Case 3
A 15 week-old, 9.1 kg female intact Golden Retriever puppy was examined
within 30 minutes of suspected pit viper envenomation after being found
outside with a left swollen muzzle and two puncture wounds two
centimeters apart. Aside from moderate left-sided facial swelling, the
physical examination was unremarkable. Vitals were normal and the pain
score* was 0/4. Abnormal clinicopathologic parameters
included mild hypoproteinemia [TS 50 g/L (5 g/dL), reference range
65-80 g/L 6.5-8 g/dL)] with slight hemolysis and hypocoagulability
(ACT >999s; reference range 80-120s). The SSS was 6/20 and
one vial of diluted F(ab)2 antivenom§was administered IV over four hours, followed by IV
LRS¶ at 3 mL/kg/hr. Six hours post-presentation, the
ACT remained too high to read and the SSS was 6/20. A second vial of
diluted F(ab)2 antivenom§ was
administered IV over four hours. The puppy was hospitalized overnight
where coagulopathy resolved and clinical improvement occurred with lower
SSS values of 2/20 and 1/20 at 13 hours and 25 hours after admission,
respectively. By day two, the puppy was clinically stable and
discharged.