Ex Med - Diagnosis And Treatment Of Common Infectious Diseases Of Reptiles

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Primary reptile that has had increasing importation

Back 1

-iguana

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Pathogenic bacteria in reptiles
-general effects

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-abscesses
-pneumonia
-dermatitis
-stomatitis

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Gram (+) bacteria
-pathogenic bacteria

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-Coagulase (+) staphylococci
-Beta-hemolytic streptococci

-All gram (+) are potentially pathogenic but most are not

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Gram (+) bacteria
-treatment based on

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-culture results
-when there is not response to therapy for Gram (-)
-when infection is present but no Gram (-) are cultured

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Most bacterial pathogens in reptiles

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-Gram (-)

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Major Gram (-) bacteria

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-Salmonella sp.
-Pseudomonas sp.
-Serratia sp.
-Providencia sp.
-Klebsiella sp.
-Aeromonas sp.

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Salmonella sp.
-major infective group

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-Salmonella arizona

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Pseudomonas sp.
-major opportunistic sp.
-found where

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-Pseudomonas aeruginosa

-oral cavity
-intestinal tract

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Reptiles become predisposed to Pseudomonas sp. via:

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-subopptimal environmental conditions
-malnutrition

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Aeromonas sp.
-associated with

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-pneumonia
-lesions of the oral cavity
-cutaneous lesions
-septicemia

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Gram (-) bacteria of reptile infection can normally be found where?

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-reptile (normal flora)

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Pseudomoans sp.
-vector

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-Ophionyssus sp.

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Approximately 50% of bacteria cultured from ill reptiles are:

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-anaerobes

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Anaerobic bacteria that may cause infection in reptiles

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-bacteroides *
-Clostridium
-Fusobacterium

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Anaerobic bacteria
-antibiotic therapy depends on

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-culture
-sensitivity

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Anaerobic bacteria
-main treatment

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-Metronidazole

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Major organisms isolated from abscesses and granulomas in reptiles

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-Gram (-)

*occasional Gram (+) and mycobacteria

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Reptile abscess
-consists of

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soft center surrounded by rings of:
-inspissated pus
-necrotic cellular debris

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Abscesses
-may arise where

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-subcutaneous tissue
-body cavities
-embedded in parenchymatous organs

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Abscesses and granulomas
-entry via

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-direct transmission (bites, wounds, vectors)
-hematogenous

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Abscesses and granulomas
-clinical signs

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-sub-epidermal hemorrhage
-swelling
-etc.

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Abscess
-treatment

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-surgical excision or incision and drainage
--irrigation of cavity
---pack with topical wound dressing
----parental antibiotic (value but not indicated unless systemic disease present)

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Reptile topical wounds dressings

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-siilver sulfadiazine
-povidone ointment

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Ulcerative Stomatitis
-aka

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-Infectious stomatitis
-Mouth rot

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Infectious stomatitis
-etiology

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Gram (-) bacteria:
-Aeromonas sp.
-Pseudomonas sp.
-others (Proteus, Citrobacter, Providencia, Staph, Strep)

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Ulcerative stomatitis
-common in what animals

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-snakes

less common in lizards and chelonians

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Ulcerative stomatitis
-characterized by

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-ulceration and caseous exudate in the oral cavity
-involvement of the bones of the jaw and teeth sockets
-possible progression to septicemia
-anorexia and emaciation
-possible subspectacle swelling or abscess
-increased salivation
-reluctance to feed
-inflammation of the oral and pharyngeal membranes

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Ulcerative stomatitis
-usually due to

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-suboptimal management

*can occur in wild

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Ulcerative stomatitis
-predisposing factors

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-mouth injury (live prey)
-wire screen
-striking glass
-suboptimal temp
-stress

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Ulcerative stomatitis
-treatment

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-combination of topical and parenteral therapy

-thoroughly cleanse and debride oral cavity with dilute chlorhexidine or providone iiodine
--topical dressing of silver sulfadiazine
---parenteral antibiotics
----supportive therapy when the animal is unable to eat or drink (administer fluids, supplement Vit B-complex and C, maintain upper POTZ)

Front 31

Parenteral antibiotics
-chosen how

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-results of pre-treatment culture and sensitivities

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Ulcerative stomatitis
-prevention

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-good managemetn and environmental conditions
-avoid live prey

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Blister disease
-aka

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-Necrotizing stomatitis
-scale rot

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Necrotizing stomatitis
-common animals affected

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-snakes and lizards housed in moist, unsanitary conditions favoring the growth of Gram (-)

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Blister disease
-pathogenesis

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-epidermal vesicles ar fluid filled
--caseous necrosis, ulceration, abscesses, septicemia

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Blister disease
-treatment

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-parenteral antibiotic therapy
-topical cleansing
-supportive care (forced feeding, fluids, etc.)
-improved husbandry (newspaper)

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Respiratory infections
-common in what animals

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-chelonians
-snakes

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Respiratory infection
-why common in reptiles

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-simple respiratory system
-lack of a functional diaphragm

-can't expel secretions and exudates via coughing

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Respiratory infections
-predisposed by

