Diseases of the Digestive System

Chapter 39 Diseases of the Digestive System



SNAKES


Snakes are frequently seen in the clinic for digestive problems.



Infectious Stomatitis


Infectious stomatitis, commonly called “mouth rot,” is a frequently seen problem in captive snakes (Fig. 39-1). This is not a primary disease, but rather is usually secondary to stress, trauma, or husbandry problems such as overcrowding, low environmental temperatures, and poor nutrition. Suppression of the immune system in snakes kept in inappropriate conditions allows for opportunistic pathogens to infect the oral tissues.


image

Figure 39-1 Infectious stomatitis is a problem in all reptiles but is most commonly seen in snakes.


(From Mader DR: Reptile medicine and surgery, ed 2, St Louis, 2006, Saunders, by permission.)



CLINICAL SIGNS



• Swollen, red oral tissue

• Petechia may be present

• Changes in color of gum tissue

• Mucus, thick ropy exudates; excessive salivation

• Anorexia

• Dysphagia

• Respiratory signs if glottis is involved


DIAGNOSIS



• Physical examination and history

• Culture and sensitivity of oral mucosa

• Complete blood cell count (CBC) and serum chemistries

• Radiology of the oral cavity

• Gingival biopsy


TREATMENT



• Correct the environmental and nutritional problems

• Gentle cleansing of the oral mucosa

• Systemic antibiotics (injectable aminoglycosides are recommended)

• Surgical debridement of severe cases or those with bony involvement


Topical therapy



• Antibiotic cream: silver sulfadiazine (Silvadene) 1%, gentamicin ophthalmic

• Dilute povidone-iodine (Betadine) or chlorhexidine flushes


Supportive care



• May include tube feeding if animal is unable to eat


INFORMATION FOR CLIENTS



• Prevention of infectious stomatitis is easier than treating it.

• Treatment of infectious stomatitis may require long-term therapy.

• Viral or fungal stomatitis will not respond to antibiotic therapy. It is important that an accurate diagnosis be made before treatment is started.

• Infections in the oral cavity may quickly spread to the lungs if left untreated.


Vomiting and Regurgitation


Vomiting is defined as the forceful expulsion of food from the stomach or anterior intestine, whereas regurgitation involves bringing up food immediately after eating. It is often difficult to distinguish these conditions in the reptile patient. Regurgitation is frequently the result of handling just after eating and represents no threat to the animal unless it is frequent or aspiration pneumonia develops. Vomiting, in contrast, is frequently related to gastrointestinal (GI) disease and should be investigated.



CLINICAL SIGNS



• Vomited or regurgitated food found in the cage

• Weight loss

• +/− Diarrhea

• Signs of systemic disease


DIAGNOSIS



• Physical examination and environmental history

• CBC and serum chemistries

• Radiography +/− contrast

• Culture/sensitivity

• Fecal floatation


TREATMENT



• Depends on the problems identified

• Correct the husbandry and diet deficiencies

• Avoid handling snakes that have been fed recently

• Systemic antibiotics for bacterial infections

• Antiparasitics for GI parasites

• Surgical removal of any foreign objects or neoplasia

• Correction of fluid and electrolyte imbalances

• Metoclopramide for vomiting


INFORMATION FOR CLIENTS



• Avoid handling snakes after feeding.

• Make sure all snakes are kept under ideal environmental conditions.

• If vomiting or regurgitation occurs, have your snake examined immediately by your veterinarian.

• Never feed spoiled or tainted food. Make sure all food has been warmed to body temperature before feeding.


Diarrhea


Diarrhea may be a result of many disease states and is usually not a primary disease entity. As in the avian patient, it must first be determined whether diarrhea actually exists. Vomitus, urine, or respiratory secretions often appear similar to loose feces and are often not observed by the owner until cage cleaning. Loose stools must also be evaluated by what is normal for that species because some snakes (boas and pythons) have firm stools, whereas indigo snakes and cobras have soft stools. Normal stool of the snake will contain feces, whitish urates, and some urine as in birds.



CLINICAL SIGNS



• Loose stools found in the cage

• Weight loss

• Acute or chronic loose stools

• +/− Vomiting

• +/− Blood, fat in feces


DIAGNOSIS



• Physical examination and history

• Fecal examinations (floats and direct smears)

• Fecal cultures and sensitivities (cloacal flush or swab)

• Radiology

• CBC and serum chemistries

• Endoscopy

• Exploratory surgery with biopsies


TREATMENT



• Depends on severity and cause

• Antiparasitics

• Antibiotics if needed

• Narcotic agents to slow the bowel


Supportive therapy



• Fluid/electrolyte replacement

• Warmth


INFORMATION FOR CLIENTS



• Any change in diet may cause diarrhea. Avoid foods with high water content or abrupt dietary changes.

