Background

Arachnid and snake envenomation of dogs is possible in deployed settings. This K9 CPG discusses general management of these injuries.

When arriving in theater, refer to the JTS Snake Envenomation Management and Spider and Scorpion Envenomation CPG for currently available antivenom products. Consult with a veterinary clinical specialist (MOS 64F Veterinary Clinical Medicine Officer) to see if any of these products can be used for Military Working Dogs (MWDs). Be aware that many antivenom products, including newly developed polyvalent antivenoms, such as POLYSERP™ have not been tested or approved for use in dogs.

For MWDs with severe clinical signs, prompt treatment with antivenom can be advantageous, if an appropriate product is available.

Antivenom is the only product that can neutralize venom thereby decreasing morbidity and mortality. It is optimally given within 4 hours after a snake bite, although it can be effective up to 24 hours or longer after envenomation. Mortality rates in snake bite envenomated dogs ranges from 1-30% and depends highly on the snake involved.1-4

Antivenom is often only available in select Role 2 and Role 3 facilities because of availability and several products requiring cold storage requirements. However, newly developed products such as POLYSERP™ are freeze dried and shelf stable.

Antivenoms, especially those that contain whole immunoglobulin components, must be used with caution due to the potential to induce Type I (immediate) and Type III (delayed) hypersensitivity reactions.1,3-6 Additionally, due to the equine and ovine origin of products, acute anaphylaxis has been documented as a complication and has been noted in 0.7% - 7% of patients receiving antivenom.1

Avoid cutting and/or suctioning the wound, ice, prophylactic antibiotics, prophylactic fasciotomy, routine use of blood products, and tourniquets. Try to minimize patient activity and movement of affected site.

Establish a timeline and note trend changes over time. Serial assessments and documentation are essential because the resolution or continuance of clinical signs will drive recommendations for antivenom therapy. Use of a permanent marker directly on the skin can be helpful in monitoring tissue effects over time.