Boa heart failure?

[caticind]

Our 16-yr old BCI had developed symptoms suggesting a respiratory infection - lethargy, loss of appetite, weight loss, and just recently wheezing. We took her straight to the exotic vet when we heard her wheezing as there's a good one locally.

They tell us she appears to have heart failure. The "RI" is secondary because she is retaining fluid, might not even be an infection. She's on an antibiotic and diuretic.

There's so little info online about boas older than 10, and practically no literature I could find on heart failure in snakes of any kind. This is a beloved snake and we hoped she'd see 30 so I want to learn anything I can. Anyone here encounter an issue like this with their snake? What did your vet say? What treatment did you give? What was the outcome?

[chairman]

You need to make 5 posts before you can put up pictures. I recommend making a couple short posts to meet that mark, so you can show us a recent picture of your snake.

In the mean time, how long is your snake, and how much does it weigh?

What has your feeding schedule been?

Realistically, your snake is probably overweight (many older boas are) and is suffering from cardiac issues the same way overweight people do. Unfortunately, I'm not familiar with what treatments are available for snakes with heart issues. However, if you share a pic of your snake then boa keepers can provide feedback on the overall body condition of your snake. Assuming your snake is overweight, you can discuss with your vet the health implications of getting your snake to a healthier weight. That may help.

[caticind]

Thanks, Chairman. I'll get to 5, I'm sure, but to cover her general husbandry (clean cage, appropriate size, substrate, heat, humidity, feeding schedule) we have gone over with a fine tooth comb.

She's 8', and not overweight. She had good body condition before her symptoms started (square not round, no fat rings) and was very much slow grown, never obese. She has never been a picky eater. She is more triangular now, definitely underweight but uninterested in food. She has lumps of fluid edema (confirmed by needle aspiration) appearing all along her body.

The vet has encouraged us to offer small prey (medium rats) often to ensure she misses as few meals as possible. We are really hoping antibiotics and diuretic will bring back her appetite so we can stabilize her weight.

Have you seen reports of a boa w heart failure before, even from obesity? Or mortality causes for mature adult boas in general? I can't find anything.

[Navboas]

Any time I’ve seen heart issues in boas, it’s caused by birth defect (usually in some form of cardiomegaly), or obesity issues. Not saying there aren’t other reasons, I’m just saying in all my years; the few boas I’ve known to develop a cardiac problem were for those reasons.

[caticind]

Thanks, Navboas. Appreciate you sharing your experience.

Vet tests confirm she has hypertrophic cardiomyopathy (a thickened heart muscle that stiffens and can't pump as well). Zero published research on this in boas (and just a couple case reports from all reptiles combined), so the vet is treating with medications that would be used for a cat. Cue hairless longcat jokes here, I guess. The vet says they think this is genetic in mammals so she may have had it all her life and the muscle finally is wearing out but really no one knows about reptiles.

The edema and her breathing have gotten better though not back to normal, so now we wait and see if she improves enough with medications to start eating again.

[ClockwerkBonnet]

:eek: A medication used for CATS? That's a new one.

[caticind]

Yes, apparently the logic is that since the basic chemistry is similar (heart contractility controlled by calcium channels), that if it works for mammals it's worth a shot, even though the heart structure and blood chemistry of a boa is...... rather different from a cat. There's no research at all on any reptiles for this condition, let alone boas.

I'll report back in a few weeks. Hoping she'll be eating again by then.

[caticind]

Just wanted to provide an update. She's stable now with only a little wheezing and edema on furosemide, pimobendan, and enalapril daily. That's a diuretic injection and two liquids that have to be given by mouth (!). Not something we ever expected to try to do with a boa. Luckily she is very well socialized and patient with us. The vet thinks she'll be on those meds for the rest of her life, unfortunately.

She still won't eat and is super underweight after less than 6 months off feed. Vet says that rapid weight loss is a thing in heart failure - she is actually burning more energy than normal to keep her heart going. She is triangular, can feel bones, lot of extra skin. Now she can breathe, unfortunately her appetite has not come back. She is 100% uninterested in rats after 16 years of never refusing a meal. Vet is working with us to try B-12 injection to get her appetite back up as she won't make it if we can't eventually get her to eat.

Something we learned from this process is how little research gets done on reptiles for conditions that we treat cats and dogs for all the time. All the reptile case studies describe symptoms, sometimes try a medication, and end with "owner decided not to proceed with care, reported animal died at home". We are hoping that, with the willingness to spend money and time, this can be a chronic condition.

For the same reason I wanted to give a little more detailed info above on how we are treating her, so that people in future with the same issue can find out what happened and whether the treatment helped in the long run.

[caticind]

Final update from me on this thread.

Unfortunately our boa died last week. She had needed increasing doses of diuretic to keep fluid from building up in her lungs.

The medications did keep her comfortable for months, but we could not get her to gain weight even with tube feeding, and eventually her heart just stopped.

Due to COVID we were not able to get an appointment at the local vet school to learn anything further about the underlying cause.

[richardhind]

so sorry to here this
at least you tried your hardest to get her sorted