Reticulated Python Colon Surgery
 

Two days ago one of our reticulated python females had to have surgery for an obstructed colon. We took her to Stahl Exotic Animal Veterinary Services (SEAVS) in Fairfax, VA last week after the area about 12" in front of her vet became hard and she felt like she had swallowed a tennis ball. Initially the vet thought she was just constipated, but exercise and massaging the area failed to improve her condition so we authorized surgery. What was found surprised all of us; left untreated she would have died, as she had an infection in her colon wall that was blocking anything from passing. That portion of the colon was removed and the healthy ends were stitched back together.

I've created a photobucket storybook with comments on each picture from the surgery at:
http://s477.photobucket.com/user/efi...Nova%20Surgery

Nova will be at the vet for a few weeks for post-op. She will also need to be tube fed carnivore care for several months while her colon heals, and she's on antibiotic shots for a while as well.

Test Results
 

Update: the histopathology results are in. No worries about cancer or an infectious disease like crypto. In layman's terms Nova had something called Pseudomembranous Colitis. How she got it is a complete mystery. Fortunately her prognosis at this time looks great.

Great news and thanks for sharing!

Thanks for doing that, I always find it really helpful to see pics of this type of thing. VERY glad to hear that she's doing well now. :thumbsup:

Update: Nova is back to eating small rodents - she had two large mice this week, her first whole prey since the surgery. If she digests and passes them normally then she will be coming home next week.

Very heartening to hear some one properly care for there reptile. Many people would have ignored or euthanized. Please keep us updated!

Not having dealt with surgery on reptiles before - was there any talk of or use of pain management during the days/week post-surgery? Not sure if there's even any painkillers approved for use on reptiles, honestly. Just curious.

Anyways, she's beautiful - here's hoping she continues to heal well.

Interesting seeing the photo bucket story book.
Kudos for getting her the care she needed!
Am glad to see that all went well and that she has come far along in her recovery.:)

While I know she was on some sort of pain medications I don't know exactly what she was being given. I will ask.

Hopefully it isn't a bother, but thanks!

I just wondered since I've heard of some (generally older) vets that didn't seem to think post-operative pain management was needed if the animal wasn't big and furry...and sometimes even then. Good to know she was treated right. :)

No worries. My vet and I are actually Facebook friends so I just got the answer.

Nova got tramadol and meloxicam for pain. I guess they made her feel pretty good b/c her attitude changed overnight from witch-with-a-B to sweet as pie.

I've had to take tramadol before, fairly strong narcotic. Not surprised she got all mellowed out on that!

WELL FINALLY SHE POOPED!!! It took a few weeks and some more small meals of 3-4 large/jumbo mice per feeding. I guess a retic doesn't leave a lot of "waste" when fed mice.

As an FYI her pre-surgery weight was 2.6 kg, she dropped down to 1.8 kg before she started eating, and now she's just under 2 kg now.

NOVA IS FINALLY HOME!!! And since she ate last week the vet said she could have three mice this week, and every five days for the next two months. Her attitude couldn't be better and she settled right in to her enclosure.

Watching a retic eat mice is rather ridiculous - think popcorn chicken. :D

All great news - and some entertainment value by the sound of it :thumbsup: :D

Ha, yes it was. Anyway, a few days ago she had a final checkup just to make sure there's no leakage and everything looks great. Over the next few weeks I can build her up to normal sized feeders.

How is she doing? Is she eating normal sized prey now?

She is doing very well. She's still smaller than her sister but is catching up quickly, and eats a f/t large rat or 1/2# rabbit every 7-10 days.

She does have issues shedding around her surgical scar. We have to soak that area with a damp, moist towel and carefully remove the shed each time. Otherwise it tends to build up.

She's also gotten a lot more "social" and interactive. Supposedly personality isn't heritable, but she and her sister could be twins in looks and attitude.

Wow, that was a really interesting album. Props to whoever took the photos, you don't see that everyday. Poor girl with that icky stuff in her colon. Does the vet have any ideas how she could have gotten the colitis? Really glad she's doing better, and thanks for sharing her story :)

No idea, apparently it's just one of those weird things.

Unfortunately there's a sad update to this story. Last week Nova started having issues with getting backed up/unable to pass feces. We took her to SEAVS and they got her cleaned out, but over the few days they had her for observation they noted issues with her back third becoming paralyzed, with a loss of muscle control in her tail, she could not close her vent, etc. We gave her a few more days to see if things would improve, but she then showed increasing signs of pain in her body just before the paralysis point.

They theorize that there may have been some nerve damage due to the surgery, and her nerves may have been torn or stretched away from the spine when they had to do the intestine resection. While the problem wasn't evident immediately post-op, it became an issue as she grew longer and thicker.

