Bite put me in the ER - Questions

[TrpnBils]

I posted this on another forum, but I wanted to get some opinions from people that keep monitors. This'll be a re-read for a couple people here, so I apologize for that, I just want to get as much info as possible.

I've had my Sav for about a month now (see the "Adopting a Sav" thread for details). He's 2 years old but was neglected and is only about 17" long. Fecal came back negative about a week or two ago. He's fairly aggressive, and I've been bitten about half a dozen times or so with no ill effects other than pain and a little blood. On Friday night, he got me real good on the arm but didn't cause me to bleed or anything. About 20 minutes later I had a bad sore throat, my chest and back hurt, and my neck was stiff. I figured I must be getting sick or something, so I went to bed around 11:00. At 1:00am, I woke up and literally every square inch of my body from my head to my feet was bruised, my tongue was swollen, and I was having trouble swallowing.

I went to the ER (off topic, but they told me the parking lot was closed, so I had to park 3 blocks away and walk. I was not happy). They didn't do a thing for me. The only known allergy I have is antihistamines, which didn't help the situation because they apparently couldn't give me anything else to help. Luckily, everything started to get a little better on its own. The doc went and did some "research" online (and called poison control, and if I may say so: WTF!?), came back and asked me AGAIN what kind of lizard it was. I told her it was a savannah monitor, so she asked me if it was black with orange beaded skin. I think she did a search on venomous lizards and thought I had a beaded or a gila monster....I dunno. To sum it up, they said that they couldn't confirm it was the bite that caused the reaction, but they had no idea what else it could've been. I'm pretty much fine now, just a little sore and the bite itches, but that's it. I can't risk a worse reaction, so I'm trading the Sav for something else hopefully later this week.

A little background on myself - LIke I said, he's bitten me before, with no reaction on my part. I've been bitten by wild and captive snakes several times with no reaction on my part. I've been bitten by other lizards (Tokays, and prehensile-tailed skinks most notably) with no reaction on my part. I'm a part-time reptile keeper at the local zoo, so I come in contact with all sorts of herps on a daily basis, and I've never had any kind of reaction to a bite from any animal before.

So here are a few questions I've been trying to get answered, and hopefully somebody here can help:

1) I'm assuming this will happen again at least as bad, if not worse, if this lizard were to bite me again. Should I expect a similar reaction to a bite from another monitor?

2) Same as above, except should I expect this from ALL reptile bites for any reason now? If so, there goes my job and my hobbies.

3) I'm going to see if I can get a prescription for an Epi-pen in case this happens again, but since they couldn't 100% confirm that this was the result of the bite, I may have to do some research to prove a point. I looked online and found limited info, and I've been talking to other herpers at work and they tell me that monitors and skinks in particular are well known carriers of some nasty stuff in their saliva. Is this true for monitors any more than it is for other species of lizards or snakes? If so, what is it that's in their saliva?

4) I'm just curious, has anything like this happened to anyone else with monitors?

I'm at a loss for what to say because I REALLY hope this isn't something I need to worry about with every reptile I touch for the rest of my life. I'm just trying to get some answers, so any info you guys can give me is greatly appreciated.

Thanks

-Jeff-

[hhmoore]

I've been bitten about half a dozen times or so with no ill effects other than pain and a little blood. On Friday night, he got me real good on the arm but didn't cause me to bleed or anything. About 20 minutes later I had a bad sore throat, my chest and back hurt, and my neck was stiff. I figured I must be getting sick or something, so I went to bed around 11:00. At 1:00am, I woke up and literally every square inch of my body from my head to my feet was bruised, my tongue was swollen, and I was having trouble swallowing.
I've gotten some pretty good bites from a variety of reptiles, including monitors. This sounds pretty strange, and I can certainly understand why the ER was hesitant to attribute the symptoms to the bite. Yes, some monitors have a very septic bite. (lots of infection causing bacteria in their mouths - remember that in the wild, monitors readily feed on carrion...and in captivity they are used as garbage cans for anything that didn't get eaten) You say he "got you real good" but didn't ...
(I got called away. it is now 20 minutes later,so forgive me if somebody else posted and I repeat things)
draw blood. Where on the arm did it bite you? Was it a quick hard bite & release? Did it bite and hold on? bite and shake? the fact that the initial symptoms were not localized is odd. The generalized soreness, combined with the widespread bruising, swollen tongue, and dysphagia certainly adds to the puzzle. the last 2 items certainly ring of allergic response...but allergic to what? can you describe the bruising and onset of symptoms more specifically. Pictures would be great, but you probably didn't take them.

