这次回顾,观察性研究描述了临床发现,案件管理趋势,以及在大学教学医院环境中暴露于东部珊瑚蛇的83只狗和9只猫的结果。回顾了在珊瑚蛇暴露后接受抗蛇毒血清的狗和猫的医疗记录。收集的数据包括信号,抗蛇毒血清管理时间到了,演示时的物理和实验室特征,住院期间的临床过程,住院时间,生存到出院。从提交到珊瑚蛇抗蛇毒血清管理的平均时间为2.26±1.46小时。不包括所有者拒绝住院护理的情况,狗和猫的平均住院时间为50.8h和34h,分别。抗蛇毒血清小瓶的平均数目为1.29(1-4)。胃肠道症状(呕吐和呕吐)发生在42.2%(35/83)的狗和33.3%(3/9)的猫中。周围神经系统缺陷(共济失调,麻痹至麻痹,无反射,和通气不足)的狗和猫占19.6%(18/92)。溶血在37.9%(25/66)的狗中也很常见,但在猫中没有观察到。12%(10/83)的狗指示机械通气(MV),但没有猫。急性肾损伤(AKI),虽然罕见,是安乐死的常见原因,占20%(2/5),是MV期间最常见的并发症,占44.4%(4/9)。88.9%(8/9)的MV病例和所有AKI病例发生色素尿/溶血。尽管抗蛇毒血清管理延迟了几个小时,接触珊瑚蛇的狗和猫的死亡率较低(6%的狗(5/83)和0%的猫)。胃肠道体征很常见,但不能预测神经系统体征的进展。因此,在神经系统症状出现之前区分珊瑚蛇的暴露和毒液仍然具有挑战性。
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.