Respiratory Infection

So I have heard some of the home remedies if the RI is minor, and was wondering if I could get some clarification on them.

1) Drop humidity and maintain high ambient temp in well ventilated enclosure - has anyone tried this with success? If so, what constant ambient temp did you keep it at (90?), what kind of enclosure did you keep it in, and how did you drop the humidity (remove the water bowl?).
2) Nebulizer with water/f10 disinfectant mix - has anyone tried this with success? How many days did this treatment take? How long was the treatment each day (20-40 mins?)
3) Any other suggestions that have worked for you (with details)?

Thanks in advance for your help/advice. Obviously if it doesn't improve or gets worse, off to the vet!

I'll possibly get shot down in flames but ..
When I first started I bought a young Albino Royal that turned out to have RI .
I did loads of research online and using one of my mum's spare nebulisers I treated it in a separate , smaller enclosed container - once a day for 30 minutes approximately and it was completely better in about 12 days ...
It was a battery operated nebuliser with a pretty strong vibration .... anyways at the end of each session the Royal was always wrapped tightly around the vibrating nebuliser !!
The opposite to what I was expecting. .

When I bought my GTP he had an RI when I got him. I didn't fool around and went straight to the vet. They did their deal and sent me out with pre-drawn injections and told me to keep the humidity high while bumping up the hotspot a couple degrees.

I did and after a few weeks of injections he was back to good and has not had any issues since.

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Originally Posted by chosen2030

So I have heard some of the home remedies if the RI is minor, and was wondering if I could get some clarification on them.

1) Drop humidity and maintain high ambient temp in well ventilated enclosure - has anyone tried this with success? If so, what constant ambient temp did you keep it at (90?), what kind of enclosure did you keep it in, and how did you drop the humidity (remove the water bowl?).
2) Nebulizer with water/f10 disinfectant mix - has anyone tried this with success? How many days did this treatment take? How long was the treatment each day (20-40 mins?)
3) Any other suggestions that have worked for you (with details)?

Thanks in advance for your help/advice. Obviously if it doesn't improve or gets worse, off to the vet!

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Well firstly, I would deep clean the whole enclosure with f10sc and let it air dry. I would switch the substrate to only paper towels and yes, drop the humidity to the mid 40's while raising the ambient temps to 92f on the warm side. That will raise the cool side a bit as well. When you switch out the substrate that will lower your humidity depending on the type of enclosure you have. F10sc works well when the concentration is correct and the RI is caught early. Duration of treatment is usually 10 days and the bp is in the tub for 20 mins while the fogger is running and then another 20 mins after the fogger is turned off. I did use it on my bp about 2 yrs ago and it helped but she was very sick with several other things going on at the same time. She did wind up getting put on antibiotics and had to be tube fed with a strict regimen of betadine soaks and silvadene cream applications. So the RI she had was concomitant with a host of other things. That is her picture in my avatar and she recently laid her first clutch. But back to your case, yeah the most definitive treatment is the herp vet. Best of luck!

I juuust went through this for the first time. It was a fun learning experience, haha.

I took her to the vet after 5 days of no improvement (had increased ambient temperature and was doing the Vicks and Eucalyptus sauna, which I learned is a very touch treatment, lots of people don't like it, some recommend it such as the vet I took her to and a friend of mine who also has snakes.). The vet gave me Baytril and about 13 needles to inject her with 0.1mL everyday for 5 days and then every other day for about a week. I discontinued the Vicks and Eucalyptus saunas as I was no longer sure about them after all the controversy over it and went on a cycle of using a humidifier in the same small room she was in.
I never got the fast improvements I've read about, it took her about three weeks till she started to shed that I noticed a difference. She never got bad enough that mucus was bubbling out of her mouth constantly, but it was smeared over her face and her nostrils were pretty plugged and dry. I gave her a bath to aid in her shed and it also cleared out her nostrils and the mucus hasn't build up again! She refused to eat, so I'm thinking she isn't back up to snuff but her nose is still clear and the wheezing has stopped. I'm not moving her out of the smaller, warmer room yet, will probably do so after she eats a few times.

