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Pharmacotherapy in reptiles

univ. prof. Zdenek Knotek, DVM, PhD
University of Veterinary and Pharmaceutical Sciences Brno
Czech Republic

Pharmacokinetism - temperature
Reptiles are ectotherm vertebrates.
Their metabolism is dependent (influenced
with) on external temperature.
In nature – reptiles try to keep the body in
preferred body temperature (PBT) optimal
condition for metabolic pathways.

Patients keep their PBT - spending maximum
time in special part of the terraria - behavioral
thermoregulation.

Pharmacokinetism - temperature
Reptiles are ectotherm vertebrates.
Preferred optimum temperature zone (POTZ) is
condition for PBT.
• Keep your patients in POTZ – during
treatment, anaesthesia, surgery, recovery
period.
• Lower (suboptimal) temperatures – prolong
the recovery time.
• Lower (suboptimal) temperatures – increase
the risk of overdose drugs (aminoglycosides).

Central organ for final urine production.Special anatomy/physiology of reptiles Quadriped reptiles . Presence/absence – urinary bladder – ventral extension of urodeum. .renal portal system.

tissues). Special anatomy/physiology of reptiles • The most of snake species have only the right lung. Do not insert the endotracheal tube into left lung rudiment. • Semia-quatic/aquatic reptiles – shunt of blood circulation within the period of submergence. . • Reptiles can tolerate very low oxygen concentration in peripheral blood (organs. • Reptiles have very low respiratory frequence. It is lowest within anaesthesia.

Special anatomy/physiology of reptiles GIT – in carnivorous reptiles (crocodiles. . Transit time for contrast fluids (X-ray). very slow passage (weeks). food. snakes and some lizards) short distance. Transit time for contrast fluids (X-ray). lizards) long. food. drug metabolites is short (days). GIT – in herbivorous reptiles (land tortoises. aquatic terapins. drug metabolites is long.

DIAGNOSIS and TREATMENT §1 Think before treat ! §2 Disease is complex ! §3 Concurrent diseases ! §4 Patient is complex ! §5 Topical and/or systemic treatment ! §6 Follow the recommendations ! §7 Reptiles.crocodiles. lizards . snakes. chelonians.

DIAGNOSIS and TREATMENT EMERGENCY ? .

only an illusion. air humidity. water. Prepare your own questionare protocol origin of the reptile housing system feeding regimen temperature. Good history . UVB any previous treatment? previous reproductive activity? .Reptiles are generally presented injured or ill. substrate. In many cases .valuable lead to the problem.

The success of treating a critical patient relies very heavily on the environment in which the animal must recover. . When possible make visually-separated housing for each of the reptile patients. They may experience unnecessary extra stress in a living with visual contact with other reptiles (predators).

haemocytometer biochemistry testing system.Basic equipment to practice with reptiles a gram scale a lightweight plastic transport containers endoscope (2. .7 mm or less) X–ray microscope with oil immersion capability quick-staining kit for smears and cytology. centrifuge.

kanamycin. cardiotox) efects .bacterial infections glomerular filtration . ototoxic. nephrotoxic (neurotoxic. netilmycin. gentamycin. Side effects Aminoglycosides amikacin. tobramycin + G.

vomitus. low nephrotoxic . bacteriostatic .infections. chlortetracyclin. oxytetracyclin. hepatotoxicefekt (liver steatosis). nauzea. tetracyclin + G+ i G. teratogenic (pregnanc). Side effects Tetracyclin ATBs doxycyclin.

ciprofloxacin + G+ a G. Side effects Quinolon enrofloxacin.infekcí. joints) . suspect teratogenic (pregnancy). negative influence on bones (growth.

Hexamita) .neurotoxic efect of reccommended doses (heavy reptiles) . Metronidazole + (Clostridia. Entamoeba.

ectoparasites) . Ivermectin + (endoparasites.toxic for tortoises. turtles .

Administartion Per os + GIT Per cloacam Parenteral SC. IPP. IM. IV. IO .

H0.75 • birds .non-passerine birds (K = 78) • mammals (K = 70) • reptiles (K = 10) . Metabolic (Allometric) scalling BMR (kcal) = K.passerine birds (K = 129) • birds .

48 x 5 .75 .5 mg/kg IM q72 h x7 Nephrotoxic agent Kanamycin 5 . Antimicrobial agents ATB Agent Dosage Comments Acyclovir 80 mg/kg PO q24h x10 Tortoises (herpes) Topical (5% ointment) q12h Tortoises (herpes) Ampicilin 20 mg/kg IM q24h x 7 Tortoises Amikacin Nephrotoxic agent 2.15 mg/kg q24 .7 Nephrotoxic agent .5 mg/kg IM. SC q72h x 7 Gentamycin 1.2.

7 Tetracycline 25 .5 mg/kg PO q12-24h x 7 Doxycycline 50(1)+25(3 . Antimicrobial agents ATB Agent Dosage Comments Chloramphenicol 20 .5 .10 mg/kg IM q24h x10 crocodiles Cindamycin 2.10 mg/kg IM q24h x 5 . PO q24h x 6 Tylosine 5 .50 mg/kg PO q24h x 7 Streptomycin 6 .6)mg/kg IM q48 .72h x 6 .50 mg/kg IM.

