Reptile & Amphibian Forums

This is about a male desert horned adder, Cerastes cerastes. He was imported about a year ago, and I thought he had been treated for parasites. Looking back through my records, I found he had just been given a panacur/flagyl 'soak'. Er.. nice try, right? Anyway, he had been doing pretty well. He didn't eat for a few months in the winter, and I think that's typical of snakes from that area (my KSB's have the same off-season). Anyway, he started eating again with gusto a few months ago. But two feedings ago, we gave him two smallish mice, and he regurged one. We thought, ok, we just gave him too much food. Next feeding we gave him one smallish mouse, and he regurged that too (took a few days). We thought, ok, this is bad. He also seems to have been losing weight despite his eager appetite, although unfortunately we don't know how much he's lost. He currently weighs only 60 grams. Naturally we're suspecting internal parasites. So we called the vet and they said they could do a fecal for us. So we fed him again, and it went through, but this happened on the evening of the third and by the time we could get it to them on the fifth it was too old. They said we have to get it there within a few hours, which given his week and a half feeding cycle and the fact that he usually goes in the evenings, could take a month for us to manage to get them one in time. He's so thin I'm worried he's just going to keel over before we can get him diagnosed, despite his fiesty attitude. I do have flagyl and albon on hand, but I'm a little reluctant to give them to him without a proper diagnosis. I've been offering him water (probably to no avail), and I haven't raised the heat because he spends most of his time on the cold side when he's not digesting. I'm not sure exactly what advice I'm looking for, maybe I'm just venting, I'm very worried about him. Like I said, he was an import, so I feel very responsible for what happens to him. But then again, any second opinion from what the vet is going to say is helpful. As I've said in the past, I really don't know about them sometimes.

OK..here's what I'd do.

It sounds like you have a little time to play with, so don't panic yet. The first thing is to separate him from the rest of your collection until you find out what's bugging him.

Then, I would try one more time to feed him normally. I'd give him a pinkie or something very small that he's likely to keep down. The idea is to get just enough food through him to get a good fecal sample. By the way, what did the feces look like? Was it mucousy, runny, unusually smelly, any traces of blood?

If he regurgitates the pinkie, then I'd start to do some supportive therapy to keep him hydrated and his electrolytes up and I would feed him very small amounts every other day by stomach tube. I'd use a mixture of Pedialyte, Hill's A/D and (I know, it's gross) pinkies emulsified in a food processor, then strained. If you have something like a pinkie press at your disposal, then straining is unnecessary. If he weighs 60 g, then I'd give him no more than 2cc every other day. You can keep the mixture in a refrigerator in a sealed container for maybe 3 days or just fill a feeding syringe and use it 2cc at a time and keep it refrigerated. Warm it to 90 degrees or so F. before you tube it to him. If you don't have a pinkie pump , one of the red French Rubber Kendall 5Fr or 10Fr feeding tubes should be ideal for that(you can get one from your vet along with a 10 cc feeding syringe). If you put it (the tube)in the refrigerator for a few minutes before you use it, it becomes a little stiffer and easier to use. Just put the tube in the refrigerator and just before you get ready to feed, put the syringe of food mixture in the microwave for a few seconds to warm it, or put it in a bowl of hot water.

For supportive therapy, I'd give SC fluids, such as Lactated Ringer's or Sterile Injectible Saline @ 2% or 3% of body weight (maybe 1.5cc to 2cc) every 3 days. I'd probably vote to go ahead and start that before I saw signs of dehydration, epecially in such a small animal.

I'd reserve measures such as cloacal washes as a last resort to obtain fecal samples. First they are not nearly as productive as a fecal sample and they are stressful to the animal. They are a way to obtain a sample if nothing else works, though.

I wouldn't just start feeding him meds until I knew what he needed. The meds themselves can cause some stress to the animal, as well as the process of giving the meds. No need to stress him unduly for something that may not do any good at all anyway.

I'd watch very closely for a hardened swelling of the stomach, cloacal bleeding, oral discharge of fluids, etc. It could be something as simple as nematode parasites or entamoeba, and likely is. On the other hand, it could be something as serious and virulent as Cryptosporidium or Paramyxovirus. These are relatively rare in captive collections, but do occur from time to time. If the animal dies, I would certainly send the remains for necropsy and specifically look for those two.

