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Reptile anaesthesia and analgesia

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EXOTICS

CPD article

Reptile anaesthesia and

analgesia
Anaesthesia and analgesia in reptiles is not more difficult than in any other veterinary species. However,
general practitioners often lose the opportunity to perform different procedures in snakes, lizards, chelonians
and crocodilians because they may feel uncomfortable with anaesthesia and analgesia of these patients. It
is unfortunately common for veterinary surgeons, even those seeing reptiles on a regular basis, to under-use
analgesics in reptile patients (Read, 20014). This article will guide practitioners on performing proper and safe
anaesthetic procedures, and will discuss the developing science of reptile analgesia. 10.12968/coan.2018.23.4.000

David Perpiñán DVM, MSc, PhD, Dip ECZM (Herpetology), RCVS Specialist in Zoo & Wildlife Medicine, Naturavets
Consultancy, Stroud

Key words: Exotics | lizards | snakes | chelonians | crocodilians| medicine | tortoises

A
naesthesia of reptiles can be performed in clinical
practice using the same equipment used for other
exotic species, although some unique anatomical
and physiological features need to be taken into
consideration. Analgesia is a developing field in reptile medicine and
recent years have seen significant advances in the understanding of
pain and its treatment in herpetological patients. Evidence-based
knowledge is paramount when using analgesics, as drugs and doses
used in other veterinary species may not work in reptiles.
Review of anatomy and physiology
Lizards and snakes both belong to the order Squamata
and are very similar in many anatomical and physiological
aspects, while chelonians (tortoises, turtles and terrapins) and
crocodilians belong to separate orders, the Testudines and
Crocodilia respectively.
Reptiles do not possess a diaphragm (Figure  1), and air
movement depends on the abdominal, pectoral and intercostal
muscles. Therefore the correct term is ‘coelomic cavity’ in reptiles,
rather than thoracic cavity and abdominal cavity. Reptiles have
higher pulmonary capacity (volume) than mammals, but the
surface available for gas exchange is not as high as in mammals,
because the caudal portion of the lung has limited gaseous
exchange function and is used mainly as an air sac in many
species (Figure 2). Some species of snakes and lizards inflate their
lungs considerably, using this technique to look bigger in front
of enemies or predators. The reptile lung is hollow in structure
(Figure  3); this can facilitate endoscopy for examination and
crocodile has the mouth open under water; the gular fold needs to
be displaced ventrally in order to access the glottis for intubation
(Murray, 2006).
The tracheal rings are incomplete in lizards and snakes, and
complete in chelonians and crocodilia. Therefore uncuffed
endotracheal tubes should be used in the latter, while either
cuffed or un-cuffed tubes can be used in lizards and snakes.
Dead space should be minimised; small reptiles can be intubated
using intravenous catheters. The trachea is particularly short in
chelonians (Figure 6).
Most snakes have one functioning lung, the right one; many
have a second lung but it is usually rudimentary.
Most reptiles function as poikilothermic organisms: their body
temperature varies considerably, depending on their environmental
temperature. Therefore anaesthetic drug metabolism, as any
other body function in these species, depends on environmental
temperature. For a successful anaesthetic event, reptiles should be
at their preferred temperature or they will not be able to metabolise
the drug properly, which can lead to increases in both induction
time and time to recovery. Respiration in reptiles varies depending
on O2 and CO2 blood concentrations, and ventilation increases in
situations of hypoxia and hypercapnia (Murray, 2006; Sladky and
Mans, 2012b; Bertelsen, 2014; Vigani, 2014).
Respiration is pulmonary in most reptiles, but some aquatic
species also perform cutaneous, pharyngeal and cloacal respiration.
These aquatic reptiles can also switch to anaerobic metabolism,
and can spend hours under water without breathing. Inducing
anaesthesia in these species using gaseous agents via face mask or
© 2018 MA Healthcare Ltd

sample collection (Murray, 2006; Bertelsen, 2014).
Reptiles do not have an epiglottis and the glottis is easily visible
in snakes and lizards (Figure 4), less so in chelonians. The glottis
of Crocodilia is behind a gular fold (Figure  5), the function of
which is to prevent the water from entering the trachea when the
induction chamber is not practical (Murray, 2006; Vigani, 2014).
Ventricular separation is more complete in crocodilia, followed
by monitor lizards, snakes and other lizards, and then chelonians.
Even those reptiles with only one ventricle possess cardiac folds
that allow for a variable degree of separation between venous and

2 Companion animal | April 2018, Volume 23 No 4

 EXOTICS

Heart Lung Stomach

Liver

Figure 1. Necropsy image of a gecko showing internal organs of a

lizard. Note lack of diaphragm separating lung and heart from the Figure 4. The glottis can be easily seen in this emerald boa
rest of the organs. (Corallus caninus).

