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]

However:

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.

Whew!

[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

Related:
Just chilling

Bring it on! [I'll be in the fallout shelter]

If Americans can think up a "we go to eleven" method that works against plagues of locusts, we should be able to come up with a defense against a measly bunch of sub-microscopic swine flu agents, shouldn't we? I mean, how hard can it be?

"Unnecessary preparation beats being caught unprepared by a flu pandemic." [Hilzoy]

But seriously, folks, we all know that a stitch in time saves nine, fortune is infatuated with the efficient, etc., so unless you've already stocked up in preparation for Armageddon or the Give All The White People's Guns To The Black People Program, this is a great time to stockpile everything from Acetaminophen to Pedialyte®. Water, check... manual can opener, check... And don't forget the dogfood!

From dKos via Obsidian Wings, here is an excellent [pdf] Pandemic Influenza Preparation and Response Guide. Check out the Appendix:

A. World Health Organization and Pandemic Phases - 48
B. World Health Organization Advice for Travelers - 49
C. Items to Stockpile for an Influenza Pandemic - 50
D. Items for Treatment of Severe Influenza - 51
E. Homemade Oral Rehydration Solution - 52
F. Possible Roles for Community Volunteers - 53
G. Example: Home Patient Medical Record - 54
H. Overview of Influenza Surveillance in the United States - 55
I. A Doctor’s Letter during the Height of the 1918 Pandemic - 57

It's as thorough and sobering as I suppose a guide for citizens in a pandemic ought to be, and I am totally printing it all out for when the Intertubes go down. Off to the fallout shelter —



[Drawing by Marc Johns via Flickr.]

"A reminder that medical research can change lives"

Thanks to Caveat for directing readers to a surgeon/scientist's look at the use of animals in medical research. Bad scientific arguments in the service of 'animal rights' activism is the title, and the author is an oncologist who blogs under the name Orac. His post begins:

One of the greatest threats to the preclinical research necessary for science-based medicine today is animal rights activism. The magnitude of the problem came to the forefront again last month with the news that animal rights terrorists tried to enter the home of a researcher at the University of California Santa Cruz (UCSC) whose research uses mice to study breast cancer and neurologic disease while she and her husband were having a birthday party for one of their children and assaulted her husband, who had gone to the front of the house to confront them. This unrelenting attack on the use of animals in research is primarily based on a belief that animals and humans should have equal rights and that eating meat or even having pets is viewed as immoral. However, increasingly, I seem to notice animal rights activists trying to use science to justify their beliefs. In other words, it is not enough to use ethical arguments; they feel they must argue that animal research is bad science.

Orac mentions a hero of his, Dr. Judah Folkman:

My favorite example to cite when I hear the argument that other methods besides animal research can do better than animal research in helping us understand disease (or, in its more sophisticated form, that animals may have been needed a few decades ago to discover, say, insulin, but our understanding has advanced to the point where they are no longer needed) comes from my field and my area of research interest. It also happens to come from my scientific hero, Dr. Judah Folkman, who passed away suddenly in January. It shows an area of cancer biology whose importance would have been incredibly difficult to model, appreciate, or target for therapy without mouse models of cancer. That area, of course, is tumor angiogenesis, and Dr. Folkman did his pioneering work that has now resulted in drugs like Avastin and other antiangiogenic drugs that are making it to market now and making a real impact on cancer. Dr. Folkman did it through an ingenious strategy that began from the clinical observation that sometimes tumor metastases appear shortly after the operation to remove the primary tumor.

Read the rest here, and check out the comments as well.

As it happens, there is an article in today's NY Times that mentions Dr. Folkman. In A Daring Treatment, a Little Girl's Survival, reporter Denise Grady writes:

Melanie was 9 months old when her parents faced an agonizing decision. She had already had two operations for a malignant brain tumor [see x-ray above], and doctors could not be sure they had removed all the cancer. She needed more treatment, but standard chemotherapy offered little hope in exchange for its harsh side effects. And yet the McDaniels knew that if they did nothing, the odds were high that the tumor would come back.

“It won’t save her, but it may help other people,” her father, Paul McDaniel, told me in an interview for a Science Times article published in April 2002. Then he paused and added, “Maybe it will save her.”

After the article was published, I was afraid to call the McDaniels again. I didn’t think Melanie would survive.

