Pain will usually begin immediately after the bite. Direct clinical cardiotoxic effects have not yet been reported in King Cobra envenomations. These have been recorded in some cobra and other elapid envenomations. Clinical monitoring of cardiac function and rhythm would be advised. Oliguria or Anuria with possible changes in urinary composition will herald the development of renal shutdown.
Dialysis is advised.
Swelling may extend proximally on the bitten extremity with bleb formation. Gangrene requiring amputation can occur. Fang marks may be present as one or more well defined punctures, as a series of small lacerations or scratches, or there may not be any noticeable or obvious markings where the bite occurred. In general, the fang marks from a King Cobra are large, well defined and spaced apart with slight bleeding from the marks. In some cases, the snake may voluntarily elect not to inject venom with the strike resulting in a dry bite.