Thanks!
I do have what's referred to as a 'pinkie pump', although I haven't yet had occasion to use it. I can get the catheters from my vet and have unfortunately had to use them on this species before. The female we bought him with had a massive systemic infection and we tried to save her, but after the necropsy the vet said it would have been almost impossible. . His stool is a bit runny now. Do Ihave to go to the vet for the Ringer's solution or the saline? I wish he'd just drink on his own, but he wasn't exactly used to standing water where he came from. Um... I'll probably think of more question after I get a nap. He looks hungry again, but it takes a lot to kill their appetite. The female I mentioned died with a rat pup in her stomach. I just look forward to the day when I can see him choke down an adult mouse again.

Yeah, Ringer's or injectible (sterile) saline will have to come from the vet. Anything injectible is by prescription, or in the case of veterinary meds "By or on the order of a Veterinarian".

The runny stool is sort of indicative of protozoan infection, but not always. Most common are Entamoeba invadens, Giardi spp., or a Coccidian such as Eimeria spp. Unfortunately, it takes two different medications for them. Giardia and Entamoeba respond well to Metronidazole (Flagyl) and Fenbendazole (Panacur) also shows a pretty good effectiveness against Giardia and possibly Entamoeba. The Coccidians can be eliminated with Sulfadimethoxine (Albon). Coccidia are difficult at best to eliminate, requiring sometimes as many as 8 treatments. Coccidia easily reinfects from the Oocysts present in feces, so successful treatment and elimination will require absolute attention to cage cleaning and disinfecting of the cage, cage furnishings and water bowls.

So I probably should put the poor guy on newspaper... he won't be happy. Is there any sort of test for paramyxo?

Unfortunately, the only thing I know of is testing tissue upon necropsy.

Hello,

Yes, there is a test for Paramyxovirus. A hemagglutination-inhibition test been developed to determine the presence of specific antibodies to Paramyxovirus in sera to exposed snakes. http://www.vetmed.ufl.edu/sacs/wildlife/proto.html
Link

This test is for live snakes.

Is there an effective treatment for it? Or...do you still end up with dead snakes anyway?

I would imagine the cost is up there and the availability is a problem, too..but, at least it's steps in the right direction. Thankfully it's rare in the U.S., at least for the time being.

I just went and read the report in the link M5 provided.

A lot has been happening on the Ophidian Paramyxovirus front in the past couple of years.

As M5 stated, there is a test now that can be done while the snake is still alive. And the availability and cost aren't that bad. $30.00 for the test. If you can get someone to do a cardiac stick and get enough blood, you just call them and send them the frozen serum. The problem I see is turn-around time. Not that it really matters a lot for the affected snake, but it will almost certainly be dead by the time you get the results back. But, at least you'll know if you have OPMV in your collection. Hopefully, you will have isolated all suspect snakes immediately and have a chance of controlling the spread.

Luckily, I've never had to deal with OPMV in my collection. At first it was thought to affect only viperids. Now it has been isolated in several different genera, including many colubrids and some boids.

I guess that's yet another good reason to quarantine new animals.

They are testing a vaccine for it, too. That's really cool....think about it..we may one day be able to innoculate our herps the way you do dogs and cats for various diseases. Of course, the collar and vaccination tags bring up a whole new set of problems...

Is really try and get this next one to the vet. I'm feeding him again today (an f/t fuzzy, not sure if he'll eat it, he didn't last time). When I talk to her about the results I'll mention steps to rehydrate him and let her decide what to tell me to do. If she tells me to soak him in warm water I'm probably going to roll my eyes. They recommend that for everything. In the meantime I'll put him on newspaper, which I want to do for as short a period as possible, because he really loves his sand. I just hope I don't have to give him medicine every day for two weeks, because he doesn't need the stress, and I'm pretty sure I don't need the stress.
He does seem relatively cool about being 'handled', which is good though.
I think the odds of him having paramyxo are low enough that I'm not going to do a 'cardiac stick', although that really does sound like fun...

