Reptile Medicine Flashcards
1
Q
What is the danger of feeding too much white bait to snakes?
A
White bait high in enzyme thiaminase which causes garter snakes to seizure
2
Q
How should reptiles be transported?
A
Make sure these animals are kept warm upon transport while trying not to cause heat damage.
3
Q
What history should be taken for reptile consults?
A
Environment – housing, temperature, lighting, substrate
Nutrition – how often they eat, what they are being fed, any supplements
Previous medical history
4
Q
What is assessed on clinical examination of the mouth in reptiles?
A
- mmbs
- Mouth rot
- Tongue flick in snakes (if this is not present in snakes this is a bad sign)
5
Q
What is assessed on clinical examination of the ears in reptiles?
A
- Mites in/around lizard ears
- Ear abscesses in tortoises particularly
- Snakes do not have ears as they just detect vibrations
6
Q
What is assessed on clinical examination of the body in reptiles?
A
- Tortoises you can palpate pre-humeral and pre-femoral fossa but limited)
- Auscultation of chest - doppler works quite well to listen to the heart)
- Cloaca
- Shell - shell rot, wounds, injuries, pink undershell is a sign of septicaemia
7
Q
What are the diagnostic tests used in reptile medicine?
A
Feacal samples
Bloods
Urinalysis
Cytology
Culture and sensitivity
8
Q
What are the differential diagnoses for a snake with a lump?
A
Prey item, enlarged heart/heart, neoplasia, FB, inflammatory, cryptosporidium gets into stomach and thickens stomach wall in snakes. X-ray to differentiate
9
Q
How is blood sampling in lizards done?
A
Ventral tail vein, careful as geckos can drop tails. Advance under hist coccygeal vertebrae, come back a bit and usually in vein. Can do cranial vena cava but can be used as euthanasia route.
10
Q
How is blood sampling in snakes done?
A
Cardio-centesis
Ventral tail vein very hard to get blood from
11
Q
How is blood sampling in chelonia done?
A
- Jugular sampling (right jugular is larger than left, is more middle of the neck rather than ventral which is where carotid is in chelonia, can put syringe holder in crook)
- Subcarapacial/supravertebral sinus until needle hits shell and pull back a bit so should be in vessel, but there are lots of lymph vessels around here so can mess up biochemistry/pink staining around blood smear
- Tail vein is an option but this is a sinus near the spinal cord so risk of contaminating spinal cord
12
Q
What is special about tortoise bladders?
A
Bladder in tortoise is a storage organ so when the dehydrate they can draw water out through the bladder
13
Q
What is the normal urine specific gravity in tortoises?
A
- Urine SG 1.003 – 1.012
- Can increase to 1.034 when dehydrated
14
Q
What is the normal pH of urine in tortoises?
A
- Catabolism leads to increased ketones and so increased pH
- Normal pH 8-0 – 8.5 for normal terrestrial
- May be less than 7 with prolonged anorexia
15
Q
How is radiography done in snakes?
A
Put inside a tube as they don’t sit flat on a plate, find it hard to reverse and good for venomous snakes, lateral and DV
16
Q
How is radiography done in lizards?
A
Do 2 views, VD and a lateral
17
Q
How is radiography done in tortoises?
A
Do 3 views – DV, craniocaudal, lateral. Can prop on something so legs pop out. Eggs can stay inside for years sometimes and become thicker.
18
Q
What are the uses of CT scanning tortoises?
A
- Good imaging of soft tissue
- Able to perform on conscious tortoises
- Takes about 15 seconds
- Can produce 3D images
19
Q
What is a consideration of using barium for tortoise CT scans?
A
Takes a few days to get through a tortoise
20
Q
Why might there be gaps between scutes on a tortoise CT scan?
A
Perhaps growing too quickly in too good conditions
21
Q
What is a consideration of subcutaneous injections in tortoises?
A
Put needle into the hub as skin is inelastic so solution may be lost through injection hole
22
Q
How are reptiles euthanised?
A
- Sedation with ketamine may help
- Intravenous or Intra-cardiac overdose of pentobarbitone
- Check heart has stopped with doppler
- Pithing to insure dead – needle through hard palate into brain
- Freezing is not an acceptable means of euthanasia
23
Q
How is acute collapse managed?
