Spring poisoning hazards

Poisoning can be seasonal. Potential toxic hazards in the spring include adders, which emerge from hibernation as the weather warms. Adders may not be seen to bite a horse, but envenomation should be considered in a horse with localised limb swelling that spreads up the leg. There are several spring-flowering plants which contain toxic compounds such as cardiogenic glycosides (foxglove, lily of the valley, oleander), protoanemonin (Hellebore) and grayanotoxins (Pieris and Rhododendron). Saplings of sycamore are a spring source of hypoglycin A which causes atypical myopathy in horses. Treating plant poisoning in horses generally involves removing the plant, providing good quality food and giving supportive care. Managing the effects of adder bite is supportive, centring around administration of specific antivenom.

Rare coexistence of unilateral erythema nodosum with erysipelas in the area of previous adder bite

INTRODUCTION. Erysipelas is an acute inflammation of skin and subcutaneous tissue. Erythema nodosum is the most frequent form of panniculitis considered as a reaction to different factors, most commonly infections, especially streptococcal. CASE PRESENTATION. A 74-year-old male presented to hospital due to skin lesions involving the same area he was bitten by an adder six months earlier. On the admission well-demarcated erythema and oedema on the right shin with accompanying fever were noted. Erysipelas was diagnosed and intravenous ceftriaxone was administered. Two days later a few tender nodules within that unilateral location appeared. Based on the clinical and histopathological picture diagnosis of Bävferstedt subtype (erythema nodusum migrans, ENM) was made. The treatment was continued, further followed by doxycycline orally resulting in clinical improvement. CONCLUSIONS. This case presents an unusual coexistence of erysipelas and erythema nodosum migrans, the more it was observed on the primary adder bite area and occurred in a man. Most probably, adder’s venom could lead to disturbed blood and lymph flow what predisposed to erysipelas, which, as streptococcal infection, could trigger ENM.

Neurological deficits after confirmed adder bite in a cat

A domestic shorthair cat presenting with pyrexia and tachycardia was given an antibiotic for suspected infection but returned 48 hours later with inability to defecate or urinate and with tail paralysis. There was swelling and bruising at the tail base but no radiographic evidence of a tail pull injury. Laboratory parameters and urinary and faecal cultures were normal. Five days later the owner reported an adder in the garden, and due to no response to supportive care, antivenom was given. Within two hours clinical signs improved, and by 12 hours the tachycardia and pyrexia had resolved. Laboratory analysis confirmed the presence of adder venom in a blood sample. Urination and defecation were normal at five months with regained function in the cranial third of the tail. It is thought clinical signs were due to direct venom-induced necrosis of nerve tissue rather than venom neurotoxins.

In Dogs With a European Adder Bite, Does the Use of Antivenom With Supportive Treatment Compared to Supportive Treatment Alone Improve Time to Recovery?

<p>The current literature does not offer convincing evidence for the positive effect of antivenom on time to recovery in dogs envenomated by the European adder. It appears that the use of antivenom in addition to supportive treatment may positively affect local swelling if given within 24 hours of the bite, but the evidence is low quality and further studies are required before a more definitive answer can be reached.</p><p><br /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" /></p>

Volkmann’s contracture of the forearm due to an insect bite: a case report and review of the literature

Compartment syndrome affecting the upper limb is reported rarely in the literature and is usually limited to single case reports. Upper limb compartment syndrome secondary to envenomation is rare, especially in the UK. Worldwide, it has been reported resulting from snake and insect bites, mostly from snakes from the Viperidae family, and from insects such as bees and wasps. Reports from the UK are limited to one case of an adder bite. We present a case of a previously fit and well adult who developed an ischaemic contracture of the forearm after an insect bite. Surgical exploration revealed segmental necrosis and contracture of the superficial and deep flexors of the fingers, requiring fasciotomy and tendon-lengthening procedures. This is the first report of a compartment syndrome, or a late ischaemic contracture from an insect bite in the UK. Owing to the rarity of compartment syndrome of the upper limb secondary to envenomation, a delay in diagnosis and treatment can lead to irreversible changes in the muscular compartments of the forearm.