Figure 2. Necropsy image of a lizard showing an inflated lung.

Note that in this animal the cranial aspect of the lung contains Figure 5. Gular fold in an American alligator (Alligator
the pulmonary parenchyma (left of the image, arrow), while the mississippiensis) (arrow). The glottis is accessed by displacing the
caudal aspect functions as an air sac (right of the image). fold ventrally.
© 2018 MA Healthcare Ltd

Figure 3. Necropsy image of a lizard where the lung has been Figure 6. Necropsy image showing the short distance between
incised, showing the characteristic parenchyma of this hollow the bifurcation of the trachea and the tip of the nose in a tortoise.
structure. Special attention should be paid to avoid intubation of a bronchium.

Companion animal | April 2018, Volume 23 No 4 3

EXOTICS
arterial blood; together with anaerobic metabolism, venous and
arterial blood mixing explains why some reptiles can spend hours
without breathing in some circumstances. However, even aquatic
reptiles should be ventilated during anaesthetic procedures in
order to avoid complications and delayed recovery (Murray, 2006;
Schumacher and Yelen, 2006; Sladky and Mans, 2012b).
There has been controversy about the renal portal system in
reptiles. Initially, it was thought that any drug injected into the
caudal portion of the animal was directed first to the kidneys,
being eliminated in some cases, and producing toxicity in some
others (Sladky and Mans, 2012b). However, studies showed that
when patients were properly hydrated the effect of the renal
portal system was barely significant (Holz, 1999). More recent
studies have shown that drugs may behave differently depending
on the species, with no clear pattern: some studies have found
no difference between injecting in the front and hind limb
(Campagnol et al, 2014) and some others have found differences,
which may be clinically significant or not (Giorgi et al, 2015;
Kummrow et al, 2008). Current recommendation would be to give
intramuscular injection in the cranial half of the body, although
injection in the caudal half of the body is expected to be effective
in many cases.
Pre-anaesthetic assessment
As in any other animal, a health assessment should be performed
before any anaesthetic procedure. This should include a complete
physical examination and may also include bloodwork and
radiographs at the veterinary surgeon’s discretion. In some cases,
if owner’s finances or blood volume limit potential tests, then the
determination of uric acid and packed cell volume are useful for
identifying conditions such as dehydration, oxygenation problems,
anaemia, infection and renal failure. It can be useful to obtain a
heart rate and a respiratory rate with the animal at rest before the
anaesthetic (Figure  7); these values will be very important later
Figure 7. Use of a Doppler probe to obtain a heart rate in a soft-shelled turtle. In
snakes, lizards, crocodilia and soft-shelled turtles the probe can be placed right
over the heart.
4
during anaesthesia to provide adequate ventilation and to monitor
cardiac function. Reptiles should always be kept at their preferred
temperature, and similar to the heart and respiratory rates,
obtaining a cloacal temperature before the anaesthetic starts may
help later to monitor this parameter (Sladky and Mans, 2012b).
The patient should be fasted ideally for 24–72 hours, and medium
to large snakes should be fasted for at least 72  hours before an
elective anaesthetic, as they are prone to vomiting.
Dehydration should be corrected before the anaesthetic event.
Fluid requirements in reptiles are estimated as 15–30 ml/kg/day,
plus the percentage of dehydration (Sladky and Mans, 2012b). If
an intravenous (IV) or intraosseous (IO) catheter can be placed,
5  ml/kg/h can be given during surgery, but for no more than
3  hours. Overhydration is a real danger in small exotic species.
Hartmann’s or a 50:50 mixture of 2.5% dextrose and 0.45% saline
provide a fluid type most similar to the osmolarity of reptiles. All
fluids should be administered warmed, at 25–35°C (Sladky and
Mans, 2012b).
Anaesthetic induction
Anaesthetic drugs can be administered through several routes. The
intramuscular (IM) route is commonly used; snakes are injected
in the epaxial muscles, between the scales, while chelonians can be
injected in the muscles of the cranial aspect of the femur or in the
large muscles between the plastron and the scapula. Lizards are
commonly injected in the cranial aspect of the femur. Intravenous
administration of anaesthetics can be carried out through an
IV catheter, although they are not particularly easy to place.
Practically, IV catheters are only used in the neck of tortoises
(Figure  8), and an incision of the skin followed by dissection in
order to find the jugular vein is usually necessary in most species.
An alternative way to maintain constant intravenous access is
to insert a needle or a butterfly catheter into a vein and secure
it in place (Hernandez-Divers, 2006; Murray, 2006; Schumacher
and Yelen, 2006; Sladky and Mans, 2012b). Regular intravenous
injections are also appropriate for injection of anaesthetic drugs
(Figure  9), although the subcarapacial vein in turtles should
be avoided when possible due to reports of serious side effects,
such as paralysis, probably due to injection of the anaesthetic
into the cerebrospinal fluid instead of the subcarapacial vein
(Innis et al, 2010).
Intraosseous catheters can also be placed in lizards and
chelonians. In lizards, it is relatively easy to place these in the tibia,
but in chelonians they should be placed in the humerus, which
is a significantly more complicated procedure (Hernandez-Divers,
2006). There is a study in tortoises demonstrating that fluids are
only well distributed when given through a jugular catheter and, to
a lesser degree, when given IO in the humerus. Injection into the
carapace does not distribute fluids very well (Young et al, 2012).
The intracardiac route is occasionally used in snakes due to the
difficulty in finding the caudal vein for IV administration in some
© 2018 MA Healthcare Ltd
specimens; while there is some damage in the heart associated
with the use of this route, studies have demonstrated no significant
adverse effects after using the heart to collect blood or inject drugs
(Isaza et al, 2004; McFadden et al, 2011). Intracardiac injections
should never be performed in fully conscious snakes. Due to the
Companion animal | April 2018, Volume 23 No 4
 EXOTICS

