Need Some Advice!

[trnreptiles]

This is gonna be a long post, since there's a lot to explain here.

My ball python, Butters, has been dealing with mouth issues for the past half year now. She first got a small case of mouth rot, which I saw a vet for (Dr. Butler) and it was treated with antibiotics. Then another issue popped up, where her jaw and throat started swelling. Butler said it wasn't anything to worry about, but it didn't go away and so I decided to try a different vet.

After asking around and doing some research, I came to the conclusion of suspecting it as a mouth infection/abscess due to a broken tooth/teeth. She did smack her jaw into the side of her tub once, since she was hanging out of the tub when I tossed a rat in for her. She turned around to strike at it, but hit the tub instead of the rat.

I took her to a different vet (Dr. Turpen) for it, and she's been to this clinic for it several times now, first having an incision made on her neck to drain any fluids in there since it was swollen, but it didn't seem to fix the issue.
Then we took her in to a different vet (Dr. Kilbane) at the same clinic, who said the infection was in her jaw area (which would be more in line with my suspicions being tooth-related) and had me do treatment with an oral rinse and medication, on top of some injectable antibiotics.
The last time we went in, he concluded that he thinks the infection is gone and that the lumps that are left are simply scar tissue. He also stated he wanted to try and get her to eat. Why, I have no idea. She's only been off food for a month or so (I stopped feeding her since these treatments were daily, I didn't want to risk regurgitation) but she's a 2600 gram snake and hasn't lost any significant weight. She's also still pretty chunky!

His thoughts were to offer her food every other day, while also giving her yet another antibiotic given orally that is also supposed to boost appetite.
I decided NOT to follow those instructions per advice given to me by other breeders on both Instagram and the MM forums. It would only cause her more stress, and pumping her full of antibiotics won't do any good either. I'll continue offering her food every 7-10 days instead, and she should eventually go back on food.

I've been told that I should find a different vet because of this, but I'd rather avoid that if I can as the closest registered exotics vet I could find on the ARAV website is a 2 hour drive away from me. It wouldn't be as much of an issue if it weren't for my boyfriend's work schedule. He works nights, and can't just take a day off either sadly, they're very strict on that.

Dr. Kilbane has been recommended to me by other people in the area, and I've been told he's very open to suggestions on treatment and learning new things. He's been pretty open to me offering my ideas and suggestions to what the issue could be.
He was also super nice and didn't charge us for the last visit or medication, so that's definitely a plus for me.

I'm confident if I can figure out what should be done next, I can present that information to him and see if he's willing to take that route.
I had one person suggest that Butters needs the scar tissue removed and the area cleaned out, but I'm not 100% on that either.
Just a lot of conflicting information that is making me rather stressed, aha.

If there's anything I'm missing, please don't hesitate to ask!

I will add pictures of her here shortly, going to do it via tapatalk since it would be a hassle to do via computer.
EDIT: Lots of pics incoming!

This was back before we took her in to see Dr. Turpen/Dr. Kilbane:


The worst of her throat swelling:



And then some recent pictures:



The swelling in the jaw area has gone down quite a bit, but the lumps are still there.
She does seem to be drinking quite a bit of water too.

Her current body condition:


If any additional pictures would help just let me know!

[Bogertophis]

Pictures or not, we cannot ethically replace your local vet, but it's well-known that when snakes have an infection the pus formed is generally solid & therefore can
only be removed surgically...it won't just get reabsorbed & flushed out by the snake's own body. I suppose that's what was meant by "scar tissue"?

I do wonder how much experience he (Dr. Kilbane) has with snakes, as virtually none of them eat every other day- unless he was just trying to make sure that
yours is now willing to eat, & didn't mean to continue feeding every other day, only to offer until she accepts? That would make more sense to me, especially since
he's also wanting to try an "appetite stimulant"...apparently he is worried that your snake won't resume feeding (as many snakes hesitate to do after vet treatments)-
he may be wrong in his approach, but I do think he cares & is still trying to learn himself. I take it that none of the 3 vets you've taken Butters to are actually exotic
vets (as listed by ARAV)?

