Exotic Med - Common Techniques And Diagnostic Procedures To Evaluate Reptiles

Front 1

Reptiles
-transporting

Back 1

Depends on size and spp.
-ventilated burlap or cotton bag (pillow case)
-large plastic box or garbage can with air holes
-plastic box with a water level that covers the animals feet (semi-aquatic)
-dechlorinated water to cover the animal (aquatic)

Keep old bedding for fecal and urine tests
-reptiles aren't defecating daily like cats and dogs

Front 2

How does evaluation of the patient start?

Back 2

-observation

Front 3

Very basic of physical exam

Back 3

-handling

Front 4

Ways to handle properly

Back 4

-turtles can bite (hold butt)
-snakes can bite (control head)
-can control lizards with Vaso-vagal effect
-tail autonomy of lizards

Front 5

Physical exam
-basic approach

Back 5

-by body system
or
-tip of the head to tip of the tail

*pick one method and stick with it

Front 6

Vital signs to measure

Back 6

-pulse/heart rate
-respiratory rate and efforts

Front 7

What is an important objective parameter of the physical exam

Back 7

-weight

Front 8

Skin
-abnormalities that can be found on PE

Back 8

-lumps
-bumps
-bruises
-missing scales
-ectoparasites

Front 9

PE
-how to evaluate the head

Back 9

-palpate skull ---> deformities
-eyes ----> swelling, redness
-ear ----> tympanum
-nostrils ----> clear
-mouth ----> teeth, mucous membranes, tongue

Front 10

Stomatitis
-aka

Back 10

-mouth rot

Front 11

PE
-evaluation of the musculoskeletal system

Back 11

-palpation
-compare to contralateral
-look for swelling/redness
-limbs and joints ---->range or motion & strength
-digital necrosis

Front 12

PE
-uro-genital evaluation

Back 12

-stool evaluation
-vent (cloaca)
-rectal exam
-look for prolapses

Front 13

PE
-sex determination

Back 13

Dimorphic spp
-femoral pores
-dewlap
-hemipene bulge
-eye color

Blunt probing for animals that don't show sexual dimorphism

*there are medical conditions related to sex (ex: eggbound females)

Front 14

Sex determination in tortoise

Back 14

-concavity in the male plastron for mounting females

Front 15

Blood samples
-evaluate what?

Back 15

-RBCs
-WBCs
-Plasma enzymes
-electrolytes

Front 16

Blood sample collection
-safe amount to collect

Back 16

0.5-0.8% of body weight

* very small amount ---> hard to collect

Front 17

Blood collection
-how to collect samples

Back 17

-use heparin over EDTA

*EDTA can cause hemolysis in some species (chelonians)

Front 18

Blood collection
-problems

Back 18

-invasive
-associated pain (select method that causes least amount of pain)
-risk of bacterial infection (aseptic technique)

Front 19

How should blood samples be evaluated?

Back 19

-fresh blood smear

Front 20

Venipuncture in lizards
-locations

Back 20

-ventral coccygeal/tail v.
-jugular

-cardiac ----> euthanasia

Front 21

Venipuncture in snakes
-locations

Back 21

-cardiac
-ventral tail v.

-Palatine

Front 22

Cardiac venipuncture
-benefit

Back 22

-large blood volume provided

Front 23

Cardiac venipuncture
-heart location in snakes

Back 23

-cranial 1/3
-dorsal position

Front 24

Cardiac venipuncture
-heart localization method

Back 24

-visual inspection or palpation
-doppler

Front 25

Cardiac venipuncture
-equipment

Back 25

-22-25 gauge needle inserted under scale

Front 26

Venipuncture in Chelonians
-locations

Back 26

-Jugular v.
-Subcarapacial v. (lymph dilution)
-Dorsal coccygeal v. (lymph dilution)
-Brachial v.
-Postoccipital venous plexus

Front 27

Reptile injection sites

Back 27

-subcutaneous (SC)
-IM
-IV
-intracoelomic (ICe)

Medication and Sedation
-SC & IM (epaxial/cranial body) --> snakes and lizards
-SC & IM (front legs) ---> lizards and chelonians

