VCBE Case of the Month

Slither - a snake that recovered from kidney infection
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Slither, a 12-year-old female corn snake, was brought in to the Veterinary Center for regurgitating her food. She also had a visible swelling in her mid-body.  Slither was last fed 5 mice 6 days before coming in to the hospital, and she regurgitated 2 mice the day before her appointment.  Slither was always fed frozen/thawed mice (the mice are ordered frozen and thawed prior to feeding); however, the mice had come from a different company (not the company the owner typically used), and the mice Slither regurgitated had a rancid smell.  When the veterinarians examined her, Slither was lethargic, and her abdomen was distended (in a snake, this means that her body was wider than normal in the region where her stomach or intestines would be).

There are many causes for regurgitation (when the body passively expels food through the mouth) in snakes.  The most common cause in snakes is a parasite called Cryptosporidium.  This is a type of parasite called a protozoon that causes inflammation and thickening of the stomach and sometimes of the intestines.  Snakes with this infection are often hungry and will eat but regurgitate their food a few days after eating.  Due to the inflammation and thickening of the stomach, a swelling is usually visible mid-way down the snake’s body.  Slither’s clinical signs definitely fit with an infection with this parasite. Since this type of infection is very common in snakes, samples from Slither’s stomach and cloaca (the slit at her tail end that is the common opening of her intestines, urinary and reproductive tracts in reptiles) were collected and submitted for a DNA test for Cryptosporidium.

Other causes of regurgitation in snakes include poor quality mice, intestinal infections, intestinal cancer, intestinal foreign objects (for example if the snake ate parts of the cage bedding), kidney disease and liver disease.  Blood was drawn from Slither in a procedure called cardiocentesis (a method of collecting blood in snakes where blood is taken directly from the heart, since snakes don’t have limbs from which to take blood, as mammals do), and the sample was submitted for general examination (a complete blood count and chemistry panel, as we have done when we go to our doctors).  A fecal sample was also submitted to check for intestinal parasites. Slither was sent home on antibiotic injections (in case of bacterial infection). Her owner was instructed to soak her regularly in warm water to ensure she was hydrated and not to feed her until the test results were back.

The test for Cryptosporidium was negative, and the fecal analysis did not show any other parasites.  However, Slither had extremely high kidney values on her chemistry panel, which made the veterinarians concerned about kidney disease.  There are many causes and types of kidney disease in reptiles.  Kidney disease may be due to age-related degeneration, toxin exposure, kidney infection, cancer of the kidneys, and commonly in pet reptiles, vitamin A deficiency or long-term mild dehydration.  Kidney disease does not always respond to treatment (especially if it’s from long term disease); however, if it is from infections or toxins and the problem is caught early, it is often treatable and reversible.  The main treatment for kidney disease, regardless of cause, is fluid therapy (to keep animals hydrated, maintain good blood flow to the kidneys, and prevent build-up in the kidneys of toxic blood products normally cleared from the body by healthy kidneys).

Slither came back in to the Veterinary Center a few days later for treatment.  Slither was given fluids underneath her skin and was sent home on an omega-fatty acid and vitamin A supplement, as well as a medication called aluminum hydroxide which helps decrease phosphorus levels in the blood. Phosphorus, produced by numerous chemical reactions in the body, builds up in the blood when the kidneys don’t function well to clear it - a common finding in kidney disease.  Slither’s owner was still giving the antibiotic injections at home, and her owner thought Slither was more active since the treatments were started.

Slither came in the following day for more fluids.  She passed a large amount of watery stool during the exam.  Her chemistry panel was repeated and showed significant improvement in the kidney values, although they were still slightly elevated.  Slither was sent home again, and her owner was very diligent about soaking her, giving her the antibiotic injections, and administering the omega-fatty acid supplement and phosphorus binder by mouth.

Slither came back to the Veterinary Center 4 days later.  Her abdomen was no longer distended and was back to normal size.  Slither’s blood work was repeated, and the vets were happy to see it was normal!  They suspected that the new mice Slither was offered were rotten or infected and gave Slither an infection that spread to her kidneys.  The veterinarians recommended that Slither’s owner throw away the current bag of frozen mice and order a new supply.  Slither’s owner was told to finish out the antibiotic course at home, and Slither was sent home feeling much better! As you can see from Slither’s case, when a reptile gets sick, if they are treated early and diligently, they can get better.

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