ABSTRACT: This article presents a brief introduction to the native British reptiles and amphibians which might be presented as casualties to the veterinary practice, along with discussion of some legal/ethical issues. Likely presentations such as trauma and common infectious diseases are described. Initial emergency treatment and housing/ hospitalisation of such cases is discussed

Although treating casualty wildlife may be controversial, it is not unusual to have advice sought, and/or casualties presented, in practice. Particularly with reptiles and amphibians, many such cases are likely to be directly attributable to action by humans (or their pets, notably cats), and therefore part of our responsibility to treat.

Note that this article discusses mainly native species casualties, although much of it will be generally applicable to all reptiles and amphibians. Nowadays you are probably more likely to be presented with an escaped or ‘dumped’ pet rather than a native species, but, in particular, treatment of shell trauma in chelonia will not be covered. More information on this subject is available in Mader (2006).

Of course, if unfamiliar with these species, referral to, or at least consultation with, a more experienced veterinary surgeon may be the best option. However, it may not be immediately practical. It is well worth cultivating the help of, or at least recording the contact details of, a local reptile/amphibian worker – most areas have a local amphibian/reptile group and/or a wildlife rehabilitation centre (see References and Further Reading).

Please note that in this paper, the term ‘herps’ will be used as a general term for reptiles and amphibians.

Our native species

The native British reptiles and amphibians classically consist of the following species (Figures 1-4):

Figure 1: Grass snake

Figure 2: Slow wormFigure 3: Common frog 

Figure 4: Smooth newt 

•  snakes – grass snake (Natrix natrix), smooth snake (Coronella austriaca) and adder (Vipera berus – our only native venomous species) lizards – Slow worm (Anguis fragilis) (legless), common or viviparous lizard (Lacerta vivipara) and sand lizard (Lacerta agilis)

•  newts – great crested (Triturus cristatus), common or smooth (Lissotriton [formerly Triturus] vulgaris) and palmate (Lissotriton [formerly Triturus] helveticus) 

•  frogs and toads – common toad (Bufo bufo), natterjack toad (Bufo calamita) and common frog (Rana temporaria).

Apart from these, there is some argument over the status of the pool frog (Pelophylax (formerly Rana) lessonae), although currently evidence suggests it is/was native. The leatherback turtle (Dermochelys coriacea) may be considered a native (transient) inhabitant of British waters, but will not be dealt with here. Several other species have been introduced and exist as significant feral colonies (especially several frog species), and, of course, now there are significant numbers of dumped exotic ex-pets, especially red-eared terrapins.

Legal issues

It is worth briefly mentioning that some of our rarer species (smooth snake, sand lizard, natterjack toad and great crested newt and pool frog – the latter from 1 st October 2008) are fully protected under the Wildlife and Countryside Act 1981, and it is illegal for anyone to take them into captivity except for essential medical care. This should not affect injured casualties brought in, but you need to be aware that taking them from the wild, as well as killing (except humanely as an act of euthanasia in an injured/ill animal) or injuring them, is illegal except as noted. The others are only protected from killing, injuring and sale.

You should also be aware that the Dangerous Wild Animals Act 1976 applies to the adder: although this does not affect you as a veterinary professional providing treatment, it does apply to any rehabilitator who might take on the animal. Legal advice from the Department of the Environment, Food and Rural Affairs (DEFRA) suggests that anyone looking after an adder, except for a veterinary surgeon who is actively providing treatment or assessing (for a ‘reasonable period of assessment’) the animal, requires a DWA licence. The case of a rehabilitator or other individual housing an adder under veterinary treatment is a grey area, undecided by the courts; DEFRA refuses to commit itself on this. At other times the default position of a licence being required applies.

Unless you have suitable experience, however (and are prepared with regard to health and safety considerations for you and your staff), you are strongly advised to refer adders to a more experienced veterinary surgeon. RCVS advice is that you are not required to provide veterinary assessment or treatment where you believe human health is at risk, but you are required to make suitable arrangements for any such case presented to you to be treated by a veterinary practice willing to do so.

General points

One of the most important things to be aware of with regard to these species is that they are ectothermic, relying largely on behavioural means to control their body temperature.

Amphibians generally have very delicate skin, vulnerable to trauma, desiccation and many chemicals, which must be taken into account with their handling and housing. Reptiles are much less vulnerable in this regard.

In terms of diet, our native species are all essentially carnivorous/insectivorous, at least when adult; early-stage frog and toad tadpoles are herbivorous, but somewhat unlikely to be presented as casualties! Non-native species may be mainly or exclusively herbivorous (many terrestrial tortoises, some larger lizards), omnivorous (some chelonia, some larger lizards) or largely or exclusively carnivorous/insectivorous (essentially all adult amphibians, all snakes, most smaller and some larger lizards).

