{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T07:20:17Z","timestamp":1769066417969,"version":"3.49.0"},"reference-count":44,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T00:00:00Z","timestamp":1604275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>There is limited information on clinical profiles, treatment, and management aspects of Indian cobra (Naja naja) bite envenoming in dogs in Sri Lanka. Dogs with cobra bites presented to the Veterinary Teaching Hospital (VTH), University of Peradeniya, were prospectively studied over a period of 72 months; local and systemic clinical manifestations and hematological abnormalities were recorded. We studied 116 cobra bite envenomings in dogs. A grading system was established using a combination of anatomical site of fang marks, as well as local and systemic clinical manifestations. Accordingly, treatment strategies were established using Indian polyvalent antivenom (AVS). Pain and swelling at the bite site were major clinical signs observed, while neurotoxic manifestations (mydriasis, wheezing, and crackles) were detected in most dogs. Leukocytosis was observed in 78% of them. Statistical analysis revealed that the grading scores obtained were compatible to initiate AVS administration according to the severity. The minimum number required was 2 AVS vials (range 2\u201312). Almost 20% of the dogs developed wheezing, crackles, hypersalivation, restlessness, and dyspnea as adverse reactions to AVS treatment. Necrotic wounds on bitten anatomical sites developed in 19% of the dogs and 2.5% developed acute kidney injuries as a consequence of envenoming crisis. Despite treatment, 3% of dogs died. No dry bites were recorded.<\/jats:p>","DOI":"10.3390\/toxins12110694","type":"journal-article","created":{"date-parts":[[2020,11,2]],"date-time":"2020-11-02T09:04:46Z","timestamp":1604307886000},"page":"694","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Development of a Treatment Protocol for Cobra (Naja naja) Bite Envenoming in Dogs"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8923-5839","authenticated-orcid":false,"given":"Ranjith","family":"Adhikari","sequence":"first","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lalith","family":"Suriyagoda","sequence":"additional","affiliation":[{"name":"Department of Crop Science, Faculty of Agriculture, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amal","family":"Premarathna","sequence":"additional","affiliation":[{"name":"Department of Veterinary Pathobiology, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niranjala","family":"De Silva","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ashoka","family":"Dangolla","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandima","family":"Mallawa","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Indira","family":"Silva","sequence":"additional","affiliation":[{"name":"Department of Veterinary Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6795-0113","authenticated-orcid":false,"given":"Indika","family":"Gawarammana","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya 20400, Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Silva, A., Maduwage, K., Sedgwick, M., Pilapitiya, S., Weerawansa, P., Dahanayaka, N.J., Buckley, N., Johnston, C., Siribaddana, S., and Isbister, G.K. (2016). Neuromuscular effects of common Krait (Bungarus caeruleus) envenoming in Sri Lanka. PLoS Negl. Trop. Dis., 10.","DOI":"10.1371\/journal.pntd.0004368"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1212\/CPJ.0000000000000180","article-title":"Neurotoxic snakes of the Americas: Table","volume":"5","author":"Rolan","year":"2015","journal-title":"Neurol. Clin. Pract."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/bies.201000117","article-title":"Snake venom: From fieldwork to the clinic: Recent insights into snake biology, together with new technology allowing high-throughput screening of venom, bring new hope for drug discovery","volume":"33","author":"Vonk","year":"2011","journal-title":"Bioessays"},{"key":"ref_4","first-page":"269","article-title":"Snake venom: From fieldwork to the clinic; Prospectus and overviews","volume":"33","author":"Freek","year":"2011","journal-title":"Bioassays"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Silva, A., Hodgson, W.C., and Isbister, G.K. (2017). Antivenom for neuromuscular paralysis resulting from snake envenoming. Toxins, 9.","DOI":"10.3390\/toxins9040143"},{"key":"ref_6","first-page":"33","article-title":"Conservation of biodiversity in a hotspot: Sri Lanka\u2019s amphibians and reptiles","volume":"5","author":"Erdelen","year":"2012","journal-title":"Amphib. Reptil. Conserv."},{"key":"ref_7","first-page":"32","article-title":"Sri Lankan colubrid snakes","volume":"6","author":"Somaweera","year":"2004","journal-title":"Sri Lanka Nat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1080\/24734306.2018.1549804","article-title":"Epidemiology of snakebite in dogs in Sri Lanka","volume":"2","author":"Adhikari","year":"2018","journal-title":"Toxicol. Commun."