A
- Collect diagnostic samples
- Keep at preferred body temperature – until they are at the correct temperature, any medication or fluids you give will not necessarily be effective
- Give fluids, and antibiotics if indicated
24
Q
What are 2 examples of traumatic injury sustained by tortoises and how is this managed?
A
Rat bites on limbs during hibernation - antibiotics as metabolism is slower and it is contaminated
Shell fractures and have open body cavities – can cope with this in coelomic cavity due to limb movement generating lung air intake. Close and use tape to stabilise the fractures, moist wound healing with gels and antibiotics due to contaminated wound.
25
What is autonomy in reptiles?
- Natural process of dropping the tail tip
- Can be triggered if pain to the tail or this gets caught
- Grows back but looks different – scales not as colourful/banded/organised
- If there are injuries or tumours on the tails, you can put under GA and snap tail off and it will grow back
- Tail tip will sit there twitching as this is how it is a defence against predators
26
How are prolapses managed in reptiles?
Don’t know what is coming out: bladder, hemipene, oviduct, rectum, cloaca. So have to determine what is going on. Often have to use surgery to re-anchor whatever has prolapsed. Purse string suture or staple either side of the vent to reduce the opening size for a day or 2. Keep prolapse moist and refer to specialist.
27
Describe respiratory disease in reptiles.
- Relatively resistant to hypoxia
- Check mouth for obstructions – mucous, pus
- Maintain animal at preferred body temperature
28
What is the effect of oxygen therapy?
Can reduce respiratory stimulus – reserve for cases with impaired respiratory capacity
29
How might you aid a snake with respiratory disease caused by fluid build up?
Physical drainage of fluid by gravity may help – holding snakes upside down to do this
30
What are the aetiologies of seizure or incoordination in reptiles?
- Hypocalcaemia
- Insecticidal toxicity
- Viral – IBD/inclusion body disease, Paramyxovirus in snakes
- Hypothiamiosis – low vitamin B due fresh fish feeding in fish eating species
- Drug over dose – Ivomectin, metronidazole
31
How is seizuring and incoordination treated?
Diazipam to control seizures. Appropriate medical therapy – calcium, atropine, vitamin B, depending on cause of the seizure
32
What are the possible routes of fluid therapy in reptiles?
Soaking, oral, intracoelomic, subcutaneous, intravenous, intraosseous
Can do epicoelomic in tortoises by into the plastron by the leg, tortoises in theory can put into junction between shell and plastron
33
How much fluid is given to reptiles in fluid therapy?
10-30ml/kg/day
34
What opiates are used in reptiles?
Compared with doses used in most mammalian species, high doses of morphine (but not butorphanol) induced analgesia in bearded dragons, whereas high doses of butorphanol (but not morphine) induced analgesia in corn snakes
35
What dose of meloxicam are used in reptiles?
- Doses of 0.2mg/kg have been used either daily or every 2 days
- In green iguanas it has been shown to last 24hrs
36
What are the possible causes of anorexia in reptiles?
- More common and less concerning in snakes – but often if an animal has gone week without eating it is worth having an investigation
- Poor husbandry
- Stomatitis
- GI impactions
- Dystocia
- Renal failure
- Post hibernation anorexia
37
What are the causes of GI impactions?
- Particularly in lizards
- Variety of substrates – see blockages in practically every substrate
- Hypocalcaemia and low environmental temperatures
38
How are GI impactions prevented?
Make sure substrate it good quality, if sand make it good sand, fed in places they can’t ingest, temperature too low can reduce gut motility and so predispose to impactions
39
How are GI impactions treated?
Oral fluids, enemas, lactulose but their faeces is fairly liquid anyway, liquid paraffin is not recommended as inhalation is fatal, surgery
40
What are the causes of stomatitis in snakes and lizards?
Immunosuppression due to poor husbandry
Retained shed
Wounds
Smacking nose against glass
41
How is stomatitis treated in snakes and lizards?
- Take swabs
- Clean with iodine
- May need to debride under GA
- May need broad spectrum antibiotics
42
What are the causes of stomatitis and rhinitis in tortoises?
- Severe cases have thick pus adhered to tongue
- Herpes virus
- Mycoplasma
43
How is stomatitis and rhinitis in tortoises diagnosed?