Hey, if you are just using regular playground sand, are you sure that he hasn't accidentally ingested some sand while he was eating? That will definitely cause regurgitation.

I don't think it's OPMV at all. The symptoms aren't right. He may throw up from that, but he would have all sorts of other symptoms, too..such as gaping, extreme restlessness, mucousy discharge from the mouth, wheezing, convulsing, etc. because it manifests itself as RI. Plus, I don't think he would have lasted this long once he started to exhibit symptoms. That stuff is quick and deadly once the incubation period is done.

It's not regular playground sand.. I believe it's sold under the brand name repti-sand. It's very very fine grade. But did poop the LAST time I fed him, it's just that he threw up the two previous times. So I guess that means everything CAN go through ok.

He ate a thawed fuzzy off of tongs, but was quite insulted at the size of the meal. I promised him another one as soon as I get my sample. He's such a good snake! And people wonder what the point of having a viper for a pet is...
Here's a pic of him taken back before his winter fast.

Yeah, I definitely don't recommend a snake like this for beginners or someone who isn't familiar with keeping and handling venomous snakes. I've found that the very large venomous, especially elapids like King Cobras, large Mambas and the like, as well as some viperids or crotalids such as large Bothrops atrox are particularly potentially dangerous to handle, as well as very small and highly toxic anmials such as this one. The others that fall in the middle, such as Monocellate Cobras, Larger Rattlesnakes, etc. seem somewhat easier to deal with as a rule. One of the most difficult snakes I ever had was a smallish Taylor's Cantil. That thing was nuts!

It's really sort of a paradoxial thing to me, keeping dangerously venomous snakes. It can be very rewarding and enjoyable for a qualified, responsible herper. In the wrong hands however, the results can be tragic. Some people seem to want venomous animals just because they are venomous. Sort of a testosterone thing, if you will. That to me, is someone who should never keep them. In a laboratory setting where you are conducting venom research, then necessarily the animals will be venomous. That's not what I'm referring to. I'm talking about the guy that wants a Monacled Cobra in an aquarium in his living room just because it's venomous and he can impress his buddies with it. In my experience, if someone doesn't end up getting bitten, the snake suffers because they guy will be a little afraid of it and won't clean the cage as often, lets water bowls go dry or stay full of feces, etc. And if it needs help shedding or getting rid of an eyecap, forget it. And then there's the problem of escapes. Venomous snakes require special caging. End of story. If you are going to keep venomous snakes in your house, you owe it to your family and neighbors to take all possible precautions to keep the snake from escaping. That doesn't mean a 10-gallon aquarium with a screen top and bricks on top of it. It needs to be secured so that the 8 year old neighbor's kid (or yours for that matter) can't open it to show his buddies. As far as to why to keep a venomous snake? It should be that there is an interest in the animal, for what it is, and it just happens to be venomous, requiring different handling and security techniques. And, in my opinion, anyone who keeps venomous snakes without receiving some training and learning everything they possibly can about safe handling and husbandry techniques, or someone who keeps them illegally is a fool, and a detriment to the rest of us.

Well, I'm perfect... I don't have any testosterone, and I don't have many friends. (ok, I have a few, but they understand about the snakes). Keeping hots does of course require some skill, but I think the most important thing is the right mindset. My husband and I are into this species because they're just our favorite snakes. We're pretty obsessed with them. We also have an atrox... she's pretty awesome too. Meaner but a lot easier to handle, like you said. She's almost practice, in a way, for some of the more exotic species we want to get into, but a valued pet in her own right too.
Both of them are excellent shedders . Makes it easy.
Cerastes would be great except they DON'T hook, which makes them pretty awful to handle. I think I'm going to break down and buy some tongs, might make it easier on everyone. Or I might try bagging and tubing. It's been over a year since I've had to tube a hot. And Cerastes doesn't really have that 'crawl down a hole' instinct, so they won't go right into a tube.

Yeah, these types are exactly what I was talking about. Some are "snappier" than others, making them even more treacherous without the right equipment and skills. However, sometimes the "calmer" ones are the more dangerous in the long run. People tend to let their guard down, you know? "Familiarity breeds contempt." They start to get a little careless becuase they have the midset, "Well, it won't bite me.", or "It hasn't tried to bite me yet." Then it happens.