Front 28

Reptile Fluid Support
-important questions

Back 28

-what fluids do I use? (type)
-how much do I give? (rate)
-where do I give it? (route)

Front 29

Fluid support
-normal range

Back 29

-20-30 ml/kg/day

***no universal rate for reptiles (approx. 1/3 mammalian rate)

Front 30

Fluid support
-routes

Back 30

-Oral (PO)
-Subcutaneous (SC)
-Intracoelomic (ICe)
-Intraosseous (IO)
-Intravenous (IV)

Front 31

Oral fluid administration
-use

Back 31

-mild absorption

Front 32

Oral fluid administration
-benefits

Back 32

-physiological route of fluid absorption
-non-invasive
-can stimulate GI motility

Front 33

Oral fluid administration
-concerns

Back 33

-backflow----> aspiration in cold, debilitated animals

Front 34

Oral fluid administration
-how much

Back 34

2-3% of body weight

Front 35

Oral fluid administration
-how

Back 35

-esophageal/stomach tube
-syringe into mouth

*careful to not have regurgitation and aspiration

Front 36

Subcutaneous fluid administration
-why rarely used

Back 36

-limited subcutaneous space
-poor vascularization
-highly variable absorption rates

Front 37

Subcutaneous fluid administration
-indications

Back 37

-possibly ok for mild dehydration

Front 38

Subcutaneous fluid administration
-how to administer

Back 38

-lateral body wall
-chelonians = brachial or inguinal

Front 39

Subcutaneous fluid administration
-caution

Back 39

-beware of high skin tension (chameleons) and fragile skin (geckos)

***check the bubble

Front 40

Intracoelomic fluids
-use

Back 40

-moderate dehydration

-avoids pressure necrosis from SC administration

Front 41

Intracoelomic fluids
-reason for good efficacy

Back 41

-coelomic membrane & serosal surfaces are highly absorptive

Front 42

Intracoelomic fluids
-problem

Back 42

-No diaphragm
-can flood in and compress the lungs/air sacs

Front 43

Intraosseous fluids
-use

Back 43

-severe dehydration
-debilitated reptile

Front 44

Intraosseous fluids
-location for administration

Back 44

-distal femur (lizards)
-proximal tibia (lizards & chelonians)

Front 45

Intraosseous fluids
-negatives

Back 45

-highly invasive
-traumatic

*beware of MBD

Front 46

Most effective route of hydration

Back 46

-Intravenous

Front 47

Intravenous fluids
-most useful for:

Back 47

-medications
-anesthesia

Front 48

Intravenous fluids
-procedure

Back 48

-requires surgical cutdown
-suture in place

Front 49

Intravenous fluids
-locations for placement

Back 49

-tail vein (lizards, no cutdown)
-jugular (all reptiles)
-cephalic (lizards)

Front 50

Common diagnostic procedures with reptiles

Back 50

-lung/tracheal wash
-endoscopy
-biopsy
-cytology
-imaging

Front 51

Shell rot
-common in what animals

Back 51

-aquatic app

Front 52

Shell rot
-ways to diagnose

Back 52

-skin smears
-scraping
-swab
-C/S

Front 53

Reptile anesthesia
-reasons why dificult

Back 53

-missing data on species physiology and drugs
-diving reflex
-poor control of the cardiovascular system (limited IV access)

Front 54

Why is the diving reflex a problem in reptile anesthesia?

Back 54

-reptiles can hold their breath for long periods of time

Front 55

How to determine state of anesthesia in a reptile?

Back 55

-determine the patient's norms before anesthesia
-relaxation progresses from cranial to caudal, then recovery is in reverse
-righting reflex
-corneal reflex
-tongue reflex

Front 56

Early stages of anesthesia

Back 56

-righting reflex
-response to stimuli

Front 57

What is important to provide reptiles who are under anesthesia?

Back 57

active respiration (no diaphragm)
-manual
-respirator

Front 58

Anesthetic monitoring

Back 58

-response to stimuli
-respiratory rate
-heart rate: doppler, ECG, pulse oximeter

Front 59

Anesthesia recovery

Back 59

-keep intubated and place on room air until spontaneous respirations occur and reflexes return

*Recovery can be slow
*make sure the animal is put onto room air for recovery, because O2 will keep them asleep