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When is Snakebite Antivenin Really Needed?

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A client relayed a story to me on how they had to take their four year old ninety pound hunting dog to an emergency clinic because she had been bitten by a copperhead.

 

The bill ended up being just under $2000, with the fee for the antivenin comprising nearly half of that amount. No doubt the antivenin helped speed the recovery process in this particular case, but the dog would have probably done just fine without it. And at $300 to $500 a vial, with multiple vials sometimes needed, it can add up fast.

I have to say that in over twenty years of veterinary practice (with over ten years as an emergency clinician), I've treated multiple cases of snakebite (mostly copperheads and water moccasins) and never used antivenin. I never lost a patient either. Does this mean it's never needed? "Never" is a strong word. Here are a few scenerios where antivenin might come in handy:

1. Cats, puppies and adult dogs that weigh less than 20 lbs and are bitten by a rattlesnake or a cottonmouth.

2. All dogs and cats that are bitten by exceptionally large snakes, especially large rattlesnakes.

3. All dogs and cats that are bitten on the tongue or on the torso, regardless of the type of snake involved.

4. All dogs and cats that receive multiple bite wounds, regardless of the type of snake involved.

5. All dogs and cats that are bitten by a dying snake, regardless of the type of snake involved. In case you didn't know, the attitude of the snake at the time of the bite can determine the severity of intoxication. For example, snakes that bite defensively will deliver less venom than those aggressive ones that take the offensive. In some instances, defensive bites may not deliver any venom whatsoever. The worst type of envenomation will come from a snake that is agonal, or in its death throes. In nearly all of these cases, the snake will inject its full complement of venom into its victim.

6. All dogs and cats bitten by a coral snake. Antivenin is a MUST in these cases. Unfortunately, supplies of coral snake antivenin are extremely limited and may not be available in the near future.

Those cases of mine I told you about earlier? None of them fell into the above categories. Most snake bites veterinarians see occur in medium to large size dogs (especially hunting dogs) that get bitten on the face. And these dogs usually do just fine on a standard course of intravenous fluids, antibiotics, and pain medication.

Sometimes the bites occurred on the legs and digits. These "digit" bites seemed to always take a long time to heal and timely antivenin therapy would probably help shorten this recovery period. If you can afford it, then by all means have your veterinarian administer antivenin in the event of a snakebite. But if you can't afford, chances are your pet will do fine without it with standard supportive care. Let your veterinarian know about your cost concerns. He/she will be able to advise you on the best course of action based on your pet's own unique circumstance.




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