Will my python ever recover?

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Originally Posted by leosantare

I believe I already mentioned when my vet did bloodwork the time before last, it came back with inclusions on the blood cells. However, the pathologist did not mention inclusions with her most recent bloodwork. My vet told me that it could have been a fluke the first time and to just keep an eye on her. Therefore, I don't really know if she has inclusions or not. For those who don't know, the only treatment for inclusions is euthanasia.

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It doesn't look like you did. Six days ago you posted that they could test for inclusions (assume that means PCR testing for arenavirus):

"The supervisor did confirm that she was originally diagnosed with stomatitis. Unfortunately, stomatitis is usually not a primary disease but, is typically the result of another problem. They can also test for the deadly inclusions and nightO viruses."

But the next day you mentioned ruling out IBD

"I believe they diagnosed her with stomatitis due to some inflammation inside her mouth. This was back in October of last year, 5 months ago.

It appears both nidovirus and inclusions are caused from contact with other infected pythons or mites. She certainly doesn't have any neurological or respiratory symptoms so, I think we can rule them both out. Although, there are specific swab tests my vet can do for these viruses."

If a sample came back with inclusion bodies detected in the blood sample, especially in light of the claimed symptoms (and the diagnosed stomatitis, which is the clearest connection), and the vet thought that was a "fluke" I'd get a second independent opinion.

Keep in mind that a snake can test positive for IBD/arenavirus and have symptoms that are not caused by that disease. Many (statistically, most) IBD/arenavirus positive snakes are asymptomatic, and many snakes that are IBD/arenavirus negative can show some weight loss and lethargy caused by many other factors, including age and less than ideal housing (and possibly nutrition as mentioned above, though I myself would start with some B Vitamins).

Euthanasia isn't a treatment; it is an option, though not without a clear diagnosis plus symptoms that support that option. Supportive care is a treatment for IBD (and for idiopathic slow declines).

First, I am so sorry about your dog. I lost a beloved Russian Wolfhound to osteoscarcoma and I never regretted opting for euthanasia as soon as I saw that he was dealing with pain.

So here's the thing. Your snake is in a different situation. Honestly, I either totally missed that previous bloodwork showed inclusion bodies or you didn't mention it. It doesn't matter either way; I just know I didn't pick up on that important piece of information. I get it now why you are reacting strongly to everything - you are dealing with stress and loss.

It's significant that your veterinarian found inclusion bodies previously but even if that diagnosis were to be confirmed (and I understand why you are not re-testing), you SHOULD NOT EUTHANIZE UNLESS THE SNAKE DEVELOPS ACTIVE ILLNESS AND POOR QUALITY OF LIFE. Please know that I am not saying you are considering euthanasia for no reason. I am saying that our current understanding of these viruses tells us that euthanasia should not be considered the first and primary option.

I put that in caps because contrary to earlier beliefs, it is now quite clear that even snakes infected with IBD or Nido may not ever become ill and/or if they become ill it may be relatively mild and still allow them overall excellent quality of life. Someone with a big collection of snakes may opt to euthanize just to reduce the risk of the virus spreading, but in the case of someone with one or two pet snakes, then the main question becomes quality of life.

So for now, just love your snake. I'd personally just not worry about trying to give her probiotics unless you can find a stress-free way of giving them. I'm not seeing any clear indication that she needs them, and while giving them will not cause her any harm, it sounds like trying to get them into her is stressful for both of you and the additional stress is definitely not good for her.

I love that you are working on a jungle gym - just take it very slow and easy with her. Any of us who had spent half of our lives being very inactive would have a tough time with increasing our activity level. When I have taken on snakes who were never offered real opportunities to exercise before, it sometimes took weeks or even months for them to realize that they had more behavioral options available and it definitely took time for them to start exploring these.

Hang in there. I know sometimes we may come on strong with opinions or recommendations, but please know that everyone who has been involved in this thread cares very much about you and your snake.

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Originally Posted by Malum Argenteum

....I myself would start with some B Vitamins)...

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So would I- & that's something many vets do for snakes that seem ill or lethargic. (But not dosing them with human multivitamins as previously suggested in a post...I would never do that.)

Below is what I need help with right now, thank you.

I saw someone mention I'm only feeding 3% of the pythons body weight, what percentage are you suggesting? She is currently about 7.6kg. I asked my vet if (1) 275-300g rodent every 10 days is appropriate for her and she said yes, based on her calculations. However, mabey my vet doesn't know what she it talking about. I'm open to different feeding schedule/rodent size suggestings as long as it won't harm my python. Maybe (2) smaller rats every 9 days? Let's see if it's possible to make her gain any weight in a safe manner. If she were to gain ANY weight it would be a great sign and I would begin to feel hopeful.

That was me. For an adult python or boa I like to feed around 5% of body weight. Also make sure you're weighing on the same day, like the morning of feeding, or immediately after you clean a pile out of the enclosure, as a healthy bowel movement is going to change the snake's weight.

Okay, I will try feeding 5% of her body weight for now and see if helps. It definitely will not harm her correct?

Can I have a little more information please, how often do you recommend feeding 5% of the body weight? I assume to feed (2) smaller rats that equal 5% instead on (1) very large rat, correct?

I ended up feeding her (2) large rats last night, which totaled 6-7% of her body weight. That was a bit much for her and I won't do that again. Hopefully, she will be okay. got some medium rats on the way.

She got a lot of probiotics last night. I put a bunch on the rats themselves and inside their oral cavity. Although, the probiotics get very sticky, I think she had a very hard time eating them because it this. She may have even bit herself a little bit in the process. Should I continue giving her the probiotics?

