https://www.vetsurgeon.org/f/clinical-questions/28007/mucolytics-in-snake-with-nidovirus Hey guys, I&#39;ve got a black-headed python I&#39;m treating as a second opinion chronic respiratory case. My viral screens have come back positive for nidovirus. Lung wash revealed moderate mucopurulent inflammation but no infectious agents (has been onen-USTelligent Community 10https://www.vetsurgeon.org/thread/208794?ContentTypeID=1Thu, 07 Mar 2019 12:49:43 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:f519b9ec-47f1-411b-ac06-be005b7b6ba9Marie Kubiak<p>There is one report of nebulisation for 30mins twice daily using 300mg acetylcysteine to 100ml sterile water (in two royal pythons) with respiratory disease alongside other medical and surgical treatments, one died, one recovered but with no assessment of the effects of this treatment specifically. I am dubious of efficacy of mucolytics in reptiles as there is no mechanism there to clear the secretions even if they are slightly less tacky given the lack of diaphragm, no convincing evidence of a functional mucociliary escalator and a simple chambered lung. Nebulisation of fluids (alongside the coupage and draining) is just as likely to help but there would be no harm in using acetyl cysteine or hyaluronidase.</p> <p>As far as I understand, Acyclovir disrupts DNA polymerases, but as nidoviruses are RNA viruses, I wouldn&#39;t have thought it effective. Ribavirin may be an option but has some pretty nasty potential side effects, I have no idea if it is available and there is no dosing regimen other than in humans. Happy to be corrected by someone wiser than me though on antiviral choice! I haven&#39;t had any benefit using mammalian interferon in avian cases as there seems to be no cross-taxa efficacy and I would assume reptiles would have the same problems as they are closer to birds than mammals.</p> <p>Nidoviruses are a problem as we can now detect them and everyone has started looking for them in respiratory cases, but we do not know relevance in disease processes. They have been shown to induce respiratory disease in experimentally infected royal pythons (n=3) but that doesn&#39;t necessarily mean that presence = cause, especially as species susceptibility appears variable. If there is residual pneumonitis, it would be useful to carry out pulmonoscopy to visualise the lung and then allow you to collect targeted samples for histo/culture/viral PCR from the clinically affected section and see if there is anything there that can be managed further, or confirm the current diagnosis. You could also place a port to allow medication to be instilled directly, or allow ongoing drainage if there is a significant quantity of secretions but that is not necessarily easy to manage in a clinically well animal.</p> <p>Marie</p><div style="clear:both;"></div>