Hi, everybody. This is Reptiles 2, as the title says, this is a follow-up from Reptiles 1, which is an intro to anatomy and physiology. This goes over snakes, elonia, and lizards, and looks at some more common clinical presentations, more common clinical techniques, some things you might come across in general practise, to give you an idea of how to handle these patients.
So first off, we'll start with snakes. So we'll go through these guys. So depending on the species, lifespan could be up to about 30 years, which is a decent long term commitment.
And as we discussed in the last lecture, ecdysis or shedding is normally in a single piece. Really important to make sure the spectacles come off and get the owners to check that shed kind of as it as it comes off, and ask them to reach out if there is retained spectacles. In practise, boas are relatively common, and so are corn snakes.
They're probably the two most common species that you come across or that you may see others. So boas are within the boadae and corn snakes are within the Calubridae family of snakes. The anatomy is fairly simple to split into different thirds, and that can be useful to know in terms of ultrasonography or radiology, you know, to find out.
Where problems might be, give you an idea of where masses or foreign bodies or things you might present. So the proximal third is this picture here. So it goes down to get some lung in there, but you can see the heart, you can see the thyroid gland is just cranial to the heart, see the windpipe, and that's the cranial third or the proximal third, and normally a radiograph and two views, so a lateral and a DV.
And the easiest way to do a snake without sedating it is to find a P is to find a pipe, you know, a thin plastic pipe, and Get it in and then you can roll it either way, so you can get a later and a DV if it's the perfect size pipe. That's pretty helpful way of doing things. So the middle third, you get the tail end of the lung plus minus the air sac.
So again, species dependent on how big those air sacs are. So aquatic snakes, the air sacs goes all the way to the cloaca. Most snakes, they're pretty limited in size.
But you might see lung and air sac here. Just ventral to that is the oesophagus kind of squeezing through with the liver. So you can see the liver is the soft tissue opacity in the ventral, caudal part of the middle third.
After that, you're going into your stomach. You might be able to pick up, pick up the spleen and pancreas and gallbladder, but it's gonna be pretty difficult, you know, you don't, it's, it's, it's not always easy to differentiate all those soft tissue structures. And then you go into intestines kind of after those lungs and 11 trick you can do here or here if you're looking for GI tract issues, or particularly foreign bodies, is you can label them.
You can put, if you use ballpoint pens and just place it next to the snake, you know, or something metallic a paper clip or something, you can use that to really guide where you are in that snake's anatomy in terms of, you know, if it's a surgical procedure where you're gonna make your incision. In the caudal third, you might see a little bit of the air sacks sneaking in, but it's generally intestines back here and colon, so you can see a lot of faeces in this radiograph, within the colon, and the kidneys kind of live up here as well. And so colon, large intestine, and then all way to the vent.
Interestingly, they got different ways to locomote, so different ways to move around. So this is a lateral undulation. So this is a A snake that moves laterally, things like races.
They, they really prefer sandy environments or rough environments. They don't really like glass, you know, they can't climb up walls very well. So that's a racist snake.
After that, we have the rectilinear. These are things like boas, and this is how a boa moves. So it kind of pulls its pulls itself forward every time, as opposed to a lateral indulating which is side to side.
So you can see the difference there. The third one is a concertina effect, so this one kind of pulls together like that and then springs forward again. So it's amazing when you think about it.
There's actually 4 different ways that snakes can move. And I bet nobody really thought about that before. And the sidewinders, which are these ones that you see on National Geographic and stuff, go down these sand dunes sideways.
And these guys are pretty cool, especially when you get rid of these, these graphics like this. So these guys move fairly quickly for snakes, but they're a little bit different. Anyway, I just thought those were interesting, so I thought I'd show you.
This slide, with these words, as opposed to these pictures, these words will become fairly common as we go through this webinar. It's the, it's very similar things throughout all species of reptiles. So husbandry, you know, snakes are carnivores, so feed them.
