Snakes With Gastric Snakes With Gastric LesionsLesions

L.J. VenterL.J. Venter

South AfricaSouth Africa

CasesCases

January 30, 2003January 30, 2003 Elaphe obsolete quadrivittataElaphe obsolete quadrivittata Yellow Rat SnakeYellow Rat Snake

February 20, 2003February 20, 2003 Pseudaspis canaPseudaspis cana Mole snakeMole snake

August 14, 2003August 14, 2003 Elaphe guttata guttataElaphe guttata guttata Corn snakeCorn snake

EnvironmentEnvironment

Display snakesDisplay snakes Behind glassBehind glass NO mixed snake/other herptile exhibitsNO mixed snake/other herptile exhibits

Non-Display snakesNon-Display snakes Plastic boxesPlastic boxes Recessed cement structuresRecessed cement structures

Exhibit ManagementExhibit Management

Cleaned dailyCleaned daily Feces removedFeces removed Uneaten food items removedUneaten food items removed Water replacedWater replaced

New ArrivalsNew Arrivals

Quarantine Quarantine Separate area for 1 monthSeparate area for 1 month All animalsAll animals

Includes “donated” animals from publicIncludes “donated” animals from public

DietDiet

Majority of snakesMajority of snakes MiceMice

Large constrictorsLarge constrictors RabbitRabbit Guinea pigsGuinea pigs

Frequency of feeding variesFrequency of feeding varies SpeciesSpecies SeasonalSeasonal

Cement depression for waterCement depression for water

Index CaseIndex Case

Yellow Rat SnakeYellow Rat Snake Found dead with an open mouth in the Found dead with an open mouth in the

enclosureenclosure No other clinical historyNo other clinical history

Necropsy FindingsNecropsy Findings

Mild post-mortem changesMild post-mortem changes No macroscopic abnormalities, abundant fat No macroscopic abnormalities, abundant fat

storesstores HistopathologyHistopathology

StomachStomach LungsLungs SpleenSpleen KidneyKidney LiverLiver Intestine/pancreatic ductIntestine/pancreatic duct

Questions:Questions:

What is your case definition?What is your case definition? Is this a potential outbreak?Is this a potential outbreak?

Cryptosporidium serpentisCryptosporidium serpentis

Clinical SignsClinical Signs Post-prandial regurgitationPost-prandial regurgitation Weight loss and debilitationWeight loss and debilitation

Necropsy findingsNecropsy findings Gastrointestinal tractGastrointestinal tract

Thickening of rugaeThickening of rugae Loss of segmental mobilityLoss of segmental mobility

BackgroundBackground

Reptiles can harbor pathogenic organismsReptiles can harbor pathogenic organisms A reservoir for other reptiles, domestic A reservoir for other reptiles, domestic

animals, humansanimals, humans Snakes do not acquire Snakes do not acquire CryptosporidiumCryptosporidium

from ingesting foodfrom ingesting food Acquire it from other reptilesAcquire it from other reptiles CryptosporidiumCryptosporidium is not host specific in reptiles is not host specific in reptiles

DiagnosisDiagnosis

Acid fast stainsAcid fast stains Fresh fecesFresh feces Coating of regurgitated itemsCoating of regurgitated items Gastric lavage (95% sensitivity)Gastric lavage (95% sensitivity) Cloacal sampling (57% sensitivity)Cloacal sampling (57% sensitivity)

TreatmentTreatment

Halofuganone and SpiromycinHalofuganone and Spiromycin Ineffective in snakesIneffective in snakes

Hyperimmune bovine colostrumHyperimmune bovine colostrum Cryptosporidium parvumCryptosporidium parvum in dairy cows in dairy cows Administered 1% of snake body weight once a Administered 1% of snake body weight once a

weekweek

Case 2Case 2

Mole snakeMole snake Found dead lying next to water bowlFound dead lying next to water bowl Ate 2 days previouslyAte 2 days previously

Necropsy FindingsNecropsy Findings

Advanced post-mortem changesAdvanced post-mortem changes StomachStomach Small intestineSmall intestine LiverLiver KidneyKidney

Diagnostic TestsDiagnostic Tests

Peripheral blood smearPeripheral blood smear Parasite identificationParasite identification Stomach content smearStomach content smear

Case 3Case 3

Corn snakeCorn snake Found deadFound dead Has not eaten for a monthHas not eaten for a month

Necropsy FindingsNecropsy Findings

Emaciated with minimal storesEmaciated with minimal stores Moderate post-mortem changeModerate post-mortem change

Stomach/intestinal tractStomach/intestinal tract LiverLiver TestesTestes KidneysKidneys LungLung

Diagnostic TestsDiagnostic Tests

Peripheral blood smearPeripheral blood smear UnremarkableUnremarkable

Outbreak ConsiderationsOutbreak Considerations

Cryptosporidiosis not identified in any of the Cryptosporidiosis not identified in any of the three casesthree cases History and clinical signs are highly suggestive of the History and clinical signs are highly suggestive of the

diseasedisease Absence of positive diagnosis?Absence of positive diagnosis?

