Reptile & Amphibian Forums

Hey,
Just looking for some thoughts on the best possible antibiotic injection sites, when treating pythons and boas? Anyone with an answer and experience. I.e, Baytril, Amakacin.
Angel
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"Until we lose our self, there is no way of finding our self."
-Henry Miller.

The best injection site for snakes is dorsally in the anterior 1/3 of the body, in the thick muscle either side of the spine. For Baytril, especially, I would recommend not injecting the full dose in one site, but rather divide it up and put a little in each of at least 4 different sites at least 6 inches apart. Baytril is a very harsh drug and can cause sterile injection site ulcers, especially in Pythons.
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We do not inherit the Earth from our ancestors; we borrow it from our children. Ralph Waldo Emerson

Hey,
Thanks for the reply, it was most helpful. What is your background?
-Angel
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"Until we lose our self, there is no way of finding our self."
-Henry Miller.

if the snake is feeding, as it can be dosed in a small food item. Even though they are both fluoroquinolone antibiotics, ciprofloxacin has a wider spectrum of bacterial activity than enrofloxacin and you eliminate the permanent ulceration and subsequent scarring caused by Baytril. I also believe the safety factor of Cipro is much greater than that seen with Baytril. The Cipro tablet comes in 100, 250, 500, and 750 mg sizes and is easily cut with a razor blade to the appropriate dose. Cipro is dosed in snakes at 10 mg/kg and I would recommend a 20 mg/kg initial loading dose. It works extremely well on R.I. and enteric bacterial problems in snakes. It is a human drug, but any vet can write a prescription for it.
If the snake is not feeding and you prefer an injectable, I would go with a third generation cephalosporin such as ceftazidime (Fortaz) or ceftriaxone (Rocephin) which are both broad spectrum and very safe, or with one of the broader spectrum aminoglycosides such as Amikacin or Tobramycin. As you know, these last two must be dosed exactly at 2.5 mg/kg as they are toxic and will cause kidney and liver damage if overdosed. The blood and short-tail python groups are even more sensitive to aminoglycosides and should receive half doses only.

Kelly

..everything that Kelly has said is accurate. I've never used Cipro on a reptile, but I cna't see any reason not to. However, the opposite is absolutely contraindicated..Enrofloxacin is toxic to humans.

Another good 3rd gen cephalosporin is Ceftoxime. I prefer to stay away from the aminoglycosides where possible, especially in dehydrated animals.

>>if the snake is feeding, as it can be dosed in a small food item. Even though they are both fluoroquinolone antibiotics, ciprofloxacin has a wider spectrum of bacterial activity than enrofloxacin and you eliminate the permanent ulceration and subsequent scarring caused by Baytril. I also believe the safety factor of Cipro is much greater than that seen with Baytril. The Cipro tablet comes in 100, 250, 500, and 750 mg sizes and is easily cut with a razor blade to the appropriate dose. Cipro is dosed in snakes at 10 mg/kg and I would recommend a 20 mg/kg initial loading dose. It works extremely well on R.I. and enteric bacterial problems in snakes. It is a human drug, but any vet can write a prescription for it.
>>If the snake is not feeding and you prefer an injectable, I would go with a third generation cephalosporin such as ceftazidime (Fortaz) or ceftriaxone (Rocephin) which are both broad spectrum and very safe, or with one of the broader spectrum aminoglycosides such as Amikacin or Tobramycin. As you know, these last two must be dosed exactly at 2.5 mg/kg as they are toxic and will cause kidney and liver damage if overdosed. The blood and short-tail python groups are even more sensitive to aminoglycosides and should receive half doses only.
>>
>>Kelly

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We do not inherit the Earth from our ancestors; we borrow it from our children. Ralph Waldo Emerson

I would always hold off on their use and only as a last resort. On that subject, the most commonly used is Gentamicin, but if possible, I would go with Amikacin or Tobramycin as they have a wider spectrum of activity and the number of resistant bacterial strains is less than is seen with Gentamicin.

I have never heard of ceftoxime, is it the same as cefotaxime? What has been your experience with it? It appears a number of the third generation cephalosporins work well in reptilian antibiotic therapy due to the broad spectrum and safety factor. In my experience ceftriaxone is the best of them, unfortunately it is also one of the most expensive. Thanks,

Kelly

>>I would always hold off on their use and only as a last resort. On that subject, the most commonly used is Gentamicin, but if possible, I would go with Amikacin or Tobramycin as they have a wider spectrum of activity and the number of resistant bacterial strains is less than is seen with Gentamicin.
>>
>>I have never heard of ceftoxime, is it the same as cefotaxime? What has been your experience with it? It appears a number of the third generation cephalosporins work well in reptilian antibiotic therapy due to the broad spectrum and safety factor. In my experience ceftriaxone is the best of them, unfortunately it is also one of the most expensive. Thanks,
>>
>>Kelly

Boy, I mispelled that one, didn't I? It's actually Ceftizoxime. It's a 3rd gen much like Ceftazadime, Cefotaxime, Ceftriaxone, Cefoperazone, etc.

