When is antivemon necessary in adder bites?

Re: When is antivemon necessary in adder bites?

Charlie Lyon — Thu, 22 Apr 2010 16:19:56 GMT

So saw the dog back today for a check - still some very slight swelling over his muzzle but this is minimal now - no signs of tissue necrosis which is always good!

He was treated with 0.3mg\kg dexamethasone IV before he left the surgery, then he was started on chlorphenamine and cold packs were applied - the swelling reduced over 12 hours and he was discharged with prednisolone daily for 10 days, chlorphenamine twice daily for 5 days and cold packs to the area for 15 mins 3 times daily.

Re: When is antivemon necessary in adder bites?

Charlie Lyon — Sun, 18 Apr 2010 22:11:14 GMT

Thank you all for your replies, we use Centaur so will have to see what they offer otherwise will look into the other sources.

The dog last year got PTS as the necrosis was so bad could lift it's lip and see the maxillary bone and it extended a long way along it's face - can't remember the exact details as it wasn't my case but do remember it being horrible.

Hopefully will have an idea of how the dog is doing tomorrow so will update then.

Re: When is antivemon necessary in adder bites?

Andrew Kent — Sat, 17 Apr 2010 19:17:55 GMT

VPIS advice is to give antivenom if the bite is to facial region and if swelling spreads beyond the next major joint proximal to the bite. It is also advisable if there is evidence of hypotension unresponsive to IVFT or ECG abnormalities.

We don't see enough to stock antivenom ourselves but can source it from a nearby Vets Now when needed.

I give under the cover of adrenaline (0.5 - 1.0 ml of 1:1000 S/C) prior to antivenom and I am yet to see adverse reaction to this.

Otherwise supportive treatment as previously discussed.

Andy

Re: When is antivemon necessary in adder bites?

Vikki Halliday LLB — Sat, 17 Apr 2010 15:51:09 GMT

[quote user="Michael Woodhouse"]Spoke to one place that had to get a certificate to obtain the antivemon[/quote]

You still have to apply for a STC from VMD, but you can do this online, if you have a previous STC, and costs nothing. If you are applying the first time, I think it has to be on paper and there is a £30 fee.

Below is the link to the VMD site.

Oh and for filling out the forms you can just use general dogs under your care in the practice.

Re: When is antivemon necessary in adder bites?

Michael Woodhouse — Sat, 17 Apr 2010 15:42:42 GMT

[quote user="Charlotte Lusted"]What is the best place to obtain antivemon from? Spoke to one place that had to get a certificate to obtain the antivemon and it cost about £190 a vial however looking at some old posts people seen to be able to get it cheaper? Wondering if that's still true?[/quote]

Which wholesaler do you use? It's on the Dunlops Catalogue for under £50. "FPANT01"

Re: When is antivemon necessary in adder bites?

Hannah Wynne Richards — Sat, 17 Apr 2010 12:02:48 GMT

It's definite that winter/early spring bites are worse-the longer it is since the adder last bit something, then the more concentrated the venom. Injecting horse protein into a dog is risky, especially if it's some curious mutt that keeps sticking it's nose where it isn't wanted, and has had it b4 !!!!!!!!!!!!!!!!

I give opioids, and IVFT, with dexadreson, and high IV boluses ( at least 20mgs/kg bid ) of crystapen-it's mostly Gm + ves and anaerobes you need worry about-need a lot of pain relief-also remember you need to kill the bacteria at the sight, so if a lot of tissue swelling, increase the crystapen so to get MIC at the depth of the wound-it's very safe unless the animal is allergic, so don't worry about overdosing -commonest mistake is the people who just give 10 mgs/kg s/c of any penicillin

Wynne

Re: When is antivemon necessary in adder bites?

Bob Russell — Sat, 17 Apr 2010 11:46:21 GMT

We do not use anti venom routinely - there are recorded cases of anaphylaxis following its use - it is packed with foreign proteins!

We would only consider its use for strikes on or around the head/neck where excessive swelling may cause problems. This was based on advice given some time ago by VPIS.

Most strikes benefit from pain relief, pain relief and more pain relief. IVFT sometimes. I do give steroids, opiates and hefty antibiotics in the hope of reducing the infection risk associated with tissue necrosis.

I am not particularly convinced that antivenom is particularly useful. If they do well without it it is unnecessary, if they do badly perhaps it might have been a good idea!!! Hind-sight will give you the answer!

Based in the New Forest we do see a lot of adder strikes. Most do well, a few are a disaster and it seems very difficult to predict the outcome for any individual.

The nastier strikes tend to be those few seen over the winter and early spring. I presume hungry adders inject more venom, fed ones inject enough to hurt and warn off!

Re: When is antivemon necessary in adder bites?

Alan Tevendale — Sat, 17 Apr 2010 10:23:40 GMT

Hi Charlotte

I've seen a couple of cases of adder bites over the last few years and sorry but can't say I have any experience of using antivenom. You are certainly right that tissue necorsis appears to be significant and presuming that you can control the pain, inflammation and infection initially then basically it's just wound managment. The last case I was involved with ended up with skin sloughing off from it's chin to mid abdomen. It took a fair amount of work to get on top of everything but the dog is now absolutely fine.

It would be good to hear how this dog gets on. What happened with the dog last year?

Alan