I would only put probiotics IN the oral cavity- much falls off the fur, or changes the taste, or "gets sticky" (if rodents are damp). And personally I'd keep giving them for a while- they shouldn't hurt anything, & might help, so why not? As previously discussed, long antibiotic therapy does a number on a snake's digestion (or ours, for that matter, or most any other animal). The fact that she seems underweight or is losing a bit of weight is a good reason to assume she hasn't been getting all she could have from her meals with better digestion (ie. WITH probiotics).

Since you just over-fed her, you'll probably need to wait a bit longer to feed again- I'd guess a good 2 weeks. You truly don't need an exact feeding schedule- feeding every 10 days is just an approximation, since humans think in terms of schedules & like to keep track. In the wild, remember there is no such thing as a schedule- & some keepers only feed after they see a snake expel waste (that tends to space meals further apart, not what you'd want to be doing right now) or when a snake is visibly hungry (which often ends up being too much food, since just like us, they don't always know when to quit).

Point is, it's not critical as long as your snake is digesting well & not regurgitating. With those large rats, a MUCH better idea would have been to feed only one at a time, & at a slightly reduced interval- maybe 8-9 days- for best digestion. ;) Large rats have thick fur & are much harder to digest.

I'm in the "camp" that never weighs food & very rarely weighs my snakes. But since you do- you don't need a precise feeding schedule- IF a snake is losing weight, feed a little more, or feed a little sooner, or both; IF a snake is gaining weight, slow that down a little. Don't make any huge sudden changes- just watch the results & make small changes based on what you see & what's needed. :snake: And remember that both snakes & humans are considered healthier when slightly underweight, as opposed to being overweight. I suspect that's where your vet's recommendation is coming from- vets are used to seeing over-fed pets.

bcr229 has a ton of experience with these large snakes- I'd take their word for it (feeding 5%) ANY day. And no, it can't "hurt anything".

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Originally Posted by leosantare

...I'm going to make another vet appointment for an examination and discussion. If they are unable to convince me they can get her better, I will have her euthanized. This has been going on too long and things are getting worse. I feel like I'm holding a close to dead snake, she has barely moved at all in 3 days. I'm sure she will stop eating soon or start regurgitating. Why let it get to that point?

If I were to test for these viruses, I would have my vet do it. They told me months ago it will require sedation since she has to be swapped about 8" down the mouth. They also told me the test is not 100% accurate. I can also do the CT scan as a last try.

What do you guys/girls think I should have my vet do? Is there anything I should mention/ask my vet when I go? I am definitely 100% taking her to my vet this week.

Thanks for the support,

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You're really over-thinking this- please do hold off on vet appointments until you have a really good reason to need one -they're stressful for your snake, & obviously you too. Let your snake eat & digest a number of meals in peace- stress is bad for everybody's health- & please keep an open mind about the state of your snake's health. Plenty of snakes will lay around (not moving) for days at a time (especially when they're digesting, OR, in a shed cycle) and it doesn't mean there's ANY thing wrong. I've kept many (!) snakes for decades (not this species) & staying low-key & just "TLC" (good food & good environment) can do wonders for keeping snakes healthy- that's how their immune system functions best.

And by the way, as a life-long "dog companion", I feel your pain & I'm very sorry about your dog's diagnosis- especially for only being 6 years old- that seems so unfair. I'd be a mess too, about that.

Quote:

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Originally Posted by leosantare

Okay, I will try feeding 5% of her body weight for now and see if helps. It definitely will not harm her correct?

Can I have a little more information please, how often do you recommend feeding 5% of the body weight? I assume to feed (2) smaller rats that equal 5% instead on (1) very large rat, correct?

I ended up feeding her (2) large rats last night, which totaled 6-7% of her body weight. That was a bit much for her and I won't do that again. Hopefully, she will be okay. got some medium rats on the way.

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If you look at the guidelines for younger snakes they advise feeding 10% of the snake's body weight but those are for growing youngsters. Feeders at 5% of the snake's body weight every 10-14 days are fine. Feeding a bit more won't hurt either, just extend out the next feeding date a bit.

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She got a lot of probiotics last night. I put a bunch on the rats themselves and inside their oral cavity. Although, the probiotics get very sticky, I think she had a very hard time eating them because it this. She may have even bit herself a little bit in the process. Should I continue giving her the probiotics?

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You don't necessarily have to put a lot of probiotics on each feeder, though I usually just lightly dust a bit on a damp feeder.

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Originally Posted by Bogertophis

please do hold off on vet appointments until you have a really good reason to need one -they're stressful for your snake

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+1 on this. According to weight records from your vet and the dates you've provided, this animal has been to the vet at least 11 times since october according to the information you've provided. Including 4 visits in less than 10 days (10/27-11/5). That will greatly stress out any living thing on earth

I had to take her to the vet every (3) days for (1) month for antibiotic injections. She was only there for less than 5 minutes during these visits.

The only focus right now is the new feeding schedule to see if she can start gaining weight. I am going to feed (2) medium rats that equal 5% of her body weight, (about 390g) every 10 days. Does anyone see a problem with this?

In one month from now, I will get her weight and let everyone know. If she still hasn't gained weight or even worse, lost more weight, then I know for sure something is very wrong.

I will continue giving the probiotics, only putting it in the rat's oral cavity, it just won't be all that much. You recommend giving her B vitamins also, which ones should I get? What should I think about the one bloodwork showing inclusion bodies and the following bloodwork not showing inclusion bodies? Should I have more bloodwork to get a better idea? I remember my vet saying that it could be because each python species has a unique blood cell. The pathologist could have been mistaken due to her being a Boelens python.