• Keep your snake at preferred optimal temperature zone (POTZ) and the cage environment clean to prevent bacterial contamination.

• Have frequent fecal checks performed to remove parasites.

• Wear protective gloves when cleaning the cage of an animal with diarrhea. Wash hands well after handling.


Intestinal Parasites


Almost every snake will harbor some type of internal parasite when purchased. These parasites typically have very involved life cycles that the technician should review. Captive snakes are, by nature of their habitat, exposed to a greater parasite load than snakes in the wild, creating a greater problem. These animals have higher stress levels that result in immunosuppression, again predisposing them to parasite infestation. Some of the most frequently found intestinal parasites of snakes are listed in Box 39-1. As shown in Box 39-1, parasitic infection in snakes can involve multiple organisms. Parasitized animals are unthrifty, have shorter life spans, and may act as a reservoir for human infestation.



Box 39-1 FREQUENT INTESTINAL PARASITES OF SNAKES



Protozoa



• Entamoeba invadens

• Coccidia spp.

• Cryptosporidium spp.

• Giardia spp.

• Hexamita spp.

• Trichomonas spp.


Trematodes



• Renifer spp.

• Dasymetra spp.

• Ochetosoma spp.

• Stomatrema spp.

• Pneumatophilus

• Renal flukes


Cestodes



• Crepidobothrium

• Ophiotaenia

• Bothridium

• Spirometra

• Dilepididae

• Mesocestoididae


Nematodes



• Ascarids

• Strongyloides spp.

• Rhabdias spp.

• Diaphanocephalus spp.

• Kalicephalus spp.

• Macdonaldius spp.

• Oxyurids

• Capillaria spp.

• Pentastomids


CLINICAL SIGNS



• Weight loss

• Failure to thrive

• Anorexia

• Dehydration

• +/− Diarrhea

• Blood in the feces

• +/− Vomiting or regurgitation

• +/− Anemia


DIAGNOSIS



• Fecal floatation/cloacal flush/direct smear

• Finding the adult parasite in the feces


TREATMENT



• Depends on the parasite’s life cycle
Antiparasitic drug therapy (parasites with direct life cycle)

Eliminate any indirect host

• Clean the cage on a regular basis

• Ivermectin (effective in snakes; DO NOT USE IN TURTLES)

• Feed only parasite-free prey to prevent infection


INFORMATION FOR CLIENTS



• Have all snakes examined for parasites at least yearly.

• Keep cages clean. Do not allow fecal material to accumulate.

• Feed parasite-free prey when possible.

• If using an oral wormer, you can administer it to the prey before feeding the snake (stuff the prey with oral paste or liquid wormer).

• Several of these parasites are infectious to humans. Wash your hands and wear protective gloves when cleaning the cages.


Failure to Feed


One of the most common problems reported to the veterinarian is failure to feed. Most of the time this is not a snake problem, but rather an owner problem. The new reptile owner may not know the proper diet for the snake, the proper feeding interval, the proper feeding technique, or the correct amount to feed the snake. The environmental temperature or the temperature of the food, or both, may be too low to initiate the feeding response. Snakes, like other animals, are not all alike; some prefer live prey, others dead prey. Some like to be hand-fed, and others like to be fed using tongs. Owners must get to know their snakes’ preferences before determining whether a problem exists.


Feeding live prey is not recommended because often the prey may injure the snake. Live prey should be stunned before feeding; prekilled prey is available frozen or fresh from specialty pet stores.


Snakes should not be handled for several days after feeding. Meal size varies with the species; smaller snakes require smaller prey. The timing of feedings also varies with the individual snake; certain species will eat at any time, whereas others eat only in daylight or darkness. Some eat often (usually small snakes), whereas larger animals may eat once every 2 to 3 weeks. Several species can fast for months without harm.



CLINICAL SIGNS



• Lack of feeding response when prey is provided

• Weight loss

• Signs of shedding (either before or after shedding)


DIAGNOSIS



• Physical examination and history

• CBC and serum chemistries to rule out disease

• Fecal examination to rule out parasites


TREATMENT



• Adjust environmental temperature and photoperiod

• Try alternative prey (live/dead, rodents/avian, etc.)

• Consult herpetologist for information concerning feeding the specific type of snake

• Vitamin supplementation

• Forced feeding


INFORMATION FOR CLIENTS



• Snakes can undergo prolonged periods without feeding. If there are no other signs of disease, it may be normal for them not to feed.

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Aug 31, 2016 | Posted by in GENERAL | Comments Off on Diseases of the Digestive System

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