Case 4
A 12 week-old, 4.3 kg male intact Beagle presented one hour after a witnessed pygmy rattlesnake bite to the muzzle. There was a noticeable swelling localized to the muzzle that was sensitive to touch and two visible bite wounds ventral to the nares. Vitals were normal. Abnormal clinicopathologic parameters included mild hyponatremia (140.5 mmol/L; reference range 146-151 mmol/L). The PCV and TS were 46% (reference range 33-55%) and 58 g/L (5.8 g/dL) [(reference range 65-80 g/L (6.5-8 g/dL)] with no hemolysis, respectively; and, the ACT was 81 s (reference range 80-120 s). The puppy’s initial SSS was 2/20. One vial of F(ab)2 antivenom§ was diluted in 100 mL 0.9% salineǁ with 25 mL administered as a bolus, then 75 mL administered as a CRI over six hours. The puppy was maintained on IV LRS at 3 mL/kg/hr. Six hours later, the ACT was normal and SSS was 2/20. The facial swelling spread to the face, lips, and eyelids. The puppy was discharged after 24 hours.