A non-surgical approach to prolonged constipation in an Indian python (Python molurus)

Constipation, urolithiasis, and subsequent anorexia are frequent issues in reptiles kept in captivity often due to inadequate management; maintenance of correct temperature and relative humidity is a fundamental factor [1]. An albino Indian python (Python molurus) of 23 years of age, 5.2 meters long and weighing 58 kg, was presented for anorexia and lack of stool production for about 11 months. The patient was kept in a terrarium at about 27 °C, without humidity control. The python was usually fed with two live rabbits every 30 days. Dehydration, dysecdysis and mild overweight were noted on physical examination; blood biochemistry tests were in the species ranges. Total body computed tomography (CT) was performed under general anesthesia, revealing presence of several uroliths and coprolites in the distal colon, which was dilated with gaseous fermentations. Two days later, a non-surgical approach with manual cloacal removal of the material was chosen, as the considerable size of the snake could allow such a procedure. Lukewarm fluids and sorbitol enema were intracloacally administered, pre- and post-operatively. For the procedure, butorphanol was pre-operatively administered and anesthesia was induced and maintained with isoflurane. After 48 hours, force-feeding (300 g, Hill’s a/d) was administered through a feeding tube. The animal was discharged 5 days later, and the owner reported resumption of spontaneous feeding and stools production after 20 days. In boids, delay in stool production up to few months could be considered physiological, as passage of ingesta is influenced by several environmental and metabolic factors [2], but in a captive animal, constipation lasting 12 month represented a pathological condition that required intervention. In intestinal diseases, CT can provide more accurate information compared to contrast radiography [3]. Treatment of constipation aims at resolution of the primary cause along with symptomatic treatment based on rehydration and removal of the material, even with a surgical approach. The non-invasive approach performed in this case, associated with changes in the management, allowed non-surgical resolution of the disease and resumption of normal condition, sparing any algic surgical stimulus to the animal.