Guidelines for Medicating Sick Herps
Margaret A. Wissman DVM DABVP and Bill Parsons, Reptiles 5(3):84-85
When a reptile or amphibian becomes ill, it is vital to seek veterinary care as soon as possible with a vet experienced in treating herps. However, there may be times when it is impossible to have your animal examined and treated immediately. Until you can get your herp looked at by a vet, there are certain things that you can do to support it short-term. Also, after your herp has been examined, there are techniques that can help your animals recover more quickly. Let's go over some general guidelines that can aid you in helping your sick herps to recover.
As a rule, sick herps require additional heat. It is preferable to keep an ill herp at the high end of its Preferred Optimal Temperature Zone (POTZ). This will vary from species to species, but Preferred Optimal Temperature Zones are published in several sources, including Dr. Douglas Mader's Reptile Medicine and Surgery text (W.B. Saunders, 6277 Sea Harbor Dr., Orlando, FL 32887). An increase in temperature will help stimulate the immune system. There must be a thermal gradient in the environment to prevent heat stress, however. Basking lights should be provided for species that spend time basking daily.
Stress should be minimized. This includes maintaining natural light cycles. It is important to provide normal light and dark periods. Sick herps should not be handled any more than is absolutely necessary. It is preferable to keep a sick reptile or amphibian isolated in a separate cage. This will prevent the spread of disease and competition for food, and will prevent the sick critter from being stepped on, scratched or otherwise injured by cagemates.
Hydration is an extremely important consideration for sick reptiles. Hospitalized herps may receive intraosseous (into the bone) fluids, intracoelomic (into the abdominal body cavity) fluids, or subcutaneous (under the skin) fluids. At home, oral fluids may be given by syringe, by tube feeding or by soaking the herp in appropriate fluids. Reptiles may be soaked in water, flavored sports drinks, infant rehydrating electrolyte solution (Pedialyte), or even fruit juice. I recommend soaking a sick reptile in warm fluid daily. The reptile must be watched closely while being soaked to ensure that it does not drown. If the herp is so ill that it cannot hold its head up, soaking is not an option, since the possibility of drowning is a real threat.
Nutrition is also very important. However, animals should usually be rehydrated before attempting to force-feed them. Only attempt nutritional support when you are directed by your herp veterinarian. There are several methods of delivering nutrition to a sick herp. To boost the nutrition of food items, they may be "spiked" with nutritional supplements. For example, vitamins may be injected into a dead mouse to be fed to a snake or monitor. Calcium tablets may be placed into the body cavity of a dead food item. Thiamine can be supplemented by injecting this vitamin into a fish prior to offering it as food.
Sick herps may require force feeding. I recommend that this only be performed as directed by your veterinarian. Force feeding may be accomplished by prying open the mouth of the animal, and gently placing the food item into the oral cavity. This may also be accomplished by passing a benefit from daily cleaning and flushing of the mouth and soft rubber feeding tube or a rigid stainless steel tube into syringe, forcing a slurry of nutrients through the tube and into the esophagus or stomach. Care must be taken to not damage the mucus membranes lining the mouth. It is very difficult to get the food into the windpipe of most herps, since it is usually quite small in comparison to the esophagus, but it is possible to cause aspiration of fluids into the lungs if large quantities of fluid are introduced into the mouth.
Some herps may require sedation to be able to force feed them. Turtles and tortoises, even near death, are often quite difficult to force feed without sedation, since prying the mouth open is usually a real struggle. Other herps, including green iguanas, may readily accept a gruel out of a syringe. A dead mouse, spiked with nutrients and covered with a touch water-soluble lubricating jelly, may be slid down the throat of a snake. It's a good idea to remove sharp toenails and incisors of the prey items to ensure that the herp is not injured during force feeding.
In some cases, a herp veterinarian may surgically place a tube into the esophagus or stomach of a sick herp to facilitate feeding. These are called pharyngostomy tubes or gastrostomy tubes, and they may be kept in place for a period of time to support nutrition until the reptile improves.
It is always best to follow the recommendations of your herp vet regarding the feeding of ill reptiles.
