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Letters to the Editor

Confounding in study of antivenom

We read with interest the retrospective study “Multicenter evaluation of the administration of crotalid antivenom in cats: 115 cases (2000–2011).”1 The authors should be commended on contributing to our understanding of the use of antivenom in cats.

However, we were concerned with the authors’ conclusion that “[t]here was no mortality rate difference between cats that did (6.67%) or did not (5.08%) receive antivenom.” Generally, patients less severely envenomated would tend to not receive antivenom, whereas those more severely envenomated would tend to receive antivenom. Without evidence that groups of cats in the study