The secretory life of pets: bites from western hognose snakes reported to the California Poison Control System

INTRODUCTION: ) is a popular pet reptile. While sometimes classified as nonvenomous, it produces mildly toxic saliva from a low-pressure secretory organ in the temporal region (Duvernoy's gland), causing local reactions following snakebites. We aim to review cases from a statewide poison control system to characterize clinical effects and outcomes. METHODS: This is a 10-year retrospective review of calls about western hognose snakebite to the California Poison Control System, using product-substance codes and a free-text keyword search. Demographic, clinical, and bite-circumstance data were summarized and analyzed. RESULTS: There were 35 cases from January 2016 to March 2026, ranging from 11 to 82 years (median 22; IQR 18-29 years), of whom 69% were female and 46% were aged 21 years or younger. A large majority (89%) were bitten by their own pets; one bite occurred at a reptile exposition. All bites affected the hands, typically during feeding, handling, or enclosure cleaning. Local swelling occurred in 91% of cases, with extension to the wrist or forearm in 43%. Skin changes (ecchymosis, erythema or blistering) were noted in 26%, and 6% developed nausea and vomiting. Vital signs and labs, checked in 23% and 11% of cases respectively, were unremarkable. Management typically included wound care, tetanus vaccination update, and anticipatory guidance for infectious complications. Two patients required hospitalization for two or more days for treatment of presumed cellulitis. In one case with extensive edema, rattlesnake antivenom was administered due to doubts about the reported bite history; in the second case, antivenom was recommended for similar reasons, but withheld after photographic identification confirmed the pet snake. DISCUSSION: The western hognose snakebite can cause cytotoxic edema, and prolonged bites may pose a higher risk of severe injury. Clinical care should focus on pain control, wound care, and anticipatory guidance for post-bite infection and hypersensitivity reactions due to the components of snake saliva, which may require specific treatment with antibiotics or anti-inflammatory medications. Rattlesnake antivenom has no role in managing this type of snakebite. CONCLUSION: Western hognose envenomation can lead to mild to moderate soft tissue injuries, which require supportive and symptomatic care and, rarely, hospital admission. Many bites occurred in pet owner adolescents, who may benefit from preventive safety education.