Tarantula venom, and anaphylaxis

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To clarify. A toxin enters the body. There are numerous actions that a hospital can take beyond immediate life saving trauma intervention. Monitoring blood chemistry and preventing or minimizing damage to the kidneys and liver is often first called on. There are hundreds of drugs that can be used to stabilize the patient and minimize the toxic effects; the kidneys can be flushed, aiding in removal of the toxin and preventive measures taken to protect the liver. The general plan is minimizing the toxic effects through symptomatic treatment and giving the body the best possible chance to reject and discharge to toxins. This is usually done even if a specific antidote is administered.

Okay. That makes sense. Thanks for the more detailed info.

 

[viper69]

@tnerd93 Don't be so pessimistic, here's the Sticky.

@ratluvr76 Why the dislike on my post above? Tnerd had a post, since deleted, expressing his doubt this would be a sticky.

I made that post to help a new person not be pessimistic about the forum here. I have no idea if the person is following the thread, hence the tag.

You have me confused.

 

[ratluvr76]

@ratluvr76 Why the dislike on my post above? Tnerd had a post, since deleted, expressing his doubt this would be a sticky.

I made that post to help a new person not be pessimistic about the forum here. I have no idea if the person is following the thread, hence the tag.

You have me confused.

ooops, had to have been a misclick. I'm sorry, it's fixed now.

 

[viper69]

ooops, had to have been a misclick. I'm sorry, it's fixed now.

Ah I see now, thanks for the clarification! And thanks for using your Mod Powers and making this post a sticky for the community!

 

[Dovey]

Just to mention something regarding anaphylaxis. A substance need not contain a toxin to cause it. In fact, it need not contain a harmful substance at all. Anaphylaxis is the body's immune system freaking out due to a foreign substance or it responding to a second dose which it improperly handles.

The other thing about anaphylaxis is most people don't know or recognize many of the symptoms. Airway restriction is the most obvious but there are numerous others: (Grabbing a convenient list from a paramed site)

• Abdominal pain
• Feeling anxious
• Chest discomfort or tightness
• Diarrhea
• Difficulty breathing, coughing, wheezing, or high-pitched breathing sounds
• Difficulty swallowing
• Dizziness or lightheadedness
• Hives, itchiness, redness of the skin
• Nasal congestion
• Nausea or vomiting
• Palpitations
• Slurred speech
• Swelling of the face, eyes, or tongue
• Unconsciousness

These are common symptoms but there are numerous others. Leg cramps for example. This can be extremely difficult to diagnose and even hemotoxicologists can miss them.

I suffer anaphylactic symptoms, actually all of the ones you mention above except unconsciousness (thus far), from the bite of our local assassin bugs, Triatoma rubida--they roam into our houses on spring and summer nights and often crawl into bed with us, looking for a blood meal. Once I can breathe again and the hives have gone down, I'm left with a horrible suppurating crater at the site of the bite with raised, deep tissue cellulittis the size of a dinner plate or larger surrounding it...and eruptions at the sites of previous bites. Other family members just get a REALLY itchy bite and a walnut-sized swelling under the skin. Reactions to venom can vary vastly. These bug's bites contain an anaesthetic and an anticoagulant along with venom, which further muddies the waters. Since these reactions have escalated to the 911 level, I've noticed a greater reaction from bee, scorpion, and hornet stings than previous to living in Arizona, much greater! I therefore take extra care around my tarantulas and scorpions and probably shouldn't keep widows, AZ bark scorpions, or our hybridized bees...but I do. Can't live life in a bubble in a world where peanuts kill people all the time!

So no,Triatoma rubida is not a deadly insect; but yes, a bad bite could kill me dead. I assume that sort of exceptional sensitivity is what many sites are alluding to with all of their dire warnings about the unpredictability of tarantula venom. Nobody wants to get sued because some customer or site visitor with a serious sensitivity dies when a chalcodes bite makes their throat close up--not that this would ever happen, but people have been struck by lightening more than once and bitten by sharks in Kansas: anything can happen.

Which reminds me of the "deadly" southern copperhead, Agkistrodon contortrix, whose bite has only EVER been fatal in a case that resulted in a fatal heart attack from the fear and stress surrounding the incident. Guess that poor fellow died, not of snake bite, but literally of the indicative present perfect tense, of having been bitten. The "antivenin" for copperhead bites, BTW, is two benadryl and OTC pain medication.

 

[The Snark]

I suffer anaphylactic symptoms, actually all of the ones you mention above except unconsciousness (thus far), from the bite of our local assassin bugs,

No doubt you have gone this route but keep up to date with a specialist(s) on the various medications available. I mention this because, as you have probably noticed, your anaphylaxis changes somewhat and the efficacy of various drugs will do the same. IE What worked great one time may have a marginal or minimal effect 6 months later.

Nobody wants to get sued because some customer or site visitor with a serious sensitivity dies when a chalcodes bite makes their throat close up--not that this would ever happen,

Some of my worst nightmares are of patients thrashing around on the floor for breath as we perform a tracheotomy. I suggest all risk takers reread that sentence.

