Emergency!!!

[Hoskins]

Hi this is an emergency I need advice! I'm an absolute idiot and I made the mistake of making a hide for my 3 month old ball python and I used tape on it. The tape came off, I'm assuming the heat lamp melted the glue, and Athena got stuck in multiple places. When I woke up some of the scales near her head were completely peeled off. There's a place about 3/4 inch long where you can see the pink of her skin. She doesn't seem to be bleeding, and she didn't draw up or become defensive when I picked her up. I managed to get all the tape off without harming her further, but the scales that were peeled off are kind of dragging and it looks really painful and I have no idea what to do. Please give me some advice with this, if would mean a lot!! I can post pics later if need be.

[CVH]

Firstly stay calm, 3/4 inch of lost scales sounds serious.
Best that you take your snake to the vet for some decent care and information before it gets infected.

[Donnie]

As mentioned you need to get your snake to a vet and keeping the wound clean is a must. Remove all substrate from the enclosure and put down kitchen roll / paper instead. I think you can use iodine on the wound to help it stay clear from infection but before you do I would like somebody else to confirm this as well (my brain is not working tonight)

[Hoskins]

I have her on fresh paper towel and I put some antibiotic on the wound, she seems to be less nervous than me. She's just a bit more jumpy than usual and it was a trick to get her to let me touch her wound to apply the mess, but otherwise she seems fine. Here's to hoping.

Thanks for your help, everyone.

[Sublimeballs]

As stated by others remove substrate in favor of paper. Go to the vet. The vet will most likely give you benzodine(iodine) to treat the wound, but still best to get a professional opinion.

[formica]

yes iodine is good - if you dont have access to that right now, you can use a mild salt water solution, boil some water, and add 1/10th of a tea spoon of salt to a cup of boiled water (dont put more than 1/10th tea spoon of salt, more is not better, it can irritate the tissues), cover the cup with cling film and allow it to cool, then use (sterile if possible) cotton wool, to soak up some of the water and drip it onto the area affected (make sure you wash your hands thoroughly with hot water before doing this, if you dont have access to sterile gloves) - do this every 3-4hrs, until you can get iodine and get to the vet.

and as Donnie suggested, get rid of all the substrate....infact I would go futher, get a new plastic tub, disinfect it with boiling water and bleach, allow it to dry completely (20-30minutes tops if the water is truely boiling when used), rinse again with boiling water, then add kitchen paper towel, sterilize a hide for her with boiling water, and add it to the plastic tub - then, once everything is cooled to room temp, put her in the sterilized plastic container until you can get to the vet


may seem excessive, but avoiding an infection in the first place, is worth the effort

[wrecker45]

Iodine on a human cut is painfull and destroys good tissue.

[Starbuck]

if the lesion is not bleeding and open, i don't think you need to go to such lengths as some have described; yes make an apt with the vet as soon as possible. Good job putting the antibiotic ointment on it, and keeping the snake away from substrate. Try to keep the antibiotic away from eyes and mouth. Let us know how things go.

[Hoskins]

Wrecker, I appreciate the input, but I'm pretty sure iodine simply removes dirt/bacteria from a wound. Which is why we use it on ourselves.

Starbuck, I definitely will. She seems to be fine thus far, but I'm keeping a close eye on her.

[MDT]

Wrecker is correct. Iodine/betadyne is no longer recommended in wound care as studies have shown it to be toxic to healing tissue. We have stopped using in the ED and are using Hibiclens or other non iodine containing skin preps for wound care.

And, just to add....it doesn't remove dirt or bacteria....it is bacteriocidal. Any "removal" of material is done by irrigation/scrubbing/debridement of tissue.

[smy_749]

Wrecker is correct. Iodine/betadyne is no longer recommended in wound care as studies have shown it to be toxic to healing tissue. We have stopped using in the ED and are using Hibiclens or other non iodine containing skin preps for wound care.

And, just to add....it doesn't remove dirt or bacteria....it is bacteriocidal. Any "removal" of material is done by irrigation/scrubbing/debridement of tissue.

