Nov 2010

Q: What is the best way to treat Mouth Rot?

Q: Sigh... As a reference please see this entry.

So now, my little Cheeto has the early stages of mouth rot. Lips are swollen, he hasn't eaten, and I can see small spots of blood on the more swollen side. So the question is, what now? I've treated him immediately with a 50/50 water & Hydrogen Peroxide solution and then followed that with Neosporin. The humidity in his bin is perfect (in fact, I might let it dry out for tonight so as not to encourage the bacteria) and I will be raising the ambient temps to 85-90. Anything else?

MORE IMPORTANTLY: Has anyone sucessfully treated this without seeing a vet? Can I get baytril without a vet appointment? To be completely honest, I don't have the patience to watch "exotic vets" manhandle my baby snake and/or give me things that won't work. HELP before this gets WORSE! Thank you <3

A: Mostly good advice all around, just a few comments. 

Recognize that you're operating on the assumption that this is a bacterial mouth rot.  It's a very GOOD assumption as most cases are bacterial in origin, but fungal, neoplastic and even viral etiologies should be in the back of your mind if this becomes chronic and refuses to respond to the usual treatment.  Anyway...

Don't ever use neosporin in the mouth, even on the gums.  It's a strong mucous irritant and it's not metabolized well when it gets into the circulation.  Your topical regimen sounds spot on.  I also like both dilute listerine as well as dilute chlorhexidine.  The maxiguard sounds reasonable too, though I don't have any experience with it in snakes.  If there's a lot of caseous debris, the H2O2 can help fo fizz away some of the smaller bits and you can follow it with listerine or nolvasan to targer the bacteria underneath.

If this has been occurring longer than you've realized, the infection may be deeper than you know and your topicals may not be reaching the site of infection.  In that case, systemic antibiotics are ideal, but I do not recommend baytril as it's powerfully cytolytic in reptiles (they absorb/metabolize the injection MUCH more slowly than mammals and it's been associated with local tissue damage -- I've burned my own snakes with this stuff on the vet's orders and learned the hard way).  If I had to choose one drug, ceftazadime has a good track record in snakes and is very broad spectrum, targeting both anaerobes as well as the aerobic usual suspects.  If you can pay for a cultuer/sensitivity though this is obviously a better and more targetted way to go.

Lastly, my self-serving plug... although you and others likely have legitimate reasons for distrusting self-proclaimed "exotics vets" -- hell, I've got a nightmare story too! -- please realize that there are a lot of snake-loving vets out there who are actually making incredible strides for the health of our captive reptiles, and they REALLY need your support.  The same way you die a little inside every time you read some ignorant facebook comment about how snakes are slimy or dangerous pets, my heart aches every time I heard a blanket statement about how exotics vets are incompetent crooks.  Do your homework, make some phone calls and try to establish a good professional relationship with a competent reptile-oriented veterinarian, even if its long distance.  When you have a real emergency, you'll be glad to have a professional to turn to! - BJW