My luck is terrible

I just noticed my BP, Schemer, ticking this evening. Funny thing was that I took a sick day from school today. I checked out his mouth and he seems to have some bubbles (but not mucous) in there. I called my vet up and it indeed sounds like RI. He's been hogging heat on his hotspot since his last shed on the 19th, but I decided to observe for more symptoms before I started to worry. I thought it was nothing at the time. I'm scheduling an appointment for RI medication; the doctor mentioned shots. Here's the vet: http://www.southviewanimalhospital.c...tes/Clean.aspx

The owner, Dr. Foster, has a great rep as a reptile specialist there, it seems. Hopefully I can get in with him. The appointment is $54 and shots are $15-20.

I mentioned that case of scale rot he had on one scale, and he said it's common for one problem to lead to others. He also said I did the right thing( read more here: http://ball-pythons.net/forums/showt...74#post1689674 ) Coincidentally, that case of scale rot is starting to fade. From what he told me, my health problems are humidity related - it's been too low. Ever since I switched to my 30 gal and started using paper towels, my humidity has averaged at 40%. I decided to opt for a larger water dish, but to no avail. I'm now covering 2/3 of my screen with tin foil, keeping the center open for ventilation and placement of my ceramic heat emitter - I need to keep the ambient temps and humidity up.

Temps have always been correct, but I've had trouble with humidity. His hotspot is normally at 88-90 but I've upped it to 93-94 for the duration of his RI. Ambient is around 84-85 & the cool end is 78-80.

I just hope he gets through this. He eats regularly, defecates and urinates regularly, and even sheds normally. It's hard to imagine he had something wrong with him. Has anyone else had terrible luck with husbandry and health issues on their first snake?

I got in with my appointment today and apparently it was a lot less severe than I thought. However, I still went through with medication to nip it in the bud. The vet tech up there injected 1 unit of amikacin subcutaneously on the upper third of Schemer's body, and I'll have to do the rest every 3 days alternating sides for 10 doses.

We had a ball practicing with saline solution; it took me 7 tries to do the injection perfectly. Mostly, it was a problem on my part of being afraid of putting pressure on my snake to hold him in place during the injections. The last fumble I had, the syringe bent and he urinated all over my clothes, lol. :8: I got it right after that...

When I'm done with the doses, I'll have a follow up appointment scheduled. They're pretty in depth.

I was pretty satisfied with the exotic care they had there. If there are any Minnesotans in the area, definitely give Southview a try.

You did the right thing by seeing the vet when you noticed symptoms. Thumbs up!!

Did the vet culture the RI? Did he explain his choice of antibiotic?

Did your vet advise fasting the snake while administering the amikacin?

Amikacin is potentially toxic on the renal system so the animal should be well hydrated and fasted to keep the kidneys flushed. It is important that since you are dosing your snake for a month that this information be given to you. It is also important that such information come from the vet prescribing the medication.

I've never had any health issues related to RIs or scale rot due to low humidity. To the contrary, you run a much greater risk for both if you raise the humidity and do not provide enough ventilation. Maybe the vet can explain the mechanism in which humidity in the 40% range leads to URIs and scale rot. I'd be very interested to hear it.

When I had to give my snake injections after his surgery - I was advised to soak him after each shot to increase his moisture level.

I would give the vet a call back and inquire about the things that Skiploder mentioned. Sounds like he knows his stuff! Also, any time you have a small space with all that heat it always going to cause the humidity to drop. I think while you are treating the RI you should do away with the ceramic heat lamp. This will keep your humidity up because it won't be so hot in there. Perhaps look into a radiator to put in the room where your snake is to take the place of the heat lamp. I would use this even after the RI clears up. A space heater would even work, but I wouldn't recommened leaving it on for 24 hours. Oh I almost forgot... A humid hide for him would be awesome, especially during the treatment of the RI. You probably alreay know how to make one, but if not you can google it or try this: get a container and cut a hole in the top, wet some moss and ring it out just so that it is damp but not soaking wet and put it in there. DONE! A homemade humid hide! I hope I helped and best of luck to you. I'm sure your BP will be just fine!!! :D

Quote:

---

Originally Posted by Skiploder

Did the vet culture the RI? Did he explain his choice of antibiotic?