I never got a blood culture done when I took her to the vet, which I guess is a no-no. The vet gave me the baytril based off his 35 years of experience with reptiles, and luckily he was right. It was just a bacterial infection, but RI's can be viral, in which case I believe Baytril won't help in curing the infection. It's better to get the culture done so the vet is definitely certain of what to prescribe. I was comfortable in giving her needles, some people do a tube feeding of medication that can be a lot more stressful. I've also heard of a spray form of Baytril that works faster than injections and they just inhale it as you spray their nose. The spray form and injection form can not be given at the same time, it's one or the other.

So after almost a month, my baby is getting back on track and this snake momma is happy and way less stressed now that I'm not pondering with unknowns! Hopefully this helps a bit, I've never had experience with the F10 mix. I kept her water bowl in her cage the whole time, she was in her hide most of the time anyways and the lamp was always above her and temps were never below 80 on the cool side. I was told to keep temps up to 100 max on the warm side.

There are a lot of things that people do as home remedies for RIs, but I'd personally take mine to the vet as soon as I was sure it was an RI. It just seems like one of those things that's easier to treat when caught as early as possible, and the accounts I've read of home remedies seem a bit hit or miss; not necessarily something to discount them, just in that they aren't sure-fire cures.

My home remedy for RI's is to pick up my home phone and call the vet for an appointment ASAP. Every day you delay is another day for it to take further hold of your snake.

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Originally Posted by ratchet

...I never got a blood culture done when I took her to the vet, which I guess is a no-no. The vet gave me the baytril based off his 35 years of experience with reptiles, and luckily he was right. It was just a bacterial infection, but RI's can be viral, in which case I believe Baytril won't help in curing the infection. It's better to get the culture done so the vet is definitely certain of what to prescribe...

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This is not exactly correct. A blood culture will almost never be positive in a RI. What you are likely referring to is a choanal culture (of the respiratory secretions); however, the most common course of action/standard of care is a 10 day course of presumptive antibiotics directed at the most likely bacterial organisms, and if the animal doesn't show significant improvement/resolution, then you culture to better direct therapy. That isn't to say that this is the only correct or reasonable treatment, but your reptile vet with 35 years experience wasn't just lucky ;).

Some advocate culturing immediately, but culture and sensitivity results can take a week or more, depending on the organism. Would you want your ball python languishing without antibiotics for a week while waiting on culture results? Unlikely. So, you are, of course, going to want to start presumptive antibiotics, and a large majority of ball python RIs are caused by a few common bacteria that are going to be cured by the presumptive antibiotics anyway. Also, cultures can be confounded by oral contaminants. So, why culture, at added expense, when you are going to start antibiotics anyway and will nearly complete the course of antibiotics by the time culture results are available - especially when you will, in most cases, have already cured the infection?

Nebulization of f10sc is done at a 1:250 concentration for 10-15 min/day and is ideally used as an adjunctive therapy alongside antibiotics, and sometimes mucolytics, for known or presumed bacterial infection (or with antifungals in fungal infection) and can be done alone or with mucolytics for known or presumed viral infection.

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Originally Posted by BoiseBallz

Some advocate culturing immediately, but culture and sensitivity results can take a week or more, depending on the organism. Would you want your ball python languishing without antibiotics for a week while waiting on culture results?

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This is precisely why you culture immediately, and start with a broad spectrum antibiotic such as Baytril or Ceftazadime. There's no reason to throw antibiotics at something without knowing what it is. I don't think it matters how much experience you have, treating without proper diagnosis is essentially guessing.

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Originally Posted by BoiseBallz

This is not exactly correct. A blood culture will almost never be positive in a RI. What you are likely referring to is a choanal culture (of the respiratory secretions); however, the most common course of action/standard of care is a 10 day course of presumptive antibiotics directed at the most likely bacterial organisms, and if the animal doesn't show significant improvement/resolution, then you culture to better direct therapy. That isn't to say that this is the only correct or reasonable treatment, but your reptile vet with 35 years experience wasn't just lucky ;).

