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September 2009

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Rattlesnake Bite !!

©  2009 Cherry Hill   © Copyright Information

Day 1

8-28 - Friday SHOCK DAY

At 7:30 AM Friday, we turned Seeker and Sherlock out together in our southwest pasture, the highest and driest pasture on our place. Horses had been turned out on that pasture all summer off and on. They were to be out for about 4 hours of grazing.

When I was out and about at 10:30 AM, I saw that they were both grazing on top of the hill.

When it was time to bring them in at a little before noon, it was about 85 degrees and sunny. Sherlock headed toward the gate but Seeker was "stuck". She was standing at the fence line at the closest point to her living quarters at the barn. I thought perhaps there was some issue with one of the leg straps on her fly sheet or perhaps she could have even stepped over the lower fence wire and then felt "restrained". I kept playing out the possibilities as I walked toward her, halter and lead in hand. But as I neared her I saw that her left front leg was very swollen and that her lip on the right side was drooping. Her normally perky personality was drained yet she gave me one of her deep whickers that tugged my heart at the core. It is at this point in horse care where a horse owner realizes they must shoulder the enormous responsibility of their horse's welfare.

My initial exam revealed several drops of blood on the outside of her left pastern and coronary band area. I immediately thought rattlesnake bite.

Richard and I quickly discussed the options of getting her down to the barn where I could begin treatment. We could cut the fence and lead her straight to the barn but the bank there is too steep even for a fit, sound horse to manage safely. We thought about bringing the trailer into the pasture but I quickly estimated the time and the jostling driving through the pasture that would require and opted for leading her to the barn which took about 3-4 minutes. I asked Richard to lead her while I got bute ready to administer to her, and got the cold water hose and sprayer ready to go.

What is bute? Bute is the commonly used name for phenylbutazone, a prescription anti-inflammatory drug. It is a NSAID, non-steroidal anti-inflammatory drug that is often used to help reduce inflammation in the limbs.

 

Note: Throughout this article, I am purposely avoiding listing dosages because each case requires its own prescriptions based on the condition, the severity, the weight of the horse and your veterinarian's advice.

Richard led her into the wash rack, I gave her the bute, we offered her a drink of fresh water which she refused. I examined her all over and saw there appeared to be at least 2 or 3 very small puncture wounds on her pastern. I started cold hosing and sprayed cold water onto her lips and into her mouth intermittently. This got her tongue and lips moving and started to restore her droopy lip to its more normal state.

I asked Richard to take over the hosing while I ran down to the house to call the vet. The vet I had been using the last few years was too busy to come up and asked me to haul her down to his clinic which would have been at least an hour's ride on our very washboard mountain road. I felt time was of the essence and I did not want to stress her any more, so…

I called another veterinarian who I had met while doing chores for one of my neighbors and he said he could come right away. I told him that I had given Seeker bute and hosed her leg with cold water and he said that was very good.

I went back to the barn and Seeker's leg had been hosed for about 20 minutes so I dried it off and clipped the hair from the area of the bites and identified four marks so figured she was bitten twice.

By this time her left cannon, knee, forearm, arm and chest were swollen and hard. I massaged her leg for about 20 minutes, then hosed again and by that time, the vet arrived - 1:15 PM.

He concurred that it was most likely a rattlesnake bite.

Will my Veterinarian use Antivenom (Antivenin)?

Antivenom is a carefully prepared biological product that counteracts the venom in a person or a horse that has been bitten by a venomous snake. The way antivenom is made is by extracting venom from the snake, such as by milking a rattlesnake, then injecting a small amount of that venom into a large, healthy host animal. The animal will experience an immune response and produce antibodies against the venom. The host animal's blood can then be harvested to produce antivenom. Common host animals for antivenom production are sheep and horses.

However, when it comes time to treat a horse that has been bitten by a poisonous snake, antivenom is not often used. First of all, at a cost of $400-800 per vial for veterinary antivenom and the fact that numerous vials would be required to treat an animal as big as a horse, many veterinarians do not even carry it around in their trucks. And most horseowners could not afford the cost. But more importantly, some veterinarians have found that the fluid and antibiotic therapy such as the one discussed in this article have produced better results than those cases treated with antivenom. Each case is unique and would require your veterinarian's personal evaluation, but antivenom is not routinely used to treat horse snake bites.

He administered one liter of hypertonic saline solution for shock and to encourage her to drink. He also gave her more bute, some banamine and dexamethasone. He also gave her a double dose of penicillin. Almost as soon as we returned Seeker to her pen, she began drinking because the hypertonic solution causes the thirst reflex to kick in.

What is saline solution? A solution of salt and water.
What is an isotonic saline solution? A solution with salts at the same concentration as blood.
What is a hypotonic saline solution? One with salts at a more dilute solution than body fluids.
What is a hypertonic saline solution? One with salts at a higher salt solution than the body fluids.
What is Banamine? Banamine is a trade name for flunixin meglumine, a prescription NSAID. It is often prescribed for horses with abdominal pain (colic) and is often used in conjunction with bute to provide comfort and ease pain.
What is dexamethasone? Dexamethasone is a potent anti-inflammatory and immunosuppressant in the glucocorticoid class of steroid hormones. A common trade name is Azium. It is used to counteract the allergic response to the snake venom.

His directions for her care included:

  • Bute twice a day for 3-4 days
  • Penicillin twice a day for 7 days
  • Soaking in Epsom salts at a temperature as hot as my hand could tolerate
  • Hot Epsom salts compresses on the forearm and knee
  • Alternating with cold hosing as I saw fit (he said "It's an art")
  • Massaging the affected leg and chest as much as possible.

His prognosis was guarded. He said rattlesnake bites are notoriously "dirty" and the antibiotic regimen was a must. Also, founder was a possibility in either the affected foot or the opposite supporting limb so to monitor heat, swelling, lameness very closely. And finally, he told me that depending on the amount of venom, some time down the road, Seeker might show heart problems, like a human heart attack, when working. Apparently the venom can affect the heart muscles and lead to future problems.

With all this good news, he left me with supplies to get me started for a day or two and a prescription for other items that I could fill at the vet supply in town. The only thing he did not have in his truck was Epsom salt and we had used up the barn supply quite a while back and had not replenished it. The amount we had in the house was barely enough to get started.

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