Iguanas and Veterinarians PART 1 (Also GREAT info for any reptile owner)

[NicoleRussell]

You, Your Iguana, and Your Reptile Veterinarian

PART 1



To be perfectly blunt, do not get an iguana, or any other reptile, if there is no veterinarian trained in reptile medicine, within comfortable driving distance for you. If you do not have immediate access to your own transportation--not public transportation, not friends who drive you when they can fit it into their schedule--do not get an iguana or other reptile. All new iguanas, whether they are hatchlings you bought from a store or expo, or someone else's pet you've taken in, should be seen by a reptile veterinarian. It can take a long time for iguana owners to recognize signs of illness and disease in their lizards. Iguanas, even long-term captives, are still wild animals and will hide, as long as possible, any signs of weakness. Don't bet on your new iguana's life by skipping the veterinarian visit. An initial visit that includes fecal tests and treatment for worms and dehydration should be included as part of the total cost of your iguana. If you can't afford the veterinarian, you can't afford the iguana.

Not All Veterinarians Are Reptile Veterinarians

Human doctors deal with one mammalian species: humans. They deal with essentially four types of humans: males (child, adult) and female (child, adult), but it is still only one species. That's it. They spend years in medical school and doing their residency, go into over $100,000 worth of debt, and what do they get when they get are done: the knowledge to work on one mammalian species.

Veterinarians go through much the same time and training, but instead of one species, they come out being able to treat several mammalian species, from rabbits to racehorses, guinea pigs to goats. The vet schools' curriculum concentrates on farm (work and food) animals, and the most companion animals (dogs, cats, rabbits). They spend relatively little time (it varies, depending on the school, from 1-6 weeks) on "exotics": birds, exotic and local wild mammals legally kept as pets; reptiles and amphibians; fish; arachnids; and more. Needless to say, there isn't enough time in a 1-6 week unit to learn everything about the hundreds, if not thousands, of these species kept as pets or pack animals. If veterinarian students and graduates want to learn more about certain types of animals, there are various avenues open to them.

The problem reptile owners have is how to find a veterinarian who is trained and experienced in reptile medicine. As too many iguana owners have found the hard way, "reptiles" in his signage or phone book listing is no guarantee that the veterinarian actually is trained and experienced. By the same token, many veterinarians who are great with reptiles make no mention of it in their signage or listings. To find a reptile veterinarian, please check with the Association of Reptilian and Amphibian Veterinarians (ARAV).

Why Iguanas Need Good Veterinarians

Pet trade iguanas are always highly stressed, usually dehydrated, have high levels of internal parasites, and sometimes external parasites (reptile mites or ticks). Since they haven't been fed properly, or maintained at proper temperatures, they are also malnourished. When you bring them home, their stress levels increase for several weeks until they start getting used to you and their new home. Getting them treated for dehydration, parasites and any infections will help enable them to better deal with all the new things in their life.

Most people who give away iguanas do so because they haven't, for some time, cared for the iguana properly and don't want or have the time or money to do so. These iguanas suffer from all the same things that the pet store iguanas do, often with the addition of abscesses, injuries, and metabolic bone disease.

Remember
The majority of the reptiles and amphibians sold in the pet trade are wild caught. As more people are getting involved in breeding and reselling imported herps--and not always particularly careful to properly quarantining all newcomers--animals sold by breeders and private parties may be suffering from the effects of stress and transport, as well as communicable and other zoonotic diseases. Farmed iguanas are no exception, given both the filthy, diseased conditions at most farms followed by the inhumane way they are transshipped around the world.

When you get a pet, you are taking on the responsibility for caring completely for an animal who, unlike most human children, will never grow up and become self sufficient. Just as you would take a sick child to the pediatrician or emergency room when the situation demands, so must you take your reptile to the reptile veterinarian. You will also have to find an after-hours veterinary clinic/veterinary emergency clinic that can appropriately treat and stabilize reptiles who are suffering from a traumatic injury or illness until you can see your own veterinarian the next business day.