characteristics of reptile skin, local anaesthesia is usually injected

subcutaneously (SC). Finally, the inhalation route can be used
for induction in some species, and for maintenance in all reptiles
(Schumacher and Yelen, 2006).

Anaesthetic induction protocols

One advantage of reptile anaesthesia is that knowing one or two
protocols is usually enough to perform anaesthesia in a wide range
of species, although those protocols may depend on personal
preferences, type of procedure and availability of drugs. However,
in some species, mainly large crocodilia, specific protocols should
be used (Fleming, 2014).
As reptiles can hold their breath for long periods of time, it is
common and convenient to induce anaesthesia with an injectable
protocol and continue maintenance with a gaseous anaesthetic
agent (Schumacher and Yelen, 2006; Sladky and Mans, 2012b).
Injectable anaesthetics distribute slowly in reptiles, so when
injection is in the caudal aspect of the body, the back legs will be
anaesthetised first, followed by the front legs and later the animal Figure 8. Intravenous catheter placement in the jugular vein of a tortoise. Note
will lose consciousness. When an IV anaesthetic is given in the tail that the skin is usually incised first. Gloves should be worn to perform this
vein, the animal can be held head down to allow gravity to help procedure.
with the distribution of the anaesthetic.

Propofol
Propofol is a short-acting anaesthetic agent that can be given
IV or IO. Doses depend on the size of the animal, but for very
large reptiles 3 mg/kg is used, and for smaller reptiles 10 mg/kg is
more appropriate. Propofol should be given by slow intravenous
injection. If given too fast, the drug will leak out of the vein.
Propofol can also be used for maintenance, but it is far more
common to use a gaseous anaesthetic agent for that purpose.
However, doses for maintenance are 0.5–1  mg/kg as boluses or
0.3–0.5 mg/kg/min as a constant rate infusion. As with any other
anaesthetic agent, propofol produces cardiorespiratory depression
and hypotension. Care should be exercised when propofol,
and probably other injectable anaesthetics, are given in the
subcarapacial vein in chelonians, as paralysis has been reported
as an adverse effect, probably due to the injection of propofol in
the cerebrospinal fluid. Propofol has been used successfully in
small crocodilia, but larger crocodilia need specific protocols that
are beyond the scope of this article (Schumacher and Yelen, 2006; Figure 9. Intravenous administration of alfaxalone in the ventral tail vein of a
Sladky and Mans, 2012b; Keller, 2015). bearded dragon (Pogona vitticeps).

