) in dogs and cats. Svensk veterinärtidning 1989; 41: 38-46.
• 11 Kraft W, Reiner B, Bodner C. Schlangenbisse bei Hunden. Tierärztl Prax 1998; 26 (K): 104-109.
• 12 Kini RM, Evans HJ. Effects of snake venom proteins on blood platelets. Toxicon 1990; 28: 1387-1422.
• 13 Langhorn R, Persson F, Ablad B, Goddard A, Schoeman JP, Willesen JL, Tarnow I, Kjelgaard-Hansen M. Myocardial injury in dogs with snake envenomation and its relation to systemic inflammation. J Vet Emerg Crit Care 2014; 24: 174-181.
• 14 Leisewitz AL, Blaylock RS, Kettner F, Goodhead A, Goddard A, Schoeman JP. The diagnosis and management of snakebite in dogs – a southern African perspective. J South Afr Vet Assoc 2004; 75: 7-13.
• 15 Lervik JB, Lilliehöök I, Frendin JH. Clinical and biochemical changes in 53 Swedish dogs bitten by the European adder – Vipera berus . Acta Vet Scand 2010; 52: 26-36.
• 16 Lund HS, Kristiansen V, Eggertsdóttir AV, Skancke E, Ranheim B. Adverse reactions to equine-derived F(ab’)2-antivenin in 54 dogs envenomated by Vipera berus berus. J Vet Emerg Crit Care 2013; 23: 532-537.
• 17 Palviainen M, Raekallio M, Vainionpää M, Lahtinen H, Vainio O. Evaluation of renal impairment in dogs after envenomation by the common European adder (Vipera berus berus). Vet J 2013; 198: 723-724.
• 18 Pelander L, Ljungvall I, Häggström J. Myocardial cell damage in 24 dogs bitten by the common European viper (Vipera berus). Vet Rec 2010; 166: 687-690.
• 19 Rijnberk A, Stokhof AA. General examination. In: Medical History and Physical Examination in Companion Animals. 2nd edn.. Rijnberk A, van Sluijs FS. eds. St. Louis: Elsevier; 2009: 47-62.
• 20 Sutton NM, Bates N, Campbell A. Canine adder bites in the UK: a retrospective study of cases reported to the Veterinary Poisons Information Service. Vet Rec 2011; 169: 607-611.
• 21 Samel M, Siigur J. Medium molecular weight factor X activating enzyme from Vipera berus berus venom. Toxicon 1995; 33: 41-52.
• 22 Samel M, Vija H, Rönnholm G, Siigur J, Kalkkinen N, Siigur E. Isolation and characterization of an apoptotic and platelet aggregation inhibiting L-amino acid oxidase from Vipera berus berus (common viper) venom. Biochim Biophys Acta 2006; 1764: 707-714.
• 23 Segev G, Ohad DG, Shipov A, Kass PH, Aroch I. Cardiac arrhythmias and serum cardiac troponins in Vipera palaestinae envenomation in dogs. J Vet Intern Med 2008; 22: 106-113.
• 24 Segev G, Shipov A, Klement E, Harrus S, Kass P, Aroch I. Vipera palaestinae envenomation in 327 dogs: a retrospective cohort study and analysis of risk factors for mortality. Toxicon 2004; 43: 691-699.
• 25 Siigur E, Siigur J, Nommeots M, Ilomets T. Fractionation and enzymatic activities of common viper (Vipera berus berus) venom. Toxicon 1979; 17: 623-630.
• 26 Yamada D, Sekiya F, Morita T. Prothrombin and factor X activator activities in the venoms of Viperidae snakes. Toxicon 1997; 35: 1581-1589.