Jaw damage - Need advice. Dial up warning

[Wrasse]

As a followup to this thread: A Sad Hungry Little Boy http://redtailboa.net/index.php?name...953&highlight=

I took the opportunity during yesterdays feeding, to take some photos. As Skinny (mcdowelli) cannot open his mouth, during feeding is the only time I get to check the jaw and with pics is the only way I can examine what I see.

I don’t like what I see.

There appears to be some activity going on. Visible in the front of the jaw there is a large open wound. Note the tooth lying along the jaw.

In this pic:

(taken end July) you can see a small amount of redness and open gum. I had expected that to heal with food, care and warmth. But now, in the new pics, this area has clearly grown larger and is looking much worse.

Note also, the redness in the belly scales.

He is coming due for a shed and although he has been soaking pretty much non-stop, I have seen no blue. I expected the shed a couple of weeks back, due to the skin flake and peel around his neck. (The bruising under the jaw is leftover from the vet check, when she was trying to pull his mouth open – not impressed.)

My vet is not available for another 4 days and to be honest, I don’t think she is really that experienced with reptiles. I don’t mind seeing her for simple things, but I think this situation may be going past simple and her reptile experience.

I would really like some experienced advice on this, what to do until I can see her, any thoughts on what is going on?

I graduated him to large rats a while back, in the hope it would help exercise his jaw, but I will go back to multiple juveniles. Perhaps the extra stretch is causing the problem. (Note the pics and the amount of skin ‘pull’ in the area while eating).

Is there a topical cream I can use inside his mouth on this area, I should be able to peel the lips back and give a liberal squirt to the area.

Help …..








Original pics (large filesizes) available here for enlargement: http://www.wrasse.net/photos/album.php?id=26

Other Skinny pics available here: http://www.wrasse.net/photos/album.php?id=24

[JuliusSqueezer]

Looks like and abcess. You will need to swab it with novasal or a 1:1 diluted antiseptic (mouthwash)...Novasal is a far better choice though and far less likely to cause further tissue damage...and scrape away any scab or loose tissue. Keep the wound open and clean while treating. Swab it twice a day. If you can get ahold of some baytril you can squirt about 1/10 to 2/10 cc directly into the wound once a day for 4-5 doses and it will clear up in no time. The pink belly scales (ulcerative dermatitis)...aka (scale rot) is likely a secondary infection that occured because of the abcess infection. This is not uncommon. If left untreated, it's a crap shoot whether he can heal up on his own but not unheard of. However with treatment his chances are better than good. Good Luck.

[JuliusSqueezer]

BTW...If you can get ahold of the meds you need and start treatment right away, It should be healed up within a couple of weeks. I would hold off feeding until then so as to not be introducing more bacteria into the wound from rats.

[Wrasse]

OK, picked up some Baytril Otic today. Had to do a full vet run as the Baytril is not available over the counter.

Vet visit was funny as....

Vet: (Standing in the corner) I know nothing about snakes
Me: It's ok, he is harmless, can't open his mouth, can't bite
Vet: (Still in the corner) What am I supposed to give him or do for him?
Me: Well, these people in America tell me I need this stuff, Baytril Otic
Vet: (Sliding backwards out the door) Here you go, Good Luck.
At about this point, the vet disappeared and I was left holding a bottle of Baytril Otic.

hehe

So, he has had his first topical Baytril already, applied as soon as I got home. He is such a good boy. I will swab twice a day with Novasol (here I believe it is called Chlorhexidine) and follow that up each time with a dose of Baytril locally about an hour later.

The scale redness seems to have dissipated somewhat, so will keep an eye on that and apply Lotramin if it doesn't continue to dissipate and disappear.

Thanks Julius and thanks to Pond and BW in chat.

[JuliusSqueezer]

I LOVE non-herp vets. I always get anything I need gladly handed over from them if I'll just leave...sometimes even for free lol

[Wrasse]

Well...

Skinny is now a permanent fixture here. My usual vet went on maternity leave and the x-rays fell to her surgery partner. (Who incidently, knows not a lot about snakes.) However, he went out of his way to find out for Skinny and through the use of digital photos, sent to him and to the Herp Specialist, phone consultation (3 way) and a two hour home visit to examine Skinny, watch him eat and examine him after, we have a verdict.

Skinny's jaw is intact. The bones can be palpitated individually, so there was no reason for a 'lockup'. The mouth can be forced open too, so there is no calcification.

Skinny is suffering from a scar tissue problem. After the 'accident' (who knows what it was but my bet is a shovel was involved) the healing process created a lot of scar tissue and muscle atrophy. The two combined means he just can't open his mouth, the muscles are not strong enough to force the scar tissue.

He could be operated on to remove the scar tissue, but that would simply mean that his chances of new scar tissue forming there are pretty high and why stress him and risk him on the operating table for nothing.

The swelling around his tooth as seen in the photo above is due to the time he takes trying to get dinner down. Apparently it is the saliva gland working overtime there due to the stress and tension that part of the jaw is in.

The outcome: Skinny will not be able to be released. He will remain in care indefinately and his jaw movement will be monitored. Likely he will not ever get full, or even partial use back, but best case scenario is that the constant feeding exercise may stretch the scar tissue and bring back a semblance of normality. He will still not be able to be released however, as a bout of bad hunting could cause it to stiffen again and hence, bring about the condition that brought him to me in the first place. Starvation.

[Jeff]

Its too bad you live on the opposite side of the world, i could sent you a few ounces of Baytril 100.

[Ghroller]

lol too funny with the vet. Most of the non-herp places around here won't even let you set foot in the building with a snake!

Glad to hear he's got a good home! If he can be set free atleast he'll be treated like a king..... with a sore jaw..

[JuliusSqueezer]

I'm not buying it 100%. There could be something to all that but that abcess is too fresh. If it was just scar tissue causing the problem, the teeth wouldn't be so bloody red and the gums wouldn't be that puffy. Besides, it still won't hurt to keep swabbing with novasal or 1:1 antiseptic just in the off chance that I'm right. One of the biggest mistakes a lot of people make (Vet's included) is that they think there is one answer to any problem and often overlook that there can be multiple issues at the same time.