Common Diseases of Snakes

What can cause increased activity in a a snake?

Excessively high temps

Lack of hiding spaces

Derm irritation from mites

Light cycle disruption

What can cause lethargy in snakes?

Non-specific illness

Low temperature

Digestion

Dyscedysis (I think)

Ecdysis

What can cause soaking behaviors in snakes?

Ectoparasites

Dehydration

How can you assess their cardiovascular system?

Mucosal membrane perfusion

Dopplers for HR

How can you assess a murmur in a snake?

Not possible with a doppler

How can you do a GI assessment?

Oral exam

Coelomic palpation (not possible if large, need CT)

Cloacal exam

Fecal exam

How do do an ocular assessment?

Ophthalmoscopic exam (no eyelids with a specticle instead)

Conjuncitval exam

How do you do a derm exam?

Need to look under the scales

What is the #1 reason for a snake to come in?

Ophionyssus natricis (snake mites)

How do you transmit Ophionyssus natricis?

Unsanitary conditions and lack of quarantine

What is the life cycle for Ophionyssus natricis?

Egg: hatch in 1-4 days after deposition

Larvae: molt 1-2 days after emergence w/o feeding

Protonymph: 3-14 days aggressive feeding stage

Deutonymph: Up to 31 days, molts into adults when conditions are ideal

Adult: Up to 90 days and females take 4-8 days to engorge and lay eggs (20-30 at a time)

What do you do if a client asks how mites could be present even if they are not vissible?

Protonymphs of Ophionyssus natricis aggressively feed and are microscopic

What are the feeding stages of Ophionyssus natricis?

Protonymph and adult

What is the best way to prevent stagnant hot air and allow for a cold side and hot side?

Have a fan from cold side to warm side and out of the enclosure to ensure a good heat gradient 

What are the feeding stages of Ophionyssus natricis?

Protonymph and adult

What are the C/S of acariasis?

Restlessness, excessive soaking, rubbing behavior (pruritus), excessive shedding, dehydration, anemia, retained spectacles, visible mites

What types of anemia can you get with acariasis?

Blood loss and anemia of chronic disease

Where are mites usually located with acariasis?

Around eyes, cloaca, sometimes chin folds

If you see white and powdery dermatologic debris, what do you suspect?

It is probably mite dust and the snake has ascariasis

How do you definitively dx acariasis?

Direct visualization of mites or from enclosure samples

How do you treat acariasis?

Need to ride out life cycle on snake and treat the environment

Can do warm baths with dilute iodine and permethrin

What should you do to prevent acariasis outbreaks in an enclosure?

3 month quarantine (that is life cycle of the mite)

How do you clean the environment for acariasis?

Must be at least 122F or 75C (boil water and then use that) cages, shelves, and lids should be cleaned weekly

T/F dysecdysis is a primary disease?

False, secondary symptoms

What are the etiologies of dysecdysis?

Low humidity (skin is not flexible), dehydration, hypoproteinemia, malnutrition

Ectoparasites, fungal dermatopathies

Lack of appropriate cage substrate to dislodge skin

How do snakes shed?

Secrete lymph between the outer layer and new skin to lift off old skin

how does dehydration cause dysecdysis?

The snake cannot produce enough lymph to lift off the old skin

What predisposes snakes to fungal dermatopathies?

High humidity

What is the problem with rack housing systems?

Can not provide enough substrate for snake to rub off the old skin

What can incomplete shedding present as?

Constriction bands around tail leading to ischemia or necrosis

Retained spectacles

Generalized retained skin

If a snake has dull, opaque eyes what is the likely cause?

Retained spectacles, can be uni or bilateral

How do you diagnose dysecdysis?

PE and history of concurrent disease and poor husbandry

How do you treat dysecdysis?

Increase humidity and offer warm 90-95F soaks

Correct underlying dehydration, nutritional deficit, or parasitism

What should be avoided when treating dysecdysis?

Forceful removal or excessively moist environments

What is the risk of physical removal of shed?

Can cause fibrosis and scaring leading to permanent difficulty shedding

How are spectacles made?

Eyelids fuse over the eye and then become transclucent

What are the 3 main etiologies of retained spectacles?

Environmental and husbandry

Systemic and nutritional

Parasitic or traumatic causes

What are environmental and husbandry causes of retained spectacles?

Low humidity prevents complete shedding with areas of retention

Dehydration

Inadequate cage conditions

How can systemic or nutritional problems cause retained spectacles?

Poor nutritional or hypovitaminosis A

Thyroid dysfunction (theoretical)

Secondary skin disease

How can parasites or trauma cause retained spectacles?

Mite infestation

Scarring from prior trauma like prey injuries or mite infestations

How do you treat retained spectacles?

Rehydration by soaking eye with warm damp cotton swabs and rub medial and lateral canthi towards center

Apply ophthalmic lubricants 3x daily for 3 days

What should be avoided when treating retained spectacles?

Forceps as improper removal can strip the new spectacle, damage cornea, and lead to blindness

What should you do if removal of retained spectacles fails?

Allow snake to undergo another shed and reevaluate while correcting husbandry deficiencies

What is stomatitis or mouth rot?

