Exotis ISSN 2398-2985

Reptiles

Constipation

Synonym(s): Obstipation, Impaction

Contributor(s): Sarah Brown, Robert Johnson

Introduction

  • Cause: slow or cessation of passage of ingesta through the gastrointestinal tract. There are numerous causes of reduced gastrointestinal motility and resultant constipation. Often related to husbandry and dietary deficiencies. Ingestion of inappropriate substrate.
  • Signs: often non-specific signs such as lethargy and anorexia. Vomiting, regurgitation, tenesmus, hematochezia, secondary intussusception, cloacal prolapse, fecal impaction, associated disease signs.
  • Diagnosis: a history may indicate minimal or no recent fecal output and may highlight dietary and husbandry issues. Radiography, bloodwork, ultrasonography, cloacal endoscopy and advanced imaging may all be useful.
  • Treatment: underlying husbandry and dietary problems should be corrected, especially relating to temperature and water provision. Fluid therapy is essential, cloacal enemas, regular soaking in warm water. gentle colon massage. Medical treatment, enterotomy.
  • Prognosis: good, provided environmental and dietary issues are addressed early in the stages of constipation, and where significant concurrent pathology is not present.

Pathogenesis

Etiology

  • There are numerous causes of reduced gastrointestinal motility and resultant constipation.
  • Often related to husbandry and dietary issues such as overfeeding, provision of inappropriate food items, dehydration, low environmental temperatures, poor environmental humidity, insufficient space for mobility and hypocalcemia/metabolic bone disease Metabolic bone disease.
  • The rate of food movement through the gastrointestinal tract will change with type, volume and composition of the food, the environmental temperature, the type and physiology of the gastrointestinal tract and the reptile’s health status Chelonia anatomy and physiology Lizard anatomy and physiology Snake anatomy and physiology.
  • Ingestion of inappropriate substrate may also contribute to constipation.
  • Certain predisposing factors (see below) can make constipation more likely to occur.

Pathophysiology

  • Reduction of gastrointestinal motility due to one or more factors, leading to lack of passage of feces through the gut.
  • Dehydration of the feces can ensue, leading to further difficulty in passing the enterolith.
  • In severe cases, the enterolith may cause complete mechanical obstruction of the gastrointestinal tract leading to increased gastrointestinal wall tension and loss of blood supply with resultant ischemic necrosis and potential bowel perforation. Shock and death may ensue.

Timecourse

  • Variable but often prolonged.
  • Keepers may not notice clinical signs until constipation is relatively severe.

Epidemiology

  • Usually restricted to individual cases; however, if the husbandry of a collection is generally substandard then multiple animals may be affected.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Mans C (2013) Clinical update on diagnosis and management of disorders of the digestive system of reptiles. J Exotic Pet Med 22, 141-162 JExoticPetMed.
  • Mitchell M A (2005) Clinical reptile gastroenterology. Vet Clin North Am Exotic Anim Pract 8 (2), 277–298 PubMed.
  • Wright K (2008) Two common disorders of captive Bearded dragons (Pogona vitticeps): Nutritional secondary hyperparathyroidism and constipation. J Exotic Pet Med 17 (4), 267-272 VetMedResource.

Other sources of information

  • Brown S J L, Naylor A D, Machin R A & Pellett S (In press) Gastrointestinal System. In: BSAVA Manual of Reptiles. 3rd edn. Ed: Girling S J & Raiti P. BSAVA, UK.
  • Johnson R & Doneley B (2018) Diseases of the Gastrointestinal System In: Reptile Medicine and Surgery in Clinical Practice. Ed: Doneley B, Monks D, Johnson R & Carmel B. Wiley-Blackwell, UK. pp 273-286.
  • Corbit A G, Person C & Hayes W K (2014) Constipation associated with brumation? Intestinal obstruction caused by a fecalith in a wild red diamond rattlesnake (Crotalus ruber). J Anim Physiol Anim Nutr 98 (1), 96-99.
  • Chitty J & Raftery A (2013) Imaging. In: Essentials of Tortoise Medicine and Surgery. Wiley-Blackwell, UK. pp 121-122.
  • Chitty J & Raftery A (2013) Vomiting and Regurgitation. In: Essentials of Tortoise Medicine and Surgery. Wiley-Blackwell, UK. pp 93-96.
  • Hnizdo J & Pantchev N (2011) Diseases of the Digestive System. In: Medical Care of Turtles & Tortoises. Eds: Hnizdo J & Pantchev N. FrankfurtamMain, Germany, ChimairaBuchhandels GmbH. pp 337-368
  • Diaz-Figueroa O & Mitchell M A (2006) Gastrointestinal Anatomy and Physiology. In: Reptile Medicine and Surgery. 2nd edn. Ed: Mader D R. W B Saunders, USA. pp 145-162.
  • Griffin C (2006) Severe Obstipation as a Result of Power Feeding in a Red Tail Boa (Boa constrictor). In: Proc 13th Assoc Reptil Amphib Vet Conf. Ed: Baer C K. pp. 112-113.
  • Jepson L (2016) Snakes, Lizards, Tortoises and Turtles. In: Exotic Animal Medicine. A Quick Reference Guide. 2nd edn. Elsevier, USA. pp 343-474.
  • McArthur S (2004) Problem-solving Approach to Common Diseases. In: Medicine and Surgery of Tortoises and Turtles. Eds: McArthur S, Wilkinson R & Meyer J. Blackwell Publishing, UK. pp 333-349.
  • McArthur S, McLellan L & Brown S (2004) Gastrointestinal System. In: BSAVA Manual of Reptiles. 2nd edn. Eds: Girling S J & Raiti P. BSAVA, UK. pp 210-229.
  • Toothill A, Johnson J, Winsatt J & Mangone B (2000) Effect of cisapride, erythromycin, and metoclopramide on gastrointestinal transit time in the desert tortoise, Gopherus agassizii. J Herpetol Med Surg 10, 16-20.


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