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A few weeks ago I noticed one of my bloods mouth wasn't fully closed. I thought it must have gotten a small piece of sphagnum stuck in its lip. At her objection, I was able to pull out a white piece of "goo" with a hemostat. I didn't think much of it, as things seemed to be alright. Today, I noticed that her lip was up a bit higher on one side than the other. I restrained her (seemingly aginst her will if you can believe it) and got her to open her mouth for a closer look. I pulled at what I thought was some debris, but i guess it was some skin from her mouth. It caused some slight bleeding. There seems to be an area around one of her top teeth that is a bit swollen.

Is this mouth rot? If not, any ideas what could have caused it? Or, what it could be? Also, direction for treatment? It has not affected her appetite though, today she ate 2 med/lg rats.

Thanks in advance,
Bjorn
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Do you believe everything you think?

Hey,
It sounds like a bit of mouth rot to me. Treated daily with betadine (Povidine) and a couple of clean Qtips dipped in the Betadine. Swab the area affected with the med, and remove any debris or detritus, from the mouth that does not look either like tissue or skin. Usually you can tell as the material that develops during an infection is rather white or opaque in color and has a bit of a stink to it. Sometimes the detritus is up in the better part of the mouth and some restraining and a good bit of cleaning must be done to remove the build up of pus and infection. Once cleaned a good dab of an antibiotic ointment or rinse with Hydrogen Peroxide will help heal the infection. Treatment without the use of a prescribed injectable antibiotic, can take anywhere from 2-3 weeks of daily treatment once or twice daily, for complete elimination of the infection. With noticeable normal coloration returning to the gums and mouth. In severe out breaks a good vet is highly recommended.

Causes of Stomatitis, run the gamut from stress and rubbing, and filthy conditions in the cage, to secondary infection associated with URI's.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

Angel-

There does not seem to be any foreign objects or detritus build up in the mouth. The affected area is fairly small and limited to the upper, right, front tooth/teeth.

Is Providin available over-the-counter?

I think daily restraint may set our relationship back a bit, but the outcome will be worth it. She started out pretty quick to strike, but fortunately for me I have never been on the receiving end of that, and now only huff and puffs when I go to get her out.

Should I avoid feeding while she is undergoing treatment?

Thanks-
Bjorn
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Do you believe everything you think?

Bjorn,

Sorry to butt in, I'm sure Angel will add more as well. Yes you can get Providin over the counter, usually labled as Betadine. Kind of expensive for topical but well worth it. You don't need to stop feeding, but I wouldn't think you would want to feed excessively during the period either. Like Angel said if it is a bad case you need to go see the vet. If your removing large amounts of tissue and there is noticable bleeding in the mouth you need to take it to a vet. Especially if it could be from a RI infection because you will need anti bio's for that as well. From what it sounds like it could have had the stomitis for awhile, so I would advice a trip to the vet. Let us know if we can help out further.

Jordan
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"It's my snake, I trained it, so I'm going to eat it!" - Mad Max, The Road Warrior

Jordan-
I have not seen any noticeable symptoms of an RI.

I don't know if I would say I've been removing large amounts of tissue. Her mouth is not gaping open, if that's the way it has come off. I noticed that the lip on one side was about 1/16 of an inch higher above the lower lip than the other side. I did pull something from under the lip a few weeks ago and it semmed to disappear. But today the lips looked similar to a few weeks ago. Upon further inspection, I did notice a slightly swollen area. After poking and pulling it I did cause a small amount of bleeding.

I am by no means trying to imply that I am taking this situation lightly, but I don't know if the situation is at a level that you seem to perceived.

As to the feeding, would a bit of stomitis affect the snakes appetite?
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Do you believe everything you think?

Hey,
Where there is stomatitis, the best possible remedy is it treat, and not feed while treating. The feeding process alone coupled with treating, poking and prodding at the area, will introduce new germs harbored on the rodent etc. Don't feed while treating, but keep fresh water in the cage, and change it daily. As for Providen, I am not sure whether it can be purchased over the counter, however, Jordan has said that you might be able to. Sorry I couldn't answer that. Also, sometimes, swelling is dissociative, which means simply that there are no symptoms of infection (idiopathic), but swelling is still in evidence.

