Once again contemplating the toughest question...

[Ryachanira]

Recently I have found myself once again contemplating the hardest question of all for a pet owner with a sick animal... am I doing the right thing for him? The last several times I have fed Silv, he has vomited up a decent portion of his food. The last time I went to his second vet (we did see vet #3 after that, haha), she told me that an indication that maybe he would be better off put to sleep is if he started vomiting up his food - which he now has. I also find I am having a hard time keeping down the infections in his eye socket (the side where the eye has degraded), and his lips are often inflamed. I do not know how to assess pain well in a snake - sure, he doesn't really like it if I poke on his face repeatedly, but... he never liked that, heh. It would seem to me if his mouth and eye are constantly infected that would be painful? I don't know... I love the little guy, he is such a sweetie, and I am totally willing to continue tube feeding and treating him as long as he is alive. But it is the right thing for him? Or am I just prolonging a painful and unhappy existence for him for my own sense of well-being? I don't know all that much about snake behavior, is there anything you guys can tell me about how to assess quality of life of a snake? Even a brain-damaged one. :)

Any thoughts appreciated.

[guidofatherof5]

You are in the worst situation when it comes to caring for any animal let alone this tough little one that has wrapped himself around your heart.
I think you have done a remarkable job with Silv.
You also show great insight into your own feelings and your relationship with Silv.
I too am in this situation with my Boomerang.
I support any decision you make.

[EasternGirl]

This is so tough. I honestly don't know how to assess pain in a snake. I do think that if he is vomiting up his food, he must be uncomfortable. I can tell you this...my yellow lab Kaela..was a very sick dog toward the end of her life. I had her put to sleep last January. She was sick for a while, but I could not bring myself to put her to sleep...partly because I did not want to be without her, but partly because I wasn't sure if it was the right thing to do...if she was sick enough at that point to do it. But I did know that she was not going to get better...only worse. I waited...and she ended up suffering terribly because I did. I now wish I had put her to sleep before she had to go through the horrible last couple of days that she had to go through before she died. If Silv is not going to get better...if it is only going to get worse for him, you may want to consider putting him to sleep before he has to suffer more. I know it is so hard...it is a terrible decision to have to make...my thoughts are with you in this difficult time.

[Stefan-A]

I know what I would do and how I'd rationalize it, but my method isn't for everyone.

What's the prognosis? Will the snake pull through if you keep doing what you're doing? I mean realistically, forget about miracles, hope or luck. If it's just postponing death by a few days or weeks, I would euthanize it. If it is supposed to just be a phase in its recovery, I'd continue the treatment.

[Ryachanira]

Thanks for the comments. So sorry to hear about your situation with Boom, Steve, as well as your pup Marnie. I have been lucky - the only time I ever had to put an animal down was when I was 12, and it was my Mom's decision to make, not mine. It is such a difficult decision.

Stefan, Silv's condition has thus far seemed relatively stable. He has not eaten since I took him in back in October 2010, not for a lack of trying on my part. I have been tube feeding him for over a year. The eye and mouth problems started in May (I believe), and have kind of come and gone. It is only recently that I haven't seemed to be able to control the infection and just the last week or two that he has been regurgitating a large portion of his Carnivore Care mix. So... I guess it is kind of hard to say what is realistic. It is possible he is experiencing a downturn that will continue to spiral until we lose him... if I knew that I would definitely put him down so as to keep him from as much pain as possible, like Marnie said. However, what is more difficult is that it is also a realistic possibility that he could live a long time, being tube fed and having persistent infection issues. That is the more difficult case, as I have to make a quality of life assessment for him and I have no way to know how he feels about it...

I just read on another post about the suggestion of something called Hibiclean diluted in water for a similar inflammation problem around his mouth... perhaps I will give that a go for now, continue with his eye drops and tube feeding for awhile, and see if I notice any sort of improvement at all. Or at least see if he can maybe keep all of his food down. He still moves around like he always has, so he hasn't shown any obvious signs of increased discomfort that I am aware of... it is the masked discomfort I worry about.

I am concerned that perhaps tube feeding twice a week has somehow damaged his mouth, possibly obstructing the channels draining from eye to mouth, causing the eye infection and mouth inflammation, and that perhaps this is a consequence of long-term tube feeding. Has anyone else ever had a snake on such a long-term tube feeding regimen - or am I the only one crazy enough to do that? That is my leading hypothesis on his infections, since they didn't start until over 6 months after the original head trauma.

I guess in short: I will give him everything I've got for a few weeks and hope he improves. If not... it might be time to consider letting him go. :(

[chris-uk]

I think try to control the infection and determine whether he is deteriorating - is this a short acute episode or the start of a long-term deterioration. It's tough to know if a snake is in pain, at least with a cat/dog/etc they have ways to indicate their pain. If you can get the infection and inflamation controlled you have returned to the same situation you were in a month or so back. Regurgitating the food isn't a good sign.

Personally I'd start preparing myself to make a decision - that you consider it do be a difficult decision is a credit to you.

If there's any change over the next week or so and you need advice you know where we are.

