# Ball Pythons > BP Husbandry >  Chronic Mouth Swelling - need advice

## Daybreaker

Need some advice please (sorry for the long read)...

Back story: I got a 2200 gram normal ball female back in early October who turned out to have a mild RI at the time of picking her up (was fine when we saw her at the previous owner's house but after the transit back up to our house -roughly 2 hour drive- she was popping and wheezing out of the snake bag when we got her home. We believe that the stress from the transit made her RI symptoms become more apparent and that's why we didn't notice anything odd when we went to get her. Took to her vet A to which she was on Baytril injections (.1 cc) every day for 10 days. Her RI symptoms came back after ~a week or so so we did .1 cc of Baytril injections for 30 days which kicked her RI. This vet was not a qualified herp vet (none in our close area).

Fast forward to late January, I noticed her upper right hand side of her mouth was swollen (both the inside near her teeth and the top of her face around her heat pits) so the next day I took her to a new vet, vet B (who sounded to have more experience with snakes, "30+ years," when I talked to the receptionist but not a qualified herp vet). This was January 27th. He recommended a diluted Betadine solution (the medicine is called Chlorehidex on my receipt) swab 3 times a day to the affected area (inside the mouth on that puffy side) for 2 weeks and do a warm compress to the swollen pit area every day as well. 

We had to do a swab 2 times a day due to work schedules and stopped the swabs after a week and a half since we had to go out of town for 2 days. When we stopped swabbing after the week and a half her mouth went back to normal (when the swelling was going down we noticed a little red pinpoint dot by her teeth so we think she might have broke one though she hasn't eaten since November 6th). After we stopped the swabbing we checked her mouth two days later and everything looked fine. But after checking a couple days after that we noticed the swelling (both inside and outside her mouth) came back and looked a bit worse than what we noticed on January 26th. 

Went back to vet B and he decided to do Baytril injections every 2 days, 3 shots total. He did a full one (1.0) cc of Baytril the first shot and .8 cc for the next two shots. She was looking fine until the morning of shot 3 where the swelling came back even worse than the previous two times. We were advised to still do the swab and compress everyday.

Fast forward to now, the 21st, where she has a checkup on Friday the 24th. So here's where I need some input/advice:

~ Vet B keeps mentioning that she may have built up an immunity/resistance to the Baytril from her previous RI: how easy is it for a snake to become "immune" to a medication or become resistant to it? Could this be the case for my snake even though the first two Baytril shots for her mouth made the swelling go down a lot and it got rid of her first RI?

~ Vet B didn't allow us to do our own injections for her at home: for the 3 shots we had to transport her to their office so the vet tech could do the shots even though we (the bf and I) are capable of doing them ourselves. Is it the norm for vets to not allow their patient's owners to give them their own shots? *Vet A did allow us to do all our own shots at home for her RI once he showed us how to do them.

~ Is a full cc/.8 cc of Baytril a LOT of medication to give in one sitting? Or is this the norm as well? Did vet A do "wrong" to give smaller but more frequent injections to kick her first RI?

~ The vet tech mentioned that if she did build an immunity/resistance to the Baytril that she'd (and quote): "need to be on another antibiotic where she would need fluids every single time" ("every single time" meaning with every shot I'm ASSuming) yet they could not tell me the name of the medication for me to research it myself because "they need to see her again in person". Does anyone know of what antibiotic this might be that they're referring to? 

~ They couldn't say what is causing/what caused the swelling (which is hard to say without monitoring her 24/7, I know). What _could_ have caused it? She hasn't eaten since November 6th (a F/T rat) and I haven't seen her rub her face on anything but would just moving around her tub cause a tooth to break/a mild infection to occur?

Any input/suggestions/advice would be wonderful. I hate to come off like I don't trust vet B but there's some things that I'd like to be more enlightened about by being her owner, and an owner of 10+ other snakes (all of which are healthy). 

This female is in QT and has been in QT since getting her back in October as well. She is being kept in a tub with a regulated UTH with a plastic water bowl and kitty litter pan hide. Her temps/humidity are spot on and checked with a digital thermometer with hot and cold spots checked with a temp gun.

Thanks

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## RobNJ

Baytril is not always effective against RI's. Also, whatever bacteria/virus is the cause of the RI, they are constantly evolving to find a way around/through whatever is being used to combat them, and Baytril has been around a while. I had a very interesting talk with my dog's vet in regards to Frontline and how it doesn't seem nearly as effective now as it did 10-15 years ago. Different scenario, same general theory at work.

