Exotics - Reptiles 4

pbhati17's version from 2017-02-08 23:33

Reptilian Dzs... CONTINUED

Question Answer
(Related to how dz spreads) When Tx a snake w/ OPMV, if there are other snakes in the clinic/home, what must you do?Recc neg airspace in quarantine room....air needs to be sucked out, bc otherwise it just circulates around the house
How do you treat OPMV?No Tx
Supportive care might extend a chronic poor doer's life but thats about it
What is IBD? Who does it usually affect?Inclusion body dz, czd by an arenavirus (was thot to be Retrovirus, notes say this, in class she said arena & emphasized) this virus usually affects BOID snakes (can affect other spp tho)
What are the main signs czd by IBD & which snakes are more prone (more specific than boids)Usually cz neurological signs... boas can be carriers, it is usually FATAL in pythons
How do you dx IBD? How do you Tx? How might you prevent this?Dx is usually at necropsy. ICIB/Histopath/Hx of GI tissue/liver. No drug is 100% effective, altho doxy might help. THERE IS NO Tx THO!!!! To try to prevent, use quarantine methods, use proper husbandry & DONT HAVE MIXED SPECIES HABITATS!!
Prey bites: What should you know about this?FEED DEAD PREY! If they dont eat dead, feed live, THEN stunned, THEN dead. If the reptile doesn't seize prey in 10-15min, they prolly dont want to eat that day-REMOVE PREY! The inappetence might be from husbandry issues! The rodent that bites might just be hungry, or perhaps it is defense biting
How would you care for a pre-bite wound on a snake?Flush copiously & debride (you will need appropriate sedation & analgesia)
Utilize bandaging, enclosure towels & antiseptics (change every other day & daily, respectively.)
BITES MAY RESULT IN PERMANANT SCARRING & change in scale pattern. The healing time will be similar to burns
Infectious Stomatitis → affects who? What usually accompanies this? What makes it more complicated?Under SNAKE DZs, but also affects lizards, crocs & turtles. Infected mouth means prolly anorexia, which complicates things by further debilitating the PTx. It is often accompanied by pneumonia & dermatitis
What are the CS of infectious Stomatitis?Anorexia (tongue paralysis)
Weight loss
Loose teeth
Ocular infxns
How would you treat a MILD infectious Stomatitis? (Incld meds)Provide proper environment, flush w/ trifectant or nolvasan+H2O2 & use topical ABx preparations
Is there abscessation in what is considered a moderate infectious Stomatitis? How would you treat a moderate case?No abscessation. The Tx is the same as the mild Tx, but w/ added systemic parenteral ABx. (Provide proper environment, flush w/ trifectant or nolvasan+H2O2 & use topical ABx preparations)
What is the defining factor which makes an infectious Stomatitis a severe case? How would you treat a severe case?There will be caseated abscessation in a severe case. You will need to do debridement & flushing & local installation of ABx
What are some things a lizard's tail is used for?Social signaling
Which lizards DONT have tail autonomy?Chameleons & Monitors
What proliferative bony dz in lizards can cz tail paralysis?Paget’s dz
HTRS: What is a disinfectant that you usually want to avoid in reptiles & why?Betadine, bc it can cz goiters
HTRS: If you have a lizard's tail which is necrosing at the end, how would you remove it?YOU SNAP IT OVER THE TABLE! Cutting w/ a scalpel will make it bleed. However, most lizards have tail autonomy & they are DESIGNED to snap off w/ minimal bleeding
What big dz must you look out for w/ crocodilians?WNV! Not only is it zoonotic, but it leaves pox marks on the hide & ruins it
HTRS: How many chambers does a reptilian heart have?EVERYONE HAS 3-except crocodilians, they have 4
Snake dz → infectious stomatitis: what are the CS & how do you dx?CS:
Tongue paralysis
Weight loss
SQ injxn & aspiration (also cytology, biopsy & Histopath)