[EasternGirl]

I think that what you are proposing makes sense. If there is the possibility that he will get better then I would wait a little bit and see if that may be the case. I would run your theory about the cause of the eye infection and mouth inflammation by the vet. Definitely try the hibiclens too. If he continues to vomit up his food...I would consider euthanizing him because that has to be uncomfortable for him. As far as assessing other possible pain...I would just look for signs of discomfort...flailing, twitching, cringing when touched...I'm just guessing here of course...perhaps that may be a question for the vet as well. If he is still moving around as usual and isn't showing any signs of increased discomfort that you can see...that is a good sign I would think. I will look in a book I have here and see if I can find anything about observing signs of pain in a snake...if I find anything, I will be sure to post it.

[Ryachanira]

I bought some Hibiclens at CVS on the way home; I will apply it after dinner. I just messed with him to take some pics so I am gonna let him chill a bit over dinner and then feed him and clean him up afterward.

Here are a few pics for anyone interested. He shed while I was at work today and looks a bit better.

3849 Yucky eye and opened mouth. His mouth looks clear to me - nothing that looks like the pictures of mouth rot I have seen. There is no eyeball in that socket. It is sunken in (has been like that for a couple of months) but it has that gross pus-like stuff in the bottom of it.
3850More of the eye
3851This shows the lip inflammation I mentioned. It looked worse this morning - looks a bit better since he shed today
3852
He is a pretty boy. :) He is looking kind of thin, but I haven't fed him for several days since his eyes turned cloudy (since I read they normally don't eat during shed time, I try to mimic that). He is always a bit on the skinny side though. I hope I feed him enough... it is kind of difficult to tell how much is enough with the tube feeding, especially when he has been sending it back up the last couple of weeks. :\

I'll keep you guys updated on how the Hibiclens works out for him

[guidofatherof5]

Nice to see Silv.

[EasternGirl]

He is a pretty boy...poor little fellow. He doesn't look much skinnier than my Seeley, who has been having problems eating for the last several months. I'm taking him to the vet this weekend. I wanted to recommend a book to you..."What's Wrong With My Snake?"...another member recommended it to me...I got it on Amazon for around $10.95. It has been very helpful...it discusses all kinds of ailments in a variety of species. I couldn't find anything on pain in the book...but there was a whole section on vomiting and various causes that you may find helpful. I think since you are dealing with a sickly snake...the book would be very handy for you. I think the hibiclens may help with the mouth inflammation...Seeley had a similar looking area on one side of his mouth last year...I just put a couple of drops of hibiclens in a cup of water (it has to be diluted) and dipped a cotton swab in it and dabbed in on his mouth a couple of times a day and it cleared up within a week. I think it is wonderful how you are caring for Silv...taking the time to do all you do for him and showing so much love...it makes me very warm inside to see someone doing that for a garter with special needs like Silv. He's lucky to have you. :)

[aSnakeLovinBabe]

I know what I would do and how I'd rationalize it, but my method isn't for everyone.

What's the prognosis? Will the snake pull through if you keep doing what you're doing? I mean realistically, forget about miracles, hope or luck. If it's just postponing death by a few days or weeks, I would euthanize it. If it is supposed to just be a phase in its recovery, I'd continue the treatment.

Agreed....

I know what I would do as well... good luck :(

[tress29]

If he continues to vomit up his food...I would consider euthanizing him because that has to be uncomfortable for him. On a cornsnake forum I'm on, a gal had a corn that was regurgitating his food. She put a powder om his food, Benebac? It is supposed to help them replace beneficial bacteria they lose when they regurge. She didn't consider him "over it" until he had been eating w/o regurge for a year. Hopefully Silv,s problem won't be so severe.

[infernalis]

May I ask what the vets have done? any oral antibiotics?? Baytril?? metecam for pain??

I'm sorry but most vets are dog doctors who are clueless with herps.

[Ryachanira]

Silv has been to three different vets in his life with us... the first one claimed to be a small animal vet that saw herps but she obviously had just read the wiki or something on it, haha... we only went to her the day after we decided to keep him just as a check up on his head wounds and such...

Second vet was listed on a herp vet website. She knew a bit more but in retrospect was also fairly clueless in my opinion. She is the one that had us start tube feeding him. I also blame her for him losing his eyeball (even if he was blind in it anyway) - I took him to her when he had this horribly pus-filled swollen eye and she said she didn't think it was an infection and couldn't do anything for it. Grumble. Oh well... she is also the one who told me to think about putting him down.

Third vet also found on a herp vet list... seemed to have more knowledge. I was actually hoping to see another vet in their practice that day but he was on vacation that week and Silv needed to go in. They are the ones that cut his eyecap to drain the swelling and put him on antibiotic eye drops. I think they also gave him something but only as a one-time deal at the vet. No oral antibiotics (that I have given him) or baytril. I don't remember what the drops are; I will look when I get home.

He didn't vomit up his food this morning! Maybe that is a good sign. :)

[EasternGirl]

That sounds like a good sign. Maybe you might want to try getting him in with that vet that you wanted to see who was on vacation...ask him/her about the pain, vomiting, infections...the things we've been discussing on here. Tell the vet that you want to avoid euthanizing if you can...that you want to know how to make him as comfortable as possible...basically just discuss all the concerns you have. Might be worth a try?

[Ryachanira]

He kept his food down again, yay! After two weeks of regurgitating at least some food each feeding, this is two in a row that he has kept it all down both times. Lips still inflamed and eye is still nasty looking... but we will see how things progress. :)

[guidofatherof5]

Glad the feeding went well.

[EasternGirl]

So glad he's keeping the food down! Keep us posted.