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==Diagnosis==
==Diagnosis==
===Clinical Signs===
===Clinical Signs===
*swelling at puncture site
*Swelling at puncture site
*altered mentation
*Altered Mentation
*cardiac abnormalities
*Cardiac Abnormalities <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>
*Initial Pyrexia <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>
===Laboratory Tests===
===Laboratory Tests===
*'''Biochemistry:''' Transient elevations in one or more of the following parameters may be seen; Alanine Aminotransferase, Alkaline Phosphatase, Bile Acids, Glutamate Dehydrogenase and Creatinine Kinase <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>.
*'''Biochemistry:''' Transient elevations in one or more of the following parameters may be seen; Alanine Aminotransferase, Alkaline Phosphatase, Bile Acids, Glutamate Dehydrogenase and Creatinine Kinase <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>.