[Health-General] Cardiac Puncture?

[NoNameXII]

Astrid, my 2013 Pearl Island female, has been acting strangely for the last few weeks; probably three weeks ago, I thought that she was starting to look blue, but then I never found a shed from her, and she has continued to be reclusive (she is normally always halfway out of her hide in the evening and watching what is going on), and I don't see her out of her hide at all. Earlier this week, she wasn't even interested in food, which hasn't happened before (she's usually a relatively aggressive eater, and always at least investigates the mouse).

Because of all of this, and since her sister (Rose) died in late 2013 from a liver problem and had exhibited similar reclusiveness before that (I thought it was just being a nervous new snake then), I made a vet appointment for yesterday morning. They did a physical exam and said that she looked good, and then they wanted to draw blood for some labs to see if they could find anything there. They drew a sample caudally, and said that they got some lymph with it due to how the lymph system runs near the surface (or something like that, I think?). They thought that they could still use it, just keeping in mind that some results, like a low red blood cell count, would have to be taken in context.

Anyway, they called me in the afternoon and said that they were not able to get results with the sample that they drew, and they would have to draw blood via a cardiac puncture in order to obtain accurate results. They said that this is not an uncommon procedure for reptiles, but that it (obviously) carries some risk. Since she had been relatively active and alert while at the vet, we decided to continue to observe her for now rather than perform that procedure; however, after an initial period of running around her cage right after I brought her back, she is behaving as she has been for the last few weeks, and I'm not sure what to do.

Does anyone have experience with drawing blood via a cardiac puncture, and whether it is a worthwhile risk for a snake that has been acting strangely, but hasn't presented any obvious or specific symptoms?

[Noelle7206]

Re: Cardiac Puncture?

Gosh, I'd sure be nervous about that! But I have no experience with that procedure so hopefully others can chime in here. Is the snake fully-awake when they draw blood this way? Because I would think that a struggling
snake would really add to the risk (of the needle being in the wrong place) as well.

Have they also checked her stool? A few weeks isn't really that long of a time...and some snakes do go off-feed, especially if they're over-fed. What is her weight like?
How long was Rose sick before she passed away? and what was the problem with her liver?

[paulh]

Re: Cardiac Puncture?

For what it's worth, I have done cardiac punctures and drawn blood from rabbits, mice, and a couple of bullsnakes (Pituophis catenifer sayi). As I recall, most of them (including the snakes) survived the procedure without problems. The snakes really disliked it, though. It is not 100% safe.

Before doing a cardiac puncture, I would review my husbandry procedures, particularly any chemicals in the environment. That would include mite killers, cage disinfectants, and anything else used in the same room as the cage. And any chemical used to kill food items. Because if Astrid has liver damage like Rose, it could be from a poison. Ly-Sol, for example, will kill snakes in six months or so when regularly used as a cage cleaner.

I am not a veterinarian and may be totally off base. In any case, I wish you the best of luck.

[NoNameXII]

Re: Cardiac Puncture?

Have they also checked her stool? A few weeks isn't really that long of a time...and some snakes do go off-feed, especially if they're over-fed. What is her weight like?
How long was Rose sick before she passed away? and what was the problem with her liver?

She has not passed any stool since I started noticing her acting differently, so that hasn't been checked... The vet said that she did not appear to be over- or under-fed, and in general, you can tell that she has a backbone, but it's not sticking out or sunken in or anything. I feed her once every two to three weeks with one adult mouse that is slightly over her maximum girth. She's always been interested and stalking at the front of the cage before she can even see the mouse, which is why this seemed abnormal (if she had a history of not being interested and/or skipping meals, it probably wouldn't worry me very much...).

It was kind of hard to tell with Rose, since it was only a few months after she arrived, and she didn't have a very established pattern of normal behavior. It's just that looking back, she was always completely in her hide and wasn't interested in food for probably about a month before she died. The necropsy came back as acute necrotic hepatitis, most likely due to some kind of indeterminate adenovirus. I never got the actual paperwork from the vet (a different one), but I'm trying to see if they still have it on file.