How long did it take for the bruising to clear?

[TrpnBils]

Where on the arm did it bite you? Was it a quick hard bite & release? Did it bite and hold on? bite and shake? the fact that the initial symptoms were not localized is odd. The generalized soreness, combined with the widespread bruising, swollen tongue, and dysphagia certainly adds to the puzzle. the last 2 items certainly ring of allergic response...but allergic to what? can you describe the bruising and onset of symptoms more specifically. Pictures would be great, but you probably didn't take them.

How long did it take for the bruising to clear?

Well, like I said he's bitten me before, but every other time it was either a quick bite or else a little longer but on a bony place like my finger so there was little "wiggle room" for him. Bite placement...picture it this way: I was sitting with him on my lap and my left hand was palm-up. He got me just below the elbow on my left arm if that makes sense. So it was on a soft area this time. He bit, shook his head for a few seconds and then rolled completely over (like a gator's death roll, no kidding) onto his back. I couldn't get him to let go, and I ended up setting him inside his cage (still on my arm) and I had to pour a bottle of water onto his head to get him to let go. The total time was around a minute or so I'd guess, or two at most. It hurt like hell, but didn't bleed (he broke the skin in 2 places, but I couldn't even get blood to come out in any amount when I went to clean the bite).

I don't know how to describe the symptoms much more specifically mostly because it was simple: everything on my body hurt...lol. I'll give it a shot though. Within 10 - 20 minutes, I noticed that my throat hurt when I swallowed, but not scratchy like a sore throat from being sick or whatever. It was just....different, although I don't really know how to describe it. Next was my chest, upper back, and neck (probably 20-30 minutes after the bite). They just felt strained like muscles would after doing a lot of hard manual labor all day long or something. It was the kind of soreness that usually feels better if you lie down. I figured I was probably getting a cold or something, so I went to sleep (although I did keep the phone by my bed just in case because I wasn't completely sure of what was going on). About 1:00 I woke up and my throat hurt worse. I noticed that my tongue was swollen , although when I looked in the mirror, I couldn't tell...it just felt swollen towards the back, then later on at the hospital they told me it definately was. By that time, my legs hurt too...the same kind of soreness like my neck and back before. The bruising on my face was weird. It wasn't like black and blue bruised, but even to touch my face at all, it felt just like a black and blue bruise. It was even like that up onto my scalp. I scratched my head at some point, and when my hair moved, it hurt my head. I wear a baseball cap most of the time, and I couldn't even keep that on for more than a few seconds because it hurt my head...lol.

Anyway, when I left here, I stepped off the curb to go to my car and my legs were stiff enough that I almost didn't catch myself and came close to falling. That made it interesting whenever the closest place to the hospital to park was 3 blocks away...but anyway, that's pretty much it. The bite was on my left arm around the elbow, but the symptoms started around my throat and radiated out from there.

As far as localized symptoms go, there weren't many, which surprised me. I have noticed that previous bites left raised scars, but other cuts didn't do the same thing. This one is the same way. That night it wasn't all that noticeable, but now the marks are, well...take a look at the picture on here. Just a little red, and the general area around it is itchy and swollen up a little, but not much.

The reason why I think this has to be related to the bite is because I didn't do anything different that night than any other night. I don't have any food allergies, but to rule it out even further, I had the same thing to eat that day that I did the two previous days, and again tonight, and probably 500 times throughout my life (ahh, the joys of being a bachelor, huh? lol). I just want to figure this out so I can avoid this problem in the future...

Hope that helps....

-Jeff-

[hhmoore]

The systemic vs localized presentation is pretty interesting...when you were in the ER, were you running a fever? and the widespread bruising was actually tenderness? (I almost said just tenderness, but I don't want to downplay it as a symptom). I could attribute that to generalized inflammation/edema associated with severe allergic response. hmmm, I think we may have to perform extensive studies and experimentation...be in my dungeon, er, I mean office, at 09:00 Tuesday.

