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

Abstract

This study investigated whether myocardial damage, as reflected by increased serum concentrations of cardiac-specific troponin I (cTnI), develops in dogs as a result of a bite from a common European viper (Vipera berus), and whether this damage occurs in the absence of clinically relevant ECG abnormalities. Twenty-four dogs presented following a snake bite were tested. On admission, and after 12, 24 and 36 hours, an ECG was recorded and serum was collected for analysis of cTnI from all the dogs. Thirteen dogs (54 per cent) had an undetectable serum cTnI concentration (<0.2 microg/l) and no abnormalities on ECG, five dogs (21 per cent) had increased serum concentrations of cTnI and no ECG abnormalities, six dogs (12.5 per cent) had increased cTnI concentrations and ECG abnormalities, and six dogs (12.5 per cent) had ECG abnormalities and undetectable cTnI concentrations. Only three dogs (12.5 per cent) had serum cTnI concentrations exceeding 1.0 microg/l at any time during the study. Evidence of myocardial cell damage was found in eight (32 per cent) of the 24 dogs. Cardiac arrhythmia was detected in three of these eight dogs.

Neurological deficits after confirmed adder bite in a cat

“…Activation of the clotting cascade can cause hypercoagulation with microemboli formation and disseminated intravascular coagulation (DIC). Cardiac effects may be due to impaired circulation and poor perfusion of the myocardium, due to coronary spasm and hypovolaemia 7. Myocardial damage may cause reduced contractility resulting in hypotension.…”

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.…”

Twenty-four-hour ambulatory electrocardiography characterization of heart rhythm in Vipera berus-envenomed dogs

“…Various cardiac arrhythmias have been described as a complication to envenomation [9, 10]. Monitoring envenomed dogs for arrhythmias by auscultation is challenging because sustained supraventricular-, idioventricular-, or ventricular tachycardia frequently present as a regular rhythm [11].…”

“…Electrocardiography (ECG) is therefore required to diagnose rhythm disturbances. Few studies have investigated arrhythmias secondary to V. berus and Vipera palaestinae envenomation [9, 10, 12]. In a prospective study of 24 dogs bitten by V. berus examined by standard (short-time) ECG, six dogs presented with arrhythmias at the initial clinical examination and ten dogs had arrhythmias 12–24 h after admission [10].…”

“…Concentrations of cTnI above reference ranges have been reported both at admission and 12–24 h after admission [9, 10, 12]. Increased cTnI concentrations do not seem to correlate with the presence of arrhythmias as some snake bitten dogs with arrhythmias have been shown to have normal concentrations of cTnI and vice versa [9, 10]. …”