title: The effect of a single dose of prednisolone in dogs envenomated by Vipera berus--a randomized, double-blind, placebo-controlled clinical trial.
abstract: BACKGROUND
  Treatment with glucocorticoids after snakebite in dogs is controversial and randomized clinical studies are missing. The objective of this study was to investigate the effect of a single dose of prednisolone in dogs envenomated by Vipera berus in a double-blind placebo-controlled study, after exclusion of dogs treated with antivenom. The two treatment groups were compared regarding clinical status and clinicopathological test results. A total of 75 dogs bitten by Vipera berus within the previous 24 hours were included. Clinical assessment, blood sampling and measurement of the bitten body part were done at admission (Day 1), after 24 hours (Day 2) and at a re-examination (Re-exam) after 10-28 days. Dogs were given prednisolone 1 mg/kg bodyweight (PRED) or saline (PLACEBO) subcutaneously in a randomized, double-blind clinical trial. Dogs were examined clinically and mental status and extent of edema were described. Furthermore, appetite, vomiting, diarrhea, cardiac arrhythmia and death were recorded. Concentrations of C-reactive protein (CRP) and high sensitivity cardiac Troponin I (cTnI), hematology variables and Prothrombin time (PT) were determined. Systemic inflammation was defined as present if CRP > 35 mg/l.
  
  
  RESULTS
  None of the dogs died during the study period. The mental status was reduced in 60/75 (80%) of dogs on Day 1, compared to 19/75 (25%) on Day 2. The proportion of dogs with no or only mild edema increased significantly from Day 1 to Day 2. About one-third of the dogs developed gastrointestinal signs during the study period. Cardiac arrhythmia was uncommon. Clinicopathological changes included increased total leucocyte count, CRP and troponin concentration on Day 2. The cTnI concentration was increased in dogs with systemic inflammation, compared to dogs without systemic inflammation. A single dose of prednisolone did not significantly affect any of the clinical or clinicopathological parameters studied, except for a higher monocyte count on Day 2 in dogs that had received prednisolone treatment.
  
  
  CONCLUSIONS
  The results of the present study do not support routine administration of a single dose of prednisolone 1 mg/kg subcutaneously in dogs bitten by Vipera berus.
authors.affiliation: Evidensia Södra Djursjukhuset, Månskärsvägen 13, SE-141 75, Kungens Kurva, Sweden. erika.brandeker@evidensia.se.
authors.forename: Erika
authors.initials: E
authors.lastname: Brandeker
authors.affiliation: Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, , SE-750 07, Uppsala, Sweden. anna.hillstrom@slu.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Hillström
authors.affiliation: Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, , SE-750 07, Uppsala, Sweden. sofia.hanas@slu.se.
authors.forename: Sofia
authors.initials: S
authors.lastname: Hanås
authors.affiliation: Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, , SE-750 07, Uppsala, Sweden. ragnvi.hagman@slu.se.
authors.forename: Ragnvi
authors.initials: R
authors.lastname: Hagman
authors.affiliation: Department of Clinical Sciences, Swedish University of Agricultural Sciences, Box 7054, , SE-750 07, Uppsala, Sweden. bodil.strom-holst@slu.se.
authors.forename: Bodil Ström
authors.initials: BS
authors.lastname: Holst
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004311:Double-Blind Method; D005260:Female; D007279:Injections, Subcutaneous / Q000662:veterinary; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage / Q000627:therapeutic use*; D012909:Snake Bites / Q000188:drug therapy / Q000662:veterinary*; D017819:Viperidae
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone