Reptile & Amphibian Forums

my female is an old tree snake i saw one egg in there yesterday...........i palpated another out today...but no more eggs have come out of her....you can visible see them getting closer to the cloaca....but i would think she would lay them all at once even being an old snake?
any help suggestions?...oxytocin will work? or just go for the surgery?
please help asap.
thanks

I'd lay off the drugs and invasive procedures for the moment. I've recently seen a mangrove throw 2 slugs, prolapse in a very ugly manner where we could not find the anal opening and there was a third slug dangling in the prolapse! We had to cut it out, and retract the prolapse, and then wait. The snake deficated with minimal blood in the stool and no relapse. About a month later, the same snake laid 9 fertile eggs! She also eats and deficates regularly.

What kind of tree snake did you say you have this problem with?

Good luck
creep

i went to a lecture by a certain r coke about dystocia and thought you would benefit from it... good luck.

ps: we have a saying in veterinary medicine..... dont let the sun go down on a pyometra
pps: email me if you want to know what a pyo is.
cheers don
Medical & Surgical Aspects of Dystocia in Reptiles (VET-579)

Rob Coke, DVM
Senior Staff Veterinarian, San Antonio Zoo
San Antonio, TX, USA

Objectives of the Presentation
· Review the common history, clinical presentation, and diagnostics of dystocia
· Review the medical and surgical management of dystocia

Key Clinical Diagnostic Points
· Dystocia
o The difficult delivery of eggs or young
o Common in captive reptiles
o Multifactorial etiology
§ Improper husbandry
§ First clutch female reptiles
§ Female reptiles with a previous history of dystocia
§ Female reptiles with an infertile clutch of ova
o Postovulatory stasis
§ Obstructive and nonobstructive
· Diagnosis
o Detailed environmental and medical history
o Complete physical examination
o Complete Blood Count (CBC)
o Biochemistry panel
o Radiographs
o Ultrasound

Key Etiologic and Pathophysiologic Points
Preovulatory Stasis
· Lack of release of the yolks formed on the ovaries
· Seen in lizards and tortoises primarily
· Etiology similar to nonobstructive postovulatory stasis (below)
· Follicle pathology
o Fragile and may rupture due to trauma
o Bacterial infection
o Inspissation of follicular material
o Necrosis
· Normal physiology to resorb the follicles in the non-reproductive female

Postovulatory Stasis
· Inability to pass ova already in the oviduct
· Seen in lizards, tortoises, and snakes
· Obstructive
o Physical obstruction to the passage of eggs or fetuses
o Maternal
§ Uterine stricture
§ Uterine lining adhered to the egg membrane
o Eggs/fetus
§ Large size
§ Abnormal shape
§ Doubled egg
§ Fractured or ruptured egg
o Extra-oviductal obstruction
§ Cystic calculi
§ Enlarged kidneys
§ Neoplasia
§ Impacted substrate or feces

· Nonobstructive
o Eggs/fetuses are often normal in size and shape
o Husbandry
§ Improper or lack of laying site
§ Improper temperature, humidity, substrate, photoperiod
§ Overfeeding
§ Underfeeding
§ Lack of exercise
o Nutrition
§ Hypocalcemia
§ Calcium/Phosphorus imbalanced diet
§ Hypovitaminosis D
§ Lack of proper UV-B lighting or sunlight
o Inflammation/Infection
§ Yolk coelomitis leading to uterine inertia
§ Bacterial infection of the eggs, fetuses, or uterine tissue

Key Therapeutic Points
Medical Therapy
· Re-establish a suitable laying environment
o Warm humid temperature
o Place lizards in a deep bucket or trashcan filled partially with damp sand/soil
o Place turtles/tortoises in an appropriately sized basin or tub with a damp sand/soil bottom
o Place snakes back into a darkened enclosure with a container of damp moss/soil
· Re-check Diagnostics
o Correct problems
o Calcium
o Fluids – Parenteral
· In addition, it the female is able to support herself, then soaking in lukewarm water may aid in fluid replacement
· If no eggs in 30 to 60 min…
o Repeat calcium administration
o Fluids
o Give oxytocin or arginine vasotocin
o After 2 to 4 hours and no egg deposition, then consider surgical options
· Physical manipulation in snakes
o Lubricate the cloaca and gently attempt to manipulate the most distal egg out through the cloaca
§ HIGH incidence of oviductal rupture, especially in inexperienced hands
§ Only attempt if the egg is visible through the oviduct and non-adherent to the oviduct
o Alternatively, if the distal egg is overly large, a percutaneous aspiration of this egg’s contents may allow for the rest of the eggs to pass
§ May be repeated for each egg if needed
§ Oxytocin may be used in-between to stimulate egg deposition

Anesthesia
· Premedication
o Butorphanol
· Induction
o Propofol
· Maintenance
o Intubation or face mask
o Isoflurane
· Vitals monitoring
o Pulse Oximetry
o Electrocardiography
o Doppler

