Surgical Nursing of Reptiles

Question 1

How do we carry out a pre-op assessment on reptiles?

Answer 1

Thorough clinical exam - will hide any signs of illness
Faecal and blood screens before GA advisable
Facilities for maintaining animal at preferred body temperature are required
Fasting not necessary

Question 2

How can we support reptiles under GA?

Answer 2

Reptiles breathe by skeletal muscle movement, so require respiratory support e.g. IPPV / ventilator
Maintain body temp. (heat pads etc.)

Question 3

How can we monitor reptiles under anaesthetic?

Answer 3

May be difficult - at surgical depths there are few reflexes to monitor, and resp. is controlled externally
Doppler probe to monitor heart rate
Capnograph may be helpful particularly on recovery

Question 4

How do we prep a reptile for surgery?

Answer 4

Wound sites prepped as for any surgery
Chlorhexidine/iodine used, time for it to soak between scales, may use brush to scrub surgical area
Use of alcohol not recommended and leads to cooling
Clear plastic drapes enable sterile field while still being able to visualise patient

Question 5

How can we position reptiles for surgery?

Answer 5

Varying shapes of reptiles make this difficult
Sandbags and foam wedges useful
Try to minimise pressure on lungs from other organs (no diaphragm!) - assisted ventilation will help

Question 6

How can we recover reptiles post-op?

Answer 6

Gradually reduce resp. rate
Breathing stimulated by low O2, not high CO2 - so will not begin breathing for themselves while ventilated at high O2 %
Capnograph useful in monitoring breathing
Keep animal at preferred body temp.

Question 7

What analgesia can we provide to reptiles?

Answer 7

NSAID e.g. meloxicam

Opioid e.g. butorphanol

Question 8

What general surgical techniques are used in reptiles?

Answer 8

Surgical incisions made between scales
Wounds closed with monofilament material using everting suture pattern
Sutures removed after 4-6 weeks

Question 9

How can we care for wounds?

Answer 9

Management of open wounds is similar to other species but maintaining dressing in place may be difficult
Dilute iodine used to clean wounds, wound rinsed well afterwards
Use of adhesive dressing e.g. Op-site, Primapore
Water-based gels/honey can aid healing

Question 10

What common surgical procedures are carried out on reptiles?

Answer 10

Mass/abscess removal
Ovariosalpingectomy (removal of ovaries and shell gland)
GI obstruction (stones/bedding)
Hemipenile amputation

Question 11

What diagnostic imaging techniques can be used on reptiles?

Answer 11

Radiography
Ultrasonography
X-ray computed tomography (CT) scans