I say, if you have the right skills, are responsible and it is legal in your area (or you have the permits), and want to keep venomous, go for it. It can be very interesting and rewarding.

Another key thing is to make certain that, if you don't keep antivenins on hand, the proper ones are available at a local hospital or can be obtained very quickly. If you get tagged by the Cerastes, the Crofab or Wyeth Polyvalent Crotalid they likely have at your local emergency room is going to be of zero value. Luckily, the venom of your Cerastes is not usually life-threatening. It, by the way, is not nearly as potent as Echis carinatus (Saw-scaled Viper). However, the local tissue destruction can be permanently disfiguring. You don't say which Genus your atrox belongs to...if it's Crotalus then the Crofab and Polyvalent Crotalid antivenins will work. If it's Bothrops...maybe, maybe not. This is not a part of this to be taken lightly. In my years, I've known of a few deaths of hot-keepers that could have possibly survived if they had taken this step. With certain snakes (Vipera russelli comes to mind) there are really no effective treatments for the systemic effects of the venom, such as the conflicting extreme venous clotting and simultaneous "weeping" of blood from smaller vessels and mucous membranes while other vessels are being "ruptured" by other effects of the venom causing a severe "bruising effects", while the neurotoxins and cardiotoxins do their thing. The usual actual cause of death is bleeding in the brain, renal shutdown, or heart failure. The only thing that really stops the effects is the specific antivenin (and the Antivenin made from Indian Russell's Vipers isn't particularly effective against Sri Lankan Russell's viper bites) and sometimes it is needed in great quantities. I've known of people requiring 20 or more ampules of antivenin for a bite.

Anyone can be bitten. Some people say it isn't "if", it's "when". Even the best hot-keepers I know have been bitten at one time or another. That's because we're human and we make mistakes, they are animals and they do what comes naturally. When those two coincide, an accident happens. I think it can be avoided, but it takes total concentration ALL the time.

She's a Crotalus... I keep forgetting there are other atroxes. She's great because she definately doesn't let you get complacent. I've never seen a snake strike while sitting on a hook like she does. I think I have a lead on a doctor who can get me AV, which I will definately look into, considering that I really want a Gaboon viper. I've read that Cerastes bites will respond to Echis carinatus antivenom in a pinch, but I'm sure it's better to have the real thing. I think Iran and France make a Cerastes a.v. The bad thing about living in the midwest is the doctors don't get a lot of snakebite cases... and I've read they can almost make it worse if they do the wrong things.

That's absolutely true. A mistreated envenomation can be worse than an untreated one.

I have a good friend, a degreed Herpetologist, who was working in a Zoo years ago and was bitten on his right hand by about a 4 ft C.atrox. When the snake bit him, it latched on to the web between his thumb and forefinger and pumped so much venom in that when it turned loose, the displaced blood squirted up and hit the cieling of the zoo display he was working in. Envenomation is graded by a number system, something like this:

Grade 0 no envenomation (dry bite)

Grade 1: mild envenomation, minor symptoms

Grade 2: mild envenomation, swelling, minor necrosis, minor systemic symptoms

Grade 3: Serious envenomation, neurological symptoms, serious necrosis and swelling, more serious systemic symptoms requiring support, may be life threatening or result in amputations without immediate care.

Grade 4: Very serious envenomation, immediately life threatening without immediate care. Patient will be critical and require drastic measures.