Meat, whole prey, feed an appropriate sized food. So this bon on the top is eating a sheep and is stuck in the middle of the road, cause it's eating too much. The sad cat one on the bottom left, and then the one on the right is eaten probably an egg or something, I think.
And I don't see any bones in there, but that's a meal with that snake getting ingested. Just a reminder, POTZ is preferred optimum temperature zone, and that is really species dependent, and it's good to know it and have an idea for different species, but it's certainly easy to find out or look up if you need to. Humidity is important.
Again, species dependent. So, you know, when you're looking at the POTZ or, you know, how to care for animals, you'll pick up things like humidity, temperature. Light requirements, stuff like that.
So humidity is important, especially for, to prevent dysectiasis. The substrate is important. Newspapers probably the most, the best one generally, but people don't like it because it doesn't look very natural.
It doesn't look like a normal snake area. So you don't see it very often, but it's easy to clean. They don't eat it, and they don't ingest a lot of sand or anything like that.
Give them a hide box so they can hide away. I think that's nice. And UV is questionable, so.
Well, we talked a bit about metabolic bone disease in the previous talk, and the requirement for UVB to utilise dietary calcium. It's very rare to see metabolic bone disease in snakes, and the feeling is that they probably ingest enough vitamin D in their diet and able to utilise it that they can manage without UVB. But it certainly wouldn't do any harm to give it.
I've never seen a metabo bone disease in a snake, despite the fact they've not been kept with a UVB light. But, you know, there's other effects of UVA and UVB. Such as reproduction and noble and behaviours which it triggers.
So it's, it's not wrong to provide it. Probably if the taxa of reptiles is the least important. Some clinical techniques.
Hydration is obviously a fairly common thing that we try and do for dehydrated animals, you know, if it's not kept in the human environment, it's likely to be dehydrated. So bathing, so although I wouldn't recommend the top picture, bathing it in a warm tub of water, however many times a week you think is necessary to severely dehydrated the animal is, is a very effective way to get fluids into almost all species of reptile. It's useful.
It's relatively stress-free. It's non-invasive. They can take what they drink water, they'll take it in through the cloaca.
And so it can be useful that way. Obviously, oral meds as well. So here's a picture at the bottom, just to show you where the stomach is, just to remind you where it fits anatomically wise.
You can put a red rubber catheter or, you know, something down there and put fluids in. That's relatively easy to do in a conscious animal, but obviously, I think it's more stressful than bathing and you're limited by stomach volume. And then subcutaneous is probably the last choice.
The subcutaneous space does not expand very well. You go either side of the spine, and you can see, you can feel the spine. Just pop to one side where the needle just go under the scales.
Don't go through the ribs because you could be in lungs or something like that, but just go in the subcue space and inject a little bit of fluid, and you'll see it advanced cranially and cordially from your injection site. It does not expand very well, so you can't get big volumes in. So really bathing is the way to go.
The easiest, most stress-free way to kind of rehydrate a snake. And then if you get presented with a sick animal, then you want to take a blood sample. Couple of different ways that we might want to use straight away.
The one I would normally go for is the ventral tail vein. So this picture on the top shows that the black arrow is pointing to the cloacro of the vent. And I know we mentioned last time that if it is a breeding animal, you don't want to disrupt the hemipes.
So what I would recommend to do, if it's a male, is go more than probably more than 12 scales cold to the vent before you start sticking needles in just in case you damage hemipes. Gravity is definitely a friend. So what I would generally do, although this picture doesn't show it very well, is have the tail kind of dangling off the table.
Leave it for a minute or two, let the blood really pool down there. They don't have massive blood pressure, so blood tends to pool, tends to flow easier. You go in on midline, advance the needle, either perpendicular or 45 degrees like this one, until you hit bone.
It's really important to stay on midline, and then once you hit bone, slowly draw back with your plunger and maybe pull your needle out a tiny bit, maybe rotate it. Small slow movements are key. Their blood, it doesn't come back fast like a mammal, so sometimes you can be sat there a little while while it fills, but that's OK.