Telephone advice

On initial telephone call, it is necessary to try to determine whether there is, in fact, any health problem in the animal; for snakes in particular, many people may call up just trying to get rid of it. It is important to be cautious in identification when the owner is describing a snake; their description may or may not be accurate, and you don’t want to advise them to handle a venomous species! The yellow neck marks of the grass snake are a fairly easily identifiable and usable feature, but not infallible. Referring the owner to identification websites, where feasible, may be useful.

If in doubt, trying to direct the animal gently into a deep box, bucket or similar receptacle with a remote object such as a broom is best, but it is important to advise the client not to take any risks. If necessary, it may be better to advise them to contact the RSPCA or other suitable organisation.

For transport, reptiles may be carried in canvas bags or similar (pillowcases are usually available) or any suitable-sized sealed container (with air holes). Adders should be transported in closed containers – they may bite through cloth bags. Amphibians may be transported similarly, but must be kept moist – note that untreated tap water should not be used. Rainwater, pond water or bottled spring water are the preferred options, or a water conditioner (available from fish/aquarium shops) may be used with tap water. Even just a few damp leaves may be used.

Admission procedures

These are similar to any wildlife; taking note of the finder, location and any notes (e.g. whether the finder wants/is happy for the animal to be released back at the same site) is advisable. The more complete the description of the local environment the better, to allow any release in similar conditions.

Handling

As with most wild animals, the general rule with casualty herps is to handle as little as possible. At best the animals will not benefit from human contact; more commonly they will be stressed by it to a greater or lesser degree. However, initial physical evaluation is necessary. Thorough visual examination in a transparent container is often the best initial step. Magnifying aids are useful for the smaller species. Handling does require some care and, if possible, you should get some handling experience with these animals before you have to deal with them as casualties. They are generally very small and relatively delicate, so gentleness is required to restrain them safely. Amphibians should always be handled with smooth wet gloves, or at least wet hands; dry hands may cause damage to their delicate skins. Unfortunately this increases the ability of frogs in particular to escape from handling – they should only ever be handled in such a situation that they can’t injure themselves by jumping from your hand!

The speed of our native small lizards, combined with their ability to drop their tails (autotomy) and small size/fragility, can make handling them somewhat fraught! Again, they should be handled in a restricted container where recapture should be relatively easy.

Handler safety

In terms of danger to you, the only one of our native species that can inflict any significant damage to you is the adder, our only native venomous snake. As mentioned above, it is not advisable to deal with these unless you have appropriate experience. If presented with one in an unsuitable container, it should be transferred safely to a more secure container.

Skin secretions from amphibians, especially the common toad, may irritate or cause skin damage particularly in already cut or damaged skin. Possible zoonoses (mainly from Gram -ve bacteria, also mycobacteria, especially from amphibians) must also be taken into account. Standard hygiene precautions should be adequate. You should also be aware of the propensity of g
rass snakes in particular to spray cloacal gland/cloacal contents everywhere – not toxic, but extremely smelly!

Anaesthesia

Anaesthesia may (rarely) be necessary for handling or manipulation; this is dealt with in detail in standard texts. Chamber induction with isoflurane is suitable, if often very slow, for reptiles. Injectable alternatives are difficult in our native species, but propofol at lOmg/kg given intravenously may be used.

Buffered MS 222 (1 g/1 MS 222 in water, buffered with equal weight of sodium bicarbonate) in bath, or isoflurane bubbled through a bath is recommended for amphibians. Be aware that there is usually an excitation phase during induction (so the induction chamber should be padded), and that the animal can drown – it must be monitored and the nostrils kept above water level.

Common presentations

Casualties

Most casualties you are likely to see will have suffered some form of trauma, commonly cat attacks. Being caught in pond netting is common in grass snakes, as well as amphibians, in spring. Road accidents do occur, but with our native species survival from such incidents is unlikely. Accidental (typically mower/ strimmer) or even deliberate human attacks are also not uncommon (Figures 5-7).

Figure 5: Grass snake caught in netting. In this case the snake was uninjured, but deep wounds may occurFigure 6: Sloworm attacked by cat. In this case the injuries were so severe euthanasia was considered best for the animal

Figure 7: Toad with injury to face/foreleg. Initial systemic antibiotic and anti¬inflammatory cover, followed by topical wound care, allowed healing lalthough with the loss of use of the left eyel. Antibiotic eye ointment was used over the eye. and cream carefully applied to the lesion around it

Disease

Cases with diseases may also be presented; an important point to be aware of here is that herps, particularly amphibians, are more likely to suffer from ‘unusual’ microbes, such as fungi and mycobacteria, than domestic pets. Thus lesion sampling, at least for Gram and acid-fast staining, is always recommended. Pending results, broad- spectrum therapy should be initiated. Masses are more likely to be abscesses/granulomata than tumours, but these do occur, and the same principles apply as in other species.

