Snake bite - Sooty Todd

Geoff received a call from Ian Todd late one Saturday afternoon. His kids dog had killed a brown snake and was showing some of the signs of envenomation. Typical signs with a brown snake include collapse, salivation, weakness, inability to walk correctly (or ataxia), paralysis and death.

Brown snakes are the second most venomous snake in the world and their venom works very quickly. Ian was at Molong, 1/2 an hour away. That day there were no traffic police on the Molong road but Sooty was in a bad way, the wind was behind him and Ian did a personal best between Orange and Molong. On the edge of Orange sooty lost consciousness and when he got to the clinic he was completely paralysed.

Geoff quickly started resuscitation. A tube was placed in Sooty's windpipe so we could breathe for him. It was thought this would be a temporary measure, little did we know what lay in store.

Sooty had received a massive dose of venom and required a massive dose of antivenom. The picture here, shows the antivenom used. Sooty needed about four times the dose normally required.

Even with the antivenom in the system Sooty was still not breathing for himself, it would be another 15 hours until he was properly able to do that. Geoff took Sooty home and breathed for Sooty every 10 seconds until 3.40am in the morning.  

In the morning the kids were stunned and over the moon to be told Sooty had made it. The last they had seen Sooty he was effectively dead.

Sooty made a rapid recovery, probably because he had been such a fit dog prior to his problems. This picture shows Sooty the next afternoon. There is still weakness but 12 hours before he had not even been able to breath by himself. One of the case studies Geoff did for his Masters degree was on snake bite in dogs and that little bit of extra knowledge may have saved Sooty's life.

From the CSL handbook

Brown snakes are the most common cause of snakebites and snakebite deaths in Australia. The fangs are small; average fang length in adults is only 2.8mm. Compared to many other dangerous snakes, they generally produce little venom, though the venom is very potent. There are several species, the most important medically being the eastern or common brown, the western brown or gwardar and the dugite. They vary in length up to 2m, rarely more. Colouration is very variable; they may be brown, orange-red, grey, almost black, unbanded, speckled, banded, or black headed. Juveniles have distinctive head and neck markings, with a black mark on the top of the head, followed by a brown to orange band, then a black band. These baby brown snakes typically hatch around February/March and are about 25cm long.

 Brown snakes are common throughout mainland Australia, in essentially all habitats, including urban areas. They are not present in Tasmania or the islands off the southern coast of Australia, such as Kangaroo Island (SA). They are relatively common in some urban and metropolitan areas. Hundreds of brown snakes are removed from houses and other properties each year in some capital cities and >10% of these snakes are found inside the house!

The venom is multicomponent and includes powerful presynaptic neurotoxins, procoagulants and possibly both cardiotoxins and direct nephrotoxins. There is no myolytic activity. The venom of the common brown snake is the second most potent snake venom in the world.

Perhaps because of their small fangs and relatively small amount of venom available, many brown snake bites are minor, not requiring antivenom therapy. Of course, this is not known initially, so all bites should be treated as potentially lethal. In the days prior to antivenom therapy less than 10% of brown snake bites were fatal. However, this low rate of lethality is more than compensated by the frequency of bites and when a brown snake does inject plenty of venom, it is both very toxic and rapid acting.

A typical brown snake bite is either painless or almost painless. The tiny fangs often leave only faint puncture or scratch marks, without local redness, bruising or swelling. Indeed, the bite can be hard to see without a magnifying glass. Do not be fooled; even such an apparently trivial looking bite can result in lethal envenoming, particularly in young children.

If a significant amount of venom has been injected, then the patient may develop local draining lymph node tenderness/swelling, a persistent ooze from the bite site, headache, nausea/vomiting, abdominal pain, severe coagulopathy and sometimes, kidney damage. Paralysis is also possible but is only rarely seen, even with otherwise severe envenoming. Myolysis does not occur. In young children and occasionally in adults, early collapse

Have a look at the CSL handbook for more information on snakebite