Just, just be aware that small movements are helpful and the tailbone is tiny, especially in things like boa. So that's often why for this big boa, you can see on the bottom picture, we've gone for a cardiac puncture. This is performed in snakes that are awake.
It's becoming less accepted as a means of blood collection. There's numerous literature out there which shows a lack of pathology in terms of post-c cardiac sampling, you know, numerous times over numerous days, but I think it's probably still a painful procedure, if you compare it to the tail. The big thing about this is you to do it, you lay the snake on its back.
And you can actually visualise the heart beating, so you can use your anatomy and know it's the cord edge of the cranial third somewhere around there. Then you stabilise it as best you can, like this, the person's hand is doing that to keep that body section straight and stable. And then you go probably 1 or 2 scales cordal to it and go in a 45 degree angle towards the heart, so you're hitting the apex of the heart.
Then slowly draw back. You'll find your syringe will fill has the heartbeats, so it'll fill in a, in a pulsatile motion as much as anything. The big one here is don't wave around in there, so go in straight towards where you think the heart is.
And start to draw back as you go in. If you, if you don't get it, don't wave the needle around in there. If you're next to a great vessel or you're next to the heart, you can easily cause a laceration or a problem.
So you really need to stay straight, get blood, and come out. And if you get, if you go in and don't get blood, you're not in the right place and moving around doesn't help. So come all the way out and redirect or reassess.
So those are the two main ways to get blood. There's also the dorsal palaine vein, which is in the mouth. Pretty, I've never done this, but hematomas are pretty common.
It's at the bitey end of the snake. It doesn't seem like the most sensible way to get it. And they do have a jugular.
There's no really good physical landmarks which are consistent among species to try and get that jugular. So if you wanted a jugular, which is where we place an IV catheter usually, you do a cut down and then put the jugular in. And certainly snakes are not the best animals to get IV catheters and long-term venous access in.
And again, just to reiterate, don't use EDTA. Put it into green top. You don't want to work hard, get a blood sample and, lice it all in EDTA.
They don't have a cough reflex, so you can intubate them conscious, and this is one of the few animals you can you can induce fire gas alone, so you can open the mouth, you can intubate, and then do very fragile, very . Be careful with bagging them. They're pretty fragile lungs.
So if you do, if you do ventilate them, just be gentle that you don't explode the lungs. And you can pump gas into the respiratory tracts and gas them down that way. Works pretty well.
They tend to do OK. And as I say, this is snakes only, the rest of them, you know, don't, don't respond well to that. This also means they can't cough.
So if they have pneumonia, they can't cough up all these exudates. So it's a double-edged sword. It's nice for gas anaesthesia, but in terms of getting rid of pneumonia, it's a problem.
This is a pretty common thing that people want you to sex the snake, you know, they're sexually indistinguishable from the outside most species, but usually it's pretty subtle. So often we do this, which is called a probing. This is the this is the best way or the easiest way to do it, I think.
So snake probes are metal. Sticks, I guess, with a blunted rounded end and you choose the appropriate size for the snake. And you.
Basically go in through the cloaca and flip it 180 or flip it 90, sorry, so you go straight into the into the cloaca perpendicular to the snake, and then drive down. And then if you go 10 to 12 snakes or more, it's a female, it's a male, and if you go only 2 or 3, it's a female. So you can see the top one would be a male and the bottom one would be a female.
Some clinical presentations you might see in snakes. So stomatitis, pharyngitis, common, commonly seen, commonly seen with other diseases as well. Again, you know, just to harp back on it, it's often poor husbandry that leads to secondary bacterial or viral infections that they'd otherwise be able to fight off.
And stomatitis is, is certainly a thing that happens. So oral exam is important. You can open the mouth of a snake fairly easily.
So you see this bottom one has been done with a, a tongue depressor, those wooden sticks. The middle one is a horrible, severe bacterial stomatitis, and then the one on the right, you can see a stomatitis again, it's horribly bloody and nasty in there. So the oral exam is pretty important during a physical exam.