I have used Ceftazadime and Ceftizoxime with good results. I have used Ceftazadime in a Texas Indigo Snake with a badly infected eye. This was a situation where the snake had a bad nose rub involving the rostral, frontals, prefrontals, internasals, and the last supralabial on both sides. It looked like he was trying to rub his entire head off. As a result of the nose rub, it had a case of stomatitis in the area of the prefrontals which extended into the soft palate. Some of that infection managed to travel up into the sinus and infect the eye socket behind the eye. I found Gram- rods on the slide, using acid-fast staining. I treated with a single course of 7 injections of Ceftazadime and cleared it right up. In the meantime, I started twice daily treatments of SSD on the rub-damaged scales, and after about a year and a half, almost all of the scales have now grown back.

I also treated another Tex for RI (Gram-rods also found in sputum) using Ceftizoxime....same results. One course of treatments and it cleared right up.
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We do not inherit the Earth from our ancestors; we borrow it from our children. Ralph Waldo Emerson

I have never used Ceftizoxime and it is good to know that it has been used successfully. I really like Ceftazidime and think it is a great antibiotic for reptiles because it has one of the broadest spectrums of activity of all the third generation cephalosporins. Thanks again for the info.

Kelly

Sorry for the extra post, I forgot to ask you what dosage of Ceftizoxime you used on the indigo. Thanks,

Kelly

>>Sorry for the extra post, I forgot to ask you what dosage of Ceftizoxime you used on the indigo. Thanks,
>>
>>Kelly

I used 20mg/kg. The Ceftizoxime I used came in a strength of 2gm/500ml, and was actually in a drip bag. It is lableled for either IV or IM. As you know, once Cephalosporins are mixed, they usually have to be kept either frozen or refrigerated. So, I just drew up a BUNCH of syringes in different doses and froze them all for future use.
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We do not inherit the Earth from our ancestors; we borrow it from our children. Ralph Waldo Emerson

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Hey Kelly,
Thanks for the wonderful update on the drug therapies and suggested doses. My guy is off to the vet tomorrow. I am completely opposed to the use of Baytril, for the obvious reasons and I'll be sure to point that out tomorrow to the vet. In days gone, I was a vet tech, and I no longer to that, so I also, don't have access to the drugs and other treatments I was once privy to. At any rate, I'll be sure to show up with a list of the recommended drugs. As you stated, Cipro, is a wonderful drug of choice and I have personally had cause to use it for an ear infection and other treatments. I'll look into it. Where are you getting your information from?
Take care!

-Angel
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"Until we lose our self, there is no way of finding our self."
-Henry Miller.

The above responses are all excellent and thorough. Great job!

As a vet tech I'm sure you remember those clients that came in and told the vet what was wrong and how to treat it... what a nightmare! I bring this up just to remind you that while passing information on to the vet (an experienced herp vet would know all this, and an unexperienced vet usually has access to this info.) is great, they still are the vet. I'm a big fan of culture and sensitivity testing, and if the results point to Baytril than oral or diluted injectable usage may be a good choice.

You, as the pet owner and the Vet's client, have a right to be involved in the treatment of your animal and to be aware of everything with respect to that treatment. (I'm sure you already know all of this, having been a Vet Tech, but I'm saying it for the benefit of other readers that don't have that experience.) You also have a right to have some input into what course the treatment will take. That doesn't mean you should be confrontational with the Veterinarian or that you should try second-guessing him. He is there to help you and your animal and will do his best to do so. Your Veterinarian is trained and experienced in the treatment of animals, you probably are not. Whatever information you recieve on forums such as this one is informational only. No one can make an accurate diagnosis without seeing the animal, and any information found in here is not intended to to the place of a Vet visit and physical examination and diagnosis.

That doesn't mean that you need to know the full pharmacology of every drug and memorize the formularies. But it is important to know which drugs are recommended or contraindicated for the particular species you are dealing with. Especially in reptiles, a drug that works wonders for a particular ailment in some species can be downright deadly in other species. For instance, Ivermectin is a good drug for treatment of certain parasites in many snakes and lizards (but not all), but is likely to kill your pet Tortoise.

