Page 250 - ATP-P 11th Ed

2. Severe Allergic Reactions
a. Remove all collars and choke chains from around the dog’s neck if swelling is
extensive.
®
b. Diphenhydramine (Benadryl ) – Administer 1–2mg/kg SC, IM.
c. Epinephrine – 2.5–5mcg/kg IV or 10mcg/kg IM (EpiPen can be used in typi-
®
cal 30kg dog)
d. many cases, use judiciously ®
Consider dexamethasone (Decadron ) – 1–2mg/kg IV or IM – Not used in
SECTION 2 e. Treat for shock. See K9 Gastric Dilatation Volvulus (GDV) / Bloat Protocol.

Envenomation
Signs and Symptoms
1. Signs and symptoms include those described above for allergic reactions. Signs and
symptoms will also depend on the type of venom. Those discussed below are a general
rule, but there are some species of each that mimic the other species’ venom.
a. Viperidea (rattlesnakes, water moccasins, pit vipers, etc.): marked pain, swelling,
and necrosis at the injury site as well as coagulopathies and cardiovascular collapse.
b. Elapidea (cobra, coral snake, etc.): Venomous bites may result in progressive paraly-
sis with death usually occurring from paralysis of the respiratory muscles.
Management
1. Treat for anaphylaxis if necessary. Treat for shock. See K9 Gastric Dilatation Volvulus
(GDV) / Bloat Protocol
2. Treat pain with appropriate opioids (morphine, hydromorphone [Dilaudid ], or
®
fentanyl), or NSAIDs as appropriate.
3. Immobilize affected limb (if extremity bite)
4. Evacuate for more definitive treatment and supportive care.
5. Antivenin may be given in a hospital setting; monitor for hypersensitivity reaction.
6. Plasma may be used if coagulopathies develop.

Disposition
1. Urgent evacuation if treated for anaphylaxis.
2. Urgent evacuation for Elapidae bites or if evidence of severe envenomation (sys-
temic signs and symptoms, progressive ascending edema) exists.
3. Evacuation not required for Crotalinae bites if signs and symptoms do not in-
dicate anaphylaxis or development of severe envenomation after four hours of
observation.

240 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 241