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.