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Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration

Envenomation by venomous snakes is life threatening for horses. However, the efficacy of available treatments for this occurrence, in horses, has not yet been adequately determined. The aim of this study was to describe the treatments provided in cases of Daboia palaestinae envenomation in horses an...

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Autores principales: Tirosh-Levy, Sharon, Solomovich-Manor, Reut, Comte, Judith, Nissan, Israel, Sutton, Gila A., Gabay, Annie, Gazit, Emanuel, Steinman, Amir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468471/
https://www.ncbi.nlm.nih.gov/pubmed/30893807
http://dx.doi.org/10.3390/toxins11030168
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author Tirosh-Levy, Sharon
Solomovich-Manor, Reut
Comte, Judith
Nissan, Israel
Sutton, Gila A.
Gabay, Annie
Gazit, Emanuel
Steinman, Amir
author_facet Tirosh-Levy, Sharon
Solomovich-Manor, Reut
Comte, Judith
Nissan, Israel
Sutton, Gila A.
Gabay, Annie
Gazit, Emanuel
Steinman, Amir
author_sort Tirosh-Levy, Sharon
collection PubMed
description Envenomation by venomous snakes is life threatening for horses. However, the efficacy of available treatments for this occurrence, in horses, has not yet been adequately determined. The aim of this study was to describe the treatments provided in cases of Daboia palaestinae envenomation in horses and to evaluate the safety and efficacy of antivenom administration. Data regarding 123 equine snakebite cases were collected over four years from 25 veterinarians. The majority of horses were treated with procaine-penicillin (92.7%), non-steroidal anti-inflammatory drugs (82.3%), dexamethasone (81.4%), tetanus toxoid (91.1%) and antivenom (65.3%). The time interval between treatment and either cessation or 50% reduction of local swelling was linearly associated with case fatality (p < 0.001). The overall mortality rate was 20.3%. Treatment with procaine-penicillin was significantly associated with reduced mortality (OR = 0.11). Three horse-derived antivenom products were available during the study period, of which the horses were administered different brands of varying dosages. Administration of the recommended dosage of any of the aforementioned products led to a significant decrease in mortality (p = 0.014), even in severe cases (scoring 2 or greater on the equine snakebite severity scale). No adverse reactions were reported. The results of this study show that species-specific D. palaestinae antivenom administered at the manufacturer-recommended dosage is effective in significantly reducing mortality in cases of envenomation in horses.
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spelling pubmed-64684712019-04-22 Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration Tirosh-Levy, Sharon Solomovich-Manor, Reut Comte, Judith Nissan, Israel Sutton, Gila A. Gabay, Annie Gazit, Emanuel Steinman, Amir Toxins (Basel) Article Envenomation by venomous snakes is life threatening for horses. However, the efficacy of available treatments for this occurrence, in horses, has not yet been adequately determined. The aim of this study was to describe the treatments provided in cases of Daboia palaestinae envenomation in horses and to evaluate the safety and efficacy of antivenom administration. Data regarding 123 equine snakebite cases were collected over four years from 25 veterinarians. The majority of horses were treated with procaine-penicillin (92.7%), non-steroidal anti-inflammatory drugs (82.3%), dexamethasone (81.4%), tetanus toxoid (91.1%) and antivenom (65.3%). The time interval between treatment and either cessation or 50% reduction of local swelling was linearly associated with case fatality (p < 0.001). The overall mortality rate was 20.3%. Treatment with procaine-penicillin was significantly associated with reduced mortality (OR = 0.11). Three horse-derived antivenom products were available during the study period, of which the horses were administered different brands of varying dosages. Administration of the recommended dosage of any of the aforementioned products led to a significant decrease in mortality (p = 0.014), even in severe cases (scoring 2 or greater on the equine snakebite severity scale). No adverse reactions were reported. The results of this study show that species-specific D. palaestinae antivenom administered at the manufacturer-recommended dosage is effective in significantly reducing mortality in cases of envenomation in horses. MDPI 2019-03-19 /pmc/articles/PMC6468471/ /pubmed/30893807 http://dx.doi.org/10.3390/toxins11030168 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tirosh-Levy, Sharon
Solomovich-Manor, Reut
Comte, Judith
Nissan, Israel
Sutton, Gila A.
Gabay, Annie
Gazit, Emanuel
Steinman, Amir
Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration
title Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration
title_full Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration
title_fullStr Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration
title_full_unstemmed Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration
title_short Daboia (Vipera) palaestinae Envenomation in 123 Horses: Treatment and Efficacy of Antivenom Administration
title_sort daboia (vipera) palaestinae envenomation in 123 horses: treatment and efficacy of antivenom administration
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468471/
https://www.ncbi.nlm.nih.gov/pubmed/30893807
http://dx.doi.org/10.3390/toxins11030168
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