Hello everyone. I have a great presentation today. It's something very close to my heart, and it's called Learning Lizards, as you can obviously see.
My name's Fabian Rivers. I've been an exotics vet for the best part for 5.5 years.
And I am very much focused in sharing how we can get more people into, exotic medicine or zoological medicine. And I'm a very keen advocate for not being an exotics vet or a small animal vet or an equine vet, but actually that we're all vets, and we all have a skill set and there's a lot more grey area than we sometimes give ourselves credit for. So today is about er er er sharing some of the things that I've learned in my time as being an exotics vet and working with exotic animals, particularly lizards, because it's, it's a, it's a very expansive area and hopefully, you'll pick something up too.
Just as a forewarning, this is not, a, a, a, a lecture at a specialist level that, will hopefully leave you, or will will leave you jaded and confused and realising that you don't want to work with lizards, and work with reptiles and work with other exotic. Animals, quite the opposite. It's more of an atlas and a direction about some of the things you're more likely to see, in GP practise, and most of the things that I see on a regular day, day, day in, day out basis.
And, yeah. So hopefully you'll, you'll get some valuable information. So, yeah, that's where we'll go with today.
So how to approach lizards in practise. So the objectives, it's a basic atlas, like I mentioned, for typical issues. This is not an exam, this is more about getting you familiar with what some of the things that you could see on a day to day basis, and, and give you some pointing direction, and basically give you my insight about some of the easy ways to identify and approach those issues.
Also something that I am going to be doing is giving you some, tips and tricks. And those tips and tricks will hopefully make that process smoother for you in practise. And also give you some insight on some of the things you can do from work up, even if you don't feel as confident as you, you would, you know, if you were, specialist you're doing it for X amount of years, then actually it's really, really quite straightforward and easy.
I'm going to be choosing, the most common lizards that, you'll see in practise and then discussing some of the individual nuances between them. But one thing I want you to take away from, today really is the virtue that there is a huge amount of grayscale, and that despite the fact we have countless thousands of species of, of reptiles and, and in tow and lizards in that sense. That there is a lot of crossover.
And that crossover is the basic physiology of, of most animals. And, you know, it's a little bit more directive when we talk about reptiles, but there's a huge amount of crossover and that, and if you're able to treat 1 or 2 or 3, that actually, there'll be many more lizards that will have present in very much the same way. And your skill set that you've picked up over those, those, those years of practise will, it will arm you with that skill set.
And the next thing is contextualising what you can achieve in a routine consult. And so one thing that I find very, very er er er what's missed quite often. In, in practise, is the idea of who you're facing and what is the essence of what you're trying to achieve.
We have a limited period of time to, to get the information. To, assess our clients, and a lot of time we're working, you know, anywhere from 8 minutes, horrific. Up to 15 minutes, a little bit better, .
And that is usually on the proviso that we have a good basis of knowing what we're doing. And so when we're trying to bring people into to exotic medicine, one of the things that I would like to see change effectively is that we get a bit more time. So if you are seeing, any zoological animal, you know, lizards, colonians, you know, snakes, or anything in between that you feel less confident in, in, we should kind of revert back to how we're probably supposed to treat the newgrats, which is give them a bit more time to be.
Able to go through and be as thorough as possible to get a feel for it. So if you can ask a double appointment or a triple appointment, depending on how long, they allow you that, that, that, that grace, then by all means, please do. I would say, even as someone who's experienced, and you, every time you pick up an exotics book, a reptile book, whatever, you will often see, half an hour is not enough.
An hour. Or is not enough, and, and, you know, I think it's great for when when specialists have that particular thought process because they're valuing the process of doing work up and working out all the things that could be wrong. However, based on the world that we exist in, and the reality that we exist in, that's not likely to happen.
So if you can go ask for a double appointment, if you're on the 10 minute points, get 20 minutes. If you're getting 8, horrible, try and get triple appointment. If you're on 15 minutes, you know, I, I would typically get my old practise, ask for 30 minutes.
and try, especially if it seems like it was a case that I was gonna struggle with, or it was gonna be difficult, it was a lot of work up, and we had that pretext to, to, discuss. And resources. Now, a lot of the, again, like I said earlier, my job today is not to say this is how you do this, this is how you do that.
This is this disease, this is how what diagnostics you need to do. This is what you send off. You need to do X-rays.
No. I, I, I, there are plenty of books, there are plenty of resources for that particular process and I'll be pointing you in the right direction of the ones that I would go to routinely. But my aim today is to to to enable you, sorry, to have a better and more honest understanding of some of the things you might see, to trigger and and and affirm and confirm some thought processes that you may have not had access to.
And if I can er er er give you those resources, ahead of time so you can do that, that finer detail and that my, that looking into the minutia, after this particular er er er er lecture, or, or presentation even. Or if you see a case and you think, wow, Fabian's told me that it's likely to be this. I've got a book handy.
I can work out the finer details, but I know I can go directly there and have a look into that, just to rest rest your mind about some of the peripheral stuff, then I can do that. I promise you it is easy, and I say this in every single one of my presentations, when I'm telling people, it is easy. And it's easy for me to say because I've done it for so long, and, but I, I mean that, that the longer I've been an exotics vet, the, the more I've understood how little I know about them, at, at face value, and we'll talk about this a little bit later.
But it's so important that we remind ourselves that we have the investigative er capacity because we're vets and we've been trained to, to do this. We have the desire to improve animal welfare and that we have er er er, you know, books and resources in. In, you know, and the internet, and just so many different resources available to us, and in exhaustive lists, and that they, that will arm us and give us the finer details to be able to move forward.
And we should be as vets, regardless of whether we're comfortable with the area or not, is continue to check the research. And being an exotics vet. Has meant that I'm always never, I'm always 2 centimetres away from a, a, a book, and I'm always going to check the research, and I'm always going back to that particular pattern, and I feel like, so many of us would, would benefit from that in our own fields and in new fields, and, and, you know, taking that curiosity into all our animals is a really important part of our job.
So, consults, and I said realistic expectations because again like I mentioned earlier, we have to be realistic. No one's likely to give you an hour to to check over a a a a lizard that's come in. So, prep is better.