Nice to have the doc around haha Stuff like this makes me wonder how many things we do currently that we will find out are bad for us. Science is a scary field. On a brighter note, judging by what youve said , Id do as formica stated and vet is a given, but dont feel so bad. We havent all done the tape mistake, but def made others. Be thankful hes alive and not critically wounded(by what youve described, I think he will be fine and the vet wont need to do much)

[Hoskins]

I was definitely thinking of peroxide and feel really silly now. I've never used iodine. But anyway, thanks for the input, everyone. If she does manage to get through, will the scales grow back after a few sheds, or will it be scarred forever? I know small patches can regenerate after a few sheds, but this is a fairly large patch of skin.

[formica]

Actually it is only speculation that Iodine slows wound healing - evidence suggests the opposite, that low concentrations, as typically used to clean wounds, infact aides healing of wounds

refer to Wounds International if you need further information: Iodine Made Easy (page 1 of 4) › Made Easys › May Vol 2 Issue 2 › Wounds International (http://www.woundsinternational.com/made-easys/iodine-made-easy) (world leading wound management specialists)

[lady_bug87]

Neosporin/polysporin without pain relief should do it and the vet.

[MDT]

Not speculation. Povidone Iodine has been shown to harm fibroblasts in healing skin. The Emergency Medicine literature is replete with recommendation to not use Betadine in wound care. The saying "don't use anything on a wound you wouldn't use in your own eye" is one we follow. Use Betadine if you want. The realistic answer is that it probably won't jack up the healing process. However, the current reccomendations are such, it is not recommended.

[formica]

Not speculation. Povidone Iodine has been shown to harm fibroblasts in healing skin. The Emergency Medicine literature is replete with recommendation to not use Betadine in wound care. The saying "don't use anything on a wound you wouldn't use in your own eye" is one we follow. Use Betadine if you want. The realistic answer is that it probably won't jack up the healing process. However, the current reccomendations are such, it is not recommended.

are you saying that Wounds International, have it wrong? for sure I also have read that iodine should not be used for the same reasons you have stated, however, when a group formed of the leading wound care specialists in the world, say that this information is incorrect, I am inclined to believe them...

[MDT]

Formica...do what you want brother. I can tell you how ED clinicians approach human wound care in the US. When the literature for my specialty recommends against or for something, we try to employ those methods. I could give a rats a$$ about Wound Care International. Like I said, will it really really matter? Probably not, but that's not how it is done.

OP...your snake will be good...sorry to have jacked your thread :)

[formica]

Formica...do what you want brother. I can tell you how ED clinicians approach human wound care in the US. When the literature for my specialty recommends against or for something, we try to employ those methods. I could give a rats a$$ about Wound Care International. Like I said, will it really really matter? Probably not, but that's not how it is done.

OP...your snake will be good...sorry to have jacked your thread :)

not asking to try and argue, i'm genuinely trying to find out why there is a difference, if there is a good reason for me to not using Iodine, then i want to know about it! I find it odd that there is a discrepancy, although I have my suspicions about the discrepancy (ie marketing!)

I cannot find anything in the literature I have access to, including my old work pubmed account, which shows that any alternative product is better than current iodine solutions, or any proof that iodine slows wound healing, and there are quite a few companies introducing products with that claim, at a significant mark up over iodine preperations...I'm going to ask my mum about it, she has been at the forefront of wound management research for the last 30 years....and i know for a fact she's got Iodine in her cupboard.



(btw Wounds International is not the same as Wound Care International, the former is a group of specialists including doctors, consultants, nurses and other researchers who provide information only when it has been peer reviewed and the data sets are available in full, unlike many private companies who provide only the parts of their datasets which support their marketing claims...)

[shaunyboy]

Actually it is only speculation that Iodine slows wound healing - evidence suggests the opposite, that low concentrations, as typically used to clean wounds, infact aides healing of wounds

refer to Wounds International if you need further information: Iodine Made Easy (page 1 of 4) › Made Easys › May Vol 2 Issue 2 › Wounds International (http://www.woundsinternational.com/made-easys/iodine-made-easy) (world leading wound management specialists)


i use a diluted iodine soulution on any snake wounds ive dealt with,done the job just fine imo

to the op
without pictures its hard to say if a vet is required or not mate ?

cheers shaun

[Hoskins]

i use a diluted iodine soulution on any snake wounds ive dealt with,done the job just fine imo

to the op
without pictures its hard to say if a vet is required or not mate ?

cheers shaun

Thanks for the advice, it's appreciated, and I was gonna post some pics in a bit, just now got to it.

