Python mouth

Re: Python mouth

Rob Davis — Fri, 14 Feb 2014 18:21:58 GMT

Much to my surprise, after 5 days of marbocyl injections it appears to have resovled! Will let you know if any further problems...

Re: Python mouth

Rob Davis — Fri, 07 Feb 2014 15:33:41 GMT

Predictably the owner doesn't want to spend any money. I have suggested referral, or failing that booking in here for me to examine under GA, but he has opted to try antibiotics alone, despite me advising that I don't think this will resolve the problem. I will let you know how things go.

Re: Python mouth

Marie Kubiak — Tue, 04 Feb 2014 17:31:45 GMT

You can try but to be honest to get intraoral views you'll need to anaesthetise it and have very good imaging and eyesight! If anaesthetised then exploration is just as likely to give you an answer and may solve the problem.

If anything like the majority of my royal owners they'll want you to fix it now for no money and full diagnostics won't be an option. Good luck!

Re: Python mouth

Rob Davis — Tue, 04 Feb 2014 16:59:51 GMT

Many thanks again, Marie. I will have a chat with the owner and see what he wants to do. Is there any reason not to try contrast radiography to identify the source of the lesion?

Re: Python mouth

Marie Kubiak — Tue, 04 Feb 2014 14:01:08 GMT

If the owner is willing for GA and proper examination this would definitely be the best approach, and gives you the option to remove it safely and hopefully completely.

If not then conscious aspiration of it for cytology and culture is possible and would help narrow causes down further as well as reducing the size of the lesion.

Antibiotics may assist if a primary infectious cause is obstructing a duct but won't help everything else. If opting for Ab cover then I wouldn't use baytril as first line as the oral form is slowly and erratically absorbed from the reptile GIT and injectable solutions can cause skin/muscle necrosis. Marbofloxacin is an alternative (10mg/kg sid by sc/im injection), or cetazidime (Fortum, 20mg/kg q72hrs) and both cover the common gram-negative flora that often are involved in oral infections though Pseudomonads aren't uncommon and can have multiple resistance.

Marie

Re: Python mouth

Rob Davis — Tue, 04 Feb 2014 11:11:20 GMT

Thanks, Marie. It appears to be enclosed in tissue, so I was a little nervous of trying too hard to remove it. Mucocoele or nasolacrimal duct cyst both sound like possibilities, though I confess by knowledge of snake anatomy is minimal.... Presumably I should anaesthetise it and get a better look. If I create a fistula then I could get a sample for C&S at the same time, however I suspect the owner doesn't want to spend any money! Would it be wrong to start it on baytril if they won't go for more thorough work up?

Would radiography be useful, and if so is it worth trying to inject some contrast to identify the source?

Re: Python mouth

Marie Kubiak — Mon, 03 Feb 2014 18:16:15 GMT

Can you remove it? Often these are just a build up of mucus in the choana that can lodge tightly but is usually able to be manipulated and displaced with microtip swabs. If actually enclosed in tissue then consider a mucocoele or nasolacrimal duct cyst. If cystic then trying to trace source and creating a fistula surgically can stop them building up but often an underlying inflammatory focus is responsible for impeding drainage so fluid cytology and culture is very useful. All oral neoplasms I have seen have been firm tissue plaques so I wouldn't expect neoplastic cause from the appearance

Marie