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FLUFFY VISITS THE VET Jessica Kerr and Aimee Faner. MEET FLUFFY. Why Is Fluffy Here?. Preventative Medicine Trauma Bite wounds from prey Spinal fractures Burns from improper heating/lights. Why Is Fluffy Here?. Anorexia Secondary systemic infections
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Why Is Fluffy Here? • Preventative Medicine • Trauma • Bite wounds from prey • Spinal fractures • Burns from improper heating/lights
Why Is Fluffy Here? • Anorexia • Secondary systemic infections • True rectal/colon or uterine prolapse • Dystocia • Constipation • Euthanasia
PHYSICAL EXAM Routine preventative care exam includes the following. . . . • Full physical exam • Fecal float and smear • Ectoparasite exam • Weight
PHYSICAL EXAM PROCEDURES 1. Observation • Preferably in own environment • Assess locomotion, respiration, and attitude
PHYSICAL EXAM PROCEDURES 2. Restraint • Unaggressive- Use both hands at two points to support • Aggressive- hold behind head and support body or palpate with other hand • Very aggressive or active- clear rigid walled plastic tubes with stoppers and holes in sides
PHYSICAL EXAM PROCEDURES Restraint continued • Snake hooks and nooses- use extreme caution if not experienced • DO NOT. . . . • Support by head only- dislocation or fracture and spinal cord injury • Support by tail only- degloving injury
PHYSICAL EXAM Restraint continued • Chemical restraint- safe and effective • Ketamine: 20-50 mg/kg IV or IM • Teletamine-zolazepam: 10 mg/kg IV or IM • Alfadalone acetate-alfaxalone acetate (Saffan): 6-9 mg/kg IV
PHYSICAL EXAM Restraint continued • Chemical Restraint • IV injection-ventral caudal vein, palatine vein • To revive quickly give diuretics or fluids DO NOT. . . . • Put them in the freezer!!
PHYSICAL EXAM 3. Assess Stage of Ecdysis 4. Palpate entire length except when shedding, look for ectoparasites 5. Assess nutritional status 6. Temperature- not useful • Huge range • Minimal febrile reaction
PHYSICAL EXAM 7. Open the mouth • Use rubber spatula or tongue depressor • Examine teeth • Oral mucosa • Tongue epithelial surface shedding • Tongue flicking absent = illness
PHYSICAL EXAM 8. Internal nares should be clear 9. Assess heart and lungs • Distinguish normal hissing from respiratory disease • Auscult lungs - use moist gauze to minimize skin rubbing • Heart auscultation not useful • Can palpate heart in small species
PHYSICAL EXAM 9. Heart and Lungs Continued • EKG • Place leads where limbs would be- either side of cloacal vent and midway down cervical region • 3 lead esophageal EKG probe effective (UC Davis) • Doppler echocardiogram- dorsal recumbency, also used to monitor fetal heartbeat
PHYSICAL EXAM 10. Palpate other organs 11. Opthalmologic exam- similar to mammals but mydriatics do not work in reptilian eye 12. Check vent for abnormalities • Fecal float and smear for parasites • Can massage to stimulate defecation
PHYSICAL EXAM 13. Sexing the snake • Takes practice! • Clean, lubed metal probe • caudally placed into hemipenis, inside caudal edge of cloaca • M: 6-8+ subcaudal scale lengths • F: 2-4 subcaudal scale lengths
HISTORY • 1. Age, date obtained, length of ownership • 2. Source of animal - captive bred or wild caught • 3. Species and sex • 4. Normal diet and appetite • Anorexia may just be wrong food • Trauma caused by live prey • 5. Normal waste elimination • 6. Ecdysis
HISTORY 7. Other reptiles or other pets in household 8. Recent exposure to other reptiles or new additions 9. Quarantine protocol 10. Previous illness or injury 11. Previous or current medications 12. Normal environment • Substrate • Water- type, amount, changed regularly? • Cage type and dimensions
HISTORY 12. Normal environment • Cage furniture and design • Temperature regulation • Humidity • Caged alone or with others • Frequency of cage cleaning 13. In owner’s opinion, what is the major problem and what do they think may have caused it?
“FARM CALL” If your client breeds reptiles or owns a collection of them, a visit to the colony to inspect and evaluate husbandry would be a valuable tool in addition to a history and physical exam.
EUTHANASIA • AVMA Panel on Euthanasia: No specific reptile guidelines • Pre-med for fiesty animals • Telazol 25 mg/kg IM • Ketamine HCl 100mg/kg IM • Sleepy in 15-20 min. • Give euthanasia solution ICe • DO NOT use freezing or decapitation
EUTHANASIA • Very difficult to assess death in reptiles • Cannot overdose on euthanasia solution!! • Give 3x dose if owner is taking home • Ask to keep body of animal overnight
HELPFUL HINTS 1. Do not panic!! The basics of medicine still apply. Training in small animal medicine will help with diagnosis, prognosis, and therapy. An educated guess is better than none at all. 2. Principles of animal handling still apply • Prevent injury to yourself • Prevent injury to others • Prevent injury to the snake
HELPFUL HINTS 3. Consider public health/zoonosis risk. After the examination, all personnel and equipment that came in contact with the snake should be disinfected. 4. Venomous snakes: Many areas strictly regulate possession of venomous reptiles, this includes your clinic. Also, you are liable for any injuries sustained on your property.
HELPFUL HINTS 5. A lot of our duty to our no-legged patients is to educate the owner. Know where to look up the specific environmental, nutritional, and physical parameters for each patient so you can provide the owner with correct information.
HELPFUL HINTS 6. For more information, Mader Reptile Medicine and Surgery text is an excellent reference. • How to market yourself to reptile owners • General husbandry and management • Longevity table • Sexing diagram
HELPFUL HINTS • Diagnosis, prognosis, and treatment of specific diseases • Procedures for diagnostic tests • Differential diagnoses for clinical signs • Formulary • Hematologic reference ranges and blood chemistry normals • Food preferences by species
SPECIAL THANKS • Angie Hastings • Jen Periat • Vance Kawakami
BIBLIOGRAPHY • The Exotic Companion Medicine Handbook. Johnson-Delaney, DVM • Reptile Medicine and Surgery. Mader, M.S., DVM • Reptile Clinician’s Handbook. Frye, DVM • www.anapsid.org/mainsnakes.html • http://www.vpi.com/9VPITipsAndTechs/DeterminingTheSexOfSnakes/DeterminingTheSexOfSnakes.htm