Anavip vs Crofrab?

[Dred Pirate]

For those of you that have made the switch, what is your experience? I am in the southeast - so are bites are predominately copperhead - so it is not as an easy decision as the west coast/texas with more rattlesnakes. I want to go ahead - it is much cheaper and likely a better product, but wanted to hear form people with real world experience using it

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[deleted109597]

Lots of AZ and Cali places have switched. Many shops are having that same question, because nobody wants to spend that much on a new product, or stock both. But everything I've seen implies it's a better product.

 

[Dred Pirate]

Lots of AZ and Cali places have switched. Many shops are having that same question, because nobody wants to spend that much on a new product, or stock both. But everything I've seen implies it's a better product.

ya - met with the rep last week- saves 30%, studies are flawed with regards to copperheads, but so was crofab.

 

[DeadCactus]

AnaVip is cheaper. AnaVip goes into solution much faster. Not enough data to compare outcomes. Theoretically it has some benefits for rebound venom effect but not really proven. AnaVip is FDA approved only for rattlesnakes, CroFab is FDA approved for all pit vipers. AnaVip should work for copperheads and cottonmouths but the lack of FDA approval may prevent your pharmacy & therapeutics committee from wanting to switch.

 

[RustedFox]

 

[southerndoc]

I royally hate snakes. Thanks for the picture. 😡

 

[RustedFox]

I royally hate snakes. Thanks for the picture. 😡

Lol. He's fang-less. Look at how cute he is.

 

[gutonc]

Lol. He's fang-less. Look at how cute he is.

 

[Dred Pirate]

AnaVip is cheaper. AnaVip goes into solution much faster. Not enough data to compare outcomes. Theoretically it has some benefits for rebound venom effect but not really proven. AnaVip is FDA approved only for rattlesnakes, CroFab is FDA approved for all pit vipers. AnaVip should work for copperheads and cottonmouths but the lack of FDA approval may prevent your pharmacy & therapeutics committee from wanting to switch.

definitely aware of this - we have actually decided to do one of two options. 1 . start a blinded trial comparing the two - we have an open enough IRB I think to make this happen 2. Push P&T to approve - the data in the original crofab trail is actually weaker than the data in the anavip trial - it was just at that time there was nothing to compare to - so something was better than nothing.

 

[The Knife & Gun Club]

definitely aware of this - we have actually decided to do one of two options. 1 . start a blinded trial comparing the two - we have an open enough IRB I think to make this happen 2. Push P&T to approve - the data in the original crofab trail is actually weaker than the data in the anavip trial - it was just at that time there was nothing to compare to - so something was better than nothing.

Would love to see someone do this - would you use it for all envenomations or just rattlesnakes?

Down here in Miami we have people get into shenanigans with all sorts of weird exotic pit vipers.

 

[Dred Pirate]

Would love to see someone do this - would you use it for all envenomations or just rattlesnakes?

Down here in Miami we have people get into shenanigans with all sorts of weird exotic pit vipers.

all - but to be honest - we have virtually no rattlesnakes in my part of the NC. My county leads the nation (at least I was told this by our poison control center) in copperhead bites.

Not at my shop but a hospital in my region had a guy get bit by a king cobra, started to drive himself to the hospital, pulled over on the side of the road and called 911 as he almost lost consciouness - people are crazy

 

[Xenophylia]

As someone who has attended many reptile shows and is a reptile (non snake) hobbyist, I've always been curious. In the event of treating a patient with a bite from something venomous and non-native, what do you do for anti-venom? I've toured several zoos and know that they keep some on site for the species they exhibit. Since time is of the essence, do you contact them? Some of these shows carry some really venomous non native species and (sadly) anyone can purchase them. Just curious.

 

[Xenophylia]

Lol. He's fang-less. Look at how cute he is.

Just 'cuz you can't see 'em, doesn't mean they're not there.....

 

[Dred Pirate]

As someone who has attended many reptile shows and is a reptile (non snake) hobbyist, I've always been curious. In the event of treating a patient with a bite from something venomous and non-native, what do you do for anti-venom? I've toured several zoos and know that they keep some on site for the species they exhibit. Since time is of the essence, do you contact them? Some of these shows carry some really venomous non native species and (sadly) anyone can purchase them. Just curious.

there are a few places in the country that have the antivenoms for this exotic snakes. I know a place in South Carolina does (that is where it was flown in from for the above pt) - also a place in Miami and Denver that I know people have used - essentially very few places. Long story short we looked into it due to the fact our state government attempted to build a snake holding facility near us to house seized snakes - we were going to have to submit essentially an IRB . abbreviated NDA to the FDA to get the ability to stock black mamba antivenom. Luckily smarter heads prevailed and the decided to just euthanize the snakes

 

[theseeker4]

there are a few places in the country that have the antivenoms for this exotic snakes. I know a place in South Carolina does (that is where it was flown in from for the above pt) - also a place in Miami and Denver that I know people have used - essentially very few places. Long story short we looked into it due to the fact our state government attempted to build a snake holding facility near us to house seized snakes - we were going to have to submit essentially an IRB . abbreviated NDA to the FDA to get the ability to stock black mamba antivenom. Luckily smarter heads prevailed and the decided to just euthanize the snakes

I thought zoos that housed these snakes generally needed to have the antivenom (if it is available) for the snakes they house. Is that not correct?

