Snakes of Texas Condensed

Home , Agkistrodon, Agkistrodon contortrix, Crayfish snake, Crotalus lepidus, Crotalus viridis, Eastern hognose snake

SNAKES OF TEXAS

2019 ANNUAL MEETING ROCKWALL, TEXAS

OCTOBER 18, 2019

PRESENTED BY CHUCK SWATSKE ELM FORK CHAPTER [email protected] MOBILE : 214/232-0704 SNAKES OF TEXAS

1. INTRODUCTION o ABOUT ME o HOW DO YOU FEEL ABOUT SNAKES?

2. THE NATURE OF SNAKES

3. SNAKE SPECIES IN TEXAS o HOW DOES A SNAKE EAT? o THE JACOBSON ORGAN

MYTHS & MONSTERS SNAKES OF TEXAS

4. TALKING SNAKES o VENOMONOUS SNAKES o NON-VENOMOUS SNAKES

5. FUN WITH IDENTIFICATION

MYTHS & MONSTERS SNAKES OF TEXAS

6. UNDERSTANDING VENOM. o OPISTHOGLYPHS, PROTEROGLYPH, SOLENOGLYPH o TOXINS – ENZIMES & PROTEINS o HEMOTOXIC & NEUROTOXIC & OTHERS 7. ALL ABOUT ANTI-VENOM o WHAT IS ANTIVENOM? o SNAKES ON A PLANE o WHY PHYSICANS DON’T GIVE ANTIVENOM 8. BITTEN BY A SNAKE? o MANAGEMENT OF PIT VIPER BITES o WHAT TO AVOID o TIME IS TISSUE o TREATMENT & AFTERCARE MYTHS & MONSTERS SNAKES OF TEXAS 9. HOW CAN SNAKE VENOM BE USED IN MEDICINE ?

MYTHS & MONSTERS SNAKES OF TEXAS 1. INTRODUCTION ABOUT ME o CERTIFIED TEXAS MASTER NATURALIST (ELM FORK CHAPTER CLASS OF 2018) o LIFE-LONG REPTILE & AMPHIBIAN ENTHUSIAST o AMATEUR HERPETOLOGIST o FOUNDER OF SNAKE CITY TEXAS (Snake Relocation, Consultation, Education) SNAKES OF TEXAS 1. INTRODUCTION CLASS POLL HOW DO YOU FEEL ABOUT SNAKES ?

• HOW MUCH DO YOU BELIVE YOU KNOW ABOUT SNAKES ?

o NOTHING?

o SOME TO A LITTLE?

o A GREAT DEAL? SNAKES OF TEXAS 1. INTRODUCTION CLASS POLL HOW DO YOU FEEL ABOUT SNAKES ? SNAKES OF TEXAS 2. THE NATURE OF SNAKES WESTERN DIAMONDBACK RATTLESNAKE

THE MOST HIGHLY EVOLVED SNAKES

ON OUR PLANET

WHEN THEY HUNT, THEY AMBUSH THEIR PREY.

THEY SIT & THEY WAIT VERY STILL SOMETIMES FOR

MANY HOURS SNAKES OF TEXAS 2. THE NATURE OF SNAKES WESTERN DIAMONDBACK RATTLESNAKE

They hunt their prey using heat-sensing pits

that do what their name implies: they help

the snake sense heat.

They can track their prey with their tongues & vaguely see them with their eyes, but it's their

loreal pits that make up the difference SNAKES OF TEXAS 2. THE NATURE OF SNAKES WESTERN DIAMONDBACK RATTLESNAKE

WHEN THEIR PREY COME PAST, THEY HIT IT,

ENVENOMATE IT USING FANGS THAT UN-HINGE.

FANGS KEPT UNFOLDED IN THE ROOF OF

THEIR MOUTH UNTIL NEEDED. SNAKES OF TEXAS 2. THE NATURE OF SNAKES WESTERN DIAMONDBACK RATTLESNAKE

VENOM THEN IMMOBILIZES THE PREY, BEGINS

THE DIGESTIVE PROCES ALLOWING THE SNAKE TO

SWALLOW THE PREY (A MOUSE) WHOLE

IT’S A SHOCKING BEHAVIOR PARTICILARILY FOR THE MOUSE. SNAKES OF TEXAS 2. THE NATURE OF SNAKES

13:37 19:01 SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS

• 3,432 known species of Snake in our world.

• Cold Blooded (Ectothermic) vs. (Endothermic)

• Scales – Kneeled & Smooth

• Snakes have a backbone

• 2 part forked tongue – Jacobson’s Organ SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS

• No extended ear openings.

• Fused eyelids with a scale.

• Single functional lung

• Jawbones made up of many moving parts

• Most are Oviparous, some are Ovoviviparous. SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS HOW DOES A SNAKE EAT A LARGE PREY ? SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS HOW DOES A SNAKE EAT A PREY SO MUCH LARGER THAN ITSELF ? SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS HOW DOES A SNAKE EAT A PREY SO MUCH LARGER THAN ITSELF? SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS The Jacobson’s Organ

• Snakes have also developed a highly a specialized scent organ known as the Jacobson organ, which allows

them to literally taste & smell the air! SNAKES OF TEXAS 3. SNAKE SPECIS IN TEXAS The Jacobson’s Organ • The snake sends out his forked tongue & some

of the moisture-laden smell particles lands on

the tips of the fork.

The snake flicks its tongue back inside where the

Tips of its forked tongue can be dipped into the

ducts from the Jacobson organ. SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS The Jacobson’s Organ BRAIN NERVE JACOBSON’S ORGAN

TONGUE This allows the snake to smell even more scents, things like pheromones and sweaty, stinky socks! SNAKES OF TEXAS 3. SNAKE SPECIES IN TEXAS

There are 115 different snake species and sub-species found in the state of Texas but only

15 of those are venomous. SNAKES OF TEXAS MYTHS & MONSTERS SNAKES OF TEXAS MTYTHS & MONSTERS

• Flower Mound, Texas (August 7, 2018)….

“Sunday night we were walking down on Cross Timbers

Road & Auburn Road on the sidewalk,

& there was a big copperhead and it was in

ATTACK MODE.

We ran back home because we didn’t have a flashlight”. SNAKES OF TEXAS MTYTHS & MONSTERS

• The myths that snakes attack humans is born from this same fear. But it doesn’t make sense.

A snake cannot eat a person. Biting someone is

more often than not going to lead to the snake’s death as venom is not instantly lethal. SNAKES of TEXAS 4. TALKING SNAKES • Identifying a snake you just saw can be a difficult task.