The Initial Physical Examination

The first thing your veterinarian will do will be to check your iguana out from head to tail-tip. The iguana's nutritional status and hydration will also be checked to see if he is dehydrated or too thin. The inside of his mouth, his eyes, the folds of skin along his neck, each of the limbs and toes and the abdominal cavity...all will be felt carefully to check for lumps, bumps, cuts and breaks. The lumps and bumps found could be related to infections or calcium deficiencies. Be prepared to answer questions about diet, environment, and any possible injuries.

While we're on the subject of questions, be prepared to answer a lot of them. Your veterinarian will want to know where and when you got the iguana, how old he (or she) is purported to be, what you are feeding him (be specific!), how you are housing him, what you are using for heating and lighting, the temperatures and photoperiods. You should also be prepared to describe the iguana's general behavior and any physical problems you have noted:

loose or discolored feces (possible protozoan or parasite infection)
favoring or dragging a limb (a possible break, abscess or joint inflammation)
clicking sounds when breathing or excessive saliva (signs of a respiratory infection)
jerky gait when moving or tremors when at rest (possible calcium or thiamin
deficiency)
abnormal changes in color (stress, illness)
Iguanas should be alert and move with smooth motions, whether they are speeding across the room or checking out a new object. If your iguana spends most of its time sleeping and is relatively non-responsive, then tell the veterinarian this, too; lethargy is a symptom of several disorders.

Basic Tests
The first test to be done is a fecal flotation. This test is used to examine the feces for the presence of worm ova. Worms live out their adult life cycle inside the host animal, releasing their eggs to be deposited wherever the animal defecates. Other animals coming into contact with the feces may eat or tongue-flick the feces, thus ingesting the eggs (referred to as oral-fecal transmission), thus giving the ova a nice place to hatch and set up housekeeping.

The flotation requires a fresh sample of feces--the brown fecal mass, not the clear viscous or white urates. (For more information on this, please read the article, Feces and Urates: The Scoop on the Poop). The veterinarian or veterinary technician mixes the feces in a special solution in the testing container. A microscope slide is placed on top to trap any ova which, being lighter than the solution, will float to the top. The veterinarian or veterinary technician will then look at the slide under a microscope to determine if and what kind of ova there are so that the proper medication can be administered.

Protozoans are another type of organism that can cause illness when present in too high a number. They require a different type of test--and medication--than do the intestinal worms. If your iguana's poop is very smelly and/or reddish and runny, he may have a protozoan infection. Protozoans are not necessarily related to worm problems. Since the feces cannot (hopefully) be smelled through the container that you brought the sample in, you will need to tell the veterinarian about the signs and smell, and ask that he run the flotation. If you see the signs of a protozoan infection after your iguana has been treated for worms, bring another fecal sample to the veterinarian and ask that a direct smear be done.

If your iguana has both worms and protozoan that need to be treated, ask the veterinarian which one should be treated first. Since giving the two different medications at one time can seriously sicken an already weakened iguana, or a very young iguana, the best way to treat them is serially, that is, one at a time. The goal is to get a sick iguana feeling better faster so that they can start eating and drinking normally and acclimating to their new environment.

	Mites Mites, close relatives of fleas and ticks

[NicoleRussell]

PART 2

Why Can't I Just Drop Off The Poop?
Veterinarians cannot dispense medication without actually examining the patient. Drug dosages for reptiles are based on actual and metabolic size, and may be different depending on what species of reptile. This means you can't just take a fecal sample from your new iguana to the veterinarian and expect them to run the test and give you medication if your iguana needs it without your bringing in your iguana for an examination.

Don't cancel your veterinarian appointment, however, if you can't get a fecal sample from your iguana on the morning of your first appointment. Go ahead and take your iguana to the veterinarian. When you are talking with the veterinarian, explain that you were not able to get a fresh sample. Ask if you can drop one off, appropriately identified as to the patient's name and species, in the next day or two. When the testing has been done, if the iguana needs to be treated, take the iguana back to the veterinarian with you. If you have never given oral or injectable medication to an iguana before, this is something you want to be taught how to do, not struggle to do it on your own.

