Vet Information

I started at the Long Sutton Veterinary Practice in September 2004 and appointments to see me there regarding veterinary problems with your reptiles can be made by ringing the number given below. Appointments are generally Monday to Friday 9-12, 2-3.30pm and then 4.30-6.30 but this does alter day to day. I am generally not free to give advise over the phone so please read the veterinary information on snake problems below and consult your local vet if you are not able to bring you animal to see me.

LONG SUTTON VETERINARY PRACTICE
2B WEST STREET, LONG SUTTON,
SPALDING, LINCS. PE12 9BN
TELEPHONE NUMBER: 01406 365683

Snake Husbandry & Disease

General

Temperature and its importance

Probably the most fundamental thing in keeping snakes is temperature and its control and yet is so overlooked as a possible problem. When purchasing your new reptile it is important that you know the temperature your specific reptile should be kept at. As you will probably understand by now, you are trying to give the reptile a thermal gradient in which it can regulate its own temperature by moving to a warmer or colder end of the cage as necessary. Thus it is important to put the heat mat or other heat source at the same end as the light. Then using the thermostat, regulate heat production so as to keep within the parameters for that species. Because there is a hot end, a cold end, day and night etc., there are 4 basic parameters of which the first is generally the most important.

1)NIGHT TIME LOW (NTL) - this is the temperature at the coldest part of the cage, i.e. furthest from the heat source, after the light has been out for some time and the room temperature has dropped to its night time temperature.

2)NIGHT TIME HIGH (NTH) - less important and not that relevant to most commonly kept spp. Usually found on the heat mat directly.

3)DAY TIME HIGH (DTH) - this means how hot it is on the heat mat under the light when the central heating is on etc. Measure on an especially hot day for maximums.

4)DAY TIME LOW (DTL) - can the reptile get away from this DTH to cool off if necessary?

The most common misconception is to say that an animal needs say 80°F and to measure the temperature on the heat mat and say that's 82°F so that's fine. Temperatures for animal maintenance should always specify which parameter they relate to and secondly more than one figure is usually needed to establish the correct conditions, e.g. a DTH and NTL.

When setting up a vivarium for a reptile, temperature needs to be measured at many points in the cage when in situ, and over at least 24h. It is vitally important to have at least one accurate thermometer. Some species are very sensitive to the correct temperature and this is especially important in boas and pythons (see section:Colubrids vs boids), which will quickly perish if not kept within their parameters. Other species such as most temperate colubrids will often show that they are not being kept at the correct temperatures by having poor appetite, poor growth, persistent infections etc. Just because one reptile out of say a pair is showing the above does not mean it cannot be a temperature problem. Some animals habits alter its susceptibility to temperature problems, i.e. one may sleep at the hot end etc.
Below is a range of temperatures relating to the specific species which you have. These are always somewhat contentious in that all individuals are different and people may maintain their animals outwith these figures, but it is best to stick to the ones below.

All temperatures are in ° F.
Species for which these guidelines relate:

Advised NTL - Advised DTH - Advised DTL - Other Parameters

Boas

100

80-85

N/A

Colubrids*

N/A

* These apply for corns and most kingsnakes but there is variety between say Indonesian colubrids where the winters are far less harsh compared to American species. There are also several mountain species that will tolerate far lower temperatures generally.

Colubrid Feeding Cycles

This is basically about colubrid snakes, but also applies to several species of boids, e.g. royals etc. The idea is that temperate species of snake have a specific cycle of feeding and breeding in the wild and although we often suppress that to some extent in captivity, it still causes problems for some pet owners. The basics of this is that in the autumn, stimulated by falling daylight and temperatures, the snakes tend to go off their food, their metabolism shows and they become more torpid. This is the inner stimulus in the body for the initiation of ovulation in the females and sperm maturation in the males. When spring arrives and temperatures increase, some animals start feeding again and others just become more active on their fat reserves. This is the mating time and can last for a few months, often culminating in egg laying.

The relevance of the above to the pet keeper is that many snakes even kept in set-ups where there are no obvious temperature changes, will often over the winter go off their food. This is often the cause of great alarm to many novice keepers as some of these animals may not feed for several months! To either suppress this or limit its length, try maintaining long lightbulb light hours and put up the temperatures just as things outside are beginning to cool. But often once initiated though, these animals will not feed until early summer no matter what you try. To be honest it is only a natural part of the cycle and so as long as the owner is happy with this situation, temperature cycling the snake presents little problems.

Boids vs Colubrid Snakes
There are fundamental differences between temperate species of colubrid such as the widely kept American ratsnakes and commonly kept species of boas and pythons. These differences relate to the boids being relatively intolerant to temperature fluctuation and particularly NTLs. For instance a corn given a temperature gradient that went down to 65 F at night will show no ill effect, thermoregulating by moving to the hotter areas when too cold. In the same gradient, most boids will become inappetant and may develop respiratory infections and other similar problems. This occurs despite the fact that they could seek out hotter areas within the cage but seem incapable of the degree of positional thermoregulation exhibited by the colubrid. For this reason it is often necessary to employ more elaborate heating and regulatory mechanisms when setting up a vivarium for a boid, thus cutting down these gradients. Every year animals in cages set up over the summer start to become excessively cold and this precipitates problems. Check your temperatures, especially NTL, regularly and keep thermal gradients small in boas/pythons.

Diseases

Egg Binding(Dystocia)

This is where all or part of a clutch of eggs are retained by the snake after the time at which they would naturally have been laid and is a relatively common problem. The two factors most commonly linked with the problem are; A) breeding of undersize and underage females. This is probably related to it being their first litter as well. B)Infertility- eggs which have not been fertilized(slugs) have a different shell consistency which means they slide along the tract less readily making them more prone to retention.

Difficulty sometimes arises as to knowing exactly when a clutch is deemed to be overdue ie when to intervene. Often one or two eggs are passed and the rest retained and this obviously makes it an easy decision. In some species egg laying routinely occurs at set stages post-final shed eg in Burmese Pythons it occurs 25-35d post-shed. Other species may present more of a dilemma and experience is the only way of making that kind of decision.

There are four things that can be done depending on the circumstances;

A) Gentle manipulation with lubrication can often be useful in expelling one or two retained eggs especially if they are relatively close to the cloaca. Be careful not to injure the snake or rupture eggs in the process .

