Bit concerned about this

[zirliz]

Assmodius 's injury or whatever you call it has returned

I've taken him to a vet before but they were no help really :(

He was ok feeding etc and only recently it returned using a good camera really shows how nasty it is.

DSC_1022 | Flickr - Photo Sharing! (http://www.flickr.com/photos/47716939@N02/8339816578/)

[guidofatherof5]

A little history please?
So, this snake had this exact injury/infection before. Did it completely clear up at some point? What treatment has been done by you or the Vet?
Have you used any topical ointment/creams on it?
Could this be a rub injury?
I would be concerned with this. Oral/injectable antibiotic and diluted Hibiclens for the topical needed in my opinion.

I found this old thread about this issue.
http://www.thamnophis.com/forum/urgent-care/8257-im-concerned-what.html

Wow, this has gotten much worse.

[Greg'sGarters]

I would go to a different vet. Ask around and try to find out the best reptile vet in your area. Get a bunch of different opinions.

[zirliz]

Not many good reptile vets nearby and tried to get hold of one recently in Dublin but his hours were so scare / didn't seem to answer phone, is there no cream I can get for him other than trip to vet?

I don't mind paying it's just very difficult to find one I was using that reptile iodine product early on but nothing seemed to be improving, when it does look like it's clearing up as it did the last time he had this he just goes and scraps it off things (itchy maybe) he is an old snake now also so maybe his immunity is down :(

[guidofatherof5]

Can you buy Hibiclens?
Hibiclens® and Hibistat® (http://www.hibiclens.com/)

[ConcinusMan]

That's an infection plain and simple. Identifying the culprit is essential because many bacteria are resistant to certain drugs. You really need a vet that can perform a debridement ( the medical removal of dead, damaged, or infected tissue to improve the healing potential of the remaining healthy tissue) and have the dead material tested in a lab to identify the culprit. Only then can they know what antibiotic to use, and then, the antibiotic needs to be in the snake's bloodstream, either given orally or by injection.

If that can't be accomplished right away, (and it wouldn't be cheap, so cost can be a factor) if it were me, I would do a warm soak as best I can, and rake off the dead material myself and keep applying a strong antiseptic to the area. If crust builds up again, remove it. You want to treat the healthy tissue underneath. But in the end, fighting it topically might not be enough if the infection is too deep in the tissues.

Like Steve suggested, you might give Hibiclens a try (or any skin cleanser containing a few percent chlorhexidine gluconate) and apply several times a day, don't rinse. Bacteria which have developed resistance to iodine or certain treatments often have less resistance to chlorhexidine gluconate because it's use is relatively new. You've probably heard of MRSA. It's a strain of staph that has developed resistance to normal treatments/antibiotics. Even iodine won't get rid of it from an active skin infection, but chlorhexidine gluconate will. Just make sure you continue treatment a couple of weeks beyond apparent healing, to prevent creating a resistant strain of the bacteria.

At this point, you already tried iodine but didn't get rid of it. So, next time you try it, it's probably not going to work at all if the bacteria have become resistant. You need something strong, but something that isn't iodine. chlorhexidine gluconate fits the bill but you gotta get that dead tissue off so the medication can bond with the live healthy tissue underneath.

If you took him to a vet and followed his instructions or had him treated, I would file a complaint. It has gotten much worse. If it was done right early when you first showed us...

[ConcinusMan]

It could be bacterial, or it could be fungal. I'd say a biopsy is probably necessary or you would just be guessing on what to treat it with and wasting time while it's getting worse and spreading.


"Fungal Infections: A number of fungal organisms can cause superficial and deeper infections of snakes. Most of these infections involve the skin and respiratory system. Fungal infections of the eyes are most likely to occur in snakes housed in damp, contaminated environments. Ringworm fungi that usually infect people, pets and livestock have also caused skin infections of snakes. Snakes must be housed in scrupulously clean and dry enclosures. The flooring must be easy to clean and should not be of a material that encourages fungal (mold) growth (see section on Housing). A veterinarian must examine Snakes exhibiting problems with their skin and/or eyes as soon as possible. A microbial culture and a skin biopsy may be necessary to obtain a diagnosis. Treatment of fungal diseases involves use of topical and systemic (oral and/or injectable) antifungal agents. Prevention of fungal disease involves correcting underlying problems with husbandry"

