Abstract
Cases of snakebite envenomation are frequently presented to veterinary practitioners in southern Africa. Despite this, no published guidelines exist on how this medical emergency should be managed. Southern African snake venoms can be classified into 3 main types based on the main mechanism of venom action and clinical presentation. A polyvalent antivenom is manufactured in South Africa and contains antibodies against the most important southern African snake venoms. The cytotoxic venoms are represented mainly by the puff-adder (Bitis arietans), Mozambique spitting cobra (Naja mossabica), black-necked spitting cobra (Naja nigricollis) (in the Western Cape and Namibia) and the stiletto snake (Atractaspis bibronii). These venoms may cause dramatic local swelling, high morbidity and low mortality and infrequently require the use of antivenom for survival (the only cytotoxic venoms used to prepare the antivenom are the puff-adder and Mozambique spitting cobra). The neurotoxic venoms (represented chiefly by the non-spitting cobras and mambas) cause high mortality due to rapid onset of paresis and require antivenom and mechanical ventilatory support which is life-saving. The boomslang (Dispholidus typus) and the vine snake (coagulopathic venom) rarely bite humans but dogs may be bitten more frequently. These venoms cause a consumption coagulopathy and successful treatment of boomslang bites requires the use of snake species-specific monovalent antivenom. There is no antivenom available for treating vine snake (Thelotornis capensis), berg adder (Bitis atropos), night adder (Causus spp.), stiletto snake and other lesser adder bites. There are some important differences between the way snakebites are managed in humans and dogs.
Highlights
Snakebite is a common medical emergency[16] with significant morbidity and mortality in small animal practice in southern Africa
The following snake venoms are used in the polyvalent antivenom manufacturing process by the South African Vaccine Producers (Pty) Ltd.: puff-adder, Gaboon adder, rinkhals, snouted cobra, Cape cobra, forest cobra, Mozambique spitting cobra, green mamba (Dendroaspis augusticeps), Jameson's mamba (D. jamesoni) and black mamba (D. polylepis).* A monovalent antivenom is produced for boomslang envenomation
Key differences include: (1) the way a diagnosis is made; (2) whereas humans are usually bitten below the knee, dogs are usually bitten around the head and neck, which in the case of cytotoxic bites may result in asphyxiation; (3) bites due to the boomslang or vine snake may well be more common in dogs than in man
Summary
Snakebite is a common medical emergency[16] with significant morbidity and mortality in small animal practice in southern Africa. EPIDEMIOLOGY Being ectotherms (cold blooded), the level of activity of a snake is determined by the temperature of its environment For this reason the highest incidence of snakebite in humans and dogs is during the warmer summer months[5,9,18,21]. Cytotoxic bites outnumber neurotoxic bites by about 10:15,9,18,21 This is likely to be similar for dogs. Morbidity is high in the case of bites from cytotoxic snake species but mortality is low. The opposite is true of bites due to the neurotoxic snake species where mortality is high and morbidity is low. Neurotoxic venoms of the family Elapidae produce progressive paresis This group is represented by the cobras (snouted, Cape and forest cobras, Naja annulifera, Naja nivea and Naja melanoleuca, respectively) and the mambas (Dendroaspis spp.).
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