Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot 7610001, Israel.
Ministry of Health Central Laboratories, Jerusalem 9134302, Israel.
Toxins (Basel). 2019 Mar 19;11(3):168. doi: 10.3390/toxins11030168.
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 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 ( < 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 ( = 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 antivenom administered at the manufacturer-recommended dosage is effective in significantly reducing mortality in cases of envenomation in horses.
毒蛇咬伤对马来说是危及生命的。然而，目前针对这种情况的治疗方法的疗效尚未得到充分确定。本研究旨在描述马蛇咬伤病例的治疗方法，并评估抗蛇毒血清的安全性和疗效。在四年时间里，从 25 位兽医那里收集了 123 例马蛇咬伤病例的数据。大多数马接受了普鲁卡因青霉素（92.7%）、非甾体抗炎药（82.3%）、地塞米松（81.4%）、破伤风类毒素（91.1%）和抗蛇毒血清（65.3%）治疗。治疗与局部肿胀停止或减少 50%之间的时间间隔与病死率呈线性相关（<0.001）。总死亡率为 20.3%。使用普鲁卡因青霉素治疗与降低死亡率显著相关（OR=0.11）。在研究期间有三种马源性抗蛇毒血清产品，其中马接受了不同品牌和不同剂量的产品。使用上述任何产品的推荐剂量都能显著降低死亡率（=0.014），即使是严重病例（马蛇咬伤严重程度评分 2 或更高）。没有报告不良反应。本研究结果表明，在马蛇咬伤的情况下，使用特定于物种的抗蛇毒血清并按照制造商推荐剂量给药，可有效显著降低死亡率。
