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→Therapy
===Therapy===
===Therapy===
Dystocia is usually not an emergency situation if the female is bright, alert and responsive, but delay increases the risk of complications and decreases the chance of a successful treatment. In cases where parturition ceases, treatment for dystocia should be instigated within 48 hours. However, treatment may be successful up to a week after parturition begins. Lizards and snakes with dystocia should initially receive supportive care, procedure carries the risk of egg rupture, oviduct rupture, prolapse and perhaps death. Risks are decreased if this procedure is carried out under general anaesthetic.
Dystocia is usually not an emergency situation if the female is bright, alert and responsive, but delay increases the risk of complications and decreases the chance of a successful treatment. In cases where parturition ceases, treatment for dystocia should be instigated within 48 hours. However, treatment may be successful up to a week after parturition begins. Lizards and snakes with dystocia should initially receive supportive care, especially environmental conditions within their POTZ and rehydration.
Treating dystocia may be problematic for viviparous reptiles (colubrid snakes, boas, blue-tongue skink and prehensile-tailed skink), especially for snakes as they carry a large number of fetuses (5-50).
Treating dystocia may be problematic for viviparous reptiles (colubrid snakes, boas, blue-tongue skink and prehensile-tailed skink), especially for snakes as they carry a large number of fetuses (5-50).
* '''Husbandry practices''' - assess temperature, nesting site, rehydration and surrounding environment.
* '''Husbandry practices''' - assess temperature, nesting site, rehydration and surrounding environment.
* '''Calcium and oxytocin injections''' - Calcium gluconate (20 ml/kg of 10%) is given followed by oxytocin (5 iu/kg IM or ICo). A second dose may be given later if no effects are observed after 1-2 hours. Vasotocin (0.01-1.0µg/kg IV or ICo) may be more effective.
* '''Calcium and oxytocin injections''' - Calcium gluconate (20 ml/kg of 10%) is given followed by oxytocin (5 iu/kg IM or ICo). A second dose may be given later if no effects are observed after 1-2 hours. Vasotocin (0.01-1.0µg/kg IV or ICo) may be more effective.
* '''Physical manipulation''' – it can relieve dystocia in species where individual eggs can be palpated and gently manipulated to the cloaca. The not to inject the proteolytic enzymes into the coelomic cavity. If the egg softens over the following 48 hours it may then be aspirated by ovocentesis.
* '''Physical manipulation''' – it can relieve dystocia in species where individual eggs can be palpated and gently manipulated to the cloaca. However, this procedure carries the risk of egg rupture, oviduct rupture, prolapse and perhaps death. Risks are decreased if this procedure is carried out under general anaesthetic. The
* '''Percutaneous ovocentesis''' - this method involves inserting a large gauge needle through the ventrum into the egg and aspirating the contents (this method is often very successful in Elaphe species). This results in a smaller egg that may be easier to pass. Caution must be taken to not allow any of the egg contents to escape into the coelomic cavity. Aspiration must be done within the 48 hours of cessation of laying since the eggs harden making aspiration impossible. Hormonal stimulation may be used to start contractions if they do not start on their own after the aspiration. Prostaglandins have also been recommended. Antibiotics should be given prophylactically. If the eggs are not expelled within 48 hours of aspiration consider surgical removal.
* '''Use of pancreatic enzymes''' - if the contents are inspissated, pancreatic enzymes may be injected into the caudal egg. Great care must be taken not to inject the proteolytic enzymes into the coelomic cavity. If the egg softens over the following 48 hours it may then be aspirated by ovocentesis.
* If oviposition/parturition does not occur within 2 or more weeks or the reptile becomes dehydrated and lethargic, consider an ovariosalpingectomy.
* If oviposition/parturition does not occur within 2 or more weeks or the reptile becomes dehydrated and lethargic, consider an ovariosalpingectomy.
* '''Surgery''' - is indicated for relief of dystocia if the above fail, if there is an obstruction or if there is prolapsed devitalised oviduct tissue. Surgery may involve single or multiple salpingotomy, unilateral or bilateral salpingectomy or unilateral or bilateral ovariosalpingectomy.
* '''Surgery''' - is indicated for relief of dystocia if the above fail, if there is an obstruction or if there is prolapsed devitalised oviduct tissue. Surgery may involve single or multiple salpingotomy, unilateral or bilateral salpingectomy or unilateral or bilateral ovariosalpingectomy.