And so what do I mean by a prep? Well, ultimately, having the things handy. Now, typically for most of your lizards in practise, you don't actually need many things, handy that are particularly different to any other small animal GP practise, to be honest with you.
You sort of scales. You need to make sure that, you've got an otoscope to look in the eyes, that you're, you know, got a pair of gloves, just so that, if there's, any signs of, of, of lesion or open lesion, that you're not getting, your hands all into that, into that area. And, and, and, you know, practising just very basic, very basic care, and that you would apply to any of the animals that come through the door.
And so, but what is really important is that we're, we're coming at an angle of it being an area that many of us won't be very comfortable with. And now I've seen this many times before, where the sals always have a checklist ready. You should always give them a checklist before they come in and they tell you all these details.
It's 3 pages long. And it's not realistic. You know, if we, if we're being really honest, the amount of times I've sent these, these long questionnaires off to clients to do when.
They're sat in the consult room, or before they've even come to the practise, you know, if, if you're dealing with a lot of these situations, it's not realistic. So, I've pulled together my own quick lizard checklist, which, by all means, you know, this is for your, for you to, to come back to and circle round to. But ultimately, I would say my kind of top 5 most important bits of information that I'm, if I'm not, not gone on a checklist beforehand.
I'm gonna be asking pretty much directly. Now this is not the only thing I'm, I'm gonna be talking about, but everything else, you guys will, will be fully aware, you know. How long is it, how long has this particular issue been going on?
Have you noticed any difference in behaviour, all those things are. Pretty universal to any animal that you'll be seeing, when you, when, when, when an animal comes into your practise, and carers should be asked about those ubiquitous er er er parts, er regardless. But these are more specific that you probably won't see in relation to, let's say a dog or a cat.
So first and foremost, something that I see a huge amount of problems with is thermostat. Er er er. With Reptiles, they are ectotherms, often colloquially cooked termed cold blooded, and what this loosely means, and I again I'll be preaching to the choir.
Its effectively is that a a a significant portion of their, their, their management for for tempor control or homeostasis, is, is, is, is all the internal environment is external heat. And I can't tell you the amount of times that something that has seemed as profound, as profound illness has been rectified by virtue of just having an understanding of heat management. So one thing that I never will er er cross over or or wash over in, in any type of, of, of consult with lizards is discussing heat.
Now, what are the temperatures for the daytime, nighttime? And well the low temperatures and the high temperatures and. Each species has a general range of an ideal temperature, we call it the PTOZ.
And you can find these in the resources that I'm going to share at the end, but the idea at least is that you should always be asking and enquiring about the thermostatic heat. And then having some reference point, either in the info sheets, I'm gonna kind of direct you to the end, or your own kind of, heat bible almost, where you know exactly where the leper gecker should be, this temperature at nighttime, at daytime. Or, you're ready for a tortoise should be this temperature in daytime, this temperature at nighttime.
You'll bearded dragon, etc. Etc. Etc.
The idea is that temperature is so important, not only for just metabolism, but immunity, er er er you know, if they're an appetite, if they're well hydrated or not. All these things are often related to heat because obviously heat is energy and they need energy to live, so it's very, very important. The next thing I'm always asking about is UVB, and, and do they have access to it.
Now, one thing I will say is that, and again, this is more of a something that I've noticed a, a huge amount of. A lot of places where you can buy your reptiles, or lizards, are being recommended this combined heat and UVB light all in one. And it comes with the, the, the added, back.
Around of being an all in one, it's cheaper and you get 2 for the value of 1. The problem is, is that heat and and access to UVB is not always a consistent balance thing. And it's important for me at least, that, first of all, they have access to UVB.
So combined is a, a, a kind of a heat, heat lamp and a UVB lamp combined, better than nothing for UVB. But if you can separate the two to a, a UVB light, which is specific for their particular species, again, it'll be in the info sheets at the end, and also a separate, heat source. Of course, then by all means you should be really aiming for that.
Because in daytime, they will have access to light. But as we know, in, in, in if the temperature goes too high, then we don't want them losing access to their UVB source, because again, they are two very separate elements that we need to control. So.
Let's make sure that we're trying to focus on, first of all, they have access to UVB but also that it's separate. A, a quick, bit to add is that UVB will not penetrate outside of a vivarium, so through the glass. And I've seen many cases of people putting strip lights, and UVB strip lights on the outside of glass.
And so the, the, the real value of, of that is, is, is limited to none. So it's really important that if you're having a strip light, UVB light, it's inside the variant, seems counterintuitive but it's very important. Access to fresh water, and, and do we bathe, a lot of reptiles, and I'll kind of mention this later on.
Are, habitually, you know, a lot of them are lizards, are, are, are desert species, or, are, are in very quite arid environments. Or where, you know, access to water can be limited, but again, this is very species, dependent. But the idea at least is that in captivity, access to fresh water is often not celebrated or highlighted enough.
And I think a lot of this is due to the fact that because they're kept often in smaller er Bavarians, that movement, the waters aren't changed er er very often, the, the environments aren't humid enough, and so all these kind of er er access to different water sources aren't as . You know, taking us as seriously as they should be, and there is a physiological, predilection to not drinking as much in captivity as well, so it's kind of two, twofold concerns. For certain lizards, and I would say, I would say, particularly for, for example, bearded dragons, again, giving them access to water is, is, is a very worthwhile thing to do, no surprise there.
But, I would say that if, Being bathed is tolerated, is a fantastic way for to ensure a routine where if they do drink from the water that you can get er er er you know, water in routinely if they do drink from it. And sometimes hold in some type of supplement like Repto Boost maybe once a week. Be really worthwhile, but again asking that information at the start.
How often do you feed and, and which foods? Again, many of the lizards we're we're gonna be, talking about today, well, all of them are gonna be insectivorous, and kind of have a different balance of, of a herbivorous element to them, particularly bearded dragons. There's a little bit of debate about, how true that is in, in, in, in, in the wild.
But again, you know, particularly for bearded dragons at least, the herbivorous element is important. What we're trying to do. Is feed something in line with.
