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Evaluation of coagulation and inflammation markers as diagnostic and prognostic markers for European adder (Vipera berus) envenomation in dogs.

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We request permission to obtain blood samples from dogs bitten by Vipera berus, a group of healthy dogs and a group of dogs with similar clinical signs that may be confused for snakebite.

Vipera berus (V. berus) is the only venomous snake in Scandinavia. Envenomation of dogs by V. berus is a common seasonal emergency in Norway. Management of V. berus bites includes hospitalisation for monitoring, pain relief and often antivenom administration. Antivenom is, however, associated with adverse reactions in approximately 10% of dogs and humans. It is estimated that up to 30% of V.berus bites in dogs are void of venom, so-called ‘dry’ bites, and thereby do not necessitate treatment. Given the incidence of dry bites and the costs and potential side effects of treatment, it would be of benefit to be able to differentiate between other differential diagnoses, a dry bite, and an actual V.berus envenomation that requires treatment.

The primary aim of this study is to investigate whether haemostatic and inflammatory markers can be used as diagnostic aids in dogs suspected to have been envenomated by V. berus. A secondary aim is to investigate whether the severity of clinical signs at presentation is associated with the subsequent development of a haemostatic/inflammatory response. Thus, possibly allowing prediction of coagulopathy and prioritisation of laboratory diagnostics and treatment in snakebite patients. A final aim is to ascertain whether the haemostatic/inflammatory response differs between dogs treated with and without antivenom.

We are seeking permission to sample a total of 75 dogs with a minimum bodyweight of 5kg. These dogs will be subject to a routine physical examination and two blood sampling events. The maximum blood volume taken will be 20 ml per sampling event. Blood samples will be taken from the jugular or cephalic vein depending on the patient's preference, with a vacutainer and sterile needle. An experienced veterinarian will take the blood samples. This is a routine procedure in small animal practice and is not anticipated to cause any major discomfort to the animal.

Findings from this study could help to minimise unnecessary use of antivenom and its associated adverse effects in cases of a dry bite, whilst also allowing rapid initiation of treatment in cases where envenomation is confirmed.

Dogs are necessary for this study to specifically investigate the effects of Vipera berus bite in this species. Any overtly nervous animals will be not be sampled.