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Objective: To determine the clinical manifestations, morbidity, mortality, and treatment methods for rattlesnake venom poisoning in horses., Design: Retrospective analysis of medical records., Animals: 27 horses with acute venom poisoning attributable to prairie rattlesnakes, and 5 with chronic problems subsequent to a rattlesnake bite., Results: Most horses were bitten on or near the muzzle while on pasture, resulting in head swelling, dyspnea, and epistaxis. Additional manifestations of acute poisoning included fever, tachycardia, tachypnea, cardiac arrhythmia, hemolytic anemia, thrombocytopenia, hemorrhage, thrombosis of venipuncture sites, colic, diarrhea, and prehensile and masticatory dysfunction. Chronic problems included cardiac disease, pneumonia, laminitis, pharyngeal paralysis, and wound complications. The most common chronic problem was cardiac disease. The most commonly used treatments were antibiotics, nonsteroidal anti-inflammatory drugs, tetanus prophylaxis, and airway support. Mortality in the 27 acutely affected horses was 18.5%; the overall mortality was 25%., Clinical Implications: Horses bitten by prairie rattle-snakes may develop multiple, often severe, acute or chronic manifestations of poisoning involving various organ systems. Thorough clinical evaluation, effective treatment, supportive care, and close observation are indicated in horses with rattlesnake venom poisoning.

Ventricular tachycardia develops less frequently than supraventricular dysrhythmias and generally is more indicative of cardiac disease. The horse in this report had clinical signs of lethargy and hypophagia and was determined to have sustained ventricular tachycardia. Echocardiography was a valuable diagnostic tool and revealed an echodense area in the left ventricle that had subnormal ventricular performance. A primary heart problem of an inflammatory nature was suspected. The horse responded favorably to treatment with lidocaine, antimicrobials, and aspirin, as well as stall rest. The horse was used successfully as a sire and hunter-jumper after treatment, but subsequently died 2.2 years later of massive hemoperitoneum. Necropsy revealed an extensive area in the left ventricle that appeared thin and fibrotic.

Clinical signs of chronic epididymitis in a stallion included recurrent signs of inguinal pain--retraction of the right testis into the inguinal area, resentment of palpation of the right testis, and right-sided scrotal swelling. The tail of the right epididymis was firm and seemed to be adhered to the testis. The tail of the left epididymis felt firmer than normal. Ultrasonographically, the diameter of the head of the epididymis was considered larger than normal, was hyperechoic in relation to the right testis, and had an irregular border. Several bright 1- to 5-mm-diameter echogenic areas that alternated with less echogenic areas were seen in the head of the right epididymis. Ultrasonographic findings were interpreted as fibrosis attributable to chronic inflammation. Unilateral castration (right-sided) was performed, but the prognosis was guarded because of presumed involvement of the left epididymis.

Patent infections with Strongylus vulgaris were established in 6 of 8 helminth-free ponies given 41 to 101 adult worms via nasogastric tube. The parasites were removed from the cecum and ventral colon and transferred within 1 to 2 hours of the death of the donor horses. Eggs were found in the feces of the recipients in 2 or 3 days; egg counts reached maximum, 28 eggs per gram of feces, at 4 weeks after ponies were inoculated. In 6 ponies euthanatized 3 to 7 weeks after parasitic transfers were done, 28% of the inoculated worms were found alive at necropsy. A 7th pony was maintained as a donor for establishing infections for chemotherapy trials and, although never passing more than 6 eggs per gram of feces, shed infective larvae over a period of 2 years.

Four horses with diarrhea had radiographic evidence of large quantities of sand in the gastrointestinal tract. Initially, none of the horses had sufficient fecal sand quantity to suggest sand enteropathy. Diarrhea resolved in all horses within 2 days of oral administration of psyllium hydrophilic mucilloid. Historically, all 4 horses had lost weight or had difficulty maintaining weight. After treatment was administered, the horses either gained weight or were easier to maintain in good condition.

Shetland ponies (n = 4) were given diethylcarbamazine orally at a dose level of 22 mg/kg/day for 1 week before they were inoculated with 800 third-stage larvae of Strongylus vulgaris. Treatment was continued for 86 (1 pony) or 200 days (3 ponies) after the inoculation. As compared with the changes seen in a similarly inoculated group of ponies (group 2) which were not treated, diethylcarbamazine did not prevent the clinical or pathologic changes due to the migrating larvae. Fewer adult parasites were recovered at necropsy from treated ponies than from nontreated (group 2) ponies, even when treatment was discontinued 86 days after inoculation. Treatment appeared to have a detrimental effect on 4th-stage larvae either in the arteries or their intestinal wall, but not until after arterial lesions resulted.