40 mg/kg IM q24h x 7 .14 Cephoperazone 125 mg/kg IM q24h x 7 lizards .40 mg/kg IM q48h x 7 chelonians Cephazolin 20 .40 mg/kg IM q12h x 7 Cephalothin 20 .14 Ceftazidime 20 mg/kg IM q72h x 14 .40 mg/kg IM q24h x 7 . Antimicrobial agents ATB Agent Dosage Comments Cefotaxime 20 .21 Cephalexin 20 .

21 Ciprofloxacin q48h x 3 . PO q24h x 7 .5 10 mg/kg PO Metronidazole 20 .5 Trimethoprim / 30(1)+15 mg/kg q24h x 10 . Antimicrobial agents ATB Agent Dosage Comments Enrofloxacin 10(15) mg/kg SC.50 mg/kg PO q24h x 3 .14 sulfamethoxazole Sulphadimidine 50 mg/kg PO q24h x 10 Sulphamerazine 25 mg/kg PO q24h x 7 .

IPP q24 .48h x 28 Griseofulvin 20 . Antifungal agents antimycotics Agent Dosage Comments Amphotericin B 0.1 mg/kg PO.40 mg/kg PO q72h x 5 Clotrimazole ointment topical Fluconazole 5 mg/kg PO q24h x 28 Itraconazole 24 mg/kg PO q24h x 28 Ketoconazole 15 .5 .30 mg/kg PO q24h x 28 .

Antifungal agents antimycotics Agent Dosage Comments Chlorhexidine 20 ml/gal water bath Lizards .u.15 mg/l water x 1 hr q24h x 14 Miconazole topical ointment Nystatin 100 000 i./kg PO q24h x 10 Tolnaftate 1% topical q12h cream . Malachite green 0.dermatoph.

Antiparasitic agents Parasites Agent Dosage Metronidazole 20 – 40 (100) mg/kg 3x Amoeba Dimetridazole 40 mg/kg q24h x 4 Paromomycin 35 – 60 mg/kg after week Metronidazole 20 – 40 (100) mg/kg 3x Flagellata Dimetridazole 40 mg/kg q24h x 4 Ronidazole 10 mg/kg q24h x 10 .

Sulfamethoxydiazine 40 – 60 mg/kg q24h x 4 Sulfadiazine 20 – 50 mg/kg q24h x 3 Cryptosporidium Trimethoprim / 30 – 60 mg/kg q24h x 7 sulfa Spiramycin 160 mg/kg q24h x 10 .day 40 – 45 mg/kg II. Antiparasitic agents Parasites Agent Dosage Toltrazuril 10 mg/kg q72h x 5 Coccidia Sulfadimethoxine 75 – 90 mg/kg I. – IV.

2 mg/kg SC  Chelonians Cestoda Praziquantel 10 – 30 mg/kg q14 days Niclosamid 150 mg/kg q14 days .2 mg/kg SC  Chelonians Trematoda Praziquantel 10 – 30 mg/kg q14 days Ivermectin 0. Antiparasitic agents Parasites Agent Dosage Ivermectin 0.

2 mg/kg SC  Chelonians Piperazine 40 – 60 mg/kg q 14 days Albendazole 50 mg/kg q 14 days Mebendazole 20 – 100 mg/kg q 14 days . Antiparasitic agents Parasites Agent Dosage Fenbendazole 10 – 30 mg/kg q 14 days Pyrantel pamoate 5 mg/kg q 14 days Nematoda Ivermectin 0.

24h Oxytocin 1 . Hormones + steroids Agent Dosage Comments Arginine vasotocin 0.1.5 i.IPP q12 .5 ./kg SC q8h x 2 .u./kg IM after 2x calcium inj. Calcitonin 1. PHA .u.10 i.0 μg/kg IV.5 mg/kg IM.4 mg/kg IM q24h x 3 Prednisolone 2 .3 Dexamethasone 2 . PO chronic pain Nandrolone 1 mg/kg IM anabolic.

hypocalcemia borogluconate 10 .2 x w.3w Iron dextran 12 mg/kg IM 1 . Nutritional / mineral / fluid support Agent Dosage Comments Ca .gluconate . SC q8h MBD. IPP q24h ´s solution .50mg/kg IM Ca .25 ml/kg SC.gluconate 100mg/kg IPP.4 mg/kg PO q24h x 2 . seizures Iodine 2 . crocodiles Lactated Ringer 10 .

/kg IM 25 mg/kg IM hypovitaminosis Vitamin K1 1000 . Nutritional / mineral / fluid support Agent Dosage Comments Vitamin A 1000 . IM q24h Vitamin D3 200 i./kg IM q7-14d x 4 Vitamin B q24h x 3-7 days complex 25 mg thiamine/kg PO Vitamin C 10 .5000 i.u./kg IM.20 mg/kg SC.u.u.u./kg IM coagulopaties . PO q7days Vitamin E 1 i.5000 i.

5 .24h Metoclopramide 0.12h Cisapride 0.0 mg/kg PO q24h Furosemide 5 mg/kg PO.1000 mg/kg PO q6 .06 .20 mg/kg PO q24h Sucralfate 500 . IM q12 .2.8h Cimetidine 4 mg/kg PO.5 mg/kg PO q24h x 7 . Miscellaneous agents Agent Dosage Comments Allopurinol 10 . IM q8 .

Miscellaneous agents Agent Dosage Comments Lactulose 0.5 ml/kg PO q24h Liquid paraffin 25 (1:1 electr)/kg PO q24h.20 ml/kg PO GIT contrast . constipation Dioctyl Na 1 .5 mg/kg PO constipation sulfosuccinate Barium sulfate 5 .