Cardiomegaly and pericardial effusion in a beauty rat snake

Abstract

Few treatment options are reported in snakes for the treatment of cardiac conditions and reptile cardiology continues to need further investigation. This case report discusses the first report of pericardial effusion in an Asian beauty rat snake (Orthriophis taeniurus), and the creation of a pericardial window to help treat the condition. The snake presented with bilateral exophthalmos, changed behaviour, and regurgitation of food items. Physical examination revealed a ventral swelling in the region of the heart and this was confirmed by radiography and ultrasonography. The pericardium was distended with a significant pericardial effusion, while the heart remained a relatively normal size. Unfortunately finances were limited, therefore treatment was instigated without further diagnostics. Initially this involved oral frusemide and metronidazole, along with pericardiocentesis. Acupuncture was also used to help treat the snake's behavioural changes, as the owner was keen on alternative medicine. Due to the recurrent nature of the disease, the owner agreed to surgery to create a permanent pericardial window, aiming to permanently relieve the pericardial effusion. The surgery itself was simple to perform and was initially successful in preventing further build-up of pericardial fluid. However, the snake died 5 days post surgery of unknown cause. In this report we discuss this surgery and potential treatment options.