SNAKES WITH BANDS SNAKES WITH STRIPES SNAKES WITH SOLID COLORS 1. COPPERHEAD 1. WESTERN RIBBON SNAKE 2. DEKAY’S BROWN SNAKE 1. ROUGH EARTH SNAKE 2. COTTONMOUTH (WATER MOCASSIN) 2. ROUGH GREEN SNAKE 3. MILK SNAKE 3. PATCH-NOSE SNAKE 4. LINED SNAKE 3. YELLOW BELLIED RACER 4. TEXAS CORAL SNAKE 4. BLIND SNAKE 5. TIMBER RATTLESNAKE SNAKES WITH BLOTCHES/ SPOTS/STRIPES 5. WESTERN COACHWHIP 6. ROCK RATTLESNAKE 1. WESTERN RAT SNAKE 6. TEXAS INDIGO SNAKE 2. BULL SNAKE 7. PLAIN BELLIED WATERSNAKE SNAKES WITH SPECIAL PATTERNS 3. PRAIRIE KING SNAKE 8. RINGNECK SNAKE (DIAMONDS, CRISS-CROSS PATTERN) 4. WESTERN HOGNOSE SNAKE 9. GRAHAM’S CRAYFISH SNAKE 5. TEXAS GARTER SNAKE 1. DIAMONDBACK WATER SNAKE 6. SPECKLED KING SNAKE 2. WESTERN DIAMONDBACK RATTLESNAKE 7. MASSASAUGA RATTLESNAKE 3. MOJAVE RATTLESNAKE 8. PIGMY RATTLESNALE 4. BLACKTAIL RATTLESNAKE SNAKES OF TEXAS 4. TALKING SNAKES SNAKES OF TEXAS 4. TALKING SNAKES

Coluber The eastern constrictor yellowbelly racer is flaviventris, found in the United States, from the Commonly known states of Montana, as the eastern North Dakota, east yellowbelly racer, to Iowa and south to is a subspecies of Texas, and racer, a southwest to nonvenomous, Louisiana. It is also colubrid snake. It found in isolated is endemic to populations in North America. Canada. SNAKES OF TEXAS 4. TALKNG SNAKES NON-VENOMOUS SNAKE SPECIES • 85% of all snake species in Texas are non-venomous

1) Western Rat Snake –(Pantherophis obsoletus) 12) Lined Snake –(Tropidoclonion lineatum) 2) Rough Green Snake –(Opheodrys aestivus) 13) Dekay’s Brown Snake –(Storeria dekayi) 3) Texas Garter Snake -(Thamnophis sirtalis annectens) 14) P-Bellied Water Snake–(Nerodia erythrogaster) 4) Western Hognose Snake –(Heterodon nasicus) 15) D-B Water Snake –(Nerodia rhombifer) 5) Western Coachwhip –(Masticophis flagellum testaceus) 16) Y-Bellied Racer –(Coluber constrictor flaviventris) 6) Ring-Necked Snake –(Diadophis punctatus) 17) Rough Earth Snake –(Virginia striatula) 7) Speckled Kingsnake –(Ampropeltis getula holbrooki) 18) Blind Snake –(Leptotyphlops dulcis) 8) Prairie Kingsnake –(Lampropeltis calligaster) 19) Buttermilk Racer –(Clouber constrictor anthicus) 9) Milk Snake –(Lampropeltis triangulum) 20) Texas Indigo -(Drymarchon melanurus erebennus) P 10) Western Ribbon Snake –(Thamnophis proximus) 11) Bull Snake –(Pituophis catenifer) Texas Indigo Snake P = PROTECTED SNAKES OF TEXAS 4. TALKING SNAKES

DIAMONDBACK WATER SNAKE

BLACK-NECKED GARTER SNAKE EASTERN PINE SNAKE SNAKES OF TEXAS 4. TALKING SNAKES

DIAMONDBACK WATER SNAKE SNAKES OF TEXAS 4. TALKING SNAKES VENOMOUS SNAKE SPECIES The State of Texas is home to 14 venomous snake species or sub-species 11) Eastern Copperhead –(Agkistrodon contortrix) 1) Western Diamondback –(Crotalus Atrox) 2) Timber Rattlesnake P –(Crotalus horridus) 12) Broadband Copperhead –(Agkistrodon contortrix 3) Western Massasauga–(Sistrurus catenatus laticinctus) 4) Desert Massasauga–(S.c. edwardsii) 13) Western Cottonmouth/Water Moccasin – 5) Mojave Rattlesnake –(Crotalus scutulatus) (Agkistrodon piscivorous) 6) Pigmy Rattlesnake –(Sistrurus miliarius) 7) Prairie Rattlesnake – (Crotalus viridis) 14) Texas Coral Snake - (Micrurus tener) 8) Blacktail Rattlesnake –(Crotalus molossus) 9) Banded Rock Rattlesnake –(Crotalus Lepidus)

10) Mottled Rattlesnake - (Crotalus Lepidus) TIMBER RATTLESNAKE P = PROTECTED SNAKES OF TEXAS 4. TALKING SNAKES Venomous Snakes of Texas THE PIT VIPERS

• All of the snakes in this group (Rattlesnake, Cottonmouth and Copperhead) are members of the Viperidae family of snakes – PIT VIPERS for short.

• The first part of the name, "pit," refers to the heat-sensing pits.

• These pits are located about midway between the snake's eye and nostril.

• The pits are thermoreceptors. They can detect differences in temperature, which helps the pit vipers locate their prey. SNAKES OF TEXAS Agkistrodon piscivorous 4. TALKING SNAKES THE PIT VIPERS • The heat sensing pits help the Pit Viper

sense heat. The biggest use for “pits” is

during hunting. Pit Vipers can track their

prey with their tonges & Jacobson organ and Venom Hemo-Toxic vaguely see prey with their eyes, but it’s the

loreal pits that make up a big difference. SNAKES OF TEXAS Agkistrodon piscivorous 4. TALKING SNAKES THE PIT VIPERS • Pits are sensitive to infrared radiation, which warm-blooded animals give off as heat.

• This allows the pit viper to physically see their prey in tones of heat & cool so their can strike. Hemo-Toxic Venom Hemo-Toxic • Pit vipers also use their pit organs to help them find cool places to regulate their internal temperatures. SNAKES OF TEXAS Agkistrodon piscivorous 4. TALKING SNAKES Pit Viper WESTERN COTTONMOUTH (WATER MOCCASIN)

• Also known as 'water moccasins', one recognized sub-species is found in Texas; The Western Cottonmouth,

• Cottonmouths can be dark brown, olive-brown, olive green or almost solid black. They are marked with wide, dark bands, which are more distinct in some individuals than in others..

• The cottonmouth gets its name from the white tissue inside its Hemo-Toxic Venom Hemo-Toxic mouth, which it displays when threatened.

• This heavy-bodied snake, which averages about 3-1/2 feet in length, is found over the central and eastern half of the state in swamps and sluggish waterways, coastal marshes, rivers, ponds and streams. SNAKES OF TEXAS Agkistrodon piscivorous 4. TALKING SNAKES WESTERN COTTONMOUTH (WATER MOCCASIN) RANGE MAP Hemotoxic Hemotoxic Venom SNAKES OF TEXAS Agkistrodon piscivorous 4. TALKING SNAKES Hooked tooth, COTTONMOUTH (WATER MOCCASIN) Pit Viper fish eater Ancistro = Hooked Oden = Tooth Piscis = Fish Voro = To Eat Hemo-Toxic Venom Hemo-Toxic Snakes of Texas JUVENILE WESTERN COTTONMOUTH 4. TALKING SNAKES WESTERN COTTONMOUTH Hemo-Toxic Venom Hemo-Toxic

JUVENILE WESTERN COTTONMOUTH Agkistrodonpiscivorous Agkistrodon piscivorous ADULT WESTERN COTTONMOUTH SNAKES OF TEXAS Agkistrodon laticinctus 4. TALKING SNAKES Ancistro = Hooked COPPERHEAD Oden = Tooth • Copperheads have chestnut or reddish-brown Contortus = Twisted, Intricate crossbands on a lighter colored body.