Secondly, it may not be a bad idea to be seeking a new vet. I know you don't want to come off like you don't trust yours, but it seems that way...and that can put you and your vet in an incredibly awkward experience. A trusting relationship with your vet is as important as your vet actually knowing what they're doing, IMO.

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## llovelace

I have a wc female, that develops the mouth swelling, I just swab out daily with regular listerine.

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## wilomn

Pictures would be helpful. If it's cheesy then it needs to be opened and drained. Is there any kind of wound or scab or abscess?

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## heathers*bps

I have seen a few of my bps ( and other snakes ) have some mouth swelling and its from rubbing their enclosure trying to get out. I see this more in my boas and retics than anything. Is there a possibility that this could be the case???

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## satomi325

> Took to her vet A to which she was on Baytril injections (.1 cc) every day for 10 days. Her RI symptoms came back after ~a week or so so we did .1 cc of Baytril injections for 30 days which kicked her RI. This vet was not a qualified herp vet (none in our close area).
> 
> Fast forward to late January, I noticed her upper right hand side of her mouth was swollen (both the inside near her teeth and the top of her face around her heat pits) so the next day I took her to a new vet, vet B (who sounded to have more experience with snakes, "30+ years," when I talked to the receptionist but not a qualified herp vet). This was January 27th. He recommended a diluted Betadine solution (the medicine is called Chlorehidex on my receipt) swab 3 times a day to the affected area (inside the mouth on that puffy side) for 2 weeks and do a warm compress to the swollen pit area every day as well. 
> 
> We had to do a swab 2 times a day due to work schedules and stopped the swabs after a week and a half since we had to go out of town for 2 days. When we stopped swabbing after the week and a half her mouth went back to normal (when the swelling was going down we noticed a little red pinpoint dot by her teeth so we think she might have broke one though she hasn't eaten since November 6th). After we stopped the swabbing we checked her mouth two days later and everything looked fine. But after checking a couple days after that we noticed the swelling (both inside and outside her mouth) came back and looked a bit worse than what we noticed on January 26th. 
> 
> Went back to vet B and he decided to do Baytril injections every 2 days, 3 shots total. He did a full one (1.0) cc of Baytril the first shot and .8 cc for the next two shots. She was looking fine until the morning of shot 3 where the swelling came back even worse than the previous two times. We were advised to still do the swab and compress everyday.






> ~ Vet B keeps mentioning that she may have built up an immunity/resistance to the Baytril from her previous RI: how easy is it for a snake to become "immune" to a medication or become resistant to it? Could this be the case for my snake even though the first two Baytril shots for her mouth made the swelling go down a lot and it got rid of her first RI?


I think it can be possible. Is the Baytril just for the swelling or does your snake still have RI? 




> ~ Vet B didn't allow us to do our own injections for her at home: for the 3 shots we had to transport her to their office so the vet tech could do the shots even though we (the bf and I) are capable of doing them ourselves. Is it the norm for vets to not allow their patient's owners to give them their own shots? *Vet A did allow us to do all our own shots at home for her RI once he showed us how to do them.


In my experience, most vets will allow you to do your own antibiotic injection treatments at home. Maybe this is Vet B's personal preference of practice or she wants to charge you more office visits? :Confused: 




> ~ Is a full cc/.8 cc of Baytril a LOT of medication to give in one sitting? Or is this the norm as well? Did vet A do "wrong" to give smaller but more frequent injections to kick her first RI?


Depends on the concentration of Baytril. But in general, I would say .8 is a lot! Typically .1-.3 would be good. I think Vet A did alright.




> ~ The vet tech mentioned that if she did build an immunity/resistance to the Baytril that she'd (and quote): "need to be on another antibiotic where she would need fluids every single time" ("every single time" meaning with every shot I'm ASSuming) yet they could not tell me the name of the medication for me to research it myself because "they need to see her again in person". Does anyone know of what antibiotic this might be that they're referring to?


No idea what kind of antibiotic they are referring to, but that sounds strange to me.




> ~ They couldn't say what is causing/what caused the swelling (which is hard to say without monitoring her 24/7, I know). What _could_ have caused it? She hasn't eaten since November 6th (a F/T rat) and I haven't seen her rub her face on anything but would just moving around her tub cause a tooth to break/a mild infection to occur?
> 
> Any input/suggestions/advice would be wonderful. I hate to come off like I don't trust vet B but there's some things that I'd like to be more enlightened about by being her owner, and an owner of 10+ other snakes (all of which are healthy).