Please do not take her to the vet to be weighed. There is no reason in this world to do that. Purchase a human scale and weigh her yourself. You can get one that measures in .1lb increments. Hold her steadily in your arms and take the weight. Then weigh yourself. Subtract the difference of the two weights and that is what she weighs.

These animals are very susceptible to stress. A vet trip is much much more than simply the time spent in the room with the vet. It’s you getting her out and putting her in a transport container (unfamiliar, uncomfortable, unsettling), a car ride to the vet, wait time, getting out of the transport container, exam time, back into the transport container, another car ride, finally home and having to resettle into her enclosure. Not to mention the temperature and environment fluctuations during all of this.

Stress can 100% have a negative effect on the digestion and body condition of a reptile. Give her and yourself a break. She’s been through a lot and now she needs time to recover, stress free.

Quote:

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Originally Posted by leosantare

The only focus right now is the new feeding schedule to see if she can start gaining weight. I am going to feed (2) medium rats that equal 5% of her body weight, (about 390g) every 10 days. Does anyone see a problem with this?

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I don't though by the time my snakes get up to taking feeders that size I prefer to feed rabbits over rats, as the rats that size are old retired breeders so they have a lot of body fat. See if you can find someone local to you who produces meat rabbits, it's cheaper getting them from a local supplier than buying them online.

Quote:

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Originally Posted by leosantare

I had to take her to the vet every (3) days for (1) month for antibiotic injections. She was only there for less than 5 minutes during these visits.

The only focus right now is the new feeding schedule to see if she can start gaining weight. I am going to feed (2) medium rats that equal 5% of her body weight, (about 390g) every 10 days. Does anyone see a problem with this?

In one month from now, I will get her weight and let everyone know. If she still hasn't gained weight or even worse, lost more weight, then I know for sure something is very wrong.

I will continue giving the probiotics, only putting it in the rat's oral cavity, it just won't be all that much. You recommend giving her B vitamins also, which ones should I get? What should I think about the one bloodwork showing inclusion bodies and the following bloodwork not showing inclusion bodies? Should I have more bloodwork to get a better idea? I remember my vet saying that it could be because each python species has a unique blood cell. The pathologist could have been mistaken due to her being a Boelens python.

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Please stop obsessing over her weight!- she looks fine & the small amount you've been stressing over truly isn't important. But the stress you're causing her IS or could be a problem.

I see nothing wrong with medium rats, but I wouldn't feed large or jumbo rats, simply because they're older, retired breeder rats, with a high fat content & are less healthy for a snake to consume.

I also would not try to change to rabbits right now- in case for some reason she doesn't like them & doesn't want to eat- why even open that "can of worms"? If it ain't broke, don't fix it!

Also, a snake's weight will fluctuate according to the amount of food being anywhere along in the digestive tract- and their weight does not truly change significantly in a month's time! It just doesn't. Stop all this nonsense.

Do NOT give B vitamins orally- they're not effective. B vitamins are best injected by a veterinarian, but PLEASE to not rush into yet another appointment to do this. The likely harm (from stress) could outweigh any benefit. Your snake is eating well & getting PLENTY of nutrition from her meals- the only indication for B vitamin injections is a SICK snake, & that you do NOT appear to have. Relax!

I think the one bloodwork showing possible inclusion bodies was probably flawed or misread- as your vet already explained to you. I would NOT get more bloodwork done!!! Your snake appears to be quite healthy. She even has nice iridescence in your photos- that's not a sick snake.

I have to say that I wish you wouldn't use vitamin supplements. There is very, very little research on using vitamin supplements in snakes, but there are plenty of clinical reports backed up with research about hypervitaminosis (abnormally high levels of vitamins, which can cause various toxic effects ranging from skin disease to gastrointestinal problems, kidney or liver disease). This includes hypervitaminosis D in snakes that were given supplements rather than provided with a natural vitamin D synthesis pathway through use of UVB light, as well as hypervitaminosis A and E.

Your snake is showing none of the signs of any known vitamin deficiency in snakes. None at all.

If you are going to insist on doing vitamin supplementation anyway, please do NOT do it at every feeding - just lightly dust the prey with supplements 5-6 times per year to allow your snake to process things properly.

Your snake looks absolutely beautiful. The weight loss you report is not clinically significant. She's showing no signs of any nutritional deficiency that would require supplemental probiotics or supplemental vitamins. She may or may not have inclusion bodies, but the important thing here is that even if she does, she is not symptomatic. And that means she has every opportunity to live a good life.

If she were mine, I'd make sure the feeders I give her have themselves been given a high-quality diet. I'd not bother her with any further veterinary visits. I wouldn't be dosing her with supplements of any kind. I'd focus on providing an environmentally complex enclosure, UVB, exercise, enrichment, and opportunities to be in the sun.

I love that you are looking into providing her with more opportunities to exercise and get enrichment opportunities which will increase her quality of life and improve her resilience overall.

All that said, I'm going to bow out of this thread; you are getting a variety of advice from a variety of sources and I don't think it's helpful for me to keep throwing my own perspective into an already-confusing mix. I wish you and your beautiful snake all the best, and hope that you enjoy many happy years ahead with her.

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Originally Posted by paulh

All of them. It would not hurt to use some vitamin A, C, D, E, ... , too.

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Yes, it absolutely would be expected to hurt. Feeder rodents are widely accepted to have sufficient levels of Vitamin D. "Metabolic bone disease is [...] uncommon to rare in snakes as they usually eat whole food items and absorb adequate dietary levels of calcium and vitamin D3" (source). "...rodents are a completely balanced diet" (Maders' Reptile Medicine, p. 216). More Vitamin D than is sufficient is not better.