PCR swab
44
How is stomatitis and rhinitis in tortoises treated?
Take swabs, clean with iodine, debride under GA, broad spectrum antibiotics
45
What is preovulatory follicular stasis?
- Ova remain on ovary
- Surgery most successful treatment
46
What is post ovulatory stasis?
- Shelled eggs in oviduct
- Provide appropriate environment to lay eggs
- Calcium and Oxytocin
- Salpingotomy
47
What is metabolic bone disease?
Nutritional secondary hyperparathyroidism
Imbalance between Ca and Phosphorus and lack of vitamin D3
48
What are the clinical signs of metabolic bone disease?
Shell deformity
Fractures
Rubber jaw
Weakness
Muscle tremors
Seizures
49
How is metabolic bone disease treated?
UV Light, Ca and Vit D supplements and injections, severe cases may be too far gone
50
What is the cause of dysecdysis?
Results from poor husbandry – inadequate humidity
51
How is dysecdysis prevented and treated?
- Provide humidity – shedding chamber with moist peat or moss. Do not soak snakes, they can drown
- Gently ease of retained shed
52
How might reptiles get burns?
Hot rocks not used and lights mut be enclosed so they are not rested against
53
How are burns treated?
- Iodine and flamazine (silver cream)
- May need dressings to cover the burn to prevent fluid losses
- If more severe – fluids and antibiotics
54
How are wounds managed in reptiles?
- Clean with iodine
- Suture or leave to granulate
- Intrasite gel and antibiotics – honey works very well in reptiles to encourage granulation and healing
55
Describe abscesses in reptiles.
Solid caseous pus – so must excise and if possible remove capsule as well and can’t just open and lance
56
How are abscesses in reptiles managed?
- Swab capsule or tissue culture
- Clean very well
- Leave to heal by granulation
57
How can reptiles be induced for anaesthesia?
- Tend to breath hold is inhalational can be challenging, can work for smaller species like geckos
- Premed opiate and/or benzodiazepine
- Induce with 5% Isoflurane
- Ketamine then intubation and isoflurane – but higher odes of ketamine can take a long time to metabolise from the system so long recovery time
- If IV access – propofol or alfaxalone (IM too) followed by isolflurane, tortoises can go into sinus, larger lizards can do tail vein
58
How is maintenance of reptiles done in anaesthesia?
- Most animals can be maintained on 2-3% Isoflurane – tend to be slightly higher iso than SA
- Reptiles are prone to apnoea so tubing is important
- Positive pressure ventilation is usually needed as most will use their legs to breathe
59
How are reptiles recovered from anaesthesia?
- Gradually reduce respiration rate, can use ambubag to give breaths of room air rather than oxygen to stimulate recovery instead
- Breathing stimulated by low O2, not Low CO2
- Keep animal at preferred body temperature – move to vivarium once breathing
60
When might pharyngostomy tubes be indicated?
Larger species
Need to medicate
Injury to mouth or jaw may indicate in tortoises
61
How are ear abscesses surgically treated in reptiles?
- Excise ventral circumference of tympanic membrane
- Lever out abscess
- Check eustachian tube at back of the throat
- Take swab – capsule, not pus itself or send section of capsule
- Flush
- Leave unsutured
62
What is a consideration if you need to enter the coelomic cavity in reptile surgery?
Need to ventilate as we have removed this pressure
63
How is the coelomic cavity entered in snakes?
In snake, between second and third layers of scales. Difficult to close thin muscle layer in snakes, may have to put in stay sutures in snakes, in smaller snakes can just close skin because this will be very difficult.
64
How is the coelomic cavity entered in lizards?
In lizards, can go midline or paramedial (as there is a vessel along ventral centre)
65
How is the coelomic cavity entered in chelonia?
In tortoises, do not hit paired abdominal vessels in tortoises, leave plastron flap at one edge, make sure is large enough, because once you have made it you cannot make it bigger, bone will die off but new bone will form.
66
What are the general surgical techniques in reptile suturing?
- Surgical incision are made between scales – scales in snakes naturally invert
- Wounds are closed with monofilament material using an everting suture pattern – horizontal mattress suture is an everting pattern that can be used. Doesn’t look neat but heals well but slowly
- Removed after 4-6 weeks
67
What suture materials are used in reptiles?