Not entirely sure if embedding images works in this forum so lemme give it a try.

This is (hopefully) Athena's neck-wound :/
http://i1218.photobucket.com/albums/dd404/Dakota_Hoskins/image_zpsb0c2368d.jpeg

And I could use one more piece of advice. Since tape is now not an option, are there any adhesives that you all use in your habitats? She's been loving to throw the paper towels in her water dish and crumple them all in a corner, so I was wondering if there was a way to make the towels stick down or anything.

Thanks guys!
(Sorry, tried to post earlier, but it wouldn't let me :/)

[LadyWraith]

I use newspaper with my BP and have the same issue with him crumpling it up. I don't really worry about it... it still does the job of absorbing waste, which is the reason it's there at all. No adhesives at all... I am unaware of any that will not cause damage as above.

TBH, if that were my animal, I'd be making an appointment with my herp vet. Just mainly to make sure that I was caring for the wound properly. It's a pretty big open wound area... may just look worse than it is, but I would want a veterinary professional's opinion in case. Poor snakey. :(

[MDT]

Wow....that is definitely a neck wound....you really should have that wound debrided.

I just use newspaper. My retics will absolutely trash their enclosure about 15 min after I "fix it up"...I just have learned to live w it. I guess you could get pre-cut cage liners. Other than that, idk.

[KORBIN5895]

There is a huge difference between missing scales and the skin ripped from the flesh. That is skin ripped from the flesh and needs vet attention.

[Hoskins]

I use newspaper with my BP and have the same issue with him crumpling it up. I don't really worry about it... it still does the job of absorbing waste, which is the reason it's there at all. No adhesives at all... I am unaware of any that will not cause damage as above.

TBH, if that were my animal, I'd be making an appointment with my herp vet. Just mainly to make sure that I was caring for the wound properly. It's a pretty big open wound area... may just look worse than it is, but I would want a veterinary professional's opinion in case. Poor snakey. :(

Yes, I agree completely. Unfortunately that won't be possible until Wednesday, as emergencies have been eating up the money I put back for these sorts of things. I've been extra careful and watching her day and night, do I'm praying that four more days won't be too late.

MDT, that thought keeps crossing my mind and I have a strong temptation to do it myself with some surgical tools my dad kept from his days as a first responder, but I'm not experienced or knowledgeable enough to confidently debride the wound, so I've kept myself from it. And I might try newspaper, that might be a bit harder to crumple up than paper towels.

Thus far I've been using a light, generic antibiotic cream every other day or so to avoid contact with her wound as much as possible, I don't want to stress her out more than she already is. She still isn't very jumpy or defensive, to my surprise on the rare times I handle her.

I have more questions for you all:

Obviously I haven't been feeding her for fear of harming her further, but I was wondering if offering her maybe a pinkie rat might be a good idea, if only to retain the resilience she's kept so far and to speed up the healing process.

Another issue, the other day when changing her substrate, I noticed a tiny pink spot on the opposite side of her neck in relation to the wound. I thought it might be a small patch of scale rot and watched or closely, but it seems to have disappeared. I've tried to keep her habitat (I keep seeing the word "viv") drier than normal to slow or prevent scale rot after the accident.

So what are your thoughts? And thank you all again for your help, it really does mean a lot.

[KORBIN5895]

If you feed it make sure it is small enough the neck won't stretch.

[Hannibalcanibal]

Yikes. I'd not even feed until the vet looks at it..

[Starbuck]

if you're going to the vet on wed (And i agree with others above, GO TO THE VET), i would wait to feed as well. A few missed days won't hurt her, and this way you won't be risking hurting her skin further, or a regurge in the car or during the exam.

I would also advise against debriding it yourself.

You may wish to look into butcher paper (it comes in 30ish pound rolls like wrapping paper), it is very sturdy, and one large piece will probably fit the whole bottom of the viv so it won't be several bits for her to toss around. It may not be quite as absorbent as paper towels, but it is definitely more sturdy.