Alfaxalone Doses of alfaxalone are 5–10  mg/kg if given IV and

Alfaxalone is in the author’s opinion the current drug of choice for
anaesthetic induction and short-acting anaesthesia in reptiles. It
has several advantages over propofol:
zzAlfaxalone is a transparent liquid, therefore blood entering
the hub of the syringe is easily visualised. In contrast, blood
entering the syringe is difficult to visualise in the dense white
formulation of propofol
© 2018 MA Healthcare Ltd
10–15 mg/kg if given IM. Similar to propofol, induction is quick
and anaesthesia is short acting. Slow delivery is recommended
when given IV. Duration of anaesthesia is about 15  minutes,
similar to propofol. Both propofol and alfaxalone can be used
alone for short procedures (e.g., placement of an oesophagostomy
tube) or in combination with sevoflurane/isoflurane for prolonged
anaesthesia (Sladky and Mans, 2012b; Hansen and Bertelsen,

zzThe shelf life once the bottle has been openened is significantly
longer than for propofol
zzAlfaxalone can be given IM, which is a great advantage in many
species of reptiles such as snakes, small individuals, dangerous
animals, etc.
2013; Knotek, 2014; West, 2017).
Ketamine plus alpha-2 agonist
When alfaxalone is not available, a combination of ketamine
and an alpha-2 agonist may be used; this has been extensively

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EXOTICS
reported in the literature (e.g. Campagnol et al, 2014). Recovery
from combinations of ketamine and alpha-2 agonists, particularly
in snakes and lizards, are more prolonged than with propofol,
alfaxalone or inhalant anaesthetics. In chelonians, the IM or SC
combination of ketamine (10 mg/kg) + medetomidine (0.1 mg/
kg) + morphine (1.5 mg/kg) has been used for anaesthesia, with
reversal of the morphine with naloxone (0.2  mg/kg) and of the
medetomidine with atipamezole (0.5 mg/kg) once the procedure
has been completed; the effect of this combination is longer than
with the use of propofol or alfaxalone alone, but it can be used
for the same kind of procedures (Hernandez-Divers et al, 2009).
Many other protocols using different drugs have been described
in reptiles.
Inhalant anaesthetic agents
Inhalant anaesthetic agents (isoflurane and sevoflurane) can also
be used as an induction agent in terrestrial lizards and snakes
(aquatic/semiaquatic reptiles usually hold their breath when they
smell the agent). Induction can be carried out in an induction
chamber (Figure 10) or in a Ziplog bag (Figure 11). Ziplog bags are
excellent for monitoring, as the reptiles can even be turned upside
down to assess the righting reflex. Another inexpensive induction
chamber can be produced by adapting a Tupperware container or
similar by making a hole through which the anaesthetic circuit
can be attached. Induction at lower percentages (e.g. isoflurane
3%) is faster and less stressful for reptiles than inducing at the
highest settings. Both isoflurane and sevoflurane have very similar
characteristics, and any difference is generally not clinically
significant (Schumacher and Yelen, 2006; Sladky and Mans, 2012b;
Bertelsen, 2014). The author usually uses isoflurane because it is
significantly cheaper than sevoflurane.
Anaesthetic maintenance
Intubation
Once the reptile has been induced, the next step is to spray a local
anaesthetic into the glottis and intubate the patient. Alternatively,
the local anaesthetic can be applied with a cotton-tip applicator
or a syringe. Csre should be taken not to exceed toxic doses of
Figure 10. Induction of a venomous snakes using gaseous anaesthesia in a
metacrylate induction chamber.
6
local anaesthetics, particularly in small reptiles. Intubation is
strongly recommended for medium-duration to long procedures,
as reptiles do not breathe very well once they are anaesthetised.
Intubation helps the clinician to provide adequate ventilation and
oxygenation, and facilitates anaesthetic monitoring.
Gaseous anaesthetic maintenance
Isoflurane at 2–2.5% is appropriate for maintenance, although
those levels should be decreased with time over the anaesthetic
procedure to avoid excessive depth of anaesthesia. If additional
analgesia is required for a surgical procedure, bupivacaine can be
used as a local anaesthetic agent, to reduce the amount of gaseous
anaesthetic agent needed (Bertelsen, 2014).
Ventilation
Assisted ventilation should start as soon as the patient is
intubated, as anaesthetised reptiles may stop breathing or may
breathe insufficiently to maintain appropriate oxygenation.
Ventilation can be manual or using an electronic ventilator
(e.g. small animal ventilators from Vetronic, UK www.vetronic.
co.uk). The second option is recommended, but only ventilators
able to provide low tidal volumes adequate for small reptiles
should be used. The frequency of ventilation will depend on the
respiratory rate obtained in the pre-anaesthetic assessment. If a
resting pre-anaesthetic respiratory rate was not obtained, then
the reptile should be ventilated every 10–30 seconds, at no more
than 10 cm H2O of pressure, which is approximately equivalent
to 50–75 ml/kg. Without assisted ventilation, some reptiles,
particularly crocodiles and aquatic turtles, may experience long
recoveries after anaesthesia, as they go into anaerobic metabolism.
Oxygen or environmental air can be provided at 0.5–1.0 l/min
for most small to medium-sized reptiles. Spontaneous ventilation
needs higher oxygen flow rates than artificial ventilation
(Schumacher and Yelen, 2006).
Anaesthetic monitoring
With the animal under anaesthesia, the next step for a successful
outcome is monitoring. In a surgical plane of anaesthesia, the jaw
tone and the righting and palpebral reflexes should be absent, but
the corneal reflex should be present. Lack of corneal reflex indicates
an excessively deep plane of anaesthesia. The corneal reflex should
be assessed using a wet cotton tip applicator. Palpebral and corneal
reflexes cannot be assessed in those animals without eyelids, such
as snakes and some geckos (Figure  12) (Schumacher and Yelen,
2006 ; Sladky and Mans, 2012b).
Reflexes should be used as a guideline of the depth of anaesthesia,
but not as an absolute reference as they are not 100% effective. As
distribution of the anaesthetic agent is slow in reptiles, some animals
may lose the corneal reflex while still moving the back legs (when
anaesthetic is injected on the cranial part of the body).
The heart rate should also be monitored using an ultrasonic
© 2018 MA Healthcare Ltd
Doppler probe. In chelonians with hard carapace, it is placed
between the neck and the front limb, directed towards the heart.
Plenty of gel should be placed between the probe and the skin and
the probe should be fixed in place using folded gauze and some
tape (Figure 13). In other species (lizards, snakes, crocodilia and
Companion animal | April 2018, Volume 23 No 4
 EXOTICS

