Cardiac Arrhythmias and Serum Cardiac Troponins in Vipera palaestinae Envenomation in Dogs

Abstract

Dogs envenomed by V. palaestinae appear to sustain some degree of myocardial injury, as reflected by increased serum cTn concentrations and by the occurrence of arrhythmias. The latter should alert clinicians to a potentially ongoing cardiac injury. An increase in cTn-T may be of clinical relevance and indicate a cardiac injury in V. palaestinae envenomations in dogs.

Venomous snakebites in the Croatian North Dalmatia region

“…Th e natural beauty in this part of Croatia and the national park of Paklenica attract a large number of tourists during the summer season, which is also when the snakebite risk is at the highest level. Snakebite incidence in Croatia matches the average snakebite incidence of other Mediterranean countries [5,6,16]. Snakebites usually happen outside the urban area usually in the fi elds and mountain tracks [12,32,37,42] (Table 2).…”

Myocardial cell damage in 24 dogs bitten by the common European viper (Vipera berus)

“…In dogs, ischaemic heart disease is considerably less common. However, cardiac troponins can be used to detect myocardial cell injury of many different aetiologies (Lobetti and others 2002, Oyama and Sisson 2004, Burgener and others 2006, Church and others 2007, Oyama and others 2007, Prosek and others 2007, Diniz and others 2008, Pelander and others 2008, Porciello and others 2008, Segev and others 2008). One suggested clinical approach is to characterise dogs as «troponin negative/mildly elevated’ or ‘troponin positive/moderately to severely elevated’, and to use repeat measurements of cTnI to assess risk (Schober 2005).…”

“…This arrhythmia was not detected by the attending veterinarian during physical examination of this dog, probably because the heart rate was within the normal range; it was discovered when an ECG was recorded for this study. IVR was one of the two most commonly observed arrhythmias in 48 dogs bitten by V palaestinae (Segev and others 2008). It may be that IVR is more common than ventricular tachycardia in dogs bitten by snakes of the genus Vipera .…”

Myocarditis along with acute ischaemic cerebellar, pontine and lacunar infarction following viper bite

“…While acute myocardial infarction following viper bite has been well documented, myocarditis following viper envenomation has only been reported in animals—in dogs11 12 and in two horses that were injected with venom for antivenom production 13. Myocarditis is hypothesised to occur either due to direct effects of the toxin on the myocardium9 10 or hypersensitivity to the venom 14.…”