I like vets that are willing to learn & listen but I'd have been talking more to him about his suggestions to feed so often & giving an appetite stimulant (what was it?).
Sometimes nothing can replace years of expertise in snake care. I sure can't tell you what ("in my crystal ball") will have a better -or even an acceptable- outcome for
your snake...it's your call whether to keep trying to work with this vet, or "go the distance" to another with the right experience. If you stick with this one, tell him why
you have reservations about his last suggestions. Ask more questions! Maybe you misunderstood something too? I do hope your snake makes a full recovery, &
you might look into adding some reptile probiotic powder to her food when she does eat again...to help her gut get back on track. (Remember that antibiotics kill off
the "good" bacteria, such as that needed for digestion, along with the bad.) Be sure to feed only a small meal, otherwise she's likely to regurgitate it...take it slow.

[Bogertophis]

OK, now you've got pictures up...I've seen this on forums from time to time...this appears to be an abscess in the jaw that needs cleaning out surgically (sorry).
That's generally the course that others have taken. Also, for best results from antibiotics your vet needs to do a culture to make sure the right antibiotic is chosen,
otherwise you're just treating halfway & making resistant germs that will come back & be harder to treat (more of a health threat to your snake). I personally would
not advise fooling around with this...infections in the head are serious because of proximity to such vital functions (brain, vision, ability to eat).

If any of these photos are supposed to be showing the "improvement", I personally would not be seeing that as an acceptable cure. I think the infection will continue
to come back (possibly resistant by now) until it's removed surgically, & that's not a job for a regular vet...you want an experienced exotic (herp!) vet for this, sorry. The sad thing is that you've already been putting this snake through so much without a cure, & probably the higher initial cost of an exotic vet would
not have been more than all the combined visits you've been doing.

Pretty snake, by the way.

[trnreptiles]

Thank you for the response!

Okay, so the "scar tissue" needs to actually be operated on and removed, got it. I was thinking something along those lines would need to be done, but it's good to have confirmation on it. I'm fairly new to keeping ball pythons, so while I have their basic care down, dealing with medical issues is still new ground for me.

I'm thinking Dr. Kilbane has not dealt with abscesses in snakes before, since they require a different method of treatment than say, one in a dog or cat would.

His thought process was to offer her every other day until she ate, not just feeding her every day! I wouldn't have listened to that advice anyways if it were the case, I know better than that lol
The medication is metronidazole, and I was supposed to give her this daily for 4 days, while also offering her food 4 hours later or every other day (reading off of what the slip said on the ziplock bag)

I can confirm that none of the vets I went to were listed on the ARAV website. Their clinics see all types of pets, but none of them specialize in reptiles.
Neither vet I saw said anything about a culture, and it hadn't crossed my mind either. This is the first time I've had to take an animal to a vet (woo for being a young adult having to take care of things on my own), so I'm still learning about things to ask about/look out for myself.

I didn't think it was an acceptable cure either, I don't like her looking like she is. She looks miserable with her jaw like that. Especially when it's gotten super swollen in the throat area, it looked like she had swallowed a balloon!

Most likely I will go ahead and look into finding a proper herp vet, even if it means taking additional measures. I can either try and find a vet that is open on the weekends, or try and work it out with my mom so she can take me. I didn't want to rely on her simply because she's taking care of my little brother -- my stepdad stepped on him while they were roughhousing and broke the poor kids leg.

I'd much rather get her the proper care she needs, especially considering as you said the location of the infection being in close proximity to the vital areas of the body.
I also had plans to breed her, so her being at optimal health is a must. She is a very nice example of a butter, I think! She'll be paired with my butter spinner boy, hoping for some super butters.
Most likely that won't be until next year though, so she has plenty of time to heal up once I get her the proper care.

I will be sure to keep that advice in mind with the probiotics and small meals to start out with!

Again, thank you so much for clearing this up for me! Gives me a bit of peace of mind knowing for sure what to do next.