Inflammatory and infectious condition of oral tissues that can extend beyond the oral cavity causing cellulitis, sinusitis, osteomyelitis, and airway obstruction

What are predisposing factors to stomatitis?

Poor husbandry, vitamin A deficiency, trauma from pry bites or striking glass in enclosure, stress/immunosuppression, oral deformity from metabolic bone disease

What bacteria typically cause stomatitis?

Usually opportunistic flora like Pseudomonas, Aeromonas, Klebsiella, Proteus

Can be gram positive anaerobes from prey species occasionally 

What are the fungal causes of stomatitis?

Candida and Aspergillus

What are the viral causes of stomatitis?

Nidovirus in ball pythons

What is a rare cause of stomatitis?

Parasitic due to embolism of the oral vessels and cause tissue necrosis

What are the C/S of stomatitis?

Perioral or intraoral swelling or mucosal ulceration

Excessive salivation

Inability to close mouth / lip margin distortion

Hyperemia, petechiation, and mucosal plaques

Reluctance to eat

Glossitis or lingual necrosis

What is a poor prognosis of stomatitis?

When the tongue is necrotic, might need euthanasia

Glossitis can also cause upper airway obstruction

How do you treat stomatitis?

Supportive care and husbandry correction

Local and surgical therapy

Systemic medical therapy

What are your surgical options to treat stomatitis?

Debride necrotic or caseous tissue

Extract loos or diseased teeth

Marsupialize deep abscess tracts

Flush affected areas with dilute chlorhex

Medicinal honey to cavities or fistulas

How do you systemically tx stomatitis?

Broad spectrum antibiotics based on cytology and gram stain (FLORFENICOL, TULATHROMYCIN, or CEFTIOFUR are common)

Meloxicam SQ

Antifungals or antivirals based on biopsy

What is the prognosis for stomatitis?

Good with early detection and correction of husbandry deficits

Guarded to poor once osteomyelitis is detected or if nidovirus is confirmed

Recurrence is common

How do you prevent stomatitis?

Good husbandry

Provide vitamin supplementation

Avoid feeding live prey

Biosecurity

What is the etiology of snake Cryptosporidiosis?

Cryptosporidium serpentis or RARELY varanii but does not cause clinical disease

How is Cryptosporidiosis transmitted?

Fecal-oral, direct contact with infected animals, or contaminated fomites

T/F Cryptosporidiosis is zoontoic?

False

What should you do if you have a positive Cryptosporidium spp. test?

Differentiate the species because serpentis requires euthanasia of everyone nearby and varanii does not cause clinical disease

What are predisposing factors for Cryptosporidioisis?

Overcrowding, poor sanitation, environmental stress

What are particularly predisposed to cryptosporidiosis?

Viperidae (rattle snakes) and amelanotic colubrids

What are the clinical findings of crypto in snakes?

Chronic regurg or vomiting after feeding

Midbody swelling

Anorexia, weight loss, and lethargy

How long is Crypto in snakes?

Can be months to years

What are your ddx of crypto?

Inappropriate temperature or prey size

GI stasis

Parasitic or bacterial gastroenteritis

Neoplasia

Hibernation associated necrotizing gastroenteritis

How do you dx crypto in snakes?

Fecal or gastric testing

Imaging: thickened gastric rugal folds

Endoscopy: inflamed hypertrophic gastric mucosa and to get biopsy

Histo: definitive, gastric mucosal hyperplasia with surface bound crypto organisms

How can you fecal or gastric test for crypto?

Direct wet smear or centrifugation then PCR, IFA

Serial sampling increases detection sensitivity

What is more reliable than fecal testing for crypto?

Gastric lavage with 20mL/kg

How do you definitively dx crypto?

Histopathology with Gastric mucosal hyperplasia with surface bound crypto organisms

What is shrader’s preferred way to dx crypto?

Endoscopy with biopsy then histo for definitive dx

Need to collect several areas for biopsy

How do you tx Crypto in snakes?

No way to tx, must depopulate

How do you prevent crypto in snakes?

Good biosecurity and isolation

What supportive care can be given to snakes with crypto, but is not ideal?

Optimize husbandry, reduce stress and provide small, easily digestible meals

What new drug can reduce organism number and reduce shedding but will NOT clear crypto in snakes?

Paromomycin

What is the prognosis for crypto?

Grave, always chronic and fatal and snakes will remain chronic subclinical shedders

How do you disinfect crypto in snakes?

5% ammonia, 10% formalin, or 3% peroxide for 18 hours at 4 degrees C

Moist heat at 45-60C for 10 minutes

Removal of all organic materials

DO NOT HOUSE MULTIPLE SNAKE SPECIES TOGETHER

What are some common behavioral problems in snakes clients will ask you about?

Inappropriate striking behavior

Psychological behaviors from habitat quality

Animal-human bond

What can cause inappropriate striking?

Feeding snakes by hand or in the same container they are housed in

What are some psychological behaviors due to poor habitat quality?

Cage surfing (wiping chin on everything)

Hiding all the time or lethargy

Star gazing or opisthotonos

How big should an enclosure be to prevent psychological stress?

Tanks where the snake can be in a straight line comfortably 

What can overhandling a snake do?

It can cause lots of stress, even if owners think that the snake loves them