[chris-uk]

Can you buy Hibiclens?
Hibiclens® and Hibistat® (http://www.hibiclens.com/)

Not sure about Ireland, but I've not found anywhere in the UK that supplies Hibiclens. The only thing I found the same active ingredient (chlorhexidine gluconate) in it was a medicated mouthwash (off the top of my head, I think it was Corsodyl) so that may be worth a try. As a general rule it's much more difficult to get hold of antibiotic ointments without a prescription on this side of the Atlantic.
A trip to a vet that knows reptiles is the way to go, it may not be so expensive as you think.


Edit:
Just did another search, and you can find Hibiclens on Amazon.co.uk:
Amazon.co.uk: hibiclens (http://www.amazon.co.uk/s/ref=sr_ex_p_76_0?rh=i%3Aaps%2Ck%3Ahibiclens&keywords=hibiclens&ie=UTF8&qid=1357306925)

It's curious that it's not available from our high street pharmacies though... makes me think it isn't officially distributed here.

[d_virginiana]

You wouldn't even need a reptile vet for that... As long as you tell a regular vet exactly what you want done, they can clear off the dead tissue and do the biopsy. They can also get antibiotics that it would be difficult to just find over the counter.

[ConcinusMan]

The only thing I found the same active ingredient (chlorhexidine gluconate) in it was a medicated mouthwash... makes me think it isn't officially distributed here.

Yeah, that won't be strong enough. Mouthwashes are typically less than 1% chlorhexidine gluconate. The funny thing is, mouthwashes with that ingredient still require a prescription here. The skin cleansers with 4% chlorhexidine gluconate can be purchased OTC. Go figure.

Yes, what is available OTC will vary depending on country. In the U.S., 3% hydrogen peroxide is labeled in a way that gives instructions on how to use it as a mouthwash. peroxide is also found in toothpastes and whiteners. Not so in Canada as hydrogen peroxide hasn't been approved for oral use.:cool:

[zirliz]

Ok I'll try and see if the vet near us can at least send a sample to be examined in the mean time I was in pet shop today (I know he knows his stuff) and he said I should try and open his mouth and if it's ulcerated which he thinks looking at the picture that it is.

I was to treat it with iodine, I'm hoping the vet can get something stronger if needed.

Thanks for the advice so far,

[ConcinusMan]

I was thinking it looked similar to a fungal infection that birds get, and like stomatitis in reptiles but it didn't look to me like it was actually in his mouth. If it is, that is how it's usually treated. They debride and yes, sometimes there's a lot of bleeding, but it's necessary, then they treat with iodine. Not easy to get rid of though. It's an uphill battle usually. Your call though if you want spend the money and try. Good luck.

[zirliz]

Was also advised to remove him from his current tank and place on his own with just a water dish to keep it sterile guess that makes sense too last time he was to the vet they gave him baytril and I kept him alone (which he did not like) but I concerned it might spread to my female.

I'll keep you updated shall ring vet and hopefully they can get sample sent off to be examined, and hopefully can advise from there.

[d_virginiana]

I agree, now that someone mentions it, it does look like it could be fungal... Also, just a thought... What temps are you keeping him at? I have no idea if this would help at all without knowing what sort of infection it is, but fungal infections in frogs can sometimes be treated by boosting temps to the upper 80's for a few days. This would also increase his immune system, so it might not be a bad idea anyway.

If he's not already by himself, you need to get him alone ASAP. Whether it's bacterial or fungal, it could be contagious and you don't want him sharing space and water with healthy snakes. If there are other snakes with him now, after you move him to a new tank you need to clean the old one and everything in it REALLY well before putting the others back.
In his new tank you can put newspaper bedding. I started using it when mine had a mouth infection, to keep dirt and stuff from getting in his mouth. No dust or debris, but it still gives them something to get traction on, since they don't seem to like crawling on plain glass.

