SnakeMap: four years of experience with a national small animal snake envenomation registry.

SnakeMap is a national cloud-based, veterinary snakebite registry. It was designed to prospectively collect data of the clinical circumstances and temporospatial information on cases of snake envenomation in dogs and cats. We herein introduce the project and summarise the data from the first 4 years of SnakeMap. The registry is a veterinary community-based online database allowing case entry from veterinary hospitals across Australia. Registry data comprise hospital characteristics, patient characteristics, envenoming snake type, treatment and outcome variables, including time and geolocation of the snake bite. We present summative information on select key variables from the SnakeMap registry (1 July 2015 to 30 June 2019). Twenty-eight hospitals from 6 states/territories entered 624 cases into the registry, including 419 dogs (67%) and 205 cats (33%). Bite time was available in 216 animals of which 90 (42%) were reported to be bitten in the 3 hours between 03:00 pm and 05:59 pm; median bite to presentation interval was 60 (interquartile range [IQR] 30, 211) minutes in dogs and 95 (IQR 41, 238) minutes in cats. Bites occurred in the owner's yard in 356 dogs (85%) and 53 cats (26%). A snake venom detection kit was used in 172 cases (28%) and antivenom was administered in 523 cases (85%). Most animals (n = 534, 88%) survived to discharge (median hospitalisation of 25 [IQR 16, 62] hours). SnakeMap effectively collects relevant clinical data from dogs and cats with presumed snake bite and provides locally specific information on the epidemiology of snake envenomation in small animals.

Presumed secondary immune-mediated haemolytic anaemia following elapid snake envenomation and its treatment in four dogs.

CASE SERIES: This case series describes secondary immune-mediated haemolytic anaemia (IMHA) in four dogs following elapid snake envenomation and its treatment. All the dogs initially presented with clinical signs commensurate with mainland tiger snake (Notechis scutatus) envenomation. None of the dogs was anaemic at the time of presentation. IMHA was diagnosed 3-9 days following snake envenomation. The trigger for IMHA was unclear in each case and may have been a component of the snake venom, antivenom, fresh frozen plasma, concurrent morbidity, administered drugs or a combination thereof. Three of the four dogs received immunosuppressive therapy comprising corticosteroids with or without azathioprine. Resolution of the IMHA was documented 6 weeks after diagnosis for one dog and 9 months after diagnosis for two dogs, with one dog lost to follow-up. CONCLUSION: IMHA is a potential complicating factor of elapid snake envenomation and its treatment in dogs, and should be considered as a differential diagnosis for a persistent or worsening anaemia. Both the incidence and aetiopathogenesis of IMHA in the context of elapid snake envenomation and its treatment in dogs are unknown and require further examination.

Bioequivalence of a new liquid formulation of benazepril compared with the reference tablet product.

OBJECTIVE: To compare the bioequivalence and 'switchability' of two formulations of benazepril (tablet and liquid) after oral administration. DESIGN: Randomised cross-over design, followed by parallel comparison. METHODS: Twelve mixed-breed dogs were administered either a tablet (Group A) or liquid formulation (Group B) of benazepril orally at 0.45 mg/kg daily for 4 days. With no washout period, the dogs then received the alternative treatment at the same dose for a further 4 days. Blood samples taken prior to treatment and serially after treatment were analysed for plasma concentrations of benazepril and benazeprilat and the activity and concentration of angiotensin-converting enzyme (ACE). The calculated percentage inhibition of ACE was defined as the primary outcome variable. RESULTS: No statistically significant differences were found between groups A and B for any variable evaluated. The mean (± SD) percentage of ACE inhibition was 85.5 ± 7.04% for the liquid formulation and 85.9 ± 6.66% for the tablet formulation. The mean of the ratios was 1.00 (80% confidence interval 0.96-1.04). No evaluated effect term (sequence, formulation or period) had any statistical effect on any outcome variable. CONCLUSION: This study supports a conclusion that, based on pharmacodynamic response, the liquid formulation of benazepril is bioequivalent to the reference tablet formulation. Further, the lack of a sequence effect supports the switchability of these two formulations.