• Depending upon subspecies and distribution,

copperheads may inhabit a variety of environs Hemo-Toxic Venom Hemo-Toxic including rocky desert outcroppings,

deciduous and coniferous woodlands. Broadband Copperhead

. SNAKES OF TEXAS Agkistrodon contortrix 4. TALKING SNAKES COPPERHEAD RANGE Hemo-Toxic Venom Hemo-Toxic

Eastern Copperhead Snakes of Texas Eastern Copperhead 4. TALKING SNAKES COPPERHEAD SUB-SPECIES

Originally five (5) subspecies of copperhead were recognized due to various reasons such as scale

counts, patterns, color morphs, size, geographic Venom Hemo-Toxic

location etc. Agkistrodon Contortrix Snakes of Texas Eastern Copperhead 4. TALKING SNAKES COPPERHEAD SUB-SPECIES

DNA testing has helped to improve the

understanding of the species. Today it is accepted to consist of only two closely related, Hemo-Toxic Venom Hemo-Toxic yet distinct species rather than five (5)

sub-species. Agkistrodon Contortrix Agkistrodon contortrix pictigaster contortrix Agkistrodon laticinctus contortrix Agkistrodon Agkistrodon contortrix contortrix Agkistrodon contortrix phaeogaster contortrix Agkistrodon Agkistrodon contortrix mokasan contortrix Agkistrodon Original Sub-Species Current Recognized Species Current Sub-Species Original Trans-Pecos Copperhead Broad-Banded Copperhead Copperhead Northern Copperhead Southern Osage Copperhead Osage Snakes Snakes of Texas 4. TALKING SNAKES Agkistrodon contortrix laticintus contortrix Agkistrodon Agkistrodon contortrix Agkistrodon contortrix Agkistrodon Agkistrodon contortrix Agkistrodon Agkistrodon contortrix laticintus contortrix Agkistrodon Broad-banded Copperhead Broad-banded Eastern Copperhead Eastern Eastern Copperhead Eastern Copperhead Eastern Broad-banded Copperhead Broad-banded Broadband Copperhead Broadband Agkistrodon laticinctus Agkistrodon

Hemo-Toxic Venom Snakes of Texas JUVENILE EASTERN COPPERHEAD 4. TALKING SNAKES JUVENILE COPPERHEAD

ADULT BROADBAND COPPERHEAD

JUVENILE EASTERN Venom Hemo-Toxic COPPERHEAD

Agkistrodon contortrix Snakes of Texas JUVENILE WESTERN COTTONMOUTH 4. TALKING SNAKES COPPERHEAD VS COTTONMOUTH

JUVENILE COTTONMOUTH Hemo-Toxic Venom Hemo-Toxic

JUVENILE COPPERHEAD Agkistrodon piscivorous Snakes ofSnakes Texas 4. TALKING SNAKES COPPERHEAD Broadband Copperhead Broadband Agkistrodon Agkistrodon contortrix Agkistrodon Agkistrodon laticinctus Eastern Copperhead Eastern

Hemo-Toxic Venom SNAKES OF TEXAS MYTHS & MONSTERS SNAKES OF TEXAS MTYTHS & MONSTERS

• Bartonville, Texas (August 7, 2018)….

”Judy had a Moccasin CHASE her Tahoe.

Biting the front wheel as she slowly passed it

driving down High Road in Flower Mound.

They are far more AGGRESIVE than Copperheads!” SNAKES OF TEXAS MTYTHS & MONSTERS • Bartonville, Texas (August 7, 2018)….”Judy had a Moccasin CHASE her Tahoe. Biting the front wheel as she slowly passed it driving down High Road in Flower Mound. They are far more AGGRESIVE than Copperheads!”

BOTH FOUND IN FLOWER MOUND, TEXAS

WHICH MOCCASIN IS MORE LIKELY YES TO CHASE YOUR TAHOE ??? NO Snakes of Texas Crotalus Atrox 4. TALKING SNAKES Crotalus – Krotalon = Meaning Rattle WESTERN DIAMONDBACK RATTLESNAKE Atrox = Cruel, Mean • The Western Diamondback Rattlesnake is also one of the most misunderstood of Texas' reptiles.

• The Western Diamondback Rattlesnake can be found in a variety of habitats including grasslands, Hemo-Toxic Venom Hemo-Toxic scrub oak-juniper forest, rolling plains, thorn scrub, rocky canyons and outcroppings & deserts. SNAKES OF TEXAS 4. TALKING SNAKES WESTERN DIAMONDBACK RATTLESNAKE

• Cold-blooded," "calculating," and "honery“

are some of the attributes credited to this

reptile.

Yet, despite this negative portrayal, it has become a hallmark symbol of the rugged West. Snakes of Texas Crotalus Atrox

4.TALKING SNAKES Pit Viper WESTERN DIAMONDBACK RATTLESNAKE • The Western Diamondback rattlesnake is the most widespread venomous snake in the state of

Texas.

• Although its' venom is quite potent few deaths Venom Hemo-Toxic are reported and “proper” medical attention can

result in a positive outcome for the bite victim. Snakes of Texas Crotalus Atrox 4.TALKING SNAKES WESTERN DIAMONDBACK RATTLESNAKE RANGE Hemo-Toxic Venom Hemo-Toxic Snakes of Texas Crotalus atrox 4. TALKING SNAKES

WESTERN DIAMONDBACK RATTLESNAKE Hemo-Toxic Venom Hemo-Toxic SNAKES 4. TALKING SNAKES Timber Rattlesnake OF OF TEXAS rtlshorridus Crotalus PROTECTED

Hemo-Toxic Venom thickets, deciduous forests in rugged terrain, high terrain, in rugged forests deciduous thickets, mountainous areas, pine & hardwood forests & forests hardwood & pine areas, mountainous Timber rattlesnakes are found in lowland cane in lowland found are Timber rattlesnakes areas around swamps & river floodplains, river & swamps around areas SNAKES also in rural habitats in farming areas. areas. in farming rural habitats in also 4. TALKING SNAKES Timber Rattlesnake OF OF TEXAS rtlshorridus Crotalus PROTECTED

Hemo-Toxic Venom The timber rattlesnake has a brown or yellowish to a to yellowish brown or a has timber rattlesnake The V-shaped or M-shaped crossbars with jagged edges with jagged crossbars M-shaped or V-shaped grayish body,grayish dark, very are individuals but some Somewhere from 20 to 29 dark brown or black or black brown dark to20 29 from Somewhere SNAKES the distinctive pattern across their back. their across pattern distinctive the 4. TALKING SNAKES almost a solid black. solid a almost Timber Rattlesnake OF OF TEXAS rtlshorridus Crotalus “The Bat“The Wing” PROTECTED

Hemo-Toxic Venom SNAKES 4. TALKING SNAKES Timber Rattlesnake OF OF TEXAS PitViper rtlshorridus Crotalus PROTECTED

Hemo-Toxic Venom bands run from each eye to the corners of the jaw. of tocorners theeye from each run bands reddish-brown stripe down the spine. Obvious dark Obvious spine. the down stripe reddish-brown Relatively thick body is grayish; back & sides are sides & Relativelyback grayish; thick is body marked with rows of dark gray-black, irregularly of gray-black, dark rows marked with especially dark and are often separated by a separated often are and dark especially shaped blotches. Blotches on the back theare on Blotches blotches. shaped SNAKES 4. TALKING SNAKES Pigmy Rattlesnake OF OF TEXAS ituu miliarius Sistrurus ) Hemo-Toxic Venom SNAKES Pigmy Rattlesnake Range .TLIGSNAKES 4. TALKING OF OF TEXAS ituu miliarius Sistrurus )

Hemo-Toxic Venom SNAKES OF TEXAS Crotalus scutulatus 4. TALKING SNAKES Pit Viper MOJAVE RATTLESNAKE • Even though all rattlesnake species are Venomous, this species is particularly dangerous to humans. • The Mojave rattlesnake has the most potent venom of any rattlesnake in North America. Neuro-Toxic & Hemo-Toxic Venom & Hemo-Toxic Neuro-Toxic SNAKES OF TEXAS 4. TALKING SNAKES MOJAVE RATTLESNAKE Not all Mojave rattlesnakes have the same type of venom in

fact there (3) three types of venom found within their

population, known as types "A" & "B“ & “A + B”.