Surgical Preparation
· Approach is slightly different due to body type
o Round bodied lizards
· i.e. Iguanas, monitors, etc
· Ventral midline or paramedian approach
o Ventrally compressed lizards
· i.e. Bearded Dragons, Uromastyx, etc
· Ventral midline or paramedian approach
o Laterally compressed lizards
· i.e. Chameleons
· Paralumbar approach
o Turtles/Tortoises
· If the diameters of the eggs are smaller than the width of the inguinal fossa, then a prefemoral fossa approach can be made.
· If the diameter of the eggs are larger than the width of the inguinal fossa, then a ventral plastron osteotomy will need to be made to access the coelom
o Snakes
· Several incisions may need to be made depending on the length of the snake and the number of eggs
· The surgical sites need to be strategically located where 2-3 eggs on either side may be manipulated
· The parallel incision should be made between the 2nd and 3rd row of lateral scales
· Surgical site preparation
o Scrub the area with chlorhexidine
o Remove any loose scales or patches of skin

Surgical Therapy – Salpingotomy
· Make the skin incision over the appropriate site (see above)
· Incise the coelomic membrane
o Between and along the ribs in chameleons
· Locate and isolate the right oviduct
· Make careful and periodic incisions throughout the right oviduct
· Carefully manipulate the eggs out through the incisions
· Repeat for the left oviduct
· Leave the oviduct incisions open
· Flush the coelomic cavity with warm ringer’s solution
· Close the body wall
o Use the adjacent ribs as stents in chameleons
· Close the skin using interrupted horizontal mattresses with absorbable suture material (ex: 4-0 PDS)

Surgical Therapy – Ovariosalpingectomy
· Make the skin incision over the appropriate site (see above)
· Incise the coelomic membrane
o Between and along the ribs in chameleons
· Locate and isolate the right oviduct
· Remove the right oviduct intact
o Ligate broad ligament as needed for hemostasis
· Remove the right ovary
o Sutures or surgical clips
o Right ovary closely associated with the right caudal vena cava
· Repeat for the left oviduct and ovary
o Left ovary has the left adrenal gland in-between the ovary and vena cava
· Flush the coelomic cavity with warm ringer’s solution
· Close the body wall
o Use the adjacent ribs as stents in chameleons
· Close the skin using interrupted horizontal mattresses with absorbable suture material (ex: 4-0 PDS)

Post-Operative Care
· Place in a warm 85° to 90° F enclosure
· Maintain fluid therapy if needed
· Post-operative antibiotics - If indicated from any bacterial pathology discovered during surgery
· With the above anesthetic protocol, recovery from anesthesia is generally rapid (< 30min)

Key Drugs, Dosages and Indications

Key Drug1 Drug Class Dose Range Frequency Route Indications
Lactated Ringer’s (LRS) Fluid 10-25 mg/kg q24h SC, Ice Fluid Therapy
Calcium gluconate Supplement 100 mg/kg q30m-2h SC, IM Calcium Deficiency
Arginine Vasotocin* Hormone 0.01-1.0 mg/kg q 1-2h IV, IM, Ice Dystocia
Oxytocin Hormone 1-10 IU/kg q 1-2h IM Dystocia
Butorphanol Analgesic 1.0-1.5 mg/kg q24h IM, SC Analgesia
Propofol Anesthetic 3-5 mg/kg IV Anesthesia
Isoflurane Anesthetic 1-3 % Inhalant Anesthesia
Carprofen NSAID 1-4 mg/kg q24h IM, SC, PO Analgesia
*Note: Arginine vasotocin is not approved for use in live animals. It is available as an in-vitro laboratory grade chemical that has been reconstituted into a parenteral form that has been used in reptiles.7

Key Prognostic Points
· Initiation of treatment before the reptile is moribund is a key prognostic indicator.
· Unfortunately, many of the dystocia patients presented have already passed into the moribund stage, and these present a poor to grave prognosis.
· Patients will eventually succumb to complications from non-passed eggs; therefore, client education is important to resolve the passage of the eggs.

Summary
· Dystocia in reptiles is a common emergency presented in clinical practice. The vast majority of cases stems from inadequate husbandry, and requires thorough client education. In addition, the female may be too young/old or possess underlying medical problems. After evaluation and diagnosis, correct any abnormalities in the clinical pathology and attempt to allow the female to pass any post ovulatory eggs. If there are physical obstructions/complications, pathologic preovulatory ova, or failure of medical therapy, then surgical intervention is required.

