Snakebite, Western Diamondback Rattlesnake
*WARNING*
Graphic photos to follow, if you are of a sensitive nature, please leave now.
Sizzle (Borzoi, adult female, 2 1/2 years old, intact) was bitten by a Western Diamondback Rattlesnake at 6:30 pm on May 19, 2004. I was home at the time, and had her at the vet in less than 10 minutes. The bite was on the left side of the muzzle, approximately one inch behind the nose leather, one fang mark is directly on top of the muzzle, the other directly below it, on the left side of the muzzle. I do not have a photo of the initial bite, I was too worried about getting her to the vet.
What follows is a pictorial record, along with her medication log, and note of my personal observations. I am doing this in hopes that if someone else has a dog bitten in the future, they will have some idea of what to expect. During her initial visit to the vet she had an I.V. line inserted (Normal Saline), steroids administered to slow the swelling, Banamine (anti-inflammatory), morphine (for pain), and antivenin via the IV line. She would not settle at the vets, so I was called to bring her home three and one half hours after the initial strike. A HepLock was placed in her IV line, to keep it open for administration of pain meds, in the event that I could not get them down her orally, and also for hydration, since she would not drink at this point.
Western Diamondback Rattlesnake
This is the snake that bit Sizzle. It was 3 1/2 feet long, with 11 rattles. Obviously, it is dead.
For those who have never encountered one of these venomous reptiles, please note the distinctive "diamond" patterning on the back. These are in the pit viper family. These snakes will generally "rattle" when threatened, it sounds more like a stuttering buzzing sound. However, they do not ALWAYS use their rattles to warn. Should you encounter one of these snakes, be EXTREMELY cautious. They generally will not bite without provocation. The best course of action is to move immediately away from them, do NOT taunt or poke at them. They are extremely venomous. I do not have a photo of the head of this snake, as it no longer has one. The head of this snake is a distinctive broad "V" shaped, with easily seen "pits" ( heat sensory organs), in front of and below the eyes, the venom glands are also visible, as an enlarged "lump" behind the eyes. These snakes can grow very large, in excess of six feet in length. Be aware, the size of the snake does not determine the toxicity......a baby rattlesnake is just as dangerous as its' adult counterpart, probably more so, since the juvenile may not have a developed rattle for warning, and are very difficult to see in grass or weeds. The venom is cytotoxic, causing tissue necrosis (flesh rotting), bleeding, swelling, and extreme pain, in the area of the bite. It is also an anticoagulant, causing moderate to severe bleeding in the general area of the bite. Liver and kidney damage is also a possibility. A Rattlesnake bite can cause an immediate and dangerous rise in body temperature, the body temp must be monitored, and the dog cooled if necessary. Shock is a serious concern, immediate care is required.
You need to learn what venomous snakes live in your area, and learn to identify them!
The antivenin is species specific, you MUST be able to identify what snake bit your animal, otherwise precious time will be lost. Each species has specific venom properties, i.e. - Western Diamondback Rattlesnake: cytotoxic, Copperhead: neurotoxic, Water Moccasin (Cottonmouth): cytotoxic, Coral Snake: neurotoxic. Some snake species are more aggressive than others. And a snakebite does not always result in envenomation, snakes can control the amount of venom injected. However, in the event of a snake bite, DO NOT DELAY MEDICAL TREATMENT!
Day One
Sizzle, 12 hours after initial strike. 6:00 a.m. 5-20-04
At this point, we are seeing the beginning of tissue necrosis, located in the mouth, at the juncture between the lip and the gums, directly behind the left canine. The necrosis appears as a dark blue or black area, followed by drying and sloughing of the tissue. There is sinus damage, blood is dripping from the left nostril. She is receiving fluids and pain meds via intravenous line, and is unable to close her mouth, or effectively swallow. The right side of her face is swollen worse than the left, as that is the side she lays on. She cannot tolerate any touching on the left side of her face. The left lip is grossly swollen and distended away from the side of the face. She is unable to eat at this point, and is in pain, even with her medication. As of right now, I cannot see any surface loss of tissue, but it will become visible within the next 3-4 days.