Did your vet advise fasting the snake while administering the amikacin?

Amikacin is potentially toxic on the renal system so the animal should be well hydrated and fasted to keep the kidneys flushed. It is important that since you are dosing your snake for a month that this information be given to you. It is also important that such information come from the vet prescribing the medication.

I've never had any health issues related to RIs or scale rot due to low humidity. To the contrary, you run a much greater risk for both if you raise the humidity and do not provide enough ventilation. Maybe the vet can explain the mechanism in which humidity in the 40% range leads to URIs and scale rot. I'd be very interested to hear it.

---

I'll get a call in the next few days after I do the first treatment myself, so I'll ask then. But yeah, I'm familiar with all the care basics and some of the intermediate stuff, so I know not to go for excess humidity. Right now it's around 50%.

He did mention well hydration, but did not mention fasting. I just fed my snake a small rat(about 5-6 inch torso, was a monster) on the 31st, so he should be fine for the duration if I decide that's in his best interest. I'll ask the vet then look into that more. I wouldn't worry about the hydration as an issue, though. He never has wrinkles on his skin (he did for his first shed because I was inexperienced, but since then I've made all the appropriate husbandry changes) and typically sheds in 2-3 sock-like portions. Never had a perfect shed, but quite close. I think it's just him. I also manage to catch him drinking out of his dish several times a week(which I change every few days) and I have caught him bathing before, but not too often. Typically before and after sheds. He passes plenty of liquid urine along with his urates and droppings to show that he's well hydrated.

As far as ventilation goes, I have plenty available while still keeping the ambient heat and humidity in. I've got a 1 inch perimeter along the top of my screen that is exposed to the air, the rest covered by tin foil and my CHE in the middle portion. The screen itself is also not airtight around the edges because it's custom made, so there's some more airflow there. I really wouldn't worry about him having trouble breathing or living in a bacterial colony of immense proportions.

I really appreciate the advice though; you seem quite the knowledgeable person. I'll be sure to ask the vet about the fasting as you recommended.

Quote:

---

Originally Posted by Spyderco1116

I would give the vet a call back and inquire about the things that Skiploder mentioned. Sounds like he knows his stuff! Also, any time you have a small space with all that heat it always going to cause the humidity to drop. I think while you are treating the RI you should do away with the ceramic heat lamp. This will keep your humidity up because it won't be so hot in there. Perhaps look into a radiator to put in the room where your snake is to take the place of the heat lamp. I would use this even after the RI clears up. A space heater would even work, but I wouldn't recommened leaving it on for 24 hours. Oh I almost forgot... A humid hide for him would be awesome, especially during the treatment of the RI. You probably alreay know how to make one, but if not you can google it or try this: get a container and cut a hole in the top, wet some moss and ring it out just so that it is damp but not soaking wet and put it in there. DONE! A homemade humid hide! I hope I helped and best of luck to you. I'm sure your BP will be just fine!!! :D

---

I don't have the walls insulated(I have them blacked out, though) so I need the increase in ambient from my CHE. I have it on a rheostat and everything monitored well enough as of now so I'm not concerned. My house gets rather cold(65-70) so it's a win-win for me and him.

Also, the cypress is doing a good job of keeping humidity in for him. I might switch back to aspen when he gets better, though, because cypress is much too dark to spot clean sometimes, especially when he burrows over his defecation. He also has a 6 inch water dish, so he has plenty of water surface area underneath the tin foil topping on my screen to keep more humidity in.

I do believe I have a space heater(I think that's what it is, I haven't used it for at least 10 years) in my basement, so I can try that if I'm having problems once again.

Quote:

---

Originally Posted by Hydrolicious

I'll get a call in the next few days after I do the first treatment myself, so I'll ask then. But yeah, I'm familiar with all the care basics and some of the intermediate stuff, so I know not to go for excess humidity. Right now it's around 50%.

