Bite put me in the ER - Questions

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-

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?

Originally Posted by hhmoore

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-

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?

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.

Originally Posted by 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?

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.

Originally Posted by TripnBils

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

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.)

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

http://www.venomdoc.com/forums/viewt...?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.

Originally Posted by crotalusadamanteus

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