Since nearly all supplement dusts use calcium carbonate as an active ingredient or carrier, and since rodents have a perfect ratio of calcium to phosphorus, increasing the level of calcium in the diet would be counterproductive.

By far most importantly, domestic feeder rodents are known to have borderline toxic to toxic levels of Vitamin A (source: Mader's Reptile Medicine, p 206 and feeder analysis chart pp 218-219). Accepted overdose rates of Vitamin A are 16,000 - 24,000 IU/kg of food; small to large rats contain 30,00 - 60,000 IU/kg. Shotgunning Vitamin A in rodent feeding herps is absolutely contraindicated.

Misdosing Vitamin A has a bad history in herpkeeping, BTW. Many turtle species were overdosed on Vitamin A when such practices were in fashion in the 1980s; this lead to a "preformed Vitamin A is toxic" scare that was addressed by using only pre-Vitamin A (carotenoids) in supplements. These supplements still exist, and currently are misused by hobby keepers for species that do not metabolize carotenoids to Vitamin A (with regular fatalities in amphibians, which seem unusually susceptible to hypovitaminosis A).

Please note, posts recommending supplementation with human vitamins have been removed. This is not something that we recommend keepers to do. Thank you to Caitlin and Malum Argenteum for outlining the reasons for this.

Update,
I took her to the scheduled vet appointment on 4/9 and it went pretty good. She was 7.9kg which indicated a very small weight gain. This was 10 days after I fed her the 2 large rats. The vet thought her body condition was okay and was not concerned with her feeling squishy in some areas. She was not sure why her activity level was poor. She also told me to hold off with any vitamins and it's up to me if I want to continue the Nutribac.

She also said to say with (1) 275-300g rat every 10 days for now. She is going to reach to her colleague about an optimal rodent size/frequency and let me know. I mentioned feeding an amount that is 5% of the body weight. My vet let me know that an average adult boelens weight is 8.6kg. I let her know that I want her to gain weight and be around 8.5kg. I'm pretty sure that is where she was before any of this started. She thinks her weight may increase in the warmer months without changing her diet. I scheduled a recheck appointment 8 weeks from then.

She finally pooped, a little bit and I dropped off a sample. It came back normal again so that isn't the problem.

She pooped a large amount on 3/18
I fed her the (2) 250-275g rats on 3/31 and that is the last time she ate.
She pooped next a little bit on 4/6
She pooped next a little bit on 4/10
She pooped next a little bit on 4/11

Yesterday, 4/11 I noticed she pooped a little bit and that she was still trying to go. I also noticed her body was swollen by her vent and it felt like there was a rock in there. I soaked her in warm water and tried gently massaging the area to help her go but I didn't have any luck.

I reached out to my vet today and showed a picture of the swollen area. They told me to bring her in asap rather than next week. I bought her in today and they did an xray. They think it's either a messed up egg or poop. They also think this is a life threatening emergency. They thing the redness on her underside is due to sepsis and I think it's because she is going into another shed, her skin is loose around the neck again.

They want me to drop her off first thing tomorrow morning to perform an enema which requires full anesthesia.

They already started her on the following medications,
Ceftiofur
Enclosed
Metronidazole

Today's visit cost me $900! and tomorrow will cost me $1500!

Should I have the enema done tomorrow?
Can this really be caused by feeding her 2 large rats one time?
I thought I felt a small area by her vent about a month ago that felt hard. I'm thinking maybe this started a while ago and not it's gotten much worse.

Can this explain the poor activity level these past few months and with the weight loss?

I first reached out to this forum asking if it's okay to feed again if the snake hasn't defecate and was told it's okay. I never fed her sooner than every 10 days and only fed her the 2 rats the one time.

Here is the picture,https://uploads.tapatalk-cdn.com/202...c146dd6a02.jpg

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I forgot to mention, she also ate (1) 275-300g rat on 3/22

Quote:

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Originally Posted by leosantare

...
Yesterday, 4/11 I noticed she pooped a little bit and that she was still trying to go. I also noticed her body was swollen by her vent and it felt like there was a rock in there. I soaked her in warm water and tried gently massaging the area to help her go but I didn't have any luck.

I reached out to my vet today and showed a picture of the swollen area. They told me to bring her in asap rather than next week. I bought her in today and they did an xray. They think it's either a messed up egg or poop. They also think this is a life threatening emergency. They thing the redness on her underside is due to sepsis and I think it's because she is going into another shed, her skin is loose around the neck again.

They want me to drop her off first thing tomorrow morning to perform an enema which requires full anesthesia.

They already started her on the following medications,
Ceftiofur
Enclosed
Metronidazole

Today's visit cost me $900! and tomorrow will cost me $1500!

Should I have the enema done tomorrow?
Can this really be caused by feeding her 2 large rats one time?
I thought I felt a small area by her vent about a month ago that felt hard. I'm thinking maybe this started a while ago and not it's gotten much worse.

Can this explain the poor activity level these past few months and with the weight loss?

I first reached out to this forum asking if it's okay to feed again if the snake hasn't defecate and was told it's okay. I never fed her sooner than every 10 days and only fed her the 2 rats the one time.

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Yes, I'd absolutely listen to the vet on this. And yes, this might explain some of the subtle changes you've been noticing. You'd be pretty uncomfortable too if you couldn't pass waste. This is something you should routinely & very gently feel around for above your snake's vent (& higher up ventrally, for any odd lumps & bumps) particularly if you think something may be wrong. Not to make a big thing of it, but when you're handling- pay attention.

