A retrospective evaluation of eastern coral snake envenomation and antivenom administration in cats: 30 cases (2012–2019)

Maxwell, Kathleen; Fraser, Brittney; Schaer, Michael; Allen, Ashley E.

doi:10.1016/j.toxicon.2020.11.177

Cited by 1 publication

(6 citation statements)

References 22 publications

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“…Besides the one dog that was euthanized four days after discharge related to catheter site infection, no owner reported complications after discharge. These findings are consistent with the previous literature reporting 87.5 to 100% survival in cats and dogs [ 8 , 9 , 11 ]. The patient mortality rate of ventilator patients was 33% in this study, while the mortality rate in a previous study was only 12.5% [ 9 ].…”

Section: Discussionsupporting

confidence: 93%

“…Pigmenturia was not documented in any cats because of the known absence of coral snake-induced hemolysis in this species, thereby causing clinicians not to assess the urine. These findings agree with a previous retrospective of 30 cats exposed to coral snakes from 2012 to 2019, which reported no significant hemolysis and a 97% survival rate [ 11 ]. Together, these findings support that cats can have an excellent prognosis after coral snake exposure and that feline erythrocytes are more resistant to the hemolytic effects of phospholipase-A2 in coral snake venom compared to dog erythrocytes [ 10 ].…”

Section: Discussionsupporting

confidence: 93%

“…While treatment with emergency epinephrine (0.01 mg/kg IM) has been previously reported for the treatment of anaphylaxis secondary to antivenom administration, the pre-drawing of epinephrine during antivenom administration was not routinely practiced in this patient population, presumably due to the low occurrence of such reactions (<5%) [ 8 ]. This lack of hypersensitivity reaction agrees with previous veterinary studies that have documented a low incidence of adverse reactions with coral snake antivenom administration [ 8 , 9 , 11 ]. However, caution should be exercised regarding the possibility of such reactions.…”

Section: Discussionsupporting

confidence: 91%

“…In contrast, humans, cats, and rabbits resist phospholipase-A2-induced hemolysis due to lower ratios of phosphatidylcholine/sphingomyelin in the erythrocyte plasma membrane [10]. This finding is supported by a retrospective of thirty cats with suspected coral snake envenomation, with only two cats having hemolysis documented, which was expected to be an artifact, supported by the absence of pigmenturia in these cats [11]. However, the incidence of hemolysis in dogs suffering from Micrurus fulvius envenomation has not been explicitly reported.…”

Section: Introductionmentioning

confidence: 75%

“…Previous studies have called for point-of-care diagnostic tests specific to Micrurus fulvius venom. An ELISA test for coral snake venom has been previously described in people, and there is ongoing research on a multiplex lateral flow assay to differentiate different venomous snakes in Brazil [ 11 , 29 , 30 ]. This would allow for significant savings in resources (antivenom, cage space for patients under monitoring for development of clinical signs, nursing care, etc.)…”

Section: Discussionmentioning

confidence: 99%

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Retrospective Evaluation of Clinical and Clinicopathologic Findings, Case Management, and Outcome for Dogs and Cats Exposed to Micrurus fulvius (Eastern Coral Snake): 92 Cases (2021–2022)

Sullivan,

Aasen,

Fisher

et al. 2024

Toxins

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This retrospective, observational study describes the clinical findings, case management trends, and outcomes of 83 dogs and nine cats exposed to eastern coral snakes in a university teaching hospital setting. The medical records of dogs and cats that received antivenom following coral snake exposure were reviewed. Data collected included signalment, time to antivenom administration, physical and laboratory characteristics at presentation, clinical course during hospitalization, length of hospitalization, and survival to discharge. The mean time from presentation to coral snake antivenom administration was 2.26 ± 1.46 h. Excluding cases where the owner declined in-hospital care, the mean hospitalization time for dogs and cats was 50.8 h and 34 h, respectively. The mean number of antivenom vials was 1.29 (1–4). Gastrointestinal signs (vomiting and ptyalism) occurred in 42.2% (35/83) of dogs and 33.3% (3/9) of cats. Peripheral neurologic system deficits (ataxia, paresis to plegia, absent reflexes, and hypoventilation) were noted in 19.6% (18/92) of dogs and cats. Hemolysis was also common in 37.9% (25/66) of dogs but was not observed in cats. Mechanical ventilation (MV) was indicated in 12% (10/83) of dogs but no cats. Acute kidney injury (AKI), while rare, was a common cause of euthanasia at 20% (2/5) and was the most common complication during MV at 44.4% (4/9). Pigmenturia/hemolysis occurred in 88.9% (8/9) of MV cases and in all cases with AKI. Despite delays in antivenom administration by several hours, dogs and cats with coral snake exposure have low mortality rates (6% of dogs (5/83) and 0% of cats). Gastrointestinal signs were common but were not predictive of progression to neurological signs. Thus, differentiating between coral snake exposure and envenomation before the onset of neurological signs remains challenging.

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