The their base metabolic rate effectively, so effectively what they, Need to be able to survive and then working out based on their activity. Their age and pushing and pulling, with regards to the amount they eat. And there are certain foods which are more calorie dense, and, and, and also have different, you know, contents of fat and things of that nature.
And so we need to be aware of that in the context. So again, getting that information is really helpful, which supplements and how often. Again, I used to find when I first started, and it's amazing what 6 years will do, when I first started and when I was a student, I used to find that many people did not supplement, at, at all.
Now I've found the complete opposite. You know, for those who know, Brian Johnson, he's a very famous person at the moment, who supplements with the best part of, I think it's 100 to 200 tablets a day, to supplement his life. And he's, he's on this health kick, effectively.
What I found is that people tend to think more is better with supplements with every animal. And so, as being up under supplemented, especially insectivorous er er lizards is an issue, being over supplemented as far as I am concerned, is becoming an issue as well. And finding ways to contextualise that and, and make that uniform is very, very important.
You know, typically once or twice a week with some type of complete er er er er er multivitamin. a, a, a supplement for most lizards in, you know, with, you know, maybe one, a quarter of the food that they're eating or, or gut loaded animal, or insect even is typically enough. And so, restraint needs to be had as much as, as making sure that we're telling people to get supplements in.
And again, I will, have some advisory in that some of the info sheets I do have. And last but not least, substrate. Now this is pretty obvious stuff, again, this is all husbandry as you, you kind of, you you you've all probably been very aware of.
Substrate is super important by virtue of the fact that typically it is the vessel for not only er disease, in the sense that if, you know, it's if you have a particular. Issue, I don't know, let's say worms, is a subject suitable and are you cleaning it, but also I'd probably say more obviously, obstipation or constipation or blockage, eating and consumption of, of substrate is, is the number one reason for, for obstruction in lizards, and there's a lot of misinformation and the idea at least is that. Activity levels, access to water.
And, and the bio biodegradable capacity of the substrate all have, have value. There is no better or worse option. There is just a risk profile to be had based on what is out there.
Now in the wild, let's use bearded dragons again as a really good example, they are. Arboreal or semi-arboreal, so they're on lots of sand, but they will, be moving very quickly and, and move quite vast distances, in the day, have access typically to some type of water in areas that they're very aware of. So that movement, that metabolism, that access to, you know, you know, 50 °C, plus sometimes, .
And, and all of that will means they can move the, the, the, the transit time of the, what the things they're ingesting, is, is rather large. In a captive environment, that changes. And by, by all marks and, and, and design, that means that that sand, whether we're using sand or something that's non-biodegradable, er er is more likely to get stuck in the intestines.
And so I'm having a, a, a risk analysis, and again, pointing in the direction of a variety of different resources which they're giving at the end, there may be a, a, a risk analysis to kind of lean towards different options, then typically just saying, well, in the wild they have sand, so in captivity they should have sand because that's not always how it, it should go. But as a very loose rule of thumb, you should be avoiding. Any type of non-biodegradable, substrate with very large pieces of stone in it and things like that, which they may not be able to pass, spontaneously, and that usually is a pretty good start point for you to, to direct.
Again, this is very much based on species, based on size, and. And, but again, there are info sheets that again I'll I'll give it the end, so. What you should remember, this is about empowering you, I'm getting onto the good stuff, I promise you.
The idea at least is that you should use your vet intuition. Observe when a lizard comes in in its carrier or sometimes on a a a carer's shoulder, or in, in the last night's er er er er Chinese food box, whatever it is. You know what pathology tends to look like.
There's an open wound, do you know what that looks like? If there's yellow stuff coming from an area around the mouth, around the eye, it's probably what you think it is. If the leg looks swollen and funky and bent in the wrong way, that typically should be in most animals that exist on this planet, then there's probably an issue there.
Use your intuition and being confident in that particular er er space is very much a matter of not only experience, but the idea that you have been armed to understand and generally speaking. And even if you've got a 1000 different breeds, you kind of have an an an an essence for dogs. Oh cats Or possibly even rabbits even there typically.
That essence can be applied to reptiles and despite the fact that in research we've. We counted 1000 times that. humans find it difficult to empathise with fish and, and, and animals that are, are, and reptiles and things of that nature, that at root, you know what pathology tends to look like, and that should be continued to apply here.
One thing that is counterintuitive to what I've just said is that suffering in itself is hard to observe. So you may identify pathology, but it, but this leopard gecko may look, as far as you're concerned, normal. Where where there's no signs of pain.
What it is is a sign of pain, and it's something that again, as typically prey species, you know, they will not want to show you, and they are, they are evolved not to show you. And so when you are seeing signs that you would mark as pain, and there are many of them, at, at that particular point, typically for lizards, it's often pretty bad. So if you notice signs of pain, you already know that your alarm bells are ringing a little bit and that you need to get started doing something.
So, next is, is what's normal. Now, I'm gonna be talking about it today, that's my job today, but ultimately, if you can have some fancy posters, what I used to have when I first er started work as an exotics vet, is I had a calendar. A calendar of of reptiles, and I'd go on Amazon or whatever and get a a calendar of reptiles and then I'd also have a calendar of birds, or some of the practises that I've worked in since then, I I have posters of of snakes in the anatomy and they have different different levels.
So you have the muscular level and the nerves and the the blood supply and the skin. The idea is that having posters around not only help show and impress the clients that come through the front door, but it also gives you a nice reference point to have a cheeky look if you're if you're unsure exactly what you're listening to or looking at or or what the client is referring to. Books are very important.
There are so many fantastic ones, the internet is fantastic. But last but not least is, is gaining what I, what I heard, and what I've, I've always known to be quote unquote, the art of veterinary medicine, which is something that it's the essence of kind of knowing what you're looking at as things, as you become more confident and build that experience up. And so that's really just exposure.
And being keen to face exposure with these guys is really important. And then last but not least. Most 6 reptiles are probably dehydrated.
Now, I, I, I'm, I'm not saying that, fluid is the answer to everything. And that It regardless of what happens, every, every reptile will need fluid. But or fluids or, or, or, or to be hydrated, but what I would say is that if, if there is any ever or any ever or any concern about the animal's in front of you.
