Long read: A dog with nine lives.

[The latest weekly Trail Report from 7th July is linked here. The following article is a long read. It is the first time since the Cranston Fire in 2018 that I have posted something only tangentially related to the trails. I hope it will become clear why I wanted to write this.]

“It’s not the size of the dog in the fight, it’s the size of the fight in the dog.” – Mark Twain

Many readers of this website, especially regular hikers to the San Jacinto mountains and Idyllwild locals, know that I often run and hike the trails with Anabel, our six year old, 35 pound, Jindo-German Shepherd mix dog. I could probably write a short book about Anabel, but in a few lines, she is a rescue who spent most of her first year of life as a street dog in the Coachella Valley, and was saved by kennel manager Edgar Santiago of the wonderful animal sanctuary Living Free literally on the day she was due to be euthanized. Since we adopted her on 14th February 2015, she has become a truly remarkable trail companion. She averages 5000 miles every year running and hiking on the trails near Idyllwild with Anne and me, and she is a tough and agile mountaineer, completing dozens of difficult winter ascents that few humans attempt. Her sweet smile and placid demeanor give no hint of her challenging past, and she seems to instantly become a firm favorite of everyone who meets her.

On 2nd July, as the three of us descended from a long, cool early morning hike in the San Jacinto high country, Anabel was bitten by a large rattlesnake.

We know it was a big snake as the puncture wounds on her paw were more than an inch (actually 28mm) apart, suggesting a rattlesnake about four feet long, typically about as big as they get up here. Further details of exactly what happened we’ll never know for sure. Anne and I had stopped briefly to look at a spring, and Anabel was just a few yards ahead of us, but around a slight bend in the trail. We never heard any noise, no yelp from Anabel, certainly no rattling from a snake, but within seconds she reappeared hobbling on three legs, hanging the fourth, two spots lightly oozing blood from her front left paw. The look on her face will live with us forever – she instantly knew this was really bad.

Getting bitten by a rattlesnake is extremely dangerous for any dog. Getting bitten by a rattlesnake in the San Jacinto mountains is fatal for a dog. The distinctive black, petrophilic, form of Southern Pacific Rattlesnake (SPR) found up here has an unusually potent neurotoxic venom. While the vast majority of lowland rattlesnakes in southern California have haemotoxic venom, which is itself dangerous enough, treatment for an attack on the blood system is orders of magnitude easier than treating the nervous system attack of neurotoxic venom.

To the best of our knowledge, no dog bitten by a neurotoxic rattlesnake in the San Jacinto mountains has survived. Death invariably occurs within hours. In addition to the toxin, without emergency veterinary facilities in our mountain communities, the simple practicality of getting a dog to treatment in a timely fashion precludes prompt treatment. Indeed, the extreme toxicity of San Jacinto SPRs was in part discovered due to the very rapid deaths of several local dogs bitten in the recent past. This alerted academics at Loma Linda University Medical Center, and ultimately the global venomous snake experts at University of Queensland, Australia, that something was unusual about our local rattlesnakes, which has led to studies of their unique venom. This research has even led to claims that San Jacinto SPRs may be the most lethal snake in the country.

As a combination of wildlife biologist, mountaineer, search-and-rescuer, and dog parent, I happen to be especially interested in our unique local rattlesnakes. I had researched the topic to the point that I gave a talk to Riverside Mountain Rescue Unit five years ago about the severe risk posed to humans by San Jacinto SPRs, and how potential bite cases should be treated.

Getting Anabel to urgent care in the shortest time possible was critical. We were five miles from the trailhead. When hiking with Anabel I carry the Airlift by FidoPro, a sling-style pack designed to carry a dog out of a wilderness situation. Easier said than done. Even though I routinely train with a 40lb pack, hiking with an uncooperative, unwieldy, 35lb dog strapped to your lower back is a completely different experience.

Stopping briefly at Saddle Junction to reassess the situation, Anne matter-of-factly said “I think we’re losing her”. Without going into unpleasant detail, that was probably an understatement. I basically jogged down Devil’s Slide Trail, holding Anabel’s limp body in place by putting one arm behind my back and supporting her neck. The many hikers I passed were clearly dismayed by what they saw.