The type "A" venom, known as the "Mojave toxin",

is very different than most rattlesnake venoms in that it is highly neurotoxic, affecting the respiratory and nervous systems of the bite victim. SNAKES OF TEXAS 4. TALKING SNAKES MOJAVE RATTLESNAKE The type "B" venom is very similar to most other

Rattlesnake venoms so it's hemotoxic,

& it effectively destroys tissue

around the bite site.

The venom type "B" is considered 10 Type “B” snakes have a restricted times less toxic than type "A" venom. geographic distribution; they are found only in central Arizona. SNAKES OF TEXAS 4. TALKING SNAKES MOJAVE RATTLESNAKE

But some Mojave rattlesnake specimens have a

mixture of both types of venom (A + B)

Even other rattlesnake species have been found to possess a small percentage of the "Mojave toxin" in

their venom. Search SNAKES OF TEXAS Crotalus scutulatus 4. TALKING SNAKES MOJAVE RATTLESNAKE Neuro-Toxic & Hemo-Toxic Venom & Hemo-Toxic Neuro-Toxic SNAKES OF TEXAS Massasauga Rattlesnake 4. TALKING SNAKES Rattlesnake Species in Texas

Sistrurus catenatus

Crotalus lepidus

Sistrurus catenatus rtlsmolossus Crotalus SNAKES OF OF SNAKES TEXAS rtlsviridis Crotalus Rattlesnake Species in Species TexasRattlesnake .TALKING SNAKES 4. Pit Pit Viper PrairieRattlesnake rtlsviridis Crotalus

Hemotoxic & Neurotoxic Venom SNAKES OF TEXAS Black-Tail Rattlesnake 4. TALKING SNAKES Rattlesnake Species in Texas

June 7, 2019

• It's fair to say this black-tailed rattlesnake is among the rarest ever seen in Travis County, the first to be documented in the area since 1953.

• The snake was found in a gated community near Lake Travis, just outside Austin in Central Texas. Crotalus molossus edwardsii catenatus Sistrurus rtlsLepidus Crotalus SNAKES OF OF SNAKES TEXAS 4. LET’S LET’S TALK SNAKES 4. Other Other Rattlesnake Species in Texas Rock Rattlesnake rtlsLepidus Crotalus PitViper

Hemotoxic Venom SNAKES OF TEXAS MYTHS & MONSTERS SNAKES OF TEXAS MTYTHS & MONSTERS

• May 12, 2018 – Flower Mound, Texas : “…Head looks round, if head looks triangle shape, watch out it is poisonous.”

• May 12, 2018 – Flower Mound, Texas : “ …So long as it doesn’t have a triangle head you are fine.”

• We’ve all heard it. If a snake has a triangle or diamond-shaped head, it is venomous, right? Wrong! This trick just doesn’t work and we should stop using it. SNAKES OF TEXAS MTYTHS AND MONSTERS THE TRIANGLE HEAD QUIZ There are three snake heads in the photo, there is one

Copperhead, one harmless Rat Snake and one Timber

Rattlesnake head.

Using the “venomous snakes have a triangle head theory”, match the head to the three snakes.

Timber Rattlesnake ? Western Rat Snake? Copperhead ? SNAKES OF TEXAS MYTHS & MONSTERS THE TRIANGLE HEAD QUIZ There are three snake heads in the photo, there is one Copperhead, one Rat Snake and one Timber Rattlesnake head.

Using the venomous snake has a triangle head theory, match the head to the three snakes.

Timber Rattlesnake

Western Rat Snake

Copperhead SNAKES OF TEXAS Micrurus Tener 4. TALKING SNAKES TEXAS CORAL SNAKE • Coral snakes are small, vibrantly colored, highly venomous snakes. They have the second-strongest venom of any snake (the black mamba has one of

The most deadly venoms).

• The Texas Coral Snake is considered less Venom Neuro-Toxic dangerous than rattlesnakes because coral snakes have a less effective venom-delivery system. SNAKES OF TEXAS Micrurus Tener 4. TALKING SNAKES TEXAS CORAL SNAKE • Coral snake venom is largely composed of neurotoxically destructive peptides & is therefore, more deadly than the venom of most other North

American reptiles. Neuro-Toxic Venom Neuro-Toxic • A lethal dose for an adult human being is as small as five to ten milligrams, dry weight—several times more virulent than the venom of the Western Diamondback Rattlesnake. SNAKES OF TEXAS Micrurus Tener 4. TALKING SNAKES TEXAS CORAL SNAKE

• Texas coral snakes average about two feet in • The Texas Coral has an length. The record is extended reproductive nearly twice the average. season, perhaps because of its small • Their prey is chiefly other home range. because snakes, some as big as the of the low sensory coral itself, which are Venom Neuro-Toxic perception. overcome by means of the potent venom. SNAKES OF TEXAS Micrurus Tener 4. TALKING SNAKES TEXAS CORAL SNAKE RANGE Neuro-Toxic Venom Neuro-Toxic SNAKES OF NORTH TEXAS Micrurus Tener 4. TALKING SNAKES TEXAS CORAL SNAKE • The Texas Coral has a pair of small, front fixed,

hollow fangs in the upper jaw through which the

snake injects venom with a quick bite.

• Elapids are different from pit vipers in that their Neuro-toxic Venom fangs do not fold back. Their fangs have to be

pretty small to fit inside the coral snake’s closed VENOMOUS mouth. HARMLESS MILK SNAKE SNAKES OF TEXAS Lampropeltis Triangulum 4. TALKING SNAKES TEXAS CORAL SNAKE VS MILK SNAKE

Micrurus Tener VS Lampropeltis Triangulum “Red Touching Yellow, Will Kill A Fellow”

“Red Touching Black, a Friend of Jack” NON-VENOMOUS SNAKES OF TEXAS Micrurus Tener 4. TALKING SNAKES TEXAS CORAL SNAKE One more curve… • Coral snakes’ colors & patterns aren’t always

typical.

There are conditions like melanism where the snake is mostly black — or albinism — where it’s

lacking black pigment. Coral Snake SNAKES OF TEXAS 4. Talking SNAKES Micrurus Tener TEXAS CORAL SNAKE • There can be regional variations of the coral snake. For example, the coral snakes in the Florida Keys have little or

no yellow, which might lead someone to misidentify the

snake if they were relying on the old rhymes.

