Blocked glottis on snake -any advice urgently welcome
 

I'm in Fiji (the south pacific country) without specialist reptile vet support, and I've got something going on I've never seen before. ANY opinions, experiences or suggestions would be very welcome.

I have an adult male wild caught endemic Fiji Boa (Candoia bibroni bibroni) who I've had in the same conditions (natural temperature, humidity and light) for more than 8 years without any problems. He's just (along with my other 4 snakes, all in good health) coming out of his winter brumation fast, but hasn't started to eat yet (the others ate 3 days ago).

He seems to have a blockage of his glottis (breathing tube). He's breathing though his nares (nose) OK, but every now and again he goes though quite a violent "fit " of gaping, hissing (very loudly), and rubbing his head upside down. I actually thought he was convulsing the first time. He's not bubbling or clicking, but when I managed to get a good look inside his mouth , his glottis seemed to be blocked, and there was a long strand of white mucous-like material between his glottis and his throat. (see photo)

I managed to clear this out with the aid of a soft chopstick and a baby toothbrush (and a struggle....), and he is resting better today, but his glottis still doesn't seem to be open.

I've never had a previous problem with respiratory infections, and the other snakes seem fine. I don't give them artificial heat, but the weather is warming naturally (right now about 32oC / 85oF ish daytime) and very humid.

Also, probably not relevant, but who knows, when I took him out of the tank he was just beginning to shed (and actually did so as I was handling him). the skin came off fine, including his face, eye-caps and throat, but his eyes are still a bit cloudy and his head a bit pale, so I'm wondering if there's another layer to come (he normally sheds very completely and without problem).

I'm afraid to feed him in case there is still a blockage. What are your opinions of fogging or steaming him? On-line I see people have tried fogging with Veterinary Disinfectant (I don't have a fogger, and not yet sure whether the mammal vets here have appropriate disinfectant), and also steaming with Vicks Vapour rub and Eucalyptus oil in hot water (I do have access to these).

I can also get Baytril but only oral, not injectable, and I'm not happy about sticking a pipette down his throat right now.

Or maybe it's not an infection and there's something else that might cause this which I don't know about?

Any advice would be MUCH appreciated. I'm posting this on 13 Nov 2017, and it feels pretty urgent to me....

Slightly nasty open mouth photo coming up....

Wish I could contribute but I've never run up against this before. Closest thing I've seen was ingested wood chip/shaving 'after' feeding, but not your case. Good luck Helen, hopefully someone else has a good suggestion.

Thanks for the response anyway Robert, it helps just to talk it over.

It's definitely not something he has ingested - I originally thought it might be a bit of his shed, but when I swiped with the chopstick it was gooey and mucous like.

I'm trying an on-line vet service, and I'll let you know if that yields anything useful.

Is the inside of their mouths normally black?

Well, that's a very good question - and the answer is I think so. (I don't see it much, there's usually food in the way :o)

I think it may be related to the individual snake pigmentation - my large female yawns pink, my two other males are noticeably darker inside, but particularly dark in winter when they are cold and not eating much.

Here are pics of of the sides of the mouths when two of them are eating - the pink one is my large female (from another locality) and the darker one is this snake's brother. I'm going to search around for more pics.

OK, looked around for feeding time photos and yes, indeed, his mouth is normally black inside (the top two pictures), while one of my others (the bottom pic) is totally pink. They are from different islands and also have different skin patterns.

(In case you are wondering, they normally eat 2 week old chicks, but I give them supplementary chicken wings, which is what they are eating in these pictures :)).

Ok if it were normally pink I would have thought that he had some weird mouth infection going on.

At this point I'd cross my fingers and try the Baytril. If you can get Fortaz/Ceftazidime, that antibiotic in combo with Baytril is very effective on bacterial RI's, if that's what he's got going on.

Side question: are you warming them in hot water, microwaving them a little or are they simply taking them at room temps?

Thanks Melinda, I'll go and weird out my local mammal vets again..... he doesn't have any other symptoms, but I've never seen an RI.

Different question: It appears there is some kind of cloth towel in his cage, does that remain in there normally? Do you feed your snakes with the towel in there?

I thaw them in lukewarm water so they are at, or slightly above, room temp (But you have to realise that my room temps are pretty high - often above 80-oF).

(I don't have a microwave - did try it once, and made a HELL of a mass of a rat :ack2:)

No, the towel was just in there to help with the shed. They live on newspaper, and I feed them in bare floor tubs.

