Trouble with hognose RI not responding to antibiotics

[SeaPancake]

Apologies in advance for the long post; I’m losing hope with trying to treat my hognose’s respiratory infection and I don’t want to leave any details out in case I’m missing something. I got my boy Boops 2 years ago from somebody who didn’t want him anymore. I don’t know much about his history, only that he’s likely in the range of 10-17 years old. He was slightly underweight when I got him (72g and is now 101g) and only ever had a heat mat without a thermostat so he probably wasn’t getting proper heating. He eats a fuzzy mouse every 10 days.

Current Enclosure:

• 50W CHE, 83°-79° ambient for 12 hours during the day with 93° basking spot, 75° ambient for 12 hours at night
• Humidity varies throughout the year, usually 30%-55%
• Resin hide on warm and cool side, plastic leaves, sandstone rock for shedding, water bowl (emptied and sanitized every 3 days)
• 3 inches of Oxbow Blend Pure Comfort paper bedding
• Once a month I replace the bedding and deep clean the enclosure and all decorations with diluted chlorhexidine (I rinse very well so no residue is left)

Symptoms:

• He has sneezing fits that come and go in frequency, I’ve heard them multiple times a day and sometimes maybe only once or twice a week
• Just the other day I witnessed him sneeze out a bunch of white stuff and got it on video (see pictures below)
• Writhing and repeatedly opening his mouth like he has something stuck in his throat
• Mucous-y and occasionally dark green poops
• Occasional bubbles at mouth but not often
• I’ve fortunately never seen him open mouth breathing while he’s just chilling, only when he’s having these fits

Vet history:
May 2022:

• Noticed he was sneezing, vet said he was healthy but that the aspen bedding was likely too dusty so I switched him to a paper bedding which they recommended

November 2022

• Sneezing did not resolve, saw a different vet (same practice) who said that he had a little bit of excess saliva and was a little gassy
• Prescribed 8 doses (can’t remember amount per dose) of Ceftazidime

December 2022

• He seemed to get mildly better but still sneezing, vet prescribed 2 additional doses of Ceftazidime

January 2023

• Got a culture done via swab to hopefully diagnose illness, no bacteria was detected that shouldn’t have already been there
• Did a fecal float, did not find any parasites

July 2023

• Same symptoms persisted so I took him in again
• Vet prescribed 4 doses (0.01mL each) of Meloxicam and 9 doses (0.02 mL each) of Ceftiofur (wound up giving him an extra dose that I was given as good measure), once again mildly improved but did not last
• Redid fecal float and added a direct since it was a fresh sample, did not find parasites in either

Since July I’ve just been trying to be more diligent than ever about sanitization and proper temperatures in the hopes that he can finally overcome whatever this is but no such luck.

The vet seemed out of ideas so I wanted to see what others thought. If this was your snake what would your next course of action be? I don’t want to just keep giving him more shots and making him suffer if it isn’t going to solve the problem.

My biggest concern right now is the white stuff he sneezed out. He was going through sneezing motions with no sound (which has never happened before) and then there was finally a sneezing noise when he shot the white stuff out which makes me think it was blocking his airway. This is the first time I’ve seen this happen.

Most of the time he seems perfectly fine – he’s never refused a meal, never regurgitated, he’s active, alert, and he’s been steadily gaining weight. It just breaks my heart every time I hear him sneeze knowing that I don’t know how to fix him. I love him so much and I feel hopeless about ever getting him healthy. I plan to take him back to the vet soon so I wanted to see if there's anything in particular that I should discuss with them that might have been overlooked before.

Any advice would be greatly appreciated

[Armiyana]

It sounds like you're doing everything as well as you can. Getting the culture done is the most important part and honestly probably the only thing I would consider doing a repeat of if the symptoms kick back up. I wouldn't try any other antibiotics without another... It's a bit more invasive, but you may want to ask about doing a respiratory flush and culture. That way it's not just the mouth mucus, you can hopefully get a sample from a little deeper down in the trachea and such.

If he's gaining weight and active otherwise, I would give him a chance. It could just be something he'll have to deal with longterm. I had a dog with chronic respiratory issues and lung damage. It was difficult at times, but she was a happy little girl. The only downside here is just that reptiles are even more secretive about when they're feeling ill. So it can be hard to pick up on the early signs of a flare up.

It's a tough decision regardless. Thank you for already stepping up and doing so much though! That's already such an important part of things. I hope that you can get some other advice and maybe a better idea from other hoggie keepers. I like the little guys but I haven't actually owned them myself.

[Malum Argenteum]

I'm not sure if there's any imaging that might be done that would have a chance of visualizing any foreign bodies (or growths?), but that's something you could run by the vet to see if they think it might be fruitful.

I'd personally do a PCR for viruses. Ferlavirus is a possible suspect, and serpentovirus does infect colubrids -- rarely, so far as we know currently, but research on this viral group is very new.