Amphibian ‘die-offs'

You may be contacted about a case of multiple fatalities of amphibians, usually common frogs or toads. Classically, these may be associated with ranavirus (currently considered more common in Britain than elsewhere) or chytrid fungus (the fungus associated with many amphibian die-offs worldwide). Other possible causes, notably environmental pollution or possibly a nasty bacterial strain, must be considered. Note that amphibians are generally more sensitive to environmental toxins than fish, so multiple amphibian fatalities with unaffected fish present does not rule out environmental problems.

Typically, ranavirus outbreaks are associated with widespread ulceration on affected individuals, which is rarer in chytrid cases. PCR tests are available from the Institute of Zoology for both ranavirus and chytrid; contact them for further details.

Treatment

With all trauma, initial broad-spectrum antibiotic cover and anti-inflammatory/ analgesic dosing is advisable, especially with any cat victims (even if apparently uninjured). Any netting should be cut away carefully, trying to minimise stress to the animal. Anaesthesia may be required, but is usually unnecessary. Wounds in reptiles may be treated similarly in principle to more familiar species – they will rarely be fresh enough for primary closure to be indicated in wild casualties.

Wounds in amphibians are somewhat different – there are theoretical or actual concerns about many topical treatments (including antiseptic washes) or dressings in amphibians. There may be local irritation from active ingredient or carrier, or systemic absorption may cause toxicity. Most should therefore be avoided. Silver sulfadiazine cream has been widely used and is considered safe and effective, but even it should be applied sparingly.

Emergency procedures/treatments

Formularies for the two groups are listed below (Tables 1 and 2). One general note with regard to fluids is that there is some concern that lactated solutions may exacerbate an acidosis if the animal’s liver is badly compromised. Thus Ringer’s solution rather than lactated Ringers may be preferable, if available. However, lactated Ringers solution is widely used and clinically is rarely associated with problems.

Euthanasia

In many cases this may be the ‘treatment’ of choice, although you do need to be aware that healing in reptiles and amphibians can be remarkable, and trauma that would dictate euthanasia in mammals may not do so in these species.

Various methods are described – the most appropriate is usually intracoelomic pentobarbitone. It is always advisable to follow this up (once the animal is anaesthetised) by a physical method, such as freezing, pithing or otherwise destroying the brain, since the often very high resistance to hypoxia of these animals raises the theoretical possibility that they could be revived up to a day later in an aware state.

Hospitalisation and husbandry

Longer-term hospitalisation is often best passed on to an experienced keeper or rehabilitator. However, emergency accommodation may be necessary.

Any enclosure for reptiles and amphibians must strive to provide a range of microclimates – areas of specific conditions (temperature, humidity and lighting being the main one
s). That way the animal can find the conditions that suit it the best; this may vary depending on time of day, state of health and other factors.

Although some frogs and newts may be largely aquatic for spring and even summer, terrestrial set-ups, as described, are recommended at least for immediate hospitalisation. Simple, hygiene- orientated accommodation is usually best for short-term hospitalisation. Plastic containers of various sizes are readily available, and suitable air holes/ventilation can be simply provided if necessary (Figures 8 & 9)..

Figure 8: Basic hospital set-up tor a smalt snake.Figure 9: Basic hospital enclosure for a small amphibian – note cut plastic edges should be smoothed off or covered to avoid risk of injury. 

You do need to be aware that herps are good-to-incredible escape artists; many apparently tight-fitting plastic lids have enough flexibility near the middle for snakes to force their way out, while newts can climb straight up a glass surface.

Heating and lighting

Heating and lighting should be provided. For the reptiles, a background temperature of 14-18°C is suitable, with a basking ‘hot spot’ of around 26-28°C. Full-spectrum lighting, providing a suitable amount of both UVA and UVB wavelengths, is also advisable for reptiles, especially lizards (it is essential if anything other than very brief hospitalisation is contemplated) – a variety of tubes and bulbs are readily available in reptile-keeping stores.

For amphibians, which are generally crepuscular, basking lights are unnecessary, although some light/temperature difference between night and day should be provided. Overheating is something to be guarded against, particularly in amphibians; general temperatures significantly over 20°C may cause problems in these. Note that many non¬air conditioned buildings are therefore potentially a problem in summer.

