OUTCOMES OF TREATMENT OF SNAKE AND SCORPION ENVENOMATION IN BIRDS OF PREY, WITH AND WITHOUT ANTIVENOM

Abstract

Birds of prey are vulnerable to envenomation from animals in their natural environment, including scorpions and pit vipers. Severity of clinical effects varies depending on envenomating species, dose of venom injected, and anatomic site of venom inoculation. Fatality from envenomation has been reported, but use of antivenom in birds of prey is rare. Of 18 identified cases involving envenomation in birds of prey, five received antivenom and survived, seven recovered spontaneously or with supportive care only, and six without antivenom treatment died: four bitten by rattlesnakes of genus Crotalus, one by a cottonmouth (water moccasin, Agkistrodon piscivorus), and one by a coral snake (Micrurus fulvius). Illustrative cases include (1) a California condor (Gymnogyps californianus) fatally envenomated by a rattlesnake of genus Crotalus; (2) a red-tailed hawk (Buteo jamaicensis) bitten by a western diamondback rattlesnake (Crotalus atrox) and successfully treated with IV equine whole-immunoglobulin antivenom despite an apparent acute infusion reaction; (3) a northern crested caracara (Caracara cheriway) with neurotoxicity following envenomation by a bark scorpion (Centruroides sculpturatus), successfully treated with IV equine F(ab')2 antivenom; and (4) a barn owl (Tyto alba) presumed stung by a bark scorpion, with diagnosis proved by specific enzyme-linked immunosorbent assay (ELISA), successfully treated with intramuscular equine F(ab')2 antivenom. Supportive care for envenomation includes oxygen supplementation, maintenance of airway, analgesics, and fluid therapy. Antivenom may be useful, and its use should be considered for symptomatic envenomation. Additional considerations in the context of antivenom use include dose, route of administration, volume, readiness of antihistamines and epinephrine for treatment of possible adverse events, and consultation with a medical toxinologist.