B) Oxytocin - The use of the drug oxytocin , possibly in combination with calcium injections, can sometimes be useful in initiating oviduct contractions resulting in egg laying (re)commencing. However unlike with other species such as tortoises, this is usually only successful when initiated within a relatively short time of the eggs being due. For this reason, best effects are seen in the cases that lay a partial clutch and treatment is given soon afterwards.

C) Surgery - If both 'a' and 'b' don't work then it is necessary to remove the egg(s) surgically. This is done through a single flank incision just above the ventral scales. Assuming the metabolic imbalances are not too bad and the snake pulls through the operation, the incisions usually heal rapidly post-operatively. Thus if the animal was in reasonable body condition preoperatively, then the prognosis is in these cases is good. The formation of adhesions post-op. will definitely increase the risk of dystocia in subsequent years but many do lay successfully.

D) Aspiration- In cases where the snake is deemed to be too weak to undergo surgery, then it is often possible using a large gauge needle, to puncture the eggs and draw the contents out through the body wall. In these cases egg yolk is relatively reactive when released inside the oviduct and thus adhesions are inevitable especially with retained egg membranes. This technique will often allow the snake to recover and start eating and improving in body condition. The decision can then be made as to weather surgery to remove the membranes at a later date is indicated. Many of these animals die as they are too weak and fluids, antibiotics and lots of TLC are needed to initiate recovery.

Respiratory Infections

Snakes and particularly boids seem relatively prone to respiratory problems in the captive environment. It can not be overstated how many of these cases are directly related to poor temperature control and even in cases where other factors seem to be prominent in the differential list of causes most are exacerbated or initiated by poor temperature control.

CAUSES
These are multiple including worms etc but the most important are;
Poor temperature control - See the section on temperature maintenance and boids vs colubrids. Be sure that temperatures fall within the criteria laid down in that section.

Bacterial infections - These fall into two groups:i) Bacteria overgrowth of otherwise relatively passive commonly isolated species due to debility and poor immune status of the snake.Temps! ii) Pathogenic species of bacteria. The most commonly implicated species is pseudomonas and this species can be particularly difficult to eliminate from the respiratory tract membranes.

Viral and Mycoplasmal infections - these are usually only found in wild caught animals and can be broken down into two groups on the potential for spread and pathogenesis. The more mild ones are of relatively low pathogenicity but become chronic problems. This is seen in some snakes that seem to come down with respiratory infections when stressed or cooled. These infections usually clear on antibiotics and resurrection of appropriate temperatures but remain latent in that snake and are prone to recurrence eg paramyxovirus infections (see more below under CNS problems). Others are highly pathogenic and once an animal has such infection they rarely improve on any medication. This form is often highly infectious and will often spread by aerosol droplets within a collection. (See Burmese infection section). Animals with respiratory infections that fail to respond to antibiotics and are not captive bred by yourself should be suspected of having some form of viral infection. Immediate isolation is very important.

TREATMENTS
This usually takes the form of isolation and an appropriate antibiotic regime. Standardly though I usually start treatment with one of three different injectable drugs and then swab if the animal does not fully recover from the problem after the antibiotic regime. Treatment in respiratory infections is unfortunately often relatively unsuccessful as antibiotics in general seem to attain poor concentrations in the respiratory tract and there are no treatments for viral causes. Respiratory problems are made worse in snakes because of the lack of ability to clear the lungs of thick mucus secretions. This is due to a lack of cilia and no diaphragm giving them the ability to 'sneeze'. I have seen many cases where the snake can even seem to be recovering but then suddenly thrash about unable to breathe and die acutely of asphyxia. It often takes many weeks for lung mucus to be removed and many continue to bring up thick strands of mucus for some time even after the causal organism has been eliminated. Persistence in treatment and keeping the snake that little bit hotter are the key to clearing such infections completely.

A newer method of treatment is to use nebulization of antibiotics such as Amikin, Fortum or marbocyl. In this case the antibiotic is made in to a fine mist of very small particles using a nebulizer and this is infused in to the snakes caging area several times a day. The small particles are then inhaled directly in to the snakes lungs. This seems to work well in some cases although I have only used it in combination with injections as I am still to be convinced it is as good as injections. Certainly less toxic but as effective?

Burmese Python Respiratory Syndrome
This has most commonly seen in the Python molurus spp but probably only because this was the first species that was bred on a large commercial scale. I have seen it transfer to Papuans and to common boas within collections. This particular problem is primarily viral in origin (probably a paramyxovirus) and the problem is that it usually only presents in a relatively mild carrier state in some animals. It was probably first brought in from the US in about 1993/4 with the large influx of Burmese colour morphs from one of the large breeders keeping multiple adults. People started reporting that although there were no symptoms with the animals before hand (many had had the animals for up to 2 years previously), on cooling for breeding in the Autumn the animals developed a bubbly nasal discharge. Bad cases can get throat swellings primarily of pseudomonas but most just get clear respiratory nasal discharge. This would only clear with antibiotics and heat over several weeks. Swabs often rendered a variety of different bacterial pathogens, most notably pseudomonas which would be difficult if not impossible to eliminate. Keys to the disease were: i) the relationship between cooling/breeding stress etc and the onset of symptoms. ii) the combination of underlying viral aetiology being made much worse by secondary pseudomonas infections iii) the mixing of animals from different backgrounds in the same cage.

This disease is now practically endemic to all older (say pre-2000) Burmese in the UK. In the 90’s this resulted in a huge drop in the number of successful breedings of the species relative to the pre-disease days and most of these are private individuals with only a pair of animals rather than breeders with multiple animals. Younger animals are much less likely to carry the disease now as many of the older animals have died off over time.

The important points to remember are; a) If all you want is a pet then buy a single animal, preferably a hatchling. Always keep it warm and there should be few problems. b) If your long term intent is breeding, it is best to buy a pair of hatchlings and grow them up separately until matting. c) If you have adults already, always maintain them separately (as I would suggest with all boids for multiple reasons!) only mixing for short periods to allow matting. d) Be sure to avoid any significant cooling (Burmese will breed without any significant temperature changes anyway!) and treat promptly with antibiotics if any symptoms occur ie do not allow mild symptoms to go untreated for any significant time as although the animal may not look too bad, respiratory mucus is building up! e) Try not to buy adult animals of unknown origin and most importantly don’t mix these with existing stock.