Safely Collecting Fecal Samples
The safest and neatest way to collect a fecal sample is to turn a new zip-lock plastic bag inside out over your hand. With your fingers and thumb protected by the plastic, use them to scoop up the brown fecal mass. While holding the feces in your grasp, use your other hand to pull the zip-lock edge of the bag down and over your hands, turning the bag right-side out. Your grasping hand will now be outside the bag and the feces sitting neatly inside. Zip up the bag, and place that bag inside another zip-lock bag. With a marker, write the day's date, the iguana's name, and the species ("green iguana") on the bag.

You can store the fecal sample in a cool place (in the refrigerator is best, as some organisms can die and start breaking down in warm temperatures) for up to four hours before delivering it to the veterinarian. If you absolutely have to, you can store it overnight in the refrigerator. Since excess heat or cold can kill the organisms in the feces, thus defeating your purpose for collecting it to begin with, don't freeze it, or leave it in your car on even a mildly warm day.

Follow Through On Treatment!
All too often, pet owners fail to follow through in giving their pets each of the treatments prescribed by their veterinarian. Just as it is critical for humans to take the full course of prescribed antibiotics, so, too, it is critical that you make sure your iguana gets every dose of medication prescribed to knock down or out the worm or protozoan mediation. The same holds true for any antibiotics and antifungals your veterinarian may prescribe when needed.

Some drugs kill organisms. Other drugs interfere with critical processes, such as the organisms' ability to eat or digest food or their ability to reproduce. The latter types of drugs then kill by causing the organism to starve to death or die a natural death but not leave any offspring. When only part of the prescribed doses are given, only some of the organisms are killed off or otherwise affected. Those most susceptible to the drug will die. Those who aren't killed or immediately affected can live to reproduce--breeding offspring who may be even more resistant to the drug. This is why we are currently facing a crisis in human medicine: we are now faced with organisms that are impervious to any antibiotic we can throw at it. Don't set your iguana or other pets up for the same situation.

There are two common reasons people and pet owners give for not taking or giving all of the doses prescribed doses. The first is along the lines of "Well, I was feeling better, so I didn't need it any more". In pet owners, the refrain is "Well, my pet was acting like he felt better, so I stopped giving him the medicine." The human and pet were both feeling better because the medication had been knocking out the most susceptible organisms. When the patient "relapses" later, it isn't a relapse: all those resistant organisms that survived have been happily reproducing, breeding generations of resistant bugs. Better to take the full dose prescribed the first time rather than make yourself-or your pet--sicker or more difficult to treat later.

The other common reason is that the patient felt or acted significantly sicker after the first several days (or after the first dose for drugs given at wider intervals). Generally speaking, this is a good thing. The patient is sicker because the drug is doing its job: it is killing or otherwise causing the death of the organisms. As the dead organisms lie around decomposing, they release byproducts of decomposition which, when you think about it, is enough to make anyone sick. If the organisms live in the gut, the dead organisms may hang around for a while as they are slowly shoved along the digestive tract by passing ingesta and, later, wastes. This feeling worse before feeling better actually has a name: Herxheimer, or herx, named after the doctor who first described it. It is a commonly experienced reaction in people who are on antibiotic and antifungal treatment, and is often seen in very young animals who are treated with wormers and other drugs.

There is one drug in particular that often causes extremely bad reactions in very small iguanas, and in young iguanas who are already in a weakened state. Ivermectin, sold under the brand name Ivomec, is an injectable wormer. Despite the fact that it has to be given in much higher, near toxic doses than other, less toxic (to the patient) wormers, I don't understand why so many reptile veterinarians still use it. If your veterinarian says your iguana needs worming, ask what medication he plans to administer. If it is this drug, ask that fenbendazole (for pentastomids) or piperazine citrate (pinworms) be administered instead.

