Prospective evaluation of the incidence of wound infection in rattlesnake envenomation in dogs

J Vet Emerg Crit Care (San Antonio). 2015 Jul-Aug;25(4):546-51. doi: 10.1111/vec.12337. Epub 2015 Jun 25.

Abstract

Objective: To evaluate the incidence of wound infection following crotalidae envenomation in dogs and determine if the use of prophylactic antibiotics is warranted.

Design: Prospective observational study.

Setting: A 24-hour private practice specialty and emergency center in Murrieta, California.

Animals: One hundred and two dogs with acute rattlesnake envenomation.

Interventions: One hundred and forty-three consecutive cases of suspected acute rattlesnake envenomation were evaluated between March of 2012 and May of 2013. One hundred and two cases received no antimicrobials as part of management. Eight cases were placed on prophylactic antimicrobials by the primary care veterinarian prior to referral and were excluded. Two cases were excluded because they were initiated on antimicrobials during hospitalization for reasons unrelated to snakebite. Three cases involved cats and were excluded. Three patients died acutely near the time of presentation and were excluded. Twenty-one cases of suspected envenomation were excluded for lack of strong evidence of snakebite. Four cases were lost to follow-up and were excluded. Follow-up was conducted within 2 weeks either by phone or by direct inspection of the wound.

Results: Of the 102 patients included in the study only 1 infection developed. This patient developed an abscess subsequent to suspected compartment syndrome.

Conclusion: The incidence of wound infection in rattlesnake envenomation is low, and the use of prophylactic antimicrobials is not recommended. The use of antimicrobials should be reserved for wounds with necrosis or abscess and the choice of antimicrobial should be based on a culture and sensitivity of the wound.

Keywords: compartment syndrome; echinocytes; snakebite; venom-induced coagulopathy.

MeSH terms

  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Antivenins / therapeutic use
  • California / epidemiology
  • Crotalid Venoms / therapeutic use
  • Crotalus*
  • Dog Diseases / drug therapy
  • Dog Diseases / epidemiology*
  • Dog Diseases / etiology
  • Dogs
  • Emergencies / veterinary
  • Female
  • Incidence
  • Male
  • Prospective Studies
  • Snake Bites / complications
  • Snake Bites / veterinary*
  • Wound Infection / drug therapy
  • Wound Infection / epidemiology
  • Wound Infection / etiology
  • Wound Infection / veterinary*

Substances

  • Anti-Bacterial Agents
  • Antivenins
  • Crotalid Venoms