Can you provide photos of the swelling? It's hard to say what could have caused it. Sounds like you have your husbandry down.

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## Daybreaker

Thanks for the comments so far, I really appreciate it!




> Secondly, it may not be a bad idea to be seeking a new vet. I know you don't want to come off like you don't trust yours, but it seems that way...and that can put you and your vet in an incredibly awkward experience. A trusting relationship with your vet is as important as your vet actually knowing what they're doing, IMO.


I know it does, and perhaps in a way I don't trust him as much as I'd like (in no way am I saying I'm an expert or more knowledgeable than him) - but that comes down to how he handled her and certain comments he made about snake care/husbandry that goes against almost everything I've read online from others with specific experience with snake infections and illnesses. But that is unrelated to the treatment and how to help my snake (Scarlett). I know there are qualified herp vets a few hours away from me though that I will be considering for any future problems, I totally agree that you need to be comfortable with your vet!




> I have a wc female, that develops the mouth swelling, I just swab out daily with regular listerine.


Do you swab her entire mouth? Does she get swelling on the outside of her face/around her pits as well?




> Pictures would be helpful. If it's cheesy then it needs to be opened and drained. Is there any kind of wound or scab or abscess?


No cheesy, so me and the vet don't believe she has mouth rot. The only wound would be the little pin point red dots by her teeth that makes me believe personally that she broke some teeth/one tooth. 




> I have seen a few of my bps ( and other snakes ) have some mouth swelling and its from rubbing their enclosure trying to get out. I see this more in my boas and retics than anything. Is there a possibility that this could be the case???


Very possible, though I have never seen her rub constantly around her tub (or rub in general for that matter). Of course she may do it when I'm not at home or when we're sleeping, it's hard to say. But yes, very possible she's rubbing herself on something.

If that's what's making her swollen I'm wondering why she's now all of a sudden swollen? Could she have broken a tooth by simply pushing on her tub/hide/or water dish? 




> I think it can be possible. Is the Baytril just for the swelling or does your snake still have RI? 
> 
> In my experience, most vets will allow you to do your own antibiotic injection treatments at home. Maybe this is Vet B's personal preference of practice or she wants to charge you more office visits?
> 
> Depends on the concentration of Baytril. But in general, I would say .8 is a lot! Typically .1-.3 would be good. I think Vet A did alright.
> 
> No idea what kind of antibiotic they are referring to, but that sounds strange to me.
> 
> Can you provide photos of the swelling? It's hard to say what could have caused it. Sounds like you have your husbandry down.


Just for the swelling, but I did bring it to the vet's attention that her saliva is getting somewhat stringy which is how it was with her first RI. He is focusing on the swelling right now though.

It's probably policy but when asked he just said simply that "he doesn't do that" (ie let people do their own shots). For her three injections so far though I only paid for the shots, not extra for a vet visit. I just wish I could have done the shots myself since it's so stressful on her to transport her so frequently  :Sad: 

I though 1 full cc was a lot but wasn't sure: vets do things different hence why I'm here asking for advice and input. I believe the dosage depends on the size of the snake though, but yeah 1-.8 cc sure looked like a lot to me!

I can get pics up of how her mouth looked when I first noticed the 1st bout of swelling (back on Jan 26th), I just need to upload them to photobucket first, I'll get them shortly. If she's not too freaked later for her swab I'll get photos of her tonight as well.

Anyone know of different antibiotics vets have recommended to treat RIs/infections in general?

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## apple2

Not sure if this is even possible in snakes, but it seems as if your BP is allergic to antibiotics. Swelling after giving medication is often a sign of that in other animals.

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## SquamishSerpents

Does it look something like this?

http://www.facebook.com/media/set/?s...3&l=6913fb8088

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## Daybreaker

Here are photos of Jan 26th, the first initial swelling. The second and third time she re-swelled up were worse, as in the swollen area around her teeth took on a purple ish color and the swelling grew up onto the top of her nose (the bridge) as well as around the pits and starting to inch around to the other side of her face.

That little red spot in the very top center of her upper mouth has been getting swabbed also, advised by the vet.

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## RichsBallPythons

I know swelling can be irritation from a feeding that scratched or bit the inside mouth. And or the teeth coming out of the gum lining causing abscess to form.