Reptilian Therapeutics

Question Answer
Why are reptilians more quickly dehydrated & hypothermic?(1) Theyre ectotherms
(2) They have ↑er body surface/to body mass ratio
Why might it actually be MORE important to hospitalize a debilitated reptile rather than a mammal?Reptiles don’t heal w/o thermal & fluid supportive care
How do you assess hydration on a reptile?Skin turgor, eyes sunken, tacky m.m. & the blood work PCV, total protein, uric acid. Also be sure to measure body weight!
When calculating fluid deficit & maintenance, what is the MAXIMUM?Maximum 2-5% body weight
What are the fluid types you could give to a reptile & what should you be careful about?LRS
HOWEVER, No greater than 2.5% dextrose to give SQ, avoid if possible
What are the routes of administration for fluids for a reptile? Which is the preferred route?PO, SQ, IV, IC*, IO.... Intracelomic (IC) is most often the preferred method
In terms of fluid therapy, a sick reptile has a ↑ _________ loadLactate
Reptiles utilize anaerobic metabolism after activity & a buildup of lactic acid can result in acidema. What is crucial for a reptile to bring its lactate levels back down?TEMPERATURE!! Lactate removal is temperature dependent
What is the reptile fluid maintenance rate???10-20 ml/kg/day
What is the equipment/technique necessary for oral administration of fluids for a reptile? What benefit does oral fluids have?Speculum/mouth-gag, tubes-stainless feeding tubes, red-rubber... lubricant is useful to prevent aspiration. Why oral route? → may reduce other necessary fluid therapy
HTRS: (Compounding medication) What can you do if you have a heavy-particle medication which you want to stay in suspension for administration orally at the proper dose?Heavy drugs can be diluted in sterile water & then put some KY jelly in there, so it’ll stay in suspension!!! USEFUL!
Which reptiles can you give fluid in the Intracoelomic route? How much can you give in this area? How can you Avoid lungs/internal organs while doing this?You can use this route in ALL reptiles & you can give large amounts of fluids this way. You can avoid lungs/internal organs by tilting PTx away from injxn side & direct injxn ventrally.
When giving fluids intracelomically, how can you be sure you're in the cavity & not somewhere else?After sterile prep aspirate & upon negative pressure inject slowly
How common is SQ admin of fluid in reptiles? Where do you administer in chelonians? What should you note about iguanas?This route is NOT OFTEN used, bc there is slow absorption, limited space, non-elastic skin, variable blood flow. In chelonians you can inject in the ventral neck or in the bridge tissue (bottom edge of shell) sure to tell owners of chameleons that their skin will turn black at the injxn site
How do you perform IV admin of fluid in a reptile? Any species differences?You need a CUT DOWN through the scales/skin to access the vessel you want to use. Which vessel depends on the species? The JUGULAR is used in Snakes & chelonians (who have a short jugular) & also some lizards. The cephalic vein, on the other hand, is used in most lizards & iguanids
What are the advantages & limits to an intraosseous administration of fluids? Which species can you use this in & where?ADVANTAGES: A bone is rigid & stable area you can use when all of the peripheral vessels are collapsing on you. LIMITS: there is a limited volume of administration. The species this is best used in is lizards/crocodilians & chelonia. For lizards/crocodilians, you can use the proximal tibia, the distal femur & the humerus. In chelonia, you can use the SHELL/BRIDGE (remember the shell is bone!!)
If you need to access vessels in a snake, what is your option(s)?YOU NEED TO USE THE JUGULAR! Technically there is the tail vein, but that's a one-time deal to get blood & it's basically impossible to thread something into the tail vein
How would you access the JUGULAR in a SNAKE?You will be doing a cut-down procedure, so you will need analgesia & anesthesia! You will find the heart (you should be able to feel/see it) & move approx. 9 scales cranial to heart. The catheter size is 22-25ga.


