My vets response continued,

DIAGNOSIS:*

1. Colonic Impaction, fecoliths - rule out secondary husbandry (inadequate humidity, inappropriate diet, lack of adequate exercise, low temperature) vs. medical (dehydration, renal disease, arthritis, neurologic, mass effect, stricture/narrowing)*

2. Cardiomegaly (enlarged heart) - due to lack of normal parameters for species, can be a normal variant or related with post feeding increase in metabolic rate, but based on displacement concerned for underlying cardiovascular disease*

DIAGNOSTICS PERFORMED:
1.*Complete Blood Count: mildly low total white blood cell count, no signs of active infection. Mild anemia with signs of regeneration.*
2.*Chemistry: elevated muscle value likely due to restraint; elevated AST (influenced by liver and muscle) likely elevated due to prolonged restraint for x-rays*
3.*Radiographs (x-rays): enlarged heart, large amount of colonic impacted material*
4.*Fecal Ova & Parasite Testing: negative for parasites*

Diagnostic tests including referral for an echocardiogram and CT scan were declined at this time.*

CASE SUMMARY: Jasmine was evaluated at MLAH Exotics for continued workup for chronic weight loss and impaction. On initial evaluation, Jasmine remains bright and alert - her weight is fairly stable from her prior visits (current weight as of 4/12/23 is 8.1 kg).*


On evaluation, her coelom (abdomen) in front of her vent was very tense with firm mass effects palpable. These were confirmed to be mineralized fecal contents on radiographs (x-rays) performed, consistent with colonic (colon) impaction. This can be secondary to a wide variety of disease and husbandry (care at home) causes, and pinpointing the exact cause can be difficult without additional diagnostics. Common causes include dehydration (which can be secondary to low humidity, diet related, kidney disease), gastrointestinal infections, an anatomical inability to pass large stools (such as a mass effect, narrowing of the colon) or other systemic disease.*


As snakes only eat a few times a month, they have to repress their organs and proteins to conserve energy. When they eat, their organs grow back in size to digest the food and make up for increased oxygen consumption during digestion due to the higher energy costs to rebuild the proteins and organs that have atrophied during fasting. In addition, there is a process called "adaptive ballast" where some snakes retain their feces for a hunting advantage in capturing large prey - this can add to a snakes muscle mass while being inert (ie not requiring calories to maintain). They can also quickly release their feces to allow for quick escape if needed. Occasionally, when this is maintained for too long, the feces can buildup and become mineralized.*

It is difficult to determine how long the abnormal feces has been present, but can be prolonged (up to months). As discussed, due to the amount of material in her colon, we recommended a sedated enema to aid in passage of this material. Due to costs and the risks of sedation, you elected to hold off on this. We also recommended medical management with oral medications, which are difficult to administer at home. We recommended technician visits for administration - you are electing to attempt to administer via a prey item at home. If medical management fails, ultimately a sedated procedure may be necessary.*

We also noted that Jasmine's cardiac size was enlarged on x-rays. While we do not have normal parameters for heart size in her species, we suspect that based on the level of enlargement this is true enlargement. Some snakes can have an increase in their heart size after a meal to increase metabolism, but we are unable to determine if there is underlying cardiovascular disease without an echocardiogram (ultrasound) of the heart to evaluate the size, shape and function. As we have limited cardiology availability here, we discussed referring to Red Bank Tinton Falls or Animal Medical Center (AMC) in NYC. You have declined further workup of the enlarged heart at this time. Without knowing the cardiac function, sedation and/or anesthesia can be riskier or even result in death.*

______________________________________________



Sent from my SM-A426U using Tapatalk