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Sick snake - any last minute advice?

5rings Apr 07, 2009 08:47 PM

I have an adult female Borneo that has developed a nasty, nasty respiratory infection. I moved her to a slightly drier and warmer cage with better circulation. She seemed to worsen the next day so off to the vet we go! I get three rounds of Baytril injections spaced three days apart. We keep her warm and well ventilated. I give her a spot lamp to bask and make sure she is well hydrated. By the third injection she is looking and sounding better, so I took my eye off of her for a few days and now she can barely breath. She is coughing and spitting up mucous in big chunks. I've cleaned out her nasal passages but it is in her lungs now.

I have never lost a snake to RI and I damn sure dont want to start now. Have any of you, or your vets, been able to fix a snake in such dire circumstances? At this point it is probably viral and has her lungs filled. Baytril is of course useless on a virus and the virus was probably a secondary infection to the original RI. She was healthy as a horse a couple of weeks ago. I have gotten plenty of snakes through this, but I've never had one with such thick mucous in her airways.

Tomorrow I am taking her to another vet about 40 miles away, but he is somewhat better with reptiles than the local guy.

Got any advice at this point?
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Steve Frist

www.serpentinelogic.com

Replies (7)

Rich_Crowley Apr 07, 2009 09:39 PM

One word: culture. Baytril does not treat everything. In fact, far less than many believe. I have great success with Fortaz or Amikacin, but you have to treat the infection with the correct meds. Summarily treating with Baytril is like giving aspirin to someone who has a sore finger. It might dull the symptoms, but it won't cure it. Most all the infections I have seen in snakes are sensitive to Amikacin though some more resilient bugs are popping up.

Good luck!
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Sarge2004 Apr 07, 2009 11:23 PM

In treating a RI I always increase the temp and humidity but do keep the cage very clean. Less humidity causes a snake with a RI to have more difficulty breathing. Bill
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...three years ago it was just another snake cult...
The Retic is King.
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5rings Apr 08, 2009 06:54 AM

Rich

Amakacin is very dangerous at high levels and would/could be used in last ditch efforts. It is sort of like Vancomyacin and generally pulled from the holster as the last resort. I would agree it or Vancomyacin is probably the choice at this time. Baytril is a good broad spectrum antibiotic with relatively low risk levels to adult snakes and I suspect that is why it is prescribed first.

A word on cultures. Culturing a respiratory tract is an odd thing. Sort of like getting a swab for strep throat. Streptococcus of various types are always present.They just aren't at pathogenic levels. I am always amazed when a strep throat culture comes back negative.

It has been estimated that 72% of the time antibiotics are prescribed by doctors for viral infections. Bacterial flora may be out of whack as a result of the virus, but the root cause is indeed a virus. This is well published data. I don't know how it applies to snakes however.

Sarge, I keep her humid enough to keep her from drying out but I dont spray her cage or anything like that. I have also soaked her every few days in a bath, which she loves and it seems to help her breath. Dry snakes are a bad thing, wet snakes are worse. With sick snakes the humidity balance and good air circulation is the key. I always keep my cages spotless. Just my opinion.

Well, I'm off for an hour drive to my "real" herp vet. That will teach me to use the guy down the street. I'll ask about Amakacin or Vancomyacin. He has always been pretty well on top of things
so we'll see. Keep your fingers crossed.
-----
Steve Frist

www.serpentinelogic.com

Kelly_Haller Apr 08, 2009 12:27 PM

On the humidity issue, I have been maintaining bloods for decades and firmly believe that it is difficult to get the humidity too high for these guys if the cage is maintained in a clean condition and has fair ventilation. The number one cause of RI in bloods is not low temperatures, but sub-optimal humidity. Temps can be in the perfect range, and RI can still be an issue if the humidity is maintained too low. The best way to aggravate an RI with a blood python is to drop the humidity. A blood with an RI should be kept in a cage humidity of at least 75 to 80% until the RI has been resolved.

The issues with Baytril are two fold. First, while the spectrum of bacterial activity is fairly broad, there are other antibiotics that have wider spectrums of activity and that are just as safe. Second, and Rich touched on this, the wide spread use of Baytril has caused a fair number of resistant bacterial strains to develop, and it is no longer as effective as it once was. Baytril is cheap, easy to obtain for Vets, and easy to use and with a fair spectrum of activity, and that is why it is usually administered first. Most of the really effective antibiotics used on pythons are human drugs, and most Vets do not stock them. Amikacin, while a toxic antibiotic, can be used successfully with the blood python group if the dosages are cut in half from the standard 2.5 mg/kg dosage that is usually used with most python species. It has a good spectrum of activity, and is effective against the really difficult strains of bacteria that are resistant to most other antibiotics. Rich also mentioned Fortaz (ceftazidime) which is a really good cephalosporin class antibiotic. Another cephalosporin that is really effective, and not used much, is Rocephin (ceftriaxone). I have seen it resolve really severe RI’s in pythons. Cephalonsporins are not nearly as toxic as the aminoglycosides like amikacin, but care still needs to be taken to not administer too much in one dose, or over too short of a time period. Cipro (ciprofloxacin) is another great antibiotic for RI and I have seen it work quite well also. It has a wide spectrum of activity, is extremely safe and I have never seen toxicity with it in a python, even when higher dosages were given.