Sooooo true. Basically boils their insides, usually blows out their stomach and makes their tails crackle, pop and curl.

You only need to do that once or twice before you realize, "Dang, that wasn't a good idea".:ack2:

Okay, just thought I would ask. I had a Burmese python m-a-n-y moons ago ingest a beach towel from it's cage that got rabbit scent on it.

I know, I know... a learning curve back in the day.

Melinda, any advice on dosage? he weighs about 3 Kg, and chances are I'd have to give it orally. Thanks

:rofl::rofl::rofl:

I hope this will turn out to be a future funny story too....

Unfortunately no as I've always injected it and the vet made up the syringes for me. It does have to be kept frozen until administered.

OK, thanks. I have used Baytril before as a precaution when they had some regurge problems during a heatwave, and I had to crush up tablets and pipette a solution down their throats (they are very used to being handled, and relatively placid, but it was still a saga...).

the strand of mucus would make me suspect an RI which I just find slightly odd since I know they are native there so your temps should be fine but perhaps he has an underlying infection of some sort and it just manifested this way?
:(

He's been resting quietly now for 2 days since the gaping and hissing, so this morning I took him out and made him move around, and he seems fine - except for limited vision because his eyes are still foggy. I opened his mouth and had a quick look inside and while his glottis wasn't visibly open, there was no more mucous or any sign of bubbles etc. He's obviously breathing because, you know, not dead :o

I'm keeping him in isolation and today will speak to the vet, and see if I can get some antibiotics on hand in case he starts exhibiting symptoms again. However, pushing a pipette of antibiotics down his throat at this point seems like an additional stress I'd like to avoid.

Has anyone ever tried, or even heard of, fogging with disinfectant or steaming with Vapour Rub/ Eucalyptus? I swear there are advocates of this out there on the interwebs, but I don't want to experiment blindly....

I might try feeding him a very small meal (so as not to block his mouth for very long) in a day or so.

I have but have also read that Vapo Rub/Eucalyptus are not recommended for reptiles. You could just use plain water. If you've ever had a cold and taken a hot shower then you know how the steam softens things up so it's easier to clear the crud out of your sinuses. Basically it gives the snake the same kind of relief, though it just treats the symptom and doesn't cure the illness if the snake has an RI.

Thanks Melinda, the online vet also suggested just a plain water steam without adding anything, but as it's currently 30oC / 84oF, and thundering (100% humid) I think just the air will do it.

I liked the idea of the Vapour Rub, as I can get it here, and it's relatively non-invasive, but I was hesitant to do it unless someone here had a direct (successful) experience of it.

It's funny what turns upon the ol' interwebs isn't it?

So, quick update, it's all like it never happened - I've had him under close observation for 5 days and he seems 100% normal, so I've put him back in his home tank.

I'm still a bit uneasy, but from what I read on here sometimes an RI can be
cleared up just by an increase in temps, right? It is a very warm week at the beginning of our summer right now, so maybe it just hit the sweet spot? Who knows.

Still not totally happy, but am going to try feeding him this weekend and see how it goes.

Thanks for helping me talk it out! :IThankYou

How to give IM injection?
 

3 weeks later and he's alive but not thriving. Found a vet with injectable Baytril, but no reptile experience. Can anyone please tell me the exact location that's best to give an IM injection? I'm assuming alongside the spine, but anywhere in particular? Thanks

How to give IM injection?
 

He ate a small meal a week ago, but struggled, and wouldn't take a second. Now he's lethargic. Going to the (non-reptile) vet on Monday.

Injections in the front 1/3 of the snake, yes more on the side of spine along the back muscle. hold needle at angle to slide it between scales, not like straight in. Usually a good idea to put your finger on spot after withdrawing needle for a moment to ensure meds don't follow it out.

Thanks so much April, we are off to the vet on Monday, will be a new experience for all of us!

Baytril dosage
 

Well, I sucessfully gave my first Baytril injection yesterday at the vet's office, surrounded by a fascinated vet and 3 technicians, none of whom had even touched a snake before. (We are taking some of the healthy ones in on Saturday to run a handling session for them).

He seems fine this morning - it's very strange, he literally went for weeks between symptoms, but when he is having a problem it's dramatic and loud wheezing, and an obvious physical struggle to breathe in, with his mouth wide open. I can literally feel his lungs vibrating when he's struggling. His glottis was visibly open during one bout, though, so that's something.

For future information if anyone's in the same position, the dosage the vet and I agreed on is 5 mg Baytril / 1 kg snake, so as he weighs currently 2.6 kg, he needs (5 x 2.6) 13 mg of Baytril. (If it was to be given orally, it would be twice that).