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1016\/j.trstmh.2009.04.002","article-title":"Epidemiology, clinical profile and management issues of cobra (Naja naja) bites in Sri Lanka: First authenticated case series","volume":"103","author":"Kularatne","year":"2009","journal-title":"Trans. R. Soc. Trop. Med. Hyg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s40409-017-0098-7","article-title":"Hematological and plasma biochemical parameters in a wild population of Naja naja (Linnaeus, 1758) in Sri Lanka","volume":"23","author":"Dissanayake","year":"2017","journal-title":"J. Venom. Anim. Toxins Incl. Trop. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"504","DOI":"10.11646\/zootaxa.4162.3.5","article-title":"A new canopy-dwelling species of Dendrelaphis (Serpentes: Colubridae) from Sinharaja, World Heritage Site, Sri Lanka","volume":"4162","author":"Wickramasinghe","year":"2016","journal-title":"Zootaxa"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Kasturiratne, A., Wickremasinghe, A.R., De Silva, N., Gunawardena, N.K., Pathmeswaran, A., Premaratna, R., Savioli, L., Lalloo, D.G., and De Silva, H.J. (2008). The global burden of snakebite: A literature analysis and modelling based on regional estimates of envenoming and deaths. PLoS Med., 5.","DOI":"10.1371\/journal.pmed.0050218"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1016\/j.toxrep.2019.08.006","article-title":"Clinico-epidemiology and management of Russell\u2019s viper (Daboia russelii) envenoming in dogs in Sri Lanka","volume":"6","author":"Adhikari","year":"2019","journal-title":"Toxicol. Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.etp.2009.08.002","article-title":"Systemic pathological effects induced by cobra (Naja naja) venom from geographically distinct origins of Indian peninsula","volume":"62","author":"Shashidharamurthy","year":"2010","journal-title":"Exp. Toxicol. Pathol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Meier, J. (2017). Venomous and Poisonous Animals-A Biologist\u2019s View. Handbook of Clinical Toxicology of Animal Venoms and Poisons, CRC Press.","DOI":"10.1201\/9780203719442-1"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jprot.2015.10.007","article-title":"A comparative study of venomics of Naja naja from India and Sri Lanka, clinical manifestations and antivenomics of an Indian polyspecific antivenom","volume":"132","author":"Sintiprungrat","year":"2016","journal-title":"J. Proteom."},{"key":"ref_17","first-page":"215","article-title":"Venomous and poisonous animals\u2014I. Overview","volume":"66","author":"Chippaux","year":"2006","journal-title":"Med. Trop. Rev. Corps Sante Colon."},{"key":"ref_18","unstructured":"Garg, S.K. (2002). Veterinary toxiciology. Zootoxins, CBS Publishers and Distributers. [1st ed.]."},{"key":"ref_19","first-page":"1136","article-title":"Establishment of reference ranges for coagulation tests for dogs in Sri Lanka","volume":"7","author":"Adhikari","year":"2019","journal-title":"J. Pharmacol. Clin. Toxicol."},{"key":"ref_20","first-page":"1","article-title":"Clinical findings and the treatment regime adapted for snake bites in canines. Proceedings of the 46th Annual Convention","volume":"41","author":"Kariyawasam","year":"1993","journal-title":"Sri Lanka Vet. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Silva, A., Hodgson, W., and Isbister, G.K. (2016). Cross-neutralisation of in vitro neurotoxicity of Asian and Australian snake neurotoxins and venoms by different antivenoms. Toxins, 8.","DOI":"10.3390\/toxins8100302"},{"key":"ref_22","unstructured":"World Health Organization (2019, August 24). WHO Guidelines for the Production, Control and Regulation of Snake Antivenom Immunoglobulins. Available online: http:\/\/www.who.int\/bloodproducts\/snake_antivenoms\/snakeantivenomguide\/en\/."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.toxicon.2013.01.022","article-title":"Antivenom for snakebite envenoming in Sri Lanka: The need for geographically specific antivenom and improved efficacy","volume":"69","author":"Keyler","year":"2013","journal-title":"Toxicon"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"26778","DOI":"10.1038\/srep26778","article-title":"Efficacy of Indian polyvalent snake antivenoms against Sri Lankan snak evenoms: Lethality studies or clinically focused invitro studies","volume":"6","author":"Maduwage","year":"2016","journal-title":"Sci. Rep."},{"key":"ref_25","first-page":"22","article-title":"Retrospective study on clinical features, therapy and epedemiology of snake Envenomation in dogs admitted to Veterinary Teaching Hospital","volume":"58","author":"Gobikrushanth","year":"2011","journal-title":"Proceedings of the 63rd Annual Scientific Sessions of the Sri Lanka Veterinary Association Abstract of Scientific Papers, Sri Lanka, 3\u20135 July 2020"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Williams, H., Mellows, B., Mitchell, R., Sfyri, P., Layfield, H., Salamah, M., Vaiyapuri, R., Collins-Hooper, H., Bicknell, A., and Matsakas, A. (2019). Mechanisms underpinning the permanent muscle damage induced by snake venom metalloprotease. PLoS Negl. Trop. Dis., 13.","DOI":"10.1371\/journal.pntd.0007041"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"20","DOI":"10.5694\/j.1326-5377.2004.tb05768.x","article-title":"Parallel infusion of hydrocortisone +\/- chlorpheniramine bolus injection to prevent acute adverse reactions to antivenomfor snakebites: A randomized, double-blind, placebo-controlled study","volume":"180","author":"Gawarammana","year":"2004","journal-title":"Med. J. Aust."