Draining a lump

[Selkielass]

After observing the very old wild caught T. Butlerii 'Cranky" for a few days, I began to suspect that releasing him back into his winter den would be a death sentence. (His muscle tone didn't compare with the other Butlers I'd been handling, and we were expecting a possibly severe cold snap.)

The lump on his side also seemed to be becoming more pronounced.

I called Steve, asked some questions, and found that draining an infection or parasite bump was not as difficult as I expected. This is the procedure I followed.

1. Cleaned and sanitized the cage completely- put down clean paper towel substrate and made sure both bowl and hide were of non-pourous materials and had been thoroughly cleaned.
2. Gave the snake a soapy cleaning in cool water. (To keep him lethargic.)
3. Put clean paper towel on my work surface, and gathered rubbing alcohol swabs, a scalpel and a new razor blade. Cleaned both cutting tools with alcohol.
4. Twined cranky around my hand so that the lump was on the outside of a coil wrapped around my index finger. Swabbed the area of the lump with alcohol prep swab.
5. Took the scalpel and carefully cut a nick on the diagonal between spread scales. Nothing happened. Even a small snake like this has surprisingly tough skin. I was afraid of jabbing to deeply with the tiny scalpel tip, so i switched to the razor blade and carefully sliced with a corner at the same area. Sliced deeper. one more time and I finally got a very small amount of blood. the cut was, at most, two scales long. (1/8 inch or less)

Cranky started protesting and moving, rolling his body- this actually helped press out what turned out to be a clump of infection- it looked like a lump of dirty cottage cheese. There was scarcely any blood, and the cut seemed to seal itself up after the infection popped out- the bleeding stopped completely.

Cranky was pretty fed up by now, and he tried to poop/musk me, but he never bit. I re-cleaned the incision and replaced him in the recovery tank.
He's been active, exploring and sunning himself. there may be a bit of infection returning, but I'm going to watch him for a week or so and look into antibiotic options before I consider draining it again.

He has shown no interest in food, but neither has the other male I found in the den area.
How long do males fast during breeding season?

Anyone know if Terramycin in his water dish would be safe- I use it for foulbrood prevention in my bees and there are instructions on the package for mixing it in water for poultry use- might this in his water dish give him the boost he needs to beat this?

Vet visit isn't an option here. He is a very old wild caught snake and all the reptile vets I have found in my area charge a very high office visit fee on top of any additional medications they prescribe. I'm looking for suggestions for home first aid and general comfort for this old fella.

[chris-uk]

I can't advise on medications you have available in the US, but it sounds like you've learned a valuable thing about amateur surgery - it isn't nearly as difficult as you think before you do it. I hope your description gives some reassurance to others that sometimes a bit of minor surgery isn't beyond us as not veterinary people.
I'm surprised that you needed to switch from scalpel to razor blade though, in my experience nothing cuts quite like a number 10 scalpel blade.

Back to the medication, is there some antibiotic ointment that you could apply direct to the incision site?

[kibakiba]

I believe most lumps are full of solid, or semi solid stuff, so making a small slice wouldn't do much I don't think.

[Selkielass]

The clump of infection was fairly solid (like a curd of cottage cheese.) The incision opening stretched and allowed it to pop out as a lump. Further pressing around the hole (& rolling bycranky made this process less than gentle -) gave no more infection & only a tiny smear of blood /fluid.

I can put triple antibiotic ointment on the surface, but I dont think it will penetrate. The cut is alredy sealed & nearly invisinvisible.

[guidofatherof5]

This would be a good time for some silver sulfadiazine.
Also a weak tea looking solution of betadine would be good.

[EasternGirl]

I can't wait until I am a nurse and I can get all kinds of cool medical and surgical stuff.

[kibakiba]

Ick. Surgical stuff is groooooooss.

[aquamentus_11]

careful with the silver sulfadiazine: it's a great TOPICAL antiseptic and will help prevent infection, but can burn and could possibly cause a tiny bit of tissue damage. it will definitely hurt. it won't be absorbed, but i'd avoid letting it get into the abscess. leave that wound open (no sutures, tape, etc.) and treat the incision with the triple antibiotic ointment, even filling the abscess if the snake will let you. try milking that area out through your incision at least once daily to prevent accumulation of the pus you described: pus and inflammation will slow and prevent proper healing. after milking, reapply ointment.

how large is the abscess? these things often recur even after they appear to be healed externally. if it's superficial enough and the overlying skin becomes scabby, i usually go ahead with debridement and uncover the lesion (use clean, sharp, tiny cosmetic scissors to clear away all overlying dead flesh: any left behind will harden and could cause further problems eventually). ideally, a vet should do this to reduce stress to the animal and prevent further infection. if that is still not an option, again apply the antibiotic ointment and just keep an eye on it, trying to express whatever might try to accumulate whenever you notice the need. i don't have actual experience with silver sulfadiazine, but know that it's used for burns and superficial ulcers: i would think an uncovered, debrided lesion would be a more appropriate time to use it, but would definitely do some research if i were you.

pictures would be helpful.