Accurate ‘day length’ should be provided, and should be approximately 14 hours in summer and 12 hours at other times; it is best to use a timer switch for this in order to maintain reasonable regularity.

Bedding

The best hospital substrate is probably newspaper for reptiles (avoiding local papers where the ink is still wet!) and damp kitchen roll-type paper (preferably unbleached) for amphibians.

Other furnishings

Other necessary furnishings for the enclosure include at least two hiding places (one at each end of the heat gradient) and a water dish large enough for the animal to get into and submerge if it wishes. A small water container within the hides, to maintain locally higher humidity, is beneficial for reptiles (the damp substrate makes it unnecessary for amphibians).

Any water used for amphibians should be natural rainwater, still, bottled spring water or aged/treated tap water (various water treatments, to remove chlorine and other potential toxins, are available from aquarist shops).

Feeding

For short-term maintenance, feeding is not generally critical, although it is always preferable if the animal is eating. Snakes in particular may be uncooperative about feeding voluntarily, and the extra stress of force feeding or stomach tubing is probably not worth the benefits unless the individual is very underweight.

Natural prey of the amphibians and lizards is largely invertebrates, although the amphibians in particular will take almost anything live that they can fit in their mouths! The live point is important; movement is what these animals mainly target, and live prey will be taken far more readily than dead. Wild-caught invertebrates may be used, as long as there is no risk of chemical exposure, or various invertebrates are available commercially. Species preferences will vary; earthworms are a good staple for amphibians, while slow worms prefer small slugs.

Snakes, being largely vertebrate-eating, are more of a problem, in that feeding live vertebrate prey, particularly small mammals, is legally problematic. For the hospital situation, thawed frozen rodents of appropriate size (approximately the same diameter as the snake) may be offered, but acceptance is usually poor.

If considered necessary, stomach tubing may be carried out, at up to 20 ml/kg body weight daily. If the animal appears thin, initially rehydration solution then Critical Care Formula (VetArk) should be used. Longer term, liquidised dog food (Hills a Id or Recovery Formula or similar) may be used.

Release

This is usually best done in discussion/cooperation with an experienced rehabilitator, and a full discussion falls outside the scope of this article. Uninjured animals should generally be released as close as possible to their capture site; amphibians generally try to return to the body of water where they were born to breed. 

Author

Bruce Maclean BSC(Vet Sci) BVM&S MRCVS

Bruce graduated from the Royal Dick (Edinburgh) vet school in 1992. Following graduation, he spent time in the Avian and Exotic department at Utrecht University further studying the veterinary care of birds and exotic animals.

On return to the UK, Bruce spent six months in mixed practice and a short period in small animal/ exotics practice, before setting up his own dedicated birds/exotics practice 16 years ago. He works full-time and exclusively with birds and exotic animals, both first opinion and referral. He has contributed chapters to BSAVA manuals and several articles in UK- and US-based veterinary publications.

Bruce has been keeping reptiles and amphibians for more than 35 years, and amphibian medicine is a particular clinical interest.

To cite this article use either

DOI: 10.1111/j.2045-0648.2012.00180.x or Veterinary Nursing Journal Vol 27 pp 220-225

References and further reading General reptile medicine

MADER. D R. [2006] Reptile Medicine and Surgery. 2nd edn. Saunders Elsevier. Missouri

COOPER. J. E (2003) Reptiles, amphibians and fish. In: BSAVA Manual of Wildlife Casualties. BSAVA. Gloucester

GIRLING. S. and RAITI. P. (2004) BSAVA Manual of Reptiles. 2nd edn. BSAVA. Gloucester.

MEREDITH. A and REDROBE. S. [2002] BSAVA Manual of Exotic pets 5th edn. BSAVA. Gloucester 

WRIGHT. M. W. and WHITAKER. B. R. (2001) Amphibian Medicine and Captive Husbandry. Krieger Publishing. Florida

General reptile and amphibian husbandry

ALDERTON, D. (1997) The Reptile Survival Manual Ringpress Books, Gloucestershire.

DAVIES. R. and DAVIES. V. (1997) The Question and Answer Manual of Reptiles and Amphibians. Salamander Books. London.

STANISZEWSKI, M. (1990) The Interpet Manual of Lizards and Snakes. Salamander Books. London.

Websites

www.anapsid.org

www.caudata.org

Identification/native species biology and contacts

www.herpetofauna.co.uk

The Herpetological Trust [www.herpconstrust.org.uk] 

Froglife [wwwfroglife.org]

Amphibian and Reptile Groups of the UK [www.arg-uk.org.uk]

Institute of Zoology www.zsl.org/ioz

 

 

Veterinary Nursing Journal • VOL 27 • June 2012 •