• 1. de Cock Buning T. Thermal sensitivity as a specialization for prey capture and feeding in snakes. Am Zool 1983; 23:363375.

  • 2. Molenaar GJ, Fizaan-Oostveen JL, van der Zalm JM. Infrared and tactile units in the sensory trigeminal system of Python reticulatus. Brain Res 1979; 170:372376.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Auen EL, Langerbartel DA. The cranial nerves of the colubrid snakes Elaphe and Thamnophis. J Morphol 1977; 154:205221.

  • 4. Frazzetta TH. Studies on the morphology and function of the skull in the Boidae (Serpentes). Part II. Morphology and function of the jaw apparatus in Python sebae and Python molurus. J Morphol 1966; 118:217295.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Lawrence K, Muggleton P, Needham J. Preliminary study on the use of ceftazidime, a broad-spectrum cephalosporin antibiotic, in snakes. Res Vet Sci 1984; 36:1620.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Jacobson E. Bacterial diseases of reptiles. In: Jacobson E, ed. Infectious diseases and pathology of reptiles: color atlas and text. Boca Raton, Fla: CRC Press, 2007;461526.

    • Search Google Scholar
    • Export Citation
  • 7. Jho Y-S, Park D-H, Lee J-H, et al. Aerobic bacteria from oral cavities and cloaca of snakes in a petting zoo. Korean J Vet Res 2011; 51:243247.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Cushing A, Pinborough M, Stanford M. Review of bacterial and fungal culture and sensitivity results from reptilian samples submitted to a UK laboratory. Vet Rec 2011; 169:390.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. Young LA, Schumacher J, Papich MG, et al. Disposition of enrofloxacin and its metabolite ciprofloxacin after intramuscular injection in juvenile Burmese pythons (Python molurus bivittatus). J Zoo Wildl Med 1997; 28:7179.

    • Search Google Scholar
    • Export Citation
  • 10. Coke RL, Isaza R, Koch DE, et al. Preliminary single-dose pharmacokinetics of marbofloxacin in ball pythons (Python regius). J Zoo Wildl Med 2006; 37:610.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11. Johnson JH, Jensen JM, Brumbaugh GW, et al. Amikacin pharmacokinetics and the effects of ambient temperature on the dosage regimen in ball pythons (Python regius). J Zoo Wildl Med 1997; 28:8088.

    • Search Google Scholar
    • Export Citation
  • 12. Sykes IV JM, Ramsay EC, Schumacher J, et al. Evaluation of an implanted osmotic pump for delivery of amikacin to corn snakes (Elaphe guttata guttata). J Zoo Wildl Med 2006; 37:373380.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Lawrence K, Needham J, Palmer G, et al. A preliminary study on the use of carbenicillin in snakes. J Vet Pharmacol Ther 1984; 7:119124.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Montali RJ, Bush M, Smeller JM. The pathology of nephrotoxicity of gentamicin in snakes. A model for reptilian gout. Vet Pathol 1979; 16:108115.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Hilf M, Swanson D, Wagner R, et al. A new dosing schedule for gentamicin in blood pythons (Python curtus): a pharmacokinetic study. Res Vet Sci 1991; 50:127130.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Hodge M. The effect of acclimation temperature on gentamicin nephrotoxicity in the Florida banded water snake (Natrix fasciata), in Proceedings. Annu Meet Am Assoc Zoo Vet 1978;226237.

    • Search Google Scholar
    • Export Citation
  • 17. Jacobson ER. Gentamicin-related visceral gout in two bold snakes. Vet Med Small Anim Clin 1976; 71:361363.

  • 18. Clark CH, Rogers ED, Milton JL. Plasma concentrations of chloramphenicol in snakes. Am J Vet Res 1985; 46:26542657.