And you're unsure about where to go with it and you need a little bit of support. One thing you can do with pretty much every single reptile that comes through that door, if you're, if you're going to commit to trying to, to, to, to rectify some of the, the, the concerns that this reptile's having is hydration. And I can't tell you the countless cases, especially with reptiles that I've hydrated.
And gone back to the, the, the, the, the, the kind of the books, taking samples, the X Y and Z. Waited for the samples and said look. To the client, we're gonna hydrate, we're gonna keep him for the day, I'm not gonna feed anything.
Because I don't think it needs it, I'm just gonna do some hydration, I do some pain relief, just supportive basic care. And within 12 to 24 hours, this, this particular reptile, this lizard is doing fine. The results come back with dehydration as being the issue, .
The old kidney values raised something like that. And I think it's so important that. Arming yourself with this particular bit of information can do so much.
And coming back to the, the point I mentioned earlier with regards to hydration and suitable hydration, is that it's, it's something that's often, paved over when people are buying them from, their, their reptile shops or online or the breeder, that hydration is, is still very important despite the fact that they can go days without drinking. And so you, as, as a, as a kind of routine, should be always thinking if this animal, I think this animal's ill, I, one thing I can do is, is, is, is, is, is hydrate, you know, 10 to 20 mL per kilogramme is a, is a very easy, ubiquitous dose of, of, of, you know, Hartman's typically, that you can give without even batting an eyelid. It's not really gonna do much harm.
So, now to assess the normal. And you're gonna get very bored of me saying this, but the idea at least is. This, if we're able to establish a norm, I'm able to then show you abnormal, and, and kind of with repeat learning is, is get you to feel more comfortable with, with working with lizards and seeing the norm.
So here we have a very perfect ideal example of a leopard gecko. And I've chosen this angle because it helps, it's because it has a slightly higher angle, you get a little bit of depth about working out, you know, er er what to look for when this leopard gecko is like I said, and that, that, that Chinese er er food carrier, . So what we're looking at is the eyes and theirs are open and clear.
Nice and bright and alert. And no signs of, of anything else blocking that. There's no retained skin, so it's something we come on to, but we, the, the, the, the, the, the shedding of, of their normal skin is called ecdesis.
And something that tends to happen in most lizards, er er is that they tend to shed in piecemeal and so bit by bit. And something that leper geckos, tend to do quite a good job of is, is they generally do it in a quite a large amount, and they will often ingest their own er er er er shed, in hole. But one area that you do find this, this retained shed.
Is often around the toes and that you can see here that the toes are, are, you can see them very clearly, er shed tends to have this kind of er translucent grey element to it that's slightly just lifted off er er er er the, the new shed. The, the new skin, sorry. And what you tend to find is that the toes and the extremities, maybe even sometimes the very tip of the, the, the tail as well, tend to be very common areas for shed to stick to, or sometimes many layers of shed cause a, a kind of a stricture and kind of constriction around the, the, the kind of periphery of, of the toes there.
But we can't see that here, so that's really good. The tail width, for what we could do body condition score, if you do it 1 to 5, this, particular specimen would be a 3. There is no necessary research to suggest that what I've said quoted here is correct, but it is a rule of thumb, and that is quite ubiquitous, and I'm gonna show you something in a second to help quantify that.
But the idea is that the, the fattest width of the tail. It's about 25% the width of the head, the widest width of the head, and you can see. Within a certain degree of confidence, that's that's the case here.
The skin is uniform, and so you've got no obvious signs of lesions, growths, lumps and bumps, and that is rich in colour and not very translucent. Now a kind of a, a small, adjunct to that piece of information that. On the venturum, particularly in the lower part of the serum, remember, these guys do not have a diaphragm, so their body cavities is called the serum, it's not separated into obviously the, the kind of the, the, the, the thoracle part and the abdominal parts of serum, which is basically the collective, the collective space where all the organs and, and, and useful stuff is kept, that they can be a little bit translucent, and also something that you may have come across is transillumination.
So in these guys, particularly if you're getting a a light, you know, your iPhone light, whatever, go into a dark room, politely hold them upside down, making sure not to hold the tail, but kind of holding them at the, the, the, the, the, the girdle, the pelvic girdle there, keeping them nice and still, shining your light on one of the sides of them, or even the back, but usually the side of the, of the kind of the flanks there. They are quite translucent. But typically, when they're looking like this, you aren't seeing much from, you know, the, the top side, the, the, the dorsum, and so you shouldn't really be.
There is a small point to say that sometimes you do get leper gecko, morphs, which is a fancy term for a kind of like a specific. Breed, let's say, for lack of better words, where they have slightly er er differences in, in, in, in, in texture. But I would say leopard geckos from my experience, typically look pretty uniform, and more are more of a, an area for, currently in my understanding, be dragons and snakes, er, tend to be more popular.
Next is good muscle tone. So this is what, this is what the muscle tone, you know, focus on the hind legs for muscle tone and across the back. Again, you'll, it's, it's very much like a kind of a dog, you know, you know, with older dogs, older cats, you, the, the spinous process of the spine tends to be quite prominent.
You don't really want that. You should be able to feel a little bit, but you don't want that, that, the, those, those, those back muscles to be really quite absent, and, and, you know, that's often a sign of, of, of, of weight loss and, and malnourishment, or, or, or whatever is the, the, the kind of primary concern for that. So you want to be round at the back.
The skin isn't taught And we're gonna come on to something, er, to discuss this as well. But again, tauntness may be a sign of, of, of, of growth in the serum, maybe be a sign of, of pregnancy. It may be a sign of obesity, or a collective of, of whatever types of, of, of space filling, or space occupying, occupying lesions that could be in there.
And the list is kind of inexhaustive. And lastly, but something that you might also we look for is the joints aren't bulbous. So what we see with in regards to the, knees, all the stifles and the elbows, is that, again, despite the fact they're pretty uniform with the, the width of, of, of, of, of the legs generally, that they do taper a little bit towards the joints and that there's a good range of motion.
So not so normal. Abnormal but not so normal sounds better. So here's the first example, so something that I've, I've, I've, I've discussed here at least is the, the, the, the idea that.
Ecdesis is normal, but again, as mentioned before, you've got this particular, let me just get the laser pointer up. You've got this particular predilection. Now, this is dysegesis.