Urate stones are not that rare (you never notice them if they're small enough for the snake to expel normally) but sometimes a snake will form a urate "stone" that's just too large to expel without help. I don't think it has much to do with feeding 2 rats at the same meal, although that's inadvisable anyway for other reasons. (And rats have very thick fur that's hard to digest, which if combined with some dehydration, could promote constipation- though it's not common.)

Snakes are fed all the time before they defecate from the most recent meal- there's nothing unusual about that. (Are you really trying to blame the forum for your snake's problem?) Many years ago, I had an old rattlesnake (given to me very late in her life- she was a "zoo surplus" animal) that formed several "stones" (aka "cloacaliths") which she needed help to pass- she was just fine after that. You want to make extra sure to keep this snake well hydrated in the future, but hopefully this is just a one-time thing. Also, more activity on your snake's part helps to "keep things moving"- another reason to add enrichment to her home- plus, more activity promotes better muscle tone.

But as your vet said, it's not even yet known IF this is a urate stone? It might also be a slug egg that was retained- you'll find out soon enough. Snakes are living creatures like the rest of us- and some things just "happen". I sure HOPE the pink tinge on her underside isn't sepsis- no way to know "from here" either. All the best- please do let us know the outcome (no pun intended).

fingers crossed for you that it is just fecal or a strangely large urate stone. That can happen at times.

What I hope that it's not is a fast growing tumor of some sort. They're rare, but can absolutely cause lethargy, blockages and weight loss. But again... rare. And also this would be an abnormally fast growth.

Sepsis is a possibility if it is some sort of large blockage or bad egg, particularly if it had also caused damages to the inner tissues. I think personally I would have liked for the vet to know for a fact if this was a growth vs. urate vs egg issue before medications. It will suck if she was just going into a shed cycle, but as far as for tomorrow it will at least be useful in preventing any potential infections after the treatment. She'll need to be on the probiotics still because of it.

Any type of intestinal blockage though is definitely something best treated as soon as possible.

Thanks so much for the very helpful reply. No, I wasn't necessarily blaming the forum but I was just saying. Im glad to know that feeding again before the last meal is pooped is a common and harmless thing. I'm also very glad that you don't think this is caused by feeding the 2 large rats the one time.

Do you see a problem with feeding her (1) 275-300g rat every 10 days regardless of when she poops? I hope not because this is what I've been doing for the past 4 months. Before that I was feeding her (1) 250-275g rat every 10 days. I noticed she started pooping less frequently about 3 months ago.

I know you recommend chilling out about her weight and that her body condition looks good to you. Although, I just know her body condition has worsened, she has lost weight and activity level had really decreased over the past 6 months. Please understand I would not be worried about her body condition, weight and activity level for no reason.

Okay, so I guess I will have the procedure done tomorrow morning. Hopefully she will be okay with the anesthesia.

Quote:

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Originally Posted by leosantare

Thanks so much for the very helpful reply. No, I wasn't necessarily blaming the forum but I was just saying. Im glad to know that feeding again before the last meal is pooped is a common and harmless thing. I'm also very glad that you don't think this is caused by feeding the 2 large rats the one time.

Do you see a problem with feeding her (1) 275-300g rat every 10 days regardless of when she poops? I hope not because this is what I've been doing for the past 4 months. Before that I was feeding her (1) 250-275g rat every 10 days. I noticed she started pooping less frequently about 3 months ago.

I know you recommend chilling out about her weight and that her body condition looks good to you. Although, I just know her body condition has worsened, she has lost weight and activity level had really decreased over the past 6 months. Please understand I would not be worried about her body condition, weight and activity level for no reason.

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I see no problem with the slight bump up in feeder size to promote a bit of weight gain- provided your vet doesn't have a different opinion once you know exactly what's going on & what treatment is done. Your question is just a bit premature- one thing at a time. ;)

Quote:

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Originally Posted by leosantare

Okay, so I guess I will have the procedure done tomorrow morning. Hopefully she will be okay with the anesthesia.

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While anesthesia has some risk to it, it's nothing like the risk of doing nothing for her. You don't really have much choice, but think positive.

Hello,

I really need your help people. This is it, her last chance to make it. Well, my last chance to try and get her better.

I have a lot of things to say and never want to go back to my vet again. Look at what they did to her mouth from the past 2 days! I had a very hard time watching her after they gave her the oral medications. She will not be getting anymore from my vet and I can't do it myself.

Here are some pictures at the vet today after they gave the oral medications. They told me today that she bit herself again yesterday when being restrained for the xray. https://uploads.tapatalk-cdn.com/202...f5983ed2eb.jpg

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Anotherhttps://uploads.tapatalk-cdn.com/202...396856319c.jpg

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I got her home from the vet, put her in her enclosure and she looked so unhappy. I checked on her a few hours later and she popped a little bit. The swollen area by her vent is less pronounced if not completely gone. I assume the diarrhea is from the medication that gave her.

The xray showed that she was impacted with stool about 18" up from her vent.https://uploads.tapatalk-cdn.com/202...bb673aa316.jpg

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They did more bloodwork today and I will provide the vets comments next.

They told me yesterday that they were very concerned with her and that she was becoming sepsis. However, the bloodwork showed no infection and must be due to the shed cycle like I told them.

It has to be bad if my vet can't determine sepsis vs shedding, correct?https://uploads.tapatalk-cdn.com/202...749bb4d3e2.jpg

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I am still waiting on the husbandry consultation. She is working on it as we speak but typically requires a few days for a thorough examination and recommendations. We will get you this information in discharge as soon as they are available.*


I wanted to send you the tentative medical aspect of Jasmine's discharges (see below), while we wait on this. When this is complete, I will email a PDF of the completed discharge summary.


