July 6, 2009

Hello Rattlesnake

Rattler on a friend's porch in the foothills, next to the dog beds, yikes. Removed and dispatched shortly thereafter. Little tyke was about two Barbies long, as we measure rattlesnakes here in Southern California.

Few things concentrate the mind like the approach of a large, venomous snake, as the saying goes, and even a small venomous snake headed in the opposite direction will hold my attention just fine, thanks. Rattlers remind me of the old line [attributed to a "Haitian farmer," so probably coined by a summer intern at Condé Nast] that a dog is a dog except when he is facing you — and then he is Mr. Dog. Well, rattlesnakes are always Mr. Snake. Coming or going, they get nothing but respect from me.

Our local emergency veterinary clinicians see "at least a few" rattlesnake bites each month during snake season. If you live or travel in rattlesnake country, you might want to call around to find out which vets are prepared to handle snakebite, since not all vets keep antivenom on hand. A trainer I know once drove her snake-bitten hunting dog from vet to vet to vet before she finally found a clinic with antivenom. The dog made a full recovery. The trainer probably felt as if she'd aged ten years.

California has been home to some legendary herpetologists and snakebite experts. The latest, and probably the best known, thanks to Animal Planet, is Dr. Sean Bush, Professor of Emergency Medicine at Loma Linda University School of Medicine and on staff in the ER as an emergency physician and envenomation specialist. You can read his articles on rattlesnake bites and moccasin bites [black widows, too] at eMedicine. He doesn't mince words ;~) Here's his page on our local rattlers.

So, you all know what the most important tool is in case of snakebite, right?

A car key.

Forget suction devices: as the doctor says, they just suck. Forget incisions, constriction bands, buckets of ice, bottles of alcohol and all those magic herbal salves the curandera gave your great-grandmother. All they do is make things worse.

1) Put the snakebite victim in the car.

2) Take the car key in your right hand, put the key in the ignition, turn the engine on, and drive carefully to the nearest hospital emergency room [or veterinary ER if, god forbid, your dog has been bitten].

[Edited to add: a cell phone is right up there with the car key.]

Don't waste time trying to catch and kill the snake so that it can be identified. In the first place, most vets aren't herpetologists. In the second place, even if your vet knows his colubrids from his elapids it doesn't matter: the antivenom isn't species-specific. A dog here in the U.S. will get the same antivenom whether he was bitten by a cottonmouth or a southern pacific rattler or a western diamondback or a Mojave "green." So will you. Vets give dogs the same antivenom that ER docs give to human snakebite victims. The doctor will probably administer CroFab, and you can read more about it here and here.

"But what if one of us is bitten by a coral snake?"

You're screwed, basically. Sorry about that.
Historically, if the snake was positively identified as an eastern or Texas coral snake and the victim was asymptomatic, or if signs and symptoms of envenomation were already present, the recommendation was to obtain and immediately administer appropriate antivenom. In the United States, however, as of October 2008, all available stocks of Wyeth's North American Coral Snake Antivenin will have expired, and this country will find itself without a commercially available antivenom. [Source]
Absent an available antivenom, victims can be managed with sound supportive care (as outlined above) with an expectation of excellent outcome as long as airway management and respiratory support are adequate, though ventilator dependence could persist for many days following serious bites.

[The truth is, you'd pretty much have to chase a coral snake down and grab him and pry his jaws open and stick your hand in his mouth to make him bite you. Most human victims of snakebite in North America are bitten because they are drunken idiots they've picked the snake up. The rest are unlucky. Two examples from California's handful of snakebite fatalities: an elderly grandmother who sat on a rattlesnake during a family picnic in the San Jacinto mountains; and a San Diego construction worker who mocked his coworkers for scrambling away when they uncovered a rattler at a construction site. "I'll show you wimps how to handle a rattlesnake," he said, or words to that effect. He picked up the snake, it bit him, and he died.]

If I lived in the foothills where B. and her hubby live, or in any other rural area of Southern California, I would look into Red Rock Biologics' rattlesnake vaccine for dogs. UC Davis doesn't recommend it yet, not, I gather, because they've heard bad things about it but because they haven't heard much either way. The best things I've heard about this vaccine come from Jennifer Clark-Ewers, a top hand who works her sheepdogs in southeastern San Diego County. Jennifer wrote the following to Sheepdog-L a few years ago, and I reprint it here with her permission.
I have vaccinated for 3 years and it has saved 4 dogs on my ranch including one this week. Last year I had a small female bit on the inside of the back leg, obviously she pee'd on the snake.. I thought she had injured herself as we always think there will be some giant amount of drama when they are bit, NO in the 4 dogs bit on my property we only knew after the fact. In 2 cases we killed the snakes in the other 2 cases we had no idea they had been bit, of course until the swelling. The legs still turn black and the skin died in the immediate area around the bite, but antibiotics and Benadryl were the only thing the vets suggested because of the vaccine. The vaccine obviously buys you an enormous amount of time since in the case of the "unknown" bites the dogs were crated waiting to go to a vet for some unknown injury; snake bite puncture holes are not exactly easy to find on a fur ridden leg. So anyhow for people that are in the area that has the vaccine available I think you are foolish not to use it. Am I complacent about the rattlesnake bite? Not even, but I am a bit more relaxed. I only have a few dogs that "alarm" me to the fact that there is a rattlesnake in the area... I believe more in the vaccine than the shock collar.
As Jennifer emphasizes, the vaccine gives you extra time and in the case of her dogs, lessened the severity of the symptoms. It isn't a cure-all: I heard from vet techs last year about a dog that had been vaccinated but died following a rattlesnake bite because the owners were away from home and didn't return in time to get the dog to the vet. And with or without a vaccine, rattlesnake bites can cause horrific tissue damage. Trainer and Open handler Amelia Smith has written a gripping account of her famous Price and his battle to survive after a big southern pacific rattler bit him on the face and paw.