Some advocate culturing immediately, but culture and sensitivity results can take a week or more, depending on the organism. Would you want your ball python languishing without antibiotics for a week while waiting on culture results? Unlikely. So, you are, of course, going to want to start presumptive antibiotics, and a large majority of ball python RIs are caused by a few common bacteria that are going to be cured by the presumptive antibiotics anyway. Also, cultures can be confounded by oral contaminants. So, why culture, at added expense, when you are going to start antibiotics anyway and will nearly complete the course of antibiotics by the time culture results are available - especially when you will, in most cases, have already cured the infection?

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And I'm still learning, haha, thanks for correcting me! I guess I'm the lucky one for having a vet with 35 years of experience. [emoji14] I have heard that they will give a medication right away regardless, then alter it if needed based on what they find. Thank you!

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Originally Posted by tbowman

This is precisely why you culture immediately, and start with a broad spectrum antibiotic such as Baytril or Ceftazadime. There's no reason to throw antibiotics at something without knowing what it is.

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This is an oxymoron. Starting broad-spectrum antibiotics before getting culture and sensitivity results is the very definition of throwing antibiotics at something without knowing what it is.

As already stated, by the time you get culture and sensitivity results, you will have already successfully treated the vast majority of cases. So, in the vast majority of cases, culture and sensitivity wouldn't change therapy, and would be a waste of time and money. You are certainly entitled to your opinion. I am just explaining the reasoning behind what is considered the standard of care. It's the same reasoning behind why humans aren't getting cultured for respiratory infections left and right. I have had many respiratory infections in my lifetime, and I suspect you have as well. I have never been cultured, and I suspect that you haven't either. You don't have to agree with the reasoning, but the reasoning is sound and is based on statistical likelihoods over large populations.

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Originally Posted by ratchet

And I'm still learning, haha, thanks for correcting me! I guess I'm the lucky one for having a vet with 35 years of experience. [emoji14] I have heard that they will give a medication right away regardless, then alter it if needed based on what they find. Thank you!

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No worries, and thank you for not getting offended or defensive. My post wasn't meant to be directed at you, per se, but was rather an attempt to educate the board a bit so that we don't end up with a bunch of folks "Burger Kinging" their vets and demanding blood cultures :D

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Originally Posted by BoiseBallz

This is an oxymoron. Starting broad-spectrum antibiotics before getting culture and sensitivity results is the very definition of throwing antibiotics at something without knowing what it is.

As already stated, by the time you get culture and sensitivity results, you will have already successfully treated the vast majority of cases. So, in the vast majority of cases, culture and sensitivity wouldn't change therapy, and would be a waste of time and money. You are certainly entitled to your opinion. I am just explaining the reasoning behind what is considered the standard of care. It's the same reasoning behind why humans aren't getting cultured for respiratory infections left and right. I have had many respiratory infections in my lifetime, and I suspect you have as well. I have never been cultured, and I suspect that you haven't either. You don't have to agree with the reasoning, but the reasoning is sound and is based on statistical likelihoods over large populations.

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I think you know what I meant.

You made the argument that you wouldn't want to have a snake languish while you wait for results from a culture.

In the event that the bacteria (presuming its bacterial) is resistant to the antibiotic you choose, you will know after three or four treatments, in which case, you'll have to go back and have a culture and sensitivity done if the snake isn't showing signs of improvement. (putting more stress on an animal with a depressed immune system)

So now it's a week after you've started treatment, the snake still isn't getting better, and you'll have to wait another week to get definitive results (hopefully). All the while the snake is suffering. I just don't quite see the benefit (other than saving money) to not having a culture done immediately.

Humans aren't being cultured for respiratory infections because antibiotics are not typically needed, and respiratory infections are not typically fatal in humans the way they are in snakes.

I'm not saying that you can't successfully treat respiratory disease without having a culture done, but I don't see any good reason other than money, not to.

Better safe than sorry.

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Originally Posted by tbowman

I think you know what I meant.

You made the argument that you wouldn't want to have a snake languish while you wait for results from a culture.

In the event that the bacteria (presuming its bacterial) is resistant to the antibiotic you choose, you will know after three or four treatments, in which case, you'll have to go back and have a culture and sensitivity done if the snake isn't showing signs of improvement. (putting more stress on an animal with a depressed immune system)

So now it's a week after you've started treatment, the snake still isn't getting better, and you'll have to wait another week to get definitive results (hopefully). All the while the snake is suffering. I just don't quite see the benefit (other than saving money) to not having a culture done immediately.

