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3. Comparative > Reptiles 2: Clinical Techniques and Therapeutics > Flashcards

Reptiles 2: Clinical Techniques and Therapeutics Flashcards

1
Q

Safety and Precautions for reptile handling

A
  • Always get back up for large and potentially dangerous reptiles
  • Wear gloves for large aggressive reptiles
  • Wear gloves or wash hands thoroughly after handling! ZOONOTIC risk with Salmonella
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2
Q

Non-Venomous Snakes
- how to handle
- constrictors
- snake defecation
- speed
- large snakes

A
  • Grasp firmly but gently behind the head
  • Support and control the body with your second hand
  • Do NOT place constrictor species around your head or neck
  • Some snakes will defecate or produce foul-smelling secretions from scent glands when handled
  • Some species can strike VERY fast, often with no warning
  • 1 person/meter for large snakes
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3
Q

venomous snakes - should we handle?
- tools?

A
  • Do NOT handle
  • Special training is required
    > Snake hooks
    > Snake tubes
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4
Q

lizard handling
- how to hold
- tail?
- eyelids
- dangers
- tools

A
  • Grasp firmly but gently at the neck/thoracic girdle
  • With the second hand, hold the hind legs into the body at the pelvis/base of the tail to prevent the legs and tail from thrashing
  • Do NOT pick up by tail  may accidentally come off or be shed in an escape mechanism (tail autotomy) in some species (e.g., iguana, skink, and gecko species)
  • Gentle pressure over the eyelids causes a vaso-vagal response and can help with handling for radiographs
  • Can bite, scratch with toenails, and whip tail
  • Can use a towel
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5
Q

large lizard dangers when handling

A
  • Monitor lizards, iguanas, and tegus need to be approached with caution
  • Have a VERY powerful bite, strong and sharp claws, and can whip their tail
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6
Q

Chelonians
- how to hold
- dangers
- examination problem

A
  • Hold across the middle of the shell or the edge of the carapace and plastron with both hands
  • Can bite and scratch with their beak and toenails (turtles > tortoises)
  • Will retract head and limbs making examination difficult
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7
Q

reptile history taking
- acute vs chronic problems?
- what issues usually involved in issues?

A
  • Remember that most reptile problems are not acute problems
    <><>
  • Husbandry issues are almost always involved (See Reptile 1 lecture)
  • Enclosure
  • Temperature gradient
  • Humidity
  • UVB lighting
  • Diet (supplements)
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8
Q

History Taking
- signalment > what to know

A

Signalment
* Species, subspecies
> Also gives idea of biotope of origin
* Age
* Sex (if known)
* Duration in owner’s care/captivity
* Origin (captive bred, wild caught, importation date)

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9
Q

History Taking
- what to know about husbandry?

A

Enclosure
* Size, type, hiding spots
<><>
Temperature:
* Gradient: maximum, minimum, basking area
* Night temperature
* Temperature control and monitoring
* Heating equipment
<><>
Humidity
* % humidity, humidity gradient, humidity boxes
<><>
UVB lighting
* Type and position, when last changed?
* Presence of a screen between the source and animal
* Any time outdoors in summer

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10
Q

History Taking
- what to ask about diet?

A
  • What is the diet?
  • When and how often is it fed?
  • How is food prepared?
  • Amount or size offered?
  • How much is actually eaten?
  • Treats/supplements used?
    > Especially calcium and vitamins
  • How is water provided?
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11
Q

History Taking
- other important questions aside from signalment, hisbandry, diet

A
  • Breeding details, if any
  • Other animals in the enclosure?
  • Disease history
  • Quarantine protocol
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12
Q

History Taking
- what to ask about current problem

A
  • Reason for presentation
  • Clinical signs
  • Duration of illness
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13
Q

Physical Examination
- how to start

A
  • Start by an overall visual assessment prior to restraint
    > Attitude, mentation
  • Always obtain weight (gram scale needed for most of these patients)
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14
Q

Physical Examination should be thorough and routinw, and progress from

A

head to toe

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15
Q

Physical Examination
- head
> what to look at, tools

A
  • Eyes, ears (not for snakes and chameleons)
  • Open mouth with credit card or soft spatula
    > Look at choana, glottis, teeth, gum, Jacobson’s organ
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16
Q

Physical Examination
* Coelomic cavity palpation
> what can we feel? in diff animals?
* what else to palapte?
* examine what structures?

A

Coelomic cavity palpation
* Snakes – can usually palpate the heart, sometimes
gallbladder, look for masses or impacted GI tract
* Lizards – kidneys can be palpated via rectal exam if large (sit in the pelvic girdle), look for masses and impacted GI tract, bilateral fat pads caudoventrally
* Chelonians – one or two fingers placed in the inguinal area between the hindlimbs and shell – cystic calculi, foreign bodies, neoplasia, potential eggs
<><><><>
* Palpation of the extremities and tail
* Examine cloaca
* Examine the shell of chelonians

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17
Q

Physical Examination
- heart rate > auscultate?
> how to take?
> where to find for snakes, chelonians, lizards

A

Cannot auscultate most of the time > use Doppler
> Where to place the Doppler?
* Snakes – approximately the end of the last third of the body
* Chelonians – on the neck over the carotid artery or in the
thoracic inlet
* Lizards – between forelimbs or axillary region; a monitor lizards’ heart is more caudal

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18
Q

consideration for taking retile resp rate?