Grade 5: Fatal envenomation

When he was bitten, he was immediately transported to the hospital about 5 minutes away. Before he arrived at the hospital (less than 10 minutes after the bite) he was already feeling the effects of the neurotoxins in the venom. His lips and fingers and toes were already numb. He was already swelling to his shoulder. He was assessed Grade 4 upon admittance. The first thing that happened to him was that he nearly drowned in his own vomit on the gurney in the emergency room. Then he started with the respiratory distress. Then he was placed on supportive systems and they began administering Wyeth Polyvalent Crotalid Antivenin. Lots of it. Of course, since it is an equestrian serum, the allergic reaction to that started and had to be treated along with what was already going on with the snake bite. It was about this time that I got the call that he had been bitten. I lived about 150 miles away at the time, so I got in my car and headed that way. I couldn't see him that night because he was in intensive care, so I went to his house to look after his collection. It was 2 more days before he was strong enough to have visitors. When I saw him then, they had performed a fasciotomy on his hand and removed the muscle between his thumb and forefinger (the site of the bite), sliced the palm of his hand open from the base of his forefinger diagonally to the point where his wrist starts below his little finger. Then they started at his wrist on the inside of his forearm and opened it all the way to his elbow. His arm was in a fixture that resembled a tennis racquet and they had sewed through each of his fingertips and through the fingernails and tethered his fingers to the bow of the racquet fixture to keep them from atrophying and permanently curling inward. The incisions were left open, so that necrotic tissue could be debrided (scraped) away on a daily basis. This went on for over a week. He was on so much pain-killer that he was barely coherent during that time, but don't think for a minute that he didn't feel the pain. They don't make pain-killers that strong. He ended up losing probably 60% of the muscle tissue in that forearm and hand. The doctor's priorities at that time were, save his life, then try to save his arm. This was a Grade 4 that very nearly was upgraded to Grade 5. He has made pretty much a full recovery since that time and still works with snakes, but if it had been a 30 minute ride to the hospital instead of 5 minutes, he probably wouldn't have made it. He was (is) probably the best I've ever known at handling venomous snakes and used every precaution. Except that once.

The point is, don't under estimate that C. atrox. It is considered (and with good reason) one of the most dangerous species in the world.

... ow ... I always envisioned that happening if I got bit by the horned adder, not the atrox.

sample in the fridge until morning to get it to your vet. Don't let it freeze, just put it in a covered container or ziploc to keep it moist.

You mentioned that he wouldn't drink the standing water . . . can you spray the cage and let it drip somehow? I have a snake who will only drink this way. If he gets too dehydrated and you can't keep anything down with the feeding tube, you can try injecting sub cu fluids. Reptiles hydrate really well this way but it does cause some stress.

Could he have a gut impaction from subtrate or something? That makes them regurge too.

e

The vet people said not to put it in the fridge. I don't know why. I thought the fridge would be good too.
As far as drinking goes, this little guy grew up in the Sahara desert, but I have a feeling that if he really needed it, he'd do it. I don't know if this is a species that drinks dew off its back in the wild, but I'd feel all guilty if I got his sand wet. I might try it once, but if he starts striating, I'm going to stop . Oh yeah, his substrate is very fine grade sand. They're one of the few snakes designed (evolved) specifically to live on sand dunes in the wild. He just couldn't do his thing on any other substrate, although he'll have to make do with newspaper while he gets better. I watch him eat every single time and he actually will hold the prey up in the air while he swallows it. I sort of doubt he's doing it to keep the mice from getting sandy, but it works.
If you can't tell, he's my favorite snake. And as a plus he barely ever tries to bite me.

Because if they are looking for certain protozoans, refrigerating can kill them and they are very difficult to find under a light microscope if they aren't moving, and some of the oocysts are sensitive to extreme temerature changes. It can cause the sporocysts in coccidian oocysts to sort of rupture making them difficult to identify. It doesn't seem to hurt the ova of nematodes and cestodes and the like too much. Plus, if it's not properly packaged, refrigeration can cause a drying out effect which is damaging to all of them. To make things easier in the future, ask your vet to give you a couple of Fecalyzer collection kits. It's always best to examine fecal samples within a few hours of collection.

He may very well be holding his prey items up to keep sand off them. That would make sense to me.

It's good that he doesn't try to bite much...but don't let that make you any less cautious. That's kind of a nasty little bite.

Yeah... from what I've read they have almost the same venom as saw-scaled vipers, and even though he's little, I think 10 out of those 60 grams is venom glands. He barely even saw-scales (striates) when we get him out of the cage now, I hope that's not because he's sick.

It is best to view your sample fresh . . . I'm uncertain about the difficulties of refrigerating because I know of at least two parasit labs that routinely refrigerate samples overnight so I had no idea that it was a problem at all.
e

It not if they are refrigerated at the proper temperatures and in the proper containers. If you are just looking for worms it's not a big deal anyway.