The bite itself doesn't look particularly bad (I've had alot worse, lol) or unusual...maybe a little extra redness at the outer marks...is the area above and below the bite reddened? kinda looks like it might be in the pic. So you received NO medication, not even antibiotics, but everything pretty much cleared up - how long til the symptoms were (mostly) gone?

[Xelda]

I think you should try getting at least one more fecal test done and maybe have your vet obtain a saliva sample from your monitor so he can do some cultures and figure out what your immune system was responding to.

[TrpnBils]

The systemic vs localized presentation is pretty interesting...when you were in the ER, were you running a fever? and the widespread bruising was actually tenderness? (I almost said just tenderness, but I don't want to downplay it as a symptom). I could attribute that to generalized inflammation/edema associated with severe allergic response. hmmm, I think we may have to perform extensive studies and experimentation...be in my dungeon, er, I mean office, at 09:00 Tuesday.

The bite itself doesn't look particularly bad (I've had alot worse, lol) or unusual...maybe a little extra redness at the outer marks...is the area above and below the bite reddened? kinda looks like it might be in the pic. So you received NO medication, not even antibiotics, but everything pretty much cleared up - how long til the symptoms were (mostly) gone?

Yes, 'tenderness' is probably a better word. It's hard to describe it. I FELT bruised, but didn't LOOK bruised, if that makes sense. And you're right, the bite wasn't bad at all, which is what surprised me about the whole thing. I got no medication at the ER aside from a tetnus (sp?) shot. I don't know about the fever because, although I didn't have one at the hospital, I took 3 asprin about 10:30 because, like I said before, I thought I was just getting a cold or something and my back was stiff.

I felt a lot better by the time I left the ER (around 3 or 3:30), but my throat still hurt and I was still sore. My throat felt better by noon the next day, and aside from my hands, nothing else hurt after about 2:00 the next day.

Just outta curiousity, somebody brought up the possibility of a spider bite. I had been setting on my floor in the corner of my livingroom when I was holding the lizard, so that's a possibility that I hadn't thought of before. Anybody know anything about those kind of bites? I haven't noticed any possible bites, swollen, or bruised places, but it's still something to keep in mind.

[crotalusadamanteus]

I just want to figure this out so I can avoid this problem in the future...
Sound like you get bit an awful lot. That lies in the handling. No where else to put it.
Don't you take precautions, like gloves, long sleeve shirts, etc.? I know if I got bit that much, I would. And being a handler at a zoo........Most zoos practice safe handling techniques, and teach the same. I'm must be missing something.
And how did it manage to get you so high in the arm? That seems like an odd place to get bit IMO. J/C

Ciao,
Rick

[Xelda]

There's a recent article discussing toxins in monitors.

<a href="http://news.yahoo.com/s/nm/20051116/hl_nm/science_venom_dc">the news article</a>

<a href="http://corallus.isaac-online.com/2005_BGF_Nature_squamate_venom.pdf">the published study results</a>

(You should read the study results instead of the news article.)

[shrap]

You folks may want to take a look at this link..... very interesting indeed.

http://www.venomdoc.com/forums/viewtopic.php?p=10760#10760

Here is a small bit from this article "What all this means is that the dogma on the Discovery Channel about toxic bacteria being responsible for the bite effects produced by Komodo Dragons (and other monitor lizards) has been wrong. Its been a venom all this time!"

I also read that even Bearded Dragons are venomous. Truly interesting stuff.

[hhmoore]

Sound like you get bit an awful lot. That lies in the handling. No where else to put it.
Don't you take precautions, like gloves, long sleeve shirts, etc.? I know if I got bit that much, I would. And being a handler at a zoo........Most zoos practice safe handling techniques, and teach the same. I'm must be missing something.
And how did it manage to get you so high in the arm? That seems like an odd place to get bit IMO. J/C

Ciao,
Rick
Rick, I have mixed feelings about that one, lol. I agree with the statements, but I don't necessarily think a keeper is wrong to let himself get bitten. Personally, aside from hots and a few special cases, I've never worried about it. I take a minimal stress approach when doing routine maintenance; and will generally support, rather than control. I freehandle many snakes that I know will bite me. only in rare circumstances will I "gear up". and in those cases, a long sleeve shirt doesn't cut it. yes, I have multiple hooks & am proficient with them - but they are not always practical from a time or labor standpoint. (ever try to get a large ATB of a perch using hooks, lol)

