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At least 50 enzymes contribute to snake venom potency that causes soft tissue damage, vasculotoxicity, coagulopathy, cytotoxicity, and necrosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Diagnosis<\/jats:title><jats:p>Snakebite envenomation may be identified by fang puncture wounds but primarily as a focal site with a rapid onset of severe swelling, hemorrhage, pain, and potentially necrosis. Crotalid venom causes hematologic abnormalities, local tissue damage, hypotension, and occasionally neurological impairment. The most marked hematologic abnormalities include thrombocytopenia, hemolytic anemia, and various forms of coagulopathy, including defibrination without disseminated intravascular coagulation (in <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>orth <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merica), summarized as a venom\u2010induced coagulopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Therapy<\/jats:title><jats:p>The mainstay of treatment includes intravenous crystalloid fluid therapy, antivenom, and analgesic medications. Currently available antivenom products include a mixed polyvalent <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ntivenin (<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>rotalidae) <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>olyvalent (<jats:styled-content style=\"fixed-case\">ACP<\/jats:styled-content><jats:sup>a<\/jats:sup>), and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>rotalinae polyvalent immune <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ab (<jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>rofab<jats:sup>b<\/jats:sup>). There are products from <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>exico and <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>osta <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>ica that have limited availability, a similar imported <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>ab product (<jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ntivipmyn<jats:sup>c<\/jats:sup>), and a polyspecific antivenom (<jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>olyvet\u2010<jats:styled-content style=\"fixed-case\">ICP<\/jats:styled-content><jats:sup>d<\/jats:sup>), respectively. Glucocorticoids, nonsteroidal antiinflammatory drugs (<jats:styled-content style=\"fixed-case\">NSAID<\/jats:styled-content>s) and antihistamines are not included in the majority of recommended treatment protocols by world authorities; however, there are some reports that describe their use. Antimicrobial therapy and blood products are used only when clinically indicated. There is a vaccine available, but at present, it is of unknown efficacy because of a lack of documented scientific information.<\/jats:p><\/jats:sec><jats:sec><jats:title>Prognosis<\/jats:title><jats:p>Mortality from <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>orth <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican crotalid envenomation is generally rare and is influenced by several variables, including the amount of venom injected, the size and species of snake, the size of the victim, the location of the bite, time elapsed until treatment, and the therapy initiated. Mortality rates range from 1% to 30%.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1476-4431.2011.00677.x","type":"journal-article","created":{"date-parts":[[2011,10,15]],"date-time":"2011-10-15T10:06:57Z","timestamp":1318673217000},"page":"461-470","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Overview and controversies in the medical management of pit viper envenomation in the dog"],"prefix":"10.1111","volume":"21","author":[{"given":"Robert A.","family":"Armentano","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Schaer","sequence":"additional","affiliation":[{"name":"Department of Small Animal Clinical Sciences University of Florida Small Animal Hospital  Gainesville FL 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