Ignorance of disease in the early stagesIgnorance of disease in the early stages Low sensitivity of acid-fast staining methodsLow sensitivity of acid-fast staining methods Unavailability of more sensitive serological testsUnavailability of more sensitive serological tests True absence of the diseaseTrue absence of the disease

Future Steps and Control Future Steps and Control MeasuresMeasures

Awareness of the diseaseAwareness of the disease Means of infection and spreadMeans of infection and spread

COMMUNICATE to keepersCOMMUNICATE to keepers

Ensure adequate hygenic principlesEnsure adequate hygenic principles Enclosure cleaningEnclosure cleaning

Clear guidelines for new reptilian arrivalsClear guidelines for new reptilian arrivals Quarantine and testingQuarantine and testing Gastric lavage required for all new reptilesGastric lavage required for all new reptiles

Vigorously pursue a diagnosisVigorously pursue a diagnosis In reptiles showing indicative clinical signs of In reptiles showing indicative clinical signs of

cryptosporidiosiscryptosporidiosis

ReferencesReferences 1. Aiello, S. E. 2004. The Merck Veterinary Manual. 8 edition. Page 1418 - 1419.

Merck & Co.,INC. New Jersey.

2. Calle, P. P., Rivas, J., Munoz, M., Thorbjarnarson, J., Holmstrom, W., and Karesh, W. B. 2001. Infectious disease serologic survey in free-ranging Venezuelan anacondas (Eunectes murinus). Journal of Zoo & Wildlife Medicine 32(3): 320-323.

3. Graczyk, T. K. and Cranfield, M. R. 1998. Experimental transmission of Cryptosporidium oocyst isolates from mammals, birds and reptiles to captive snakes. Veterinary Research 29(2): 187-195.

4. Graczyk, T. K., Owens, R., and Cranfield, M. R. 31-12-1996. Diagnosis of subclinical cryptosporidiosis in captive snakes based on stomach lavage and cloacal sampling. Veterinary Parasitology 67(3-4): 143-151.

5. Graczyk, T. K. and Cranfield, M. R. 1996. Assessment of the conventional detection of fecal Cryptosporidium serpentis oocysts in subclinically infected captive snakes. Veterinary Research 27(2): 185-192.

6. Graczyk, T. K. and Cranfield, M. R. 1997. Detection of Cryptosporidium-specific serum immunoglobulins in captive snakes by a polyclonal antibody in the indirect ELISA. Veterinary Research 28(2): 131-142.

7. Graczyk, T. K., Cranfield, M. R., and Hill, S. L. 1996. Therapeutic efficacy of halofuginone and spiramycin treatment against Cryptosporidium serpentis (Apicomplexa: Cryptosporidiidae) infections in captive snakes. Parasitology Research 82(2): 143-148.

ReferencesReferences 8. Graczyk, T. K., Cranfield, M. R., and Bostwick, E. F. 1999. Hyperimmune bovine

colostrum treatment of moribynd Leopard geckos (Eublepharis macularius) infected with Cryptosporidium sp. Veterinary Research 30(4): 377-382.

9. Graczyk, T. K., Cranfield, M. R., and Bostwick, E. F. 2000. Successful hyperimmune bovine colostrum treatment of Savanna monitors (<i>Varanus exanthematicus</i>) infected with <i>Cryptosporidium</i> sp. Journal of Parasitology 86(3): 631-632.

10. Carmel, B. P and Groves, V. 1993. Chronic cryptosporidiosis in Australian elapid snakes: control of an outbreak in captive colony. Aust Vet J 70(8): 293-295.

11. Oros, J, Rodriguez, J. L, and Patterson-Kane, J. 1998. Gastric cryptosporidiosis in a wild frilled lizard from Australia. Journal of Zoo & Wildlife Medicine 34(4): 807-810.

12. Taylor, M. A, Geach, M. R, and Cooley, W. A. 1999. Clinical and pathological observations on natural infections of cryptosporidiosis and flagellate protozoa in leopard geckos (Eublepharis macularius). Veterinary Record 145(24): 695-699.

13. Terrell, S. P, Uhl, E. W., and Funk, R. S. 2003. Proliferative enteritis in Leopard geckos (Eublepharis macularius) assiciated with Cryptosporidium sp. infection. Journal of Zoo & Wildlife Medicine 34(1): 69-75.

14. Brower, A. I. and Cranfield, M. R. 2001. Cryptosporidium sp.-associated enteritis without gastritis in rough green snakes (Opheodrys aestivus) and a common garter snake (Thamnophis sirtalis). Journal of Zoo & Wildlife Medicine 32(1): 101-105.