This is an example of dysectiasis. So we saw a picture of this in the previous one. This is just another one, a snake not shedding in one piece, lots of different pieces coming off.
And then this is a retained spectacle, so you can see the sheds peeled away from this animal on the right. You see the old shed, and you can see the spectacle is kind of wrinkly there. Be careful.
It's, it's not always easy to distinguish what is retained spectacle, what is new spectacle, and what is cornea. So be sure before you start messing around too vigorously. What I generally recommend for these is putting them back in the Bavarian with a wet towel and let them kind of crawl or wriggle through that wet towel over a few days, increase the humidity.
You know, this is not a life threatening situation, and it's something that you want to fix for future sheds, but you know, in terms of now, it doesn't have to be fixed right away. So send them home with a wet towel, increase humidity, and encourage them to move through that wet towel, it'll take the stuff off and hope for the spectacle. You can put artificial lube on it or artificial tears to lubricate that spectacle and hope that peels away.
You can use wet cotton tip cotton tip applicators and kind of rub it away. I would avoid using forceps and trying to peel it away just in case you've got the wrong thing and you've got a piece of cornea or, you know, the actual spectacle there. So those are all options, but softly, softly, increased humidity, those are the, those are the main ways to fix them.
So this is a pretty common presentation. It's not one you want to see, but it does happen. So this classic kind of clinical picture, the mid-body swelling about halfway down the snake in conjunction with regurgitation, which you obviously causes weight loss and then it dies.
This is, this is a classic picture for a parasitic infection known as cryptosporidium. You could argue it's neoplasia too. If there's neoplasia in the stomach.
I don't think you'd be wrong, but the first thing that springs to mind is cryptosporidium, which lives within the gastric wall, causes a hypertrophic gastritis, so it narrows the lumen of the stomach so food can't pass, so it gets to regurgitation. It creates, it makes it so big that you see this mid-body swelling from the outside. This is a highly infectious disease process.
That is not treatable. So it's nasty. It's Cryptosporidium serpenty.
If you've got a one snake household, then it's bad luck. If you've got a multi-snake household with lots of snakes, you've got a problem on your hands. Because of the, the lack of treatable options.
You can diagnose it in numerous ways, so stomach wash and look for the crypto or stomach biopsy and do it that way like the picture on the top right. You can do a faecal look for crypto. Be careful and make them speciate it.
Sometimes, some mice carry cryptosporidium murus, that's cryptoridium of mice, the usual prey. And so you can actually get a diagnosis of cryptosporidium, but if it's not speciated to crypto to cryptosopenty, it can be misdiagnosed and it's actually cryptomurus. So be aware of those things.
This is a nasty disease that doesn't go away. Another infectious disease you might see is inclusion body disease or IBD. This really primarily infects bowed snakes, so that's boas and pythons, and it affects them differently.
So boas, you generally see regurgitation as the first option. And Pythons, you normally see neurological issues. So neurological snake looks like this one on the left, which is a star gazing animal that's up in the air, doesn't really know what it's looking at.
And then non-writing is the snake on the right. I've seen that in generally sick snakes. I don't think it's primarily or always a neurological thing, but if it's otherwise in good body condition and seems OK without any other disease processes, you might be classed as neurological.
It's caused by an arena virus. Snake mites have been implicated in transmission, but it's not 100% known. And it's, it's, it's a problem for snake breeders or people in multiple snake households.
Different ways to diagnose it, so the cheap and cheerful way is a blood smear and see if you see consistent inclusion bodies within the heterophils or the white cells. It's cheap and cheerful because it's the least sensitive, so you can definitely miss positives, . A few years ago, the big one was either a tonsil biopsy or a kidney biopsy, which you can do relatively routinely.
You know, once you know where the kidney is through your snake anatomy, you can punch a bit of kidney and look for it on histology. But now there's a PCR available for renovirus and IBD, which is probably the most useful diagnostic tool. So that's it for snakes.
