Nagel, Salome SusannaSchoeman, Johan P.Thompson, P.N. (Peter N.)Wiinberg, BoGoddard, Amelia2015-06-152015-06-152014-11Nagel, SS, Schoeman, JP, Thompson, PN, Wiinberg, B & Goddard, A 2014, 'Hemostatic analysis of dogs naturally envenomed by the African puffadder (Bitis arietans) and snouted cobra (Naja annulifera)', Journal of Veterinary Emergency and Critical Care, vol. 24, no. 6, pp. 662-671.1479-3261 (print)1476-4431 (online)10.1111/vec.122367005814117J-6765-2013J-2534-20137403220452http://hdl.handle.net/2263/45495OBJECTIVE – To investigate hemostatic changes in dogs envenomed by cytotoxic (African puffadder) and neurotoxic snakes (snouted cobra) using thromboelastography (TEG) and plasma-based coagulation assays. DESIGN – Prospective observational clinical study. SETTING – University teaching hospital. ANIMALS – Eighteen client-owned dogs; 9 envenomed by African puffadder (Bitis arietans) and 9 by snouted cobra (Naja annulifera). Ten healthy dogs served as controls. INTERVENTIONS – None. MEASUREMENTS AND MAIN RESULTS – Blood was collected at presentation and 24 hours post envenomation. Platelet count, TEG, prothrombin time, activated partial thromboplastin time (aPTT), antithrombin activity, and fibrinogen (Fib) and C-reactive protein (CRP) concentrations were measured. Outcomes were analyzed using linear mixed models at 5% significance. At presentation, R time was significantly prolonged in the puffadder group compared to the cobra (P = 0.01) and control groups (P = 0.05). Platelet count was significantly lower in the puffadder compared to the cobra (P = 0.04) and control groups (P = 0.001), respectively. Antithrombin activity was significantly decreased in the puffadder (P = 0.002) and cobra groups (P = 0.004) compared to the control group. Both prothrombin time and activated partial thromboplastin time were significantly prolonged in the cobra group compared to the control group (P = 0.03 for both). The TEG variables, maximum amplitude (MA) and G, were significantly increased 24 hours post envenomation in the puffadder group compared to their values at presentation (P = 0.05 for both). Fib and CRP concentrations were significantly increased 24 hours post envenomation in both snake-envenomed groups. CONCLUSIONS – Prolonged clot initiation was a common feature in puffadder-envenomed dogs at presentation and this was likely venom induced. Snouted cobra-envenomed dogs were normo- to hypercoagulable at presentation. Dogs from both puffadder and cobra groups progressed to a more hypercoagulable by 24 hours post envenomation, most likely due to marked inflammation as indicated by the increased Fib and CRP concentrations. TEG proved a sensitive tool for detecting abnormal hemostasis in snake-envenomed dogs.en© Veterinary Emergency and Critical Care Society 2014. This is the pre-peer reviewed version of the following article : Hemostatic analysis of dogs naturally envenomed by the African puffadder (Bitis arietans) and snouted cobra (Naja annulifera), Journal of Veterinary Emergency and Critical Care, vol.24, no. 6, pp. 662-671, 2014. doi :10.1111/vec.12236. The definite version is available at : http://onlinelibrary.wiley.comjournal/10.1111/(ISSN)1476-4431VenomSnakesCoagulopathyThrombocytopeniaThromboelastographyAfrican puffadderBitis arietansSnouted cobraNaja annuliferaPostprint Article