There is, and has been for some time, talk of a vaccine, but this seems of little use once acquired and the best treatment is prevention using the points outlined above. Remember that burmese, as with all other species, can get more straight foreword infections as well!! The best regime of antibiotics for treating any chronic boid respiratory problems is probably Amikacin (best vs pseudomonas) in combination with Baytril or Marbocyl (kill mycoplasmas). {See later drug list}

Mouth Rot

This is a relatively common condition and again often relates to poor temperature control, but is often associated with gingival trauma. In mild cases the snake may continue to eat, but seem to show mouth irritation and often fails closing the mouth fully. In moderate cases, the ginigiva can be seen to be infected with caseous pussy material which often extends onto the palate. In severe cases all the membranes of the mouth become affected with ulceration, erythema, and large pus accumulations which may 'eat' into the ginigiva over the teeth and palate. Mild forms can in theory be treated with good husbandry such as washing out the mouth and applying tamodine or a similar disinfectant. Moderate cases usually clear relatively easily on a course of appropriate antibiotics either orally (polyfax) or systemically and raised stable environmental temperatures. The antibiotic most widely used in these cases is Baytril as it can be given safely and relatively effectively daily by the oral route. Severe cases need systemic injectable antibiotics and due to the high proportion of these problems caused by relatively resistant pseudomonas the drug of choice is amikacin every three days. Failure of an initial problem to improve would then precipitate a bacteriology swab and more appropriate antibiotics. It is also worth swabbing for Candida as this fungal infection can often secondarily invade the damaged mucosa and be difficult to shift.

Treatment is rarely unsuccessful bar i) cases involving very small hatchlings where injecting the better antibiotics can be difficult due to the dilution affect. ii) in thin animals that fail to eat so as to improve their nutrient levels and help with the repair process iii) wild caught or cross contaminated animals where even after persistent antibiotics we have to conclude that perhaps there is viral involvement here?

Cloacal prolapse

This occurs in two forms depending on exactly what's actually prolapsing out. This can be hemipenes in males or a complete lower bowel prolapse.

HEMIPENE Prolpase - this usually occurs over the matting period but can also occur when heat stressed. It is the result of the hemipene being unable to retract into the cloaca after inversion and is usually the result of inflammation caused by trauma or substrate attachment. Once swollen it will not retract and becomes swollen still further. The most important thing in these cases to keep the organ moist so it does not dry out and clean so as to avoid infection. The organ can often be lubricated and gently replaced within the cloaca. The snake may need an anaesthetic to achieve this successfully. Any cuts can be sutured before replacement. If the organ is severely compromised or can not be put back then it is best surgically removed. These animals can and do still breed successfully with the remaining hemipene.

BOWEL Prolapse - this is usually seen in one of three forms i) A very weak usually inappetant animal in which cases it probably relates to the breakdown of connective tissue holding the bowel in place. ii) Very easily stressed animals such as baby chondropythons and iii) Due to straining to pass excessively hard faecal material. In any case the problem is similar to the above in that it needs to be replaced asap and kept damp and clean in the meantime. Replacing it is usually relatively easy but it often comes back out again relatively soon afterwards. In these cases one of three methods can be used; i)The use of regularly replaced micropore around the vent to maintain pressure. This method works well in small animals such as the chondropython cases ii) The placement of a purse string suture around the cloaca to decrease the aperture. iii) Surgery (in larger animals) to attach the lower bowel to the body wall internally.

Regurgitation/Inappetance/Wasting Problems

This is commonly seen in snakes and occurs for a number of reasons. Most are a defence mechanism against problems associated with the presence of the food.

Temperature extremes - if a snake is taken either too hot or too cold it will usually vomits its recently ingested food. This is a defence mechanism as in both cases excessive toxins would potentially build up in the bowel. NB. Some tropical species of snake are unable to tolerate temperature gradients ie if presented with a hot end and a cold end they are not used to having to seek out heat to aid the digestive process. This is especially common in Red-tailed boas but can occur in any Boid taken from a stable hot environment with little heat gradient and put into a 'colubrid style' temperature gradient set-up.

Bacterial overgrowth - If a snake is exposed to temperatures colder than its used to it will often get bacterial flora overgrowth. This is especially common in boids where animals are maintained as though they were a colubrid ie on too large a temperature gradient or too low a NTL. In these cases the animals will often seem relatively keen to feed and yet will regurgitate it again 24-48h later. This is debilitating longterm and must be corrected initially by providing more stable temperatures often in conjunction with a single dose of the antibiotic 'Flagyl' to kill off the excessive gut flora. (Read the section under temperature on Boids vs colubrids!)

Protozoa - these are most commonly flagylate protozoa that infect the gut and cause poor digestion initially and often then results in regurgitation. These organisms destroy the bowel wall when allowed to become chronic and cause death in combination with secondary bacterial growth, bowel toxin absorption and uncorrected dehydration. Treatment is relatively easy in the early stages with 'Flagyl s-suspension' on a three dose weekly regime(at 100mg/kg), but can prove very difficult if the bowel wall has been irreversibly damaged as in chronics. Treatment in bad cases often requires antibiotic cover to kill the other bacteria and fluids to correct the dehydration. Animals never die of flagylates directly but they do die of these secondary problems if they are overlooked!!. [NB.protozoa are easily spread within a collection and attention should always be focused on good hygiene.] Cryptosporidial infection (see later section for more details) can start with vomiting before progressing to inappetance and body swelling)

Worms and Viruses - these are together as although a definite differential in a wild caught animal are relatively rare in captive bred snakes. Worms are usually easily treated with either Panacur or Ivermectin. Viruses are usually only diagnosed by exclusion of other reasonable causes or when the vomiting occurs in combination with other symptoms such as BIBD and Paramyxovirus usually also manifests with CNS signs(See below)

Too large a food item - some species can for their relative size manage to eat proportionately very large prey items. In some cases this is relatively normal and the item will be digested normally eg. baby burmese pythons. Other species will often eat this other items but then be unable to fully digest the prey and thus regurgitate it(small red-tailed boas). This is often more common where animals are kept in racking systems and not allowed to bask to their optimal temperatures for maximum digestive activity.

Stress - Some animals that are very nervous will often regurgitate their food if hassled in the first couple of days post-eating. These animals are usually always going to be like this and you learn which ones to leave in peace. Some people say that you should never handle your snake for a few days after feeding. This is very rarely a problem in a CB common species such as corns etc, but may be true of nervous species eg. Timor Pythons.