Recently, Mr. McDaniel sent me an e-mail message. “Melanie is now 7 years old, attending first grade, and doing very well,” he wrote. “The doctors told us last year that they do not see any residual tumor in her brain. Their original diagnosis was that her tumor had no known cure.”

What had prompted him to get in touch was the death on Jan. 14 of Dr. Judah Folkman, the researcher at Dana-Farber whose work had led to Melanie’s treatment. Mr. McDaniel wrote that he wanted “to celebrate the accomplishments of Dr. Folkman, who faced resistance on his ideas that, by the grace of God, cured my daughter of an incurable brain tumor.”

May Melanie go from strength to strength, and may Dr. Folkman's name be a blessing. Thanks again to Caveat for the link [and for fighting the good fight in the Great White North].

"Killing Dogs in Training of Doctors Is to End"

UPDATE: Edited for syntax. Content unchanged.

From the NY Times:

By next month, all American medical schools will have abandoned a time-honored method of teaching cardiology: operating on dogs to examine their beating hearts, and disposing of them after the lesson.

Case Western Reserve School of Medicine was the last to use the method, but the dean, Dr. Pamela Davis, said it would no longer do so after this month.

On Nov. 19, New York Medical College in Valhalla joined New York’s 11 other medical schools and announced that it would close its dog laboratory.

Among the 126 American medical schools, 11 still sacrifice animals for teaching, according to the Physicians Committee for Responsible Medicine, an advocacy group that tracks the practice. Other than Case, none of them use dogs.

Francis Belloni, a dean at New York Medical College, said his students now used echocardiograms to study heart function, and the subjects were live medical students rather than live dogs. Dr. Belloni said the use of animals was not done lightly and had value, but added that students would “become just as good doctors without it.”

Somewhere, I'm sure a blogger is posting this article with the headline changed to "Murdering Dogs..." Did he or she enjoy a nice factory-farmed ham for holiday dinner, I wonder. Not for me, thanks. I think about our American factory farms whenever someone gets on a soapbox about, say, those evil, dog-hating Chinese:

Factory meat production is an industrial rather than an agricultural enterprise. Animal husbandry is nonexistent. Industrial pork barons produce pork chops and bacon and the animals themselves are treated only as industrial production units. Genetic manipulation for meat production has produced hog breeds that are high strung and nervous. They live short miserable lives characterized by extreme cruelty and extreme terror.

By nature, pigs are active, inquisitive and intelligent, and they spend much of their time exploring ground cover and rooting for food. They are communal animals with a highly developed system of vocalization that they use in courtship, self defense and raising their young. The female pig, the sow, has a strong instinct to build a nest before giving birth. She will wean her young for several months and take care of them even longer.

In industrialized hog factories, pigs are raised in intensive confinement for their entire lives in huge windowless structures choked by their own foul stenches. Subject to disease from overcrowding and entirely deprived of exercise, sunlight, straw bedding, rooting opportunities and social interactions that are fundamental to their health, factory hogs are kept healthy only by constant doses of subtherapeutic antibiotics. Their growth rates are unnaturally sped-up by feed additives including antibiotics, hormones and toxic metals. Sows endure in tiny crates that are too small for them to turn around, giving birth on bare metal grate floors, their babies taken away after only three weeks of weaning. Driven by frustration and depression, sows continually gnaw on the metal bars of their crates. Severe restrictions on the pigs’ movement over a lifetime impede bone development frequently resulting in broken legs. Injured pigs are “culled” sometimes by being dumped alive into waste lagoons. There are many accounts of brutal treatment of these animals, including teeth pulling, castration without anesthesia, and beating disabled sows unable or too terror stricken to walk to slaughter. According to the U.S. Humane Society, one in five of all factory-raised pigs die prematurely, before reaching the slaughterhouse.

In 1999, Smithfield made a major foray into Poland. At the invitation of the Animal Welfare Institute, Andrzej Lepper, the President of Poland’s largest farmers’ union, came to the United States and toured Smithfield hog factories. Mr. Lepper later recounted that he was shocked by what he saw in the American hog factories which he referred to as “animal concentration camps.” He added that, “industrial husbandry methods of raising hogs are not in harmony with nature.”

Read the article that "deserves to be ranked with Schlosser’s [Fast Food Nation] in the annals of excellent food-chain investigative journalism." And you might want to avoid these products the next time you're at the market. More here: Wikipedia. Testimony before the Senate Committee on Government Affairs [source of the blockquote above]. And an alternative to factory meat production: yes, there are alternatives.