[formica]

allot Vets offer payments plans, there is really no need to wait until wed, that is a very serious wound that needs professional attention asap.

and why is she still on substrate? whats the point of asking for help if you are going to ignore it?!?

I feel really sorry for this snake :( i know you are not intentionally trying to do harm, but you havent listened to anything anyone has told you, I cannot believe you have left her in this state for 5 days without medical help.

[Donnie]

allot Vets offer payments plans, there is really no need to wait until wed, that is a very serious wound that needs professional attention asap.

and why is she still on substrate? whats the point of asking for help if you are going to ignore it?!?

I feel really sorry for this snake :( i know you are not intentionally trying to do harm, but you havent listened to anything anyone has told you, I cannot believe you have left her in this state for 5 days without medical help.

The OP said it is on paper towels now.

OP I would get her to the vet ASAP as formica said you can put the care on a payment plan if you have no money now.

[formica]

fair enough, i read 'substrate' in previous post and assumed it was not paper towels


please get her to vet before wed, cant imagine the pain she's in right now. and OP i apologise for my rather abrupt previous post, i know thats not what you need right now, just feeling your snakes pain.

[KORBIN5895]

If they fed a small meal now then it will be digested by Wednesday. It will also need the energy to promote faster healing.

[Hoskins]

allot Vets offer payments plans, there is really no need to wait until wed, that is a very serious wound that needs professional attention asap.

and why is she still on substrate? whats the point of asking for help if you are going to ignore it?!?

I feel really sorry for this snake :( i know you are not intentionally trying to do harm, but you havent listened to anything anyone has told you, I cannot believe you have left her in this state for 5 days without medical help.

Um, even if I had left her on substrate (and I didn't; she is on paper towels, as stated), that statement would not be true. I've applied antiobiotics and made sure that her viv is spotless and sanitary, as instructed.

If you couldn't tell by the initial post, I was very distraught by the accident, I am an amateur snake-owner, but nonetheless an avid lover of animals. I have literally done everything in my power to help her, as I feel incredibly awful about this. This includes calling multiple vets to see which treat snakes, and which would be willing to work out a payment plan for an emergency visit. Only two of the six I called were willing to treat any kind of reptile at all, and neither of the two allowed payment plans or any aid of the sort, especially to a 16 year old.

As I previously stated, I've had multiple emergency-type situations in the past month that have eaten up the money I keep for these sorts of unfortunate events. I have done everything in my power to keep both my snakes happy and healthy.

I'm sorry for the retaliation, but I really don't wish to be called out on something like this on a post asking for help and advice.

Anyhow, I'm going to keep her off feed until I can get her to the vet, just in case, and no I don't plan on doing any debriding, I did say I don't have the knowledge to confidently do it myself.

As for her behavior, she's as active as ever, which really does surprise me, as I'd expect her to coil in her hide.

[CVH]

Can you give an update?

[formica]

i understand your difficulty - have you tried contacting any charity animal welfare groups, they may be able to help

[Hoskins]

Can you give an update?

Yup! I changed her water and switched from paper towels to newspaper, she seems to be normal, the spot is the same as before. One more day til she goes to the vet!

Side note: My brother's ball pooped on me yesterday. Anyone know how to prevent this?

[Donnie]

Side note: My brother's ball pooped on me yesterday. Anyone know how to prevent this?
Don't pick it up

[Mellik's mamma]

hoskins, i am so sorry you and your love are going through this. i am sick to my stomach and can't imagine what you are going through!! hang in there. sending healing thoughts to your snake. wish i could help, but i don't know what i would do in your situation besides keeping everything sterile and going to the vet. i would say feed b/c they need energy to heal, i am not a snake vet, soooo


good luck!! hope to hear a positive update soon!!

[DeadlyDesires]

please let us know what the vet says...

[Hoskins]

please let us know what the vet says...

I will do it. I'm taking her to a vet first thing in the morning!

[DeadlyDesires]

i thought she was going today?

[Kera]

i thought she was going today?

Tomorrow is Wednesday, OP said they're taking the snake Wednesday. :)

[Hoskins]

Hey everyone, update time.

We went up to the vet today, at first the technician said they would flush the wound with saline and give me an antibiotic and that it would be done after a couple hours. Total was $75.