Seasonality - see back to the section on colubrid feeding cycles. This is a very common problem in colubrids over the colder winter months.

TREATMENTS usually involves ruling out the more common causes such as those related to temperature. After this we would usually advocate the use of Flagyl-s-suspension, possibly in combination with antibiotics as a relatively all-in compassing treatment for many of the above conditions. This clears the bowel of most flora and allows recolonisation. Cases that fail to respond to this warrant swabbing where less common problems such as Cryptosporidium, Candida, resistant bacterial and viral problems may be implicated in the cause.

Nervous System Disturbance

There are many things that can affect the nervous system of snakes but here are a few of the more commonly seen causes. Treatment if usually unsuccessful depending on the initial cause;

Septicaemia - bacterial meningitis like problems usually only occur in debilitated animals often in the presence of untreated concurrent sepsis. Prompt antibiotics and fluids may help if caught early.

Protozoal encephalitis - the symptoms this causes are often termed star gazing. This usually only occurs when animals are kept in poor conditions or exposed to/contaminated by wild caught animals. Very large doses of flagyl-s-suspention are indicated probably in conjunction with corticosteroids, antibiotics and fluids. Unfortunately these cases rarely improve although I have occasionally seen some do so and certainly

Viral encephalitis - there may be other viruses capable of causing CNS disturbance but the ones of largest concern are the virus that causes Boid Inclusion Body Disease (BIBD) and the Snake Paramyxoviris (OPMV)

i) Paramyxoviral Disease – This is caused by an RNA virus named Ophidian Paramyxovirus (OPMV). It is fairly widespread in all snake species. Clinical signs include anorexia, regurgitation, head tremors, "star gazing," and respiratory difficulty. Clinical signs may last up to 10 weeks before the animal succumbs. Animals may ultimately die of secondary bacterial diseases. Antibiotics and supportive care are warranted as much as anything because it may not be OPMV. Diagnosis is made from the history (recent exposure to non-quarantined animals), hemagglutination-inhibition antibody titre, and histopathology and electron microscopy. The virus is very difficult to isolate from a live snake so definitive antemortem (before death) diagnosis is not possible. When this disease is suspected, strict isolation and quarantine protocols must be adhered to. New animals should be quarantined for at least 90 days before being exposed to other animals in the collection.

ii) Inclusion Body Disease (BIBD) - Also known as IBD, this disease appears limited to the boid family (boas and pythons). The causative agent appears to be another RNA virus belonging to the Retrovirus group. Clinical signs include regurgitation, head tremors, ataxia, and inco-ordination. As a rule, boas tend to regurgitate and the pythons display tremors, disorientation, and appear flaccid. There is no treatment and diagnosis is made upon histological and transmission electron microscopical examination of the brain, spinal cord, liver, pancreas, and kidney after the snake dies. Affected snakes have eosinophilic intracytoplasmic inclusion bodies in the cells of the above mentioned tissues. As with several of these viruses a pronounced neutrophilia is seen on blood samples taken from the live snake but this is not definitive for an IBD diagnosis. IBD is a serious disease and quarantine, disinfection, and isolation should be used judiciously to prevent its spread.

Chemical exposure - this can occur in snakes exposed to any chemical but is especially common with organophosphates such as those used to kill flies, ticks and mites. Atropine is the drug of choice in such cases and if administered early in the process may bring about regression of the clinic signs.

Heat Stress - this causes a specific encephalitis usually preceded by periods of mouth breathing and excessive activity as a means of trying to get away from the heat source. This can occur when ambient temperatures are over 40C. Most cases do improve with time on cooling.

Others such as tumours, endotoxins or physical trauma(this has to be relatively severe to cause CNS damage).

Body Thickenings

This very broad heading is to cover five conditions that may present with similar clinical findings, notably inappetance with a mid body swelling, in an often otherwise bright animal. The six conditions are;

Kidney Sloughing
This condition is, as far as I know, unique to snakes, certainly as far as higher species are concerned. It occurs when a snake kidney is damaged for some reason. This kidney dysfunction is somehow sensed by the snake which is able spontaneous slough and pass the affected kidney. The mechanism by which this is achieved in unknown and the occurrence is unusual, most suspected cases turning out to be other problems. Most of these cases will eventually fully slough the affected kidney and in most cases the snake appears to function perfectly happily on the remaining kidney. The condition will present either as i) swollen damaged kidney in situ ii) a swelling which moves over time down the body and is eventually passed or iii) the sudden passage of a whole kidney. These presentations obviously represent different stages in the same process, the passage and early swelling being more noticeable in colubrids vs boas.

Cryptosporidium
This is a Zoonotic* protozoa that is most often picked up from wild animals such as wild caught snakes/lizards cross contaminating CB colubrids, or most commonly from the wild rodent population contaminating and thus infecting propagated CB rodent colonies used to feed the snakes. Once infected the organism colonises the gut wall causing a thickening and a decrease in the acid producing capacity (and thus reduced digestive ability) of the stomach. An infected snake will often seem bright bar it will start to regurgitate food items at regular intervals. Over time this will be followed by inappetance and weight loss. A combination of the weight loss and the stomach wall thickening will cause the mid body swelling to become more obvious until it can be obviously seen on general observation. These masses are often akin to the mass that would occur if the snake had just eaten, even though it has not. Treatment is in theory possible with high doses of Trimethoprim-sulphonamides but in most cases seems to be unsuccessful at completely eliminating the bacteria. Thus if diagnosed, careful consideration regarding future hygiene considerations vs zoonotic risk have to be weighed up and usually pets are best euthanased once the condition is confirmed
NB. A similar condition can be caused by Salmonella infiltrating the bowel wall in a similar manor and these too can be difficult to eliminate even with antibiotics to which the Salmonella is sensitive in vitro.
(*Zoonosis means that it can cause harm to people as well, in this case resulting in diarrhoea & sickness)

Ovulation or ovum retention
Female snakes are sometimes bought to the surgery as they are either in the process of ovulating or they have only produced a small number of eggs that present as a mass rather than as the full body of eggs. Both cases are obviously only going to happen in females but can be difficult in isolation to diagnose especially when a small number of eggs is involved and where an animal is eating, making distinguishing between faecal material and eggs very difficult. See back to section on dystocia for more details.

