Exotics - Reptiles 2

drraythe's version from 2016-03-15 15:52

Reptile Hx & Physical Exam....CONTINUED. (HTRS = helpful things Rush said)

Question Answer
If you see a testudo sp. (a type of tortoise) & it has small or scarred nasal openings, what are you thinking?Previous mycoplasma infxn
If you want to do an oral exam, what are some tools you need? What are some basic things you'd look for?Spatula, beak speculum. Look at the dentition, look for irritation
What is a Rhamphotheca? Why does overgrowth of this happen?In chelonians, it is the keratin layer of their bill (of their mouth). Overgrowth is usually due to a nutritional deficiency (#1 cz) (usually Vitamin A she added)
What is a chelonian's tongue like?Fleshy & non-distensible
What are the large vessels in a snake’s mouth? What is unique about them & why might you care about them?They are PALATINE vessels & the R side is LARGER than the left side!! These are useful for an emergency IV
What are the teeth like in a snake? How many rows are where?They are retrograde teeth (point backwards), there is 1 row in the lower jaw & 2 in the upper jaw (think double buck teeth, aww). The teeth are not regionally differentiated & are shed regularly.
What is a unique feature of an iguana's tongue you should keep in mind?It is normal for it to have a red(er) tip
What does Pleurodont mean? Who is a pleurodont? Are these teeth replaced?This is when the teeth are just attached to the side of the mandible w/o sockets & are able to be replaced-iguanas have this setup
What does Acrodont mean? Who is an acrodont? Are these teeth replaced? What are some problems this setup has?The teeth are attached to the biting side of the jaw w/o sockets. They are NOT replaced. This means they are prone to severe tartar formation & dental dz. Animals w/ this setup are: Agamids ("dragon lizards"), Chameleons, Tuataras (New Zealand reptiles which look like lizards but arent)
Aural exam → snakes: what is their ear like? What is their hearing like?NO external tympanum, NO external or middle ear. However, snakes can hear, but in a totally diff range from us: 150-600Hz.
Aural exam → chelonia: what is their ear like? Which chelonia has a particular ear problem, what is it & why might this be happening?They do have an external tympanum. Box turtles are prone to inner ear infxns, the current theory is that this is due to organophosphates.
Aural exam → lizards: what is their ear like?They have an external tympanum, a tympanic membrane & it is covered by a thin transparent skin
Aural exam → ALL SPP: what is something you should look out for in the ears???PARASITES LIKE TO LIVE IN EARS
What are some neurological tests you can perform on reptiles?The righting reflex (if you flip them upside down will they flip back over? don't do this in tortoises tho), extremity pinch reflex, skin pinch reflex
If a snake fails the righting reflex test, what are you thinking is the reason?Usually due to IBD (inclusion body dz) which primarily affects boids
What are the 3 places you look for to conduct a BCS on a reptile? & any exceptions?(1) TAIL FAT (many Saurians, aka giant group of reptiles including lizards, store a sig. amount of fat & mm mass in the tail, evaluate as for spinal musculature)
(2) Spinal musculature (palpate lumbar/spinal musculature & evaluate similar to avian BCS)
(3) Pelvic bones-can you see them? Or are they emaciated?
What is a carapace? What is it made of?It is the top of the shell of turtles/tortoises! It is LIVING TISSUE & is composed of 50 bones. It is derived from Ribs, vertebrae & skin.
What is a plastron? What is it made of?It is the BOTTOM of the shell of turtles/tortoises. It is derived from the clavicles, interclavicles & gastralia (abdominal ribs)
What are scutes? How are they named?These are the bony plates which compose the carapace & plastron...they are named based on adjacent body portion (eg, abdominal, anal, femoral...)
