The effect of a single dose of prednisolone in dogs envenomated by Vipera berus - a randomized, double-blind, placebo-controlled clinical trial

Abstract

Treatment with glucocorticoids after snakebite in dogs is controversial and randomized clinical studies are missing. The objective of this study was to investigate the effect of a single dose of prednisolone in dogs envenomated by Vipera berus in a double-blind placebo-controlled study, after exclusion of dogs treated with antivenom. The two treatment groups were compared regarding clinical status and clinicopathological test results. A total of 75 dogs bitten by Vipera berus within the previous 24hours were included. Clinical assessment, blood sampling and measurement of the bitten body part were done at admission (Day 1), after 24hours (Day 2) and at a re-examination (Re-exam) after 10-28 days. Dogs were given prednisolone 1mg/kg bodyweight (PRED) or saline (PLACEBO) subcutaneously in a randomized, double-blind clinical trial. Dogs were examined clinically and mental status and extent of edema were described. Furthermore, appetite, vomiting, diarrhea, cardiac arrhythmia and death were recorded. Concentrations of C-reactive protein (CRP) and high sensitivity cardiac Troponin I (cTnI), hematology variables and Prothrombin time (PT) were determined. Systemic inflammation was defined as present if CRP> 35mg/l. Results: None of the dogs died during the study period. The mental status was reduced in 60/75 (80%) of dogs on Day 1, compared to 19/75 (25%) on Day 2. The proportion of dogs with no or only mild edema increased significantly from Day 1 to Day 2. About one-third of the dogs developed gastrointestinal signs during the study period. Cardiac arrhythmia was uncommon. Clinicopathological changes included increased total leucocyte count, CRP and troponin concentration on Day 2. The cTnI concentration was increased in dogs with systemic inflammation, compared to dogs without systemic inflammation. A single dose of prednisolone did not significantly affect any of the clinical or clinicopathological parameters studied, except for a higher monocyte count on Day 2 in dogs that had received prednisolone treatment. Conclusion: The results of the present study do not support routine administration of a single dose of prednisolone 1 mg/kg subcutaneously in dogs bitten by Vipera berus.