Well I've put this off long enough... Pseudo Clown

[Coleslaw007]

I wanted to share this mostly because I find it very interesting from a medical perspective, and because I know several site members were quite fond of this snake. This will be a novel, sorry. I'll try to keep away from technical medical jargon as much as possible.

A few might remember this thread: http://ball-pythons.net/forums/showt...llen-face-Help!

and I'm sure many remember this little guy, he was the favorite of my collection for many, and one of my own top favorites:


Well I didn't lie at the end of that thread, he really did get better, but about 2 weeks later he started to show signs of the puffiness again. I immediately brought him back into the vet, on 3/16. On examination he did not still have any symptoms of RI, only the swelling. The vet decided to try a couple weeks of baytril injections just to see if we saw a response. Nothing, the swelling became more constant vs the previous come-and-go nature, and he seemed to become weaker and more lethargic over time. 4/03: back for another appt, this time with a different vet at the same clinic. He examined him with a fine-toothed comb and the only thing he noted out of the ordinary was that it seemed as though Pseudo's heart was much larger than it should be, you could physically see it beating through his skin, something that had to have developed very recently, as we hadn't observed it previously. He did say that an enlarged heart could easily be the causation of the facial swelling, so we really needed to get to the bottom of the cardiomegaly (enlarged heart.) He decided to run a full blood workup to check for liver function, blood cell counts, etc. as there were no signs of anything infectious.

4/5 the blood came back work the only thing that seemed out of the ordinary was that some of his white blood cells, specifically his azurophils, were elevated. Pretty much everything else seemed normal. The vet explained that azurophils typically indicate inflammation. The vet suggested that it may be some type of virus and that these are secondary infections. He said the only 2 things we could do were tissue biopsies of his organs to see if they could find obvious signs of any viruses and identify them, difficult but sometimes possible on a live snake, or try one last dose of the gentamicin he'd responded to before. I decided that if I was going to do the biopsies I would just have him euthanized and do a necropsy, I didn't want to put him through even more suffering and the chances of him surviving the procedure weren't high. We mutually agreed one last round of gentamicin would be the best idea, and if there was no response still we would put him out of his misery and do a necropsy. I gave him the first does that night. I woke up the next morning and he had passed away some time in the night. We had him immediately sent in for a full necropsy. It was a long week waiting for the results, I'll fully admit I was afraid of the worst: that it could be something that may effect the rest of my collection. Everyone else was acting fine and eating normally and he was QT'd as soon as he became sick, but the worry was definitely there.

The final results were good in that no other snakes were at all at risk, but very strange. They found zero pathogens; bacterial, viral, or otherwise. The rest of my snakes were definitely safe. The only things much out of the ordinary were that his heart was very enlarged and calcified, essentially it was covered in and filled with scar tissue. His lungs were also very red and sank in formalin, healthy lungs would float in a sink-test. There were some slight abnormalities in his kidney but the vet said it was secondary, caused by the issues with his heart and lungs.

So, what the vet explained based on these findings was: At the root of it all was the original respiratory infection with the pseudomonas. He said the vast majority of the time they come through similar infections just fine with rapid treatment like he received, but for whatever reason, we'll never know why, it immediately affected his heart as well as his lungs. His inflamed heart caused the swelling, which alerted us to his being sick. We cultured, identified, and successfully killed it, but the damage was already done. After though the bacteria causing the infection was gone, his body attempted to heal itself by destroying the infected and inflamed tissue, as the tissue was destroyed it turned into scar tissue. Being as the affected tissue was his heart and lungs, this meant they only got worse and more inflamed as they had to work harder, it just turned into a never ending cycle. His body was destroying itself by attempting to fix the problem and his health just continued to decline. His heart continued to become more and more enlarged and inflamed, which caused the edema (swelling.) This is why his only symptom was the swelling, which didn't respond to anything. It went away briefly after the first round of antibiotics, until his body started the healing process after we eliminated the infectious agent. In the end he died of congestive heart failure and there was truly nothing more we could have done for him. The vet said he was fascinated by it, as he'd never seen anything quite like it in a snake. He had seen the body attack the lungs and cause scaring due to infections, but never quite just wipe out the entire respiratory system so completely. He explained the most similar case he knew of, which was in a human, he said one of the first people to receive an artificial heart actually had almost the same thing happen as did with my snake. He got the flu and for some unknown reason the virus affected his heart, it's very rare but does happen, his body then attacked the tissue in an attempt to heal itself until he ended up needing a heart transplant.

I'm sad to lose him. He was one of my top 2 favorite snakes in my collection, not even so much for his looks but for his personality, he was always so friendly and curious despite many traumatic experiences. When I originally got him he wouldn't feed, I had him examined and he had a lot of internal parasites, even with a couple of weeks of oral meds and a few re-checks he was STILL friendly. Then for a full year he thrived and was one of my best feeders. He was also quite probably THE snake I most wanted to see fully grown, he'd have looked SO cool big, and with his boa-like personality he'd have just been wonderful. That said, I am VERY glad he is no longer suffering and that I don't have to worry for the rest of my snakes, this was a freak occurrence. It also is a huge reassurance that I well and truly did absolutely everything I could. I know that if I had waited on the initial vet visit, or refused the culture due to cost (it was not cheap,) or really did anything less than I did, I would be beating myself up now wondering if he would have survived had I done things differently. Had I known he wouldn't survive I'd have put him down quickly to avoid the suffering, but until close to the end I firmly believed he would pull through.

I've speculated that there may always have been something wrong with his heart, lungs, immune system, various possible underlying issues. I mean with so much damage to his organs after the fact I'm sure it would be hard to tell. In the end I guess we'll never quite know why exactly this happened. He's the only snake I've had develop any sort of illness so far, and hopefully ever. I wanted to give a detailed account because I feel that these sort of things should be documented so that we can learn from them, I think too many people keep quiet about illness.
Sorry for not updating the original thread when he relapsed, I honestly throughout thought he would get better and I would tell everyone after the fact that he got worse again but was now fully in the clear. As it progressed I just got tired and didn't have the energy or urge to. Thank you to the few I confided in and those who offered advice and reassured my fears.

I think the main thing we can take away from this is that no matter how much we feel we're in control, these are still animals, and we don't ever fully have control over life despite our best attempts.