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.4269\/ajtmh.17-0877","article-title":"Research into the causes of venom-induced mortality and morbidity identifies new therapeutic opportunities","volume":"100","author":"Girish","year":"2019","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ranawaka, U.K., Lalloo, D.G., and De Silva, H.J. (2013). Neurotoxicity in snakebite-The limits of our knowledge. PLoS Negl. Trop. Dis., 7.","DOI":"10.1371\/journal.pntd.0002302"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.toxicon.2015.09.017","article-title":"Cobra venom cytotoxins; apoptotic or necrotic agents?","volume":"108","author":"Ebrahim","year":"2015","journal-title":"Toxicon"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1000181","DOI":"10.4172\/2161-0495.1000181","article-title":"Snake venom cytotoxins, phospholipase A2s, and Zn2+-dependent metalloproteinases: Mechanisms of action and pharmacological relevance","volume":"4","author":"Gasanov","year":"2014","journal-title":"J. Clin. Toxicol."},{"key":"ref_32","first-page":"1","article-title":"Snakebite envenoming","volume":"3","author":"Calvete","year":"2017","journal-title":"Nat. Rev. Dis. Prim."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.toxicon.2015.11.014","article-title":"Differential action of medically important Indian BIG FOUR snake venoms on rodent blood coagulation","volume":"110","author":"Hiremath","year":"2016","journal-title":"Toxicon"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/j.toxicon.2009.05.006","article-title":"Acute ischemic strokes due to bites by Daboia russelii in Sri Lanka-First authenticated case series","volume":"54","author":"Gawarammana","year":"2009","journal-title":"Toxicon"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/2689171","article-title":"Acute severe anaphylaxis in Nepali patients with neurotoxic snakebite envenoming treated with the VINS polyvalent antivenom","volume":"2019","author":"Sharma","year":"2019","journal-title":"J. Trop. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1111\/jth.12218","article-title":"A randomized controlled trial of fresh frozen plasma for treating venom-induced consumption coagulopathy in cases of Australian snakebite (ASP-18)","volume":"11","author":"Isbister","year":"2013","journal-title":"J. Thromb. Haemost."},{"key":"ref_37","first-page":"713","article-title":"Posterior circulation stroke in a young male following snake bite","volume":"56","author":"Mugundhan","year":"2008","journal-title":"J. Assoc. Physicians India"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.toxicon.2018.04.015","article-title":"Toxin-resolved antivenomics-guided assessment of the immunorecognition landscape of antivenoms","volume":"148","author":"Calvete","year":"2018","journal-title":"Toxicon"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1136\/emj.2004.022251","article-title":"Snake antivenom research: The importance of case definition","volume":"22","author":"Isbister","year":"2005","journal-title":"Emerg. Med. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/0041-0101(92)90854-X","article-title":"Envenoming by viper bites in France: Clinical gradation and biological quantification by ELISA","volume":"30","author":"Audebert","year":"1992","journal-title":"Toxicon"},{"key":"ref_41","unstructured":"Deva Kumar, K. (2018). Adverse Drug Reactions of Anti-Snake Venom among Haemotoxic and Neurotoxic Snake Bite: A Prospective Observational Study. [Ph.D. Thesis, Dhanalakshmi Srinivasan Medical College and Hospital]."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1111\/j.1440-1797.2006.00599.x","article-title":"Snakebite nephropathy","volume":"11","author":"Sitprija","year":"2006","journal-title":"Nephrology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.ekir.2019.03.014","article-title":"Snake envenoming-An underreported cause of acute kidney injury","volume":"4","author":"Gopalakrishnan","year":"2019","journal-title":"Kidney Int. Rep."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"8","DOI":"10.4038\/sljch.v30i1.790","article-title":"Envenomation by the hump nosed viper (hypnale hypnale) in children: A pilot study","volume":"30","author":"Karunatilaka","year":"2009","journal-title":"Sri Lanka J. Child. Health"}],"container-title":["Toxins"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6651\/12\/11\/694\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:28:10Z","timestamp":1760178490000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6651\/12\/11\/694"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,2]]},"references-count":44,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["toxins12110694"],"URL":"https:\/\/doi.org\/10.3390\/toxins12110694","relation":{},"ISSN":["2072-6651"],"issn-type":[{"value":"2072-6651","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,2]]}}}