He did mention well hydration, but did not mention fasting. I just fed my snake a small rat(about 5-6 inch torso, was a monster) on the 31st, so he should be fine for the duration if I decide that's in his best interest. I'll ask the vet then look into that more. I wouldn't worry about the hydration as an issue, though. He never has wrinkles on his skin (he did for his first shed because I was inexperienced, but since then I've made all the appropriate husbandry changes) and typically sheds in 2-3 sock-like portions. Never had a perfect shed, but quite close. I think it's just him. I also manage to catch him drinking out of his dish several times a week(which I change every few days) and I have caught him bathing before, but not too often. Typically before and after sheds. He passes plenty of liquid urine along with his urates and droppings to show that he's well hydrated.

As far as ventilation goes, I have plenty available while still keeping the ambient heat and humidity in. I've got a 1 inch perimeter along the top of my screen that is exposed to the air, the rest covered by tin foil and my CHE in the middle portion. The screen itself is also not airtight around the edges because it's custom made, so there's some more airflow there. I really wouldn't worry about him having trouble breathing or living in a bacterial colony of immense proportions.

I really appreciate the advice though; you seem quite the knowledgeable person. I'll be sure to ask the vet about the fasting as you recommended.

---

You misunderstood the point - amikacin is one of the harsher antibiotics out there that is used to treat RIs. That's why it is important to use a vet that understands the critical importance of culturing and determining the sensitivity of the bacterial infection you are paying him to treat.

Frankly, I have never had it prescribed as a first line treatment for an RI. I suppose a vet in the habit of not culturing these infections may feel the need to pull out the big guns first..........whatever.

You paid good money for that vet visit - you and your snake deserve a vet that would recognize the need to culture that infection - especially in light of the fact that the symptoms were so light.

You also understand why feeding your snake when he is being treated with a drug that could harm his renal system could be a bad thing - right? Additionally, you are injecting this animal every 72 hours for 30 days. Have you considered what could happen if you feed him then have to dose him the next day? The last thing you need is a regurge.

I did not misunderstand your point; on the contrary, I focused my attention on all of them equally. Did you read my post, or just skim through it? Regardless, I understand now that you decided to focus on one thing.

I didn't have the money for a culture(it was $120) nor an x-ray($180). They did request that I pay for one, but I couldn't so they opted for amikacin. They didn't mention anything about feeding, as far as I can recall. They did mention potential kidney damage, but said I didn't have to worry because it was only 1 unit every 3 days.

So from all the worry here, I gather that I was under-informed. Am I right in this regard, then?

Quote:

---

Originally Posted by Hydrolicious

I did not misunderstand your point; on the contrary, I focused my attention on all of them equally. Did you read my post, or just skim through it? Regardless, I understand now that you decided to focus on one thing.

I didn't have the money for a culture(it was $120) nor an x-ray($180). They did request that I pay for one, but I couldn't so they opted for amikacin. They didn't mention anything about feeding, as far as I can recall. They did mention potential kidney damage, but said I didn't have to worry because it was only 1 unit every 3 days.

So from all the worry here, I gather that I was under-informed. Am I right in this regard, then?

---

Digestion requires, among other things, water, and it requires the production of uric acid which is work that the kidneys need to do.

A sick snake on a medication that can stress the renal system means that you need to do everything possible to ensure that your snake does not suffer kidney damage during treatment. One of the safest ways to insure that is to fast your snake. You have started down a road that is going to be very difficult for your snake - a harsh medication and being stabbed with a needle every 72 hours. There is a good chance that the stress of all this may change it's drinking habits or make it prone to other ailments. That is why it is imperative that you allow for those changes and also make choices that guarantee that you will only be doing one round of medication.

Additionally, any antibiotic will deplete the good bacteria along with the bad, impairing the bacteria in the digestive system that aids in the processing of food.

While I do not understand why the vet would have wanted to do an x-ray, it would have been wise to allow him to do a culture. Not only would this have pinpointed the bacteria responsible, but also which antibiotic it would be most effective in treating it. Such a culture may have shown that a less hard-core antibiotic could have been used - it may have even shown that no infection was present.

It would have also guaranteed only one round of treatment.