  • 19. Hejnar P, Kolar M, Sauer P. Antibiotic resistance of Stenotrophomonas maltophilia strains isolated from captive snakes. Folia Microbiol (Praha) 2010; 55:8387.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Adkesson MJ, Fernandez-Varon E, Cox S, et al. Pharmacokinetics of a long-acting ceftiofur formulation (ceftiofur crystalline free acid) in the ball python (Python regius). J Zoo Wildl Med 2011; 42:444450.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. He T, Shen J, Schwarz S, et al. Characterization of a genomic island in Stenotrophomonas maltophilia that carries a novel floR gene variant. J Antimicrob Chemother 2015; 70:10311036.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Goodhart GL. In vivo versus in vitro susceptibility of enterococcus to trimethoprim-sulfamethoxazole. A pitfall. JAMA 1984; 252:27482749.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Hilf M, Swanson D, Wagner R, et al. Pharmacokinetics of piperacillin in blood pythons (Python curtus) and in vitro evaluation of efficacy against aerobic gram-negative bacteria. J Zoo Wildl Med 1991; 22:199203.

    • Search Google Scholar
    • Export Citation
  • 24. Mirtschin P, Ormerod S. Indications for the treatment of cryptosporidiosis in snakes. Australian Herp News 1990; 5.

  • 25. Nouws JF, Vree TB, Breukink HJ, et al. Pharmacokinetics, hydroxylation and acetylation of sulphadimidine in mammals, birds, fish, reptiles and molluscs. In: van Miert ASJPAMM, Bogaert G, Debackere M, eds. Comparative veterinary pharmacology, toxicology and therapy. Ghent, The Netherlands: Springer, 1986;301318.

    • Search Google Scholar
    • Export Citation
  • 26. Plumb DC. Sulfadiazine/trimethoprim-sulfamethoxazole/trimethoprim. In: Plumb DC, ed. Plumb's veterinary drug handbook. 7th ed. Stockholm, Wis: PharmaVet Inc, 2011;948951.

    • Search Google Scholar
    • Export Citation
  • 27. Lashev LD, Mihailov R. Pharmacokinetics of sulphamethoxazole and trimethoprim administered intravenously and orally to Japanese quails. J Vet Pharmacol Ther 1994; 17:327330.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Gibbons PM. Antimicrobial agents used in reptiles. In: Carpenter JWM, ed. Exotic animal formulary. 4th ed. St Louis: Saunders, 2012;8490.

    • Search Google Scholar
    • Export Citation
  • 29. Toleman MA, Bennett PM, Bennett DM, et al. Global emergence of trimethoprim/sulfamethoxazole resistance in Stenotrophomonas maltophilia mediated by acquisition of sul genes. Emerg Infect Dis 2007; 13:559565.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30. Landrum ML, Conger NG, Forgione MA. Trimethoprim-sulfamethoxazole in the treatment of Stenotrophomonas maltophilia osteomyelitis. Clin Infect Dis 2005; 40:15511552.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31. Frye FL. Biomedical and surgical aspects of captive reptile husbandry. Edwardsville, Kan: Veterinary Medicine Publishing Co, 1981.

  • 32. McArthur S, McCellan L, Brown S. Gastrointestinal disease. In: Raiti P, Girling S, eds. BSAVA manual of reptiles. 2nd ed. Gloucester, England: British Small Animal Veterinary Association, 2004;210229.

    • Search Google Scholar
    • Export Citation
  • 33. Mehler SJ, Bennett RA. Oral, dental, and beak disorders of reptiles. Vet Clin North Am Exot Anim Pract 2003; 6:477503.

  • 34. Macdonald JB, Socransky S, Sawyer S. A survey of the bacterial flora of the periodontium in the rice rat. Arch Oral Biol 1959; 1:17.

  • 35. Araújo F, Castro C, Severo M, et al. Normal microbiota of the perialveolar region of incisors of rats. Arquiv Brasil Med Vet Zoo 2007; 59:15861588.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Surgical management of maxillary and premaxillary osteomyelitis in a reticulated python (Python reticulatus)

La'Toya V. LatneyDepartment of Clinical Studies-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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Colin McDermottDepartment of Animal Heath, National Aquarium, 501 E Pratt St, Baltimore, MD 21202.

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Gregory ScottLong Beach Animal Hospital, 3816 E Anaheim St, Long Beach, CA 90804.

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Maria M. Soltero-RiveraVCA San Francisco Veterinary Specialists, 600 Alabama St, San Francisco, CA 94110.