Humans aren't being cultured for respiratory infections because antibiotics are not typically needed, and respiratory infections are not typically fatal in humans the way they are in snakes.

I'm not saying that you can't successfully treat respiratory disease without having a culture done, but I don't see any good reason other than money, not to.

Better safe than sorry.

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RIs in balls are almost exclusively bacterial. Viral and fungal infections are very rare. While this isn't necessarily the case in other reptile species, it is in balls. Most ball bacterial RIs are gram negative organisms. In other words, with rare exception, you already know what you are treating.

Truly antibiotic-resistant RIs in balls are also uncommon. Failure of therapy and development of resistance is due to inappropriate dosing; inadequate or incomplete administration of dosing by the reptile owner; failure to complete the full course of therapy; failure to prescribe a full course of therapy; failure to address contributing factors such as husbandry issues; and inappropriate early switching of antibiotics - which is occasionally due to chasing inaccurate or inadequate culture results.

You say that human's aren't being cultured for RIs because antibiotics aren't typically needed, but that is not why. Human bacterial pneumonias aren't typically cultured and antibiotics are needed. Untreated bacterial pneumonia in humans isn't any less virulent than untreated ball python RIs. Also, ball python RIs aren't typically fatal.

As with sputum cultures in humans, choanal cultures in BPs are unreliable and prone to inadequate sampling as well as cross contamination (see above re: chasing cultures) . I doubt that you are advocating tracheobronchial lavage (lung washings) routinely.

Are you advocating anaerobic, fungal, and viral cultures as well? If so, that's quite an expensive routine workup. If not, I would be curious to know why. It would be somewhat hypocritical for your reasoning to be that these tests would only likely add unnecessary expense while rarely effectively changing therapy.

I'm not going to continue to go round and round on this. I believe I've explained the reasoning behind practicing evidence based medicine, and I doubt anything I type will change your opinion. I'm not saying that what you are advocating is horribly unreasonable or is bad medicine, but it isn't evidence or outcome - based.

At this point, I think it would be most reasonable to agree that we respectfully disagree.

Cheers

Not saying this in the interest of starting/continuing an argument, but unless the cost is going to be prohibitive I prefer to get any reasonable tests/cultures done before treating. Not an RI, but I had a snake come down with a typically mammalian parasite a few years back. The vet initially wanted to do a general treatment, but I decided to wait on the fecal to be done before treating. Had we waited till the general treatment failed to do the test it would have certainly been much worse (if not too late). Considering the amount of stress it puts on reptiles to go to the vet and get the meds in their system, I just personally prefer to get as good an idea as possible before treating to minimize the amount of times they have to go through that.

That being said, I do understand the logic behind doing a general treatment first, and there are upsides to both strategies. It's just down to the keeper to decide what works best for them.

Some symptoms will have the same generic drugs and culture tests are meant more as assurance for the owner than as a truly needed diagnostic test. Other symptoms may be caused by a more variable infection. I think it is a good idea to treat with broad spectrum antibiotics when in any doubt. If it is something else, those antibiotics may have prevented a serious secondary infection.

For future reference, for those of you that do believe in the F10 SC in the nebulizer method of treating mild RIs, do you add 3ccs or 5ccs of the product to 1 liter of water?

Also, how many air holes should the tub you are using to treat the snake in have in it? I'm assuming it needs some unless the nebulizer provides enough oxygen during the 40 minute treatment time?

I have used f10 sc to treat a very minor case of RI in a female ball that i got from a show it cleared it up she had no signs at the end of 10 days of treament and been fine ever since i had the f10 sc so i gave it a shot i did the way Brian fro bhb said on a you tube

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Originally Posted by chosen2030

For future reference, for those of you that do believe in the F10 SC in the nebulizer method of treating mild RIs, do you add 3ccs or 5ccs of the product to 1 liter of water?

