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Background: Envenomation by the European adder (Vipera berus) is common in dogs in Europe. Cardiac arrhythmias occur but clinical studies of envenomated dogs are limited. Objectives: To describe arrhythmias in dogs within 48 hours of envenomation, and investigate associations between arrhythmia grade, serum troponin I (cTnI), and snakebite severity score (SS score). Animals Twenty‐one client‐owned dogs bitten by V berus. Methods: Prospective cohort study of envenomated dogs. Ambulatory electrocardiograms were recorded from presentation to 48 hours after snakebite, and arrhythmias graded 0 to 3 based on frequency and severity. Serum cTnI was measured at presentation, 12 hours, 24 hours, 36 hours, and 14 days after bite. An SS score of 1 to 3 was recorded at admission and based on clinical examination. Results: All dogs survived. Twelve dogs (57%) developed arrhythmias, all of which were ventricular in origin. Severe complex ventricular arrhythmias (VAs) were observed in 6 dogs (29%). Eighty‐one percent of dogs (n = 17) had increased cTnI concentrations at 1 or more time points. Dogs that developed arrhythmias had significantly higher concentrations of cTnI at 12 hours (1.67 [0.04‐32.68] versus 0.03 [0.01‐0.052]; P =.002), 24 hours (1.88 [0.2‐14.23] versus 0.06 [0.01‐2.06]; P =.009), and 36 hours (3.7 [0.02‐16.62] versus 0.06 [0.01‐1.33]; P =.006) after bite compared to those that did not. Contingency table analysis showed that SS score was not significantly associated with arrhythmia grade (P =.9). Conclusions and Clinical Importance: Myocardial cell injury, reflected by increased cTnI concentrations and VAs, is common after V berus envenomation in dogs. Prolonged electrocardiography monitoring is advised, particularly where cTnI is increased. [ABSTRACT FROM AUTHOR]

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It is estimated that worldwide there are 5,000,000 snakebites per year of which 2,500,000 lead to symptoms of venomization, nearly 400,000 result in permanent sequelae and 125,000 are fatal. In Germany there are only two venomous snakes, the European adder and the European aspis viper (asp). Bites by venomous snakes in Germany as well as in geographical Europe should always be classified as a life threatening emergency unless there is evidence to the contrary and even with a lack of symptoms a minimum of 24 h inpatient monitoring should be recommended, if possible with medical care in an institution experienced with snakebites. Travellers are urgently advised to inform themselves about the local occurence of venomous snakes usually to be found at the travel destination, before starting the journey.