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Kyla BeguesseDepartment of Pathobiology, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Melissa D. SánchezDepartment of Pathobiology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104.

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John R. LewisDepartment of Dentistry and Oral Surgery, North-Star VETS, 315 Robbinsville-Allentown Rd, Robbinsville, NJ 08691.

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Abstract

CASE DESCRIPTION A 1-year-old reticulated python (Python reticulatus) was evaluated because of a 2-week history of wheezing and hissing.

CLINICAL FINDINGS Rostral facial cellulitis and deep gingival pockets associated with missing rostral maxillary teeth were evident. Tissues of the nares were swollen, resulting in an audible wheeze during respiration. Multiple scars and superficial facial wounds attributed to biting by live prey were apparent. Radiographic examination revealed bilateral, focal, rostral maxillary osteomyelitis.

TREATMENT AND OUTCOME Wound irrigation, antimicrobials, and anti-inflammatory drug treatment resulted in reduced cellulitis. A 3-week regimen that included empirical antimicrobial treatment and improved husbandry resulted in resolution of the respiratory sounds and partial healing of bite wounds, but radiographic evaluation revealed progressive maxillary osteomyelitis. Microbial culture of blood yielded scant gram-positive cocci and Bacillus spp, which were suspected sample contaminants. Bilateral partial maxillectomies were performed; microbial culture and histologic examination of resected bone confirmed osteomyelitis with gram-positive cocci. Treatment with trimethoprim-sulfamethoxazole was initiated on the basis of microbial susceptibility tests. Four months later, follow-up radiography revealed premaxillary osteomyelitis; surgery was declined, and treatment with trimethoprim-sulfamethoxazole was reinstituted. Eight months after surgery, the patient was reevaluated because of recurrent clinical signs; premaxillectomy was performed, and treatment with trimethoprim-sulfamethoxazole was prescribed on the basis of microbial culture of bone and microbial susceptibility testing. Resolution of osteomyelitis was confirmed by CT 11 months after the initial surgery.

CONCLUSIONS AND CLINICAL RELEVANCE Focal maxillectomies and premaxillectomy were successfully performed in a large python. Surgical management and appropriate antimicrobial treatment resulted in a good outcome.

Abstract

CASE DESCRIPTION A 1-year-old reticulated python (Python reticulatus) was evaluated because of a 2-week history of wheezing and hissing.

CLINICAL FINDINGS Rostral facial cellulitis and deep gingival pockets associated with missing rostral maxillary teeth were evident. Tissues of the nares were swollen, resulting in an audible wheeze during respiration. Multiple scars and superficial facial wounds attributed to biting by live prey were apparent. Radiographic examination revealed bilateral, focal, rostral maxillary osteomyelitis.

TREATMENT AND OUTCOME Wound irrigation, antimicrobials, and anti-inflammatory drug treatment resulted in reduced cellulitis. A 3-week regimen that included empirical antimicrobial treatment and improved husbandry resulted in resolution of the respiratory sounds and partial healing of bite wounds, but radiographic evaluation revealed progressive maxillary osteomyelitis. Microbial culture of blood yielded scant gram-positive cocci and Bacillus spp, which were suspected sample contaminants. Bilateral partial maxillectomies were performed; microbial culture and histologic examination of resected bone confirmed osteomyelitis with gram-positive cocci. Treatment with trimethoprim-sulfamethoxazole was initiated on the basis of microbial susceptibility tests. Four months later, follow-up radiography revealed premaxillary osteomyelitis; surgery was declined, and treatment with trimethoprim-sulfamethoxazole was reinstituted. Eight months after surgery, the patient was reevaluated because of recurrent clinical signs; premaxillectomy was performed, and treatment with trimethoprim-sulfamethoxazole was prescribed on the basis of microbial culture of bone and microbial susceptibility testing. Resolution of osteomyelitis was confirmed by CT 11 months after the initial surgery.

CONCLUSIONS AND CLINICAL RELEVANCE Focal maxillectomies and premaxillectomy were successfully performed in a large python. Surgical management and appropriate antimicrobial treatment resulted in a good outcome.

Contributor Notes

Address correspondence to Dr. Latney (llatney@vet.upenn.edu).