Sizzle 24 hours after initial strike, 5:00 p.m. 5-20-04
The swelling has continued to spread, now moving up the head, and into the jaw area. The pink arrows on the right photo indicate the fang marks. She is having extreme difficulty swallowing, and will take nothing by mouth. Hydration continues via her I.V. line, which is used for pain relief as well. The necrosis is spreading, now extending from the midline at the front of the upper jaw to the large molars in the back of the left upper jaw. She is still bleeding lightly from the left nostril, with some sloughed tissue becoming apparent, and I am seeing some minor bleeding from around the perimeter of the necrosis in her mouth. No difficulty breathing, heart is strong. She is more alert this evening, and has begun urinating, which helps calm my fears of kidney failure. At this point, we are still giving her opiates for pain, Banamine for inflammation, and keeping her hydrated. She is most comfortable in a very cold room, with fans blowing on her. The swelling appears worse on the right (non-bitten) side, because she lays on her right side, and the fluid gravitates downward.
Day Two
Sizzle 36 hours after initial strike, 6:00 a.m. 5-21-04
The swelling has stopped progressing, and has receded from the area around her eyes, and over the top of the head. The large swelling on her left lower jaw is due to fluid settling towards gravity (she has been laying in the sphinx position, resting her jaw on the blankets). Sizzle began drinking some on her own last night, which was a major hurdle. She is still on the I.V., since she simply cannot drink enough to maintain her body fluids right now. The supplemental fluids also help her body flush the toxins out, and keep her kidneys working well. Urine output has greatly increased, and kidney panels run yesterday look good. Urine is slightly blood tinged, due to hemolysis in the damaged areas. Liver damage is still a concern, as her body detoxifies the venom and removes it. Still no interest in food, but I think a lot of that is due to her mouth hurting. Also, her nasal passages are damaged, so she most likely cannot SMELL the food either. She is still having difficulty swallowing. You can see the beginning of a slough area in the right photo, the bloody split just to the left of her nose leather indicates necrosis. The necrosis in her mouth has not progressed further, she still has some blood tinged fluid, and decomposed blood coming from her left nostril. Her antibiotics have been changed to Clavamox, as we are concerned of possible nasal infection due to the loss of tissue. She is still receiving opiates for the pain, via her IV line. I have begun gently flushing her face with water, to aid in the sloughing process. She still gets hot very easily, and requires a very cold room, and fans. A word of advice, if you choose to attempt treatment like this at home, you MUST have a vet that will work with you. Your vet needs to be willing to issue medications needed, and should be available 24 hours by phone. You need to be competent in inserting IV catheters, changing IV bags, administering intra-muscular as well as IV injections, and you must not have a weak stomach. You also need to have experience in deep wound care.
48 Hours after strike, 6:00 p.m. 5-21-04
There has been no perceptible change in appearance, so I have not posted photos. Sizzle began eating a small amount this evening, but she must be hand fed. She is unable to "pick" food up with her mouth. Her pain levels continue to decrease, and she has been moved onto Terbutaline for the pain, now that I can get it down her orally. She continues to drink well, as long as I hold the bucket for her. A note on this.......the buckets/bowls that I use MUST be wide enough that no part of her muzzle touches them, she cannot tolerate any stimulation to the muzzle. She continues on the Clavamox to prevent infection. She is very unsteady on her feet when walking, and her eyes are still somewhat swollen, so she has difficulty seeing where she is going.
Day Three
Sizzle 60 hours after bite, 6:00 a.m. 5-22-04
Things are looking a little better this morning. Urine output is still up, and is no longer blood tinged. The large swelling under her throat is starting to go away, and her left upper lip is not as swollen this morning. She still has swelling around the eyes, and her muzzle is still grossly swollen. She now has a good appetite, and is eating well, as long as I hand feed her. Her eating method is somewhat odd...she does not want me to put food into her mouth, so what I have to do is "tent" my fingertips into a pyramid shape, with one little piece of food on the very tip, she will then lick this up and swallow. She cannot chew, it causes pain. The food must be extremely strong smelling, or she will not touch it. I am sure this is because she is having olfactory dysfunction. All food is cut into tiny pieces, 1/2" or less. She is still drinking well. We are going to cut her pain meds to once a day, in an attempt to keep her more alert. The necrosis continues to enlarge, I don't think we have seen the worst of it yet. She no longer has the bloody fluid dripping from her left nostril, but if she snorts, there is still decomposed blood and tissue expelled. She continues on the Clavamox to prevent infection, and I am watching her closely for any signs of dehydration. She has started wagging her tail when I speak to her, and has started attempting to groom herself now. The tissue sloughing has now started in her mouth. The split in her muzzle has continued to widen, and when she drinks or eats the damaged area will ooze blood. She still requires a very cold room to rest comfortably. I will now be updating her page every 24 hours, to follow the course of her treatment and recovery.