We have also seen several cases where ovulation has not gone according to plan and the ovaries become grossly enlarged due either to tumour or cyst formation. These females gradually loose weight and the mass becomes more obvious as a more discrete mass than would be found in normal gravid individuals. A similar case is where the products of ovulation become toxic, caused a rapid endotoxaemic dehydration & weight loss later in ‘pregnancy’.

Abscess

These can either be cutaneous ie outside external to the rib cage or internal ie within the body cavity. Large internal abscesses are most commonly found in the liver where they seed out of the blood from other points. Most snakes with internal abscesses are very dull and sore and treatment is very difficult even with surgery and good antibiotics. External abscesses need removal by surgical means as the use of systemic antibiotics alone seems never to fully halt the problem due to the inspisated nature of the pus and the difficulty with antibiotic penetration into such masses.

Bowel Penetration
These usually present at post mortem or soon will in that they invariably seem to die. In this case, penetration of the bowel wall causes infection to seed out into the body cavity. This causes a large inflammatory response and an area of inflammation and body swelling. The cause of the penetration seems unclear but is often linked to feeding colubrids at suboptimal temperatures. These animals are usually in severe distress and are seriously unwell. Prompt antibiotic therapy and coelomic lavage is indicated, but unless quickly diagnosed and promptly treated such cases die of septicaemia and shock.

Gout
Kidney insufficiency causes the body to retain urates which form crystal deposits in the body. We have seen these crystals localised to specific organs such as the heart and liver or more widespread throughout the body cavity. The exterior 'lump' formed obviously depends on which organs is affected but can be particularly marked in the heart with a 'tennis' ball like body swelling or very much larger and longer when affecting the liver.

A common presentation in some young large breed Python species is heart enlargement due to gout in the cardiac tissues. This causes a cardiomyopathy which can appear to come on quickly and rapidly kills the snake. I have seen this in Olive, Carpet and Macklots pythons usually in animals 1-2 years old where the animal has been overfed and kept at excessively high temperatures. A combination of the high metabolism, excessive protein intake and the dehydration conspiring to cause the problem. Rapid rehydration and treatment of the gout has resolved the cardiomyopathy in a couple of cases but I haven’t followed either through to see if the snake’s heart became normal again with time and growth.

Other Body lumps

There are several other conditions in which a mass can appear within the skin of the snake. These masses are outside of the body cavity and appear under the skin in a distinguishably different way to the above conditions. There are many causes but a few are listed here;

i) Oedema - these can be secondary to an obstruction such as egg retention, or due to primary kidney dysfunction.

ii) Cysts - These can be primary iatrogenic or they can be caused by the encysting of migrating parasites. Either way drainage of the cyst and organisms is often curative. In multiple cases in wild caught animals it is sensible to treat with a wormer.

iii) Tumours - The most common being the Lipoma (harmless soft fatty mass) but they can be more serious and spread throughout the body in the more traditional cancer manor such as fibrosarcoma.

iv) Ectoparasitic bite reactions - this is an inflammatory reaction to a bite by a tick (or less commonly mite) which causes either an immune reaction or a slight bacterial infection and body reaction.

v) Microchips - be sure that the animal has not been identichipped using an implanted transponder which can migrate from the original implantation site. If you were unaware that a snake was chipped then it may present as an unknown mass.

vi) Yolk Sac Abscess - this is where young hatchlings develop a firm abdominal mass below the umbilicus initially, but which may move down into the lower parts of the body. This firm mass obstructs the body cavity and with time the little snake becomes toxic and dies. It is the result of infection entering through the umbilical ends after birth and seeding out into the rich medium of yolk in the sac. Treatment is best achieved by early recognition and instigation of antibiotics but rarely are they presented until the mass is much worse than this. At this time extensive surgery is required to remove the mass in its entirety. This should be worthwhile attempting especially if the animal is still bright & non-toxic, but is extensive surgery and in a dull toxic neonate is rarely successful.

Obesity

This is an all too common problem in snakes, especially unbred females. Longterm, the accumulation of excessive fats in the body tissues and especially organs is very detrimental and will lead to premature death. It occurs due to several factors;

a) Excessive feeding ie both volume & frequency

b) General lack of activity and the rich nature of the foods

c) Lack of cyclic activity in terms of providing the snake with year round heat and nearly year round eating. Most snake species would naturally have a period of several months when feeding at least slows or stops altogether.

d) No breeding activity. In the males of most species the activity of matting/trying to mate not only burns calories but is usually accompanied by inappetance, their minds being on other things. The process of ovum formation and carrying those to laying or birth is a very energy consuming process and is also usually accompanied by at best limited, if any, eating.

Treatment
This is a slow process and basically relies upon reversing the causes as laid out above. Thus the usual process is to either i) give a winter cooling of 3-4 months without food at all. This is a natural thing to happen and during this time the animal will tend to be at cooler winter temperatures associated with natural cycling patterns. ii) a ‘summer’ of reduced feeding volume and frequency. It is important that during the summer months some solids be given ie do not reduce down to pinks or similar as they have little solids and over a long time this will cause the bowel to become dysfunctional. Reduction to a small mouse or rat given every 2-3 weeks is better.

The process is a slow one. Mammals burn fat to provide mostly warmth and as the snakes do not do this, the rate at which they use this stored fat is often slow. In addition, snakes used to being fed very regularly will become hungry and more temperamental during this diet. This is an unfortunate problem, but must be endured for the long term health of the snake.

Thermal Burns

These are all too common in reptiles and yet completely avoidable. They can be divided into two groups:
Contact burns: By this we mean that the surface itself is that hot that it burns immediately on contact. Within the confines of a vivarium this is usually caused by heaters such as ceramic heaters.

Prolonged burns: These occur in snakes because of two factors i) The vivarium is too cold and thus the animal is sitting directly on the heater trying to get heat but failing to raise its overall core temperature, it is however gently 'cooking' its underside. ii) The heat is very localised to a particular area ie a small heat mat, hot rock etc. This very local heat again fails to raise the snakes core temperature but does burn the area in direct contact with the heater.

Treatment in these cases involves i) initially treated for infection using antibiotics. Too many of these animals die of septicaemia even when the burns themselves initially look relatively minor. Thus always at least initially use antibiotics. ii) Cleaning the wound - personally I like a small paint brush and the use of an Iodine based disinfectant painted on to the lesion daily. In these cases the animal is best kept relatively dry and on a 'clean' substrate such as newspaper. The cleaning must continue until the lesion is completely dry and has stopped producing tissue fluid. iii) Gently aiding with shedding over the affected areas and once shed and restarting the cleaning process again until it is once again dry. iv) It is important to keep the snake at the higher end of its thermal range and on a good nutritional plane to speed recovery.

