Changes

*In secondary gout acquired disease interferes with the uric acid metabolism. Terrestrial reptiles are predisposed to secondary gout since nitrogenous waste is excreted as uric acid.  

*In secondary gout acquired disease interferes with the uric acid metabolism. Terrestrial reptiles are predisposed to secondary gout since nitrogenous waste is excreted as uric acid.  

In snakes kidney disease often leads to the development of the visceral form of gout.

In snakes kidney disease often leads to the development of the [[Visceral gout|visceral form of gout]].

 

'''For more information on excretion, see''' [[Lizard and Snake Excretion]].

==Examination==

==Examination==

History may show poor husbandry including limited access to water. Snakes often present as anorexic and lethargic. Often if kidney disease is involved there is a palpable lump in the caudal third.

History may show poor husbandry including limited access to water. Snakes often present as anorexic and lethargic. Often if kidney disease is involved there is a palpable lump in the caudal third.

[[Image:Necropsy_copy.jpg|200px|thumb|right|'''Tophi in renal tissue''' - ©RVC and its licensors, Peer Zwart and Fredric Frye. All rights reserved]]

[[Image:Necropsy_copy.jpg|200px|thumb|right|'''Tophi in renal tissue''' - ©RVC and its licensors, Peer Zwart and Fredric Frye. All rights reserved]]

==Diagnosis==

==Diagnosis==

The diagnosis of gout may be suspected on history and physical examination. Biochemistry may indicate a hyperuricaemia. Sometimes radiography is useful if calcium is deposited with the urate crystals. Biopsy of any lumps may be useful. A definite diagnosis is the demonstration of tophi in diseased tissue.  

The diagnosis of gout may be suspected on history and physical examination. Biochemistry may indicate a hyperuricaemia. Sometimes radiography is useful if calcium is deposited with the urate crystals. Biopsy of any lumps may be useful. A definite diagnosis is the demonstration of tophi in diseased tissue.  

[[Image:Renal_gout_python_regius.jpg|200px|thumb|right|'''Tophi in diseased tissue''' - ©RVC and its licensors, Peer Zwart and Fredric Frye. All rights reserved]]

[[Image:Renal_gout_python_regius.jpg|200px|thumb|right|'''Tophi in diseased tissue''' - ©RVC and its licensors, Peer Zwart and Fredric Frye. All rights reserved]]

==Therapy==

==Therapy==

Supportive treatment especially aimed at rehydration may be useful but gout carries a poor prognosis. Previously allopurinol (a xanthine oxidase inhibitor that decreases formation of uric acid) has been recommended as a treatment of hyperuricaemia in reptiles and birds but in fact appears to be of little use. Other drugs such as uricases (enzymes involved in the degradation of uric acid to allantoin) may be more useful.

Supportive treatment especially aimed at rehydration may be useful but gout carries a poor prognosis. Previously allopurinol (a xanthine oxidase inhibitor that decreases formation of uric acid) has been recommended as a treatment of hyperuricaemia in reptiles and birds but in fact appears to be of little use. Other drugs such as uricases (enzymes involved in the degradation of uric acid to allantoin) may be more useful.

==Prevention==

==Prevention==

Any bouts of dehydration will predispose to the development of gout so good husbandry is important in prevention (as always!).  Veterinarians should ensure adequate hydration of reptiles prior to any drug therapy especially the use of nephrotoxic drugs.

Any bouts of dehydration will predispose to the development of gout so good husbandry is important in prevention.  Veterinarians should ensure adequate hydration of reptiles prior to any drug therapy especially the use of nephrotoxic drugs.

[[Category:Snake_Diseases]]

[[Category:Snake_Diseases]]