Day Four
Sizzle is much more alert today, and it appears her ability to smell is returning. She began sniffing the air when I appeared with her breakfast. She still cannot eat properly, and requires hand feeding. Food still must be very small, but she is trying to chew now. She is still drinking well. Her swelling has gone down more. The left lip has reduced in size, and her nose can now be seen. She still has the large swelling under her neck, but it is decreasing in size. Her muzzle profile is beginning to reappear. Her eyelids are still swollen, and she still has difficulty seeing. Breathing is still hard for her, and I am still keeping her in a very cold room, with fans. As of right now, there is no sign of secondary infection, although one of her I.V. sites does appear swollen, but not hot to the touch. Her temperature is normal. She is still very depressed, and continues to sleep most of the time. Her pain medication has been cut to once a day, just before bedtime. The tissue sloughing continues inside her mouth, but appears to cause little pain. There is minor bleeding from the periphery of the sloughed area. The outside of her muzzle is still very sensitive to touch, making cleaning the area difficult. The vet and myself are prepared debride the wound on Wednesday, May 26th, at which time we will see the true extent of the damage.
Day 5
Sizzle continues to improve. She was seen by the vet today, as well as the visiting reconstructive surgeon. The pink arrows on the left photo indicate necrotic areas, and there is more tissue loss in her mouth that you cannot see. As you can see her swelling has gone down considerably. Her antibiotics have been changed to Baytril, as she has an inflamed I.V. site that was not responding to Clavamox. Both my regular vet, and the surgeon, were amazed at the improvement. The Surgeon, who came specifically to see Sizzle, felt that she will do best without reconstructive surgery. In his words "she may be a little lopsided, but not enough to risk anesthesia and surgery". There is permanent sinus damage on the left side, and she will always have some difficulty breathing through her nose. She will remain an indoor dog for the rest of her life. Her appetite has really returned, and she is still drinking well. We have taken her off the pain meds, as she seems to be doing well, and the medication is just an added strain on an already overworked liver. Today she is very alert, and seems very comfortable.
June 8, 2004
As you can see, Sizzle is well into her recovery. She receives hydrotherapy daily, and the new tissue is filling in nicely. The pink areas are expected to remain hairless and unpigmented. She has returned to her normal exercise and diet. She still has difficulty breathing through her nose, and it is audible if she becomes excited. She no longer receives any pain medication, but is still on Baytril long term. The main concern now is a gram negative infection from the sinus damage. The wound is dry, and scabs over daily after her hydro. Her muzzle is still very sensitive to touch, and she resists my efforts to handle it (not that I blame her, but it has to be done). I am unable to get a clear photo of the healing inside her oral cavity, but the damage has sloughed, and filled in with pink scar tissue. Her body is obviously returning to normal, as she came in season yesterday. The trauma of the bite delayed her heat by 3 weeks. I will continue to occasionally update this page, until her recovery is complete.
Feb. 18, 2005
Her healing is complete. 9 months after her initial injury, she looks and feels well. Her new home reports that she is active and very interested in daily life. Much to the surprise of my vet, the scarred tissue pigmented in, however, it is still hairless. Her muzzle is no longer sensitive to touch, and with the exception of the scar, you would be unable to tell what a terrible ordeal she went through. She is very happy being a couch decoration, and we are just so very happy to see how well she has recovered.
I did not write this journal for shock value, or to upset anyone. It is simply an attempt on my part to provide information. At least now, should another dog be bitten, the owner will have some idea what to expect. I know that I would have rested a lot easier when Sizzle was bitten, had I known just what to expect during her recovery. If this record helps just one dog owner, then I have accomplished what I set out to do. Please feel free to print from this page, download it, or hand it out. Once again, know what snakes live in your area, and what to do if you, or your dog, are bitten. To all of you who have taken the time to email...I Thank You. Should anyone ever wish to email me questions about this injury, please feel free to do so.