I agree that a viral infection is untreatable with antibiotics, however, if you are seeing thick opaque mucous, then you have a bacterial infection. Even if the problem was initiated by a virus, the secondary bacterial infection is the problem, and that can be treated effectively with the proper antibiotic. Please keep us posted on the outcome. Thanks,

Kelly

5rings Apr 09, 2009 03:52 PM

An interesting disscussion. My last post was done in the we hours of the morning and probably not quite lucid. No sleep, no coffee. You get the idea.

I would agree with humidity to some extent. The single occasion in which I have had a healthy snake develop an RI while in my care was with too low temps and too much humidity. I do not think the humidity was the cause as my healthy adults can literally tolerate soaking wet conditions IF temps are right and the circulation is good. As you well know a warm, wet, stagnant environment is the perfect incubator.

I am anal about my cages, so they stay spotless. I do however waffle considerably on the newspaper/bedding issue. I love Cypress for its humidity retention, but it is a pain in the butt. A topic for another day.

I have never lost a snake due to an RI and my belief is that I should err to the side of relatively dry (60-70%) humidity and better air flow with a sick snake (i.e bigger vent holes in the cage/tub). The better airflow in itself is a problem in a house with the furnace running as that tends to dry the cages drastically, so I mist them to desired humidity. I give them a more controlled temp range of 82-88 believing and perhaps wrongly, that consistancy reduces the struggle for homeostatsis and thus reduces stress.

This snake, as with most of the other sick snakes I have ever owned came with infection in situ. The PO had an infection in his collection and I bought a group of them. This one had the sniffles but I think the stress of moving turned it into a full blown head cold. I have received other snakes in similar condition but I have only had 1 single snake develop an RI after being in my care for more than a couple of weeks. Cage was too cool, too wet and not enough circulation. A real trifecta!

Now, to the topic at hand. Let me re-phrase my earlier comments. Antibiotics are in fact used way too often and thus we are develoing strains of bateria that are much more resilient. Often such things start with a virus and then as the mucous thickens and the animal becomes stressed viola, we have a secondary bacterial infection. I think I said it backwards yesterday. I also put my pants on backwards too if that tells you anything.

Antibiotics and cultures? Wow, what a tough topic. I agree with Rich that in an ideal situation we would have a lab culture the infection and determine the most likely antibiotic to use. However even healthy animals test positive for a pathogen in more than 30% of the cases. It would then seem problematic to determine which antibiotic to use, thus for the sake of expediency and in search of a magic bullet, the wide development of broad spectrum antibiotics. It is the shotgun approach and we dont have very good aim, we are just making them of a bigger caliber.

Why aren't the cephalosporins used more widely in reptiles? As for amikacin, it is indeed primarily for gram negative multidrug resistant bacteria and is quite toxic at high levels. A precision weapon with lethal killing power. It is also prone to induce renal failure. So, use the shotgun and hope we kill everything or the sniper rifle and hope only kill the thing we want to die. And what about those pesky viruses? I worked in a virology lab for a couple of years. I worship their insidious perfection.

I found this and thought that it might be interesting. I know it is dogs and cats but we might be able to extrapolate something from it.

http://www.baytril.com/43/Bacterial_Flora_of_the_Respiratory_Tract.htm

By the way. Here is what the second vet, a snake collector himself, said. Tell me if it is right.

baytril is the best antibiotic. Amikacin is nephrotoxic and easily damages kidneys. That is what they used to give but the introduction of baytril was “revolutionary”. She weighed 4.2kg by the way. She also sneezed while she was there so he got sample for culture. (paraphrased)

Wish me luck!
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Steve Frist

www.serpentinelogic.com

Kelly_Haller Apr 13, 2009 08:17 PM

I would agree, antibiotics are probably prescribed too hastily as most pre-RI conditions and some actual RI’s can be successfully treated with heat and humidity therapy if caught early, and will not require antibiotics. When it comes to healthy captive boids testing positive for gram negative pathogenic bacteria, actually it has been found that 95% of them will test positive. This is why culturing is highly problematic with using the results to determine treatment, and makes the sniper rifle approach extremely difficult in most cases.

Cephalosporins are being used with greater frequency, and they are in most cases adequate for treatment of most bacterial strains that are responsive to amikacin. However, amikacin is sometimes needed for the more resistant strains that have developed recently, as very few strains have developed widespread resistance to amikacin. I would disagree with the reluctant use of amikacin. Although it can be a dangerous antibiotic due to the possibility of nephrotoxicity, it can be used safely if used carefully and intelligently. I didn’t see anything in the Bayer website that I would disagree with. It was interesting to note that dogs appeared to have a much larger percentage of pathogenic gram positive respiratory bacteria than has been attributed to boids.

I would not totally agree that Baytril is the “best” antibiotic. It maybe the best of the commonly used veterinary antibiotics and was definitely a huge step in the antibiotic treatment of animals. However, there are human antibiotics that are much more effective when used in boids. Case in point is ciprofloxacin. It is a fluoroquinolone class antibiotic just like Baytril, and is the human counterpart, and has been shown to be slightly more effective than Baytril when used to treat bacterial infections in boids. Also, as you eluded to earlier, the human third generation cephalosporins are also extremely effective antibiotics for boids, and easily as effective, or maybe more so, than Baytril.

Good luck and keep us updated.

Kelly

Kelly_Haller Apr 08, 2009 11:08 PM

This is a potent antibiotic, and very few target bacterial species have developed resistance to it. However, vancomycin is only effective against gram positive species of bacteria. The vast majority of bacterial infections in reptiles are caused by gram negative bacteria. The odds that this antibiotic will be effective in resolving an RI in a python is very remote.

Kelly

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