A

Remember: reptiles can hold their breath for long periods of time

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19
Q

TPR for reptiles - can we do it?
- normal values?

A
  • TPR: no temperature and no palpable pulses
  • Normal physiologic values > Extremely variable – depends on ambient temperature, age, species, health status
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20
Q

reptile BCS - scale? how to take?

A

Body condition scoring
* Range 1 (emaciated) to 5 (grossly obese)
> Look at: the palpability of ribs, pectoral/pelvic girdles, the girth of the tail, the muscle mass of forelimbs and hind limbs

21
Q

Physical Examination
- what about animals about to shed? how to tell?
> why should we care?

A

Avoid handling animals about to shed if possible – appear dull, blue-tinged, or opaque in color
* May be more aggressive
* Underlying skin is not fully developed
> handling may cause damage to newly developed skin

22
Q

Physical Examination
* Assessing dehydration
- MM
- skin
- CRT
- eyes

A
  • Mucous membranes – should
    be pink and moist
    > Common sign of dehydration in reptiles – dry or tacky mucous membranes with saliva strands
    <>
  • Skin – may lack normal elasticity and appear wrinkled
    > Can tent skin in many species
    <>
  • Capillary refill time – should be about 1-2 seconds
    <>
  • Eyes – dehydrated reptiles appear to have sunken eyes
23
Q

Physical Examination
- sexing
> in snakes, how to

A

Snakes – use a well-lubricated, clean metal probe or rubber feeding tube > insert into the lateral portion of the cloaca (left or right), directed caudally > stop once resistance is met
<><>
- can probe far deeper in male cloaca

24
Q

Physical Examination
- sexing lizards, how to for various types

A
  • Hemipenis bulges caudal to cloaca
  • Enlarged femoral pores in most male lizards
  • Precloacal pores in geckos (more prominent in male)
  • Sexual dimorphism
    > Male iguanas – large dewlap, taller dorsal spines, larger opercular scales, large and well-developed femoral pores
25
Q

Physical Examination
* Sexing Chelonians
- how to

A
  • Males have longer tails than females
  • Males often have a concave plastron, and females tend to be flat
  • Males have longer nails than females (especially freshwater turtles)
  • Male cloaca protrudes beyond the edge of the plastron (for females it is within the margin of the plastron)
26
Q

Venipuncture puncture in snakes
- where?

A
  • Ventral coccygeal
  • Heart
27
Q

Venipuncture in lizards
- where?

A
  • Ventral coccygeal
  • Jugular
  • Lateral tail vein (iguanas, large lizards)
28
Q

Venipuncture in chelonians
- where?

A
  • Jugular
  • Brachial
  • Dorsal coccygeal
  • Subcarapacial plexus - not reccomended
29
Q

Lymph Dilution
- what is this concern for blood sampling?
- when to suspect
- what it can alter

A
  • Lymph dilution is a concern – any sample with clear fluid or a watery appearance may have lymph dilution (or it may appear grossly normal!)
  • Can reduce all parameters, but most severely affected are
    > CBC parameters
    > Total protein
    > Potassium
30
Q

Hematology for reptiles
- ref ranges
- all techniques are automatic or manual?
- extrapolation?
- unique cells?
- husbandry considerations?

A
  • Reference ranges are available for some species, but not all
  • Like birds, all hematological techniques are manual
  • Difficult to extrapolate among species
    <><>
  • Unique cells on CBC – azurophil, heterophil
    > Heterophil:
  • > Function similar to a neutrophil, but lacks the enzyme myeloperoxidase > therefore, purulent material is thick and not liquified
    Azurophil (mainly seen in snakes and lizards)
  • > Behaves like a heterophil in snakes
  • > Behaves like a monocyte in all other reptiles
    <><>
  • Appearance of cells varies by species
  • Hematologic response heavily influenced by captive husbandry
31
Q

Biochemistry for reptiles
- similar interpretation to what other animals?
> urea
> liver panel
> best parameter for renal disease??
- electrolytes?
<>
- differences between sexes
<>
- seasonal effects
- husbandry

A

Similar overall interpretation as birds with a few exceptions
* Some species produce urea in a significant proportion (most
chelonians, but aquatic chelonians in particular)
* Liver panel is not very sensitive
* Ca:P ratio is the most sensitive parameter to detect renal disease
* Can withstand drastic changes in electrolytes
<><><>
Effect of sex
* Females – higher cholesterol, total calcium, total protein, albumin
> Protein electrophoresis also required for albumin/globulins
<><><>
* Seasonal effects – brumation
* Affected by captive husbandry

32
Q

Diagnostic Imaging for reptiles
- how to radiograph
> views and positioning

A
  • Always collect at least 2 views (3 in chelonians) = orthogonal!
    <><>
    Positioning
    1. Dorsoventral
    1. Lateral – horizontal beam
    1. Craniocaudal – horizontal beam (only in chelonians)
33
Q

Diagnostic Imaging
- can we ultrasound?
> what do we need?
> A-fast for what?

