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.