Remarkably when we got to the truck at Humber Park, Anabel seemingly improved. Being out of the sling, in a less stressful situation, in a cool shady truck bed, did her some good. Anne appeared a few minutes later, jogging down with both of our day packs. Fast forward a couple of hours, and we arrived at the Emergency Pet Clinic in Temecula. This ultimately proved to be the perfect decision. (Our regular vet in Hemet didn’t have an appointment available, the Banning vet couldn’t see Anabel until the evening, and the mobile vet was closed due to the coronavirus crisis. Thankfully we established all of this by ‘phone before leaving Idyllwild, so our decision-making was relatively efficient.)

On admission, Anabel didn’t appear to be in terrible condition. When it was clear she was going to be staying for the night, we reluctantly headed back to Idyllwild. All we could do was think positive thoughts. The next 48 hours seemed to last for weeks.

My ‘phone rang just after two o’clock in the morning that night. It didn’t exactly wake us up, as we’d hardly been sleeping. The overnight doctor was requesting permission to give Anabel more VenomVet. She had had one vial shortly after arrival at the Pet Clinic, once it was clear from her very low platelet count that the snake had given her a little haemotoxic venom mixed in with the nerve toxin (which is typical). We asked the doctor to do whatever it took. In an 18 hour period, Anabel would receive six vials of VenomVet (plus one of RTLR, a similar antivenin designed for use on horses).

VenomVet is a broad spectrum antivenin which works well for haemotoxic snake bites, and as its name suggests, it is specifically designed for veterinary use. Although it is technically certified by the Food and Drug Administration for use on neurotoxic bites too, it is clearly no match for the venom of San Jacinto SPRs.

In ‘phone calls on 2nd and 3rd July, managing veterinarian Dr. Tedder started one with “well, she’s hanging in there”, and another with “she hasn’t read the book on how these rattlesnake bites go”. The straightforward honesty of her euphonious Arkansas drawl belied the fact that, despite Anabel’s blood numbers normalizing thanks to the VenomVet, there was an unspoken understanding between us that Anabel would die if we couldn’t address the neurotoxin. We both knew the answer was CroFab.

The drug CroFab is specifically designed for treating neurotoxic snakebites in humans. Treatment is supposed to start within six hours of the bite, and it can take at least a couple of dozen vials to treat a human. Although not approved for veterinary use, it has been widely used for bitten dogs, and occasionally it is stocked by vets in southern California for that purpose. Unfortunately at $5000 per vial, it has become cost prohibitive for vets to keep even single doses of CroFab on hand.

Calls to all likely veterinary clinics in southern California drew blanks. In one conversation with the doctor, I had mentioned the research I had read on SPRs by Loma Linda University Medical Center. Just before 3pm on the 3rd, Dr. Tedder called to say that miraculously they had found that the Murrieta campus of Loma Linda Health, just two freeway exits north from the Pet Clinic, had CroFab, and that the nurse in charge of the pharmacy there had agreed to sell it to us. The doctor needed our approval for such a major financial commitment, but doubtless she knew the answer before even picking up the ‘phone. She immediately dispatched one of her vet techs to drive up to Murrieta to pick up the tiny box containing the CroFab.

Anne and I are not religious people. The critical events that would ultimately save Anabel’s life occurred on 3rd July. I mention the following only for readers with different belief systems to draw their own conclusions. San Jacinto is the Spanish for Saint Hyacinth, and the San Jacinto mountains are named for Hyacinth of Caeserea, a Christian boy martyred by the Romans some 1900 years ago, who became the first (of several) Saint Hyacinth. In the Catholic calendar, the celebration day of Saint Hyacinth is, of course, 3rd July.

It was an agonizing six hours before Dr. Tedder finally called again. Anabel had received a vial of CroFab in an intravenous saline solution about two hours earlier. All vital signs and lab tests were improving. The doctor suggested we get some sleep. The ‘phone didn’t ring that night. A textbook case of no news is good news.