A
  • Need to get a lot of gel and alcohol between scales to get a good image
  • A-fast to check for fluids, masses, and eggs
34
Q

are CT-scans good for reptiles

A
  • Extremely useful in reptiles
35
Q

Fecal Floatation in reptiles
- importance?
- parasite pathogenicity?

A

Routine fecal exams important
* Especially important with wild caught reptiles
* Lost of common intestinal parasites in pet reptiles
<><>
Pathogenicity of various parasites varies by species
* Flagellates are commonly seen on wet mount, but most are non-pathogenic

36
Q

Intramuscular Injections for reptiles
- where?
- how to insert needle?
- what drugs go cranial? why?

A
  • Typically, in the limbs (epaxial muscles in snakes)
  • Insert needle between scales
  • Cranial half of the body for drugs with hepatic metabolism (e.g., dexmedetomidine)
    > Historically, it was thought that the renal portal system may increase the elimination of drugs given in the caudal half
    > We now know that there is a hepatic first-pass effect when given in the caudal half
37
Q

Subcutaneous Injectionsin reptiles
- character of SQ space? what this means?
- skin tent?
- location for snakes, lizards, chelonians
- technique

A
  • Small subcutaneous space with limited vascularity – absorption of medications and fluids variable
    <>
  • No need to tent skin in reptiles
    <>
  • Location:
  • Snakes – lateral body wall
  • Lizards – lateral body wall, inguinal space
  • Chelonians – axillary and inguinal space
    <>
  • Technique: insert needle parallel to body wall in between scales
38
Q

should we give intracelomic injections

A
  • No longer recommended
39
Q

are oral injections a good choice?

A
  • Absorption and efficacy are questionable – consult research
40
Q

IV injections for reptiles
- where in snakes, lizards, chelonians

A
  • Snakes – challenging, palatal veins in large snakes
  • Lizards – ventral coccygeal
  • Chelonians – jugular
41
Q

do we always have to treat iintestinal parasites in reptiles?

A
  • generally not a problem > just because we find on fecal doesnt mean we need to worry
42
Q

Intraosseous injections
- easier than what other option?
- where in snakes, lizards, chelonians

A

(easier than IV catheterization)
* Snakes – not possible
* Lizards – distal femur, proximal tibia
* Chelonians – humerus, femur, shell (bridges) also but not great

43
Q

can we inject stuff up the reptile cloaca?

A

its possible

44
Q

where to put catheter for reptiles

A
  • jugular (can be difficult, need them asleep), tail
  • can be intraosseous
45
Q

Nutritional Support
* Force Feeding
> strategy for lizards, snakes, chelonians

A
  • Lizards – usually take food from a syringe
  • Snakes – least commonly needed; hold upright and use a red rubber feeding tube
  • Chelonians – difficult
46
Q

Nutritional Support
* Esophagostomy tubes in chelonians
- is this useful?

A
  • Easy to place
  • Can be kept long-term
47
Q

Fluid Therapy for reptiles
- principles
- environment
- methods of rehydration
- crystalloids
- types of fluids to give

A
  • Same principles as for other species
  • Correct underlying environmental problems
  • Methods of rehydration:
    > Soaking (NOT in the bathtub)
    > SC
    > IV/IO
  • Crystalloid fluids: 10-30 mL/kg/day
  • Types of fluids
    > Consult normal osmolality
    > LRS or Plasmalyte-A in most species or for IV
    > For SC in chelonians: 2/3 LRS, 1/3 NaCl 0.45%
48
Q

drugs in reptiles
- are they well studied?
- doses vs mammals?
- admin route
- Abx
- Antiparasitics
<>
- other, pain

A
  • Few pharmacokinetic studies
  • Doses and frequencies are typically lower than mammals
  • Parenteral administration is common in reptiles
    <><>
  • Antibiotics:
  • Ceftazidime or long-lasting ceftiofur crystallin-free; IM/SC q2-5 days
  • Enrofloxacin oral or SC diluted in fluids, NOT IM
  • TMS – 1st tier
  • Metronidazole
    <><>
  • Antiparasitics:
  • Ivermectin – NOT IN CHELONIANS
  • Fenbendazole
  • Ponazuril
    <><>
  • Others:
  • Meloxicam
  • Hydromorphone, methadone, morphine, tramadol

3. Comparative (23 decks)

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