Guess that poor fellow died, not of snake bite, but literally of the indicative present perfect tense, of having been bitten.

Very possibly some degree of psychogenic shock was involved. As example, the acute pain from a rattler bite is quite capable of triggering it. Do not underestimate ANY form of shock. When 2 airliners collided over San Diego and it rained body parts, at least one bystander died of psychogenic shock just from what they were seeing.

 

[Matabuey]

Something i should've added to my initial post, is this particular study. I have access to the full document through my university, but I'm not allowed to share it. However the abstract is more than enough to show that tarantulas can pose serious risk to our pets.

Bites by spiders of the family Theraphosidae in humans and canines:

http://www.sciencedirect.com/science/article/pii/S0041010102003951

"Spiders of the family Theraphosidae occur throughout most tropical regions of the world. There have only been three case reports of bites by these spiders in Australia. The aim of this study was to describe the clinical effects of bites by Australian theraphosid spiders in both humans and canines. Cases of spider bite were collected by the authors over the period January 1978–April 2002, either prospectively in a large study of Australian spider bites, or retrospectively from cases reported to the authors. Subjects were included if they had a definite bite and had collected the spider. The spiders were identified by an expert arachnologist to genus and species level where possible. There were nine confirmed bites by spiders of the family Theraphosidae in humans and seven in canines. These included bites by two Selenocosmia spp. and by two Phlogiellus spp. The nine spider bites in humans did not cause major effects. Local pain was the commonest effect, with severe pain in four of seven cases where severity of pain was recorded. Puncture marks or bleeding were the next most common effect. In one case the spider had bitten through the patient's fingernail. Mild systemic effects occurred in one of nine cases. There were seven bites in dogs (Phlogellius spp. and Selenocosmia spp.), and in two of these the owner was bitten after the dog. In all seven cases the dog died, and as rapidly as 0.5–2 h after the bite. This small series of bites by Australian theraphosid spiders gives an indication of the spectrum of toxicity of these spiders in humans. Bites by these spiders are unlikely to cause major problems in humans. The study also demonstrates that the venom is far more toxic to canines."

This doesn't give a 100% fatality rate for bites in canines, as there will have been other envenomations that did not result in death - thus weren't reported.

But it would be wise to ensure any venomous animal regardless of toxicity, doesn't come into contact with pets, to be safe.

Which reminds me of the "deadly" southern copperhead, Agkistrodon contortrix, whose bite has only EVER been fatal in a case that resulted in a fatal heart attack from the fear and stress surrounding the incident. Guess that poor fellow died, not of snake bite, but literally of the indicative present perfect tense, of having been bitten. The "antivenin" for copperhead bites, BTW, is two benadryl and OTC pain medication.

There have been either 5 or 6, can't quite remember, confirmed deaths from Agkistrodon contortrix, by the way - the majority from anaphylaxis. As previously stated, snake venoms are more immunogenic, especially that of vipers/pitvipers - as they contain larger proteins, in general.

But yes, copperheads aren't strictly "deadly".

The man who suffered a heart attack, was having heart problems prior to the envenomation.

 

[bryverine]

I wonder how pain levels effect shock, especially in smaller people. While it may not be deadly directly, the stress/trauma is no doubt taxing on the body.

There's no doubt in my mind that even if my eldest child were to get bit, it WOULD be deadly: my wife would kill me.

It's nice to know humanlings won't die from a bite.

 

[Dovey]

No doubt you have gone this route but keep up to date with a specialist(s) on the various medications available. I mention this because, as you have probably noticed, your anaphylaxis changes somewhat and the efficacy of various drugs will do the same. IE What worked great one time may have a marginal or minimal effect 6 months later.


Some of my worst nightmares are of patients thrashing around on the floor for breath as we perform a tracheotomy. I suggest all risk takers reread that sentence.


Very possibly some degree of psychogenic shock was involved. As example, the acute pain from a rattler bite is quite capable of triggering it. Do not underestimate ANY form of shock. When 2 airliners collided over San Diego and it rained body parts, at least one bystander died of psychogenic shock just from what they were seeing.

Yep, just because it starts in your head doesn't mean it isn't real--or that it is limited to your head!

 

[The Snark]

I wonder how pain levels effect shock, especially in smaller people.

Ever smacked your thumb a good one with a hammer or got similarly crunched and felt light headed, woozy or dizzy right afterwards? Or the typical Hollywood movie of some person going FREAK OUT and fainting? That's psychogenic shock.
Just think what typical non hemorrhagic shock is. The blood vessels in the extremities expand. This can be instantaneous, sudden onset, on out to very slow, malignant. Your blood flows downwards, pooling in the lowest extremities, depriving the brain of blood and oxygenation. The commonest form of shock is Psychogenic.

 

[Dovey]

There have been either 5 or 6, can't quite remember, confirmed deaths from Agkistrodon contortrix, by the way - the majority from anaphylaxis. As previously stated, snake venoms are more immunogenic, especially that of vipers/pitvipers - as they contain larger proteins, in general.

But yes, copperheads aren't strictly "deadly".

The man who suffered a heart attack, was having heart problems prior to the envenomation.

