Case 5
A 20 week-old, 15.2 kg female intact Australian Blue Heeler was presented after an unwitnessed bite 30 minutes prior to arrival. Physical examination revealed moderate right-sided muzzle swelling with two bleeding puncture wounds ventral to the right eye. The puppy appeared dull, nauseous and had a tense abdomen. The puppy’s pain score* was 2/4; and vitals were normal. Abnormal clinicopathologic parameters included mild hyperlactatemia (2.4 mmol/L; reference range 0.4-1.5 mmol/L) and hemolyzed serum with a normal PCV and TS, 53% (reference range 33-55%) and 78 g/L (7.8 g/dL) [reference range 65-80 g/L (6.5-8.0 g/dL)], respectively. Blood smear revealed echinocytosis and mild thrombocytopenia (mean 9 platelets per HPF; reference range >10 platelets/HPF). Systolic blood pressure was 90 mm Hg, and the ACT was 58 seconds (reference range 80-120 s). The SSS was 5/20. The puppy was administered one vial of diluted F(ab)2 antivenom§ IV over 30 minutes and a second vial over the next 2 hours along with LRS IV fluids at 3 mL/kg/hr. Six hours later, the SSS remained 5/20. The puppy was hospitalized overnight for monitoring. The facial swelling continued to spread, but the pain resolved. By day two, the appetite was hearty, the SSS had decreased to 2/20, and the puppy was discharged.