I also wanted to discuss her bloodwork results:*

Her overall white blood cell count was low, especially compared to her most recent bloodwork. This makes me concerned that she is immunocompromised - I do not know why at this point in time, because additional diagnostics would be needed for this. Even though there are no signs of active infection, I would like to keep her on the antibiotic in order to prevent any infections from forming - we can have her back for a recheck visit and repeated antibiotic injection in about 9 days for this.*Her overall red blood cell count is low, called anemia. It is very mild, but progressive from her last bloodwork. This can also be seen if she is immunocompromised if her body is not producing enough red blood cells to replenish its normal supply. I would like to recheck this value in about a week, with her next antibiotic injection.*Her liver value (AST) was slightly elevated, however this value gets released from muscle damage after about 12 hours. With the amount of restraint required for x-rays yesterday, I feel very confident that this is secondary to obtaining the x-rays. This is backed up with the fact that her muscle value (CK) is very high as well.*

Please let me know if you have any questions. I will be in the office tomorrow afternoon to answer any questions and update you with the husbandry recommendations.*

I can't say for certain, but I pretty damn sure that I will never take her there again. She has had antibiotics, 5 blood tests, 3 fecal samples and an xray. That should be enough testing, if they still don't know what to do, then they will never know. They want to continue the antibiotics they started yesterday and they want me to continue the oral medications for 2 weeks. By putting the medication in a small rodent and feed her one every other day.

So, this is my last chance to get it right.

I asked for confirmation from my vet and this forum multiple times if it's okay to feed her 1 275-300g rat every 10 days. I even sent pictures to my vet that showed me measuring the rat and the snake with a ruler! If anything, the forum made it sound like I was feeding her enough and recommending 5% of her body weight.

I tried, I have taken her to the vet about 10 times in the past 6 months. Please let me know if you recommend euthanasia now.

In the meantime, I am going to soak her every day for 1 hour. She is in shed so I'm not going to fed her for at least a week, although I have no idea what size to order now. Thanks again for your help

This is how I'm soaking her,https://uploads.tapatalk-cdn.com/202...cb1bed81c8.jpg

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Do this force acceptable exercise? If so, she is well hydrated/getting enough humidity, getting exercise, at the correct temps, more than enough space in her enclosure and eating well. What more can I do, other than make the pvc jungle jym?

I have an automated misting system for her enclosure that goes off about 4 times per day for 15sec. Plus there is very large humidifier in her room and I hand mist her a lot almost every night.https://uploads.tapatalk-cdn.com/202...3aa629ccbb.jpg

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I spot clean her cage every 2-3 days and clean every inch of the entire enclosure along with everything inside it once a month. I give her fresh water every 1-2 days. There is much more that I could have done for her.

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My vets response continued,

DIAGNOSIS:*

1. Colonic Impaction, fecoliths - rule out secondary husbandry (inadequate humidity, inappropriate diet, lack of adequate exercise, low temperature) vs. medical (dehydration, renal disease, arthritis, neurologic, mass effect, stricture/narrowing)*

2. Cardiomegaly (enlarged heart) - due to lack of normal parameters for species, can be a normal variant or related with post feeding increase in metabolic rate, but based on displacement concerned for underlying cardiovascular disease*

DIAGNOSTICS PERFORMED:
1.*Complete Blood Count: mildly low total white blood cell count, no signs of active infection. Mild anemia with signs of regeneration.*
2.*Chemistry: elevated muscle value likely due to restraint; elevated AST (influenced by liver and muscle) likely elevated due to prolonged restraint for x-rays*
3.*Radiographs (x-rays): enlarged heart, large amount of colonic impacted material*
4.*Fecal Ova & Parasite Testing: negative for parasites*

Diagnostic tests including referral for an echocardiogram and CT scan were declined at this time.*

CASE SUMMARY: Jasmine was evaluated at MLAH Exotics for continued workup for chronic weight loss and impaction. On initial evaluation, Jasmine remains bright and alert - her weight is fairly stable from her prior visits (current weight as of 4/12/23 is 8.1 kg).*


On evaluation, her coelom (abdomen) in front of her vent was very tense with firm mass effects palpable. These were confirmed to be mineralized fecal contents on radiographs (x-rays) performed, consistent with colonic (colon) impaction. This can be secondary to a wide variety of disease and husbandry (care at home) causes, and pinpointing the exact cause can be difficult without additional diagnostics. Common causes include dehydration (which can be secondary to low humidity, diet related, kidney disease), gastrointestinal infections, an anatomical inability to pass large stools (such as a mass effect, narrowing of the colon) or other systemic disease.*


As snakes only eat a few times a month, they have to repress their organs and proteins to conserve energy. When they eat, their organs grow back in size to digest the food and make up for increased oxygen consumption during digestion due to the higher energy costs to rebuild the proteins and organs that have atrophied during fasting. In addition, there is a process called "adaptive ballast" where some snakes retain their feces for a hunting advantage in capturing large prey - this can add to a snakes muscle mass while being inert (ie not requiring calories to maintain). They can also quickly release their feces to allow for quick escape if needed. Occasionally, when this is maintained for too long, the feces can buildup and become mineralized.*

It is difficult to determine how long the abnormal feces has been present, but can be prolonged (up to months). As discussed, due to the amount of material in her colon, we recommended a sedated enema to aid in passage of this material. Due to costs and the risks of sedation, you elected to hold off on this. We also recommended medical management with oral medications, which are difficult to administer at home. We recommended technician visits for administration - you are electing to attempt to administer via a prey item at home. If medical management fails, ultimately a sedated procedure may be necessary.*

We also noted that Jasmine's cardiac size was enlarged on x-rays. While we do not have normal parameters for heart size in her species, we suspect that based on the level of enlargement this is true enlargement. Some snakes can have an increase in their heart size after a meal to increase metabolism, but we are unable to determine if there is underlying cardiovascular disease without an echocardiogram (ultrasound) of the heart to evaluate the size, shape and function. As we have limited cardiology availability here, we discussed referring to Red Bank Tinton Falls or Animal Medical Center (AMC) in NYC. You have declined further workup of the enlarged heart at this time. Without knowing the cardiac function, sedation and/or anesthesia can be riskier or even result in death.*

______________________________________________



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Quote:

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Originally Posted by leosantare

It has to be bad if my vet can't determine sepsis vs shedding, correct?

