Reptile & Amphibian Forums

I am cross posting the following from the boa forum as I feel I might get more timely advice here, and I am honestly scared.
Below are the two messages so far, starting with the one from two/three days ago:

I have a BCI of approximately 5-6 years of age, currently about five feet, rescued from somebody's driveway close to five years ago. She has been healthy as a horse the entire time and has received a few vet checks since being picked up.

I got home from work yesterday, and her lower jaw was HUGELY swollen. It was sticking out from beyond the top jaw line by about half an inch all around, the flesh inside the mouth could be seen, and I was unsure of how the hell she could still be breathing. She could move, she was breathing, and she could still flick her tongue out somewhat although she couldn't come close to closing her mouth. No discharge, no breaks in the skin, no redness in the mouth flesh, just huge swelling around and below the jaw.

I freaked a bit (understandably, I think) and took her to a local vet. The odd thing is, by the time I got her to the vet, her lower jaw/chin/jowl area looked slightly less swollen than when I first got home. I spent a decent amount of cash, got x-rays taken, and the vet said her lower jaw seemed a little too 'mobile' even for a snake, and decided the most likely cause was a jaw fracture. All the time I was there, it seemed like the swelling was going down slightly as she moved around a bit.

No abcesses presented, no growths, no nothing under the jaw.

Anyway, to try and cut a long story short, I was sent home with some anti-inflammatory medicine (Metacam) to provide each day, and a hilarious-looking jaw splint on my snake. I woke up today, and she had unsurprisingly rubbed off all splinting materials and had knocked over her water dish doing so.

Her mouth looks almost normal today, but I'm not sure if it was the medicine, or if there's something else that was going on. I'll be going back to the vet to see about other ridiculous splint options today until I hear if there might be something else going on here.

Info about her keeping:
Currently in a glass terrarium (soon to be in a boaphile type cage), it and water dish cleaned often.
NEVER eats live, so a bite is not the cause.
Temps are kept standard for a BCI, might drop slightly below ideal at night due to poor insulation in our house and the crappy heat-retaining properties of glass.

I DID change my food source recently, getting my frozen rats from a new person. Not sure if that could affect anything.

Here's the post from today containing an update and a pic:

I'm still really not liking this.
His facial swelling went down, but when I gave him his anti-inflammatory meds this evening via a needleless syringe as I have been each night, his face began swelling after he'd been handled. I also noticed that the flesh inside his mouth is much lighter than normal- though there is still no discharge or breaks; nothing even remotely suggesting mouthrot.

COULD this be a fracture that's only presenting swelling when it is physically manipulated? I'm worried that giving him the meds is harming his face worse.

What the hell else could this be?
If it IS a fracture, what can I do? I'm waiting for the vet to get some more input from others, but in the meantime I'm nervous that I'll wake up to a dead snake.

Here's a quick pic of the swelling that's coming up, not even remotely as massive as the first night but you can likely see what I mean; the underjaw is swelling and the mouth doesn't close all the way.

---------I could REALLY use some input.

This is a toughy. X-rays were not revealing? The way that you are seeing dramatic increasing and decreasing size changes has me thinking that there is a fluid shift responsible for what you are seeing. It's the only thing that I can see changing that quickly. This could be intracellular, like a cellulitis, or extracellular like a serum or blood build-up in damaged tissue. Was a fine-needle aspirate done?

For medications; metacam is available in an injectable form. This might be a more helpfull method of administration.

For your vet, I recommend if they don't already have it, a subscription to www.vin.com. The experts they have on hand are outstanding and can really help out with difficult cases like this.

Other diagnostics that may be of some help would be a biopsy and/or a more helpfull method of imaging the soft tissues of the jaw. MRI or CT scans, or perhaps ultrasound (less likely in this case). Unfortunately these arn't available in a lot of vet clinics.

Good luck!

Ian

Thank you so much for the response!

No, x-rays were not revealing. I have pictures of my x-rays, but I doubt they are sufficiently detailed enough to be useful here.

Aspiration wasn't done, nor was any bloodwork, which I was a bit confused by.

She seemed relatively convinced that it was a skeletal issue, as there were no growths or much of anything going on in the swollen area; I personally have been doubting it.

She appears to have a subscription to vin, as she told me she'd be calling me back once she consulted with some reptile-savvy vets online.

At this point, I'm betting/hoping it was light damage in some of the ligature, as was suggested over on the boa forum. His jaw is staying much more stable at this point, though I'm still administering the meds when it seems needed.

We'll see what my vet comes back and says. Again, I appreciate the response!

there is a condition termed oropharyngeal cellulitis that is essentially a deep tissue bacterial infection of the neck and throat area. Its main symptom is swelling of the head, throat, and/or neck region. Amikacin has typical been the most effective antibiotic, however some of the more advanced cephalosporin class antibiotics may possibly work as well. I'm not saying that this is conclusively the cause of the swelling, but if it does not improve rather quickly, or suddenly advances, it is a strong possibility and rapid response will be required.

Kelly