Question Answer
Nutritional support in reptile’s → Enterals (is feeding or drug administration by the digestion process of a gastrointestinal (GI) ) what do you want to avoid? What is a good general food?You want a↓PURINE DIET, bc Purines add to uric acid avoid the A/D food. However, Eukanuba maximum calorie is a great diet she said. ↓ Protein diets!
Nutritional support → what are some things you can feed CARNIVORES? (Snakes, monitors)Eukanuba maximum calorie, Oxbow carnivore care
Nutritional support → what are some things you can feed HERBIVORES? (Tortoises)Oxbow Herbivore critical care
Nutritional support → what are some things you can feed INSECTIVORES & OMNIVORES? (Bearded Dragons, Box turtles, water turtles)Meat/veggie baby food, or Walkabout farms
What is something you MUST be careful about if you are providing nutritional support to an anorexic PTx?“Re-feeding syndrome”
“Re-feeding syndrome” → explain what happens w/ this & how you can try to prevent thisIn critically starved PTx, the animal has↓total Phosphorus & potassium. THEN, when enterals are provided, electrolytes move w/ glucose into cells-resulting hypokalemia. PREVENTION: offer 50% calories over 24 hours, repeat daily until improved. *be sure to monitor blood values
Nutritional support → what is gavage? Who do we like to use this in & who is this difficult in?Gavage = supplying a nutritional substance by means of a small plastic tube passed through the nose or mouth into the stomach. You can use this method in assisting feeding of snakes... their teeth will help guide whole prey food in once introduced. In chelonia tho, gavage is difficult at best, there is usually Pharyngostomy tube placement (tube through neck)
Nutritional support → Pharyngostomy tube placement in chelonians → how do you do this?ANESTHATIZE ANIMAL, Measure tube to pectoral scute, Approach on right side-> insert hemostats into oral cavity caudal to angle of the jaw-> skin incision made (avoid jugular)->grasp tube & pull through oral cavity->re-direct down esophagus-> secure.....then you can administer your Fluids, medications & nutrition
What Rush's favorite choice in anesthetic for putting down a chelonian for a pharyngostomy tube placement?Ketamine & Medetomidine (reversible, good relaxation).... other choices arE:
(1) Ketamine 20-40 mg/kg & Butorphanol 0.2 mg/kg & Lidocaine
(2) Telazol 10 mg/kg, Butorphanol, Lidocaine
W/ a pharyngostomy tube placement, if you aren't sure you got your placement right, what can you do? What do you do if it's plugged? What is a risk of having a P. tube in & what can you do to prevent this problem?If in doubt, RADIOGRAPHS!!! If the tube plugs, you can use meat tenderizer (Adolph’s is amazing), or coca-cola!! Having the tube in leads to a risk of Candidal /fungal colonization... you can flush tube w/ Nystatin or nolvasan to help prevent this (Random fun fact: top dressing dog food w/ Adolph’s will stop them from eating their poop!!)
If you're going to IM inject drugs, where must you do this? (In general)In the Cranial ½ of body....bc they have a renal portal system!!
Where would you IM inject a snake?Epaxial muscles parallel to spine
Where would you IM inject a lizard?Epaxial muscles parallel to spine plus limb muscles
Where would you IM inject a chelonian?Limb mms
Where would you IM inject a crocodilian? (What is a limitation in crocs w/ IM injxns in some areas?)Limb muscles, Tail based muscles (certain medications only). In crocs, Osteoderms of dorsal body wall limit use of epaxial muscles
Why might reptiles have some more problems w/ lungs & what might you be able to NEBULIZE to help w/ various lung problems?Reptiles lack diaphragm & are More prone to accumulation of debris, retained bacteria in lungs & air sacs (they cant cough & they can only form caseated inflammation). Agents you can nebulize for a reptile are ABx, saline, Terbutaline (respiratory distress), Acetylcysteine (break down of caseated discharge)
If you are going to use ABx, you need it to be a RATIONAL REASONING-need defensible reasoning. How can you make it a defensible reason?(1) Culture - Anaerobic & aerobic indicated (> 50% of reptiles anaerobic infxns)
(2) Cytology
In general, w/ drugs, how well do reptiles metabolize them & how do you handle them bc of this?Reptile metabolism is slow, drug hang around awhile...bc of this, do a conservative dose on toxic drugs
WHICH ANTHELMENTIC IS TOXIC IN SOME CHELONIAS? (Which?)Ivermectin appears toxic to some chelonia (ESP BOX TURTLES-might be safe in some Tetsudo sp
HTRS: If you see protozoa in the feces of a reptile, what are you thinking?Protozoa are part of their normal flora, so don't be concerned unless they are OVERRUN w/ it
5 anthelminthic you can use on reptiles (separate info on diff cards)Ivermectin

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