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Snake Physical Examination (view source)

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==Introduction==

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The physical examination involves observation of the snake, taking measurements and a thorough methodical area by area examination. Many techniques are similar to other animals, but before examining the snake ask the owner if it is accustomed to being handled. [[Snake Handling and Restraint|See here]] for information on handling and restraint of snakes. A veterinarian who is inexperienced with reptiles may be likely to focus on the presenting signs but then can end up treating exclusively the secondary problems. Stomatitis and rectal prolapse are secondary conditions where a full examination with husbandry review, including [[Snake Housing|housing]] and [[Snake ~~feeding~~|nutrition]], is vital in determining the principal problem.

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The physical examination involves observation of the snake, taking measurements and a thorough methodical area by area examination. Many techniques are similar to other animals, but before examining the snake ask the owner if it is accustomed to being handled. [[Snake Handling and Restraint|See here]] for information on handling and restraint of snakes. A veterinarian who is inexperienced with reptiles may be likely to focus on the presenting signs but then can end up treating exclusively the secondary problems. Stomatitis and rectal prolapse are secondary conditions where a full examination with husbandry review, including [[Snake Housing|housing]] and [[Snake Feeding|nutrition]], is vital in determining the principal problem.

==Observation==

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Snakes should have active tongues that are sampling scent particles in the atmosphere. Normal movement should be observed although allowances must be made for any chilling effect in transit since this will reduce the patient's metabolism and give a misleading impression of lethargy and lack of strength. A healthy snake will have adequate muscle tone and grip the clinician's hands. There will be a level of activity befitting the particular species. A sick snake usually remains limp. The righting reflex should be tested since poor reactions can be a result of weakness and not necessarily neurological disease. Neurological function can be assessed by checking head position, body posture, cloacal tone and righting reflexes. Respiration, including rib movements and any sounds produced should be noted.

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Snakes should have active [[Snake Special Senses|tongues]] that are sampling scent particles in the atmosphere (see [[Jacobsons Organ|Jacobson's organ]]). Normal movement should be observed although allowances must be made for any chilling effect in transit since this will reduce the patient's metabolism and give a misleading impression of lethargy and lack of strength. A healthy snake will have adequate muscle tone and grip the clinician's hands. There will be a level of activity befitting the particular species. A sick snake usually remains limp. The righting reflex should be tested since poor reactions can be a result of weakness and not necessarily neurological disease. [[Snake Neurological System|Neurological function]] can be assessed by checking head position, body posture, cloacal tone and righting reflexes. [[Snake Respiratory System|Respiration]], including rib movements and any sounds produced should be noted.

==Organ positions==

The organisation of internal structures varies between snake families and genera. However it is important to know the approximate position of the organs during a physical examination. The following is a generalisation if the snake's body is divided into thirds from snout to vent:

*'''Cranial third''' - contains the trachea, oesophagus and heart

*'''Middle third''' - contains the liver, lung and stomach

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*'''Caudal third''' - contains the small intestine, the triad of pancreas, spleen and gallbladder, the adrenal glands, large intestine, gonads, reproductive tract, kidneys, fat body and cloaca. Behind the vent are the musk and, if the snake is a male, the hemipenes.

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*'''Caudal third''' - contains the small intestine, the triad of pancreas, spleen and gallbladder, the adrenal glands, large intestine, gonads, [[Snake Reproductive System|reproductive tract]], kidneys, fat body and [[Cloaca|cloaca]]. Behind the [[Vent|vent]] are the musk and, if the snake is a male, the [[Hemipenes|hemipenes]].

==Skin==

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Check the general appearance of the skin. The skin should be bright and shiny. Assess elasticity and skin tenting. Dehydrated snakes show outwardly directed folds of skin and dysecdysis. Examine the skin both dorsally and ventrally for retained shed, blisters, pustules, burns, discharges, erythema, pettechi, ulcers, loss of scales, lacerations ad swellings. Examine for ectoparasites, especially mites that tend to ~~hde~~ under scales of the skin. Brushing the body of the snake over a white sheet may be helpful in checking for mites. The snake's body can be palpated by simply moving the hand, both dorsally and ventrally, down its length. Identify any masses and swellings under the skin. Subcutaneous lumps are usually due to abscesses but neoplasia and the second-stage cysts of cestodes can also be encountered in snakes.

