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Consider examining in a quiet area; the use of the oculovagal reflex will allow for a more relaxed clinical examination.
==Ophthalmologic Examination==
==Skin==
Examine under a bright light and with a hand lens if necessary. A common problem is retained shed especially on the digits. This may cause avascular necrosis of the digits.
Examine for:
* Ectoparasites
* Trauma due to fighting, mating or thermal burns
* Discoloration (previous scars, injection sites)
* Dysecdysis - retained skin is often dry and brown while normal ecdysis occurring in a piecemeal fashion is flexible and transparent. Retained skin is a focus for infection and acts as a tourniquet on the tail tip and digits leading to ischaemic necrosis
* Examine the scales for loss, scabs, blisters and haemorrhages, ensuring the ventral scales are inspected
* Assess for abnormal masses, swellings or bruised areas
* Assess skin elasticity
Skin folding indicates dehydration, cachexia. Assessment of dehydration in reptiles is analogous to mammals. With 5-8% dehydration there is loss of skin elasticity with a wrinkled appearance. With more severe dehydration (10-15%) the eyes are sunken and the mucous membranes become dry and sticky (consider that the oral cavity of most reptiles is relatively dry compared with mammals).
==Shedding==
Shedding is regular and generally occurs in a piecemeal fashion. It occurs about every 4 to 6 weeks, more often for younger animals during the peak growing seasons and more slowly during winter.
==Head==
===Rostrum===
Trauma and ulcerations due to repeat escape attempts are very common in water dragons.
===Nares===
Check the nares are patent and free of discharge (some iguanids excrete salt from nasal glands via the nares).
===Eyes===
====Ophthalmologic Examination====
The eyes are usually considered as a barometer of general health and environmental conditions; therefore a full ophthalmologic examination should be performed in all cases.
The eyes are usually considered as a barometer of general health and environmental conditions; therefore a full ophthalmologic examination should be performed in all cases.
'''For more information on the eye, see [[Lizard Eye|'''Lizard Eye''']] page.'''
'''For more information on the eye, see [[Lizard Eye|'''Lizard Eye''']] page.'''
The eyes should be clear and free of discharge.
The eyes should be bright and clear
Note blepharospasm swelling, redness
===Tympanum===
Check that there is no abnormal swelling.
The tympanum: note the clear scale in the centre of the image
===Skull and mandible===
Note abnormal swelling, bony masses, soft jaw bones (esp. MBD).
Note the parietal eye on the dorsum of the head
===Oral cavity===
Assess the internal extent of rostral abrasions, assess mucous membrane colour and condition (cyanosis? pallor? – normally clear and no petecchiation or oedema). Check for excess salivation and stomatitis.
====Tongue====
Large fleshy; reddened, split tip in iguanas.
Note that there is a reddened split at the end of the tongue in this iguana
The tongue is forced to the left due to an oral granuloma
====Glottis====
Push craniodorsally on the submandibular area to force the glottis up into better view; check for discharges and foreign body; observe during respiration to differentiate between discharges originating from respiratory or GIT.
====Pharynx====
Examine using a bright light source.
==Temporomandibular joint==
Check medial aspects for white deposits (uric acid deposits).
==Limbs==
Assess the tone and strength of skeleton and muscle.
In the new area, such as a consulting room, a healthy
lizard will stand so that it is supporting its bodyweight
(for a quick getaway if an opening appears!)
Palpate for abnormal swelling or masses, especially in the joints. Decide if swellings are bone (fibrous periosteal reactions or fractures) or soft tissue (includes abscesses).
Flex and extend joints individually and assess for range of movement and pain.
Check digits for retained skin and digital necrosis.
Assess withdrawal reflex by pinching a digit.
Muscle twitching may be associated with MBD.
==Coelomic cavity (thorax/abdomen)==
Requires a silent examination area for auscultation. Place stethoscope ventrally between forelimbs or laterally in axilla region for heart and lateral thorax for lungs. A thin, damp cloth between stethoscope and scales aids auscultation. Cardiovascular problems are not uncommon due to calcification of bronchi and major arteries.
Palpate abdomen for abnormal swellings and masses (e.g. foreign bodies, cystic calculi, constipation, enlarged kidneys). Enlarged kidneys may be palpated ventrally just cranial to the pelvic inlet.
Small lizards such as leopard geckos are
delicately restrained for abdominal palpation.
Smaller lizards e.g. geckos can be transilluminated. A powerful light (e.g. endoscope) held against the body of smaller lizards or inserted into the oesophagus or cloaca of larger lizards. Care is necessary if light source produces heat. It is possible to visualise internal structure e.g. coelomic masses.
==Cloaca/tail base==
Check that the cloaca is free from faecal staining, discharge, oedema, erythema, masses or infection. The cloaca can be examined in larger species with a lubricated, gloved finger.
Enlarged kidneys may be palpated by this method. Endoscopic examination should be considered.
Examine the tail for swellings, masses, tail tip necrosis and evidence of tail loss and regeneration.
==Sexing==
==Sexing==