RECTAL PROLAPSE - DIAGNOSIS AND TREATMENT
Written by Zoe Stevens
Note: The following information pertains to Candoia c paulsoni, but in many cases can be applied to other snake or lizard species. The information below should not replace the advice of a qualified reptile veterinarian.
Rectal Prolapse occurs when the last section of the intestines - the rectum - "pops out" of the anus. The danger then is that the prolapse can dry out, swell and die off, and this can be fatal if not treated quickly.
Rectal Prolapse in Candoia appears to be very rare, which may simply be because so few Candoia are captively kept. Prolapse in snakes in general, however, is not rare, but not quite common. In some species, like neonate green tree boas, it can be common. There are a few possible reasons for a prolapse: parasites, dehydration, stress, and overfeeding / powerfeeding. I do not by any means overfeed my snakes (I like to keep them lean because it seems to me that most captive snakes are too chubby!) The Candoia in question, Sol, was treated for parasites shortly after I got her, and is not in a high stress/high traffic situation. I came to the conclusion that dehydration is the cause, despite the large bowl of water and thrice-weekly mistings.
I noticed the prolapse one evening after work, and although it was too late for me to take her a vet that night, I began looking for one. I was very lucky in finding an excellent herp vet who worked in zoos in Africa. His experience with "pet" snakes is limited, but he was happy to take my own suggestions and do some extra research and assist me in any way possible. When I got her in the next day, her prolapse was quite swollen and a bit dry despite by attempts to keep it hydrated - it wasn't shriveled up, but did seem to be developing an outer layer of "skin". When the vet tried to re-insert the prolapse, the "skin" split, causing some minor damage to the prolapse. We thought for a while that it would not be possible to re-insert it and that it would need to be excised, but the vet inserted a thermometer into the rectum, and it did go back in. We used some surgical tape and gauze wrapped fairly tightly around her butt to keep her from "flexing" and popping it back out again. We determined that two stitches on either side would probably be in order to keep the rectum in place. However, when the prolapse did not recur within a day, the vet opted not to do surgery. I did not feed her for a month and the prolapse has not recurred. Because I suspect the culprit was - at least in part - dehydration, I have begun injecting her (f/t) prey with warm water in the belly, and providing her with a much more humid enclosure. I also opted to treat her with antibiotics, and she was put on a 10-day course of oral antibiotics. She was not a happy camper by the end of those 10 days, but seems to be doing fine otherwise.
In the event of a prolapse in your snake, you can try to re-insert it using a gloved finger and some KY jelly. If the prolapse is swollen or dry, or if you do not feel comfortable doing it yourself, do not attempt to re-insert it. You can use a sugar and water paste slathered on the prolapse, or some hemorrhoid cream, to try to reduce swelling to help with re-insertion. You must also keep the prolapse humid with some mineral oil or KY jelly. You should schedule an appointment with your vet as soon as possible - within a day or two. If the prolapse is left too long, it will dry out and need to be surgically removed.
The vet may be able to push the prolapse back in using his finger or a thermometer. If he cannot, but the rectum is still healthy, he may suggest a small incision to enlarge the anus, giving enough room to push the prolapse back in. If the prolapsed rectum is damaged, dead or dried out, he will have to excise the prolapsed rectum and sew the next bit of healthy rectum to the anus.
Two stitches, one on either side, may be recommended to ensure proper healing. You or your vet may also want to treat your snake with oral antibiotics. Do not feed your snake for at least 3 weeks (more if possible) - you want the rectum to heal as much as possible before the snake passes feces. This also means that you should avoid soaking your snake, which may induce the passing the feces. Instead, provide a small bowl of water and a moist hide with moist sphagnum moss.
You will also have to address the root cause of the prolapse - if you know what it is. Treat for antibiotics if necessary; reduce feeding to one small meal (just enough to cause a small lump) every 2-3 weeks; increase humidity, inject dead prey's stomach with water; move your snake to a more appropriate, less stressful enclosure, etc.
If caught soon enough and treated promptly and properly, there is no reason that a snake cannot recover fully and quickly from a prolapsed rectum.
Zoe's site: http://www.candoia.ca