This is very, very common, in, in, in leopard geckos, and this is a very common presentation here. And there are many different things that can contribute to that. One of them, as mentioned before, is dehydration, and not only dehydration with regards to how much water they are, are, are, or, or, you know, taking on or, or, or, or ingesting, but also the collective hydration of the setup that they're in.
Now, humidity is a very kind of under valued part of of husbandry, and so making sure that. If you see signs of this, you should be kind of informing the, the carer that this may be an issue. But also something to, to be aware of in these guys up.
Is that Hydration, and as you'll be fully aware, it's not just a matter of how much water we take on, it's how much we're losing. And where are the losses, but also what can facilitate a greater loss of fluid, and in these particular cases where you've already gone through the husbandry, where we are, we drink ample amount. And that, you know, there's, there's, there's a, a decent commitment to humidity.
What other reasons could be causing, you know, generalised dehydration? Well, the kidneys. And so if you're seeing something as, as, as boring as this, you should never ever omit the possibility that something like the kidneys might be at play here as well.
But again, there's a long list of of of conditions and and issues that may cause that. But again, this is about familiarising yourself and what to look for. Here we have a particular case of of what looks to be a really horrible eye.
It is not. It is effectively debris. And something that we see a lot of in, I've seen a lot of in in leopard geckos, probably overrepresented for the lizards that I have seen is hypervitaminosis, hypervitaminosis A, tongue twister there.
And what can happen at least is, is. Because of the absence or. Low amounts of vitamin A in the diet.
And from inappropriate diet, which is very common for insectivorous lizards, is the idea that the, Ability to shed appropriately. Makes it very difficult, and remember they are shedding across their own eyes as well, that sometimes the ability to shed appropriately is is lost. And so what happens is you have a layer of shed on the eyes, which is a particular er er kind of area of course of concern, and they don't shed.
And then the next time they need to shed, they still haven't corrected the vitamin A or they're not hydrated enough. And then you have another layer of shed, another layer of shed. And in between these layers, lizards and reptiles, generally speaking, aren't the cleanest things, so their, their skin tends to be, have quite a, a large variety of, of, you know, opportunistic bacteria.
And so you have layers of this buildup of, of potential er sources of, of bacterial infection. But also you have these layers and layers and layers building up with, with this, with this, this kind of cellular debris. And what ends up happening is, is that they have a fantastic ability to recess their eye back into the orbit into their, their version of their, their eye socket.
And this debris occupies more space and occupies more space until it looks like this. You can remove this with some some gentle manipulation and, and, you know, fluids and flushing things out and a cotton bud. And effectively what this is, is what it looks like.
This here is what it looks like once you remove it. And you see that smooth edge, that's where the eye was, was occupied. This can also be attached to things like keratitis as well.
So once you and if you feel comfortable removing that type of cellular debris with a bit of flush and maybe sometimes. Some type of lubricant, a non irritating lubricant, that you actually find is there's some keratiti and then, you know, conjunct devices attached with that as well, as I mentioned before. So, as mentioned, we've got this idea of this leopard gecko body conditions called harp.
This is just very loose. It's the idea is to give you an idea of what to look for and what not to look for. What I really want you to focus on particularly is the tautness of the skin here.
there's a lot, there's a nice area of movement here. This tail, no fat, no sign of anything, just bone, a little bit of muscle. and, and lots of muscle loss across the back, sorry.
And again, you have this as a, as a, as a, as a, as a framework. So thanks to Dana for this, and, you know, overall, a really good outline. Here What we're focusing on, we want to look at something.
Now, apart from the fact that we've got this really skinny tail, we do look a little bit translucent. We don't have the, the type of, of colours that are, are vibrant and rich. What we do have is swollen joints, very, very prevalent swollen joints.
And this here is a very typical presentation for gout. So, . I, I, I, I think it's, it's important that we are able to, to identify the likelihood, not the guarantee the likelihood.
I've seen cases like this where one or two of the joints are filled like this, and it's septic arthritis, and we have to approach that differently. So again, doing workup, doing x-rays, blah, blah, blah. Very, very important.
But in itself, if you have a systemic, systemic sign of all the. Joints being built up with this type of, of, of firm bulbous protrusion at the joints, you know, alongside all the things that you would, kind of confirm with gout. Then again, think of the kidneys, think of gout, and, and you're probably moving in the right direction.
And last but not least with regards to the not so normal in leopard geckos, is this bulbous element here, now. What I had, in the context of this is that, this particular career, leper gecko had passed an egg, and there was still this bulbous element to it, and they were unsure what it was. Now leper geckos tend to lay one or two, eggs at a time, typically two.
And so this is what is left over of this kind of, egg that's left inside. . At this particular point, there were no issues with husbandry, and effectively direction probably would have been best to just say, look, give us one, this little place to hide, and, and some place to, to dig.
Leave, her alone for a little bit, and, see how you get on. There are 1000 different ways to approach this, but ultimately, if you see this in leopard geckos, they are quite translucent, but you can also feel the edges of the eggs, cause there's a firm, large egg inside the abdomen, and you can see it there. It's pretty, pretty easy to see.
So let's go to Bearded dragons. Beer dragons. So this is a very, you know, photoshoot like beard dragon, er, er, situation here.
And it, I mean, being so, being adults, I'm sure that this is quite a stressful presentation here for them, but it's very helpful for us, because it gives them an idea of, of several different views of what to look at. So again, what are we looking for? So again, and you'll be bored of me hearing saying this, eyes and ears are open and clear, we can see that here.
No retained skin, especially around the toes, same thing, muscular tail. So these guys often carry very muscular tails. Now something I didn't mention, but it's very common, and not very common is is is species specific, sorry, is that leopard geckos are able to drop their tail, the, the, the infamous autoomy, but these guys cannot.
So they have a very muscular tail that is permanently er er er attached, and this is very important, effectively. So have a nice muscular tail, and the next thing is, is that they also have. The skin is uniform and rich in colour.
But again, I would say, bearded dragons, there's a, a, a, a, a lot of different variation with regards to, morphs. So, I've seen in my time, you have silk backs, you have leatherbacks, and so the scales and leatherbacks tend to be very less, almost not. They're in silk bags, they're completely absent.