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The appropriate concentration is 1: 1000 . That is a 3cc dose of f10sc to a 1000cc of distilled water. Remember this is in no way a substitute for actual herp vet examination and treatment. It's usually for a mild case of RI but is better facilitated as a adjunct to other vet supported therapy. The ventilation holes should be placed in a way that there is adequate oxygen exchange for the animal. Make sure to place paper towels in the tub the reptile is in so as to absorb the condensation and droplets from the nebulization. Then place the tub in a larger tub with the connections of the tubing for the procedure. Make sure to advise your vet about the procedure and get his approval beforehand.

Baytril is a good broad spectrum antibiotic and is used alot in this manner With animals and People. If the culture comes back and is not on the list the Doctor Changes the Med.

Sent from my SGH-T999

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Originally Posted by J&A exotics

I have used f10 sc to treat a very minor case of RI in a female ball that i got from a show it cleared it up she had no signs at the end of 10 days of treament and been fine ever since i had the f10 sc so i gave it a shot i did the way Brian fro bhb said on a you tube

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But you shouldn't do the treatment more than once a day, is that right?

I only did once day

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Originally Posted by Albert Clark

...The appropriate concentration is 1: 1000 . That is a 3cc dose of f10sc to a 1000cc of distilled water...

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This is not correct. The concentration supported by the literature is 1:250 which is 4 mL f10sc in 1 L of solution, which in studies is normal saline, but as most don't have normal saline readily accessible, distilled water seems to work just as well, anecdotally. Treatment can be 1 to 3 times per day for 10-15 minutes for each treatment and, ideally, should be combined with antimicrobial treatment.

3mL f10sc in 1000 mL is a concentration of 1:333

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Originally Posted by BoiseBallz

This is not correct. The concentration supported by the literature is 1:250 which is 4 mL f10sc in 1 L of solution, which in studies is normal saline, but as most don't have normal saline readily accessible, distilled water seems to work just as well, anecdotally. Treatment can be 1 to 3 times per day for 10-15 minutes for each treatment and, ideally, should be combined with antimicrobial treatment.

3mL f10sc in 1000 mL is a concentration of 1:333

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So use distilled water specifically? Not tap, purified, spring, etc.?

Purified or spring water would likely be fine. I wouldn't recommend using tap water because of the chlorine/chloramine. Even if filtered or treated with dechlorinator, it's still more likely to gunk up your nebulizer with mineral deposits.

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Originally Posted by ratchet

I juuust went through this for the first time. It was a fun learning experience, haha.

I took her to the vet after 5 days of no improvement (had increased ambient temperature and was doing the Vicks and Eucalyptus sauna, which I learned is a very touch treatment, lots of people don't like it, some recommend it such as the vet I took her to and a friend of mine who also has snakes.). The vet gave me Baytril and about 13 needles to inject her with 0.1mL everyday for 5 days and then every other day for about a week. I discontinued the Vicks and Eucalyptus saunas as I was no longer sure about them after all the controversy over it and went on a cycle of using a humidifier in the same small room she was in.
I never got the fast improvements I've read about, it took her about three weeks till she started to shed that I noticed a difference. She never got bad enough that mucus was bubbling out of her mouth constantly, but it was smeared over her face and her nostrils were pretty plugged and dry. I gave her a bath to aid in her shed and it also cleared out her nostrils and the mucus hasn't build up again! She refused to eat, so I'm thinking she isn't back up to snuff but her nose is still clear and the wheezing has stopped. I'm not moving her out of the smaller, warmer room yet, will probably do so after she eats a few times.

I never got a blood culture done when I took her to the vet, which I guess is a no-no. The vet gave me the baytril based off his 35 years of experience with reptiles, and luckily he was right. It was just a bacterial infection, but RI's can be viral, in which case I believe Baytril won't help in curing the infection. It's better to get the culture done so the vet is definitely certain of what to prescribe. I was comfortable in giving her needles, some people do a tube feeding of medication that can be a lot more stressful. I've also heard of a spray form of Baytril that works faster than injections and they just inhale it as you spray their nose. The spray form and injection form can not be given at the same time, it's one or the other.