[What "big" means:
Rattlers are heavy-bodied snakes. They're not long — a 6-foot rattlesnake is humongous — but they can be mighty hefty. The largest one I've seen in California was a southern pacific as big around the middle as my knee. He was in the basement of the San Bernardino County Museum, back when Bob Sanders kept his live rattlesnakes there and Dee Simpson's Joe - a big, bonny Gila monster - would ride around on your arm like a puppy. That southern pacific had a ginormous rattle going like crazy and you could hear it two floors up — when I first heard him I thought a steam pipe had burst.]

I should mention that a vial of antivenom costs hundreds of dollars, and the cost of treating a dog with multiple vials can easily hit four figures. The local veterinary ER has euthanized dogs at owner request in a few cases where the owner was unable or unwilling to pay for the cost of treatment for poisonous snakebite.

On the phone Jennifer pointed out that it can be impossible, sometimes, for a sheepdog to avoid a snake while the dog is working stock. This is one of the problems I have with aversion training, which is the use of electric collars to teach dogs to avoid snakes. What good will aversion training do when the dog is completely focused on stock? Aversion training might help a dog avoid a snake on a dirt road, but not during an outrun or a gather.

It was late Friday afternoon near beautiful Oak Glen when that rattler at the top of the post had his picture taken. On Sunday - yesterday - another one showed up. Gophers in the new apple orchard... ssssssspread the word...

Good-bye rattlesnake! [Click for bigger.]
DancesWithGuars photographed this magnificent southern pacific rattlesnake crossing a trail in Rancho Sierra Vista.

"But never met this Fellow
Attended or alone
Without a tighter Breathing
And Zero at the Bone."
Emily Dickinson

Just chilling


Jan said...

Good information which I hope I never need to know.

I can't imagine the person driving from vet to vet to vet with a snake bitten dog without any of them knowing where they could get treatment or at least calling to find out.

Anonymous said...

Excellent advice. I teach pet first aid and cpr classes and this is exactly what we tell clients. The only thing I'd add is do whatever you can to keep the dog calm (low heartrate slows spread of venom) and monitor breathing and heart rate carefully *if* you can do so while someone else drives.

Rattlers are gorgeous creatures. I spent much of my life in snake country and have come across several of them - most recently a small Mississauga rattler in my driveway. It was a cold morning and he was drowsy so I put on gloves, picked him up and moved him off to a nice spot in the coulee where there were more rodents - and less dogs.

Bill Fosher said...

We supposedly have timber rattlesnakes here in God's Country, but in all my nearly 47 years of sticking my hands and feet in places where I shouldn't I have never come across one. Fine with me.

Heather Houlahan said...

There's some evidence that outcomes with anti-venin are not measurably better than outcomes with just good supportive therapy -- humans and animals.

Trouble is, who wants to be the control group for that study?

Your western rattlers are much more aggressive than our timber rattlers, copperheads, and extremely rare Mississaugas. Our pit vipers try to go along to get along. Here, most bites to dogs are to the muzzle, when the dog is messing with them. Almost all bites to humans are preceded by the testosterone-tainted death cry "Hey, watch this."

I've lived in PA for fourteen years, spend untold hours in the woods and fields, and have seen maybe three or four pit vipers. They were all exiting stage left or trying to hide from me.

But on brief visits to California, New Mexico, and Arizona, I've seen huge rattlers lying out wherever they damn well please, offering to mess up anyone who screws with them.

Unknown said...

I like rattlesnakes (especially when they are not being stepped on by me). They eat ground squirrels (or at least try to, the ones we have around here are all "ROAR, THROW ROCKS IN THE RATTLESNAKE'S FACE!!!" and also mice/rats. I also like the few king snakes I've seen around here as they eat the rattlesnakes. :)

I've had a rattler slither across my foot, nearly stepped on one who decided to rattle merely as an afterthought and have unknowingly walked by far too many to count. We probably catch between 24-30 a year at the sanctuary. We don't kill them, of course, as we feel they have every right to be there and generally they are pretty darn docile (in my five years at the sanctuary, maybe 10 have tried to strike the tongs. We do move them to a safer spot on the property.

I've never really understand the fear of rattlesnakes. They don't kill a lot of people, as a general rule. They don't kill a lot of dogs, as a general rule - even without antivenin treatments or without treatment period (or supportive care), most dogs survive rattler venom. While I can appreciate the immediacy of protecting one's companions, I have a hard time being convinced it's necessary to kill them. (Which isn't a personal attack, btw, just my own general feelings on the matter).

Amelia said...

"I should mention that a vial of antivenom costs hundreds of dollars, and the cost of treating a dog with multiple vials can easily hit four figures." Hello Luisa, the tab for Price's recovery was just over $6,000 and I'd gladly pay it again. Thanks for the kind words and sharing his story.

Neil said...

I just happened upon your blog in search of info on an old mentor of mine (Bob Sanders) from SBCM. It's fun to see Bob, Dee and Joe mentioned here. I was a part time helper of Bobs as a 12 and 13 year old in '80-'81. I have fond memories of Bob, Dee, Joe and Dee's pet ground squirrel "Chipper". Best wishes Neil R.