Before doing a cardiac puncture, I would review my husbandry procedures, particularly any chemicals in the environment. That would include mite killers, cage disinfectants, and anything else used in the same room as the cage. And any chemical used to kill food items. Because if Astrid has liver damage like Rose, it could be from a poison. Ly-Sol, for example, will kill snakes in six months or so when regularly used as a cage cleaner.

I haven't used any mite killers or anything like that... I use F-10SC 250:1 to clean their cages, and I wipe the cages down with a wet (water only) cloth twice before putting the snake and their hides, water, etc. back in. Astrid is kept on shredded aspen, with one hide on the warm side and one on the cool side, ambient is nominally 78 degrees (it varies slightly with room temperature), and the basking spot is nominally 88 degrees. She is almost always on the cool side. The target humidity is 60%, and it stays close to that in the summer. In the winter, however, it varies throughout the day between ~40% and ~80% because I lightly spray the cages once a day with water. The water is changed each day (ok, if I'm being 100% honest, if i'm super tired in the evening, sometimes it's changed the next morning...). I don't think that there have been any other chemicals present... We did have to have the carpet replaced due to some water damage, but the water was never near the snake rooms, and I think that her change in behavior began before the carpet was changed. Can you think of anything else that I may have overlooked?

[Noelle7206]

Re: Cardiac Puncture?

So many possibilities...but I'd still hold off for a while on the cardiac puncture for blood work. I'm pretty sure they can get a fecal swab without an actual stool sample, you might ask the vet. They can on dogs, but dogs
'go' daily (?) & I've always been able to provide 'samples'. If that were me, the original blood diagnosis for her sibling would be my first priority. This could be something genetic, or something both were exposed to? But
I still think it's premature to jump to that conclusion.

FYI: new carpet off-gasses plenty of chemicals (as do new cars) but while I'd avoid exposure (for me & pets) as much as possible, I don't think you'd have a reaction in your snake for a much longer time, assuming no fresh
air in the room.

Since her weight seems normal, she can go a long while without a health issue (as can most snakes) so I wouldn't be overly concerned now, though I can understand how it would make you nervous after the loss of her sibling.
Sometimes snakes just aren't hungry...they aren't burning up calories sitting in a cage as they would in the wild, & their meals in the wild are never on a schedule the way many of us provide. They are "designed" to fast.

[malcularius]

Re: Cardiac Puncture?

As a veterinary technician who had some formal training in blood draws in snakes. It is the most common place to draw blood. Most of the time it is done without sedation. From what I remember it was tolerated by the snakes we were trained on. But I wouldn't say they liked it. Who does if you really think about it. I think the IC sticks wig people out more than it harms the snake and if you need a good diagnostic sample it is the best spot to draw from

[NoNameXII]

Re: Cardiac Puncture?

As a veterinary technician who had some formal training in blood draws in snakes. It is the most common place to draw blood. Most of the time it is done without sedation. From what I remember it was tolerated by the snakes we were trained on. But I wouldn't say they liked it. Who does if you really think about it. I think the IC sticks wig people out more than it harms the snake and if you need a good diagnostic sample it is the best spot to draw from

Do you remember if there were ever any complications from this? The vet indicated that while there was some risk, it wasn't as serious as it sounds (pretty much what you said)... In any case, I'm still watching her, and while I did see her peeking out a few times today, she still wasn't acting normal. I wouldn't be able to take her in for a non-emergency for at least a few days anyway, so no matter what, I guess I get to be the nervous mom for a while...

[malcularius]

Re: Cardiac Puncture?

There is always potential to bleed from the site or to introduce infection if aseptic technique isn't followed. Blood can give you valuable information. If it was me,I would do the IC stick to get diagnostic answers.