You know, they are sometimes a little bit translucent in all sorts of ranges of colours. There is a very big market, particularly for bearded dragons, in my experience, for a variety of different colours and shapes. And the more weird and wonderful, the more expensive they are, and that's important contextualization for you when they come through your door, as a case for you to treat.
So this is not a an exhaustive, rich in colour is not always the case. Skin isn't tall, again, very much the same, less so much of a, they tend to be a little bit more wrinkly, than, leopard geckos, but something to be aware of. And last again, joints are not bulbous and you can start to see that there is a pattern going on here.
Here's a not so normal. Now we've got this interesting jaw situation, metabolic bone disease, in this particular case, we should always be asking about UVB, you know, calcium and supplementation. And what happens when they have MBD is they kind of sometimes get this weirdly.
Rounded rubber jaw, very soft, they often get cricks in their spine, and with their joints, so it looks like they're fractured or bent in the wrong ways. A very unhappy, er er er er chappy there, . And something that is very hard to improve once it's got to that stage.
I mean they can go on to have a a a a fantastic life at this particular point, but again, rectifying this type of jewel is, is to, to how it should be is, is, is, is pretty much impossible. So, managing, client's expectations is very important. Here we have yellow fungus disease, or yellow fungus, also known as CAV, there's a little bit of debate about whether it's CV or not, but ultimately.
This is a a a very typical presentation of Kanvi and bearded dragons, as you can see on that, that, that lip there, that yellow er er pigmentation is very typical, . It is extremely difficult and has an extremely high eventual has a very high morbidity rate. And, a mortality rate.
It's a very slowly progressing fungus, and that is extremely difficult to, to, approach and manage. And so, you know, being proactive with that, but also getting clients to understand how difficult it is to get rid of is, is, is, is really important, but yeah, very difficult to handle. Next is, this, now this is a typical sign of something that I've found a million times where I've got it wrong a million times a minute before.
So we have this red mark on this, on this beard, it's this very what looks like a very healthy bearded dragon. And what do we, what do we see? Well, we see this red area, and it could denote several different things.
One, it could denote probably something like dental disease. Now, as you may or may not know, bearded dragons are very, very, very likely to get dental disease, and so it could be a sign of something like mouth rot. It could also be something with regards to hematosis, so vomiting blood, or regurgitating blood even.
And, and, bearded dragons have a high predilection, especially the younger ones, middle aged, the younger ones, to kind of tumours of the stomach. And so I've seen many cases where neoplasia is at play for, or, you know, regurgitating, blood. And bringing up blood from from the kind of lower gastrointestinal tract, and then also, which always makes things great, is a lot of bearded dragons like fruit.
And so many times they've been fed strawberries or blueberries, and I thought, oh, problems I need to get on top of this, X, Y, and Z. And it turns out all they've only just given them strawberries or something like that, which they really shouldn't be having in any great amount anyway. So, always really helpful to, to, to not panic when you see this, but also to, to make sure you do your due diligence as what they're eating.
This is tail rot, again, has a, a, a, a tail rot, as mentioned before, bearded dragons tend to have a slightly melanated end of a, a tail anyway, but if you're having a feel, it feels dry, there is a, a, a kind of a. The scales have come off, sometimes you see exposed bone. All those things can be indications at least of, of, of, of the beginnings of tail rot.
And this is a pretty early presentation of what tail rot, can look like. If the colour has got really dark at the end, and you, you see this kind of abnormal presentation or sometimes even a kink. And again, like I sometimes I, I said with regards to an exposed vertebrae, tail rot, this will ascend.
Typically speaking, what you're looking at is, is kind of an amputation and making a discussion with the client how far you want to amputate before it progresses up, because often it can. This is Yellow fungus again, probably more typical presentation. I, I normally find that can be is a, all yellow fungus is obviously a, a manifestation of poor general, husbandry alongside, possibly some immunous suppression in, the bearded dragon attached to some other type of illness or condition.
So check the husbandry, but again, this is probably more typical presentation. The, the, the ventrum, is covered in this kind of yellow. Yellow to brownish, spreading lesion, not particularly nice, very difficult to get rid of, and, and, you know, a, a, and a discussion contextualised with other issues and illnesses, going on to, to have with the client.
Here, we've got a big boy, no easy way to say this, but . This This here is, is a, is, is a, a very chunky boy, probably, and this is probably, he's probably fine in every other way, except the fact that this here, this one of these fat pads, this is from a bearded dragon, but what happens is when they eat a lot of food, they build up all this, this, this, this, this fat, and they're overfed, especially with insects or fatty insects like wax worms. And this, this here is where the fat accumulates, if I just go back one.
And this is what happens. So their skin is nice and taut. Again, they are on a, a, a, some type of stick there.
But again, you can imagine that, that fat pad probably is occupying this space here. I'll go back to to show you once more. And so it's often a sign of a.
Obesity. I would say for most typical breeds, breeds, most typical, bearded dragons that come through your practise should be somewhere between 450 to maybe 600 grammes. If you're looking at, you know, certain, bearded dragons at 650 plus, you'll start to notice.
Typically, they are looking a little bit chunkier. But again, this could also be. Dystopia, this could also be a variety of things, so making sure you're doing your, your checks and your your due diligence and workup is really important.
Next, we've got cloracal prolapse, something I see very often, very difficult to fix, but this is an idea of, of, of what it is, can be attached to a variety of issues, obstipation, as mentioned before, er, hypercalcemia or metabolic bone disease, . And, but again, you know, also neoplasia, there's a long list of, of possibilities. But if you see something like this, where it's a prolapse, where it's really occupying the whole of the vent and the clolaca here, then really, you're looking at lacker prolapse.
It's a very smooth surface. And also in between here, there is a lumen, one lumen. It's pretty much always gonna be a lacker in this particular case.
The other side is that we have, heavy pe prolapses. So I haven't gonna be able to get very good pictures. Now, don't take this too seriously.
This is a picture I took, for a heavy premium prolapse, which had a type of either a stricture or neoplasia on the end of, of the hemipene. I believe I amputated this, and the client didn't want to send off for, . Histology, but the idea is that you should be able to see that there is a unilateral presentation.
