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| | ===Prevention=== | | ===Prevention=== |
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| − | Good nutrition and keeping snakes within their POTZ will decrease the incidence of maternal causes of dystocia. | + | Good nutrition and keeping lizards and snakes within their POTZ will decrease the incidence of maternal causes of dystocia. Iguanas housed in enclosures at least 2m high and can climb up and down for eating appear to have fewer incidences of dystocia. The best prevention for dystocia is neutering. |
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| − | Dystocia treatment options
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| − | There are several treatments for dystocia and it is always best to start with the simplest. The initial treatment is to keep the snake within its POTZ and give an injection of calcium followed by oxytocin. If unsuccessful, ovocentesis is a simple procedure and is often very successful in Elaphe species. Finally, salpingotomy is sometimes necessary and in some cases is the recommended initial treatment.
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| − | Physical manipulation - Physical manipulation can relieve dystocia in species where individual eggs can be palpated and gently manipulated to the cloaca. The procedure carries the risk of egg rupture, oviduct rupture and perhaps death. Risks are decreased if this procedure is carried out under general anaesthetic.
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| − | 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.
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| − | Percutaneous ovocentesis - Percutaneous ovocentesis is used to collapse an egg that is then hopefully passed within 48 hours. Series of photos of egg-bound snake with fluid being drained: A needle is inserted through the ventrum into the egg and its contents aspirated. Calcium and oxytocin may be given after the aspiration. Prostaglandins have also been recommended. A large gauge needle is used to allow the thick contents to be aspirated although this introduces more risk of yolk contamination of the coelomic cavity. Antibiotics should be given prophylactically.
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| − | 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. Surgery should be performed if the egg is not passed within 48 hours after aspiration.
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| − | Surgery - 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.
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| − | Follow the following procedure for salpingotomy:
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| − | Left ventrolateral skin incision between the first and second scale row overlying the retained egg or foetus
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| − | Incise oviduct and remove eggs; one or several incisions may be necessary
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| − | Close oviduct with 5/0 vicryl
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| − | Routine skin closure
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