Environmental Diseases and Traumatic Injuries of Reptiles

Beak anomalies in chelonians inhibit feeding and are often associated with trauma or secondary nutritional hyperparathyroidism leading to hypocalcemia, distortion of the skull, and abnormal occlusion and wear. Increased levels of dietary protein may contribute to accelerated growth of these tissues, while a lack of abrasive food items limits natural wear in captivity. Treatment consists of trimming and reshaping the beak into a more normal conformation. The condition usually recurs because of primary malocclusion, and long-term maintenance may be required (see image of abnormally long upper beak.

Abnormally long upper beak, tortoise

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Courtesy of Dr. Stephen Divers.

Males of many species can be highly territorial and exhibit aggression toward other males or toward females during mating periods. Injuries to cagemates can be severe and are best avoided by separating animals at feeding and decreasing the number of animals in a breeding group. When separated individuals are placed together for breeding, they should be carefully monitored. If reptiles must be kept together, it is vital to provide an enclosure large enough to avoid competition for resources, especially basking areas, and retreats. Food and water are best placed in multiple locations to prevent dominant cohabitants from intimidating others.

Fractures due to trauma commonly occur in all reptilian species. They are often associated with secondary nutritional hyperparathyroidism in chelonians and lizards. Long bones may be repaired with lightweight external coaptation. A simple way to splint a fractured lizard leg is to tape the injured leg to the body (forelimb) or the tail (hindlimb). These splints are tolerated well and protect the injured limb from further injury. Fractures unaffected by metabolic bone disease can be repaired using established fixation techniques.

Injury to the spinal column must be assessed individually; when clear displacement is not evident, radiographic evaluation should be performed. Spinal injuries caudal to the vent may be well tolerated; however, injuries cranial to the vent frequently result in constipation and retention of urates, with variable limb movement. Environmental changes (eg, low branches, shallow water dish, nonabrasive substrates) may permit the lizard to survive with an acceptable quality of life. Because these fractures are often pathologic (secondary to secondary nutritional hyperparathyroidism or chronic osteomyelitis), a thorough investigation is typically required.

Aggressive iguanids may frequently lash out with their tails and damage them against the vivarium glass or other furniture. Continual damage can lead to ischemic necrosis of the tail. Secondary infection may follow and progress to osteomyelitis. In some cases, septic emboli may lead to tail infection. In either scenario, tail amputation, in addition to investigation and correction of predisposing factors, is required. Radiography should precede surgery, because osteomyelitis may appear more cranial than the external lesion.

Tail amputation in iguanids should be performed under anesthesia, taking advantage of the lizard’s ability to perform autotomy. The tail is simply bent and twisted sharply to cause a fracture through a fracture plane. Muscle fibers are trimmed, but the tail is left unsutured to encourage regeneration. Clean postoperative conditions are essential; however, antimicrobials are not required. Tail necrosis in reptiles that do not exhibit autotomy requires a more traditional surgical amputation with primary closure of the wound.

Burns are generally associated with unscreened incandescent lights or other heat sources. Fluid loss, dehydration, and secondary bacterial or fungal infections are common sequelae. However, many burns can be treated by cleansing the site, applying topical antimicrobial agents, providing analgesics, and placing the reptile in a clean, dry environment. With uninfected burns, sterile skin protectants can be applied to the area to act as a “second skin.” These products allow affected reptiles to continue to be able to go into water but help keep contaminants out. With severe burn cases, fluids are given to offset losses, and systemic antimicrobials may be indicated, especially if surgical debridement is required.

Traumatic injuries to turtles can result in fractures to the plastron, the carapace, or both. Repairs should be delayed with anything other than fresh wounds. Contaminated tissues should be gently debrided, flushed, and appropriately bandaged using a wet-to-dry technique. Holes in the bandages can be created to allow the legs to remain exposed.

If obvious infection is present, samples should be submitted for microbiological testing before systemic antimicrobials are started. Once the animal is stable, wounds should be debrided, and fractures should be realigned under general anesthesia and repaired using zip ties or a similar fastener (see carapace fracture image). Traumatic injuries also can be repaired using epoxy resin or a quick-setting epoxy glue layered over fiberglass screen. Dental and orthopedic cements have also been used to stabilize fractured tissues. Healing is slow and may require 4–6 months or longer.

Repair of carapace fracture, turtle

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Courtesy of Dr. Stephen Divers.

Dysecdysis, or incomplete or inadequate skin shedding, may be caused by low humidity, ectoparasitism, nutritional deficiencies, infectious diseases, lack of suitable abrasive surfaces, or even decreased thyroid function.

Often, eyecaps or annular bands on the tail or digits are retained. Eyecaps (retained spectacles) in snakes are best treated by application of an ophthalmic ointment for several days or by placing the snake on wet towels in a ventilated, warm box overnight. If the spectacles do not fall off, they can be carefully removed using magnification and fine forceps. Patience is advised—eyecaps should never be forced off because of the possibility of damaging the spectacle and exposing the cornea. (See image of complete shed skins.)

Two complete shed skins, pythons

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Courtesy of Dr. Stephen Divers.

Prey-induced trauma, caused by live, uneaten invertebrate and vertebrate prey, can cause severe trauma, with secondary infection and abscessation. Whenever possible, rodents that have been freshly killed or frozen and thawed should be offered to prevent injury to the reptile (dead prey should be discarded after 12 hours if uneaten). The feeding of live prey is illegal in many countries, but even where legal it should be actively discouraged. (See image of boa with prey-induced trauma.)

Trauma, boa constrictor

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Courtesy of Dr. Stephen Divers.

Fresh bite wounds may be treated by cleansing with povidone-iodine (diluted 1:10). Topical antimicrobials are indicated; however, parenteral antimicrobials, based on results of culture and susceptibility tests, also may be necessary. Untreated wounds frequently abscess and are evident as soft or hard swellings. The abscess, including the fibrous capsule, should be removed surgically. Open or draining abscesses should be curetted and flushed with povidone-iodine until closed by second-intention healing. (See also Abscesses in Reptiles.)