It's quite thin, there's no obvious lumen, and, and these are typically hemipene, presentation. For male bearded dragons, they have two recessed sacks very much like, snakes. And so when you lift at the tail, you should be able to see, I'm not sure you can see, it's like a, a raised bit here.
And then this is where that he hemipenis has to go up here as well. So another example of some things that you'll typically see or not see on a day to day basis. Chameleon, normal, I've got a, a video here.
This is a, with my, me when I was 2 years into practise, I believe, and this is just the normal locomotion and pretty a relatively healthy, bearded dragon, bearded dragon chameleon, with some, with some, some, some. Retained shed here, it's probably gonna come off with its own, volition. Again, like I said before, it comes off in piecemeal.
And I've, this particular picture is, is obviously taking in the fancy pants studio, really helpful because it helps give some depth and some idea of shape. Both of these are veiled chameleons because they have this shape here as well. So pretty, two pretty good specimens of chameleons, which are becoming very popular despite my frustration.
Again, eyes and the eyes and ears are open and clear, and they retains skin. muscular prehensile tail. So at the start here, you can see we're using that tail to, to, to help balance.
Now, these guys don't tend to like human interaction, to be honest with you, and I would, I would probably say that as a routine. They're Pretty rubbish. they're pretty rubbish pets.
And they don't do well in captivity. So, as a rule of thumb, probably just avoid people suggesting that, well, you know, that they should get them in the first place. next thing is the skin is nice uniform, and rich in colour.
Skin isn't taught yet again. And they have a, they have a very strong grasp, so they will, no surprise because of their, their, their predilection to climbing things that they're very, they're very strong, so any weakness in their in their kind of hands and feet. Is an indication or lack of use of their prehemptile tail is an indication there might be some illness.
And Johnson not bobs, as you'd be bored of hearing me say. Not so, not so normal. Yeah, these guys will get lumps and bumps.
I'm not saying all of them will be squamous cell tumours but we have some recent research that strongly suggests at least that, . The lumps and bumps that these guys get all over their body, typically around the ages of 2 onwards, often, often squamous cell tumours. I believe in the research, there's another, picture of it, at a, in, from the research.
But, from my understanding at least, is that there were 7 different, chameleons that had samples, and found that they were squamous cell tumours, and 2 of them had, metastasis. in the lungs of some shape or form up postmortem, so it's something to be aware of that even if you do remove them, and I would say typically it's, it's. Whether you do or not is, is, is kind of neither here nor there, to be honest with you, that there is a potential for, for malignancy.
I would say typically they tend to be well, identified, er and and and demarcated, they tend to be non painful. And I would say that unless they were really getting in the way, or there was a concern about er er malignancy, or we wanted just some clarity, then removing them is a is a kind of give or take situation cos often. I've seen other things, I've seen er chameleons pass from other things and have squamous cell tumours for years and have no real issue with them.
. Another issue here, you'll see in a lot of chameleons, is the inability to retract the tongue. Secondary typically to hypercalcemia, again, another case here, just coming back to this one, this is another example, just here below of the exact same thing. Calcium, as we'll be fully aware, is a very important part of our ability to use our muscles.
And the muscles of the tongue are no different. And so inappropriate husband energy can sometimes cause this just for context. If this happens, getting it back in and is, is very dangerous or can be very dangerous, because a lot of the time what they'll do is swallow their own tongue and not be able to put it out.
And I've, I've heard of cases of, of chameleons who've put their, have had their tongue put back in and then. That they've somehow managed to, or the tail, the tail. The tongue has, er, er, er, dropped off, effectively, and then they've ingested it.
And then what they're left with is the base of their tongue and nothing else. Whether that's a horror story or not, who knows, but the idea at least is that trying to correct, this type of issue is very difficult. Here's a picture that my friend sent me in a, in a panic, and she said to me, I don't know what's going on, I'm not an exotics fan, I don't know what I'm doing.
I just know that the belly feels very full and feels lumpy. And despite the fact that I love her, I was thinking to yourself, well, think of it this way, you've got a female chameleon. With a lumpy belly, what could it be?
And as you may have seen, dystopian. And so what happened was is that. This partic particular chameleon, if I remember correctly, had stopped eating, and was pretty, pretty, lazy, not moving much.
And effectively what we found on, on X-ray, what they found on X-ray was just, an abdomen, or so, I'm sorry, full of eggs. And, with a little bit of, of hydration, as always, and I believe they took a quick blood test and found some suggestion of hyper. Themia, and, and I suggested some, some calcium, some calcium gluconate.
I believe within a couple of days they ended up, laying all of their eggs. So yeah, very basic, just, you know, use your intuition, as I mentioned earlier. And so this last one here, well, there's the penultimate one, as you can see, muscle tone is poor, very drawn back in eyes.
It's just, just, just really poor, poor body condition, no surprise malnourishment, anorexia, very typical presentation. And lastly, chronic dermatitis, very, very, very, very common, with these guys. And you know, this kind of er er mouth right that's attached to them.
So quickfire diagnostics, I'll try and wrap this up nice and quick for you. Things you can do with lizards straight off the bat, radiographs, they don't root, if they don't, if they're in some type of container, they don't move very much, especially bearded dragons, really great. Pop them down, take a quick X-ray, don't need any general anaesthetic, I need to have support typically.
Ultrasound. Hold them still, as long as you're not grabbing their tail at any particular point for any lizard. Hold them nice and still, whack a probe on them, and you can see all sorts, and there is a picture of a a a a a a a an egg inside a leopard gecko, just to confirm the concern of dystosia.
Faecal floats. Really easy to do. You know, you can beg your practise to, to give you a, a, a, a faecal float, or the capacity for faecal flotation.
And literally all you do is, is follow the rules and then have a look into your microscope. Takes about 10 minutes to turn around. And here's a really great picture that I've used for years that I found on an app, back in, in, when I was a student.
This is what Oxuries look like, and this is what CoxyD look like. And if you see. A lot of these, or a lot of these, or any of these typically, but a lot of these are any of these, then there are treatments.