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-poor sanitation
-malnutrition
-improper environmental temperature and humidity

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Respiratory infections
-signs

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-anorexia
-lethargy
-open-mouth breathing
-dyspnea
-occasional mucopurulent nasal discharge
-buoyancy problems in turtles (typically unilateral)

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Respiratory infection
-diagnosis

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-signs
-radiography
-hematology
-culture and sensitivities of trachea (tracheal wash)

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Respiratory infection
-treatment

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-parenteral antibiotic administration
-general supportive care

May be helpful:
-nebulization therapy
-diuretics
-bronchodilators
-mucolytic agents

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Upper Respiratory Tract disease of Desert Tortoise
-clinical signs

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-rhinitis with clear purulent nasal discharge
-palpebral edema
-dehydration
-cachexia
-high mortality rate

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Upper Respiratory Tract disease of Desert Tortoise
-etiological agent

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-Mycoplasma agassizii
-Pasteurella testudinis (secondary)

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Upper Respiratory Tract disease of Desert Tortoise
-diagnosis

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-ELISA for detection of M. egassizii antibodies

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Middle ear infection of chelonians
-species affected

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-eastern box turtles

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Middle ear infection of chelonians
-signs

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-bulging of tympanic scale overlying the middle ear
-caseous
-occasional osteomyelitis

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Middle ear infections of chelonians
-etiology

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-Citrobacter
-Enterobacter
-Pseudomonas
-etc.

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Middle ear infection of chelonians
-treatment

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-surgical removal of caseated material
-flushing area with dilute organic iodine solution
-antibiotic therapy if severe

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Mycobacterium infection
-pathology

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-caseous necrosis and formation of granuloma that contains acid-fast cellular debris

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Salmonellosis
-most common serotype

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-Salmonella arizona

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Salmonellosis
-signs

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Generally asymptomatic
-anorexia
-lethargy
-diarrhea

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Salmonellosis
-lesions

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-enteritis
-septicemia
-abscesses
-osteomyelitis (spinal in snakes)

-granulomas
-hepatitis
-nephritis
-pneumonia

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Salmonellosis
-transmission

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-fecal-oral
-occasionally via egg contamination

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Salmonellosis
-predisposed by

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-overcrowding
-stress
-poor hygiene

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Salmonellosis
-diagnosis

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Difficult to culture
-intermittent shedders
-need proper media (SS media)
-False negative are common
-Recheck all (-) animals 2-3x with 2 wk waiting period between tests

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Salmonellosis
-potential carriers

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-All reptiles should be considered as potential cariers

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Reason for increase in Salmonellosis

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-increase in iguana popularity

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Salmonellosis
-people at high risk

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-infants
-children
-immunocompromised

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Salmonella
-treatment with antibiotics

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-leads to resistance often

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Salmonella
-recommendations to reduce transmission to man

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-education
-persons at risk should avoid contact
-don't keep in child day care centers
-reptile owners must practice good personal hygiene (wash hands, keep out of kitchen
-preventative medicine (quarantine, avoid overcrowding, decrease stress, hygiene, necropsy, etc)

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Salmonella
-treatment

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-generally euthanize clinically infected animals

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Inclusion body disease
-animals affected

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Boids
-Boas (boa constrictors)
-Pythons (burmese pythons)

-uncommon in ball pythons and rosy boas

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Inclusion body disease
-etiology

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-retrovirus

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Inclusion body disease
-transmission

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-route of natural transmission unknown
-vector ---> Ophionyssus (snake mite)
-body fluids? feces? aerosol? PO?
-vertical transmission

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Inclusioin body disease
-signs in boas

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-Poor doers: anorexia, listlessness, dec. weight
-Regurgitation 1 wk post-prandially
-Rare neurologic sings: dull mentation, subtle head tremors, dec. tongue flicking)

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Inclusion body disease
-signs in pythons

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-more rapid course
-anorexia
-dec. weight
-occasional respiratory component
-neurologic signs: dull mentation, listless, slow righting reflex, head tremor, disorientation flaccid paralysis

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Inclusion body disease
-antemortem diagnosis

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-history and clinical signs
-CBC (leukocytosis occasional)
-blood smear (inclusions within WBCs)
-biopsy of esophageal tonsil, gastric mucosa, liver, kidney, commonly other tissues

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Inclusion Body Disease
-definitive diagnosis

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-histopath or EM --> eosinophilic intracytoplasmic inclusions in epithelial tissue

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Inclusion body disease
-common tissue for intracytoplasmic inclusions (boas, pythons)

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Boas
-pancreas
-kidney
-liver
-brain

Python
-brain

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Inclusion body disease
-recommendations for boid collections with IBD

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-strict quarantine (3-6 mo)
-euthanize positive snakes
-separate snakes with clinical signs
-disinfect housing
-increase husbandry
-don't ship snakes around
-individual testing

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Inclusion body Disease
-treatment

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-none
-supportive care


-euthanasia recommended

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Inclusion body disease
-prevention

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-strict hygiene (control mites)
-strict quarantine