NB. The time it takes to heal is relative to the number of sheds. Burns look very much better after the second shed post-trauma and are usually completely healed by the 4th/5th shed. It is also vitally important that the cause of the problem be identified and rectified.

Slough Failure

This is when old skin is retained attached to the underlying new skin after the animal has incompletely shed in the correct manor. Depending on several factors this can be more or less significant, most notably the location of the retained slough and the species involved.

As a general rule, the dryer the habitat the species usually inhabits, the less the consequences of skin retention. e.g. a Royal python may naturally have very dry periods of the year where complete skin sloughing may naturally be unlikely and this skin may not come off until wetter months of the year. Other species such as Rainbow Boas and Blood Pythons are very sensitive to retained slough and may become inappetant due to its presence.

Retained eye caps - this is a relatively common place for snakes to retain a small are of skin. This is common in the Royal python where it is usually of little consequence, but may need removal through soaking if it occurs in more sensitive species. The decision as to whether to intervene or not depends on the time that has elapsed since the skin should have been shed, but basically if the snake is bright and eating well then leave them on until the next shed cycle.

Body skin retention - this is more likely to cause the snake discomfort and result in inappetance. Many cases can be soaked for several hours and at least partial relief achieved by gently pulling at the slough and getting as much of it off as possible.

Tail tip skin retention - this is the potentially one of the worst places to have skin retained as the snake may not realise it has been retained and thus show no signs of having a problem. However, as the skin dries it contracts and constricts the tail base decreasing blood flow and effectively killing the cells. The tail tip then becomes necrotic and is prone to infection which can spread up the tail into what was undamaged tissue. At best the area of tail damaged by the constriction will usually have to be surgically removed and this may have to be more extensive if infection is spreading up the tail.

Causes : In most cases, failure to slough correctly in the first place can be attributed to one of the following causes. In all cases the cause needs to be ascertained so as to prevent it happening again. This never 'just happens' and always occurs due to an underlying cause.

i) An animal in very poor health will often fail to produce the normal oils and fluids between the old and new layers of skin. This results in them failing to separate during the sloughing process.

ii) An excessively dry environment: This is by far the most common cause in that an environment that is dryer than that species ideally requires will manifest in skin retention.

iii) Inadequate water provision: Large desert species are usually tolerant of dry conditions but do rely on body fluid reserves or ingestion of fluids in the days leading up to shedding. If inadequate water is available this process may not be completed.

iv) In animals that have not eaten for some time the body becomes vitamin deficient. The two most important vitamins are Vitamin A (involved in skin reproduction) and Vitamin C (involved in the laying down of binding connective tissue within the body). Lack of these basic nutrients either in say double clutching female snakes or hatchlings that prove difficult to get feeding initially, can lead to skin retention and in the case of Vitamin C a much more serious condition where the skin becomes fragile and tears easily. Such tears need repairing using tissue glue and the condition treating using vitamin injections or a more appropriate feeding regime.

Reasons for poor appetite/failure to grow in snakes

This is obviously a broad topic and encompasses many things. This section attempts address some of the potential causes so as they can be eliminated. Many of the causes are less serious cases of processes described under the vomiting/wasting section.

Just inherently a 'poor eater' - this is probably the most common cause most owners attribute to their animal not thriving. It is however very unusual for an animal to have such a defect if born at a normal size and weight. Most snakes that survive the process of being born or hatching are normal in themselves and tend to acquire problems due to the other reasons given below.

Inadequate progression of food size - all too often small snakes are fed on an inadequate food size because we attribute human food volume values to them i.e. that looks huge in comparison to the snake. This is somewhat dependent on the species for instance a baby red-tail boa is very sensitive to food size where as a baby royal will eat comparatively huge pray soon after hatching.

Low Temperatures - by this we mean temperatures that fall within the range that the snake can cope i.e. it is not too cold to cause respiratory infections or regurgitation but the temperatures are somewhat low. This is usually associated with inadequate basking provision i.e. the vivarium may be warm enough for the animal to live in generally but there is no provision for the animal to bask and aid the digestive process etc. These temperature problems cause poor growth by a number of ways; i) depresses appetite directly ii) Decreased digestive capacity - this relies on heat to activate enzymes etc. Less digestion means that less of the 'goodness' of what has been eaten is taken in by the snake. iii) Allows for overgrowth of normal gut flora due to immunosuppressive effect - indirectly causes the snake to eat less keenly and to digest the food it does eat less proficiently

Bowel pathogens - it may be that a snake, even one that has been in someone's possession for a long time, may harbour pathogens i.e. bugs that shouldn't really be there. These include protozoa and many harmful bacterial species. These may either be pathogenic enough to cause major clinical disease (see section on vomiting) but may also only cause chronic malabsorption and poor growth/appetite. Examples would be some salmonella infections, E.coli and Coccidial infections.

Organ disease/failure - This is obviously much more common in an animal that is of unknown origin or where wild caught as an adult i.e. we don't know the age of the specimen. Likewise it is very unlikely in a captive bred juvenile or any young animal of known origin.

Investigation: Ensure food size and temperatures are optimized or are unlikely to be involved. The next step is to take a faecal sample for analysis or give a short course of antibiotics/flagyl to clear out the current bowel flora and see if after re-establishing it the condition improves.