Figure 12. Palpebral and corneal reflexes cannot be assessed in snakes and
some geckos, as the eyelids of these species are transparent and fused together
forming a spectacle. The spectacle of this snake has turned blue due to
impending shedding.
Figure 11. Induction of an Indigo snake (Drymarchon couperi) using
gas in a ziplog bag. A small opening is left to introduce the gas,
but once the bag is full of anaesthetic it can be closed completely.

softshell turtles) the probe is placed directly over the area of the
heart. Significant decreases in heart rate should raise concern.
The heart of reptiles can continue beating after death, so weak,
slow Doppler signals may not necessarily mean the animal is alive
(Sladky and Mans, 2012b; Vigani, 2014).
Monitoring oxygenation is a bit more difficult in reptiles.
Pulse oximetry, capnography and blood gases have not been
validated in reptiles, and we may only use them to assess trends
(Sladky and Mans, 2012b). While there have been suggestions
to keep capnograph values in reptiles at 15–25  mmHg, these
recommendations have not been based on scientific studies
(Hernandez-Divers et al, 2005). Therefore, the best option to
ensure adequate oxygenation is to provide appropriate ventilation.
Temperature should also be monitored, ideally with a cloacal
probe. The patient’s body temperature can be maintained with
heat mats, forced air warming devices (e.g. Bair hugger®) or bottles Figure 13. In chelonians, the Doppler probe should be placed in the area
or gloves filled with hot water (Figure 14). Hypothermia increases between the neck and the front limb, aiming to the heart.
the risk of anaesthetic complications and prolongs recovery.
Blood pressure studies are still in their infancy in reptiles
(Schumacher and Yelen, 2006; Sladky and Mans, 2012b).