We're gonna move on to Tilonia. That was just a few, a couple of different things that you might see in snakes. I thought I'd talk about Tillonia for a little bit.
So in terms of species, they live the longest, the Galapagos up to about 150 plus years, probably longer. And the largest is leathery turtles, up to about 700 gigs. And there's two, there's two main umbrellas.
There's a side neck turtles, which is the loradera, and there's a hidden neck turtles, which is the cryptodira. Normally we see the hidden necks rather than the side necks. To cool themselves off in the wild, the burrowing vegetation, and then it, and if you're in a desert and you don't have vegetation, you salivate or urinate on your legs in the plastron, and that evaporative stuff helps cool them down.
It's important to be aware of the normal anatomy. So a lot of these might be traumatised, bitten by a dog, hit by a car, something like that. So it's important to know what is normal in terms of fractures.
So this is the pectoral girdle, which is inside the ribs. Knowing what's what here is definitely useful. So the scapula, see the acromion process of this scapula is, is a decent size, and you can see that on the radiograph as well.
As well as the carraoid, which is the caudal facing bone there, and again you can see that on the radiograph. So knowing what that pectoral girdle looks like is useful and there's also the pelvic girdle which you should be aware of, which is obviously around the pelvis. The carapace is the dorsal and the plaster is the ventral part of the shell, and those are both made up of bone scoots, so instead of scales, they have scoots.
Generally, the male plastin is concave, so there's a depression there. And what's that? What the function of that is for breeding potential, so they can actually mount the female and sit on top of them.
Males usually have longer tails they're a bit thicker, and the vent is outside the carapace, whereas the females is inside the carapacece. And that's probably like you, you kind of pointers to sex than male versus female. There are names and numbers.
There is the menclature for all the, for all the scoots on the carapace. So you can see, the nucle scoot is the front one, the neural scoots 1 to 8, the costal scoots 1 to 8. And the peripheral scoots 1 to 11 on each side.
So if you had to describe a fracture or something, a wound, you could actually give some nomenclature to that, to that wound or. Pathology. This is a box turtle, so these guys are cool because they can close up.
So this is actually a plaster on hinge where this is, so this is not a fracture and you see it here in the DV as well. This is a nice radiograph. You can see the pectoral girdle and the pelvic girdle here along with a load of faeces, but just ignore that.
So that's a plasterron hinge and they can actually close up completely. So again, you'll recognise the words from the snake slide, but feed inappropriate food. So what, what is the species?
Is it herbivorous? Is it carnivorous? Is it omnivorous?
Knowing knowledge of the normal species really helps you pin down whether the husbander is correct. Again, they have a POTZ which is species dependent, and a great resource for this is a website called Anapsid.org, A N A PSID.org and NASID.
And what that has is a is a is a good array of commonly kept pet reptiles, and it gives care sheets for them, but it also provides things like what they should eat, the POTZ, the humidity, you know, good ideas for substrate, things like that. So that's, that's a useful resource for you to look at, when you're seeing a reptile or to direct your clients to when you when, when they're struggling for husbandry advice. Hide box again is useful and UV provision again is useful.
So see pretty similar here for the snake one apart from, you know, diet's a little bit different, but same words. Clinical techniques in terms of blood sampling. Again, a couple of different ways to do it.
There's, I might, there's the jugular vein, which is, here. So this picture on the left is showing jugular vein. You track it from the ear to the shoulder, and it's kind of in that fold.
It can be, it can be tricky because the, I think in my hands, it's tricky cause the folds of the neck are kind of wrinkly, so it's hard to tell exactly what's a jugular and what's not. And you can see it in this diagram here, you can see external jugular vein. So you can see there's the, that's where the ear will be down to the shoulder.
You see it's kind of on that line. Sometimes it pops up really nicely when you raise it, sometimes it doesn't. I find it hard to get to in an awake animal because they want to pull the head back inside whenever you poke them, and that makes it difficult.