Coral Snake SNAKES OF TEXAS 4. TALKNG SNAKES NON-VENOMOUS SNAKE SPECIES • 85% of all snake species in Texas are non-venomous

• Large snakes capable of growing more than 77 inches in total body length. The largest individual FREE PEST CONTROL recorded measured 86 inches or 7.2 feet. SNAKES OF TEXAS Pantherophis obsoletus 4. LET’S TALK SNAKES Family : Colubridae WESTERN RAT SNAKE • Western Rat Snakes are non-venomous and

pose no threat to humans.

• Highly adaptable to a wide range of Non-Venomous environments including forest, grasslands,

suburban areas, and even locations within an

urban setting. FREE PEST CONTROL Pantherophis obsoletus SNAKES OF TEXAS Family : Colubridae 4. LET’S TALK SNAKES WESTERN RAT SNAKE RANGE Non-Venomous Pantherophis obsoletus SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES WESTERN RAT SNAKE

• The presence of this snake in any setting near

human habitation is a strong indicator that

rodents such as rats and mice are Non-Venomous also in the vicinity. SNAKES OF TEXAS 4. TALKING SNAKES WESTERN RAT SNAKE • These snakes are effective & efficient

predators of disease spreading rodents.

• Because of the benefit this snake

serves, it should not be killed or

molested. Lampropeltis triangulum SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES MILK SNAKE • Milk Snakes are so named because of the

myth of their attaching to cow's udders

& receiving nourishment.

• Some Milk Snakes feed primarily on Non-Venomous

other snakes, whereas other Milk Snakes incorporate lizards, insects & mice in its diet. Lampropeltis triangulum SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES MILK SNAKE

• The Milk Snakes are egg layers, breeding in the spring & lay their clutches of 5-12 eggs in

the summer. Non-Venomous

Mexican Milk Snake Lampropeltis triangulum SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES MILK SNAKE RANGE Non-Venomous Heterodon nasiscus SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES WESTERN HOGNOSE SNAKE

• The Western Hognose snake exists throughout

most of the eastern half of Texas.

• Even though it is harmless, this unique snake puts

on an extraordinary defensive display when

threatened. Non-Venomous Heterodon nasiscus SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES WESTERN HOGNOSE SNAKE • When threatened, the Hognose will roll over on

its back, go into what appears to be convulsions,

and then lie still as if it is dead. It will even Non-Venomous open its mouth and let its tongue out to help with

the charade. Heterodon nasiscus SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES WESTERN HOGNOSE SNAKE • The Western Hognose consume a variety of prey

items, including small rodents (mice), lizards,

Amphibians & the eggs of ground-nesting animals. Non-Venomous

• Adults are generally 20 to 30 inches in length

with the record length being 45.5 inches. Heterodon nasiscus SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES WESTERN HOGNOSE SNAKE RANGE Non-Venomous Heterodon platirhinos SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES EASTERN HOGNOSE SNAKE RANGE Non-Venomous Heterodon kemmerlyi SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES MEXICAN HOGNOSE SNAKE RANGE Non-Venomous SNAKES OF TEXAS 4. LET’S TALK SNAKES Storeria dekayi SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES DEKAY’S BROWN SNAKE RANGE Non-Venomous Virginia Striatula SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES ROUGH EARTH SNAKE RANGE Non-Venomous Nerodia rhombifer SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES DIAMONDBACK WATERSNAKE RANGE Non-Venomous Nerodia erythrogaster SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES PLAIN BELLIED WATERSNAKE RANGE Non-Venomous Nerodia rhombifer

SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES Harmless Water Snake or Venomous Cottonmouth Non-Venomous

PLAIN-BELLIED WATER SNAKE Nerodia erythrogaster DIAMONDBACK WATER SNAKE WESTERN COTTONMOUTH Agkistrodon piscivorus Nerodia fasciata confluens

SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES Harmless Water Snake or Venomous Cottonmouth Harmless Venomous Watersnake Cottonmouth Usually found around water : YES YES Body Shape is : SLENDER HEAVY Dark body, with bands : YES YES Keeled scales/rough looking YES YES Head Shape is : SLENDER/ FLATTENED THICK/ BLOCKY

Neck Shape : NON-DISTINCT NARROWER THAN HEAD Non-Venomous Dark facical band or mask NO YES Vertical lines on lips, mouth YES NO Eyes, pupils ROUND ? VERTICAL? Heat Sensing Pits NO YES BROADBAND WATER SNAKE Opheodrys aestivus SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES

RING-NECK SNAKE (Diadophis punctatus) (Thamnophis proximus) Non-Venomous

(Thamnophis cyrtopsis)

ROUGH GREEN SNAKE SPECKLED KINGSNAKE (Lampropeltis getula holbrooki) Pituophis ruthveni SNAKES OF TEXAS Family : Colubridae 4. TALKING SNAKES

COACHWHIP

(Masticophis flagellum) Non-Venomous

EASTERN YELLOW BELLIED RACER (Coluber constrictor flaviventris) LOUISIANA PINE SNAKE Pituophis ruthveni is listed as endangered by TP&W & is therefore protected by the LINED SNAKE State of Texas (Tropidoclonion lineatum) Coluber constrictor SNAKES OF TEXAS Family: Colurbridae 4. TALKING SNAKES

BLIND SNAKE (Leptotyphlops dulcis) Non-Venomous

LONG-NOSED SNAKE (Rhinocheilus lecontei)

EASTERN BLACK RACER PLAINS THREADSNAKE (Rena dissectus) Lampropeltis triangulum elapsoides SNAKES OF TEXAS Family: Colurbridae 4. TALKING SNAKES

PRAIRIE KING SNAKE (Lampropeltis calligaster) Non-Venomous

GRAHAM’S CRAYFISH SNAKE (Regina grahamii)

SCARLET KINGSNAKE MUDSNAKE (Farancia abacura) Pituophis catenifer sayi SNAKES OF TEXAS Family: Colurbridae 4. TALKING SNAKES

BUTTERMILK RACER (Coluber constrictor anthicus) Non-Venomous

TEXAS INDIGO SNAKE (Drymarchon melanurus erebennus)

The Texas Indigo is listed as BULL SNAKE BROADBAND WATERSNAKE threatened in Texas and cannot be (Nerodia fasciata confluens) hunted, harassed, or killed. SNAKES OF TEXAS 5. FUN WITH IDENTIFICATION

1. 2. 3.

4. 5. 6.

EASTERN HOGNOSE WESTERN COACHWHIP PLAIN BELLIED WATERSNAKE BROADBAND COPPERHEAD WESTERN DIAMONDBACK RATTLESNAKE WESTERN RAT SNAKE SNAKES OF TEXAS 5. FUN WITH IDENTIFICATION

1) PLAIN BELLIED WATERSNAKE 3. EASTERN HOGNOSE

2. WESTERN RAT SNAKE

5. BROADBAND COPPERHEAD 4. COACHWHIP 6. WESTERN DIAMONDBACK RATTLESNAKE SNAKES OF TEXAS 5. FUN WITH IDENTIFICATION

2. 3. 1.

6. 4. 5

WESTERN RIBBON SNAKE ROUGH GREEN SNAKE DEKAY’S BROWN SNAKE DIAMONDBACK WATERSNAKE TIMBER RATTLESNAKE COTTONMOUTH/WATER MOCISSIAN SNAKES OF TEXAS 5. FUN WITH IDENTIFICATION

1. ROUGH GREEN SNAKE 2. WESTERN RIBBON SNAKE 3. DIAMONDBACK WATERSNAKE

4. COTTONMOUTH/ 5. DEKAY’S BROWN SNAKE WATER MOCCASIN 6. TIMBER RATTLESNAKE SNAKES OF TEXAS 5. FUN WITH IDENTIFICATION

1. 2. 3.