What are the heavily scaled reptiles called (the order is called). How would you suture heavily scaled skin?Heavily scaled are in the order "squamata" which inclds snakes & lizards. If you suture your skin, you must do an EVERTING pattern.
What is ecdysis?Molting!
How do lizards molt (ecdysis)? How do snakes molt?Lizards molt in multiple pieces, snakes molt in 1 large piece
What is snake behavior/appearance like during molting (ecdysis)?They start to get a dull blue coloration, which happens bc there is lymph btwn the layers prior to shedding. Sometimes their breathing is raspy & it may go off food & be more prone to bite bc of visual impairment. (BE CAREFUL! If you pick it up during this time, you can tear its new skin)
What are some reasons for dysecdysis?Husbandry
Which reptiles have skin glands & what are their fxn?Snakes, they have anal scent glands aka musk glands of the snake. They are paired & may deter predation
HTRS: Where are a chelonian's lungs?AT THE TOP OF THEIR CARAPACE! So if you flip them over theyre gonna have problems breathing!!
HTRS: If you inject a chameleon, what must you warn clients about?The injected area might turn black & that it is normal for this to happen
In general, why would you want to do some celomic palpation?To look for foreign objects, eggs, renomegaly, uroliths, perform ballottement
In turtles/tortoises, what could you palpate from the inguinal shell opening?The caudal viscera & the caudolateral liver lobes
In turtles/tortoises, what could you palpate from the axillary shell opening?Cranial viscera, craniolateral liver lobes
In turtles/tortoises, what could you palpate from the mediastinal shell opening?Heart
Major vessels
Gall bladder
How do you determine the gender in a snake? Explain the male genitaliaBlunt tipped probe inserted gently into hemipenal sheath...if it is a short pouch, it's a GIRL (no penis so no need for long pouch), if long pouch, it's a boy. The boys have 2 hemipenes which they have in the pouch at the base of the tail & their testes are intraabdominal & enlarge during mating season
How are box turtles sexually dimorphic?Male has RED eyes (not 100% tho)
How are land tortoises sexually dimorphic?Males have an indentation on their plastron (bottom shell-used for mounting females & not rolling off them)
How are water turtles sexually dimorphic?Males have long fingernails
In many species, how might you be able to guess if it's a boy or girl?Boys have longer tails
What is the male chelonian penis like? What should you be mindful of?The penis is commonly everted during excitement of breeding season & this is normal! However, it might prolapse & devitalize if constricted.
What are 4 ways you might be able to determine the gender of a lizard?(1) FEMORAL & PRECLOACAL PORES: larger in males
(2) HEMIPENES might calcify in adult male monitors, which you can then see via radiograph
(3) males generally have a larger & more ornate head
(4) there are HEMIPENAL BULGES in some species (such as chameleons)
Hematology: what kind syringe should you use? What important skill must you have? How do you run the CBC? What are their blood cells like?Heparinized syringe bc it might be a slooow draw (low blood pressure) so use your PATIENCE! You will have to manually run the CBC bc the machines don't like weird blood-reptile blood is similar to avian blood, so it has nRBCs! & HETEROPHILS! & AZUROPHILS!
What should you know about BUN/creatinine levels in reptiles?NOT a reliable measure of renal fxn... they have uric acid, so basically have to do an endoscopic renal biopsy
What should you know about Calcium levels in reptiles?There will be HYPERCALCEMIA w/ ovulation! (Also some spp just have naturally ↑ levels of Ca++, like indigo snakes)
What is the #1 reason we care about the Ca++/Phos ratio in reptiles?IMPORTANT in NMBD (nutritional metabolic bone dz)