[Bogertophis]

Assuming this all gets cleared up, I still wouldn't try or plan to breed her in a year...safer to give it 2+...snakes take a long time to fully recover & adding reproductive
stress "so soon" after this ordeal (which is still a long ways from being "over") could be a disaster. Not to mention the time it takes her to fully clear the medications
from her body...who knows what effects they might have on eggs? Reproduction is hard enough on snakes...the females really should be in prime condition, & even
if she looks & acts great by next year, I'd wait longer.

Offering a snake food every other day will almost surely make it HARDER to get them to feed...especially a BP. Such frequent attempts causes them stress, & stress
results in no appetite & refusals. For most snakes, best to offer no sooner than once a week. Having a swollen jaw like this cannot feel good either...I doubt she'd
want to eat now anyway, just looking at her. I sure wouldn't...

When you mentioned the medication (to stimulate appetite) I kinda figured it was metronidazole- that's a welcome side effect. But for now, you might wait on using
that, and on feeding. It's far more important that she see the right vet as soon as possible, & if she has surgery, you don't want her full of food, nor taking other
medications that may interact or interfere with what the next vet needs to do. I'd suggest you call & ask them about that when you make the appt'mt. Snakes just
do better when dealing with fewer medications at one time, & you'll want to let the next vet know what all she has had.

Best of luck, let us know how it goes?

[trnreptiles]

Yeah, I suppose that's true. I'm perfectly fine with giving her 2+ years to recover, I want to do what's best for her.

I can agree, she definitely freaked out a bit when I offered her a rat. I've had another female refuse food because she was stressed (had to take her out to clean her tub), but after giving her a couple hours she calmed down and took a meal pretty readily.

I think I found a clinic up in Indianapolis (Avian & Exotic Animal Clinic) that deals specifically with exotic animals, and it's about a two and a half hour drive from where I live. I think it's worth it for her.

I will definitely let the new vet know of what medications/treatment she has already gotten!
And I will make sure to keep this thread updated as well <3

[Bogertophis]

In case you haven't thought of it: when you take a snake for a car ride, like to the vet, the best way is in a styro-foam shipping box or insulated ice chest, so they
aren't exposed to chills & temperature changes. Bag the snake first (cloth bag or pillow case), use a wire twist-tie, then fold that end over itself & wrap with a rubber
band...no snake has ever gotten loose on me, & I've moved across country with my snakes packed this way. You do NOT want a snake loose in your car...the distraction
can cause an accident, but if you don't see them get out, they'll disappear into your car seats or engine.

Anyway, inside the "ice chest", a little padding (crumpled paper or a towel) under the bagged snake, & since it's cold, a bottle of hot water will keep it warm inside the
chest also. Your snake will be protected this way if you have to stop suddenly too.

[trnreptiles]

Thanks for the tips! I've been actually pondering a better travel setup for my snakes in general, I was just taking her in a pillowcase and carrying her on my lap.

I think we have a styrofoam cooler, though I'd have to see if it's still intact as last I knew my little brother destroyed part of it. Not like I can't get another for fairly cheap though, lol

[Bogertophis]

Thrift stores often have them too...ppl get steaks, seafood, candy or "mousicles & ratsicles" for their snakes shipped in styro boxes & the boxes get donated.

[Bogertophis]

By the way, about car trips with snakes:

I know it's cold now this time of year, but even if you were taking a snake in the car in the summer, remember that using a styro-foam cooler to contain your snake
on the way there also protects them from excessive heat, which can & has killed snakes. Sun coming thru windows can over-heat a pet quickly.

I still remember a guy on another forum some years ago who took his favorite bagged snake on a several hour ride in his truck with the bagged snake on the floor-
the heat from the road & engine coming up thru the under-insulated truck's floor killed his snake by the time he arrived at his destination...the poor snake couldn't
escape the heat & of course, couldn't make a sound to indicate discomfort...just suffered in silence. As snake owners, we have to think ahead on things like this.

A guy in my town (I'd seen him once, but didn't know him) used to walk around with his boa on his shoulders in warm weather. I found out later from a vet tech that
his snake died from heat stroke: the combination of absorbing direct sun while sitting on his owner's shoulders -he somehow forgot he was yet another heat source,
at roughly 98.6* body temperature, and the poor snake could not escape the heat, nor could he let him know.