I was told by a vet a few months ago, when one of my big black girls, no pun, was also stricken with a swollen mouth; upper, that the swelling could also be part of an allergic reaction. The swelling did subside and she returned to normal after a few treatments or wash with Povidine to keep the area clean. I don't know for sure if this was a result of some allergic reaction, as the vet had suggested, or if the reaction was a result of her rubbing her mouth against the glass edges or corner, with subsequent lose of a tooth or teeth, or none at all. I have however, noticed that when well fed, there is less likelihood of this occuring, as there is also, less prowling, making for a more content blood or short-tail.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

Hey all,

Just a heads up that hydrogen peroxide is NOT recommended for cleaning wounds. First, it stings like the dickens and will make your patient quite uncooperative, and it actually causes as much tissue damage as it heals. Most vets will tell you it delays healing, and there are better ways to clean a wound and remove infection.

Saline solutions or dilute betadine are much better for cleaning wounds.

Hey,
Sorry but I have to disagree with you on that comment. HP, does not sting or cause any type of skin sensation other than that it foams up when applied to an area. I don't know what vet you've talked to, but it does not have any caustic effect. Mercuricone, on the other hand does cause a burning and stinging feeling. I've used peroxide for well over 30 years on snakes and have not had any failures or problems from its use on infections like stomatitis. In fact, some dentist use it and recommend its use for rinsing the mouth when there is infection of the gums. Hydrogen Peroxide is one of the safest meds you can use on your herps. I don't know where you are getting your facts from. I've been at this game well over 30 year and have worked as a tech and I've yet to see or experience adverse affects from it.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

I'm a veterinary student. Yeah, I know it means I don't know hardly anything yet (not 30 years worth), but I do know a little bit.

Hydrogen peroxide is the same substance produced by your neutrophils to destroy bacteria, so there's no doubt that it creates a bacteriocidal effect. However, when your neutrophils get overexcited and produce their respiratory burst too quickly, they release hydrogen peroxide into the interstitial space between the cells and it kills your cells too, producing as much, if not more necrosis than would have ocurred with the bacteria alone. Therefore, common sense tells you that if premature respiratory bust is bad for your tissues, dumping straight hydrogen peroxide on your tissues is bad too.

I've never been in a vet clinic that used Hydrogen peroxide. I also did a quick search on VIN (veterinary information network) to make sure I wasn't spouting nonsense, and I found several references talking about the bad effects of hydrogen peroxide, and not a single reference that recommended it as a disinfectant.

You're trying to clean the tissue so that it can heal, not kill it.

Hey,
Well, thanks seriously for the information, as this is all news to me, regardless of whether it has worked for me over such an extended time. I was unaware of the implication of HP, and its use for wound healing. Are you also, suggesting that it not be used for anything other than superficial wounds, barring stomatitis? Just curious as you've got me thinking. This is a great topic as I think so many of us will benefit from the info.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

I actually wouldn't use it for anything other than cleaning surfaces. Its just too damaging to tissue. Its not recommended for puncture wounds, but even for superficial scrapes you've got fresh new tissue trying to grow. I much prefer to use an antibiotic ointment which will encourage tissue growth and still keep out the nasties...

I use alcohol on any scapes I get myself (ouch) although it dries tissue, and may be just as bad for your skin as H202. I might have to do some reading now that I'm actually thinking about what the chemicals do. I only use it when I get a nasty swollen scratch from a rat or something where I'm worried about infection. I would never use it on my animals, I couldn't subject them to it... LOL

I think its a matter of just using what was available and recommended by others without actually thinking aobut what it does. Or in the case of H202, people thought it did one thing and didn't know it did something else. My mom still uses it, just because its what she's always done.

Hey,
Thanks for the info. I think I owe you a bit of an apology too for replying as abruptly as I did. I was completely unaware of the implications and harmful effects of the old stand by and go to, H202, as so many of us here I am sure were. The technical jargon and printed dissertation on this forum by our good friend Kelly, did surprise me a bit, and opened my eyes and mind to this notion and albeit, harmfulness of the product so many of have used for so many years on just about anything, from scrapes to bumps and bruises.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

No biggie. I was actually more worried that I came across as a smarty. When I know my stuff, I tend to come across rather strongly too and have to work not to make others feel like I'm looking down on them. I get harrassed by the BF all the time for talking technical jargon I learned in class thats over his head.

I didn't think you came across poorly at all. You were just called out by people with less experience than you, and its perfectly reasonable to make sure they know what they're talking about before you believe them. There's too many newbies who think they know whats going on, but really have no clue to be listening to every joe schmoe posting info.