Anaesthetic recovery
Recovery may take a long time in reptiles, therefore it is good
practice to cease providing inhalant anaesthetic before finishing
the procedure, and to start reducing ventilations and changing
oxygen for room air (e.g. using a small Ambu bag). This may
stimulate reptiles to recover faster. It is still controversial whether
changing oxygen for room air speeds recoveries; some studies
have shown a benefit, some others have not. After completing
*
© 2018 MA Healthcare Ltd

anaesthesia, reptiles should be placed in an environment at their

preferred temperature (25–30 °C may be adequate for most
reptiles, but specific preferred temperatures should be consulted). Figure 14. Tortoise positioned for laparotomy. There is a temperature probe
Both low and high temperatures are detrimental to reptiles placed in the oesophagus (arrow) and a Bair hugger® (asterisk) is being used
recovering from an anaesthetic event. to prevent hypothermia.

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EXOTICS
Anaesthetic complications
Complications such as bradycardia, bradypnoea and loss of heart
rate can be treated with the same drugs used in small animals.
Changes in reptilian heart rate are usually gradual, therefore
careful monitoring enables action to be taken to correct abnormal
rate and hence avoid cardiac arrest.
zzFor respiratory depression, doxapram can be given IV at
5 mg/kg
zzAdrenaline (epinephrine) is indicated for cardiac arrest or
bradycardia: 0.1 mg/kg IV (dilution 1:1000 = 1 mg/ml). If used
intratracheally, the dose should be doubled and diluted with
saline
zzAtropine should be used for bradycardia: 0.04 mg/kg IV
or IO, or 0.2 mg/kg IM or SC (Carpenter, 2005; Funk and
Diethelm, 2006).
Analgesia
Analgesia in reptiles is a developing science. In some cases,
antialgid postures (Figure 15) can help us identify pain in reptiles;
in other cases, veterinary surgeons will need to assume that if a
procedure is painful for people it is painful for reptiles (Figure 16)
(Sladky and Mans, 2012a). Different groups of reptiles tend to
respond differently to a given analgesic drug. Drugs typically used
to control pain in small animals may not be effective in reptiles;
this is the case for buprenorphine and butorphanol, for example.
Opioids have been shown to be the best analgesics for reptiles.
Morphine (1.5–5.0 mg/kg SC q24 hours), pethidine (10–50 mg/
kg SC or IM q2–4 hours), hydromorphone (0.5–1.0 mg/kg SC/IM
q24 hours) and methadone (3.0–5.0 mg/kg SC/IM q24 hours) have
been used in chelonians with positive results, and morphine at the
same dose has been used in lizards also with positive results. The
higher the dose, the more analgesic effect and the more respiratory
depression will be seen. Morphine was not effective in snakes, and
unfortunately, few other studies have been performed in snakes
Figure 15. Antialgid posture in a green iguana (Iguana iguana) after a surgical
correction of an intestinal prolapse.
8
Figure 16. Traumatic injury to a gopher tortoise (Gopherus
polyphemus) caused by a road traffic accident. As the structure of
the carapace contains bone, veterinary surgeons should assume
these wounds are painful.
(Sladky and Mans, 2012a).
Tramadol (5–10 mg/kg PO q48–72 hours) has also been used
successfully in chelonians and is a good option for treatments at
home by the owners, as it can be given orally and is not as heavily
controlled as opioids. Intramuscular administration of tramadol
is also effective (Duvall, 2017). There have been pharmacokinetic
studies of meloxicam in reptiles, but without functional studies
it is unknown if the drugs works as an analgesic in reptiles.
While doses for other NSAIDs can also be found in books and
other sources, no scientific study has proven their efficacy. A
recent article in snakes determined that COX-2 was not involved
in inflammation, while COX-1 did increase with inflammation;
therefore, at least in snakes, selective COX-2 inhibitors may not be
effective (Sladky and Mans, 2012a; Sadler et al, 2016).
Conclusions
Reptiles can be anaesthetised using just a few protocols (mainly
involving isoflurane/sevoflurane, propofol and alfaxalone), but
knowledge of anatomy and physiology, as well as specific methods
to apply, maintain and monitor anaesthesia, are necessary for a
successful outcome. Reptile analgesia is a developing science;
doses and drugs applied in other animals cannot be extrapolated
to reptiles, and veterinary surgeons should be aware of specific
scientific studies in order to relief pain effectively in these patients.
CA
Conflict of interest: none.
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Companion animal | April 2018, Volume 23 No 4 9

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