Coral snakes are among the Texas reptiles you may encounter in your back yard.
While they are shy, non-confrontational creatures—which makes human encounters uncommon—when a coral snake’s “hand” is pushed, they may choose to strike, and although those bites are rare, they are also extremely deadly.
That’s why doctors at the Texas A&M Veterinary Medical Teaching Hospital (VMTH) consider Renee and Angela Nino’s 1-year-old French bulldog, Coco Chanel, to be a very lucky girl.
The Ninos heard Coco and her playmate, an English Mastiff named Xena, barking as they prepared for a party outside at their Austin home on Feb. 17. When they found the two entangled with a coral snake, the Ninos knew they needed to take action, and quickly.
“They saw their Mastiff holding in his mouth a coral snake and their other dog, the Frenchie, pawing at her face,” said Dr. Stanley Sowy, a second-year resident in the VMTH’s Emergency and Critical Care service. “They put two and two together and realized that the Frenchie was bitten by the coral snake and rushed her to their closest emergency veterinarian in Austin.”
“It was traumatizing for everybody,” Renee said. “It was terrifying because at that point, we’ve taken our dog to the hospital and they say there’s nothing they can do.”
Because an anti-venom does not exist in the United States for dogs, the couple was referred to the VMTH’s Small Animal Hospital (SAH), where they were met by veterinary intern Dr. Jennifer Gray.
“With coral snake envenomation, most of the bites are dry bites, which means they don’t really release any venom,” said Sowy, who was the overseeing resident on duty. “But if it’s a wet bite, where they release venom, most of these patients develop neurological signs; in the most severe cases, there’s paralysis, and the difficulty is that they can’t breathe on their own.
“When I first saw Coco, she was OK for a bit and then, slowly, she started to decline,” he said. “That’s when I knew this was serious and we had to intervene; we knew that in 20-30 minutes she wouldn’t be breathing on her own, and we had to put her on the ventilator.”
Coco remained on the ventilator for 24 hours before showing signs of improvement; as the venom left her system, the medical team—including clinical assistant professor Dr. Justin Heinz, first-year resident Dr. Katrina Schmitz, and intern Dr. Alena Strelchik—were able to turn their attention to making her stronger.
“The venom basically prevents the signal from the nerves to act on the muscles, so there was no signal going through, and, as such, Coco couldn’t move her muscles; she was so weak,” Sowy said.
“Dogs bitten by venomous snakes regain their function in the order they lost it,” he said. “First, Coco lost her ability to move, her strength, and then, lastly, the ability to breathe; when they recover from it, first, they regain the ability to breathe, then regain the ability of their strength, and then the ability to move again.”
Within a few days of Coco undergoing rehabilitation with Dr. Daniel Eckman, a veterinarian in the SAH’s Sports Medicine & Rehabilitation service—who helped her regain her standing and walking strength—Coco was able to be discharged back to her family.
Renee said while they would drive over to College Station every day to see their pup, she is extremely grateful for the quality of care Coco received at Texas A&M.
“She had excellent care,” Renee said, emotionally. “I feel really good about it. She was in the best place she could have possibly been. In our family, (as Austin residents) we’re UT fans, but I joke around, saying that I’ll never again say a bad thing about A&M. I’ll wear maroon, that’s for sure. I’m really happy.”
For those on the Emergency and Critical Care service, Coco’s case was unusual, as the bulk of the snakebite cases they see involve pit vipers, which cause trauma to the patient, but are not usually fatal.
“A coral snake is very rare; we don’t see a lot of them, and, if we do, it’s usually something catastrophic, because if we don’t do anything about it, their breathing is going to fail,” Sowy said. “But if we get them on a ventilator and we breathe for them, their chances are pretty good. We just have to wait for the toxin to wear off and they will eventually recover.”
Sowy attributes Coco’s positive prognosis to her family’s quick-thinking in, first, being cognizant in identifying the coral snake— something Renee also attributes to Xena—and, second, in getting Coco to a doctor as quickly as possible.
“Xena was the mama in it all; she was the one who made us aware of it, and thank God, because without seeing the snake, we wouldn’t have known what she had gotten into because our house is on an acre of land,” Renee said.
While Coco can ultimately thank her parents and her playmate for her positive prognosis—Sowy said she may not have survived had she arrived 20-30 minutes later; many coral snakebite victims can die within minutes—others at the VMTH also attribute her survival to Sowy, saying he saved her life.
“I feel ecstatic about the case. It’s something that I’ve read a lot about in books—about coral snakes—but I’ve never dealt with it before,” Sowy said. “It’s a great case for us to learn from, and the mechanical ventilation is one of the things that we at Texas A&M can offer that not a lot of places can.
“But Coco’s case was a team effort,” Sowy said. “And, I’m just one member of the team.”