Annual Veterinarian Visits

We tend to think of annual veterinarian visits in terms of dogs and cats who need annual vaccinations. There is another reason for an annual visit: sometimes problems arise that set in so slowly that the pet owner doesn't notice them. The veterinarian, who hasn't seen the pet for a year, is able to spot some of those problems and address them before they become a major health problem.
To better enable the veterinarian to spot problems, have a blood test done every year. Having blood work done when the iguana is healthy provides baseline information against which changes can be compared and assessed. Iguanas are a lot like humans: the "norms" for all the different things tested has a range that is considered "normal" for the species. There are veterinary clinical pathology labs that specialize in exotics; labs that do mostly cat and dog pathology may miss things in blood and tissue collected from reptiles. Some of the data on norms for the different things tested are based on data compiled and published by reptile veterinarians; some comes from information published by the labs. So, getting the same tests done annually when your iguana is health will establish what the norms are for your iguana. Your veterinarian will use that, as well as species' norms and data published in other sources, to assess your iguana.

Confounding Variables
There are a couple of tests whose results may indicate a health problem but, in an otherwise healthy iguana with otherwise normal test results, are nothing for you (or your veterinarian) to worry about. One or more of the following can cause these abnormal test results in these iguanas:

the stress of the trip to the veterinarian, or being at their office;
stress due to the restraint and needle sticking required to get a blood sample for
testing;
using too small a needle for the collection or forcing the blood through too small a needle, causing hemolysis (breaking the cell walls).
The white blood cell (WBC) count can be temporarily elevated as a result of the stress of the visit or blood collection. The white blood cells are part of the immune system's infection-fighting force and so are typically elevated when the body is fighting an infection. It can also become very elevated due to certain blood disorders. When a veterinarian sees a moderate elevation, the first thought is of infection.

Stress can also cause the elevation of creatine phosphokinase (CPK). This enzyme is found in the skeletal, smooth, and cardiac muscles. Its elevation in a sick iguana should set alarm bells ringing. In a healthy iguana, however, a slight to moderate elevation, in the absence of any other signs of illness (excepting the mildly elevated WBC) is nothing to be concerned about.

Emergency Veterinary Care
Any condition that would cause you to get a human being to the emergency room as fast as possible should trigger the same response in you those conditions are happening to your iguana. The following conditions might sound like obvious reasons to get the iguana into the veterinarian right away, but based on email, posts and phone calls from people who ask what they should do in these situations, I decided it apparently needed to be stressed for some people. The emergency conditions include but are not necessarily limited to:

[NicoleRussell]

PART 3

Bites from any type of animal
Bleeding that cannot be stopped within a few minutes of the injury
Broken limbs (both when the bones poke through the skin, as well as when there is a
unilateral swelling and favoring of one limb)
Bulging eyes (may be accompanied by drooping lower eye lids)
Deeply sunken eyes
Extreme lethargy (not related to improper temperatures or hypothermia)
Hemipenal or cloacal prolapse
Paralysis, full or partial
Seizures
Swollen neck and/or dewlap
Because emergencies often occur outside of your reptile veterinarian's regular office hours, you should know, long before you ever need one, the name, phone number, and actual location of the emergency veterinary hospitals in your area that can treat reptile patients. Not all such hospitals want to deal with reptiles because the staff and veterinarians don't like them or have
enough experience to even feel comfortable making a tentative diagnosis and stabilizing the animal until the client can get to their regular veterinarian. The time to find out that the emergency hospital closest to you doesn't "do" reptiles is not when your iguana is bleeding nonstop or is lethargic and apparently has stopped breathing.

A Note On Blood and Bleeding
It is estimated that blood accounts for between 5 to 8 percent of a reptile's body weight. Reptiles can generally loose up to 10 percent of their blood volume before going into shock.