Baytril comes in different strength liquids - my vet has 50 mg/ml (= 10 mg / 0.2 ml, or 1 mg / 0.02 ml), so to get the 13 mg, we need (13 x 0.02) 0.26 ml of the Baytril solution.

Because neat Baytril can cause cell death at the injection site, we are diluting this 50/50 with sterile saline, so we draw up 0.26 ml Baytril, then 0.25 ml saline, and let them mix in the syringe before injection of the total 0.5 ml.

So now it's just fingers crossed, I'm giving injections every 2 days for the next 4 weeks.

Thanks again for all help offered, this is the true value of these forums for me, and I really appreciate it.

He ate!
 

Quick update, 1 week into giving Baytril injections every 2 days, and he ate 3 small pieces of chicken wing yesterday.

I know we're not out of the woods yet, but it's such a good sign - he was moving around and tongue flicking as normal. No further wheezing or gaping. I am hopeful we are on the right track. :thumbsup:

Nice! I would keep the meals smaller than normal for a little while unless he truly needs the nourishment as abx can be hard on a snake's liver and kidneys.

The problem is that he was at the end of his winter brumation when this started, and he actually hasn't eaten now for almost 6 months. He normally fasts for up to 4 months and doesn't lose any weight, but he's currently 300 gm down (10% of his body weight), and I'm concerned he won't have the energy to fight the infection.

He's normally a very eager feeder, grabbing 3 or 4 large portions at every feeding (usually every 2 weeks). This time I offered him 3 very small sections of chicken wing, and held the ends as he fed, to make sure he could easily ingest without blocking his airway. He fed very slowly for him, but I'm happy he has got something inside him. He is drinking as normal, and passed urates the other day.

I am concerned that it does require energy to digest. If I stick to small meals, would you normally feed him on his regular schedule, or more or less frequently?

For now I would stick to his regular schedule, just smaller meals, and bump him back up to normal when you stop the meds. I thought he had eaten fairly recently though?

He took one very very small piece over a week ago but then refused more, so I'm not counting it. I'm starting from yesterday's proper meal.

Fingers crossed he continues to improve!

Thanks, I am a lot more hopeful now than I was a week ago.

Im happy he is improving! Looking forward to more updates!


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I finally tried steaming
 

Thanks to all enquiring after Samael's health. I'm now over half way through the course of antibiotics, and I thought we were through the woods until last night when he went back to gaping and wheezing, and again had a thread of white mucus in his mouth. :(

As snakes don't have a cough reflex (which I only just found out when researching this), I think the quite violent wheezing and contorting are the only way he has of ejecting mucus from his lungs and airway.

I went back in with a soft pipette and baby toothbrush, and cleared his mouth of what I could, and he seemed better, but still breathing with some effort, so I decided it was worth trying the steaming idea. As has been pointed out to me, breathing warm steamy air is not a cure for an RI, but may temporarily relieve some of the symptoms.

I boiled water (no additives, just water) and put it into 2 Pyrex beakers (from a coffee press) and stood these in a small tub, inside a larger tub with him in it, with a towel over the top to prevent steam escaping from the airholes. I left him in that warm steamy atmosphere for 30 minutes under very close observation to ensure he did not come into contact with the hot water.

He stopped wheezing and gaping in the tub, and seems OK this morning (although I do understand I'm probably just projecting my own wishes onto him...), so I think it at least didn't do any harm and might have made him more comfortable in the short term. I'm going to continue doing this on a daily basis for a while, at least until I have finished the antibiotic injections.

He has now had three sessions of this wheezing and mucus projection, one at the start of all this, one a month later, which prompted me to start the antibiotics, and then this one, in the third week of antibiotics. Between these episodes he's seemed fine.

Can anyone with experience of RIs tell me if this seems normal? Do they often relapse after seeming OK, or it is usually all done once the symptoms stop the first time?

Here are some photos from last night - holding his mouth open with a plastic pipette to clear the white mucus thread; him gaping to breathe after clearing (but at least with an unblocked glottis); and him in the steaming tub.

Poor baby. Sometimes we just have that one baby that’s always sick [emoji16] You’re doing great, Helen. I have very little experience with RI’s, so I’ll let someone else that knows, answer your question.


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Thanks for the sympathy. These snakes are usually so resilient I'm not used to having to nurse them - but thankfully he's a very patient patient. Can't imagine doing this with something less tame....