Reptilian Dzs

Question Answer
Explain why QUARENTINEING is like SO SUPER IMPORTANT!If there are multiple species, you really ought to quarantine to prevent dz
How long should you quarantine snakes? What tests should you ideally run & what dzs are you concerned about?Snakes 45-90 days, you should do a PE, CBC, chem, fecal (both direct & float to look for parasite & ova) & look out for Cryptosporidium & Paramyxovirus
How long should you quarantine turtles? What tests should you run?30-45 days, do a PE, CBC, chem, fecal (both direct & float to look for parasite & ova)
How long should you quarantine lizards/crocodilians? What tests should you run & what are you worried about?30-45 days, do a PE, CBC, chem, fecal (both direct & float to look for parasite & ova) & we are concerned about WNV
What are some general, species non-specific signs which would concern you & give you extra reason to want to quarantine?Anorexia
Thermal burns
Prolapse (cloacal, paraphimosis ← foreskin becomes trapped behind glans penis)
Nutritional metabolic bone dz
Give some examples of when anorexia is due to husbandry/behavioral problemsEnviro
Dominant animals
Autumn anorexia
Pre-shedding anorexia
Explain reproductive anorexiaUsually occurs w/ gravidity, dystocia, or when reproductively active
Who are thermal burns most common in? What is the etiology? DDX? Where are the lesions usually?Most common in lizards & snakes! Etiology is any direct heat source (HOT ROCK, heating pad, spot lamp..) malfxn of the thermostat, if they are left outside in aquarium, or if it's in the wild, fires. The Ddx diagnoses are bacterial dermatitis & fungal dermatitis. The lesions can be dorsal or ventral, usually local & a Hx would be important in figuring out what happened
HTRS: the easy method for palpating snakesIf you push on the snake to palpate...they are 1 giant mm & all you'll feel is that mm. But if you let the snake “give you” the physical exam. Let it crawl over your fingers & you'll be able to feel it then. IF there's something abnormal, you should be able to feel it.
What is the general Tx for thermal burns? (5 main things)(1) FLUIDS-NECESSARY! Shock dose, 20-40ml/kg/day, can be give IV or IO
(2) Steroids-(don't give long term she said, bc it can cz fungal problems...she recc dexamethasone)
(3) IPPV - intermittent positive pressure ventilation
(4) Check temp for hyperthermia
(5) Supportive care (POTZ, nutrition)
Describe the 3 categories of burn thickness & give a basic description of them(1) SUPERFICIAL - pain, erythema, discoloration, scale wrinkling
(2) PARTIAL THICKNESS - middermis, scales lost, blisters, plasma exudate to crust
(3) FULL THICKNESS - dry dark eschar (An eschar is a slough or piece of dead tissue that is cast off from the surface of the skin, particularly after a burn injury), slough, surgical debridement
Describe bandaging for thermal burns (what should you do & what should you avoid?)She LOVES wet-to-dry bandaging (doesnt dry out wound, doesnt stick as bad, pulls out bad stuff) which can be used w/ adherent bandages, Biodress, or Newskin. For ointment, you can use silver sulfadiazine, betadine, or chlorhexidine. When bandaging/having bandages, AVOID PARTICULATE BEDDING!
HTRS: what does she LOVE TO USE to heal up wounds?RAW HONEY! Natural antifungal, antibacterial & stimulates granulation bed
HTRS: what should you know about absorbable sand?IT ISNT ABSORBABLE. Still czs impactions. Bad news.
HTRS: what might you do w/ topicals which might help stimulate more granulation?Alternating them! Like a 10 day cycle
If you give a PTx ABx, how would you decide & how would you give them?Based on culture/cytology & you'd want to give systemic parenteral
***WHAT IS THE HEALING TIMELINE FOR THERMAL BURNS?6-10 shedding cycles for defects to heal!!! This can take months to over a year. Epithelization might not be apparent until after a shed. Unfortunately, the wounds might cz continued dysecdysis & will require additional soaking. Chelonians in particular might lose keratin scutes
What are some reasons there might be a prolapse of the penis/hemipenes?Infxn
Gender determination
Forced separation of copulation
Neurologic dysfxn
What are some reasons there might be a prolapse of the bladder?Cystitis, calculi, retrograded eggs
What are some reasons there might be a prolapse of the uterus/oviducts?Egg binding
Tenesmus (straining to defecate or urinate)
What are some reasons there might be a prolapse of the colon?Tenesmus (straining to defecate or urinate)
Constipation (small enclosure might be to blame)
Bacterial enteritis
Parasitic enteritis
So you're looking at some weird prolapsed thing... describe how the UB, PENIS/HEMIPENES, COLON & SHELL GLAND appear/feel to differentiate themUB: thin walled & translucent, you can aspirate urine from it
PENIS/hemipenes: solid tissue w/ no lumen
COLON: there is a lumen, it is soft walled, you might feel fecal material
SHELL GLAND: there is a lumen, but no feces & there are LONGITUDINAL STRIATIONS on the surface
If removal is not needed, what is the Tx for prolapsed organs?1st, determine the type of prolapse & the CZ of the prolapse!. The cleanse, lubricate & SHRINK the organ in a solution of 50% dextrose or Epsom salts
How would you go about an amputation of a prolapsed penis/hemipene?*Amputation is last resort! you'd have to do mattress sutures to base & must transect the tissue distally (if you just dissect 1 they can still reproduce normally)

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