- Absorbable material will absorb but after a long time so remove of skin sutures is still needed
- Cat gut and polyfilament sutures are avoided as the create a lot of tissue reaction
- Tissue glue may be used to aid wound apposition but is not sufficient on its own and it does not last long enough
68
What is a doppler probe used for in reptile surgery?
To hear heart – difficult to monitor because you are breathing for them and they have very few reflexes so good to hear heart
69
What should the owner be warned about in any lizard spay?
Even leaving a few cells behind – they can re-grow their ovaries
70
What can the owner do initially to encourage a 60 year old tortoise to eat?
Warm water baths and provide heat lamp – getting tortoises into appropriate temperature and rehydration is needed after hibernation. Used to do glucose syringe but this risks re-feeding syndrome and spikes in potassium
71
Where would you take a blood sample from in tortoises?
Jugular – difficult to access but least likely change of lymphodilution
Or subcarapacial sinus
72
What indicates kidney failure in tortoises?
High potassium and uric acid. Poor prognosis
73
What advice is given around hibernation of tortoises?
Ensure correct hibernation temperature, hibernate for shorter periods, check tortoise during hibernation. Don’t hibernate if unhealthy.
74
How should tortoises be monitored during hibernation?
- Tortoises should be checked regularly during hibernation
- Examining them will not wake them up
- Temperatures should be monitored during hibernation. Too warm will increase metabolism
75
When should tortoises be woken up from hibernation?
- They lose more than 1% bodyweight a month
- They urinate
- They sustain any injuries
- If they are waking up
76
How long should hibernation last for tortoises?
- Long periods of hibernation (6 months) that occur if left to owner devices in the UK are detrimental
- Hibernation should be a maximum of 16 weeks
- 12 weeks is ideal
- Either keep awake longer so will be waking when weather conditions improving or if cannot stop progressing to hibernation wake early
77
What temperature should tortoises hibernate in?
Under 10 degrees but not below 2 degrees – 3-6 degrees
78
What factors may predispose a leopard gecko to have green yellow materials covering a sore closed eye? How is this investigated?
Poor shedding, vitamin A deficiency
Chloramphenicol eye drops, fucidic acid eyedrops, lubricant eyedrops possibility
79
What other problems can be associated with shedding difficulties?
Toe damage, tail damage, stomatitis, abscesses
80
What is the most likely cause of a 3 week anorexia in a female leopard gecko? How could you confirm this?
Impaction or pregnancy/ovarian stasis
Radiographs – DV, lateral
81
What factors may contribute to impaction?
Inadequate temperatures
Wrong bedding
Calcium deficiency (end up trying to eat bedding to get more calcium)
GI parasites
82
How might GI impaction be treated in a leopard gecko?
Saline with/without oral lactulose – not liquid paraffin due to inhalational risk causing fatal pneumonia
Oral fluids
Enemas
Lactulose
Surgery
83
What is the course of treatment for a tree python with an ulcerated sore in its mouth that a biopsy revealed had acid fast rods?
Euthanasia – mycobacteria are hard to treat and difficult to inject in the mouth due to health and safety
84
What are the causes of stomatitis in lizards and snakes?
Immune suppression due to poor husbandry
Retained shed
Wounds
85
How is stomatitis in lizards and snakes treated?
Take Swabs
Clean with iodine
Debride under GA
Broad Spectrum antibiotics
86
How would you treat a retained spectacle in a king snake?
Lubricate first with artificial tears and then gently remove with forceps
87
What is a complication of snake mites?
Poor shedding
88
What is the normal appearance of the tongue in a leopard gecko?
Pinkish tint to the tongue – this is normal is leopard geckos and other tissues
89
How would you initially try to resolve a female corn snake with a 2 week history of anorexia and palpable eggs but no effort to lay?
Provide a laying chamber and make sure conditions are perfect to lay for that species
90
If a female corn snake has laid 1 egg but is now not passing anymore, what is your next course of action?
Oxytocin – not very effect, tortoises respond well, lizards respond okay. Calcium.
91
How is post ovulatory stasis managed?
- Provide appropriate environment to lay eggs
- Calcium and oxytocin
- Salpingotomy
- Draw out fluid from egg to remove in centesis procedure
