![\"\"](\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2024\/12\/Sadar_TVPJanFeb25_ReptilePhysicalExam_Fig1.png\")
<\/a>Figure 1. Normal feces and urates produced during the physical examination of a bearded dragon.<\/p><\/div>\n
Handling and Restraint<\/h2>\n
Safe handling involves safety for both the handler and the reptile. As the handler, it is important to recognize the defensive mechanisms of the type of reptile being handled. For many species, the first instinct is to escape. However, some may be quicker to resort to aggression, such as male green iguanas, and the clinician and handler should be aware of this. Handling gloves and long sleeves can be used to help protect the handler\u2019s hands and arms. Due to the concern for Salmonella<\/i> species, which all reptiles have the potential to shed intermittently, the handler and the examiner should wear gloves. It is also recommended that owners wash their hands after handling reptiles at home. <\/span><\/p>\nHandling Snakes<\/h3>\n
Identify the head of the snake and restrain it first, before removing the animal from its container. The head can be held behind the skull, using the thumb and fingers along the lateral aspects of the body. The other hand is used to assist in supporting the remainder of the body; in general, there should be 1 handler per 3\u00a0feet of snake. Docile snakes can be allowed to roam over the hands and arms to get an idea of muscle tone, mobility, and proprioception.<\/span><\/p>\nHandling Lizards<\/h3>\n
Due to the variety of sizes, temperaments, and strengths of the animals in this group, a variety of handling techniques are needed. Lizards should never be grasped by the tail because some species, including leopard geckos and green iguanas, undergo tail autotomy to avoid predators. <\/span><\/p>\nSmall individuals can move quickly; therefore, caution must be exercised when removing them from containers. Restraint of small lizards can be achieved by holding them around the pectoral girdle with the forelimbs against the coelom. Use caution to avoid impairing the animal\u2019s ability to breathe. Larger individuals can be restrained with the forelimbs held laterally against the body, and the pelvic limbs can be held laterally against the tail base to avoid the handler getting scratched. <\/span><\/p>\nHandling Chelonians<\/h3>\n
The presence of a shell creates challenges in the handling and physical examination of chelonians. This may lead to a need for sedation, even for basic procedures, as access to the head and limbs may be limited. Aquatic species are generally more apt to bite than terrestrial ones. Tortoises tend to be stubborn and uncooperative, which can make working with them frustrating. Due to these challenges, the importance of the distant examination cannot be emphasized enough. <\/span><\/p>\nSmaller species can often be examined on a table with restraint only needed for coelomic palpation and examination of the mouth. Larger species may require sedation for a full examination due to their strength. For coelomic palpation, the chelonian should be restrained in a vertical position, with the head up and the tail down. The restrainer should position their hands along the bridge area to avoid being scratched by the forelimbs and to stay out of the way of the examiner. Once the examiner is in position to palpate, rocking the animal back and forth can allow for appreciation of abnormalities. <\/span><\/p>\nHands-On Examination<\/h2>\n
Once the reptile is in hand, monitor its mentation, response to stimuli, and behavior throughout the physical examination and restraint period. During palpation, be aware that reptiles do not have lymph nodes. <\/span><\/p>\nA general, brief neurologic examination should be performed with each physical examination.1 <\/sup>While moving through the physical examination, note the cranial nerves and appreciate reflexes and motor and sensory responses. <\/span><\/p>\nThe oral evaluation is often left for last as it can be the most stressful part of the examination, but this decision is ultimately based on clinician preference. <\/span><\/p>\nLung auscultation is not routinely performed in reptiles due to the challenges associated with scales and artifact noise; however, in lizards, a damp gauze can be placed between the stethoscope and the scales to decrease noise. <\/span><\/p>\nThe vent of all species, which is the external opening of the cloaca, should be evaluated. The cloaca is the communal chamber of the digestive tract, urinary tract, and reproductive tract.<\/span><\/p>\nEvery animal should be accurately weighed, and a body condition score should be assigned. Pairing these measurements is important and allows for tracking trends over time. Body condition scoring is subjective but becomes more accurate and precise with repetition. Either a 5-point or 9-point scale may be used as long as it is consistent within the practice. To assess body condition in lizards, palpate over the tail, pelvis, and pelvic limb areas. Some species store fat within their tail, such as leopard geckos. In snakes, palpate over the spine to evaluate the musculature. Weight loss can lead to loose skin folds with more of a pronounced spine in lizards and snakes (FIGURES 2 AND\u00a0<\/strong><\/span>3<\/b><\/span>). Assessing body condition in chelonians often relies on the musculature of the limbs and dorsal skull, as well as the subcutaneous fat stores.<\/span><\/p>\n