[SeaPancake]

It sounds like you're doing everything as well as you can. Getting the culture done is the most important part and honestly probably the only thing I would consider doing a repeat of if the symptoms kick back up. I wouldn't try any other antibiotics without another... It's a bit more invasive, but you may want to ask about doing a respiratory flush and culture. That way it's not just the mouth mucus, you can hopefully get a sample from a little deeper down in the trachea and such.

If he's gaining weight and active otherwise, I would give him a chance. It could just be something he'll have to deal with longterm. I had a dog with chronic respiratory issues and lung damage. It was difficult at times, but she was a happy little girl. The only downside here is just that reptiles are even more secretive about when they're feeling ill. So it can be hard to pick up on the early signs of a flare up.

It's a tough decision regardless. Thank you for already stepping up and doing so much though! That's already such an important part of things. I hope that you can get some other advice and maybe a better idea from other hoggie keepers. I like the little guys but I haven't actually owned them myself.

I just made another appointment for him and I'm definitely going to bring up the possibility of doing a culture via respiratory flush (if it's even possible on a snake his size, he's about as small as full grown males tend to come). When he got the swab culture done there was a bit of blood in the sample which the vet said might mess with the results, but in the end I was told the sample turned out to be fine. I've always wondered if it ended up being a bad reading.

I would be less concerned if his symptoms were holding steady and it just seemed like something chronic but the recent sneezing up of white fluid is something new so that's what has me worried right now. I'm seeing a different, very experienced, vet this time to get an overall second opinion on next steps. Fingers crossed!

[Bogertophis]

In case you don't know about this- it can help you find an experienced herp vet: https://members.arav.org/search/custom.asp?id=3661

I know that in many areas, they're as "rare as hen's teeth". And sick snakes can be very frustrating-

If he's in the neighborhood of 10-17 years old, I think he's also getting up there? Hoggies are awfully cute, but I had poor luck with them when I had a pair many years ago. That's great that you were there to take him in & give him a better life.

[SeaPancake]

I'm not sure if there's any imaging that might be done that would have a chance of visualizing any foreign bodies (or growths?), but that's something you could run by the vet to see if they think it might be fruitful.

I'd personally do a PCR for viruses. Ferlavirus is a possible suspect, and serpentovirus does infect colubrids -- rarely, so far as we know currently, but research on this viral group is very new.

I'll definitely bring a PCR test up to the vet at his next appointment since he's only been tested for bacterial stuff, and I'll also ask if there's reasonable suspicion in terms of some sort of issue that a scan could detect. Thanks!

[SeaPancake]

In case you don't know about this- it can help you find an experienced herp vet: https://members.arav.org/search/custom.asp?id=3661

I know that in many areas, they're as "rare as hen's teeth". And sick snakes can be very frustrating-

Thanks, I've actually looked through the list and my vet is one of them! It's very reputable and I'm fortunate that I'm nearby.

[Zincubus]

I haven’t the time nor inclination to read all through this thread but I will add that I fixed / cured one of my Royal /Ball Pythons of RI ..by nebulising diluted F10 !!!


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[Bogertophis]

I haven’t the time nor inclination to read all through this thread but I will add that I fixed / cured one of my Royal /Ball Pythons of RI ..by nebulising diluted F10 !!!


Sent from my iPhone using Tapatalk Pro

I know you're trying to help, & I'm glad that seemed to work for you, but I think that might be a bad idea for several reasons:

The OP already has qualified veterinary help on board, which IMO is way better than a method spread on the internet by non-vets & without serious objective medical & scientific testing. (I know that some claim that nebulizing F10 has worked for them, but we don't have combined statistics for all those that it didn't work for, & some recoveries may have been coincidental. And since the product labeling spells out it's toxicity to living things, I'd personally want more to go on than internet claims, or the claims of people that are in big business selling snakes & for whom snakes are merely merchandise, not personal pets.)

A Western hognose is a small snake from a dry climate, as opposed to a much larger snake from a more humid climate. Do you see a potential problem with this? I do.

[Homebody]

I know you're trying to help, & I'm glad that seemed to work for you, but I think that might be a bad idea for several reasons:

The OP already has qualified veterinary help on board, which IMO is way better than a method spread on the internet by non-vets & without serious objective medical & scientific testing. (I know that some claim that nebulizing F10 has worked for them, but we don't have combined statistics for all those that it didn't work for, & some recoveries may have been coincidental. And since the product labeling spells out it's toxicity to living things, I'd personally want more to go on than internet claims, or the claims of people that are in big business selling snakes & for whom snakes are merely merchandise, not personal pets.)

A Western hognose is a small snake from a dry climate, as opposed to a much larger snake from a more humid climate. Do you see a potential problem with this? I do.

Wouldn't hurt to bring it up with the vet. Personally, I'd love to know what a qualified herp vet thinks of this method.