Lizards, medium sized monitors in particular, can be supported and gently restrained rather easily...Also, if you take a look back a few days, there was an article posted regarding the possibility that more lizards than previously thought are venomous - monitors and iguanas were specifically mentioned. The theory being that some of the responses that were attributed to a septic bite are actually caused by envenomation (the delivery, like in heladerms, is fairly crude...and inefficient in a "protective" bite). I believe that article would be found in the Herps in the News section

[hhmoore]

See what happens when I try to post at work - I get paged in the middle, and somebody else posts the info first, lol

[crotalusadamanteus]

Rick, I have mixed feelings about that one, lol. I agree with the statements, but I don't necessarily think a keeper is wrong to let himself get bitten. Personally, aside from hots and a few special cases, I've never worried about it.

Well, to demonstrate a point, or satisfy my ongoing curiousities, even i have voluntarily taken hits from known biters. Other than to demonstrate, or otherwise teach someone or yourself, a certain point, I have to disagree with "letting" a snake or lizard bite you. It just makes NO sence. LOL But hey, if it thrills you.......... :raspberry

As for the article. That was very interesting. My mom sent that too me on thurs. and I was going to post it here, but SOMEONE beat me too it. LOL
It's amazing what we all "thought" we knew about the infectious nature of the bites of some lizard species.

Looks like we all got different links too LOL

http://www.newscientist.com/channel/life/dn8331.html

Ciao,
Rick

[hhmoore]

I agree that it makes no sense...it's not so much that I volunteer for the hit, but more that I don't worry about it or go to great lengths to avoid it. Using my above example of the ATBs (when I have to remove them) - sure, I could make a point of donning gloves and long sleeves, or even doing everything without touching the snakes (what fun is that, lol). Instead, I reach in, avoid their initial strike and gently grasp them. I coax them to release the perch and let them move freely. Most are fine, but there are others that at some point will come to the realization that they haven't bitten me yet. It really does seem like an afterthought, too, lol. a quick shot to the hand or forearm and they are happy. I like happy snakes :rofl:
Seriously, though, the more serious the bite, the less likely I am to just take it...I have never let my bloods get me. They were hook only for a long time & a few of them still are.
As far as the article - don't go discounting the septic nature of monitor bites...that hasn't gone away. I am also inclined to think that if they are venomous, the effectiveness of the delivery system is probably on par with that of heloderms: they have to chew on you a bit to really get things happening

[TrpnBils]

Rick, I have mixed feelings about that one, lol. I agree with the statements, but I don't necessarily think a keeper is wrong to let himself get bitten. Personally, aside from hots and a few special cases, I've never worried about it. I take a minimal stress approach when doing routine maintenance; and will generally support, rather than control. I freehandle many snakes that I know will bite me. only in rare circumstances will I "gear up". and in those cases, a long sleeve shirt doesn't cut it. yes, I have multiple hooks & am proficient with them - but they are not always practical from a time or labor standpoint. (ever try to get a large ATB of a perch using hooks, lol)

Exactly.

I've used gloves, and especially with the smaller animals like tokays, I don't really feel comfortable using them because I can't really "feel" the animal in my hand. With gloves heavy enough to withstand a good bite from those lizards, they're also going to have to be really thick. It'd be real easy to accidentally squeeze the animal too hard and hurt it.

And in reality, I've only been bitten three times at work that I can think of. Once by a tokay (superficial), once by a prehensile tailed skink (let go right away, nothing a band aid couldn't fix), and once (barely) by an over-excited leopard gecko at feeding time. When was the last time you wore gloves to handle a leo? lol

As far as wild snakes go, I dont' know anyone who does a fair amount of field herping that hasn't been bitten. The first, and worst time, was last year when I was helping in a trail restoration project with a group of scouts. They freaked out about a ~12" garter snake and started throwing rocks at it, so I picked it up to get it out of the way. It was perfectly calm until a kid came up behind me a hit it with a glove....then it got mad and bit me. Accidents happen.

[YJHB]

All those symptoms sound like pure allergic reaction to me. You are most likely allergic to the proteins present in your monitor's saliva now. I would take every precaution to not get bitten again by that particular animal. If you do get bitten again by that monitor, take your epinephrine and go straight to the hospital without waiting for onset of symptoms, because next time your reaction may kill you! You could have taken a dozen hits from that animal before becoming allergic, but once you've had a systemic reaction like that your body is primed for the next one. The next one will be swift and severe...

