Hognose venom "debate" over.

[Aaron_S]

Originally Posted by jaleely

Too true Aaron. I want to say i take them seriously, but obviously I allow myself a false sense of security since they are usually so docile. My one male has never even acted upset...however this male is a very feisty baby, who should be handled more seriously. I just didn't think. I really didn't think he'd care that i couldn't get the fish smell off of my hands *lol*
That's twice i've underestimated him. Completely my fault and I admit it!
It's too easy to get in the mindset that he's a cute silly little critter....which he is, but he is a critter with instinct and should be respected as such.

What does this mean "venoms get used to their counter part quite frequently"? lol
I just mean explain that further for me.

Honestly, the reason i posted the title the way i did is because MANY people, me included scoff the idea that these snakes can cause harm. I didn't really scoff, but i was unsure about the reaction, i should say.

My swollen hand that' now reached past my wrist begs to differ *lol*

First off, I didn't mean my post was directed to you about the seriousness part. I guess after I re-read it that you'd be included to.

I don't like ever reaching in and grabbing a snake like a hognose bare handed for the reason you now know first hand. There's a member here who had one or two who were super hissy and puffy but I would never barehand grab them. It's not worth the risk of injury or any single finger.

What I meant by that is that venoms will grow stronger against antivenoms. Which are their counter. Sometimes it takes a vial or two (usually a dozen) to save a life and if that person doesn't grow allergic to the antivenom and they get bit again they will usually take twice as many vials or more to help out.

I hope you're swelling goes down soon. If it progresses I fear the ER will have to cut you to help relieve the pressure. Hopefully it goes down soon.

[SAW]