 

[Apollyon]

In 2000, a knucklehead here in Buffalo had a Gaboon viper (you know, with the 2 inch fangs) as a "pet". Snake does what snake does, and bit him. The Buffalo Zoo didn't have any antivenin (because they didn't have any Gaboon vipers in their collection), and it had to get flown in from the Bronx Zoo.

Now, research shows that he had permits for all of his exotic pets, including a cobra, a rattlesnake, and an alligator that had free run of the house.

 

[Apollyon]

I thought zoos that housed these snakes generally needed to have the antivenom (if it is available) for the snakes they house. Is that not correct?

Yes, that is correct. However, as the person above said, it was going to be seized snakes, not exhibited specimens.

 

[DeadCactus]

As someone who has attended many reptile shows and is a reptile (non snake) hobbyist, I've always been curious. In the event of treating a patient with a bite from something venomous and non-native, what do you do for anti-venom? I've toured several zoos and know that they keep some on site for the species they exhibit. Since time is of the essence, do you contact them? Some of these shows carry some really venomous non native species and (sadly) anyone can purchase them. Just curious.

There is an antivenom database you check to see who in the country has the antivenom, you then make some phone calls and get it transported to the patient. Some people who house venomous snakes keep their own antivenom for their specific species as do some of the private organizations of these people.

 

[deleted109597]

Zoos do have them typically. Florida also has Venom 1 (Miami-Dade) and Venom 2(Lake) antivenom banks. Because Florida man.
If you got tagged by an exotic, a zoo is a good place to start. Most of them are affiliated with local poison control anyway.
Yes, exotic venomous animals are present in many places.

 

[Xenophylia]

I had an "inside tour" of the reptile habitat at the DC zoo and got to see where they kept their antivenom. They gave me the impression they had to keep some for any relevant species they exhibited. Some states have laws requiring licensing for exotics. As far as I know, PA (my home state) has no laws whatsoever, which is possibly why we seem to have a lot of reptile shows. Many years ago we had a local die from a cobra bite. He was trying to "assist" his pet during shedding. Snakes get awfully irritable during shedding, and he found out the hard way. He was quite dead by the time the paramedics arrived. Always made me wonder why the laws are so lax in some areas, as they exist for both the protection of the reptiles and their would be owners. Some of the people you see purchasing potentially dangerous species at these reptile shows are quite scary.

 

[Xenophylia]

Luckily smarter heads prevailed and the decided to just euthanize the snakes

That's a shame for the snakes, but in reality that is the best option. I really feel that there is no need for anyone to keep animals that dangerous as a "hobby". Leave the dangerous species for the zoos, where they can be kept both properly and safely by trained handlers.

 

[Apollyon]

Zoos do have them typically. Florida also has Venom 1 (Miami-Dade) and Venom 2(Lake) antivenom banks. Because Florida man.
If you got tagged by an exotic, a zoo is a good place to start. Most of them are affiliated with local poison control anyway.
Yes, exotic venomous animals are present in many places.

Again, zoos have them for what they have in their collection. They're not going to carry something species-specific that they do not have.

 

[deleted109597]

Again, zoos have them for what they have in their collection. They're not going to carry something species-specific that they do not have.

You're not wrong. I didn't think I was implying they had an all encompassing bank of antivenom. There's also a fair amount of overlap between species, so you might be able to use a similar antivenom if PC though it was important enough.
But yeah, don't handle venomous creatures is the easiest way to avoid this.
I say this as a consultant at a couple of zoo/aquaria

 

[theseeker4]

Yes, that is correct. However, as the person above said, it was going to be seized snakes, not exhibited specimens.

I understand that. I meant they should be able to get the venom needed from the closest zoo that has these species.

 

[EsTxDr]

So the zoo keeps it for their employees, I'm not aware of a law that requires them to give it to you just because you ask.
The VenomOne organization is probably one of the best places to start for exotic envenomations.

As to the Crofab vs Anavip I think the data is just still too lacking. Anavip has worked well with copperhead envenomations in practice but they didn't get FDA approval. I'm curious to see the data in a few years on outcome as well as repeat dosing and recurrence. The anaphylaxis data would be nice to see as well.

 

[Dred Pirate]

I understand that. I meant they should be able to get the venom needed from the closest zoo that has these species.

in the case that I am referencing - that was the closest for this particular snake I believe - but it wasn't at my hospital