If your snake indeed has scale rot and an URI, then something in his environment is off and it's not low humidity - I can guarantee you that. However, from the pic of the rot and the description of the one symptom you posted, I'm not sure he had either. The fact that your vet would pinpoint the cause to a non-cause is concerning.

Snakes can click for a variety of reasons that have nothing to do with bacterial infections and depending on the animal, you may see some fluid/saliva when you open their mouths. If that saliva is near the glottis, it may appear bubbly during respiration.

So a few extra $$$ on a culture may have saved the money for the antibiotics and 30 days of jabbing the animal with a needle filled with a strong medication.

Were you under informed? Some vets will both insist on a culture and also take the time to explain to you why it is a critical step in the process. I would only do business with vets that ensure that you fully understand the importance of this step.

Can we find a way to upload ur brain to the internet so i can download it Skiploder??? ;P I also wasn't told to fast and i did get a culture and the same med... now my vet worries me!

Quote:

---

Originally Posted by Atherosdragon

I also wasn't told to fast and i did get a culture and the same med... now my vet worries me!

---

If your vet cultured, then your snake had a bacterial infection that was susceptible to amikacin. I wouldn't worry about your vet - next time you see visit you may want to ask him if he/she has any concerns about amikacin and renal toxicity. If he wonders why you are questioning, just explain that both the Merck and the Veterinary Formulary both recommend concurrent fluid administration and list it as a nephrotoxin. See how he responds to that.

All of the aminoglycosides (of which Amikacin is one) are potentially toxic to the renal system. Amikacin is considered the safest one for systemic use, however it is still eliminated in the kidneys. In the case of treating a large colubrid with a higher metabolism, I was directed to inject IP fluid therapy along with the amikacin.

In general, when dosing a snake with meds every few days, feeding becomes tricky - even without hydration worries or stress on the kidneys. The simple fact that you will be manhandling and injecting an animal during digestion carries the risk of a regurge. Unless the animal desperately needs to eat, a safe course of action is to NOT feed it while treating it.

Quote:

---

Originally Posted by Skiploder

If your vet cultured, then your snake had a bacterial infection that was susceptible to amikacin. I wouldn't worry about your vet - next time you see visit you may want to ask him if he/she has any concerns about amikacin and renal toxicity. If he wonders why you are questioning, just explain that both the Merck and the Veterinary Formulary both recommend concurrent fluid administration and list it as a nephrotoxin. See how he responds to that.

All of the aminoglycosides (of which Amikacin is one) are potentially toxic to the renal system. Amikacin is considered the safest one for systemic use, however it is still eliminated in the kidneys. In the case of treating a large colubrid with a higher metabolism, I was directed to inject IP fluid therapy along with the amikacin.

In general, when dosing a snake with meds every few days, feeding becomes tricky - even without hydration worries or stress on the kidneys. The simple fact that you will be manhandling and injecting an animal during digestion carries the risk of a regurge. Unless the animal desperately needs to eat, a safe course of action is to NOT feed it while treating it.

---

From what you've told me and how knowledgeable you seem to be, I guess I won't be feeding my snake during the injections. It does make sense, and I got his last feeding out of the way so he should be all good.

I did however point out other symptoms to the vet that started appearing shortly after I posted this topic, which included face rubbing and minor stargazing. Clicking was not his only symptom. He has since stopped with all of those(I do notice clicking, though) and he's been on his hotspot ever since I got back from the vet.

Quote:

---

Originally Posted by Skiploder

Digestion requires, among other things, water, and it requires the production of uric acid which is work that the kidneys need to do.

A sick snake on a medication that can stress the renal system means that you need to do everything possible to ensure that your snake does not suffer kidney damage during treatment. One of the safest ways to insure that is to fast your snake. You have started down a road that is going to be very difficult for your snake - a harsh medication and being stabbed with a needle every 72 hours. There is a good chance that the stress of all this may change it's drinking habits or make it prone to other ailments. That is why it is imperative that you allow for those changes and also make choices that guarantee that you will only be doing one round of medication.

Additionally, any antibiotic will deplete the good bacteria along with the bad, impairing the bacteria in the digestive system that aids in the processing of food.