So, we made the tough decision to have her euthanized.

Since her particular case was included in the recently released edition of Mader’s Reptile and Amphibian Medicine and Surgery, Dr. Stahl will be doing a necropsy on her as a follow-up, in case he finds anything useful to include in a future release of the book.

I'm so sorry Melinda

Rest in peace Nova

Very sorry to hear. Heartbreaking...

Very sorry to hear that. :(

I hope it is some consolation to know how much you and she contributed to veterinary knowledge by letting us know all the details though.

Re the tail paralysis - I had a snake with a similar problem after a heat wave (the snake died the next day). I'd never heard of it before, but I imagine nerve damage was a very likely factor in that case.

Thank you Melinda
 

I think I might be in your situation at the moment: one of my Fiji Boas, Samael (1.8m 2.5 kg not sure how old but I've had him for over 10 years), has two hard lumps in his gut, about 8 scales above his cloaca.

It does not appear to be causing him pain or discomfort, and at this colder time of the year, (we are coming to the end of our southern hemisphere winter) they fast, so there is no danger of him eating and causing more trouble right now. He would start to eat again next month if all was well, so I do need to get this sorted out if it is possible.

I have tried warm water soaks and belly massages, but cannot move or change them. The next step would be to force feed him a little mineral oil, or try an enema, and failing that, surgery.

We don't have specialist reptile vets in Fiji, but I am sending useful links, including your photobucket album, to the few vets we do have, and while I'd be delighted if anyone had any hints of tips for us, I'm primarily posting here to thank you, Melinda, for posting this up, it's going to be very helpful in informing vets here if we can try to do something for him.

BTW, this is the same snake that had a severe respiratory infection in 2017 and went off feed for 1.5 years after that, so he's not my simplest snake, see thread http://www.faunaclassifieds.com/foru...d.php?t=640431
:face_palm_02:

I think that's different. Nova's infection was on the colon wall so there was no visible lump. Her swelling was symmetric due to backed-up feces in the colon before the infection.

This may give the vets a better idea of how to treat:
https://ball-pythons.net/forums/show...oa-with-a-lump

Thanks very much, I'll pass that along.

Hi again Melinda.
Do you still have your photo bucket story on file? I went back to photo bucket but the link is no longer there. I should haver saved it the first time.
My snake still has his problem, and although you don't think it's the same thing, I'd like to show our local (non herp) vets what a scan of a blockage can look like.
Many thanks

I'll just upload them here. The Photobucket account was my husband's and when he moved over to Instagram he kind of stopped using it so I think they clobbered it.

Next set of pics

Thanks a lot.
I'm taking Samael in for an X-ray tomorrow. Did you also have an X-ray of your snake that you can share?

More pictures

Almost done...

All done and sewn up

No unfortunately we don't.

Ok, thanks for all the photos, I know our vet will be very interested.

It's like taking your car to the mechanic
 

Just back from the vet with good news. :D

He took three X rays, as below, and decided that the blockage is contained within the intestines, but there was no torsion, so we were pretty sure it was impacted faeces, not a tumour or a twist, making it possible to consider giving him oral laxatives.

We were just discussing laxative possibilities (anyone have an opinion on Mineral oil or Lactulose laxative in snakes?) when he started to pass urates.

That was messy but good news, but then there was a little blood in the urates, and a visible inversion of rectal tissue, and he passed a decent size stool, soft on the outside but dry and impacted on the inside. I've rarely been so happy to be pooped on :o

So, it's pretty obvious he had impacted faces for some reason, and we are hopeful that with the help of some mineral oil, which we are trying to source now, we may be able to shift the rest of it. The remaining lump is much smaller and softer and is nearer the cloaca than it had been, so we will continue with bathing and handling to keep him moving, and wait for another stool before we try feeing again.

I'm sure we are both much happier this morning - 3 - 4 months of constipation can't have been nice for him.

(Please excuse my rings in one of the X rays - the local vets aren't too thrilled to hold a snake still, so I had to do it myself)

Excellent!

He passed a second stool that afternoon after another hour's soaking and massage, so now he's just going to rest for a few days before I try feeding him again.

I don't want to hijack your thread further, so I'll start a new one and detail the process I went through with Samael, in the hopes that someone else might find it as useful as this thread was to me. (Our newly certified surgical intern vet was fascinated by the surgery photos, thank you).

On that note, did you ever get / can you post the necropsy results of your python?

I did not get anything in writing. The vet did say that the internal and external incisions had healed very well and there didn't seem to be a lot of scarring, which is why they were thinking nerve damage that became evident or worsened as she grew.