4. 5.

BULL SNAKE RINGNECK SNAKE PIGMY RATTLESNAKE TEXAS CORAL SNAKE ROUGH EARTH SNAKE YELLOW-BELLIED RACER SNAKES OF TEXAS 5. FUN WITH IDENTIFICATION

1. ROUGH EARTH SNAKE 2. PIGMY RATTLESNAKE 3. RINGNECK SNAKE

5. 4. YELLOW-BELLIED RACER TEXAS CORAL SNAKE 6.BULL SNAKE SNAKES OF TEXAS 6. UNDERSTANDING VENOM SNAKES OF TEXAS 6. UNDERSTANDING VENOM There are three types of Venomous Snakes OPISTHOGLYPH PROTEROGLYPH SOLENOGLYPH • The rear fanged snakes • Fixed front fang snakes • Hinged front fangs

• Mostly harmless or • Small non-movable • Fangs fold into mouth mildly venomous * front fangs Elapidae Viperidae Colubridae

* Exception Boomslang SNAKES OF TEXAS 6. UNDERSTANDING VENOM VENOM - What is it ? • Snake venom is the fluid secretions from the modified salivary glands of

venomous snakes, made up of a combination of proteins, enzymes, &

other molecular substances . SNAKES OF TEXAS 6. UNDERSTANDING VENOM • There are approximately 20 different types of toxins found in snake venom.

• Snake venom is usually a combination of several of these toxins.

• Each of these enzymes & proteins has its own special function. Some aid in

the digestive process, while others specialize in paralyzing prey. 5’-Nucleotidase Phosphomonoesterase Collagenase Phospholipase B Arginine ester hydrolase RNase L-Anino acid oxidase Phosphodiesterase Hyaluronidase Phospholipase C Thrombin-like enzymes DNase Lactate dehydrogenase Acetylcholinesterase Phospholipase A2 (A) Adenosine triphosphatase SNAKES OF TEXAS 6. UNDERSTANDING VENOM There are approximately 20 different types of toxins found in snake venom. Snake venom is usually a combination of several of these toxins. The main types of toxins are: o Neurotoxins – Cholinesterase o Anticoagulants – Thrombin  Paralysis of voluntary muscles  Impedes blood clotting o Hemotoxins – Phospholipases o Cytotoxins – Metallo-Proteases  Destroys red blood cells  Destroys tissue o Coagulants – Thrombin o Hyaluronidase – Hyaloronic Acid  Causes blood clots in blood cells  Increases the spreading factor of venom. SNAKES OF TEXAS 6. UNDERSTANDING VENOM • Hemotoxic venom radically attacks blood and tissue cells causing traumatic damage to the area which received the bite. In some cases the after-effects are so bad the • Neurotoxic venom works by attacking patient may require skin grafts due the human body’s central nervous system tissue degeneration and muscle and brain. When the neurotoxic venom damage. attacks the central nervous system it often causes paralysis. With that, bite victims experience a loss of muscle control in their diaphragm and are unable to expand their lung to breath SNAKES OF TEXAS 6. UNDERSTANDING VENOM

• Question: What is the difference between

poisonous & venomous ? SNAKES OF TEXAS 6. UNDERSTANDING VENOM Technically Correct Man

• If you bite it & die, it is

poisonous; if it bites you & you die, it is

venomous. SNAKES OF TEXAS 6. UNDERSTANDING VENOM Poisonous Venomous • There are no poisonous • Venomous snakes snakes in Texas!!! are reptiles that produces a toxin in a • A poisonous amphibian, specialized gland & such as the poison dart possesses a specific frog, has to be eaten or venom delivery touched & ingested in order system, which is to deliver their toxins. typically injected bufo marinus (the Giant, Marine or Cane toad) through fangs upon • Poison must be ingested, biting prey. rather than injected SNAKES OF NORTH TEXAS MYTHS & MONSTERS SNAKES OF TEXAS MYTHS & MONSTERS • Flower Mound, Texas (June 19, 2018)….”….I called animal control & they

came and got my copperhead… “The baby ones are more poisonous”

• The legend goes that young snakes have not yet learned how to control the

amount of venom they inject.

• They are therefore more dangerous than adult snakes, which will restrict the

amount of venom that accompanies a bite. SNAKES OF TEXAS MYTHS & MONSTERS • Flower Mound, Texas (June 19, 2018)….”….I called animal control & they

came and got my copperhead… “The baby ones are more poisonous”

• The fact of the matter is baby venomous snakes are not more venomous than their parents. In fact, quite

the opposite is true in a great many snake species;

adults have far more virulent venom than the young

snakes. SNAKES OF TEXAS MYTHS & MONSTERS • Flower Mound, Texas (June 19, 2018)….”….I called animal control & they

came and got my copperhead… “The baby ones are more poisonous” • Similarly, an adult snake is capable of delivering a

much larger venom dose than a smaller snake.

• Juveniles typically deliver less than 70 milligrams

of venom, whereas a healthy adult specimen may • Roughly 100 milligrams of venom deliver 492 to 666 milligrams of venom is considered a lethal dose for an adult human. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM WHAT IS ANTIVENOM ? • Antivenom is a substance used to • When this occurs, the

treat people who have had injured party may have it

venom injected into their bodies administered to them, usually

through the either through a vein, or less

bites or stings of an animal. often, through a muscle.

It works to neutralize the venom that is in the patient’s body,... SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM WHAT IS ANTIVENOM ? WHAT IS THE BENEFIT OF ANTIVENOM? • All but the mildest of envenomations should • Some people estimate up to 20% be treated with antivenom. of mild bites that go untreated result in permanent disability. • Although MANY (Particularly Copperhead) The percentage is even higher in envenomations that go untreated will moderate and severe, and bites. eventually recover fully, there’s a significant percentage of patients who end • Permanent damage is highly up with permanent disability. unlikely when the patient is treated in a timely fashion with antivenom. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM WHAT IS ANTIVENOM ? WHAT IS THE BENEFIT OF ANTIVENON? • There’s no question that treatment with • Patients who receive antivenom also antivenom accelerates recovery. In the only end up requiring less opioids than randomized clinical trial that evaluated the patients who go untreated. In this efficacy of CroFab in treatment of age of opioid abuse, reducing total copperhead bites, patients who received opioid usage is beneficial. antivenom performed better on the PSFS at 14 days compared to patients who went untreated. Additionally, patients who were treated within 5.5 hours had the fastest recovery. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM WHAT IS ANTIVENOM ? WHAT IS THE BENEFIT OF ANTIVENON? Below are links to some of the important studies: https://www.annemergmed.com/article/S0196-0644(17)30510-3/pdf https://www.annemergmed.com/article/S0196-0644(17)30510- 3/pdf?fbclid=IwAR3R0sF8LmBCrZJA8Wlc1jKg_7A3VR6IhaV-Aj-wxUdcbAwEQD1WICx3XfE https://www.ncbi.nlm.nih.gov/m/pubmed/30175628/?fbclid=IwAR2cQFsAwahS8YteTIY9SteUS LWf-SjLy7DXhtQ-7t7RhJqzc1KZKw_HosI https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526891/?fbclid=IwAR0ICB8lqvmx- Gup4Z6vjPUEayEw6dxD2PbpJUdsh_UEsyqgswaoOS3f4h8 SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM • There is one FDA approved antivenom

for the treatment of ALL North American

pit viper (Crotalidae) envenomation's.

