Blister Disease

[littlemay]

Ok so, so i just got a call back from the vet with the test results

Good news: Tests show the lesions are not cancerous and not consistent with other types of malignant tumours (yay!!!!)

Bad news: They haven't been able to culture any bacteria, so we're still unsure as to exactly what is causing the infection. The vet has been so good and asked for more testing to be done with a different pathologist at no extra cost.

Snuffles is actually doing pretty well - he's reasonably active and seems less agitated. Been spending most of his time curled up in his warm hide. The biopsy area/stitches are healing well and i should be able to feed him today.

We're going to keep going with the fortum at this point, the vet is worried that introducing any other antibiotics might result in a resistant strain of bacteria. Sooo it's another week of waiting for test results :/

 

[Pythoninfinite]

Mmm, very interesting indeed. I'll be very keen to know the outcome of any further investigations. Many committed vets will cut some slack regarding costs if it's an interesting case for them - they stand to learn about something they haven't seen or read about before, so it's an important experience for them professionally as well.

Please do keep us posted - I admit I was leaning towards the tumour side of things initially, cancers being fairly common in snakes.

Jamie

 

[littlemay]

I was also really concerned we were looking at tumours, so i am feeling a bit relieved. But the two big worries were tumours or tuberculosis - and there's still a possibility it could be TB.

It's so weird to actually be hoping that it's just some form of resistant bacteria. Will definitely keep you updated.

Still eating like a pig though, which has got to be a good sign. You can see just how much the jaw lesion has developed.

 

[Justdragons]

really nice looking python.. hope for all the best. good luck.

 

[littlemay]

Second round of bacterial stains have failed to show anything. Fortum isn't working; lesions are continuing to grow, belly has taken on a pinkish hue, he's incredibly flat.

Dropping him off at the vet tonight. Starting to prepare for the worst

 

[ronhalling]

Chin up littlemay, i will add a prayer for your snuffles tonight, and 1 for you as well, we can all see what a devoted and loving carer you are and you deserve all the best, i have known people, who, after the first vet visit and not getting the answers they wanted, have disposed of their pet and gone out and got another, you on the other hand are doing all the hard yards and for that you have my admiration....Snuffles is in good hands. ...............................Ron

 

[littlemay]

Thanks ron, i appreciate your kind words.

Just got back from the vet, i was only supposed to drop him off so he could be seen to tomorrow (i had missed the consultation hours) but the exotics vet (Joanne Sheen) said she would see him anyway. Everyone at North Shore Veterinary Hospital has been so good.

Anyway, literally right before i left the main blister on his back burst and was ripped off. There was a lot of clear liquid, but no pus and no decaying flesh underneath. Though it looks bad, Joanne is pleased that wound looks clean.

The main worry is how he hasn't been responding to the fortum (had his 11th injection this morning), hes been very lethargic and has the pink colour to his belly. She's concerned this may be septicemia taking hold. Further blood tests/cultures are being done tomorrow and he's being put on a different antibiotic (i don't quite remember the name, possibly Amikacin).

I also got the 'we might have only caught this in the advanced stage, it may not be treatable' talk.

He's been subjected to so much over the past few months, it keeps bothering me that maybe all of this treatment is stressing him out and preventing him from getting better. But then when we leave him he just seems to deteriorate.

- - - Updated - - -

Here is the biopsy report if anyone is interested...

 

[littlemay]

Got the initial blood report today, the culture should follow soon.

It's not looking good

There is a mild anaemia that subjectively is either nonregenerative or poorly regenerative; however, the reticulocyte count will follow to further evaluate. Given the clinical signs and presentation consider anaemia of chronic/inflammatory disease. The leucocytosis with predominantly heterophils and monocytes supports inflammatory disease, likely secondary to the skin lesions. No other significant abnormalities are noted on the CBC.

The low albumin with high normal globulins supports chronic inflammation. The elevated AST and CK support muscle damage that could be associated with extension of the skin lesions into the underlying muscle or other focal/systemic myositis. No other significant abnormalities are noted on the biochemical panel.

ADDITIONAL (15.11.13): The reticulocyte % is marginally elevated supporting a poorly regenerative anaemia suggesting perhaps haemorrhage with concurrent inflammatory disease.

 

[littlemay]

Sigh, so got the blood culture back - still negative. So still not a clue what bacteria are causing the infection. Can't begin to describe how frustrating that is.

On the plus side, he's improved significantly on the Amikacin/Fortum combination so far. The small blisters which were developing have disappeared, the larger blisters have burst and after a week have still not started to grow again. His belly is no longer pink, he's so much more alert and active and has had a really strong feeding response. Overall he just looks better, he was even strong enough to bite me the other day (which i was overjoyed about!)

Only on the 5th injection so far so let's hope the full course really kicks the hell out of the infection. Go Amikacin, go!

Here's Snuffles, looking a little like the joker with his burst jaw blister.

 

[bundy07]

Hey I really hope he gets better soon, beautiful snake sucks when you cant do anything but prey they get better.

 

[littlemay]

Just finished the first round of Amikacin/Fortum and took him to see the vet for re-evaluation... Verdict is huge improvement! He's put on weight, is feeding ferociously, regulating his own body temp etc. Lethargic behavior hasn't been evident for weeks. All the blisters have shrunk, including the two really bad ones. So far no signs of kidney damage from the Amikacin either.

He's been put on another 30 days of Amikacin/Fortum and then after that we will take bloods to see how effective the treatment has been. So happy, things are finally starting to curve towards a recovery.

 

[Darlyn]

Woohoo! Good news. Well done to you, Snuffles and your vet.

 

[RedFox]

I'm glad to hear snuffles is on the mend.

 

[littlemay]

Thanks for the encouragement guys Though i don't think i'll be fully happy until he's made a complete recovery.

 

[littlemay]

So Snuffles shed today and everything is looking so much better. Since i'm off work sick today i thought i would compare photos of his progress over the last few months; thought some might find it interesting to observe the healing process of the lesions..

 

[Pythoninfinite]

Excellent news! It would be great if there was a definitive ID on the bug though - but the main thing is the improvement is fantastic.

Jamie

 

[RedFox]

Good to see it healing. Definitely looking much better.