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## Daybreaker

> I know swelling can be irritation from a feeding that scratched or bit the inside mouth. And or the teeth coming out of the gum lining causing abscess to form.


Her last meal was November 6th - a F/T rat so don't think it was from that.

A broken/ripped out tooth however is my #1 guess as to her problem, it's just so hard to say though  :Sad:

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## wilomn

That could be a tear duct problem. Either an infection or closed entirely. That I have seen before.

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## Daybreaker

> That could be a tear duct problem. Either an infection or closed entirely. That I have seen before.


Could you give more info on tear duct problems? I have to say I don't know anything about tear duct issues. What can cause them to become infected? How are they treated?

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## Daybreaker

> Not sure if this is even possible in snakes, but it seems as if your BP is allergic to antibiotics. Swelling after giving medication is often a sign of that in other animals.


Could be, though a day or so after her injections the swelling would go down a lot. It's just odd that it keeps coming back, unless it's just not getting "cured" anyway.




> Does it look something like this? (URL)


Very similar, though my snake's swelling was concentrated on one side (well the last time it re-swelled it started going onto the other side as well).

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## Daybreaker

Here's photos from tonight, literally 10 minutes ago for her daily swab and compress.

Swelling and purpleness has gone down significantly from yesterday (her last Baytril shot was on Monday, 8:00 am), but now I'm seeing redness around her throat and trachea. She didn't have this aggravated redness with her last RI (or yesterday when we did her swab/compress) - I wonder if she's coming down with something new?



^that's the stringy saliva that she had with her last RI^



^New redness and RI looking bubbles^

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## SquamishSerpents

Oh poor thing!  :Sad:  I'm not sure about her internal bubbles and redness, but our snake (the one in the link to Facebook) was rubbing her nose. We switched her to a bin with no little plastic bits jutting out, and put a plastic lid and it went away completely. She did do a round of Baytril, though, but I'm pretty sure it was caused by the rubbing and not an infection.

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## heathers*bps

Yea looks like what I've seen my snakes looking like after their rubbing their enclosures.

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## RichsBallPythons

Swab the mouth few times daily with mouthwash. That swelling looks more abscess that needs to pop than anything. The mouthwash could kill the bacteria and help, if not no harm done doing so.


I still stick with the tooth getting out of line causing that.

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## Daybreaker

^ Is Listerine swabs consistently better than diluted Betadine solution in your personal opinion? Would any Listerine do or a certain type/flavor?

Quick update: Her swelling is down enormously, the only swelling she has is outer swelling on the top of her snout (warm compresses being gently applied); the area around her pits are down to normal size as well. The redness in her throat is gone but we'll be keeping an eye out if she develops RI symptoms. 

We'll see what the vet says tomorrow at the checkup, I believe she may be okay with daily swabs but if it gets worse or if she develops other problems I'm sure we'll have to go to other options. I'll see what the vet recommends to do with her.

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## Daybreaker

Got back from the visit with good news: she doesn't need any more medication for the time being since the swelling and redness is going away and the vet gave her a vitamin shot to try to boost her appetite and further help with her mouth issues. Plan to swab and compress daily to see if we can get that last little bit of swelling down that's exterior on the bridge of her nose. She'll need to return to the vet if she goes downhill though or if the swelling in the one little red area by her tooth line doesn't go away as she could have a broken tooth in there that would need to be removed. Fingers are crossed that she'll beat this herself with the addition of swabs and get to eating for me.

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## heathers*bps

Good luck with her. Keeps us updated ok?

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## Daybreaker

^ Definitely will, I hope there will be good updates in her future. Poor girl has been my one "problem snake" from the get go, it's time for her to get well and stay well for me!

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_dragonboy4578_ (02-24-2012)

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## Daybreaker

Just a quick update: she hasn't needed to go back to the vet and all the swelling inside the mouth is gone and back to normal (no redness either). She only has some slight exterior swelling still on the bridge of her nose, but even that is down from last week. She isn't showing signs of an RI either, her throat is healthy and perfectly clear. Still not showing interest in food, but I'm hoping she'll break soon (my two big other females are still off food too). 

Looks like she's in the clear in regards to her mouth swelling  :Good Job:

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## Slim

Great to hear she's doing so much better!

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## heathers*bps

Yay! I'm glad she's doing better  :Good Job:

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## Daybreaker

Thanks guys  :Smile:

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