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Check the general appearance of the skin. The skin should be bright and shiny. Assess elasticity and skin tenting. Dehydrated snakes show outwardly directed folds of skin and [[Snake Dysecdysis|dysecdysis]]. Examine the skin both dorsally and ventrally for retained shed, blisters, pustules, burns, discharges, erythema, pettechi, ulcers, loss of scales, lacerations and swellings. Examine for ectoparasites, especially [[Snake Mites|mites]] that tend to hide under scales of the skin. Brushing the body of the snake over a white sheet may be helpful in checking for mites. The snake's body can be palpated by simply moving the hand, both dorsally and ventrally, down its length. Identify any [[Snake Lumps and Bumps|masses and swellings]] under the skin. Subcutaneous lumps are usually due to abscesses but neoplasia and the second-stage cysts of cestodes can also be encountered in snakes.

Find out more about [[Snake Skin|snake skin]]

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===Shedding===

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Ecdysis (shedding) generally takes place every 14 days although this is dependent on many variables such as environment, age and size of snake. Snakes shed their entire skin in one piece, including the spectacles, although large snakes greater than 3m in length may shed their skin in incomplete sections. Prior to ecdydsis, a snake will become anorectic and handling may be hazardous to the animal at this time if the underlying epidermis is damaged.

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[[Ecdysis]] (shedding) generally takes place every 14 days although this is dependent on many variables such as environment, age and size of snake. Snakes shed their entire skin in one piece, including the [[Snake Eye|spectacles]], although large snakes greater than 3m in length may shed their skin in incomplete sections. Prior to ecdydsis, a snake will become anorectic and handling may be hazardous to the animal at this time if the underlying epidermis is damaged.

==Head==

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Initially check that the snake moves and supports its head normally and that it investigates its surroundings with an active flicking ~~tonge~~. Examine the rostrum for abrasions that may indicate an unsuitable cage. Check the nares for patency and discharge. Examine the heat-sensing pits, the crevice around the spectacle and the skin between the scales for ectoparasites or retained skin. Palpate the jaws for any abnormal swellings.

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Initially check that the snake moves and supports its head normally and that it investigates its surroundings with an active flicking tongue. Examine the rostrum for abrasions that may indicate an unsuitable cage. Check the nares for patency and discharge. Examine the [[Snake Special Senses|heat-sensing pits]], the crevice around the spectacle and the skin between the scales for [[Snake Mites|ectoparasites]] or [[Snake Dysecdysis|retained skin]]. Palpate the jaws for any abnormal swellings.

===Eyes===

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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. Observe the movement and general position of the eye within the socket. The optic nerve and other cranial nerves associated with eye function are assessed by observing the snake's reaction to movement and by normal and co-ordinated eye movements. Strabismus may indicated dysfunction. Bulging eyes may result from retrobulbar or periocular cellulitis, absecesses or neoplasia. Inspect the spectacles. They should be clear, not wrinkled, distended or discoloured although they are normally bluish-white prior to shedding. The subspectacular space should be clear. Check for any signs of conjunctivitis. Remember that the mydriatics are not useful and that there is no consensual light reflex.

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The [[Snake Eye|eyes]] are usually considered as a barometer of general health and environmental conditions; therefore a full ophthalmologic examination should be performed in all cases. Observe the movement and general position of the eye within the socket. The optic nerve and other cranial nerves associated with eye function are assessed by observing the snake's reaction to movement and by normal and co-ordinated eye movements. Strabismus may indicated dysfunction. Bulging eyes may result from retrobulbar or periocular cellulitis, absecesses or neoplasia. Inspect the spectacles. They should be clear, not wrinkled, distended or discoloured although they are normally bluish-white prior to shedding. The subspectacular space should be clear. Check for any signs of conjunctivitis. Remember that the mydriatics are not useful and that there is no consensual light reflex.

* Other diagnostic tools, such as tonometry (measurement of the intraocular pressure), stains, cytology, bacteriology, histopathology and electron microscopy, in addition to routine diagnostic tools (haemotology, biochemistry, radiology and ultrasound) can also be used to detect an ocular disease or underlying problem in snakes.

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Snake Physical Examination (view source)

Revision as of 12:52, 11 April 2010

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