Hi, to interested members of this stimulating forum.
I am new here and am one of the clinical toxinologists/herpetologists involved with the Women’s and Children’s Hospital clinical toxinology website (toxinology.com). I am compelled to offer readers here information re this discussion of hognose snake bites/“venom”, and that of other non-front-fanged colubroids. I was informed of this apparently ongoing discussion earlier today, and after reviewing the string, am glad to see a lively and thoughtful discussion of the subject, but dismayed to see repeated misinterpretations of both toxinology and clinical medicine. Although I have limited time, and comprehensive discussion could take a great deal of time, I will very briefly comment on some of what is posted here.
First, some of the basis of my reply is refelected in terminology. The reason why species such as the false-water cobra, Hydrodynastes gigas, hognose snakes, Heterodon spp., and a number of others are termed “nonvenomous” on our web site, and in most of my publications (and those of some other investigators) is because they do not meet the traditional criteria for having “venom” in that the biological function of their oral secretions (Duvernoy’s secretions) are not verified. It is unfortunate and biomedically incorrect to interpret toxins present in an oral secretion as a “venom” without having solid observational field and/or laboratory evidence of their use in subjugating, or possibly, digesting prey and/or in anti-predator functions. It is unfortunate that the term, "venom", is increasingly used as an indicator only of toxin presence. The traditional definition of venom is: a complex substance produced in a specialized gland and delivered by an associated specialized apparatus that is deleterious to other organisms in a given dosage and is actively used in the subjugation and/or digestion of prey and/or in defense (Minton, 1974; Minton and Minton, 1980; Russell, 1980; Mebs, 2002). This cannot be determined through conjecture. Only a handful of non-front-fanged colubroids such as the ringneck snakes (Diadophis punctatus ssp.) have had formal verification of their use of Duvernoy's secretions in subjugation/tranquliization of prey. Of course, Diadophis punctatus ssp. have no medical importance. This is why I have proposed the term, "prey-specific venom" (in the case of Diadophis, ophidian-specific) in our new book (see ahead) when discussing some of these taxa. Of course, dispholidines such as the boomslang, Dispholidus typus and twig, vine or bird snakes, Thelotornis spp. have venoms that clearly are used in prey capture and are also secondarily medically important (as is the case with a relatively small number of other species as well).
In the traditional consensus view, and this is currently under animated debate between investigators including me, just because an oral secretion is made in a specific gland, has associated teeth and produces a clinical effect does NOT mean that it is a “venom”. Again, unless there is a universally accepted change in the consensus definition of venom, biological function, how it is used, is a crucial defining factor. Therefore, clinical effects should not be a primary defining contributor; only a secondary consideration to be considered in relation with the primary criterion. As a very brief example: the human salivary proteome is comprised of well over 300 proteins; this includes many biologically-active components including toxins, and is too extensive a sub-topic to describe here. I can assure you as a physician who has treated many such bites, and as many readers probably know, there are few animal bites worse than that inflicted by a human. Only bites from rabid animals, felines with the pathogenic Gram negative bacterium, Pasteurella multocida, as well as large canines, megapredators (great cats, bears, etc) and non-human primates (that may have several viruses potentially fatal to humans) are worse. Human saliva is toxic when injected into experimental animals (thus, there is a toxic as well as septic effect), produced in salivary glands that may differ in secretion flow characteristics as measured by planar MRI (sub-mandibular vs parotid), and there is salivary flow around modified dentition (incisors). We do not use our buccal secretions in subduing prey, but we do partly pre-digest our food, and we don’t use them in defense (well, most of us don’t anyway…). Are we venomous? No.
I don’t have any time to detail the misinterpretations of atopy (allergy) that have been posted here. However, the first exposure to an allergen absolutely can produce an effect, and this is why allergic tendencies are likely inherited. The initial effect is far milder than repeated exposures as this is how mnemonic (memory cells) cell populations are generated that function as antigen-presenting cells and subsequently release autopharmacological substances such as histamine, vasoactive peptide, slow-reacting substance of anaphylaxis, heparin, etc all which cause allergic responses (that can include dermatopathology such as blistering, some “discolouration” [e.g. erythema] and exfoliating dermatitis as well as well-known constitutional and life-threatening signs/symptoms including: hypotensive shock, laryngospasm, lingual angioedema, etc) the severity of which are dependent on the nature of the allergen, the host response, degree of prior sensitization, etc. Patients with similar sensitization often show similar manifestations that may differ in severity and progression depending on the nature and site of exposure. Some substances (e.g. n-acetylcysteine) produce severe hypersensitivity response without any prior exposure. The mechanisms for this are unclear. In addition, the oft made comparison with bee venom allergy is a somewhat inappropriate example of this as honeybee, Apis mellifera, and bumblebee, Bombus bombus, venoms contain mast cell degranulating peptides. These venom components can directly cause mast cell degranulation, e.g. anaphylaxis, without any IgE cross-linkage. Meaning, although one commonly can develop life-threatening bee venom allergy with repeated exposure, one can also have an anaphylactic response of varying severity without a prior sting. More to the specific relevant point here, in 15 years treating snakebites, I have never seen a life-threatening anaphylactic response to Heterodon nasicus Duvernoy’s secretion. Of course, how often is anyone exposed to Heterodon spp. Duvernoy’s secretions? However, sensitization can occur via exposure to shed skins and snake products (through routine captive husbandry) as well as from exposure to buccal secretions/venoms. Dan Keyler and I recently reported a case of protracted H. nasicus bite that almost certainly included local hypersensitivity (=stimulation of the immune system) in addition to the likely local action of Duvernoy’s secretion components (probably proteases; Weinstein and Keyler, 2009). The extent of possible allergy to Duvernoy’s components is almost fully unknown and must be cautiously considered as more serious effects could conceivably occur (but are unlikely), whereas acquired venom allergy is well-known and has contributed to a number of serious and fatal cases (especially involving elapids). I also recommend that one should read with great caution reported “medical effects” of snakebites of any kind that are written or posted on the internet by non-medically qualified authors. These are often replete with misinterpretations due to unfamiliarity with such pathology and in comparison to individual responses to purely physical trauma. Also, many such effects described in the non-front-fanged colubroid literature are anecdotal, and are perpetuated in the literature without verification by a clinician.

Unfortunately, I have taken far too much time in writing this, and thus, I cannot address the specifics of Heterodon functional morphology (not "inefficient" or "poor" delivery; likely, adapted for a different function in comparison to the high pressure front-fanged venom apparatus). In a terse nutshell: lacking from the literature is convincing formal and repeated verification of active use of Duvernoy’s secretion by wild and captive Heterodon in subjugating/tranqulizing/pre-digesting prey. None of the 4 species aggressively bite, and the uncommon documented bites have occured almost wholly as a consequence of feeding behavior. As those reading assuredly know, Heterodon spp. expends a great deal of energy in self-defense by performing some very entertaining displays of death sham, neck-flattening, mock striking, etc, but not in biting (e.g. not by using Duvernoy’s secretion defensively). This is where I will make a shameless and blatant plug for our new book as this is the first comprehensive treatment of the topic, and includes substantial discussion of Heterodon ("'Venomous' Bites From Non-Venomous Snakes: A Critical Analysis of Risk and Management of "Colubrid" Snake Bites", with my co-authors David A. Warrell, Julian White and Daniel E. Keyler). I must add that any interested party should probably obtain the e-book (as it was intended; however, it is a bit more expensive than the print version) as this contains many colour photos (>300), an excellent search function, and aside from a few poorly reproduced osteology photos, is a good book per this fascinating topic. Interested readers can check out a sample at elsevierdirect.com or in the kindle version on amazon (also in colour). The print version is in black and white and lacks an index (this because it was intended first as a digital product), but is still contains all of the information and is a nice book (I am a bit subjective here in case you hadn't noticed...).