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Apparent redness concurrent with some sort of blockage and non-distinct "off" appearance sure sounds like sepsis isn't a completely unreasonable suspicion. Expecting any vet to see a reddish belly on a snake that's ill from unknown causes and rule out all possibilities visually isn't at all reasonable.

The vet may well feel to be in a position where they are expected to voice every suspicion, and to treat every possibility aggressively. The vet might be feeling sort of overwhelmed, or feel like there is excessive pressure being put on them. Just speculating here, but if euthanasia is mentioned to the vet as often as it is in the thread, or arbitrary 'last chances to get it right' are mentioned, I suspect the vet might be in a position they don't like to be in or want to be in.

As to the appearance of the snakes' mouth -- it looks pretty angry, apparently from being forced open for the meds. That happens frequently, at least when I open mouths for dosing or swabbing; snakes' mouths bleed pretty easily, but they heal up quickly too. It is far better than not getting necessary meds.

Quote:

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Originally Posted by leosantare

... Please let me know if you recommend euthanasia now...

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ABSOLUTELY NOT. :( I'd have had the vets DO the enema as they proposed doing today. I would NOT try to medicate her at home now by putting medication in food, as feeding while impacted is NOT a good idea...it's a very BAD idea, assuming you don't enjoy making a snake's condition worse & the snake suffer more?

The soaking (as shown) might have helped if done sooner (& multiple times), but when a snake's fecal material has compacted & "mineralized"- she NEEDS HELP NOW. Preferably professional help.

I have a hunch that the vets consulted are being extra cautious (ie. very thorough) perhaps because they realize the value of this rare snake, not to mention the way you seem to keep bringing up euthanasia rather than helping her. I would be helping her- get the enema done.

The more you stall & the more vet visits you keep doing, the worse you're making this for your snake- every visit stresses the snake & that's bad for their health. A snake that simply needs help to defecate is NOT a candidate for euthanasia- this is perfectly fixable.

Why do the enema, when we don't know the cause and it can just happen again? I wasn't doi g anythong wrong. Plus, the risk of death from anthesia with an enlarged heart.

Plus, she just did poop without an enema. I posted pictures.


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Just speculating here, but if euthanasia is mentioned to the vet as often as it is in the thread, or arbitrary 'last chances to get it right' are mentioned, I suspect the vet might be in a position they don't like to be in or want to be in.

What a thing to say, thanks anyway.

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Quote:

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Originally Posted by leosantare

Why do the enema, when we don't know the cause and it can just happen again? I wasn't doi g anythong wrong. Plus, the risk of death from anthesia with an enlarged heart.

Plus, she just did poop without an enema. I posted pictures.


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It wasn't clear when that picture was taken.

Note, the vet's report said that the enlargement they thought they were seeing might be a normal variant for this species- it is also possible that there is some issue, but since that's not definite, it would not deter me from getting her necessary medical help. For all living things, just waking up in the morning carries a risk of death, if you know what I mean? ;)

Snakes can get constipated without anyone doing something wrong, & without involving any big health issue- just like humans do sometimes. It doesn't necessarily recur, though an enclosure that encourages her to move around more would likely help to prevent recurrence. Constipation is not the big deal you're trying to make it sound like. Get this snake the help she needs, or find another responsible owner who will.

Bottom line- I've never heard of anyone, ever, that euthanized a snake for being constipated. (And I've been keeping many snakes for decades.)

Quote:

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Originally Posted by leosantare

Hello,

I really need your help people. This is it, her last chance to make it. Well, my last chance to try and get her better.

I have a lot of things to say and never want to go back to my vet again. Look at what they did to her mouth from the past 2 days! I had a very hard time watching her after they gave her the oral medications. She will not be getting anymore from my vet and I can't do it myself.

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What kind of oral meds? If they were administering something like mineral oil for the impaction, that can be injected into a f/t feeder.

The swelling in the picture - is that right at her vent or is it further up? If at her vent did the vet check for impacted glands? One of my king snakes gets that periodically and the glands just need to be expressed (beware - the smell will run you out of the room!) and then she gets antibiotics afterward. The vet said it's just something that happens with certain individuals, though it's more common in colubrids than pythons.

Quote:

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Originally Posted by leosantare

Just speculating here, but if euthanasia is mentioned to the vet as often as it is in the thread, or arbitrary 'last chances to get it right' are mentioned, I suspect the vet might be in a position they don't like to be in or want to be in.

What a thing to say, thanks anyway.

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If you're offended by what I posted, either you've misinterpreted me or I'm terrible at wording things. I did work on the wording in that post for quite some time, but I'll take your response into account in the future. I only meant to make suggestions to help make the situation better for the snake.

She is still alive, still eating but still losing weight.

She looks the worst she ever has. I swabed her mouth and feces. Her boid and crypto panels were all negative from RAL. I'm fed her (2) medium rats, (350g total) last and she is no longer impacted with feces.

Does anyone know how I can make her gain weight? Can anyone make sense of why she is losing weight when she is eating more, test negative for most things and never has been in contact with another snake. She had mites when she was a year old but if anything were to come of that, it would have happened much sooner, correct?