While I do not understand why the vet would have wanted to do an x-ray, it would have been wise to allow him to do a culture. Not only would this have pinpointed the bacteria responsible, but also which antibiotic it would be most effective in treating it. Such a culture may have shown that a less hard-core antibiotic could have been used - it may have even shown that no infection was present.

It would have also guaranteed only one round of treatment.

If your snake indeed has scale rot and an URI, then something in his environment is off and it's not low humidity - I can guarantee you that. However, from the pic of the rot and the description of the one symptom you posted, I'm not sure he had either. The fact that your vet would pinpoint the cause to a non-cause is concerning.

Snakes can click for a variety of reasons that have nothing to do with bacterial infections and depending on the animal, you may see some fluid/saliva when you open their mouths. If that saliva is near the glottis, it may appear bubbly during respiration.

So a few extra $$$ on a culture may have saved the money for the antibiotics and 30 days of jabbing the animal with a needle filled with a strong medication.

Were you under informed? Some vets will both insist on a culture and also take the time to explain to you why it is a critical step in the process. I would only do business with vets that ensure that you fully understand the importance of this step.

---

The only thing I can think of is the few times I bathed him around the 17-20th when he was shedding, which may have something to do with both.

Quote:

---

Originally Posted by Hydrolicious

From what you've told me and how knowledgeable you seem to be, I guess I won't be feeding my snake during the injections. It does make sense, and I got his last feeding out of the way so he should be all good.

I did however point out other symptoms to the vet that started appearing shortly after I posted this topic, which included face rubbing and minor stargazing. Clicking was not his only symptom. He has since stopped with all of those(I do notice clicking, though) and he's been on his hotspot ever since I got back from the vet.

---

If he does indeed have an RI, and given the fact the he needs injections for the next month, I'd forego everything but water until he's done.

If his weight is good, he'll be fine. If he's a young snake I would check his weight halfway through the treatment and also check his overall condition.

You can add some powdered Benebac to his water while he's on the meds. It will make sure that his digestive system maintains it's beneficial bacterial during the antibiotic treatment.

Is he clicking all the time?

The only thing the baths could have done is stress him out. Maybe this lowered his immunity resistance - maybe not.

It's amazing that the amikacin cleared up all the other symptoms so quickly. I'd go as far to maintain that they were normal or even transitory behaviors for this snake.

What people often claim is stargazing is normal. True signs of neurological damage or even changes in head posturing while afflicted with an RI are completely different.

As for the head rubbing, this can be normal behavior and in the absence of signs of discharge, I would not rush to attribute it to an RI.

He's 386 grams, but that was a weighing at the vet 3 days after I fed him a small rat. He looks like he has a healthy size normally, though. No visible ribs or anything, and he has a good set of muscles on him.

I don't know where you're assuming he didn't have discharge from, though. There were some bubbles in that brief period between the vet appointment and the first injection around the edges of his mouth(not mucous, though).

All of the symptoms I've told you about aren't normal for him. Once in a while I do notice him breath, but stuff like clicking and head rubbing aren't normal for him. I pay a lot of attention to my lil' guy. I'm his watchdog, in a way. I can't hear him clicking through my tank, it's really light. If I hold him, but not necessarily up to my ear, I can hear him make these noises. Granted, I'm avoiding handling for the duration of the injections.

I do admit I'm surprised he stopped all of those after the first shot, though.

I'm supposed to give him another shot today...

Anyway, I really appreciate all of the advice you've been giving me here.

Quote:

---

Originally Posted by Hydrolicious

He's 386 grams, but that was a weighing at the vet 3 days after I fed him a small rat. He looks like he has a healthy size normally, though. No visible ribs or anything, and he has a good set of muscles on him.

I don't know where you're assuming he didn't have discharge from, though. There were some bubbles in that brief period between the vet appointment and the first injection around the edges of his mouth(not mucous, though).