So unless they're very weak and you can hold the head out, or, or if they're asleep, it makes that jugular a little bit, more difficult to hit. My favourite is the subcaripacial sinus, which is this picture on the top. So this is a sinus that runs underneath the spine, and you can do this with the head in or the head out.
So if it's, if it's a turtle that's, that doesn't want to come out, he can have his legs in, he can have his head in, and there's still a little window just in there for you to insert your needle and go for it. This is a great site for me because of that reason. The only drawback is this is the one that we will get lymph contamination with or it's very easy to.
So sometimes if you, you, you advance the needle and aim dorsally and draw back as you go in. If you get blood, great, hang there and take the blood. If you get a clear fluid that's lymph, and then you've got two options.
You either draw back a little bit until you get the vein because you've gone through it, or you come all the way out, dispose of that and start again. I think it depends on your level of concern, on your comfortable on your area of, you know, kind of how comfortable you are sticking an animal again, or how comfortable you are assessing those those, those blood values with respect to some degree of lymph contamination. So be aware of that one.
That's my favourite, that's my second favourite, and I rarely use a coccygeal vein. In terms of rehydration, sub-Q works, but again, similar to snakes, the skin doesn't expand very well. You can go epilomic, which is above the plaster and below the pectoral muscles in the alum.
You go ventrally to the scapular humeral joint and it is the opposite rear leg. You don't really risk an organ penetration because you're below the pectoral muscles, so it's around the sallomic cavity and it should absorb in. That's one, it's 2 injection routes, then it's intrasyomic, which is the ventral inguinal fossa.
I think you've got to be careful with this because you're injecting fluids into a closed space or a box because of the rigid carapace and plastron. So you inject too much, you can compromise the lung space. If you, it, you certainly could perforate the bladder, if you go really wrong, you could perforate the lungs.
So be careful when you're doing intracellomic. It's intravenous. Again, it's hard work because they pull the head in, you lose the catheter, never have really have much success with that, I have to say.
You know, you can get it in and they pull the head back in and curl it up and you lose your catheter or it kinks, doesn't flow. So it can be difficult. Intraosseous is also difficult but doable.
The limbs don't work very well because they pull the legs inside the shell, so you'll lose it. And there is the bridge, the, the plaster carapaceal bridge, so you can see in this picture it's where that person's thumb is. So that's the bridge that joins the plaster on the carapace.
You can put a catheter in there, which is relatively simple to put it in. The trouble is the fluids don't. Don't get absorbed very well, so, you know, if you're at a fluid pump, it will constantly alert because of the high pressure.
So it's a very slow fluid rate you can get into there before it absorbs through the rest of the body because it's a small enclosed space, you know. Really the best way to do it is just to bathe them, I think. It's a shallow bath.
Again, similar to snakes, they'll drink it, they'll take it through the cloaca, and that's probably the easiest way to rehydrate a tortoise. This is plaster anotomy. So this one, moving on to different clinical techniques is more surgical.
This is a tiny little one with a bladder stone, so you can see the radiographs on the right. They're not the greatest quality, but I think we can all make out a bladder stone in there. Plus I'm not going to go into a lot of details for plasterotomy just to show that it can be done even in tiny guys like this.
I have a reptile surgery webinar which will go into more techniques, more discussions on this, but this is just to show you the possibilities that you can do. Again, with limited equipment. You don't need very hugely specialised equipment to do it.
Shell trauma is what we commonly see, so whether it's dog bites or whether it's hit by a car, and I would advise you to always kind of take a full radiograph, especially because they can obviously hide fractures inside there. So whether the pectoral or pelvic girdle has been damaged, or whether it's just a shell. I think it's important to remember that these are fractures, they are painful.
Please use analgesia. And when you try and fix those shells, and again, I'll go over some more of this in terms of surgery. In the reptile surgery lecture, but this is shell repair.
You can use all kinds of things to fix them and pull those pieces of shell together. You might see prolapse. So whether it's a reproductive prolapse, a urinary prolapse, or a gastrointestinal prolapse, it's important to work out what's what when you're gonna fix it.