So after almost a month, my baby is getting back on track and this snake momma is happy and way less stressed now that I'm not pondering with unknowns! Hopefully this helps a bit, I've never had experience with the F10 mix. I kept her water bowl in her cage the whole time, she was in her hide most of the time anyways and the lamp was always above her and temps were never below 80 on the cool side. I was told to keep temps up to 100 max on the warm side.

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"BASED of his 35 years"..... You mean what all lazy vets do, I dont mean to sound like a :cens0r::cens0r::cens0r::cens0r:, but this is a go-to for all vets, Now most will TAKE a culture and give you Amakasin (or Fortaz) while results are coming as Baytril is very un-effective vs most RI's (and often snake bounces back after a few weeks without injections) I do hope your guy stays healthy, but its always better to take a culture (120$ish) vs paying for meds that do not work, and haveing to redo/re inject crap into your animal

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Originally Posted by BoiseBallz

This is not correct. The concentration supported by the literature is 1:250 which is 4 mL f10sc in 1 L of solution, which in studies is normal saline, but as most don't have normal saline readily accessible, distilled water seems to work just as well, anecdotally. Treatment can be 1 to 3 times per day for 10-15 minutes for each treatment and, ideally, should be combined with antimicrobial treatment.

3mL f10sc in 1000 mL is a concentration of 1:333

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Well, we obviously have been reading different literature. And one 4cc dose of f10sc in 1000cc's of anything else besides distilled water is not the recommended solution concentration. Depending on your delivery system, which for most, is a reptifogger. It's also a once a day treatment for only very mild RI that is not accompanied by adjunctive antibiotic therapies. 20 minutes in while the nebulizer is operating and another 20 minutes to allow for inhalation while the nebulizer is off. :salute:

http://www.healthandhygiene.co.za/do...ds/rhh0115.pdf

http://www.healthandhygiene.co.za/is...sue6/index.htm

http://www.healthandhygiene.co.za/is...sue7/index.htm

http://www.fda.gov/downloads/AnimalV.../UCM440013.pdf

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Originally Posted by BoiseBallz

Purified or spring water would likely be fine. I wouldn't recommend using tap water because of the chlorine/chloramine. Even if filtered or treated with dechlorinator, it's still more likely to gunk up your nebulizer with mineral deposits.

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A few more general questions: when treating an animal this way (nebulization) do you remove the water dish from their tub? Same if in a screen top terrarium? Allow the animal to soak partially or fully submerged?

Best to get a separate tub dedicated to nebulization treatment. Don't treat them in their enclosure. It needs to essentially be a closed system, so a screen top won't work.

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Originally Posted by BoiseBallz

Best to get a separate tub dedicated to nebulization treatment. Don't treat them in their enclosure. It needs to essentially be a closed system, so a screen top won't work.

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sorry for the confusion - I meant what should the animal's normal enclosure be set up like between treatments, not the nebulization tub during the treatment. Any different from normal husbandry?

Bringing the ambient temp up and holding it at 85 degrees helps them fight infection, and it's always good to give their tub and everything in it a good sterilization, but otherwise, normal husbandry.

So my animal seems to have recovered from it's mild RI with the following treatment. Raised ambient temp to mid-90's with only small bowl of water in a terrarium. This is so the animal would be in a well ventilated enclosure and keep humidity low, but could still partially soak to self-regulate temp. Over 11 days I did the nebulization treatment using 1 liter of water to 3.75 ml of F10 SC.

Why 3.75? I had received advice stating that the ratio was from 3ml to 1 liter of water to 5ml to 1 liter of water, so when I pulled out my syringe and it only had 1.25, 2.5 and 3.75 markings on it, I decided to go with 3.75. By day 8 he sounded almost clear, but really seemed to be trying to soak in the water bowl. I continued the nebulizations and I thought I started to hear a very slight wheeze again and started to worry it hadn't worked.

I stopped after 11 days of nebulization and put him back into his tub with heat tape temp set at 87. Day 12, he had a great shed and a giant turd with urates. Day 14 he made quick work of a medium rat. I should also note that he is a hisser, so when he had the mild RI it was immediately noticeable. He is still hissing away but now there are no observable symptoms of RI.

He seems to be out of the woods and back to his old self, but we shall see if it lasts - fingers crossed!