Common Garter Snake Problems

Whilst garters are obviously subject to many of the conditions outlined in the other veterinary sections, they are generally seen with one of the following three problems:

i) Poor temperature control: Whilst it is true that Garters do not have exacting temperature requirements, so people take this too far and do not provide enough heating, have too much fluctuation or overheat their garters. Most of these problems stem from inadequate advice at purchase, where many small pet shops seem to consider they do not need thermostatically controlled heating, but instead choose to rely on either uncontrolled heat sources or room heat. This can often lead to a multitude of subsequent illnesses most of which are a result of a depressed immune system. Please make sure that you keep your garters at suitable temperatures as outlined in the section on Colubrid species.

ii) Neuropathies: This particular condition is all too common and is almost exclusively caused by thiamine deficiency. This deficiency can manifest as in-coordination and minor muscle tremors but more commonly on presentation these have progressed to the more severe circling, body contortions and complete blindness. This problem could be seen in other species for the same reasons but is usually almost exclusive to Garters because frozen fish is low in Thiamine (Vit.B1) and high in thiaminases (enzymes that break down B1). Thiamine is an essential vitamin for the snake and without it the nerve cells degenerate and over time deficiency causes severe, often irreparable neurological damage. The problem can be easily avoided with the feeding of a suitable varied diet (one not more than 50% fish based i.e. feed them pinkies!) or more commonly the feeding of a proprietary brand of 'Garter Grub', which is a frozen food designed for garters which has a suitable amount of additional vitamins and minerals. Alternatively, the addition to any diet of a suitable vitamin supplement such as Reptisol or BSP drops which can be administered orally weekly if they put the garter off eating its normal foods.
In minor cases that appear to be loosing their sight but are still eating, this change to the regime may be enough to reverse the clinical problems in a week or so. However in many cases and certainly those with more severe clinical manifestations need to be injected with a B-vitamin injection and then given the oral drops every 4-5 days until clinical signs regress. If caught early there can be complete remission within 2-3 weeks, but in many long standing cases the animal at best improve and stop twitching but many remain blind. Euthanasia is the only option for cases that fail to respond at all.

iii) Gastroenteritis: This is usually the result of temperature fluctuations, the feeding of contaminated or decomposed foods. This can sometimes be seen when a garter fails to find his food for some time and the food partially decomposes with bacteria causing toxins to build up on it. All uneaten foods should be removed from the cage or the Garter may consume this at some later stage. The toxins it ingests at this stage can all to frequently kill these little animals or at least give them severe diarrhoea. Unfortunately because of the smelly watery nature of even normal stools and the intermittent feeding patterns of some healthy adults, gastroenteritis can be difficult to identify until late on and many cases are not taken to the vets until them are weak and dehydrated. At this stage fluids and antibiotics is the treatment of choice and if the snake makes it through the first 48h of treatment, most will pull through. Please remember than many old Garters may still have been wild caught and thus can be carriers of diseases that are far less likely in captive bred stock such as Salmonella and Campylobacter (See previous sections on Zoonosis). These diseases are not only of Zoonotic concern, but can also lead to disease in the Garter which will require similar treatment to that indicated above.

Hibernating Snakes and the Problems this Causes

This refers most importantly to boids but also to a large extent to some colubrids. In the US this process is often referred to as brumation, but basically we are talking about the same process.

In the wild many of the snakes commonly kept by herpetologists are exposed to a winter cooling period. During this time temperatures often become too cold in which to eat and digest food well and many of these snake species hide away during these cold periods to preserve what energy levels they can. This is a very stressful time for the snake metabolically in that many of the animals with concurrent disease or sub optimal fat reserves will not make it through these winter periods to the warmer months when food & heat is more readily attained. This is a natural 'dying' off process and probably accounts for a large percentage of the mortality rate of baby snakes, many not making it through their first winter. This cooling process is important in terms of the cycling activity of many of these snakes such that on heating the remaining animals will often mate and go on to produce next years babies. It has been speculated in many species and I see no reason why the same should not hold true for snakes, that very cold winters produce and even higher urge to produce offspring in the spring. Whilst not a conscious thought, this is an adaptation to replace the numbers that would be assumed to have perished over the harsh winter i.e. more babies are needed to replace the greater numbers of snakes lost in the preceding harsh winter.

I captivity we generally aim to produce near ideal temperatures and husbandry regimes such that the snakes have the best possibility of thriving and the maximum number will make it through to adulthood and breeding age. Taking the snakes outside of these optimal temperatures lowers their metabolism, which makes them unable to fight infection in the normal manor. In a healthy animal with good fat reserves and a competent immune system, this should mean only slight lowering of resistance and is likely to be of little consequence. Having said that, some snakes with low fat reserves, animals stressed from having been wild caught etc. are likely to have a very reduced capacity to fight off infection. In cases where infection is present, these snakes are prone to septicaemia, mouth rot, meningitis, abscesses, enteritis and all manor of other bacterial and viral problems that otherwise the snake was keeping in check. For this reason you have to weigh up the pros and cons of cooling. By this I mean that if you are attempting to breed the snakes, then there is no doubt the chances of being successful are greatly increased by cooling the snakes to temperatures well outside what would be considered optimal husbandry temperatures. Thus you are endangering the health of the adults for the increased chances of babies. This is fair enough and is a decision that every keeper must take, but there is no indications to take say a single non-breeding pet snake to these extremes, as breeding is not involved at all. Similarly, why take an baby snake to cold temperatures at all and always realise that cooling a snake that is not in really good health even when it was hot, is only generating problems of your own making!

Whilst within the context of this general section it is impossible to give exact temperatures for each species of snake (more can be found in individual species sections) in general I would say that most boas and python species require a DTH >95F a DTL of 80-85F and a NTL of 75-85F. In this context allowing say your common boa to fall to 65F at night is taking it well outside what I would recommend in terms of optimal husbandry, but might well be employed as part of a breeding program.

Disease
As stated earlier these are usually bacterial in nature but can also have viral or fungal aetiology. There are several common presentations;

i) Septicaemia: the animal becomes blotchy in that it has petaechial haemorrhages under both the skin and in the mouth. These animals range from normal in nature to those involving the nervous system becoming limp or throwing themselves about the cage. Many of these cases may bite themselves on the flanks and are often found dead still in that position.

ii) Meningitis: This is closely linked with septicaemia and is often the end result of that. It can however occur on it¹s own and usually presents as a limp snake with poor muscle tone, little righting reflex and these are often seen mouth breathing.

iii) Abscesses: these can be localised to one particular area such as the cloaca or rostral nose or can be more generalised with skin lumps appearing anywhere on the body. All require both local surgical excision and antibiotics as described in the specific section on abscesses.

iv) Mouth Rot: again this is described elsewhere, but is perhaps one of the easiest to treat in terms of access via the mouth.

v) Respiratory Infections: These can range from a few bubbles to abscessation. See other section on this topic.
Disease can occur in a single animal from a group, but can involve multiple snakes where the pathogens present are nasty enough or the cooling very excessive. Even some of the most successful breeders can have problems with certain groups of snakes and this can involve multiple deaths. These same breeders may have cooled the same snakes in a similar manner the previous year and have no problems; it just happens that the specific conditions are right for problems this year. In many cases when these lesions are swabbed for bacteriology, the finding are bugs that are found in healthy snakes as well and the only reason they have become a problem here is the snakes inability to cope with them due to the conditions.