-

Hey Kelly,
What is your experience with HP, as I am not understanding what it is your suggesting with its use. I've never felt any problem while using it, and don't understand what or experience you reacting to with the use of HP.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

it has been shown to cause some minor tissue damage and does slow the healing process somewhat. Betadine and it’s generics would be easier on the tissue than H2O2. See the excerpt below for a more detailed explanation:

Hydrogen peroxide is less used now as a debriding agent than in the past. When hydrogen peroxide is applied to a wound it combines with catalase produced in the tissues and decomposes into oxygen and water, producing effervescence (Potter and Perry, 1993). The rationale was that this helps to loosen materials that might hinder wound recovery and enables them to be washed off more readily. Six-percent w/v hydrogen peroxide (known as ' 20 volume' solution) liberates twenty times its own volume of oxygen upon decomposition (Thomas, 1990a), and is generally diluted 1 in 3 for the irrigation of wounds. The release of oxygen also kills some anaerobic bacteria such as the tetanus bacillus or Escherichia coli that might otherwise infect the wound. This anti-microbial action of hydrogen peroxide can be amplified 100-fold by the addition of L-cysteine (Berglin et al, 1982).

The problem with hydrogen peroxide and some other traditional debriding agents is that they also damage the healthy cells (keratinocytes and fibroblasts) that are needed for wound healing and inhibit their necessary migration into the damaged area (Tatnall, Leigh, and Gibson, 1990; Tatnall, Leigh, and Gibson, 1991; O'Toole, Goel, and Woodley, 1996). In current practice the emphasis has moved away from the use of cytotoxic materials to those which promote healing, including the use of natural signalling molecules such as platelet-derived growth factor (Higgins and Ashry, 1995). In the British National Formulary (1996) hydrogen peroxide is now listed under "Astringents, oxidisers and dyes", and not as a desloughing agent.

The application of hydrogen peroxide has been replaced with the use of saline wash, substances such as Debrisan and Intrasite Gel for the removal of necrotic tissue, and the application of hydrogel dressings such as Granuflex. Varidase is a desloughing agent with wound cleansing properties, and contains streptokinase and streptodornase (Thomas, 1990b).

References

Berglin, E.H., Edlund, M.B., Nyberg, G.K., and Carlsson, J. (1982) Potentiation by L-cysteine of the bactericidal effect of hydrogen peroxide in Escherichia coli. Journal of Bacteriology, 152(1), 81-88 (Oct).

British National Formulary (1996) 13.11.6 Astringents, oxidisers, and dyes: hydrogen peroxide. Joint publication of the British Medical Association and the Royal Pharmaceutical Society of Great Britain (p. 492).

Higgins, K.R., and Ashry, H.R. (1995) Wound dressings and topical agents. Clin Podiatr Med Surg, 12(1), 31-40 (Jan).

O'Toole, E.A., Goel, M., and Woodley, D.T. (1996) Hydrogen peroxide inhibits human keratinocyte migration. Dermatol Surg, 22(6), 525-529 (Jun).

Potter, P.A. and Perry, A.G. (1993) Fundamentals of nursing: concepts, process & practice (3rd edition). St. Louis: Mosby-Year Book, Inc (p. 1666).

Tatnall, F.M., Leigh, I.M., and Gibson, J.R. (1990) Comparative study of antiseptic toxicity on basal keratinocytes, transformed human keratinocytes and fibroblasts. Skin Pharmacology, 3(3), 157-163.

Tatnall, F.M., Leigh, I.M., and Gibson, J.R. (1991) Assay of antiseptic agents in cell culture: conditions affecting cytotoxicity. Journal of Hospital Infections, 17(4), 287-296 (Apr).

Thomas, S. (1990a) Wound cleansing agents. In Wound Management Dressings. The Pharmaceutical Press (Chapter 11, p. 76).

Thomas, S. (1990b) ibid p. 78.

Hey Kelly,
Thanks for that thorough explanation. That is quite the bundle of info.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

-

there are identical generics that are much less expensive than Betadine.

Kelly

Hey,
I agree, I used Povidine applied directly to a few Qtip swabs and coated the gums with the solution directly and did not dilute as most Vets suggest. Vets suggestion is to dilute the Povidine with water to a light tea color. This is what I would do when flushing the wound or infection. For applying a more permament med to the area, I apply the Povidine at full strength, leaving a brown coating over the gums, after debriding the infected area or parts.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil

Kelly-

Thanks for the tip. The generic brand was 1/2 the cost of Betadine.

I also want to thank everyone for sharing their knowledge and expertise. I hope I can get any infection cleared up rather quickly.

I did enjoy the H2O2 dissertation as well...

Thanks-
Bjorn
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Do you believe everything you think?

Dam near knocked me off my chair.
-Angel
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In life you can fall many times, but you're only a failure, if you don't try to get back up!
Evil Canevil