Most iguanas, even healthy ones, have some degree of chronic dehydration. This means that a healthy captive iguana has somewhat less blood volume by weight than a similarly sized wild iguana. If you can't get the bleeding stopped within a very short time, get to the veterinarian right away. There is no way to state how much time, as the length of time is going to vary based on the size of the iguana and what his starting blood volume was before the bleeding started.

Non-Emergent Veterinary Care
There are conditions for which you need to get to the veterinarian much sooner than waiting for your iguana's annual appointment, but for which you don't need to go racing out of your house in your pajamas at midnight on Saturday night. You do need to call your veterinarian's office the first day after it is open and make an appointment to get in to see the veterinarian within the next day or so.

Abscesses (dry or oozing lumps anywhere on the body, limbs, digits, tail, head/neck)
Bilateral swelling of lower jaw and/or hind legs
Bumps/Lumps along spine and tail
Constipation (not resolved by correcting temperatures and a bath with massage)
Favoring any limb or body part with no signs of swelling
Females entering breeding season (get that serum calcium checked!)
Oozing or crusty lesions or lumps
Small black patches larger than one scale in size
Smelly feces
Abnormal snappy or irritated behavior
Swollen joints
Tail that is swollen, mush and/or oozing, or drying out and collapsing in on itself
Twitches and tremors, serial, intermittent (not the occasional benign single myoclonic twitch or jerk)
Urates thickened, reddish or orangey (not associated with breeding season)
There is a wide range of microorganisms that can cause a wide range of signs and symptoms. Until you have several years to learn what is normal for iguanas and what is not, take your iguana to your veterinarian. If you post these signs and symptoms on Internet message boards or email lists, the experienced people probably can give you a good idea of what the diagnosis is. They will, however, always add that you need to get your iguana to the veterinarian for a proper diagnosis and treatment. Don't try to treat any of these or other conditions at home, on your own or with information you are unable to adequately assess.

Iguanas, like most other essentially wild animals, hide pain and illness as long as they can. By the time most humans realize something might be wrong, things are usually very wrong. If there is any doubt, any question, any concern, don't wait: investigate!

Important Iguana and Human Health Concerns

As iguanas have been imported in ever increasing numbers, and have been selling ever more cheaply, they are usually much sicker by the time they reach the pet store. Ten years ago, the incidence of mites on an iguana was almost unheard of. Now, mite- and tick-infested iguanas are all too common. Pet store remedies do not work and pesticides must be used with extreme caution. If you do have mites, please read the article on Reptile Mites to find out how to go about treating your iguana and its enclosure, and the pros and cons of some of the commonly recommended products.

Another health problem affects both the iguanas and their humans. Several years ago, there were only scattered reports of Salmonella-infected people who picked up the Salmonella organism from their iguana. Again, due to the increasing numbers and correspondingly poor conditions in which the pet trade maintains these lizards, Salmonella has risen dramatically. Salmonella is of especial concern to pregnant women, newborn babies, infants and toddlers, the elderly, and anyone with a compromised immune system, cancer, and HIV/AIDS. Strict disinfection must be done, and contact with new animals limited to persons not vulnerable to infection until such time as the new iguana has stabilized and is healthy (a healthy reptile can still have Salmonella but may be less likely to excessive numbers of the organism).

Since iguanas (or other pets) who have Salmonella may not shed the organisms every time they defecate, a fecal exam to test for Salmonella may give false negatives. Talk to your veterinarian about doing blood tests for Salmonella detection. If your iguana is otherwise healthy but tests positive for Salmonella, knowledgeable veterinarians and the Centers for Disease Control and Prevention recommend that they not be treated with drugs to try to eradicate or reduce the level of Salmonella. Treating iguanas who are not actually sick from the Salmonella will lead to antibiotic-resistant strains of Salmonella. That will increase the health risk to humans as the same or similar antibiotics are used in humans as are used an iguanas.

(Taken from: http://www.veterinarypartner.com/Con...=4&SourceID=59)

	Mites Mites, close relatives of fleas and ticks

[JuliusSqueezer]

Great post Nicole! This will save us all a LOT of typing. Thanks for posting this.