So reproductive can be dystopia or mating or hypercalcemia. Urinary is generally associated to a bladder disease, whether it's a cystitis. And the gastrointestinal tract, often we, we link it to parasites, but also hypocalcemia or constipation or obstruction kind of flows in there as well.
Working out what it is is important to work out how to fix it and how best to repair it. Three main infectious types of upper respiratory tract infections, there's herpes virus, mycoplasma, or rhinovirus. You can test for all three.
You can treat as indicated. And refloxacin for mycoplasma works pretty well. Herpes and rhinovirus, it's symptomatic care, and supportive care.
This snots, the swollen eyes, the stomatitis, that's all the classic upper respiratory tract infection in a, in a tortoise. Can progress to pneumonia. So again, they can't cough very well, so they don't have because they don't have a diaphragm.
So this is a pneumonia. So when I take radiographs, I generally like 3 views. So top down view of the tortoise is great to assess bone structure, pelvic pectoral girdles.
A craniochordal view is great for the left and right lung fields like this one. You can see this lung on the right hand side has got much more opacity and this is a pneumonia versus this one is, is a lot better. And then, a lateral view allows you to see if this pneumonia is in the cranial, or global portion of the lungs.
So that's it for colonia, or Chellonia, however you wanna say it. And so next we'll move on to some lizards, talk about some lizard conditions and how to look after those guys. So lizards are a really diverse group of reptiles.
They could be arboreal, flying, gliding, I guess they don't really fly. They could live in rocks, they could be semi-aquatic, and then squaw mates are about the vast majority of all reptile species. So to be seen in practise, probably the most common ones you'll see, greeny guana, beady dragon, chameleons and geckos.
I guess you could see some monitor lizards that's on there, but it's probably less likely. So bearded dragons, geckos, are a lot of kids' favourite first pets that parents buy and sometimes they end up in your vet clinic. The hearts of the pectoral inlet, so it's way up here, more advanced lizards of a heart more caudal.
So you can see here's the pericardial cavity here. So it depends on the species as to where the heart is. You can see this is a nice lateral radiograph of a, of a lizard.
They normally have 55 digits, and the number of phalanges varies with the number of digits, so don't be tricked into thinking they've lost a load of toes or lost a load of phalanges. So if it's digit 1, it's normally got 2, it's digit 2, it's normally got 3, digit 3, it's normally got 4 phalanges, digit 4 normally has 5 phalanges, and then digit 5 that says break the trend and digit 5 normally has 3 phalanges. So this is what a normal lizard foot looks like.
While the lizards can show autotomy or self amputation when the tail breaks off. It's a, it's a predator prey response. So somebody grabs them by the tail, they can escape, they can lose it.
And iguanas, skinks, and geckos can all do it. If you're, if you're a species that needs that for climbing or defence, so chameleons or monitors, generally you don't have autotomy. And on radiographs you can see the fractured planes if you were, if you're not sure if it's a species that has it or not.
Here's what it looks like. You get this kind of squid, for want of a better word, kind of stuck out the old one and the, and the new one, and this is what it looks like when it's broken off. Don't stitch it.
It don't suture it, don't mess with it. It heals just fine by itself. It's designed for that.
They will generally grow a tail back, but it'll be a smaller, skinnier poor excuse for a tail than they used to have. And I think this is important to be aware of if you decide to take a blood sample from the tail of someone's prized leopard gecko. Throwing the tail is certainly a risk that you might want to discuss with them.
Again, this is exactly the same slide as in Shelloni, just to hammer at home, so feeding appropriate food, herbivores, carnivores, omnivores, or sometimes they change through life. So bearded dragons will start off as a young age and eat primarily crickets and insects, and then as they age or as they become a mature set size, they should switch to a 90% leafy greens vegetable diet and only 10% crickets and stuff, so. A lot of people don't do that, but just be aware of that as a, as a dietary thing.
Again, POTZ species dependent, you know this by now, humidity, decent substrate, high box, and provide UV is important. So how do you sex them? A lot of sexual dimorphism, .