Dr. Tedder suggested we visit Anabel on the afternoon of 4th July. We had been told how much her condition had improved. Although we tried not to show it at the time, we subsequently agreed how shocked we were when Anabel stumbled into the visiting room, with her head hanging low to the ground, wheezing heavily with each step. It was clear she had not so much been at death’s door, but rather had had one or two paws across the threshold. She barely recognized us at first, but the vet techs were so thrilled when her tail started softly wagging as she sniffed us for the first time in two-and-a-half days. After we had laid there gently petting Anabel for an hour or more, the doctor took time from her ridiculously busy schedule, with critical cases seemingly breaking out all around her, to have a long talk with us. Dr. Tedder was so impressed with how positive her reaction was to seeing us that we ended up returning home with Anabel that night.

Dr. Tedder worked for years in Escondido, treating hundreds of dog rattlesnake bite cases. She estimates that in cases using CroFab as part of the treatment, the survival rate was about 5%. Given the much greater logistical difficulties of getting to care from Idyllwild, let alone five miles up into the mountains, Anabel’s probability of survival was perhaps a couple of percent at best.

A hugely improbable sequence of factors had to fall into place for Anabel to survive. To get bitten on the paw and apparently not get a full envenomation (those two factors being related). To recognize the gravity of the situation and have the equipment and ability to get her off the mountain as quickly as possible. To get her promptly to the right place for treatment. To have a staff that was remarkably dedicated to keeping her alive against long odds. To have a doctor with huge expertise in the field of rattlesnake bites in dogs and who was genuinely personally invested in Anabel’s health. To have someone willing to supply a very expensive human drug to save a dogs life when frankly it would have been much easier for them to say no. And perhaps ultimately, to have a dog fit enough and strong enough, mentally and physically, to withstand everything she went through.

Anabel would not be alive today but for the incomparable Dr. Belinda Tedder and her amazing staff at the Emergency Pet Clinic of Temecula. The RN working in the pharmacy at Loma Linda Health Murrieta on Friday 3rd July made the most important decision of Anabel’s recent life. The suggestion of our beloved friend Erin Riley – who has had one of her own dogs survive being bitten by a (haemotoxic) rattlesnake – led me to buy a dog carrying system a couple of years ago. There are more comfortable options on the market, but FidoPro makes a product that can save the life of a dog, and crucially it is light and compact enough that I always took it with me whenever I went into the high country with Anabel, fully expecting to never need it. Words will never adequately express our profound gratitude to all of these people.

Doubtless we will hear some criticism for having Anabel off leash. She is blessed with a wonderful life of freedom. We avoid the most snake-prone trails in season, and put her on leash as temperatures rise. Anabel has done thousands of miles without incident in conditions more likely to encounter a rattlesnake than those we experienced on 2nd July. She has had multiple rattlesnake aversion trainings, and as a result has behaved perfectly during the half-a-dozen prior encounters we have had with San Jacinto SPRs. We were well above the highest elevation where I had previously recorded rattlesnakes on the mountain, in atypical habitat, and we had deliberately hiked very early on a cool morning to minimize the chance of a snake encounter. The air temperature was below 60°F at the time and place of the incident. It was a freak accident. Thankfully after it happened, we did everything else we could about as efficiently as possible.

Anabel’s recovery may take months. Right now her health improves in leaps and bounds every day. She may never completely recover, although I wouldn’t put anything past her. Just seeing that tail wag gently as she lies on her bed at first light every morning is more than we ever could have hoped for.

Postscript: On Tuesday 7th July, I finally felt up for a hike back into the San Jacinto high country. As I loaded my daypack before dawn, Anabel was watching me from her bed near the front door. She knew the routine, having done it hundreds of times before. Only three days removed from ICU, she slowly got up, and, wobbling slightly, walked over to the door mat where she sat down, waiting for her collar to go on. It brought tears to my eyes, for the umpteenth time in the past few days. Soon enough baby girl, soon enough. The San Jacinto mountains seem to kill human hikers with no thought, and with disconcerting frequency. This time they had let a small dog live, just barely, to hike another day.

Copyright text and photographs Jon King 2020.