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Rhabdophis tigrinus
General Details, Taxonomy and Biology, Venom, Clinical Effects, Treatment, First Aid , Antivenoms
Rhabdophis tigrinus  ( Yamakagashi )  [ Original photo copyright © Dr Julian White ]
Family: Colubridae
Subfamily: Natricinae
Genus: Rhabdophis
Species: tigrinus
Subspecies: tigrinus , formosanus , lateralis
Common Names
Yamakagashi , Japanese Garter Snake , Tiger Keelback , Red-sided water Snake
Local Names
North Asia + Russia
China, Japan, North Korea, South Korea, Russia, Taiwan
Taxonomy and Biology
Adult Length: 0.65 m
General Shape
Medium in length, slender ( males ) to medium ( large females ) bodied snake with a moderately long and slender tail. Can grow to a maximum of about 1.70 metres but rarely exceeds 1.30 metres. Head is moderately distinct from neck, slightly elongate with prominent brow ridge. Eyes are moderately large in size with round pupils Dorsal scale count 21 - 19 - 17.
Diverse range of habitats from lowland plains and rice paddy fields to mountain forests.
If cornered it will flatten its anterior body and arches its neck ready to strike.
Feeds mainly on frogs, occasionally on toads and fish.
Species Map
Small (Approx 20k) version
Average Venom Qty
8.5 to 20. 5 mg ( dry weight ), Sakai et al (1983) ( Ref : R000565 ).
General: Venom Neurotoxins
Not present
General: Venom Myotoxins
Not present
General: Venom Procoagulants
Mixture of procoagulants
General: Venom Anticoagulants
Possibly present
General: Venom Haemorrhagins
Possibly present
General: Venom Nephrotoxins
Not present
General: Venom Cardiotoxins
Not present
General: Venom Necrotoxins
Not present
General: Venom Other
Not present or not significant
Clinical Effects
General: Dangerousness
Severe envenoming possible, potentially lethal
General: Rate of Envenoming: Unknown but likely to be low
General: Untreated Lethality Rate: Unknown but has caused deaths
General: Local Effects
Local pain, swelling, bruising & bleeding
General: Local Necrosis
Not likely to occur
General: General Systemic Effects
Variable non-specific effects which may include headache, nausea, vomiting, abdominal pain, diarrhoea, dizziness, collapse or convulsions
General: Neurotoxic Paralysis
Unlikely to occur
General: Myotoxicity
Not likely to occur
General: Coagulopathy & Haemorrhages
Uncommon to rare, but may be moderate to severe coagulopathy
General: Renal Damage
Recognised complication, usually secondary to coagulopathy
General: Cardiotoxicity
Unlikely to occur
General: Other
Not likely to occur
First Aid
Description: First aid for potentially dangerous non-front-fanged colubroid snakes (see listing in Comments section).
1. After ensuring the patient and onlookers have moved out of range of further strikes by the snake, the bitten person should be reassured and persuaded to lie down and remain still. Many will be terrified, fearing sudden death and, in this mood, they may behave irrationally or even hysterically. The basis for reassurance is the fact that many venomous bites do not result in envenoming, the relatively slow progression to severe envenoming (hours following elapid bites, days following viper bites) and the effectiveness of modern medical treatment.
2. The bite wound should not be tampered with in any way. Wiping it once with a damp cloth to remove surface venom is unlikely to do much harm (or good) but the wound must not be massaged.
3. All rings or other jewellery on the bitten limb, especially on fingers, should be removed, as they may act as tourniquets if oedema develops.
4. If the bite is on a limb, a broad bandage (even torn strips of clothing or pantyhose) should be applied over the bitten area at moderate pressure (as for a sprain; not so tight circulation is impaired), then extended to cover as much of the bitten limb as possible, including fingers or toes, going over the top of clothing rather than risking excessive limb movement by removing clothing. The bitten limb should then be immobilised as effectively as possible using an extemporised splint or sling.
5. If there is any impairment of vital functions, such as problems with respiration, airway, circulation, heart function, these must be supported as a priority. In particular, for bites causing flaccid paralysis, including respiratory paralysis, both airway and respiration may be impaired, requiring urgent and prolonged treatment, which may include the mouth to mask (mouth to mouth) technique of expired air transfer. Seek urgent medical attention.
6. Do not use Tourniquets, cut, suck or scarify the wound or apply chemicals or electric shock.
7. Avoid peroral intake, absolutely no alcohol. No sedatives outside hospital. If there will be considerable delay before reaching medical aid, measured in several hours to days, then give clear fluids by mouth to prevent dehydration.
8. If the offending snake has been killed it should be brought with the patient for identification (only relevant in areas where there are more than one naturally occurring venomous snake species), but be careful to avoid touching the head, as even a dead snake can envenom. No attempt should be made to pursue the snake into the undergrowth as this will risk further bites. In Australia and parts of New Guinea, Snake Venom Detection Kits are available to identify the snake from venom left on the skin.
9. The snakebite victim should be transported as quickly and as passively as possible to the nearest place where they can be seen by a medically-trained person (health station, dispensary, clinic or hospital). The bitten limb must not be exercised as muscular contraction will promote systemic absorption of venom. If no motor vehicle or boat is available, the patient can be carried on a stretcher or hurdle, on the pillion or crossbar of a bicycle or on someone's back.
10. Most traditional, and many of the more recently fashionable, first aid measures are useless and potentially dangerous. These include local cauterization, incision, excision, amputation, suction by mouth, vacuum pump or syringe, combined incision and suction ("venom-ex" apparatus), injection or instillation of compounds such as potassium permanganate, phenol (carbolic soap) and trypsin, application of electric shocks or ice (cryotherapy), use of traditional herbal, folk and other remedies including the ingestion of emetic plant products and parts of the snake, multiple incisions, tattooing and so on.
Treatment Summary
Capable of major envenoming, with potentially lethal coagulopathy, reversible with specific antivenom therapy, less certainly with Cryoprecipitate/FFP, no role for heparin.
Key Diagnostic Features
Local pain, swelling + coagulopathy & haemorrhage
General Approach to Management
All cases should be treated as urgent & potentially lethal. Rapid assessment & commencement of treatment including appropriate antivenom (if indicated & available) is mandatory. Admit all cases.
Antivenom Therapy
Antivenom is the key treatment for systemic envenoming. Multiple doses may be required.
1. Antivenom Code: SAsJSI01
Antivenom Name: Anti-Yamakagashi Antivenom
Manufacturer: The Japan Snake Institute
Phone: ++81-277-78-5193
Address: Yabuzuka-honmachi Nittagun,
Gunma Prefecture 379-2301
Country: Japan
Rhabdophis tigrinus ( Yamakagashi ) [ Original photo copyright © Dr Julian White ]
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Rhabdophis tigrinus ( Yamakagashi ) [ Original photo copyright © Dr Julian White ]
Larger version
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