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Veterinary Experts Do Not Recommend The Rattlesnake Vaccine

Every spring, as the weather warms up, we want to shed our winter coats and get out with the dogs onto trails and into open spaces. Unfortunately, as our pooches explore the environment with their noses, they may encounter snakes coming out of brumation.

This can cause concerns for dog owners. Many will ask their vets, “What can I do?” Unfortunately, some vets will recommend the rattlesnake vaccine. Touted to “buy time” getting to an emergency clinic or even to ward off the envenomation, the rattlesnake vaccine is an often used but poorly supported treatment for dogs.

The rattlesnake vaccine uses inactivated western diamondback rattlesnake (Crotalus atrox) venom. The manufacturers claim it “is intended to help create an immunity to protect your dog against the effects of western diamondback rattlesnake venom.” However, there is no evidence to support the vaccine being effective, and some data suggest it could be harmful by causing an allergic reaction to snake venom.

The American Animal Hospital Association (AAHA) recently released a statement highlighting the lack of evidence of vaccine (toxoid) efficacy. Read It Here.

Key points from the AAHA’s statement:

1.      There is NO published data supporting the efficacy of the vaccine in dogs.

2.      In a study that was performed in mice, where mice were given 50-1,500 TIMES the dose of the toxoid given to dogs during routine vaccination, survival following exposure to snake venom was still not guaranteed, and some vaccinated mice actually died or required euthanasia earlier than unvaccinated mice exposed to the same amount of venom.

3.      Adverse reactions, including anaphylaxis, have been reported in vaccinated dogs.

4.      Though the manufacturers make claims of cross-protection (protection from envenomation by pit viper species other than the western diamondback rattlesnake, the species used in the production of the toxoid), there are no data to support this claim.

From the AAHA: “Veterinarians choosing to use this toxoid should be aware of the lack of peer-reviewed published data. Polyvalent antivenin therapy is an alternative to vaccination in suspect cases of rattlesnake bite.”

The vaccine did not prove effective in a retrospective study looking at 272 cases of rattlesnake envenomations in dogs. Read It Here.

Key findings from the study:

1.      There was no evidence that vaccination lessened morbidity or mortality.

2.      No measurable benefit could be identified associated with rattlesnake vaccination.

From this case series: “Vaccination for protection of the general canine population from rattlesnake envenomation cannot be recommended by these authors.”

Furthermore, the rattlesnake vaccine toxoid may predispose snakebitten dogs to anaphylaxis by providing the necessary sensitizing exposure to snake venom antigens. Read It Here.

Key findings from the study:

1.      There are no peer-reviewed publications providing evidence of clinical efficacy in snakebitten dogs.

2.      Anaphylaxis requires prior sensitization to an antigen; it is proposed that repeated vaccinations with the rattlesnake toxoid vaccine serve as a sensitization event to snake venom.

From the authors: “These dogs had previously been vaccinated with the C. atrox toxoid vaccine on more than one occasion, which may have served as the initial sensitization required for the development of anaphylaxis.”

Snakebites are medical emergencies for pets and humans alike. Effective antivenom is the only thing that can neutralize venom and improve outcomes.

If you would like to learn more about veterinary ativenoms, please see this post by Dr. Cory Woliver (A Primer on Antivenoms Used by Veterinarians).

If you found this article helpful, please consider donating to ASF today. Every donation is 100% tax deductible and goes directly to patient care in Africa.

A Primer on Antivenoms Used by Veterinarians

Many people ask about the antivenoms that are used for envenomations in dogs and cats, so here is your immunology lesson for the week.

We have three veterinary-specific products available to us: Venom Vet, Rattler, and ACP. These are all licensed to be used for ALL North American pit viper bites (rattlesnakes, copperheads, and cottonmouths). It is rare to use CroFab or Anavip (the human pit viper antivenoms) in veterinary medicine due to the cost and the fact that there are labeled products for animals, but either could be used in animals. Coral snake antivenom is a human product that we use on animals and is different from pit viper antivenom.

