OCTOBER 2013: POSTMORTEM REPORT OF IMPALA SANCTUARY WHITE RHINO

By DR. E. Ndambiri.

Background Information

The rhino had been treated on 13/10/2013 for what appeared to be swollen right fore carpal joint. The rhino died on the morning of 16/10/2013 after deteriorating from lameness to recumbency. It was found on left lateral recumbency. Both front and rear horns were intact. There was no obvious external injury. The two horns were excised and wet weight taken 6.2kgs and 2kgs respectively. They were handed over to Warden Kisumu Station.

Important Postmortem Findings

1. Signs of struggle before death were evident as the tail wagged and limbs peddled pushing the mud to the sides.

2. There were traces of froth from the nostril. Mucus membranes of the eye were congested

3. Right neck region was doughy on pressure

4. Anteriolateral of the right armpit depicted points of blood ooze (possible fang marks)

5. After skinning the whole of the right side of the animal capillaries at the right armpit area were heavily congested and petechial/ecchymotic hemorrhage areas were obvious corresponding to points where blood was oozing. The congestion was evident on deep cut into the surrounding muscles. The rest of the skinned surface had no congestion or haemorrhage. 

6. The whole of the skinned right side was opened to expose the thoracic and stomach cavities. The whole of stomach organs with exception of liver had little or no congestion/hemorrhage. Colons had little fermentation gas. Liver was mottling on pressure and was completely dark and enlarged. Lungs were not collapsed and the pleural surface had fibrin with some areas raised above others. The anteriodistal edges of the anterior lobe of the lungs were congested. The whole of bronchial tree was full of whitish froth. Thoracic fluid was bloody i.e. Hemothorax. Heart was collapsed with no blood in any chamber. Coronary vessels were heavily congested and surface of myocardium had different forms of hemorrhages (superficial petechial and ecchymotic hemorrhages). Blood from ascending and descending aorta was ‘boiling’ i.e. flowing mixed with air bubbles.

Fig. a) Rhino on left lateral recumbence

Fig. b) Congested ocular vessels

Fig. c) Frothy discharge from Nostrils

Fig. d) Seemingly fang marks oozing blood

Fig. e) Skinning the dead Rhino

Fig. f) Congested capillaries at fang mark area

Fig. g) Congestion inside fang mark area

Fig. h) Fibrin (red dots) on the lung viscera surface

Fig. i) Congested anteriodistal parts of lungs

Fig. j) Heavily congested liver (Visceral surface)

Fig. k) Congested liver (Pleural Surface)

Fig. l) ‘Boiling’ blood and froth in the trachea

Figs. m) & n) Heart showing coronary vessels congestion and different forms of superficial hemorrhages

Conclusion

Tentatively this is a case of envenomation more so by a viper or adder. Death of the victim was as a result of circulatory failure due to disseminated intravascular coagulation (DIC) syndrome leading to multiple organ failure.

Insight.

Poisonous Snakes Found within Kisumu-two slides and signs of envenomation below courtesy of National Museums of Kenya, Ministry of Health, and Kenya Red Cross

Signs of Envenomation

Snake	½ hour	½ to hour	Plus hour
Vipers and adders -have long hinged hollow movable front fangs. They strike and inject venom (voluntary action) and withdraw	-Severe radiating pain -Local oedema	-Persistent pain -Spreading oedema	-Gastro-intestinal disorders -Necrosis, infection gangrene -Haemorrhage, DIC(Disseminated Intravascular Coagulopathy)
Cobras and Mambas -have fixed front short fangs and tend to hang on and ‘chew’ venom into their victims	-Moderate diffuse pain -Numbness	-Intense asthenia -Palpebral ptosis -Neuro-muscular disorders	-Paralysis -Asphyxia -Collapse

Diagnosis. Unless bite has been witnessed diagnosis is not easy and vice versa. Typical pit viper bites are characterized by severe local tissue damage that spread from bite site. Tissues become markedly discolored within few minutes and dark bloody fluid may ooze from fang wounds if not prevented by swelling. In elapine snakebites pain and swelling are minimal and systemic neurologic signs predominate. Where possible the snake has been caught or killed head should not be mutilated as it helps in identifying the snake type.

Treatment Intensive therapy should be instituted as soon as possible because irreversible effects of venom begin immediately after venomation. Some points worthy noting;

-        - Animals bitten by elapine snake(cobra, mamba) may be treated with antivenin and supportive care including anticonvulsants if necessary

-        - A polyvalent antivenin (horse-serum origin) against pit vipers can be used upon envenomation

-        - Although not infallible it is important to consider both the size of the snake as an indicator of quantity of venom injected and size of snake relative to that of the victim.

-        - Probably the site of the bite matters in relation to mortality. It has been noted that mortalities are higher from bites to thorax or abdomen than from bites to head or extremities in dogs and cats. However this may relate to size and vulnerability of the victim

-        - Reportedly degree of sensitivity to venom varies among the animals. For example sensitivity to pit vipers in domestic animals in decreasing order is horse, sheep, goat, rabbit, pig and cat.

-        - It has been reported that previous exposure may result to some degree of active humoral immunity thus less vulnerability

-        - Treatment for pit viper envenomation is directed to prevent or controlling shock, neutralizing venom, preventing or controlling DIC, minimizing necrosis and preventing secondary bacterial infection

-        - Smaller animals probably receive larger dose (per unit body weight) of venom than more massive animals and require proportionally larger doses of antivenin.

-        - Tetanus antitoxin is usually administered in treatment regime

Note

Sanofi Pasteur P.O. BOX 30104-00100 NAIROBI, TEL: 6939128/141 does business of selling Fav-Afrique Polyvalent Antisnake Serum