Louise Abuzet BVM&S CertAVP (ECC) CertAVP (ZM) BSc(HONS) MRCVS presented her webinar on Reptile Emergencies on the 14th of January this year, and gave us a great comprehensive webinar on potential emergencies in common species that can come in through those doors. It’s increasingly common for the public to own reptiles – varying from chelonians to lizards and snakes. Being prepared for what could show up in an emergency situation is key.
“Reptiles usually do things slowly… They get ill slowly, they die slowly, and they get better slowly.”– Louise Abuzet, “Reptile Emergencies”
We start off the webinar with the general approach to reptiles. They’re much like smaller, less fuzzy dogs and cats. With your history taking you want to cover the general basics (when did this start, has it improved, eating/drinking/defecating/urinating etc) as well as venture into the husbandry side of history. Make sure to cover substrate, enclosure type, lighting, supplements and more details as often husbandry is the core of the issue. While in your clinical exam, ensure that you check the muscular and neurological systems to rule out common issues like metabolic syndrome and IBD. Checking hydration may be slightly different from normal, but using skin tenting, checking for sunken eyes and looking for thick saliva are all great techniques that Louise recommends. Louise shares some great information on how to palpate tricky animals, and other husbandry questions to ask.
One of the common hurdles that we come across in exotics and zoo medicine is the lack of research and licensing in medications. In general practice, there is little data on efficacy of our common analgesic medications but some recommendations from the webinar include morphine, fentanyl, meloxicam (if well hydrated), ketamine, and alpha-2 agonists. You can also use local analgesics like lidocaine but remember to calculate your maximum doses – in little creatures it’s easy to accidentally overdose!
The general fluid therapy goal for rehydration is approximately 5-10ml/kg/day, but getting the fluids into the body can be tricky in itself! Often the patients presenting are victims of chronic changes, so the typical “immediate IV access and connection to IVFT” is not only going to be incredibly challenging but also may be unneccesary. Gradual rehydration with subcutaneous or intraosseous fluids are the most common attempted, and although intracoelomic fluids are possible it can be risky due to the potential to pieces abdominal organs. Per os rehydration can be slightly more challenging (especially for the feisty patients!) but thankfully there’s also the option of soaking the patient! Reptiles have a brilliant ability to absorb water through their cloaca, and rehydrate while you’re hands-off.
Louise also covered euthanasia, anaesthesia medications and monitoring, and CPR. This is an action packed webinar with excellent information in an interesting format, so to catch up on the rest of these topics make sure to tune into the webinar here.
Common Reptile Emergencies
Later in the webinar, after we’ve got a solid grounding on the basics of reptile emergency clinic, we’re introduced to the top six categories of reptile emergencies. These are:
- Bites, Trauma, Shell Damage
- Cloacal Prolapses
- Dystocia and Follicular Stasis
Louise certainly has her work cut out for her, there are so many variations between reptile species that for each of these categories we have at least three versions to cover. For example, in ocular emergencies we are briefed on reptiles with spectacles, and those with corneas. In the case of prolapses, the structures that can prolapse from the body can include phallus or hemipenes, oviduct, or colon and potentially bladder as well.
We’re given diagnostic and treatment plans for each of the emergencies, as well as tips and tricks to deal with them. It’s definitely a recurring theme that these emergencies are usually the end-point of chronic poor husbandry, so further investigations into why they happened is almost always essential. Unfortunately, the opposite happens occasionally – as illustrated by a poor tortoise in the webinar that had a chair fall on him. In these accidental injury cases, the history usually gives you a bit of a clue as to whether there’s underlying issues or not.
This webinar probably ranks as one of my favourites on the website at the moment. It covers an interesting, relevant topic in an easy to understand way. Reptile emergencies are one of the scenarios I can imagine see myself having to face in the upcoming year, and I’d much rather be prepared rather than pulling out a book and trying to absorb information in a situation that is already stressful! I highly recommend the webinar, and I’m looking forward to any upcoming webinars that will be coming up from Louise in the future!