iHerp_Australia_-_November_-_December_2018

With the increasing popularity of keeping captive
reptiles, comes the need to ensure the healthcare of these
animals is considered. Whether one owns a single reptile
or has a large collection, a focus on disease prevention,
early recognition of illness and an emphasis on welfare is
essential. The following article will discuss the use of
home visits in herp medicine and why I have found this
to be an essential complement to my practice. We will
also have a look at some of the specialised equipment
and set up used in reptile/amphibian veterinary medicine
both on the road and back at the clinic.

The reptile consult.

As any keeper knows, the key to a healthy reptile is

husbandry. The typical reptile consult involves asking a

number of questions to determine if the living conditions

support ideal health and vitality. To facilitate this, a pre-

consult health and husbandry assessment form is filled

out. Providing pictures of the enclosure (or enclosures),

bringing in a recent shed, collecting a recent faecal

sample, or bringing in water in the case of aquatic species

adds to this information databank. When combined with

a physical exam, all this helps to determine the overall

health of the animal. In many instances this is adequate,

but there are a few key issues with this form of

consultation.

Every time a reptile or amphibian is removed from the

enclosure, its body is under stress. With reduced access

to heat, their body temperature drops and parameters

such as activity levels, heart rates and respiratory rates

will start to change. Healthy individuals will generally

handle this without concern, but if there are already

environmental stressors or disease is present, this

increases the risk of illness. These issues are com-

pounded when multiple animals are brought in at once.

Special consideration needs to be made to avoid contact

between individuals so as to avoid stress, trauma and

spread of disease. When more than 3-5 patients require

examinations, this can be a logistical nightmare and often

requires multiple visits. To avoid this, a home visit can

be of benefit. Examining the animals in situ, visualising

the enclosure set up and being able to assess the environ-

mental conditions (UVB, temperature gradient, basking

areas, feeding material, etc.) in person enables greater

insight and can improve treatment recommendations.

Simple procedures such as sex determination, blood

collection, viral testing, ultrasound and biopsies can be

easily performed on site. If necessary, individuals that are

in need of hospitalisation or more complicated proce-

dures can be brought to the clinic and transported with

appropriate travel enclosures and heat provided en route.

If a hospital trip is not required, they can quickly be

returned to the comfort of their enclosures. This approach

greatly reduces the risk to the animals and produces the

best information in the shortest amount of time.

Healthy herps on the

road and at the clinic:

developing a reptile-

specific practice.

Herpvet Dr Josh Llinas explains what you can expect from a dedicated

reptile veterinary practice. And if you can’t go to him, he may be able to

come to you!

1.

Image by Michael Cermak.

My typical home visit kit contains digital

scales, blood and pathology collection

paraphernalia, stethoscope and Doppler

for cardiac assessment, portable ultra-

sound, portable radiographic equipment, a

myriad of medications, instruments for

simple procedures and restraining

equipment.

Clinical procedures.

Once back at the clinic there is access to

a complete suite of specialised equipment

including digital x-ray, dental x-ray, CT

scan, endoscopic equipment and the

in-house laboratory.

When a procedure cannot be performed

without sedation, and general anaesthetic

is required, this can be accomplished in

the controlled environment of the

surgery. One of the complicating factors

of managing reptile patients is their

tendency to stop breathing when they are

anaesthetised. This requires our patients

to be intubated and ventilated and there-

fore is not appropriate to be performed

outside of a clinic or full mobile hospital. Once anaesthe-

tised, an apnoeic (non-breathing) patient can be attached

to an automatic ventilator. This sensitive piece of

equipment will provide anaesthetic gas and oxygen and

frees up our hands during the anaesthetic. It is also

sensitive enough to reduce the risk when ventilating the

smallest of patients (down to 10 grams); protecting the

delicate lung structures. During anaesthetics, the heart

can be assessed by electrocardiogram, Doppler and visual

observation. Carbon dioxide and oxygen trends are also

monitored along with the temperature, muscle tone,

withdrawal reflexes and other subtle signs. Temperature

is a critical part of the anaesthetics. If the temperature is

not maintained in a reptile or amphibian’s preferred

optimal temperature zone, this will lead to alterations in

the way they metabolise the anaesthetic and can lead to

prolonged recoveries or issues with blood pressure and

organ function. To assist with this, the patient is brought

to their correct temperature (often over a 24-hour period)

in the hospital ward; the surgery room itself can also be

temperature controlled. Effective temperature

management is achieved using equipment such as

thermostatically-controlled, circulating, warm-water

blankets, warm-air blankets or other warming agents.

Once in surgery, the anatomy of the species needs to be

considered. The difference between a gecko, a turtle and

a Scrub Python require advanced planning to ensure a

smooth anaesthetic, surgery and recovery. Specialised

oscillating saws may be needed for entering a turtle’s

body cavity (trans-plastron), or instruments such as the

Lone Star retractor can be used to improve visualisation.

Magnification with surgical loupes greatly assists with

the smaller surgeries and allows for the precision

required for successful outcomes.

1. Josh’s home visit kit includes a myriad of medications, along
   with instruments for simple procedures.


2. Back at the clinic, there is access to a wide range of
   specialised equipment.


3. A feeding tube may be required for turtles that cannot be fed
   underwater. All images courtesy Dr Josh Llinas.

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