title: Clinical and biochemical changes in 53 Swedish dogs bitten by the European adder--Vipera berus.
abstract: BACKGROUND
  Every year many dogs in Sweden are bitten by Vipera berus, the only venomous viper in Sweden. This prospective study investigated clinical signs, some biochemical parameters, treatment, and progress of disease after snakebite in 53 dogs. Effects of treatment with and without glucocorticoids were evaluated.
  
  
  METHODS
  All fifty-three dogs bitten by Vipera berus were examined the same day the dog was bitten and the next day. Two more examinations during 23 days post snake bite were included. Creatinine, creatine kinase (CK), alanine aminotransferase (ALT), glutamate dehydrogenase (GLDH), alkaline phosphatase (ALP) and bile acid results were followed through 3 to 4 samplings from 34 of the dogs.
  
  
  RESULTS
  All dogs had variable severity of local swelling in the bite area and 73 per cent had affected mental status. Initial cardiac auscultation examination was normal in all dogs, but six dogs had cardiac abnormalities at their second examination, including cardiac arrhythmias and cardiac murmurs. All dogs received fluid therapy, 36 dogs were given analgesics, 22 dogs were treated with glucocorticoids, and ten dogs were treated with antibiotics. Evidence of transient muscle damage (increased CK) was seen one day after the snake bite in 15 (54%) of 28 sampled dogs. Moderate changes in hepatic test results occurred in 1 dog and several dogs (22 of 34) had transient, minor increases in one or more hepatic test result. No dog died during the observation period as a consequence of the snake bite.
  
  
  CONCLUSIONS
  Snake bite caused local swelling in all dogs and mental depression of short duration in most dogs. Some dogs had transient clinical signs that could be indicative of cardiac injury and some other had transient biochemical signs of liver injury. Treatment with glucocorticoids did not have any clear positive or negative effect on clinical signs and mortality.
authors.affiliation: Södra Animal Hospital, Månskärsvägen 13, S-141 75 Kungens Kurva, Sweden. jessicabergerlervik@live.se
authors.forename: Jessica Berger
authors.initials: JB
authors.lastname: Lervik
authors.forename: Inger
authors.initials: I
authors.lastname: Lilliehöök
authors.forename: Jan H M
authors.initials: JH
authors.lastname: Frendin
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D001647:Bile Acids and Salts / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D003404:Creatinine / Q000097:blood; D004283:Dog Diseases / Q000378:metabolism*; D004285:Dogs; D005969:Glutamate Dehydrogenase / Q000097:blood; D011446:Prospective Studies; D012909:Snake Bites / Q000662:veterinary*; D013548:Sweden; D014757:Viper Venoms / Q000378:metabolism* / Q000633:toxicity; D017819:Viperidae / Q000378:metabolism*
chemical_list: D001647:Bile Acids and Salts; D014757:Viper Venoms; D003404:Creatinine; D005969:Glutamate Dehydrogenase; D000410:Alanine Transaminase; D003402:Creatine Kinase; D000469:Alkaline Phosphatase