All veterinary antivenom products are derived from horses. Basically, venom is collected from snakes and injected into horses. This process is repeated a number of times. After enough time has passed for the venom to generate an immune response (antibody production), a sample of the horses’ blood is collected and filtered to harvest the antibodies.

Antivenom is a product derived from those horse antibodies. These antibodies or antibody fragments are what work to neutralize the venom. Antibodies look sort of like a Y. The top part is called the Fab (fragment antigen binding) region.  The bottom part is called the Fc (fragment crystallizable) region. Collectively, the entire antibody is referred to as an IgG molecule.

https://ruo.mbl.co.jp/bio/e/support/method/antibody-structure.html

Antivenom can either be made using the whole antibody or just a region of the antibody. The larger the molecule size, the longer the half-life, meaning the antivenom stays in circulation longer. Full IgG molecules are larger than F(ab)2 pieces (the top of the Y, minus the Fc). The upside of IgG antivenoms is that because they stay in circulation longer, you may end up needing less total antivenom. The downside is that with the Fc fragment still attached, you have a higher risk of hypersensitivity reactions.

The Venom Vet product is an F(ab)2 molecule. This means that the most reactive part of the antibody (the Fc portion) has been removed, so there should be fewer allergic reactions in theory. ACP is a whole IgG molecule, making it theoretically more likely to cause an allergic reaction. Rattler is also whole IgG, but instead of being a small, highly concentrated volume of antibodies, it is 50ml of equine plasma. Due to Rattler being plasma from a different species, there is a larger theoretical chance of allergic reaction. The coral snake antivenom is also an IgG product.

Overall, reactions to these products are rare. Usually, fewer than 10% of cases. If allergic (hypersensitivity) reactions occur, they are treatable, whether it is hives or anaphylaxis. You can treat these reactions with Benadryl and/or epinephrine. The reason allergic reactions happen is because there are foreign (horse) proteins in the antivenom. Studies have shown that all of these products have the same efficacy but varying allergic reaction rates. Lower reaction rates have been noted for F(ab)2 products (2.5-3.5%) compared to IgG (7.2-9.3%). But all are good products; if your pet needs antivenom, any of these is a solid option.

Average costs for these products range from about $300-1,000 per vial. If you live in an area with venomous snakes, you should consider getting pet insurance or putting aside some money in case of a bite to a pet, as total envenomation treatment costs can range from about $800-10,000+ depending on how bad the bite is.

Cory Woliver, DVM

University of Florida

If you found this article helpful, please consider donating to ASF today. Every donation is 100% tax deductible and goes directly to patient care in Africa.

The truth about commercial snakebite kits (including the venom extractor)

As snakebite experts we are frequently asked about first aid for snakebite patients. One of the most common questions is “Do venom extractors and other commercial snakebite kits actually help?” The short answer is no. In fact, most of the advice about snakebite first aid that has circulated over the past 500 years or so (and probably much longer) is bad information. Things like pocket knives, suction devices, tourniquets, gunpowder, vitamin C, freezing, burning, and even electrocution have been advocated for snakebite first aid over the years; the only thing all of these “treatments” have in common is a high likelihood of making the situation worse…

How to survive a snakebite in the wilderness

How to survive a snakebite in the wilderness

Have you ever wondered what you should do if you are bitten by a snake in the backcountry far from medical care? This is a question that comes up frequently enough that we decided to put together a post to answer it. Pretty much everything that is “common knowledge” about snakebite first aid, including the use of tourniquets or venom extractors, is either completely ineffective or potentially dangerous. The only definitive treatment for a serious snake envenomation is the appropriate antivenom, but that doesn’t mean that there is nothing you can do in the meantime. In this post we will provide you with medically sound advice written by snakebite experts detailing what to do if you are bitten by a snake in the wilderness far from medical care so you can make it to the hospital alive and receive the necessary antivenom treatment. Read this post for some information that could potentially save your life, or the life of a loved one, if a snakebite occurs hours or days away from the nearest hospital.