Reptile History and Physical Exam....CONTINUED. (HTRS= helpful things Rush said)
If you see a testudo sp. (a type of tortoise) and it has small or scarred nasal openings, what are you thinking?
previous mycoplasma infection
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 cause) (usually vitamin A she added)
what is a chelonian's tongue like?
fleshy and non-distensible
what are the large vessels in a snakes mouth? what is unique about them, and why might you care about them?
they are PALATINE vessels, and 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 one row in the lower jaw and two in the upper jaw (think double buck teeth, awww). The teeth are not regionally differentiated and 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 without sockets, and 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 without sockets. They are NOT replaced. This means they are prone to severe tartar formation and dental dz. Animals with 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, and why might this be happening?
they do have an external tympanum. Box turtles are prone to inner ear infections, 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, and 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 though), 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 disease) which primarily affects boids
what are the three places you look for to conduct a BCS on a reptile? And any exceptions?
(1) TAIL FAT (many saurians, aka giant group of reptiles including lizards, store a sig. amount of fat and mm mass in the tail, evaluate as for spinal musculature) (2) Spinal musculature (palpate lumbar/spinal musculature and 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 and is composed of 50 bones. It is derived from Ribs, vertebrae, and skin.
what is a plasteron? what is it made of?
it is the BOTTOM of the shell of turtles/tortoises. It is derived from the clavicles, interclavicles, and gastralia (abdominal ribs)
what are scutes? how are they named?
these are the bony plates which compose the carapace and plasteron...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 includes snakes and lizards. If you suture your skin, you must do an EVERTING pattern.
what is ecdysis?
how do lizards molt (ecdysis)? how do snakes molt?
lizards molt in multiple pieces, snakes molt in one large piece
what is snake behavior/appearance like during molting (ecdysis)?
they start to get a dull blue coloration, which happens because there is lymph between the layers prior to shedding. Sometimes their breathing is raspy, and it may go off food and be more prone to bite because 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, illness, mites, trauma
which reptiles have skin glands, and what are their function?
snakes, they have anal scent glands aka musk glands of the snake. They are paired, and 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, and 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 ballotment
in turtles/tortoises, what could you palpate from the inguinal shell opening?
the caudal viscera, and 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, liver, gall bladder
how do you determine the gender in a snake? explain the male genitalia
blunt 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 two hemipenes which they have in the pouch at the base of the tail, and their testes are intaabdominal and 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 plasteron (bottom shell-- used for mounting females and 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, and this is normal! However, it might prolapse and devitalize if constricted.
what are 4 ways you might be able to determine the gender of a lizard?
(1) FEMORAL AND 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 and 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?
heparanized syringe because it might be a slooow draw (low blood pressure) so use your PATIENCE! You will have to manually run the CBC because the machines don't like weird blood-- reptile blood is similar to avian blood, so it has nRBCs! and HETEROPhiLS! and AZUROPHILS!
what should you know about BUN/creatinine levels in reptiles?
NOT a reliable measure of renal function... 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 with ovulation! (Also some spp just have naturally high levels of Ca++, like indigo snakes)
what is the #1 reason we care about the Ca++/Phos ratio in reptiles?
usually occurs with 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 and snakes! etiology is any direct heat source (HOT ROCK, heating pad, spot lamp..) malfunction of the thermostat, if they are left outside in aquarium, or if it's in the wild, fires. The differential diagnoses are bacterial dermatitis and fungal dermatitis. The lesions can be dorsal or ventral, usually local, and a history would be important in figuring out what happened
HTRS: the easy method for palpating snakes
If you push on the snake to palpate...they are one giant mm and all you'll feel is that mm. But if you let the snake “give you” the physical exam. Let it crawl over your fingers, and you'll be able to feel it then. IF there's something abnormal, you should be able to feel it.
what is the general treatment 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, because it can cause fungal problems...she recc dexmethazone) (3) IPPV- intermittant positive pressure ventilation (4) check temp for hyperthermia (5) supportive care (POTZ, nutrition)
describe the three categories of burn thickness and 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 and 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 with 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! nautral antifungal, antibacterial, and stimulates granulation bed
HTRS: what should you know about absorbable sand?
IT ISNT ABSORBABLE. still causes impactions. Bad news.
HTRS: what might you do with topicals which might help stimulate more granulation?
alternating them! like a 10 day cycle
if you give a pt antibiotics for treating burns, how would you decide and how would you give them?
based on culture/cytology, and 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 cause continued dysecdysis and will require additional soaking. Chelonians in particular might lose keratin scutes
what are some reasons there might be a prolapse of the penis/hemipenes?
infection, gender determination, forced separation of copulation, constipation, neurologic dysfunction
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, and SHELL GLAND appear/feel to differentiate them
UB: thin walled and translucent, you can aspirate urine from it. PENIS/hemipenes: solid tissue with 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, and there are LONGITUDINAL STRIATIONS on the surface
if removal is not needed, what is the treatment for prolapsed organs?
first, determine the type of prolapse and the CAUSE of the prolapse!. The cleanse, lubricate, and 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, and must transect the tissue distally (if you just dissect one they can still reproduce normally)