Changes

==Introduction==

==Introduction==

The adder, also known as the viper, is native to many parts of the UK, where it is the only poisonous snake living in the wild <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>. Adder bites are most frequent between february and october. The habitat of the common european adder (Vipera Berus) extends throughout England, Wales, Scotland and some islands off the coast of Scotland, and the isle of Wight <ref> '''Treatment of bites by adders and exotic venomous snake''',Warrell DA,''BMJ'' 2005;331:1244 doi:10.1136/bmj.331.7527.1244(Published 12 november 2005) </ref>. <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>. Adder bites can be accommpanied by the injection of venom <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>, by one of the most sophisticated of mechanisms seen in the animal kingdom <ref> '''http://www.forestry.gov.uk/forestry/adder''', accessed on 10.11.2010 </ref>, or they can be venom-less in which case the damaged caused to the victim is limited to the puncture wounds <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>.

The adder, also known as the viper, is native to many parts of the UK, where it is the only poisonous snake living in the wild <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>. Adder bites are most frequent between february and october. The habitat of the common european adder (Vipera Berus) extends throughout England, Wales, Scotland and some islands off the coast of Scotland, and the isle of Wight <ref> '''Treatment of bites by adders and exotic venomous snake''',Warrell DA,''BMJ'' 2005;331:1244 doi:10.1136/bmj.331.7527.1244(Published 12 november 2005) </ref>. <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>. Adder bites can be accommpanied by the injection of venom <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>, by one of the most sophisticated of mechanisms seen in the animal kingdom <ref> '''http://www.forestry.gov.uk/forestry/adder''', accessed on 10.11.2010 </ref>, or they can be venom-less in which case the damaged caused to the victim is limited to the puncture wounds <ref name="multiples"> '''http://www.nhs.uk/conditions/Bites-snake/Pages/Introduction.aspx'''accessed on 10.11.2010 </ref>. The mortality rate in dogs that have received venomous bites is thought to be 3.5% to 4% <ref name="multiples"> '''Clinical and biochemical changes in 53 Swedish dogs bitten by the European adder - ''Viper berus'' ''', Lervik et al, Acta Vet Scand. 2010; 52(1):26, accessed at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2873270/?tool=pubmed#B1 on 08.12.10 </ref>

==Signalment==

==Signalment==