>>The above responses are all excellent and thorough. Great job!
>>
>>As a vet tech I'm sure you remember those clients that came in and told the vet what was wrong and how to treat it... what a nightmare! I bring this up just to remind you that while passing information on to the vet (an experienced herp vet would know all this, and an unexperienced vet usually has access to this info.) is great, they still are the vet. I'm a big fan of culture and sensitivity testing, and if the results point to Baytril than oral or diluted injectable usage may be a good choice.

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We do not inherit the Earth from our ancestors; we borrow it from our children. Ralph Waldo Emerson

Hey,
I agree, that, telling the vet what course of treatment would be best would not be in my best interest, however, to the contrary, I do have a right, as an experienced keeper (aforementioned tech), to make my point known should there be something objectionable about the choice of drug. I am fully aware of the negativity and damage that aminoglycosides can have on both tissue and other organs (hepatic, renal) and the dangers involved with their use. I will make my point regardless of the experience, however good or bad it might be, because the animal in question is a particularly amazing animal that was procured with lots of difficulty and tugging. He arrived in a bit of a compromised state. However, he did have a meal the first couple of days in my care. The RI, and Stomatitis, are all probably the result of some bad husbandry on the part of the original keeper secondary to the stress of the shipment; which couldn't have helped much!

I thank all for taking part in this great thread, and for lending their thoughts and experiences with the subject. Now on to the vet!

Note: the patient is a Sumatran short-tail (aka, black blood).


-Angel
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"Until we lose our self, there is no way of finding our self."
-Henry Miller.

You, as a Vet Tech, possess a knowledge of drugs and their pharmacology, uses and possible side-effects that the average person doesn't have. You should be able to communicate this effectively to the Veterinarian, no problem.

My intent was to keep people who don't have this level of knowledge from going to their Vets with poorly understood information (or part of the story) and saying, "But I saw on KS.com that you should do this or not do that." We aren't here to second-guess the Veterinarian that is seeing the animal or to provide diagnoses and recommend treatment courses. Rather we should be providing general information that is for the purposes of information only.
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We do not inherit the Earth from our ancestors; we borrow it from our children. Ralph Waldo Emerson

Hey,
Again, thanks for being so forthcoming with your knowledge of the latest drugs old and new, I should say. Even an old herp person like my self, am not always up to date on the latest and greatest drug treatments if there is such a thing. At any rate, I thank you for your quick response and contribution to this thread; it is very informative and will come in very handy. All the best to you!

-Angel
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"Until we lose our self, there is no way of finding our self."
-Henry Miller.

in the late 70's and early 80's I took a number of pharmacology classes, but most of my antibiotic work with boids came under the direction of Dr. Richard Ross. I had many phone conversations with him in the mid to late 80's on the topic and learned a great deal about antibiotic treatment in snakes. His knowledge on the subject was truly vast. I did a lot of antibiotic experimentation on my own boids when needed, but mostly on other peoples snakes over the years and learned even more. I have not spoken with Dr. Ross in many years, but continue to read as much as I can find on antibiotic treatments. There is still not a large amount of information available concerning antibiotics in reptiles, but many times more than was available even 10 years ago. Good luck with your short-tail.

Kelly

Hey,
Well, as was stated, Jet was taken to the vet yesterday, and was put on a course of antibiotic (parenteral), and the decision was made to put him on the safer, Fortaz (Ceftazidime). The infection site was also, debrided and flushed using a ringers solution as an irrigant. Most of the detritus was removed from the infection site involving the upper mandible just under the rostrum. He was put on an antibiotic course of 6 total injections given TID (every 72 hrs). He looks none the worse for ware and should make a full recovery. I was able to find some warmers at a sporting good store in NYC, called EMS, that last about 12 hours, and placed him into a styrofoam layered box, with the heat packs and traveled by subway to the vets. Not to mention that we also, walked another 8-10 blocks as the vets office had moved over the years with out my knowledge of it. At any rate, Jet arrived toasty warm as he was removed from the box and inspected. Thank God, for the makers of warmers (heat packs), as they sure made the difference. Anyhow, that's all folks! thanks again for all of your input and the sharing of your knowledge.

-Angel
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"Until we lose our self, there is no way of finding our self."
-Henry Miller.

I highly recommend a hot water bottle for transporting during herps during the winter, since it can be reused it is more environmentally sound. Heck, I have even used 21oz plastic bottles for holding warm water.
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"I know the human being and fish can coexist peacefully."
Governor George W. Bush, Jr.

"Sometimes I think the surest sign that intelligent life exists elsewhere in the universe is that none of it has tried to contact us."
Calvin and Hobbes (Scientific Progress Goes 'Boink', 1991)