It is hoped the new SnakeMap initiative will do much to help prevent, diagnose and treat snake bite in pets. By Dr Phil Tucak
Veterinarians will have access to a deeper understanding of the epidemiology and clinical aspects of snake envenomation in dogs and cats with the development of SnakeMap, a national snake envenomation database.
Set up to strategically collect epidemiological data on small animal snake bite in all regions of Australia, it is hoped that SnakeMap will provide a mechanism to generate new knowledge on snake envenomation, and to advance the prevention, diagnosis and treatment of snake envenomation in domestic animals and people.
The origins or SnakeMap
The SnakeMap project was co-founded by veterinarians Dr Manuel Boller and Dr Kylie Kelers of the Melbourne Veterinary School at the University of Melbourne. Importantly, SnakeMap also features collaboration with clinical, emergency and epidemiology veterinarians from across Australia, including members of the Australian and New Zealand College of Veterinary Scientists – Emergency and Critical Care Chapter (ANZCVS ECC), together with veterinary snake envenomation expert Dr Andrew Padula and human population health expert and toxinologist Dr Ken Winkel.
“We established SnakeMap in conjunction with the ANZCVS ECC chapter, to aid identification of snake envenomation risk factors which may then inform veterinarians to optimise their care delivered to snake envenomed pets,” says Dr Boller, who is a senior lecturer in Veterinary Emergency and Critical Care at the Melbourne Veterinary School. “Snake envenomation is of unique significance in Australia, both in human and veterinary medicine, due to the exceedingly large number of highly venomous snake species present here.
“Due to their inquisitive nature, dogs and cats are at particular risk of being envenomed and can succumb to the rapidly acting and potent snake venom if they’re not treated in an expeditious manner,” Dr Boller adds. “Consequently, snake bite is a common emergency presentation of dogs and cats to veterinary clinics throughout Australia.”
Expanding the database
Dr Boller built and now manages the medical database that constitutes the foundation of SnakeMap, and his team are encouraging all veterinarians to submit their own snake envenomation data into SnakeMap, as the long- term success of the initiative depends on sustained and increasing contributions by veterinary hospitals.
“SnakeMap is a volunteer organisation that is open to all veterinary practices in Australia to join and contribute,” he says. “SnakeMap contributors can access their own data, or can request a de-identified set of data to answer a specific hypothesis and thus be part of the generation of new knowledge on snake envenomation in Australia. We definitely need more veterinary hospitals so as to obtain a more comprehensive picture of what happens all across Australia, as there is significant regional heterogeneity. We are currently completing a website that will allow veterinary hospitals to showcase their contribution and to also post snake envenomation treatment experiences, including links to their own hospital websites.”
Dr Boller says that once the SnakeMap data are extensive enough, this will inform tools such as an outcome prediction instrument and develop treatment recommendations based on severity of illness. He explains that the SnakeMap workflow for inferential data analysis foresees that SnakeMap hospital contributors apply to receive data to answer specific questions of interest. For example, it is not clear beyond the experiences of a single centre what causes mortality in snake envenomed dogs and cats that are treated with antivenom, and what the risk factors for mortality are.
The SnakeMap initiative will also have potential benefits to pet owners too, with plans to feature a heat map that visualises the risk of a future snake bite based on the temporospatial and meteorological data collected. It is also hoped that this could generate a warning system for pet owners, as well as additional information that may be useful, such as the fact that most dogs (85 per cent according to data already collected), are bitten in the pet owner’s own yard, rather than when out on walks.
The data so far
Since the project’s inception four years ago, SnakeMap now has almost 800 snake bite cases within its registry. These data have already highlighted some interesting findings, including that nine of 10 dogs or cats presenting for snake bite survived to discharge.
Of pets that didn’t survive, approximately one third died subsequent to cardiopulmonary arrest, one third were euthanased due to the severity of their illness, and the remaining one third were euthanased due to financial constraints of the pet owner. The existing SnakeMap data have also shown that nearly one third of dogs included in the registry are some type of terrier breed, such as Staffordshire bull terriers or Jack Russell terriers.
“Geocoding data, or coordinates, have been available for most animals listed in SnakeMap, thus informing the actual map,” says Dr Boller. “Not surprisingly most of the animals were bitten in the outer two rows of houses that border open non-developed space. Also, in Victoria, where tiger snakes are very common, the risk of snake bite decreased with increased distance away from a water way.
“The data may elucidate the intimate interrelationship between the location of a snake bite occurrence and snake habitat, and in the long term, how this relationship is influenced by human behaviour and housing developments in the snake habitats.”
SnakeMap has been a huge collaborative effort, and the project is set to grow as more veterinarians across Australia get involved in submitting their own data. “SnakeMap has basically been all about getting snake envenomation enthusiasts with a wealth of shared expertise working together on this project,” says Dr Boller.
Veterinarians are invited to express their interest to contribute to SnakeMap via: redcap.link/snakemap. There is also a recently published journal article about the SnakeMap research at onlinelibrary.wiley.com/doi/abs/10.1111/avj.12993.