This could mean you are now allergic to other reptile bites, but not necessarily. The fact that you already have an allergy predisposes you to allergies in the first place, but this doesn't necessarily mean that the next Tokay that nabs you will cause your demise. The microbes present in the monitor's bite could also have been a factor that caused the allergic reaction...while your body was fighting off the microbes, some Chicken Little in your body's army started pointing at all the strange proteins running around. This could have happened with your next to last bite. Then with that last bite, your body's defenses thought the sky was falling when all those proteins reappeared!

You'd think if this fairly commonly kept monitor caused symptoms like this in everyone after a few bites, that there would be more papers on the subject.

When your whole body felt bruised, you were right; allergic reactions do not confine themselves to your skin, all of your organs were also 'bruised'. Scary stuff.

[YJHB]

Oh, for god's sake this started off as an old thread...

[hhmoore]

blame it on Rick, lol, he revitalized it. personally, I rather enjoy the subject though

[crotalusadamanteus]

I've opened up older cans of worms before. LOL

I think I get what you guys are saying. I just didn't read it that way. I believe in the gentle approach also, being, if I should take a hit, I'm Not likely to run out and get a screwdriver to start prying with. I will patiently wait for them to let go. But at the same time, if I am reaching in, and receiving aggressive stances, and hissing, I am going to take what ever precautions I need to. Getting bit don't exactly feel good. Well, not to me any way.

BTW.......Did that prehensile tailed skink get a good latch on you? LOL I got bit by one a few years back. He got my pinky while changing water. He lunged from under his hide so quick, I could not even react. Jaws like a freakin pit bull. He held on for like 5 minutes, just crushing, and chomping, then a good shake, and when the skin peeled off, he was happy and let go. Actually the worst lizard bite I've ever had. Hurt like the dickens.


Ciao,
Rick

[coyote]

The article lists Iguania as one family that may have venom.
My brief introduction to the evolution of venom in reptiles is that it serves to begin digestion of the prey. Why would an herbivorous Iguana iguana need venom?

And in the article Agamid lizards (Bearded Dragons) are referred to as Iguania. Is this taxonomically correct? This seems contrary to my education.

[Matt Haines]

As far as I know Pogonas are considered Agamidae.

[TrpnBils]

BTW.......Did that prehensile tailed skink get a good latch on you? LOL I got bit by one a few years back. He got my pinky while changing water. He lunged from under his hide so quick, I could not even react. Jaws like a freakin pit bull. He held on for like 5 minutes, just crushing, and chomping, then a good shake, and when the skin peeled off, he was happy and let go. Actually the worst lizard bite I've ever had. Hurt like the dickens.


Ciao,
Rick

well, it surprised me more than anything. It was during one of our reptile shows, and for those of you not familiar with the species, let me point something out. They have long nails that are VERY sharp, and they're pretty strong. They tend to want to climb, so if you try to hold them in your hand you've got two options: LET them climb, or get ripped up by the nails. What I usually did was let them climb up to around my shoulder and then move them back to my hand to start all over again while I was talking. We have 4 that we use for shows (only one at a time though), and none of them have a particularly bad temper once they're out of the exhibit (and even while they're in, only one is aggressive sometimes). This day though, when I reached up to take him off of my upper arm, I must have spooked him because he bit my ear...lol. I'm glad he didn't hang on, and it didn't hurt at all actually which surprised me - just bled a little bit and then was itchy a couple of days later like most cuts are.

Also, Coyote, I think I posted it earlier in this thread, but I found some info about the relationship between the two families of lizards and you're right...they're distantly related, but not the same anymore.

[TrpnBils]

Oh, for god's sake this started off as an old thread...

lol..yeah this was an old one. I got rid of the monitor about a week after this all happened. And I see you're from Wexford - do you know Brad McCarthy of Butler? He's pretty well-known around the area from what I understand because he sells a lot of hots. I'm from Kittanning originally, and a couple of people mentioned his name to me, so he ended up taking the monitor and I got a 4 year old female BCI off of him.

[YJHB]

aw, no I don't! Don't know much of anyone around here that shares my interest in herps..

