Lumps and Bumps in Snakes
Dr. Jenni Bass
History and physical. First he will take a history, to understand the background of both the lump and the snake. He will also question you as to the snake's diet and environment, with particular attention to the temperature and humidity. Then he will perform a physical examination. In some cases this will be enough for your veterinarian to be able to make recommendations or to prescribe treatment. In most cases, he will prefer to have more information.
In most instances, when presented with a snake with a lump, your veterinarian will follow a sequence of steps, which should allow him to arrive at a diagnosis.
Blood tests. These allow for the evaluation of function of organs such as the liver and kidneys, and even when a mass does not involve these organs directly, their role in the snake's overall health is important and needs to be assessed. An evaluation of the red and white blood cells can indicate anemia or sub-clinical, that is undetected, disease. In the case of bacterial, viral or fungal conditions, blood tests provide a means to diagnose disease, assess its severity and monitor response to therapy.
Bacterial or fungal culture. In the case of skin lumps, infection is often suspected, and your veterinarian may take a sample of the lump contents to assess the infectious agent and to choose the best treatment.
Radiographs (X-rays). Radiographs are often used to assess internal organ enlargements. They may reveal changes to the skeleton, retained eggs or fetuses, foreign bodies or other masses. If the lump in question involves the digestive tract, it is common to tube-feed the snake with barium, which will coat the digestive tract and show up as bright white material on the radiograph, outlining any masses, obstructions or abnormalities.
Fecal testing and stomach washes. These may reveal parasites, which may directly or indirectly cause swelling of the digestive tract. Particularly in the case of fecal testing, fresh samples are best. A sample containing no parasites does not necessarily indicate that the snake is free of parasites. Serial samples are often required.
Endoscopy. A fiber-optic endoscope, which is like a very small microscope on the end of a slim rod or cord, allows internal examination through a small incision or through the mouth. The extent of the problem can be assessed this way, avoiding more invasive procedures. Biopsies or samples for culture can also be obtained this way.
Biopsies and fine needle aspirates. Relatively large samples comprised of up to a few millimeters of tissue (biopsy) or just a few cells aspirated through a needle directed into a lump (fine needle aspirate) can be revealing when examined under a microscope. Depending on the circumstances, this test may be done by your reptile veterinarian, or at a laboratory by a veterinary pathologist. Biopsies and aspirates are often taken from the skin or other superficial lumps, but are also used as part of an exploratory surgery. For example, a snake with a mid-body swelling, which appears by palpation and on a radiograph to be an enlarged liver, might undergo an exploratory surgery. The intent of the surgeon is to be sure of the origin of the swelling, and should the swelling be a foreign body in the gastrointestinal tract, or an abscess, it can be removed. However, if the lump inside the snake is discovered to be a swollen liver, it obviously cannot be removed. However, a small sample of liver (that is, a biopsy) can be taken. This can be examined microscopically, in an effort to reach a diagnosis of the type of liver disease and to determine an approach to treatment.
It is not unusual to find a lump on a pet snake. Changes in your pet's body, which manifest as lumps, either on the skin or within the body are seldom normal. Regular inspection and careful handling of your pet snake will allow you to detect these changes as early as possible. The causes of masses or lumps are many and varied but are always worth being examined by a reptile veterinarian, because a number of conditions, some serious and some not, can appear the same at first glance.
In most cases, a detailed history and a thorough physical examination will be sufficient to narrow down the possible diagnoses. At this point your veterinarian may have a good idea as to the extent and general nature of the problem. Your reptile veterinarian should be able to explain to you why he recommends a given test or tests, and should be able to help you to choose an approach that meets your budget and also addresses the needs of your snake. This may be as simple as a few husbandry changes or basic, inexpensive tests.
In the event of a more complicated or more serious condition, a reptile veterinarian will be able to outline a stepwise investigation, designed to lead to a definite diagnosis, a prognosis and a treatment plan. It is almost always worth trying to reach a definite diagnosis; once we know what to call the problem, we can address it logically.
Reptile medicine has made huge advancements in recent years, and tests and treatments are improving along with our knowledge of reptile disease. Many disease conditions remain to be understood, and no doubt many are yet to be discovered. Reptiles never fail to surprise those of us who work with and care for them; a step-by-step, scientific approach, will inevitably lead to improved medical care for all snakes, as well as to the best treatment options for your pet.