[Selkielass]

Pictures of the lump are near the tailor the Butler color variation thread. (Can't link from my phone, sorry.)
I will take some post drainage pics topost here soon. (New old camera to test.)
I'll get some assistance to hold cranky still from my D.H. if opening and debriding seems necessary. The small cut I made sealed itself very quickly- probably too quickly.

[Selkielass]

Reopened the incision yesterday, and scared myself silly.
cleaned everything, nicked the incision open, then snipped it wider with a tiny pair of scissors...
Shoot! Out popped a sharp pointy object like a rib bone and next to it a lump of something whitish-gray and ugly d
looking.
Damns, damn, damn, I must have screwed up totally.
Wait, calm down, you've seen tatters surviving much much worse.
Take tweezers in hand to... oh no! He's starting the rolling.
He won't stop! What's that?

On the paper is a mass sized and shaped like a smallish guppy.
Cranky looks fine, slim & very cranky.

Packed wound with antibiotic ointment & set him to rest.
Mass head àppears to be a lump of tissue enveloping a bone or splinter encased by an oblong of solid infection. Sort of a uni- guppy.
Cranky is looking great' sunning himself and giving me death looks whenever I approach the cage.
Cranky old coot.

[guidofatherof5]

The mass you found is likely the cause for the infection. With that mass (not infection mass) out it may be able to heal up.

Cranky has never had anyone care for him before so be patient with the old guy.:D
The only other humans have probably tried to kill him.

[aquamentus_11]

Reopened the incision yesterday, and scared myself silly.
cleaned everything, nicked the incision open, then snipped it wider with a tiny pair of scissors...
Shoot! Out popped a sharp pointy object like a rib bone and next to it a lump of something whitish-gray and ugly d
looking.
Damns, damn, damn, I must have screwed up totally.
Wait, calm down, you've seen tatters surviving much much worse.
Take tweezers in hand to... oh no! He's starting the rolling.
He won't stop! What's that?

On the paper is a mass sized and shaped like a smallish guppy.
Cranky looks fine, slim & very cranky.

Packed wound with antibiotic ointment & set him to rest.
Mass head àppears to be a lump of tissue enveloping a bone or splinter encased by an oblong of solid infection. Sort of a uni- guppy.
Cranky is looking great' sunning himself and giving me death looks whenever I approach the cage.
Cranky old coot.

that's AWESOME

[chris-uk]

I think that Steve is probably spot on. First time round you drained the infection, now with reduced inflamation you've been able to remove the source of the infections.

What are people's thoughts on the bone/splinter? My concern right now would be that it's a bone which has perforated the intestine and worked it's way out, although with a wild snake it's probably more likely to have been a penetrating injury - so an embedded splinter that then got infected.

[Selkielass]

It really looked like a fish bone or, what I imagine a snake rib bone to look like. Very fine and sharp.
He is doing well today, but still hasn't eaten.
I'll try for pics when the weather improves. My attempts at indoor pictures seem to be doomed to blurs and terribly off colors.

[EasternGirl]

I'm not sure...I would certainly be concerned about possible internal injuries going on. Especially if he isn't eating...of course, if he had a bad infection...that could affect his appetite as well.

[Selkielass]

I'm not sure...I would certainly be concerned about possible internal injuries going on. Especially if he isn't eating...of course, if he had a bad infection...that could affect his appetite as well.
He is also fresh out of brumation, and its breeding season for Butlers.
Rooster, the healthy male from the same den has also shown no interest in food.
Both are drinking plenty of water.

Anyone have any idea how long this spring fast could go on? Rooster is fine and fat but Cranky here is pretty thin.

[guidofatherof5]

He is also fresh out of brumation, and its breeding season for Butlers.
Rooster, the healthy male from the same den has also shown no interest in food.
Both are drinking plenty of water.

Anyone have any idea how long this spring fast could go on? Rooster is fine and fat but Cranky here is pretty thin.


Not until their work is done.:D

[Selkielass]

Rooster has stopped courting Trax, but he is still sticking fairly close to her. Honestly Trax is plump enough to be carrying already (Ravenous too.)
Cranky has been testing the lid of his cage- perhaps he smells her from across the room. He is active and has produced several nice solid poops, so I'm hoping he will eat soon.
All 4 snkes I. Have found this spring are slow to eat compared to last summers ravenous ladies.

[aquamentus_11]

good job fixing him up <thumbsup>

[Selkielass]

Update;
Gardened yesterday and brought in about 1/2 cup of fresh garden worms. All 4 wc butlers decided to pig out.
Cranky is scary thin, so this is a relief. I am still concerned for him as he is showing some raised scales that concern me, and he still has a touch of swelling at the incision site. He is coming out of blue phase, I'm. Looking forward to seeing what the injured areas look like after shed.

I plan on continuing with baths and antibiotic ointment on all scars and raised scale areas.

[guidofatherof5]

Any chance we can see a couple photos of these raised scales?