• CROTALIDAE POLYVALENT IMMUNE FAB (OVINE)

CROFAB is a registered trademeark of BTG International Ltd. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM • ANAVIP® Crotalidae Immune F(ab’)2 Equine

ANAVIP is an equine-derived antivenom

• Anavip is only FDA-approved for North American

Rattlesnake envenomations.

• That is not to say it’s not effective against

Agkistrodon bites; it’s just not FDA approved. Instituto Bioclon S.A. de C.V. Mexico D.F., Mexico SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM

• Some studies show that F(ab')2 antivenom would be superior to Fab in the prevention of late coagulopathy

following treatment of envenomation.

• Coagulopathy is generally a bleeding disorder or

prolonged or excessive bleeding occurring following

a trauma, an injury, or a medical procedure. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM

• CroFab has excellent safety data.

• There are three major studies from the past 10 years that estimate the incidence of acute adverse reactions between 1.4 - 8%.

• Serious reactions are exceptionally uncommon, although they can certainly happen.

CROFAB is a registered trademeark of BTG International Ltd. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM

• Most Pit Viper bites (80 – 85%) will result in envenomation

• Most envenomations should be treated with Antivenom.

• Antivenom will minimize the amount of local tissue

damage, reverse hematotoxicity (destruction of red blood

cells) & treat systemic toxicity (airway swelling,

Hypotension – low blood pressure) SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM • Many physicians do not treat with antivenom when they should treat.

When you should receive Antivenom :

• Progressive local injury – swelling that crosses any major joint

• Systemic toxicity such as hypotension, airway swelling

• Hematotoxicity (disrupt blood clotting) SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM Why physicians don’t give Antivenom.

“Some people mistakenly believe that antivenom is very unsafe, and that the cure is worse than the disease”

Spencer Greene, MD, MS, FACEP, FACMT, FAAEM Bayou City Medical Toxicology & Emergency Medicine Consultants, PLLC 6711 Stella Link Road #313 West University Place, TX 77005 TIME IS TISSUE !! SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM Why physicians don’t give Antivenom.

• “Some people mistakenly believe • This is untrue. Although any medication can have an adverse that antivenom is very unsafe, & reaction, the incidence of acute adverse reactions to CroFab range that the cure between 1.4 and 8%, depending on the study. And significant adverse is worse than the disease” reactions are seen in fewer than 1% of patients. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM Why physicians don’t give Antivenom.

• Some people mistakenly believe • This, too, is incorrect. Multiple that antivenom isn’t effective. studies have demonstrated the benefit of antivenom.

• Some doctors are reluctant to give • This, too, is incorrect. it because they mistakenly believe Patients can receive that It can only be used once & they antivenom multiple times want to save it for a severe without incident. envenomation. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM Why physicians don’t give Antivenom.

• Some doctors are reluctant to use • Most people with mild bites will antivenom because they’re not recover even without treatment. sure if the benefits are worth the And treatment is not cheap. cost. For for very mild bites, it’s worth having a discussion with the patient whether or not he or she wants to be treated.. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM Why physicians don’t give Antivenom. • Even with mild bites, up to 20% of patients may have long-term disability, &

that is expensive and life altering.

Ultimately, it’s actually more cost

effective to treat, & especially if it’s a

more than mild bite. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE

Why Snakebite Antivenom Is So

Astronomically Expensive ? SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE • By all accounts, being bitten

by a venomous snake is

painful, dangerous &

terrifying.

But did you know it's also

astronomically expensive? SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE • CROFAB has dominated the American snake antivenom

market for two decades.

• Although antivenom has been around for more than a

century, the process of making CROFAB

involve scientists, snakes, & sheep across

three continents. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE

1. At snake colonies in Utah & Florida, handlers milk four

different kinds of snakes found in the North America to

obtain their venom.

They collect a variety of venom to make sure the drug

works on the range of effects from toxins found in North

American pit vipers. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE

2. Snake Venom is sent to the United Kingdom for quality

control to ensure it meets potency standards. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE 3. The four types of snake venom are injected into separate

flocks of sheep in Australia.

These animals are used because their

antibodies (the molecules that help block the venom), are

less likely to produce an allergic reaction in humans

(according to the manufacturer). SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE

3. The flocks of sheep are certified to be disease free.

After the sheep develop sufficient immunity against the

venom, blood serum is collected from the sheep. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE 4. An enzyme called papain breaks apart antibodies in the

sheep serum into pieces called Fab fragments, which

neutralize the snake venom.

The serum is filtered & checked for viruses back in the United Kingdom.

Finally, the Fab fragments from different venoms are mixed

into one product. SNAKES OF TEXAS 7. ALL ABOUT ANTIVENOM SNAKES ON A PLANE 5. In Maryland, USA the product is lyophilized, or freeze-dried

& the powdered form is then packaged for distribution. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ?

• Approximately 9,000 patients are

treated for venomous snakebite & (5)

people die in the USA each year.

• Nearly half of those are envenomated

by a single species,

the Copperhead Agkistrodon contortirx - laticinctus SNAKES OF TEXAS 8. BITTEN BY A SNAKE ?

• 2012 – 2016 Data*

Copperhead bites – 9,247

Cottonmouth bites – 1,234

Rattlesnake bites - 4,912

Coral Snake bites – 400 Agkistrodon contortirx *Data from American Association of Poison Control Centers SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES

• Unified treatment algorithm for the

management of Crotaline snakebite

in the United States :

Results of an evidence-informed consensus

workshop SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES

• Envenomations by crotaline snakes (Rattlesnakes, Cottonmouth, Copperhead) is a complex, potentially lethel condition affecting thousands of people in the United States each year.

• Treatment of crotaline envenomation is not standardized, & significant variation in practice exists.

SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES • Mark the bite area, area of

swelling & tenderness with

a Sharpie pen

& note time of the

bite. Track progression of

swelling & note time. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES • Sole purpose is to get snakebite victims

connected with experts who practice the

proper management of snake

envenomations. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES Why is there a need for NSS? Why don’t hospitals/doctors know proper snakebite management?

“This is a complicated question. Snakebites are a very niche area of medicine that not many physicians stay up to date on. This leaves said physicians using other supportive staff such as poison centers to supplement their knowledge. Some poison centers are very good, some less so. Many physicians just rely on what they learned two decades ago which is often out of date and/or potentially harmful to the patient without consulting anyone….” From Dr. Nick Brandehoff Emergency Physician & Medical Toxicologist. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES PRE-HOSPITAL (FIELD) PRE-HOSPITAL (FIELD) PRE-HOSPITAL (FIELD) MANAGEMENT OF MANAGEMENT OF MANAGEMENT OF SNAKEBITES SNAKEBITES SNAKEBITES

• Remove victim from • Keep victim flat with head • Wash the bite site with water vicinity of the offending slightly elevated. snake to a safe location • Do not rub or massage the • Do not give victim bite site. • Attempt to identify the anything to eat or drink. species by photo • Mark the fang puncture & • Remove any tight-fitting leading edge of the swelling • Keep the victim calm clothing or jewelry. with a pen. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES PRE-HOSPITAL (FIELD) PRE-HOSPITAL (FIELD) PRE-HOSPITAL (FIELD) MANAGEMENT OF SNAKEBITES MANAGEMENT OF SNAKEBITES MANAGEMENT OF SNAKEBITES

• Copperhead & Cottonmouth • Notify the hospital of the • Ensure Poison Control is bites should be elevated incoming snakebite victim. notified of the bite. above the level of the heart. • Estimated time of arrival • Record any symptoms & the time of the • Transport the victim • Species of the snake if occurrence. immediately to a hospital known capable of treating a snakebite SNAKES OF TEXAS 8. BITTEN BY A SNAKE ?