References/Suggested Reading
1. Carpenter JW, Mashima TY, Rupiper DJ. Exotic Animal Formulary, 2nd ed. Philadelphia: WB Saunders Co, 2001;41-105.
2. Coke RL. Surgical management of dystocia in chameleons. Exotic DVM 1999;1:11-14.
3. DeNardo D, Barten SL, Rosenthal KL, et al. Dystocia. J Herp Med Surg 2000;10:8-17.
4. DeNardo D. Reproductive Biology. In: Mader DR, ed. Reptile Medicine and Surgery. Philadelphia: WB Saunders Co, 1996;212-224.
5. DeNardo D. Dystocia. In: Mader DR, ed. Reptile Medicine and Surgery. Philadelphia: WB Saunders Co, 1996;370-374.
6. Divers SJ. The use of propofol in reptile anesthesia, in Proceedings. Annu Conf Assoc Rept Amphib Vet 1996;57-59.
7. Lloyd ML. Reptilian dystocias review – Causes, prevention, management and comments on the synthetic hormone vasotocin, in Proceedings. Annu Conf Am Assoc Zoo Wildl Vet 1990;290-296.
8. Lock BA. Reproductive surgery in reptiles. Vet Clin North Am: Ex Anim Pract 2000;3:733-752.
9. Ross RA, Marzec G. The Reproductive Husbandry of Pythons and Boas. Stanford: Institute for Herp Research, 1990;270.

Keywords or phrases
· Squamata
· Serpentes
· Chelonia

its a jackson tree snake..................well crap i went with oxycotin...........just a little paranoid but now i will sit and wait and see what happens.

hydrate, hydrate, hydrate.... do you have the ability to give fluids and maybe a few shots?

yes i do...................what do you recommmend?

I recommend taking the poor snake to a vet, stat.

Messing around at home with dystocia usually results in the death of the snake. Oxytocin only works within a narrow time window, if you've missed it, it won't help and may do harm. Manual palpation often causes serious injury. Don't leave this animal in pain any longer. Surgery may or may not be required, but the vet needs to make that determination.

i agree with tanith. Take it to a vet and get a rad. I assumed you have some veterinary exp, but mstt is right, the $50 you gonna pay for a visit is well worth a first hand opinion.
cheers, don

Why stress the poor animal out more by moving it all over the place when it will probably lay the rest in time if it has some peace and quiet???
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CB

"I post because I'm bored"

Since when are prescription medications just hanging around for casual use? Don't be the hick farmer down the road who fires any med's he can get into his cattle to "sav'um".
Now assuming that the oxytocin is already given and you have the correct dosage, keep your snake at home, quite, dark and warm ect and see if the problem subsides.
If no progress withen the hour take it to the vet.
Next time start with a vet visit first and do things right.

Just a point of interest to Dr. Vet, your post was awesome, if geared towards colleges (I had a rather comical image of a guy reading it like a recipe book and getting ready to do surgery).
The benifits of butorphanol may be negligeable in herps. Search the VIN for past posts and documents regarding such. A midazolam mix is more effective; and meloxicam has been shown to work better for post-op pain.

Ok Dr. vet. Yes we all want to give you all our $$$. If the animal has passed an egg and waits a few days to pass more does this give cause for alam????? I don't think so! If an animal is passing infertile eggs, will it get egg bound if the rest are infertile???? I would be more than happy to hear your reply "EXPERT". I happen to know the answers, DO YOU???
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CB

"I post because I'm bored"

I would not take your $$$ because I am not a qualified herp vet. If you honestly think that your experience (however much that may be) means that you have nothing to gain by a vet visit then you are mistaken.
If you're too cheap to spend a few bucks then give them a phone call and get their advice that way.

I had a stimsons python get egg bound this year. She laid one one day and another two days later and that went on till she laid about six.
I waited about a week after that and she didn't lay any more so I went to the vet with out her and told him I had an egg bound snake. He gave me the correct amount of oxytoson, I went home gave her a shot, waited on hour and gave her the other shot. she laid one egg that day and a few days after that she laid the rest. now she's eating and doing everything normal.
Thats about all the experience I've had with dystocia.
Hope that helps in some way.

Jason

If I need a vets assitance, I will contact them, but not unless it's absolutely neccessary. Most will not treat venomous anyway.
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CB

Being the devil's advocate I thought I'd mention that you kinda bring up another point.
If you plan on keeping herps it's a good idea to plan ahead and get aquinted with a reptile vet.
Doesn't it make sense to get aquinted with a venomous herp vet if you keep hots? (Travel may be more obviously but keeping Hots has other compromises too)

That is true. I was going to travel 4.5-5 hours to save my egg bound O. hannah, but luckily she passed the eggs before I did that. It took alot of calls & knowing people to find this vet (very stressful 3 weeks).
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CB

I am sure you know much more than me bro...LOL.
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CB

Oxytocin will probably make it worse. If she dont pass all them within 2-3 weeks, then surgery. The first year I bred King cobras the female was bound with only 12 good eggs out, and 20 some stuck for three weeks before she passed them, she went on to breed the next year with no problems (I think I had her too fat). I tried Oxytocin with her & it did nothing.

Good luck
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CB

"I post because I'm bored"