She asked me to come back in a couple hours, so I was killing time in that area as it's far from my house, when the vet called with bad news. The technician did not note the torn skin, which is a problem in that neck area. The options were to graft skin on the wound, which she noted was risky and would cost well over $300, or to stitch the wound and keep it moist with a (silvadene?) cream. I opted for the stitching as she personally advised it, and I didn't have enough money to fund the grafting.

So the total ended up being $175, and they are keeping her until Friday. :( My brother told me not to, as it was, "a twenty dollar snake." While reason tells me that he's right, I'm attached to her and couldn't just let her die when I knew that I had the power to save her. You enthusiasts can probably empathize with me when I say that I would never forgive myself if I let it happen, especially since the accident was my fault in the first place.

[formica]

you are right, we get it, I would do the same in your position

glad to hear they have a solution for her, get well soon little ball python :)

have they given you a prognosis? (expected recovery time, etc)

[Starbuck]

I've never heard of a skin graft in snakes, but it is interesting that that was one of the available options. Without seeing the snake in hand i can't truly comment on how severe the wound is; but from the pictures you posted i think stitching and sulfazidine? Silver sulfadiazene? sylvadine? (can you let us know once you have her home?) is what i would do in this situation. Hopefully some other members can comment, but i would agree with KORBIN et al, once you do start feeding her again i would keep the meals small so as not to strain the stitches. Snakes can take a very long time to heal, and you may not see much improvement until after she sheds a few times, which may be especially risky. (when it comes time for shedding, make sure she has spot on humidity, i would also offer a humid hide)

Good luck, i look forward to seeing her progress, and I'm glad you were willing to commit to 'just a 20$ snake'

[MDT]

Hoskins...is your vet a "reptile vet"? I'm not judging, as I don't know jack about reptile "healing process", but in humans it would be very unlikely to close a wound this old. Not that it's never done, just not common. Will you be able to find out if they use absorbable sutures or will they need to be removed after 10 or so days? I'm interested in how this heals over time for a number of reasons. Thanks in advance....

[Starbuck]

I thought OP said it was a herp vet? Maybe I misread something? OP?

Mdt, sutures are generally left in reptiles for longer than 10 days (as I mammals) because thwy do not heal as quickly. I don't know for sure, you may be right that its too late for stitches, but the vet could have debrided the edges of the wound before suturing, or it could still be able to close if it truly is a slower process? I'll be interested to see what thw vet says when OP picks up the snake....

[Mellik's mamma]

glad we have a solution. i hope with all my heart it all goes very well for you two.

[MDT]

I thought OP said it was a herp vet? Maybe I misread something? OP?

Mdt, sutures are generally left in reptiles for longer than 10 days (as I mammals) because thwy do not heal as quickly. I don't know for sure, you may be right that its too late for stitches, but the vet could have debrided the edges of the wound before suturing, or it could still be able to close if it truly is a slower process? I'll be interested to see what thw vet says when OP picks up the snake....

Yeah.. that's interesting regarding suture time in reptiles...I honestly didn't know. When suturing bipedal mammals (usually the drunk type on Friday nights), we will typically leave in for 10 days (5 for the face)...

So is fibroblast activity in reptiles just simply "slower" than mammals (humans) or temp dependent (like most of their metabolic activity)? I would've thought the wound would have began to granulate by this time making repair a little less likely and letting heal by secondary intention...

I'm learning new stuff :)

[Starbuck]

Mdt I will look into it.... still a firstyear so I'm leatning too :-P our professors at this poibt only like answering questions about horses, ogs, and cats :-P

[shaunyboy]

Yeah.. that's interesting regarding suture time in reptiles...I honestly didn't know. When suturing bipedal mammals (usually the drunk type on Friday nights), we will typically leave in for 10 days (5 for the face)...

So is fibroblast activity in reptiles just simply "slower" than mammals (humans) or temp dependent (like most of their metabolic activity)? I would've thought the wound would have began to granulate by this time making repair a little less likely and letting heal by secondary intention...