So these are, this picture shows femoral pores, which are in the, in the back of the leg. And that's on, that, that's on males, things like bearded dragons. You can either hemipes, you can endoscope them or radiograph them if they've got calcified hemipes, or you can ultrasound them for hemipes or ovaries and follicles.
Hydration is again very similar to previously, so oral works, so dis subcutaneous, but soaking is really the least, the least stress, most effective way to get fluids in there. Put them in a warm bath for 20 minutes once a day and you'll rehydrate your animal fairly successfully. And then in terms of blood sampling, we mentioned the ventral tail, again car with autotomy.
So the ventral tail, very similar to a to a snake, go in midline, hit that bone and gently draw back. Again, gravity can be a friend. You can go lateral or you can go ventral, especially for the big ones, so you can hit a lateral tail vein as well.
There is a ventral abdominal vein. I've never had much success with this vein, but you can go right on the midline of the salomic cavity, and, and hip blood and take blood samples from that ventral abdominal vein. I just thought I'd show you pictures of an esophagostomy tube placement.
This is normally done under general anaesthesia. It's not different to any sperm mammal. So, oh, excuse me, so sedate them, pre-measure the tube.
So here's the feeding tube, here's where, here's where the, here's where you're gonna mark it. This thing is intubated. Going with curved hemostats through the mouth, push up against the oesophagus, where you see that, make an incision.
Grasp the tube and pull it rustrally so it comes out the mouth. Then you've got your marker, you do a Chinese finger strap shoot to the skin, and then you can take this end and flip it 180 and push it into the stomach. So that end gets pushed 180 in the stomach.
So this is Chinese finger trap sutured here, and here's a feeding tube and it's placed in the stomach. You should always check it's in the stomach, the radiographs. I've seen it once or maybe twice when you've flipped that 180 and push back down the oesophagus, the end of the tube has actually come out your esophageal wound and gone into subcutissues, which is not recommended.
So, always go ahead and check. Some presentations you might see, this is great, this is sand impaction. We see this in animals that are kept on sand because people like to do it because it looks great, it looks nicer for them, but as they eat over the years or the months, they ingest sand with their food.
So it can cause problems. So, different ways of advice, to advise people on this. Either feed them from a bowl only.
Either get rid of the sun, put them on newspaper, or find, you know, find some way of finding a happy middle ground that keeps everybody happy. This is a lot of grit in there. You can manage this maybe medically.
So lots of soaking, mineral oil, enemas, and see if it can pass. If it doesn't pass, it's a surgical consideration. They tend to eat weird things.
So this is a, I forget what species this is. They ate some plastic leaves. So we had to pull those out of his backside.
The sand inactions are probably the most common. And again, medical treatments the first line before we go for surgery. Follicular stasis can happen, so it's only females, right?
And follicular stasis when they produce the follicles but don't actually lay them, they just sit there. So whether that's a maternal obstructive cause or a husbandry cause, such as low calcium or no death in space, or being in poor condition generally, it can be any of those. And you can manage that as best you see fit.
And probably that's gonna be surgical as shown up here with a spa. In terms of neoplasia, there's not a lot of neoplasia, big stuff in reptiles, obviously it's there, but it's scattered case reports. These are the two main ones we see, so squamous cell carcinomas, or mucous membranes of bearded dragons, and also gastric and neuroendocrine carcinomas.
Both of these should be on your on your lookout list when you're doing an exam for these animals. The gastro neuroendocarcinomas can cause a variety of symptoms, but you can often feel them in the stomach. And squamous cell carcinomas are visualised and confirmed on biopsy.
So that's the end of reptiles 2. We just, that's just what we've gone over some general anatomy physiology is reptiles 1 procedures and presentations for snakes, lonia, and lizards for reptiles 2. These are some resources that we used.
This is the book that I got all those grey clinical note things from the Madareptile medicine surgery book, The Fowler medicine, and the Fowler Zoo animal medicine book is useful as well. So that's it. So thanks for listening.