This is a tale of two sisters. It all started when Puck, a 6 year old spayed female Yorkshire Terrier cross, was presented to Atlantic Street Veterinary Hospital when her parents noticed that she was not wanting to use her left front limb. In a very short period of time, the paw had become quite swollen and developed a draining wound.
On examination, the swelling was found to extend all the way up to her elbow, the skin beneath the hair had become dark red, and she did not want anyone touching her paw. At that time, our suspicions were either a nasty bug bite (like a spider), a foxtail tract, or some sort of abscess (pocket of infection) with cellulitis (inflammation of the soft tissues). A plan was developed to lightly anesthetize Puck in order to clip all the hair from around the wound, clean it thoroughly, and see if we could discover the source of the problem. Preliminary blood work was performed first, to make sure that Puck was healthy enough for the anesthesia, and her blood work was normal.
But the story thickens. Just before Puck was to be anesthetized, we got a call that Puck’s parents were on their way back down with Puck’s sister (literally, litter mate), Bella. Bella had a swollen muzzle. Upon examination, sure enough, Bella’s muzzle was significantly swollen, although she was not having any trouble breathing. Two very small puncture wounds were noted over the top of her muzzle, approximately 1.8cm apart. Upon further questioning, it was discovered that Puck and Bella’s parents had recently found two rattlesnakes in their yard two days prior!!
There was no doubt that Bella had been the victim of a rattlesnake bite! However, Puck’s case was still a bit of a mystery. We still needed to clean up her wound and get a better look. Her anesthesia went very smooth, with her heart rate, blood pressure, and oxygen saturation (pulse ox) being monitored every step of the way. She also received IV fluids before, during, and after the procedure and was started on IV antibiotics and pain medicine early on. No distinct puncture wounds could be identified on Puck’s paw, but it was very swollen, severely bruised and there were areas that we were concerned could slough. Because of the fact that Bella had been bitten by a rattlesnake, we were not going to take any chances, and we assumed that Puck had also.
Both Puck and Bella were admitted to the hospital for monitoring and supportive care. Unfortunately, neither one had received the Rattlesnake vaccine, which is available for dogs. Normally, both pets would have benefited from antivenin. This is a biological product containing antibodies to the venom which is given to animals after they have been bitten and is meant to decrease the severity of symptoms as well as recovery time. However, right now there is a nationwide shortage of the antivenin. Therefore, Puck and Bella were treated by other means. This included one-time doses of corticosteroids and antihistamines to help combat the inflammation and allergic reaction. In addition, both dogs were kept on very broad spectrum antibiotics, as serious tissue infections can occur from snake bites due to the multitude of bacteria in the mouth of the snake, as well as tissue damage which causes the tissue to become susceptible to infections. They were also treated with pain medicine as this is obviously a very painful event!
Besides infection, rattlesnake bites can also cause other very serious side effects, mainly protein loss (into the swollen and/or bruised tissues) and coagulopathies (clotting problems). Sometimes the inability to clot, or even the degree of bruising, can also result in anemia (low red blood cell counts). Due to these concerns, Puck and Bella had there blood values monitored very frequently—sometimes every 6 hours because things can change so rapidly. As a result of this diligent monitoring, it was found that Bella was experiencing a clotting problem and her proteins were getting dangerously low. Therefore, Bella was given a transfusion of plasma which contains the proteins and clotting properties that she needed to recover. After this her blood values eventually stabilized.
There is a very happy ending to this story. After two and a half days in the hospital, both Puck and Bella were discharged to go home. They were sent home with antibiotics and pain medications for their owners to continue and we asked that they have their blood values rechecked with their regular veterinarian in a few days. But today, their parents report that they are both doing very well and you would never know that anything had happened!
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| Puck with swollen leg |
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