All of the symptoms I've told you about aren't normal for him. Once in a while I do notice him breath, but stuff like clicking and head rubbing aren't normal for him. I pay a lot of attention to my lil' guy. I'm his watchdog, in a way. I can't hear him clicking through my tank, it's really light. If I hold him, but not necessarily up to my ear, I can hear him make these noises. Granted, I'm avoiding handling for the duration of the injections.

I do admit I'm surprised he stopped all of those after the first shot, though.

I'm supposed to give him another shot today...

Anyway, I really appreciate all of the advice you've been giving me here.

---

Your right - I assumed from your first post that the bubbles you saw were in the mouth - not at the edges.

Are there still bubbles? It would be amazing if those were gone after the first injection.

There were some in the back of his throat at the time of the post, but I guess I was too vague on where they were - my bad.

I opened up his lips a bit, and the teeth look a bit moist, but there are NO bubbles around the edges anymore. I'll check the inside of his mouth in a few days, he's going to be stressed as it is after his shot today.

Also, he's still clicking continuously, with a bit of a... I wouldn't call it a weez, as I'm not sure what that sounds like in snakes, but more like a strained breath every now and then.

Speaking of improvement, I noticed him leave his hotspot for something other than a drink for the first time in a while. When I woke up, the substrate on the cool end was overturned. So, it seems like he's starting to resume his normal hide-switching behavior.

Ah, I just got a call from the vet to check up on my snake. Guess I need to keep you updated on that, too.

The reptile vet wasn't there today, so they forwarded me to her at home(apparently she was on call). Anyway, I voiced my concerns about the fasting issue, and she said that while amikacin can cause kidney damage, there's nothing to worry about in healthy snakes that are well nourished and hydrated. I suppose that's why she didn't mention that in the office, because there were no worries on her part. She also said because the case of RI was so small, there wouldn't be much stress from the medication.

Quote:

---

Originally Posted by Hydrolicious

I don't have the walls insulated(I have them blacked out, though) so I need the increase in ambient from my CHE. I have it on a rheostat and everything monitored well enough as of now so I'm not concerned. My house gets rather cold(65-70) so it's a win-win for me and him.

Also, the cypress is doing a good job of keeping humidity in for him. I might switch back to aspen when he gets better, though, because cypress is much too dark to spot clean sometimes, especially when he burrows over his defecation. He also has a 6 inch water dish, so he has plenty of water surface area underneath the tin foil topping on my screen to keep more humidity in.

I do believe I have a space heater(I think that's what it is, I haven't used it for at least 10 years) in my basement, so I can try that if I'm having problems once again.

---

To be honest and I don't think alot of people take this into consideration... The ambient air temp is irrelevent. Balls are mainly floor snakes and thats where they hang most of the time. The air surrounding the enclosurewill only affect the hot spot when it gets colder where you will need to up the heating element. As long as that hot spot is between 88 and 92 (it actually can go up to 95 but now more) you are good to go. Still provide a hide over the cool spot, but don't go crazy trying to get the cool side to stay at like 80 or 82. If he gets warm on the hot side he'll move somewhere else.

Thanks... for the information. While it was indeed informative, my house gets down to 60-65, though... I think it does still matter, especially since it's the winter now, though. I understand not keeping it exact, but having temps 20 degrees less than normal sounds utterly unacceptable.

Oh, I haven't posted in a while... I totally forgot I had subscribed by email to this topic, lol. I guess I'll update you on the little guy's status:

He's doing a lot better, 6 shots in. He's no longer rubbing his face, corkscrewing, stargazing, or showing bubbles from the sides of his mouth. He's also no longer clicking at all, so I'm pretty sure the medicine is working! He's also resumed his thermo-regulation, which he had stopped entirely up until I started giving shots - he would stay constantly on his hotspot. He doesn't do it consistently now, but he has started to do that again, which is a sign of improvement - maybe once or twice a day? I do notice a yawn once in a while, but I'm not sure if that's just him realigning his jaws or whatnot. I may pay a bit too much attention to detail. :rolleyes:

As far as feeding goes, I haven't fed him for 3 weeks due to the concerns skiploder posted about, despite my vet's inquiry into the matter. He's doing fine, other than that. I might consider feeding him off the shot schedule soon, though, as I don't want to starve him.