Or it, typically fembendazole for oxyurids, and for Coccidia, Solvitrim, or whatever brand name we are using these days because Solvitrim no longer exists. Cotrine sensitivity, again, this is really basic stuff. You see an open lesion, you see mouth rot, or you're concerned by, a, a faecal sample, you wanna know what's going on, because we've, our, our, our, our passings are, are not so nice.
Culture and sensitivity, jobs are good and really straightforward to do. Blood sampling. I'm gonna give you some resources at the end to show you places where you can actually see how to do that, instead of me explaining it to you, because I think videos and actual seeing it happen is much better than me explaining to you.
But the idea at least is that for most lizards, remember, also telling certain species, remember leopard geckos in particular, that most lizards, tail vein sampling is relatively straightforward and easy way to take samples. It's a very well tolerated. And yeah, that's important.
The tips and tricks Something I use a lot of is er er these tick removers. And this for you is a really easy way to get inside a mouth of a bearded dragon, er, er, or a, you know, you know, most lizards, just gently, without feeling like you're going to, to destroy their, their teeth, cos a lot of these, these species will only have one set of teeth where the teeth are actually attached to the jaw. And so you want.
Something that will prompt them to open their mouths, but at the same time won't damage their jaw or the teeth that they do have. And so I've, there's a bit of a quick video here, here's me just with my own bearded dragon just effectively opening that, that mouth there. And and taking and and basically getting good access, so you see it put it in the front of the mouth, we get round, bit of leverage.
There you go there's my dog barking in the background as well. Info sheets, and I'm gonna put you directly at the end, but Sonia Miles, who's works at Highcroft referrals, I use her info sheets all the time, and I use them. To really make my life easier, she's absolutely fantastic.
All you have to do is sign up, go to Justexotics.co.uk.
I'm not sponsored by her. I just think she's great. And all you have to do is, is if you need someone to go through the husbandries, print it off, give it to them at the end, or give it to them to begin with.
And whilst you're doing what you need to do, you can print it off and give it to them, and it's just a, it's a fantastic resource and it's completely free. We like free things. Tips and tricks 2, the less signs you have, the more diagnostics you needed.
Lizards are difficult animals because they don't show signs, as I mentioned before, so you're gonna have to do something. And a lot of the time without the diagnostics, this is what you look like. No clue.
No clue. I could guess. I could have a a a a, but again, a bit like with regards to any other er er er species without the diagnostics.
The lack of clarity is difficult and especially if you're someone who's not so familiar with, like I mentioned, the art of lizards or the art of reptiles, the art of zoological medicine. So it is a really good way to, to like get a little bit of money into your practise, but also give you a bit of breathing time to be able to collect your thoughts about what's the next step, as mentioned before. And who's the client?
So the general public, and this is really a a a really quickfire breakdown. If it's the general public, this is tends to be what happens. They're very well intentioned, but there is often a knowledge gap, so you tend to have to go back to basics.
But if they understand you, they're often very willing and very optimistic about getting on board and making the adjustments needed. Breeders, breeders are a very different group of people. So they're asking tends to be how much, you know, there's there's often, the illnesses tend to be, not always, but can be very last minute.
And often very standoffish about certain workup, and, you know, a lot of the time, not all the time, but in my experience, a lot of breeders very much, it's, it's about the profit margin, it's about the turnaround. And if the turnaround isn't worthwhile for them, then it can be a a a real issue. So again, this is about how you pace your console with these groups of people based on some loose stereotypes that they've pulled together.
And then last but not least, The hobbyist, hobbyists tend to be the people that are the most financially ready to commit. And they're, they're, they're very keen to accept your, your opinion. But they want to know why, they want to know the motivation, and they also have their own information.
They have, they will, they'll have all sorts of inside tricks or species specific nuance that you may not er er er be able to, to, to kind of understand or not understand, sorry, do you not, that you won't have known beforehand. And so using that opportunity to add to your own skill set is super important. But what I will say is that if they don't have confidence in you, because their animals are of extreme importance to them, they can lose confidence quite quickly.
And so that in the background is something to be aware of, like being thorough and methodical er in a way that you may not be with breeders or the general public is very important. And so there's this collaborative element to it. Commonly used drugs, I'm gonna smash through these really quickly.
These are the things that I would use. If you're looking for guidance, use the Bible of of the exotic animal formery. But what I would say is, to be truthful and and and to be really truthful, I'm not always going to carry around my carbon with me, and take it into every practise, because I do a lot of different work.
I do small animals as well. That some days I will prefer to go on an app on my phone and, access this. If it's something's niche, or it's something specific, or it's something that I need to work up, or it's something that requires, you know, a, a, a, a, a complex anaesthetic, then by all means, I'm going into this for my reference point.
But for your day to day, Ay, you know, you know, basic level, you know, workups or, or, you know, antibiotic doses, whatever, I will probably go to this, because it is pretty, pretty damn comprehensive, and there's a lot of crossover here. But if you're ever unsure, this is your first reference point, but this is to make life easier. So if you're, if you join the BSAVA, you'll be able to get access to the app for free.
So, I put commonly used drugs. I actually meant to say resources, so apologies for that. But here are my, my top resources.
I would, definitely, I've highlighted three, and the Beaver manual for reptiles, fantastic. And the formula I was mentioned before for exotic pets, fantastic. And last but not least, just exotics free info sheets.
Thank you, Sonia, again, for, for, for those, again, sign up on her website. The others are fantastic as well, but I would say less of something I would use day in, day out, depending on what type of situation I'm in. For your videos, Trinity CPD High Croft Vets 9463.
Again, Sonia, thank you, Sonia. Go on to either of those. We have lots of free videos for you there.
And, this is a pretty comprehensive breakdown of some of the things that I use. And, yeah. So, overall, I hope that was really useful.
It was nice and accessible for you. I know I've filled a huge amount. Information in without any direct pinpointing of certain diseases.
This is more about enabling you to understand and feel comfortable and exposed er er to some of the things you would see with lizards on a day to day basis. And if there is any fine details that you'd like to er er er contact me on, I'm dready vet on everything. And, and, and, and hopefully, you know, that's been useful for you.
So thank you very much and have a great day.
