title: Successful use of camelid (alpaca) antivenom to treat a potentially lethal tiger snake (Notechis scutatus) envenomation in a dog.
abstract: This report describes a confirmed clinical case of tiger snake (Notechis scutatus) envenomation in a domestic dog that was successfully treated with a novel polyvalent camelid (alpaca; Llama pacos) antivenom. Samples collected from the dog were assayed for tiger snake venom (TSV) using a highly sensitive and specific ELISA. The TSV concentration in serum and urine at initial presentation was 365 ng/mL and 11,640 ng/mL respectively. At the time of initial presentation whole blood collected from the dog did not clot and the Prothrombin Time was abnormally increased (>300 s). Serum was also visibly hemolysed. The dog was administered antihistamine, dexamethasone and 4000 Units (sufficient to neutralise 40 mg of TSV) of a novel polyvalent alpaca antivenom diluted in 0.9% NaCl. At 4 h post-antivenom treatment the dog's clinical condition had improved markedly with serum TSV concentrations below the limit of detection (<0.015 ng/mL), consistent with complete binding of venom antigens by the alpaca antivenom. Coagulation parameters had begun to improve by 4 h and had fully normalised by 16 h post-antivenom. Venom concentrations in both serum and urine remained undetectable at 16 h post-antivenom. The dog made a complete recovery, without complications, suggesting that the alpaca-based antivenom is both clinically safe and effective.
authors.affiliation: Australian Venom Research Unit, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Melbourne, Parkville, Australia. Electronic address: andrew.padula@unimelb.edu.au.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Padula
authors.affiliation: Australian Venom Research Unit, Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Melbourne, Parkville, Australia.
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Winkel
mesh_terms: D000818:Animals; D000997:Antivenins / Q000009:adverse effects / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000187:drug effects; D002161:Camelids, New World; D003907:Dexamethasone / Q000627:therapeutic use; D004283:Dog Diseases / Q000188:drug therapy*; D004285:Dogs; D004546:Elapid Venoms / Q000037:antagonists & inhibitors* / Q000097:blood / Q000652:urine; D004797:Enzyme-Linked Immunosorbent Assay; D006633:Histamine Antagonists / Q000627:therapeutic use; D012909:Snake Bites / Q000188:drug therapy / Q000662:veterinary*
chemical_list: D000997:Antivenins; D004546:Elapid Venoms; D006633:Histamine Antagonists; C072139:Notechis 11'2; D003907:Dexamethasone
keywords: Alpaca; Antibodies; Camelid antivenoms; Dog; ELISA; Immunoassays; Notechis scutatus; Snake antivenom snakebite; Snake venom; Tiger snake; Venom