[EasternGirl]

Thanks for the update. Photos would be good. :)

[Selkielass]

Update:

Still working on photos- managed to get to the library today for the first time in over a week.
Cranky is doing very very well!
Went into blue phase a few days after the incision sealed itself up- started eating like a horse while half blind.
Needed a bit of help with the shed, but since the hospital tank is very warm and dry, I'm not at all surprised. Butlers really seem to need higher humidity or a wet hide for easy sheds.

He looks like a whole new snake now, and since I moved him into the large tank with this seasons juvenile w.c.'s his attitude has improved markedly. (Still skittish, but considerably more relaxed and less frantic when examined.) He is still thin, but no longer looks withered or emaciated.

I'll try for some pics this weekend- lets see how things go.

[guidofatherof5]

Time for an update Ellen. How's Cranky doing? Any infection return? Did it heal up?

[kerensa]

when doing things like this in the past, I found that a squirt of aqueus penn in the insicion does a lot to stop infection. Does anyone know if snakes can have penn?

[guidofatherof5]

Never heard of Penicillin being prescribed for garters.

[kerensa]

found out it can be used with garters. Care must be taken that they are not dehydrated at all when giving it to them either via injection or oral use as it can cause kidney dammage if they are. using it as a wound wash then would be safe under the same conditons.

same warning on dehydration was given for the tetricycline and amoxicillin.

[d_virginiana]

I just read this whole thread, and I'm really glad I did. I'm glad Cranky is doing better!
So often the only options for reptiles are paying through the nose for a specialty vet or just getting the meds and doing things on your own. That can be pretty difficult, so I really like seeing threads like this.

[Selkielass]

Cranky is doing great and he's turned into a griff old sweetie - no more striking or rolling, but he puts up a momentary protest run before allowing himself to be picked up. (Must keep upappearances ya know.)

Pictures have been taken- I will post when I get to a wifi hot spot.

[Selkielass]

Here we go...
Fat,sassy and curious
http://www.thamnophis.com/thamphotos/data//796/medium/IMG_20120710_150923.jpg

He is battle scarred all over, but it suits him.
Head
http://www.thamnophis.com/thamphotos/data//796/thumbs/IMG_20120710_150808-1.jpg (http://www.thamnophis.com/thamphotos/showphoto.php?photo=10977&title=cranky-butlerii&cat=796)

Back
http://www.thamnophis.com/thamphotos/data//796/thumbs/IMG_20120710_150120-1.jpg (http://www.thamnophis.com/thamphotos/showphoto.php?photo=10976&title=cranky-butlerii&cat=796)

Flanks
http://www.thamnophis.com/thamphotos/data//796/thumbs/IMG_20120710_145546.jpg (http://www.thamnophis.com/thamphotos/showphoto.php?photo=10979&title=cranky-tbutlerii&cat=796)
http://www.thamnophis.com/thamphotos/data//796/thumbs/IMG_20120710_145655.jpg (http://www.thamnophis.com/thamphotos/showphoto.php?photo=10980&title=cranky-tbutlerii&cat=796)
http://www.thamnophis.com/thamphotos/data//796/thumbs/IMG_20120710_145803.jpg (http://www.thamnophis.com/thamphotos/showphoto.php?photo=10981&title=cranky-tbutlerii&cat=796)
At the top of the above shot you can see his incision scar. Pretty tidy healing.

[Selkielass]

He is a he... isn't he?
http://www.thamnophis.com/thamphotos/data//796/thumbs/IMG_20120710_150026.jpg (http://www.thamnophis.com/thamphotos/showphoto.php?photo=10975&title=cranky-butlerii&cat=796)
Im never sure of my guesses.

[ProXimuS]

Looks like a male to me...but I'd definitely like to see what others say, since I'm still new..:p

[Steveo]

I say male too, but I'm no expert...

[kibakiba]

Definitely male.

[Invisible Snake]

Yes definitely male, he's packing lol. He looks great you did an awesome job with him, I'm glad he found you.

[Selkielass]

Came across this thread at another forum and had to link to it!
Biopsied one of my Basins today in Corallus Discussion Forum (http://corallusforums.yuku.com/topic/138/Biopsied-one-of-my-Basins-today?page=1#.UCJqJqO67m0

T)he initial photo of the lump looks *exactly* like Crankys lump aside from scale structure and coloration. (Diff species here.)

This poster has far more medical experiences and resources at his disposal, and his incision is many times larger than I dared (He used local anesthetic and stitched up the incision.) but the cause of the lump similar to Cranky's- a thorn or splinter causing irritation beneath the skin.

Brilliant pictures- I wish mine were a fraction as good at showing what was happening.

[aquamentus_11]

is that a northern ribbon? if so, i'm very jealous. i've never even seen one back in MI.

[EasternGirl]

Well hello Nate! Nice to see you on the forum. Mike recently had a lump on one of his snakes that ended up having a parasite in it. I knew as soon as he told me about the lump what it was. I told him to look on the forum for info about it because many members have had snakes with lumps.