[ConcinusMan]

If they didn't do a biopsy, which requires a culture done in a lab, and extra expense, usually vets do just give them baytril and if that clears it up as it would most infections, you're all good. But if it didn't work, then get that biopsy done because there are plenty of agents, although not as common, that baytril won't get rid of. I know that when I, or one of my friends' bird collections got a "mouth rot" outbreak, knowing the exact culprit right away was key to knowing what medication to use. Using the wrong medication does nothing to help.

[zirliz]

Ok just back from vet and they took a sample hopefully we will know more later on in the week he thought it looked fungal but also said he could be bacterial he would know more after it's cultured.

[zirliz]

I got a call from vet friday unfortunately the cultures showed nothing he said he'd grow the fungus ones (he thinks) for a bit longer and tomorrow I'm suppose to call again otherwise he'll just have to give him something and hope for the best.

[zirliz]

Assmodius shed today vet said cultures showed nothing :( I'm getting some pictures of him now that the scabby looking thing is gone (when he shed) so will put those up Would his old shed with that scabby thing on it be any use to the vet?

[guidofatherof5]

Not sure if it will be of any use to the Vet. but since this is a recurring problem you're not out of the woods in my opinion.
I think some preventative measures need to be taken.

Looking forward to seeing the photos and a much cleared up face on your scrub.

[d_virginiana]

Save the scabby thing. Kinda gross, but make sure the vet doesn't need it for samples before tossing it.

[ConcinusMan]

That's pretty bad when a biopsy / culture still won't tell you what the heck is causing it. I guess you're pretty much screwed if that didn't work.:cool:

[guidofatherof5]

I certainly wouldn't say that as it appears to have improved after the shed.. Maybe this, whatever it is has run its course.
The fact that it isn't spreading is a good sign and the fact a shed seems to improve the condition.
This is all looking at it from a "glass half full" philosophy. ;)

[zirliz]

DSC_1041 | Flickr - Photo Sharing! (http://www.flickr.com/photos/47716939@N02/8424755939/) DSC_1045 | Flickr - Photo Sharing! (http://www.flickr.com/photos/47716939@N02/8424687703/) Not the best shots I know but he is a lively bugger I hope it looks better but it's hard to tell

[guidofatherof5]

I would say there is still something active going on there. Have you gotten any of the F10 ointment yet?
I would hit this thing hard. You don't want it going septic.
If you would like I will send you a small amount to Hebiclens.

[ConcinusMan]

Dang that looks like it's getting into his eye too. Eye looks damaged/infiltrated by whatever this creeping crud is. Doesn't look better at all to me. Still an active infection. Like any wound it's going to crust over and then come off at times but the problem is still there.

[d_virginiana]

Yikes! I'd say you need to nuke that with the strongest stuff you can that's safe for the snake...

Is there any way you could get a photograph of what it looks like under a microscope? I know that's a long shot, but checking it out yourself or taking a swab and growing it up on a plate would at least give you an idea if it was bacterial or fungal... I'm surprised nothing turned up when the vet checked it out, but maybe all the tissue before was dead, since it all seems to have sloughed off so easily? That could make it hard to get good biopsy results...

[ConcinusMan]

Yeah, I was thinking that if the problem is deep in the live tissue, gathering a little dead scab material from the surface for the biopsy probably wouldn't be very revealing. There has to be an agent at work and it was just missed.

[zirliz]

ive ordered that f10 ointment , when you say strongest stuff do you have an example

[d_virginiana]

Well, I don't know what anti-fungal stuff is safe for snakes, so someone else would have to give you some advice there.
If it's bacterial, then washing it out with a 50/50 solution of hydrogen peroxide and water would probably be the strongest thing I can think of... I wouldn't normally recommend that, because hydrogen peroxide can be pretty rough on the snake, but idk. In this situation I think the priority is keeping whatever this is from spreading any further.

[CrazyHedgehog]

be careful with peroxide, it is sold in much stronger concentrate in the uk!!:eek:

[mike_panic]

If I can offer my two cents. Before taking the animal to the vet again, try Terramycin. I use it on my boas for eye infections. It worked so well that I started using it for any infection and the medication has been terrific. You can find it at most tortoise supply websites. I think tortoise supply.com is one of the ones who carries it. It's good stuff. Best of luck. Mike Panichi

[guidofatherof5]

Please keep us posted on this situation.