Quote:

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Originally Posted by leosantare

Does anyone know how I can make her gain weight? Can anyone make sense of why she is losing weight when she is eating more, test negative for most things and never has been in contact with another snake. She had mites when she was a year old but if anything were to come of that, it would have happened much sooner, correct?

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I'm sorry. I don't have any suggestions that you haven't thought of already, but I sympathize with your frustration and hope you find a solution soon.

Quote:

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Originally Posted by leosantare

She is still alive, still eating but still losing weight.

She looks the worst she ever has. I swabed her mouth and feces. Her boid and crypto panels were all negative from RAL. I'm fed her (2) medium rats, (350g total) last and she is no longer impacted with feces.

Does anyone know how I can make her gain weight? Can anyone make sense of why she is losing weight when she is eating more, test negative for most things and never has been in contact with another snake. She had mites when she was a year old but if anything were to come of that, it would have happened much sooner, correct?

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Weight-wise, she looks fine to me in the photos you've shown. Gaining weight is a matter of eating, & some snakes, just like some humans, are more prone to overeating than others (& hence more prone to gaining unnecessary weight than others.)

Also, her weight may seem to fluctuate & be lower now just because of how much food & water is currently in her body. As you said, she's no longer impacted with fecal material- therefore she's going to weigh less now. The same thing happens with all creatures, humans included. Weights fluctuate daily- it's normal.

I agree that having mites when she was a yearling (some 10 years ago) is very unlikely to cause anything now, & besides, you just ran some tests that are negative (ie. show she's healthy).

Sorry but I can only conclude, at least from "here", that the only problem with this snake is your perception of her, & that's pretty hard to adjust. Since you seem so unhappy with her- apparently you really want a snake with more muscle mass & that's just not who or what this snake IS, this might be the wrong pet for you? Ever think of that? You've already said your vets find nothing wrong (other than what's already been addressed)- so what does that tell you?

As far as I can tell, the problem, if any, is not with the snake (and the stress of too many vet visits is not doing her any favors either). Our pets deserve our love & acceptance for who & what they are, & to do that, we have to be realistic, & not expect them to conform to some idealized notion of how they should look. Living creatures don't all look exactly the same (or have the same build), but that doesn't mean they're not as healthy as they can be.

Do you have a recent picture of her? Once my snakes get up to adulthood I look more at body condition than weight. Some of my retics weight has varied +/- five pounds at vet visits from year to year.

Hello,

Again, I've owned my python since she was 3 months old and she is 11 years old now. I have never been concerned with her body condition or weight until recently. It should be obvious that I wouldn't be concerned for no reason.

I did take her to a different vet for a second opinion. He can see that she is underweight and suggested to increase the temperature a bit. I'm not going to change the temperature from what is has been for years nor will I be going back to any vets. I had a lot of people confirm the temperature is ideal.

My python is underweight, that is not my opinion, that is a fact. About 2 months ago at her last vet visit, she weighed her lowest, 7.3kg. I suspect she may be even less than that now. Remember, she was about 9kg before this all started which is a significant amount of weight loss.

Stress, I don't really think so, she hasn't been to the vet in a while and most of the visits were stress free. She is processing food differently and I read that is a sign of illness. Every time I feed her I wonder where it goes. It's as if it dissappears.

Her activity level is still very low even when she is outside of her enclosure. For example, now that it's summer time I been taking her outside and I let her in roam the house a bit. She does move around a little bit more outside her enclosure but not much. Although, I think taking her outside her enclosure helps motivate her to go to the bathroom. As if she is too depressed to do so on her own, in her enclosure. This makes things even more confusing. By eating larger meals along with very little activity should make her gain weight, not lose weight. I know my enclosure is pretty bare, but she has the necessities. I'm making a PVC jungle gym to put in place of the blue tub/hide box.

I also wanted to point out that there are no labs with accurate testing for most viruses on live animals. Anyone deal with RAL before?

Thank you for all the help. If there is anything I can do to help her gain weight and become more active, please let me know. Here are some recent pictures..



https://uploads.tapatalk-cdn.com/202...787fb38a7b.jpghttps://uploads.tapatalk-cdn.com/202...5006eabc6e.jpghttps://uploads.tapatalk-cdn.com/202...3292a4858d.jpghttps://uploads.tapatalk-cdn.com/202...231fc0c049.jpghttps://uploads.tapatalk-cdn.com/202...4e09d7e513.jpghttps://uploads.tapatalk-cdn.com/202...8b62009bac.jpghttps://uploads.tapatalk-cdn.com/202...b5c5e77269.jpghttps://uploads.tapatalk-cdn.com/202...b5cb7a621b.jpghttps://uploads.tapatalk-cdn.com/202...ae41396539.jpghttps://uploads.tapatalk-cdn.com/202...6642738ea4.jpghttps://uploads.tapatalk-cdn.com/202...59295b2346.jpghttps://uploads.tapatalk-cdn.com/202...f88c0864d5.jpghttps://uploads.tapatalk-cdn.com/202...edce036ca1.jpghttps://uploads.tapatalk-cdn.com/202...14865fe9c0.jpghttps://uploads.tapatalk-cdn.com/202...198db69248.jpghttps://uploads.tapatalk-cdn.com/202...cfcdd2b06b.jpg

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This is a picture of her within 24 hours after she ate (1) 300g chick. As you can see, I'm definitely feeding her large enough meals every 10 days. https://uploads.tapatalk-cdn.com/202...ee3db7b870.jpghttps://uploads.tapatalk-cdn.com/202...4a1efa7295.jpg

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