Only administer medications as prescribed by your veterinarian. If you start using leftover medications from other animals, it is possible to cause more harm than good. Some medications can be dangerous in dehydrated herps. It is possible to overdose herps, as well, since the dose may differ between species. Finally, by administering medications prior to having your herp properly diagnosed, it may be impossible for your vet to make an accurate diagnosis. This is because antibiotics will prevent accurate bacterial culture results, and will confound the sensitivity portion of the test. Also, indiscriminate antibiotic use may lead to bacterial resistance. If antibiotics are not given at the correct dosage, interval and for the correct length of time, then the infection will be improperly treated, the bacteria may become resistant to that antibiotic, or the bacterial infection may recur.
Injections should always be given in the front two-thirds or of the herp, unless directed otherwise by your veterinarian. Often, medications are administered by injection, and a competent herper (who isn't squeamish) may be shown how to give the injections at home. Why the front section? This is because of the renal-portal system that herps possess. This is type of circulation whereby any medications injected in he back half of a herp may be absorbed and go directly rough the kidneys before entering the general circulation. Some drugs may be nephrotoxic (causing kidney damage), and if concentrated, some may injure the kidneys. Drugs ay also be excreted by the kidneys without ever reaching therapeutic levels in the body, as well. So, as a general rule, is safer to avoid injections in the back end of a herp.
Herps with mouth infections (infectious stomatitis) may benefit from daily cleaning and flushing of the mouth and gums with hydrogen peroxide (make sure the herp doesn't the mouth, and then, using a swallow any), diluted povidone iodine solution or diluted - chlorhexadine solution. Cotton-tipped applicators can be used to gently swab the teeth and gums. Mouth infections should always be evaluated by a herp vet.
Herps with serious respiratory infections and pneumonia may benefit from nebulization therapy. With nebulization, the antibiotic is diluted in sterile saline and then reduced to microscopic particles that can be inhaled deeply into the lungs, delivering the antibiotic to the site of infection. Some vets rent or loan out nebulizers for home treatment, others prefer to nebulize in the clinic. For owners with large collections, it may be worthwhile to purchase a nebulizer for treating herps. This should only be done when advised to do of so by your herp vet. Used nebulizers are sometimes sold for less than $ 100 from human respiratory therapy companies. I know that I have saved some seriously ill herps by using a nebulizer as part of their therapeutic regime. Nebulizers are very different from humidifiers, as the particles vaporized with humidifiers or vaporizers are much larger and unable to reach the lower respiratory tract.
Sick herps may benefit from the administration of supplemental vitamins and minerals. I often treat sick herps with an injection of vitamin A, which is necessary for the normal functioning of the lining of the respiratory system, eyes and the lining of the gastrointestinal tract. An injection of B complex vitamins may help stimulate appetite. Herps that are egg-bound may benefit from an injection of a calcium solution. These injections should only be administered by herp veterinarians, or under their direction.
Illness in herps may be caused by several factors that gang up on them. For example, the herp may be housed in a cage with the wrong temperature gradient, the husbandry may be poor (such as the cage not being cleaned properly and frequently) and there may be a parasite load building up. Having your vet periodically perform fecals to check for intestinal worms or protozoa is wise preventative medicine. If the herp is not defecating (and therefore a fecal cannot be run), it may be beneficial to prophylactically deworm a sick herp. In some cases, a stomach wash or cloacae wash may be performed to examine for parasites. Using a safe and efficacious dewormer may be a good idea. Herps that are not defecating may do so once they have been soaked repeatedly and have become rehydrated. Stool softeners, which are available over the counter in many pharmacies, may be administered as directed by your herp veterinarian.
This information is in no way meant to replace veterinary medical care, but to offer some suggestions and additional information to reptile owners. Often, in the excitement and confusion of an office exam, it is easy to forget the specific instructions that your Yet has given. Most herp vets supply discharge instructions so that herp owners have written instructions for how to properly treat their animals once they take them home. The more information that you have, the better able you will be to properly treat and support your reptile or amphibian so that it can completely recover.
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