Respiratory Infection

[BoiseBallz]

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.

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