Snakebite Suction Devices Don’t Remove Venom :

They Just Suck… *

It was only a few decades ago that incision &

suction were recommended snakebite first-aid.

* From Dr. Sean Bush – Department of Emergency Medicine, Loma Linda University School of Medicine, Medical Center & Childrens’s Hospital – Loma Linda, Ca. 2004 SNAKES OF TEXAS 8. BITTEN BY A SNAKE ?

Snakebite Suction Devices Don’t Remove Venom :

They Just Suck… *

The Sawyer Extractor does not reduce swelling, but it did result in further injury to some people.

These extractors removed a clinically insignificant amount of venom & are essentially useless. * From Dr. Sean Bush – Department of Emergency Medicine, Loma Linda University School of Medicine, Medical Center & Childrens’s Hospital – Loma Linda, Ca. 2004 SNAKES OF TEXAS 8. BITTEN BY A SNAKE ?

Snakebite Suction Devices Don’t Remove Venom :

They Just Suck… *

• Snakebite kits, venom extractors do not work

& they could make things worse.

Snakebite Suction Devices Don’t Remove Venom :

They Just Suck… *

• The best first aid for snakebite is a

cell phone

& a helicopter or ambulance.

IN-HOSPITAL MANAGEMENT IN-HOSPITAL MANAGEMENT OF OF SNAKEBITES SNAKEBITES

• Any airway or circulatory • Opioids are often needed compromise will be rectified immediately • The affected extremity should be ELEVATED if it’s a • NSAIDs such as Ibuprofen, pit viper bite. Motrin, Advil should be avoided. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? Hospital Snakebite Management The affected extremity should be ELEVATED if it’s a Pit

Viper bite. For coral snakes below heart level makes good sense

Spencer Greene, MD, MS, FACEP, FACMT, FAAEM Bayou City Medical Toxicology & Emergency Medicine Consultants, PLLC 6711 Stella Link Road #313 West University Place, TX 77005

* From Dr. Spencer Greene – Hospital Snakebite Management – July 2018 SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES

• Call 1-800-222-1222 for poison control

information. This is a national toll-free

number that works from any location in the

United States and it is manned 24 hours a

day, 7 days a week. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES • Compare an envenomation like you

would treat a fire.

• If you are treated early & aggressively,

before fire (the bite) spreads, you can extinguish it with fewer resources & less resultant damage than if you wait for the venom to spread. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES • If you treat after the fire (the bite) has

spread, there is more damage & you use

more resources.

• Ideal treatment of pit viper envenomation's differ greatly, & can result

in severe complications. SNAKES OF TEXAS 8. BITTEN BY A SNAKE ? MANAGEMENT OF PIT VIPER BITES • If you treat after the fire (the bite) has

spread, there is more damage & you use

more resources.

• Ideal treatment of pit viper envenomation's differ greatly, & can result

in severe complications. SNAKES OF TEXAS 9. HOW CAN SNAKE VENOM BE USED IN MEDICINE? • Venomous snakes have a reputation of being the most-deadliest and dangerous animals in the wildlife world.

• But the same deadly venom that makes these snakes dangerous is the same thing that makes it valuable to the medical research community. Over the years, scientists & medical researchers have discovered that the very compounds that makes venom poisonous, are useful in the treatment of several human diseases. SNAKES OF TEXAS 9. HOW CAN SNAKE VENOM BE USED IN MEDICINE?

• Medicines derived from hemotoxins are • Medical researchers have used in treatment of heart attacks and developed a synthetic version blood disorders. of the snake venom protein that is used in medicines to treat high blood pressure. • The first drug derived from snake venom toxin was developed to treat • A venom protein from the high blood pressure. This venom was African saw-scaled viper is taken from a Brazilian pit viper, used in treatment of minor heart attacks. They work by helping to dissolve and prevent blood clots. SNAKES OF TEXAS 9. HOW CAN SNAKE VENOM BE USED IN MEDICINE?

• Medical tests indicate that small • Researchers are studying the dosages of the venom from Malayan potential of snake venom proteins pit viper help to dissolve stroke- to be for the treatment against related blood clots and prevent new cancer. clots from forming. • Researchers are looking at how • Medicines derived from neurotoxins effective these venoms are in the are used to treat brain injuries, treatment for circulatory system strokes, and diseases such as disorders. Alzheimer’s and Parkinson’s. SNAKES OF TEXAS 9. HOW CAN SNAKE VENOM BE USED IN MEDICINE?

• Scientists think that a property of • Scientists are also studying and snake venom could be used to exploring of using snake venom as disrupt the flow of blood to a a potential source of painkilling tumor and thus preventing its compounds. growth. Since the venom toxins act on certain types of cells, hence the healthy cells would not be unaffected. SNAKES OF TEXAS 1. INTRODUCTION RESOURCES o Facebook:SnakeCity - Texas  https://www.facebook.com/cityofsnakes/

o YouTube : SnakeCityTexas  https://www.youtube.com/channel/UC3Y2yURkxgtZ4A3mTLZ1X8A

o Facebook: What Kind of Snake is this North Texas ? North Texas Educational Group  https://www.facebook.com/groups/whatsnakeisthis/

o Facebook: Texas Herpetological Society o https://www.facebook.com/Texas-Herpetological-Society-538386902913193/ SNAKES OF TEXAS 1. INTRODUCTION RESOURCES

o Facebook: Wild Snakes Education & Discussion  https://www.facebook.com/groups/snakeED/

o Facebook: Texas Snake ID  http://www.texassnakeid.com/

o Facebook: All Things Akistrodon  https://www.facebook.com/groups/124462866608/

o Facbook : North American Field Hepring Association  https://www.facebook.com/groups/NAFHA/ SNAKES OF TEXAS 1. INTRODUCTION RESOURCES

o Facebook: Live Snake Identification & Discussion  https://www.facebook.com/groups/602600596920781/

o Facebook: National Snakebite Support  https://www.facebook.com/groups/987850051297436/

o Facebook: National Snakebite Veterinary Support  https://www.facebook.com/groups/195627434402563/

o Facbook : iNaturalist.org  https://www.facebook.com/inaturalist/ Snakes of North Texas

REFERENCES 1 – Snake Venom : www.chm.bris.as.uk/webprojects2003/stoneley/two.htm

2- Mojave Rattlesnake (Crotalus scutulatus scutulatus) with Type B Venom from Mexico https://bioone.org/journals/copeia/volume-2014/issue-1/OT-12-041/Mojave-Rattlesnake-Crotalus- scutulatus-scutulatus-with-Type-B-Venom-from/10.1643/OT-12-041.pdf

3. Comparison of F(ab')2 versus Fab antivenom for pit viper envenomation: A prospective, blinded, multicenter, randomized clinical trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4364250/ SNAKES OF TEXAS

Thank You