Finally, please note that I am not responding in order to “convince” anyone to change their “beliefs”. Rather, I have written this to make interested readers aware that there is another considered consensus view in this less-traveled area of biomedical and life science research and this is reflected in the use of differing terminology.

I must add that although as most physicians, including myself, do not give medical advice without seeing a patient in person, I will suggest the following (see below) re Jaleely's recent Heterodon bite. This is not to be misconstrued as direct medical advice due to the aforementioned need for physical examination in order to appropriately guide management.

NEVER apply ice to any snakebite or spiderbite, etc. Scorpion stings are another story. Again, the reaction to the bite MAY be a combination of Type I hypersensitivity AND specific effects of the Duvernoy's secretion. PROMPT review by a physician is strongly advised and treatment is limited to symptomatic management. By the way, the antihistamine response to H1 antagonists (first generation antihistamines) such as benadryl (diphenhydramine) doesn't diminish with repeated use in a case of Type 1 hypersensitivity. It's "off label" use as a sleep inducer can produce tolerance of that specific effect; not when it is used [U]episodically[U] in such a case of hypersensitivity, However, it may not be sufficient to treat some cases and other therapeutics may be indicated such as steroids, adrenaline, leukotriene receptor antagonistsm, etc. There is NO INDICATION WHATSOEVER here for any need of fasciotomy and they will not "cut you" to relieve the pressure. This is why prompt review is recommended as the earlier some of the above treatments are initiated, the more likely a shorter duration of some of the symptoms. I hope it improves rapidly and if you require wound care, follow the recommendations of the attending physician(s) carefully.
Hope this was somewhat informative.


Scott A. Weinstein, MSc, PhD, MBBS, MD
Clinical Toxinologist/Attending Physician
Women’s and Children’s Hospital
Adelaide, South Australia, Australia
And
Attending Physician/Clinical Toxinology Consultant
Bayside, New York USA

[brandonh]

Originally Posted by jarich

I don't think ibuprofen is a good idea. Your liver and kidneys are already going to be working overtime with the envenomation. Ibuprofen will tax them further. I would think a bucket of ice water and your doctors appointment are best

thank you for your post i didnt think of about the liver or kidneys that are aready clearing the toxins out of the body good call

[shaunyboy]

over on the other hognose bite thread,greg m posted links,to scientific papers, prooving hognose are venomous

cheers shaun

[RandyRhoads]

Didn't feel like reading that entire post. SRS-A popped in my head in regards to the benadryl. Too tired to play DR. and i'm sure that guy did enough but browse through info on it if you're bored.
[Mediators of the aller... [Allergol Immunopathol (Madr). 1975 Jul-Aug] - PubMed - NCBI

Don't compress it.... I'd still take the Ibuprofen or aspirin despite the "envenomation" but i'm no toxicologist....

[jaleely]

Aaron that makes sense. Oh and no worries i didn't think you were saying i personally didn't take them seriously, or maybe i did, either way i wasn't offended or anything and in all truth it's just a fact that i need to be more aware when i handle that little hungry brat *lol*

I was already on an ibuprofin regimen for some joint issues. I read that post about that though and cut it down to half while i am still swollen...hurts all the way up my arm though from the swelling!

The tips of a couple of my fingers are gaining sensation again though!

Saw: That was a LOT of text. lol Maybe a short summary is in order. It was indeed a feeding response and hognose do not normally bite, as they would rather play dead and run away.
They do have the Duvernoy gland, but it is not used for defense, as you stated.

[Gregg M]

Jaleely,
There is nothing at all you can do for the swelling. No doctor visit or shot will help you out. The best a doctor can do is treat you to prevent infection. It will go down on its own over the next week. To me, that is not a serious bite. Then again, you are talking to someone who keeps real venomous snakes. LOL.

Seriously though, this is nothing to worry about.

I have yet to have a reaction like that to a hognose bite. I usually get them off within seconds.

You have very nice hands by the way. LOL

[BarelyBreathing]

Ouch!!!!!!!!!!!!

