Common surgical procedures in reptiles (Proceedings)

Look at the Whole Patient

Full history including diet and environment and recent changes

-When a pet is sick clients will often do some research and find that diet and environment is incorrect. Many times they make those changes just prior to their visit and report to you only the recent diet and environment. It is up to you and your staff to find out what the real situation is that the patient has been in prior to the visit.

Watch the Patient During Amanesia

-While gathering the history sit and watch the patient's affect without the client or your staff interacting with the patient - how it stands, how it interacts with its environment, the expression on its face, whether the eyes appear to be bright and alert, the posture of its body, how it acts when it ambulates. A healthy patient will calm during this time and begin to interact and explore the new environment with time.

Full Physical Exam Looking at the Affected Part Last

-We often get so involved with the presenting complaint that we miss other problems that are less obvious and possibly more serious. Examine the whole patient and do not let the client distract you from examining the whole patient.

Watch how the patient recovers after the exam

-A healthy patient recovers quickly from the stress of restraint and handling and resumes normal activity and curiosity about its environment.

Perform Diagnostics

Radiographs

Bloodwork

Culture and Sensitivity

Ultrasound

Fine Needle Aspirates

Cytology

Know What is Normal for that Species

- Mucus membrane color

- Physiologic erythemia vs. hemorrhage

- Syringe feeding incorrect diets

- Mistaking the sex

- Anatomical structures

General Considerations for Surgery in Reptiles

Provide fluids

Keep the patient warm

Provide analgesia

Monitor – minimally HR, Sp02, mm color

Anesthesia in Reptiles

-During endotracheal intubation in lizards, place pressure in dewlap area to elevate the trachea

- IPPV should be gentle

- Check ET tube for mucus plugs

- Support ET tube well

- Never place reptiles on pure oxygen for recovery – use room air w/ambubag instead

Surgery in Reptiles Incision

- laser vs. surgical blade

- between scales if possible

- everting suture pattern

Ligation of Vessels/Bloodloss

- suture

- hemoclips

Common Surgeries in Reptiles:

- Tail and limb amputation

- Foreign body removal

- Cystotomy

- Reproductive surgeries

- Abscess repair – caseous purulent material requires surgical removal

- Shell or laceration repair

- Esophagostomy tube

Tail amputation is done manually at natural breaking planes – between vertebrae and do not suture

Limb/Digit amputation

Reproductive Surgeries in Reptiles

Salpingectomy

-preovulatory stasis

-egg binding

Salpingotomy

Castration

Hemipene Amputation

Esophagostomy Tube Placement

-anesthesia and analgesia

-similar to mammal

-tape over dorsum

Bite Wounds/Lacerations

- appropriate diagnostics

- anesthesia and analgesia

- antibiotics

- prognosis

Mistakes with Reptiles

Not giving the patient the benefit of the doubt when prognosis is poor

Assuming the client will not do all they can

Not recognizing abnormal behavior

Surgery on the obvious w/o a full exam and diagnostics

Shotgun treatment without diagnostics