Indeed, I meant to say "except in cases of anaphylaxis." I got fed up with my dogs getting repeatedly bitten and bringing some truly (and understandably) furious copperheads into the cabin as (ahem) gifts and did some serious research on just what dangers our most common pit viper did or did not actually pose to us. Basically, both dogs and self were in far greater peril from the mosquitoes that were also fellow residents of our wetland property than from panicked and infuriated agkistrodons. And also from the Chagas Disease-spreading assassin bugs of East Texas, blast their evil little hearts and sneaky mouth parts!

 

[Dovey]

Here was the real villain. Not even a venomous snake, either. Vicious little monsters were cleaning out my koi tanks!

 

[The Snark]

To get back to the original topic, T venom and Anaphylaxis. Checking several pre hospital patient management books.
It is recommended that, for the untrained lay person, anaphylaxis and shock be grouped together in that the presence of one is usually accompanied by the presence of the other. Either one by itself can be lethal. So the books are getting at the common rescuer failing of tunnel vision. Don't just focus on one symptom. Do your full patient assessment, head to toe, repetitiously.

One book also states to assume both anaphylaxis and shock with all envenomations as a constant watch for. (EMT 1, basic course)

 

[The Snark]

Found it!
"Toxemia as from an envenomation will always cause some degree of shock." (Toxic shock)
We use shock as it is relatively easy to diagnose while the effects of venoms can and usually do vary drastically and most cannot be diagnosed in the field except by Mechanism Of Injury. Likewise, anaphylaxis can be very difficult to diagnose as the symptoms may be obscure, masked or otherwise obscured by pre-existing conditions.

 

[Matabuey]

Found it!
"Toxemia as from an envenomation will always cause some degree of shock." (Toxic shock)
We use shock as it is relatively easy to diagnose while the effects of venoms can and usually do vary drastically and most cannot be diagnosed in the field except by Mechanism Of Injury. Likewise, anaphylaxis can be very difficult to diagnose as the symptoms may obscure, masked or otherwise obscured by pre-existing conditions.

Generally speaking, their venom is not highly neurotoxic that it will cause things like cardiogenic shock. Hence there have been no cases of such, unlike with highly neurotoxic snakes/scorpions there are cases of this.

I guess you could go into shock from the pain, but again, people rarely go into full on shock from much more painful envenomations. Neurotoxic bites all in all, aren't really that painful - in comparison to other venoms. Cytotoxic venoms for example, my friend has been bitten by H.mac and Crotalus atrox, and says the tarantula is a walk in the park in terms of pain - in comparison.

 

[The Snark]

I can personally testify a one fang zap from a young western rattler, C Viridis, makes you want them to amputate the entire limb.

Let's not forget one of the commonest and basic forms of shock, anaphylactic. And if munching a few peanuts or just the smell of certain sea foods or sea animals can trigger it, getting any form of venom injected into the system makes it a suspect in addition to what the venom may do.

 

[Storm76]

I'd like to thank you for putting this together. Especially with some more reading linked. Greatly appreciated information

 

[Charlottesweb17]

Being a nurse, being treated symptomatically would be the approach of ER staff. I always have epicene around as my son and husband both have allergies which require we have them around. My son in particular is allergic to etc and has extraordinary reactions to mosquitoes and leeches.
It may not treat every symptom however can prolong your life and treat some symptoms. It is not known how anyone will react when bitten.
Venom can also cause infection at site or even necrosis of tissue.
Always good to know what type of venom your pet has if information can be found. That way Doctors will know how to treat you.
I have heard putting a turnoquet above bite site can stop the spreading of the venom.
When and if ever bitten I would go to ER right away.

 

[viper69]

I have heard putting a turnoquet above bite site can stop the spreading of the venom.

This is wrong. When one does this, the region cut off is now subjected to a much more concentrated amount of venom. This significantly increases the effects of the venom to a localized region, not good.

This is particular not good with venom that causes necrosis, such as Brown Recluse Spider venom.

Even if a rattlesnake bit a person, still not a smart idea. I've spoken to a venom expert on this one.

 

[Abyss]

Great read, really great read.
I have an interesting story.

When i was young an messing w/true spiders all the time i got bit all the time too. The doctors said i developed an alergic reaction to them and warned me about my tarantulas (which 20 yrs later i still keep).
When i got bit on this particular occasion i became very itchy around my eyes (similar to pink eye) and my eyes so kets actually swelled up bad enough they were worried about my eyes. My airway did not close up but did swell a little.
They gave me an injection of some sort (corticosterioid i assume) and sent me home w/some sort of steriod pills to take.

Everything worked out ok and to my knowledge i have not been bitten since and never been bitten by my T's.

Looking back at that vs what the doctors said about me being alergic an such. I wonder if i were bit by say my P. met, wouod it be worse for me then the populous?
What im essentially curious about is everyone is always talking about how pokies are so advanced an have such a nasty bite so how bad is it really and whould it be worse for me?
Doctors dont know everything so perhaps im not allergic but just curious how a T's venom stacks up to true spiders in general and if its true i am "highly alergic" (thats what they said), how could i possibly react to a pokie bite?