I'm learning new stuff :)


all the stitches ive ever had were taken out on day 10 to 12,staples were left in a little longer

cheers shaun

[Hoskins]

Hoskins...is your vet a "reptile vet"? I'm not judging, as I don't know jack about reptile "healing process", but in humans it would be very unlikely to close a wound this old. Not that it's never done, just not common. Will you be able to find out if they use absorbable sutures or will they need to be removed after 10 or so days? I'm interested in how this heals over time for a number of reasons. Thanks in advance....

I actually just got off the phone with her, she calls me every time there's an update, which I like quite a bit! And she did say yesterday that closing the wound would be difficult and somewhat unlikely, but she just called and told me that she was able to successfully debride and close it! And I can ask for you, is an absorbably suture one that's absorbed into the healing tissue rather than falling out?

She also said that she's started a shedding cycle already because of the wound, and once it starts to peel back, she wants me to trim it around the wound so the sutures aren't shed with it, if that tells you anything.

She also mentioned that once the shed is complete, that tube feeding will need to be done, which I'll have to research, as I know nothing about it.

Not to jinx anything, and we're not out of the woods yet, as it could still become infected (she's giving me an antibiotic, I believe she said silvadene cream), but I have a good feeling, and I'm excited to go pick her up tomorrow! :)

If anyone has any advice for tube-feeding, trimming the shed, or applying antibiotics, please let me know! I'm still kind of an amateur herp-owner, with only a one year old kingsnake and a three month-old ball python with lots to learn. Thanks for everyone's advice and support thus far, I plan on keeping you all updated.

[MDT]

all the stitches ive ever had were taken out on day 10 to 12,staples were left in a little longer

cheers shaun

Did you get yours put in after a "rough Friday night"? ;)

[MDT]

Hoskins, yes....absorbable means they degrade over time and do not require removal..Also, it would seem that since the sutures (should) go the thickness of the skin, simply shedding the outer layer should not dislodge the sutures. But, it would stand to reason that the wound would make shedding around that area difficult. I think you are just simply using scissors to trim away the "stuck shed" so to speak around the wound.

Applying the meds should be just that....smear over the wound margins how ever many times a day the vet recommended.

Tube feeding....no clue.

[Starbuck]

i would ask the vet why she is recommending tube feeding; and ask if you could instead offer a small prey item more frequently… it seems like if she will take it that would be much less stressful, but maybe the vet has a better reason they are recommending tubing? Im glad the debridement went well! Will keep my fingers crossed for you in the coming months.

[Hoskins]

i would ask the vet why she is recommending tube feeding; and ask if you could instead offer a small prey item more frequently… it seems like if she will take it that would be much less stressful, but maybe the vet has a better reason they are recommending tubing? Im glad the debridement went well! Will keep my fingers crossed for you in the coming months.

She said she didn't want that area expanding at all, should the skin break and expose muscle tissue. Keep in mind that she is only three months old, and even pinkie mice could pose issues for her wound.

UPDATE (or lack thereof):
She said she'd call me today to let me know how she is- but no call, and by the time I thought to call, they were already closed, so I left a message.

[shaunyboy]

Did you get yours put in after a "rough Friday night"? ;)

a rough Friday night around here requires re attatchment of limbs mate ;):laugh:

cheers shaun:)

[shaunyboy]

i would ask the vet why she is recommending tube feeding; and ask if you could instead offer a small prey item more frequently… it seems like if she will take it that would be much less stressful, but maybe the vet has a better reason they are recommending tubing? Im glad the debridement went well! Will keep my fingers crossed for you in the coming months.

personally i would have tube fed a snake with that injury,even if the vet had'nt said to...

imo when done correctly tubing food into a snake with a wound like that would be less stressful on the wound,as the tube is only a few millimetres in diameter,which will cause no expansion of the neck,or movement which would happen as the snake walks its jaws up over a prey item...

re tubing
i have found it easier doing it with 2 pairs of hands

one person using one hand holds the snake behind the head where the neck starts,the other hand holds mid way down the body,keeping the head,neck and body in a straight line...

that leaves the other pair of hands to open the mouth and slide the tube in far enough so the food/meds go into the stomach,and not back out the mouth

cheers shaun

[MDT]

a rough Friday night around here requires re attatchment of limbs mate ;):laugh:

cheers shaun:)

I would expect nothing less! :)

[CVH]

How is he doing? Can you give us an update.