EXCEPT Stef, who I met right here in Fauna just a few weeks ago!!!

[coyote]

As far as I know Pogonas are considered Agamidae.
Yes, this is my understanding. Has been my understanding. The article says that Bearded Dragons are Iguania.

Agamids are Old World lizards and Iguanids are New World lizards.
Agamids fill the same niches in the Old World as Iguanids fill in the New World. So I figure the families must have branched off from each other a long time ago and Agamid lizards taxanomically aren't Iguania. So either I need to brush up on my taxonomy or this statement is incorrect.

The only reason I bring it up is because I have a tendency to nitpick (read: be anal about) certain details. And, I like to be correct. So, I am hoping that if my understanding is deficient someone who knows can correct it for me.

[dragonss]

well I don't own large repts but i do know that savs have bacteria in there mouths just like komodo dragons just you won't die if the small savs bites you.. If it was me i take my sav into the vet (if you have one or even ur zoo could help) have them swab the savs mouth... Test the sample you just might had a lerject reaction to it's self defence spit like a cat scratch it could get infected, but also remember the savs are wild rept and in adaptation through species thy have nasty saliva. i hope that help good luck

[varnyard]

Not only these few lizards, but anoles, and all snakes. That is the claim they are making. I have read in one of the journals that all snakes have venom, don't ask me what journal, I have since looked and cannot find the statment again in them.

[Valley Dragons]

Does anyone else think this sounds like an episode of "House", lol?

Jamie

[snake5007]

Wow! Interesting thread. I'm gonna have to say "you learn something new everyday" again. :)

[RowingMunkeyCU]

Gah! Old thread...

[hhmoore]

The fact that it is an old thread doesn't mean that some people might not find it interesting...the comments would seem to indicate they do.
Thanks for doing your part to keep it on top, Dustin

[Mitosis]

An herbivore would not need venom to kill prey, it could of retained it from previous ancestry, hence the reduced toxicity.....talking Iguanidae here.

Yeah Beardies are Agamadae, I dont see why they have thme listed other wise. But it seems Pogona barbata has been found to have some venom,as have monitors,and Iguanidae.

See the section.....its wikipedia but here it is...

Venom and bacteria in the Komodo dragon and other monitors.

Komodo dragons have recently been discovered to produce a venom. In late 2005, University of Melbourne researchers discovered that Perenties (Varanus giganteus), other monitors and Iguanians may be somewhat venomous. Previously, it had been thought that bites inflicted by these lizards were simply prone to infection because of bacteria in the lizards' mouths, but these researchers have shown that the immediate effects are caused by mild envenomation. Bites on human digits by a Lace Monitor (Varanus varius), a Komodo dragon and a Spotted Tree Monitor (V. scalaris) have been observed and all produced similar results in humans: rapid swelling within minutes, localized disruption of blood clotting, shooting pain up to the elbow, with some symptoms lasting for several hours.

In addition to the venom, dragons also possess virulent bacteria in their saliva, of which more than 28 Gram-negative and 29 Gram-positive strains have been isolated.[25] These bacteria cause septicemia in their victim; if an initial bite does not kill the prey animal and it escapes, it will commonly succumb within a week to the resulting infection. The deadliest bacteria in Komodo dragon saliva appears to be a very deadly strain of Pasteurella multocida, from studies performed with lab mice.[26] Because the Komodo dragon appears immune to its own microbes, much research has been done searching for the antibacterial molecule in the hopes of human medicinal use.

Pogona barbata- Eastern Bearded dragon

Venom
In late 2005, University of Melbourne researchers discovered that Komodo Dragons (Varanus komodoensis), Perenties (V. giganteus), other Monitors, Gila Monsters (Heloderma suspectum), Iguanians such as Pogona barbata and Beaded Lizards (Heloderma horridum) are somewhat venomous. Previously, it had been thought that bites inflicted by these lizards were simply prone to infection because of bacteria in the lizards' mouths, but these researchers have shown that the immediate effects (at least in the Komodo Dragon, Spotted Tree Monitor (Varanus scalaris) and the Lace Monitor) are caused by mild envenomation. The Eastern Bearded Dragon, "retains characteristics of the ancestral venom system, namely serial, lobular non-compound venom-secreting glands on both the upper and lower jaws .