Veterinarians and veterinary technicians play important roles in the management of reptile cases presented to the veterinary hospital. Individuals working with these animals should become comfortable with the proper techniques to restrain, examine, and collect diagnostic samples so that they may provide the best care for the patient and client. The purpose of this presentation is to provide attendees a review of these clinical examination methods for reptiles.
Lizards and non-venomous snakes can be restrained by grasping the head at the level of the quadrate/mandible and supporting the animal's body. For snakes, an additional handler should be used for every 3–4 feet of the body to support the spine. Snakes should never be draped over the neck of an individual.
Only trained professionals should handle venomous snakes. Hooks and tongs should be used to remove venomous snakes from their enclosure. Once collected from an enclosure, the snake should be directed into an appropriately sized, clear plastic tube. The snake should be allowed to crawl to the midpoint of the tube and then prevented from advancing. This technique allows for safe management of the snake and allows veterinarians to grossly examine the snake and collect blood from the ventral coccygeal vein. Intravenous propofol (5 mg/kg) can be administered slowly via the ventral coccygeal vein to anesthetize the snake, or isoflurane can be directed into the tube to anesthetize the snake.
Most chelonians can be handled by grasping the shell at the midpoint of the body. For aggressive species, such as snapping turtles, the shell should be handled more caudally. Restraining the head of a turtle is similar to that described for the snakes and lizards.
Always observe a reptile patient from a distance prior to restraining it for a physical examination. Special attention should be given to mentation, respiration, and locomotion. The physical examination should be performed in a thorough and consistent manner. The eyes should be clear with no discharge. A baseline ophthalmic exam should be performed to evaluate the conjunctiva, cornea and anterior chamber. The nares should be clear and free of discharge and retained shed. The oral cavity should be opened using a soft, pliable speculum. The mucous membranes should be pale to pink and free of thick, ropey mucus. The tongue should be identified and evaluated for function. The glottis should be free of discharge. The teeth should be closely inspected for fractures. The integument should be closely inspected for ectoparasites, traumatic injuries and inflammatory responses (dermatitis). The spine and ribs should be palpated. The epaxial muscle should be well developed. The spine will be prominent in reptiles with muscle wasting. For chelonians and lizards, the limbs should be palpated for any traumatic injuries, abscesses or granulomas. Palpation should be performed to assess the coelomic cavity for abnormalities. A thumb or finger can be used to gently palpate the viscera. Any abnormal masses should be further evaluated using appropriate diagnostic tests. An audible ultrasonic crystal Doppler and stethoscope may be used to determine heart and respiratory rates, respectively.
Reptiles are stoic animals and have evolved to mask their illness. A thorough physical examination may be helpful in characterizing certain disease problems, but its overall value may be limited. A veterinarian must also use available diagnostic tests, such as hematology, plasma chemistry analysis, microbiological culture, cytologic examination and parasitologic examination, to aid in the diagnosis of disease.
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