Many people say "oh, it couldn't be the temperatures or they'd all have it" and this is just a misunderstanding of the problem. Clinical disease is usually sporadic and it is the cooling that has made the disease process possible.

Treatment
The most obvious thing is to stop breeding efforts and increase the temperatures back up to the high end of the normal range for that species. This will reactivate the snake's immune system to help fight the infection. The only problem here is that this process often takes several days in which time the snake is likely to remain susceptible to infections. In addition to this the vet will start the snake on an antibiotic course. In most cases this will be a Fluoroquinalone such as Baytril/Marbocyl/Ciproxin etc. or a cephalosporin such as Fortum.
Should there be time bacteriology on available material may prove useful, but often by the time the results are known the snake is either getting better or has died. Outcome depends on how delicate and important the primary organ system involved is. Mouth rot cases are usually easily treated. Abscesses can take some time and even then have the tendency to flare up again at later dates. Septicaemia needs treating rapidly and if you can get through the first 48 hours of antibiotics & heat then most will survive. Many however may not survive, often dying of cardiac involvement. Cases involving the nervous system rarely if ever improve and death is usually rapid.

Prevention
Well this is easy as far as pets go i.e. don't cool them, it is much more difficult where breeding is an intention. All you can do is make sure that only snakes in optimal condition are chosen for breeding and that both during the cooling and in the few days after being warmed, all such animals are checked regularly for signs of disease. If at all concerned about an individual's health, then isolate and warm it up. In this case, if normality is restored, you could always re-cool it and let it rejoin the breeding group.

In addition, on presentation, many keepers with such problems say that they are not entirely sure how cold it does get in the coldest point of the vivarium in the depths of the night. This is then an obvious point: always make sure you know accurately, just how cold your vivarium is in the middle of the night by using a max-min digital thermometer.

REPTILE DRUG DOSAGES

All antibiotics and most of the drugs listed below are classified as POM drugs and thus your vet will need to see your snake before giving out any such products. Please note that this list is supplied on this site for general information but it will be down to the individual vet to prescribe what they feel is best for an individual condition.

Drug	Trade Name	Dose	Extra
Antibiotics
Amikacin*	Amikin	5mg/kg SC initial dose then perhaps reduce to 2.5mg/kg	Less Toxic than other members of the same group, but still refrain from use in dehydrated animals or in conjunction with fluid therapy.
Amoxycillin	Several brands	10mg/kg SC sid	Not very effective in reptiles!
Ampicillin	Several brands	20mg/kg SC sid	Not very effective in reptiles!
Cephalexin	Ceporex	20mg/kg SC etd	Thick suspension difficult to inject.
Ceftiofur*	Exocenel RTU	10mg/kg etd	Good in large animals where small volume very useful. Can be use in combination with amikin?
Ceftazidime*	Fortum	20-25mg/kg IM etd	Great stuff. Very little toxicity.
Ciprofloxacin*	Ciproxin	10mg/kg IC eod	Good especially if small animal
Chloramphenicol	Chloromycetin	30mg/kg IM sid	Bit outdated bar GIT infections
Danofloxacin	Advocin	5mg/kg SC eod	Alternative to baytril
Doxycycline	Vibramycin	1mg/kg PO sid	Some resistant RNS
Enrofloxacin*	Baytril	10mg/kg SC PO eod	Most commonly used reptile antibiotic. Can get nasty reaction at inj. site.
Fluorphenicol	Nuflor	50mg/kg SC sid	RNS?
Gentamicin	Pangram	2.5mg/kg IM etd	Older cheaper alternative to amikin
Marbofloxacin*	Marbocyl	7.5mg/kg SC eod	10% does blister skin like 10% Baytril does.
Neomycin	Neobiotic	20mg/kg PO sid	Toxic by injection! Can use orally.
Oxytetracycline	Terramycin LA	20mg/kg IM etd	Not much use in snakes
Piperacillin	Pipril vials	100mg/kg eod IM	Use as alternative to other drugs
Ticarcillin*	Timentin	100mg/kg sid IM	Safe alternative for pseudomonas
Tylosin	Tylan	5mg/kg IM sid	Not really used much nowadays!
Wormers
Fenbendazole	Panacur	50-100mg/kg PO weekly	Best general wormer
Ivermectin	Panomec SA	200mcg/kg(0.2mg!) IM Rpt in 14d	Kills roundworm and mites
Levamisole	Levicide	10mg/kg SC.Rpt 14d?	Kills flukes & lungworm
Oxfendazole		68mg/kg PO	Oral anti-roundworm
Praziquantel	Droncit injectable	6mg/kg(0.1ml/kg) IM	Kills tapeworms
Ectoparasiticides
Fipronil	Frontline	Spray every 7 days	Avoid eye contact and wet conditions.
Ivomec (Sprayed on)	Oramec drench	Spray with 1 in 100 dilution eod	Safer than frontline in wet conditions.
Ivomec(by Inj)	Panomec	200mcg/kg SC IM (This equates to 0.02mls/kg)	Easy to give to large snakes Difficult to dose in smaller animals
Other Products
Metronidazole	Flagyl-s-suspension	100-200mg/kg PO weekly	Kills protozoal & anaerobic bacterial infections. Care in Kingsnakes.
Nystatin	Nystan	100,000iu/kg PO eod x4	Oral antifungal for GIT Candida
Ketaconazole		30mg/kg PO sid	Systemic anti-fungal
Calcium	Calcium borogluconate 20%	1-2ml/kg SC IC sid	Repeat as neceesary to solve hypocalcaemic crisis, then reduce to PO.
Dexamethasone	Azium	0.2mg/kg IM etd	Anti-inflammatory. Use in CNS disturbance.
Fluid Therapy	Saline or Hartmans	10-25ml/kg IC sid	Use higher dosages in very dehydrated animals

* these are the best snake antibiotics.

SID=given once daily
BID=given twice daily
EOD=given every other day
ETD=given every third day
PO=given orally
SC=given subcutaneously by injection
IM=given intramuscularly by injection
IC=given intercelomically by injection

Vet Information

Quick Links

Snake Husbandry & Disease

Temperature and its importance

Egg Binding(Dystocia)

Abscess

Other Body lumps