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斯里兰卡犬类被罗素蝰蛇咬伤的临床流行病学与治疗

Clinico-epidemiology and management of Russell's viper () envenoming in dogs in Sri Lanka.

作者信息

Adhikari Ranjith B, Gawarammana Indika B, De Silva D D N, Dangolla Ashoka, Mallawa Chandima, Premarathna A D, Silva Indira D

机构信息

Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya, Sri Lanka.

Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.

出版信息

Toxicol Rep. 2019 Aug 7;6:809-818. doi: 10.1016/j.toxrep.2019.08.006. eCollection 2019.

Abstract

INTRODUCTION

Russell's viper envenoming in dogs is a significant problem in Sri Lanka. The current study focused on investigating clinical profile, laboratory findings of three selected tests and to develop a treatment strategy with Indian polyvalent Anti-Venom Serum (AVS). It was also intended to report adverse effects and complications caused by both Russell's viper venom (RVV) and AVS in Russell's Viper (RV) envenomed dogs.

OBJECTIVE

To evaluate and report the clinical manifestations, to find out the minimum effective vials of AVS and to record AVS induced adverse reactions of RV envenoming in dogs.

MATERIALS AND METHODS

A prospective study was conducted on Russell's viper bitten dogs (n = 65) admitted to the Veterinary Teaching Hospital (VTH) in Sri Lanka. Indian polyvalent AVS was used to treat all the envenomed dogs. The number of vials of AVS that was administered to a patient was decided upon by a second degree polynomial model with a number of vials of AVS in the X axis verses Prothrombine Time (PT), Activated Partial Thromboplastine Time (aPTT) and Clotting Time (CT) in the Y axis respectively.

RESULTS

Varying degrees of pain were exhibited by all the victim dogs. Mild swelling and necrosis at the site of bite was seen in 54% (n = 35) and 37% (n = 24) of dogs respectively. Prolonged values of, PT, aPTT and CT were seen from all the RV envenomed dogs. The mean leukocyte count in these dogs was 39.79 × 10/μL (normal range; 4-20 × 10/μL) (IQR:29.05 × 10/μL-45.92 × 10/μL). Statistical analysis showed that the initial vials of 7 AVS would be the minimum required vials. Therefore, a range of 6-15 AVS vials in total were administered to these dogs and in 7.6% (n = 5) of dogs, the results of PT, aPTT and CT became normal with 6 AVS vials at 32-97 minutes. Acute Renal Failure (ARF) was detected from 29% (n = 19) of dogs as a complication.

CONCLUSIONS

Systemic clinical signs of haemorrhagic lesions, cardio respiratory toxicities were common in Russell's viper envenomed dogs. Initially 6 vials of AVS must be administered. AVS induced reactions were reported commonly. Russell's viper envenoming was found to be lethal in dogs.

摘要

引言

在斯里兰卡,狗被罗素蝰蛇咬伤是一个严重问题。当前研究聚焦于调查临床特征、三项选定检测的实验室结果,并制定使用印度多价抗蛇毒血清(AVS)的治疗策略。研究还旨在报告罗素蝰蛇毒(RVV)和AVS在被罗素蝰蛇(RV)咬伤的狗身上引起的不良反应和并发症。

目的

评估并报告临床表现,找出AVS的最低有效瓶数,并记录AVS在狗被罗素蝰蛇咬伤时引起的不良反应。

材料与方法

对入住斯里兰卡兽医教学医院(VTH)的被罗素蝰蛇咬伤的狗(n = 65)进行了一项前瞻性研究。使用印度多价AVS治疗所有中毒的狗。给患者使用的AVS瓶数由一个二次多项式模型决定,X轴为AVS瓶数,Y轴分别为凝血酶原时间(PT)、活化部分凝血活酶时间(aPTT)和凝血时间(CT)。

结果

所有受害狗都表现出不同程度的疼痛。分别有54%(n = 35)和37%(n = 24)的狗在咬伤部位出现轻度肿胀和坏死。所有被罗素蝰蛇咬伤的狗的PT、aPTT和CT值均延长。这些狗的平均白细胞计数为39.79×10/μL(正常范围;4 - 20×10/μL)(四分位距:29.05×10/μL - 45.92×10/μL)。统计分析表明,最初7瓶AVS将是所需的最低瓶数。因此,总共给这些狗使用了6 - 15瓶AVS,7.6%(n = 5)的狗在32 - 97分钟内使用6瓶AVS后,PT、aPTT和CT结果恢复正常。29%(n = 19)的狗被检测出患有急性肾衰竭(ARF)作为并发症。

结论

出血性病变、心肺毒性等全身临床症状在被罗素蝰蛇咬伤的狗中很常见。最初必须使用6瓶AVS。AVS引起的反应很常见。发现罗素蝰蛇咬伤对狗具有致死性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9f3/6702329/7a5a4568bfae/ga1.jpg

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