[bladeblaster]

Originally Posted by Aaron_S

It's due to the fact a lot of people don't take rear fanged snakes seriously. They said the same thing about boomslangs until someone died. They said the same thing about vine snakes, until someone died. A hognose WILL kill someone and then they'll be venomous.

people don't want to believe it's "more than a bee sting."

Melissa, I hope for the best and your hand. Benedryl isn't working because you've already used it once. In general, venoms get used to their counter part quite frequently with snakes and thus the antivenim usually doesn't work or the person becomes allergic to it.

Couldn't agree more, the amount of people who insist on free handling mangroves and FWC's is frankly rediculous.

[Terranaut]

To Saw
I totaly love what you have written here. One of the most complete explanations of anything ever asked on this site that I have read so far. I am sure the OP took a ton of knowledge away from this. I do hope anyone thinking of keeping these reads this to understand what they have and what they should do in this situation. Given the length of your post and the fact that some others have already said they did not read the entire thing I have decided to summarize in short.
1: not venomous technically but venomous with a nasty bite if it happens.
2: you will be ok unless you have a major reaction to the toxins
3: take steps in handling to not allow this to happen due to #1
4: (now this is my own $.02) get that sucker off ASAP!!!!

Another thing is wash your hands before handling. I have to do this with my king as he will pull the same manuver and try to eat your hand if he smells prey which includes any other snake you held that day.

Thanks to both the OP for sharing her hard lesson in hog snake handling and to Saw for his PHD level post

[bladeblaster]

Originally Posted by Terranaut

To Saw
I totaly love what you have written here. One of the most complete explanations of anything ever asked on this site that I have read so far. I am sure the OP took a ton of knowledge away from this. I do hope anyone thinking of keeping these reads this to understand what they have and what they should do in this situation. Given the length of your post and the fact that some others have already said they did not read the entire thing I have decided to summarize in short.
1: not venomous technically but venomous with a nasty bite if it happens.
2: you will be ok unless you have a major reaction to the toxins
3: take steps in handling to not allow this to happen due to #1
4: (now this is my own $.02) get that sucker off ASAP!!!!

Another thing is wash your hands before handling. I have to do this with my king as he will pull the same manuver and try to eat your hand if he smells prey which includes any other snake you held that day.

Thanks to both the OP for sharing her hard lesson in hog snake handling and to Saw for his PHD level post

All he has really written amounts to.

I don't think is really a venom although it is clearly toxic, some other scientists think it is a venom, and we haven't done bitching about it yet.

I think he has a Phd in 'Long winded explanations'

Its scemantics.

[Will0W783]

To Jaleely- OUCH that looks awful...I hope you recover quickly and you don't get bitten again!

To Saw- THANK YOU for that awesome explanation...btw, I LOVE Toxinology.com and actually have printouts of the species accounts/antivenin list/bite treatment in my Hots Folder for every species I keep. I have found your website to be perhaps the nicest, easiest and most complete source of venomous snakebite care protocols I have yet found! Keep up the good work!

[StudentoReptile]

Originally Posted by bladeblaster

Couldn't agree more, the amount of people who insist on free handling mangroves and FWC's is frankly rediculous.

Ditto. I've seen photos and videos of people free-handling hots. Venomous species can be just as "docile" as a non-venomous snake. The thing is, even docile snakes have their bad days. When a ball python or corn snake has a "bad day" or wakes on the wrong side of the water bowl, its no big deal. If your normally placid cobra or viper has a "bad day," it IS a big deal. The risks and consequences are just SOOOO much greater, which is why (obviously) it is not suggested to handle hots...excpet with hooks or tongs, and similar equipment.

We're beginning to realize (as jaleely as demonstrated in this thread) that rear-fanged colubrids should be treated with a little more respect than previously given.

[red ink]

@Saw

A lot to digest and I thank you for taking the time and writing this... very informative.

[Will0W783]

@ StudentoReptile....I too have seen too many videos of people taking chances with their hots. I do handle my hognose...he hasn't bitten me yet, but I'm careful to wash my hands immediately before and maybe now I will treat him even more carefully!

I saw a video of a guy holding a Wagler's viper and shedding it by hand. Geez...I mean, they are insanely docile snakes usually, but any snake can get cranky when you're pulling shed off of it! I use the gloves and hooks to handle mine, even though I could probably get away with not being tagged. Why take the risk? It could be the last one you'll ever take.

I've also seen Viperkeeper (who I've met and generally like) pet his black spitting cobra in a Youtube video...that really peeved me off...it is NEVER ok to pet a cobra. He was ticking it and laughing "tickle the black beast"....IMO that shouldn't be online, because other people are going to copy it not knowing their animals and end up dead!