Respiratory Infections

Respiratory infections in reptiles can be cause by a variety of different pathogens- or disease causing organisms.  They can be bacterial in nature, viral like nidovirus, fungal, or even parasitic such as with lung worms.  Regardless of the cause, certain factors predispose reptiles to such infections.  As with many reptile diseases, husbandry is front and center.  When environmental parameters are inappropriate, such as humidity or temperature imbalances, this can cause damage to the respiratory tract, allowing for opportunistic pathogens to take hold and cause disease.  Environmental cleanliness can also play a factor.  If the environment is excessively dusty or not properly maintained, this can cause similar damage to the respiratory tract or allow for continued re-infection (especially with parasitic pneumonias).  Some conditions as well can always be present but only cause problems when the immune system is suppressed, such as Mycoplasma infections in chelonians and nidovirus infections in snakes. 

Some signs of respiratory disease in reptiles can be quite marked, where there is copious amounts of frothy discharge from the mouth, watery discharge from the nares and eyes, open mouth breathing, or inability to maintain buoyancy (if an aquatic reptile).  However, signs can be also very subtle.  It can be as simple as lethargy, reduced appetite, and increased breathing effort.  Breathing effort can be difficult to assess in reptiles- but in general, if you can see a reptile breathing- which for lizards and snakes is rising and falling of the ribs and for chelonians increased gular pumping and movement of the forelimbs- they are having issues breathing.  

When a respiratory reptile case is brought to the clinic, I always start with a thorough review of husbandry, followed by the medical history of the progression of signs.  My physical exam starts with simple observation of the animal’s breathing and its activity levels, and then I handle the animal for a more thorough examination.  The work up of some respiratory infections can end here, whereas other may require further digging.  Radiographs always help to visualize the lungs to confirm the presence of pneumonia, while bloodwork may indicate the severity of an infectious process.  For some species such as tortoises and Ball Pythons, infectious disease testing for things such as Mycoplasma and nidovirus is important.  If a respiratory infection is confirmed, I then prescribe an antibiotic to help with potential infection and also additional supportive care depending on the condition of the reptile.  I also then go through the owner’s husbandry to not only create the most conducive environment for healing as possible but also to reduce the chance of this issue recurring again.  Additionally, I stress the importance of biosecurity, especially for owners with larger collections, to minimize the spread of disease.  For my own Uromastyx, I was able to confirm her respiratory infection via radiographs and bloodwork.  She is currently on antibiotics right now.  At home, I reduced environmental dust in her enclosure and provided her a more appropriate humidity range with a bioactive enclosure. 

When I start medical treatment for reptiles with respiratory disease, I then like to evaluate them halfway through treatment. Since reptile metabolism is slow, they take time to recover.  While I do not expect them to make a complete 180 by the halfway mark, I do expect them to be improving.  If a reptile is not improving by this time, I then proceed with a lung wash.  This procedure requires me to sedate the reptile and infuse sterile fluids into the airway to collect for both cytology and culture.  This testing allows me to figure out the primary causes of said pneumonia and find the appropriate antibiotic choice for the particular infection.  These can provide me with quite a bit of information. I once had an Ackie Monitor that presented to me with a persistent pneumonia that I performed a lung wash on and ended up finding that there were three different bacterial organisms that were growing in the lungs that were resistant to the initial antibiotics.  I’ve had similar experiences with a Russian Tortoise, Yellow Bellied Slider, and Kenyan Sand Boa.  With the Boa, we were even able to find fungal elements in the culture, which for us indicated the usage of antifungals. 

Overall, not every respiratory infection is the same, and collaboration between the client and the veterinarian is required in order to provide the best standard of care for the reptile.