The snake had been power-fed before the owners rescued him. Blood was collected from the ventral coccygeal vein and a haematology and biochemistry profile was performed. Bloods revealed a non-regenerative picture with a PCV of 2%. Renal involvement was suspected with a uric acid 732 umol/l (118-402). In combination with clinical signs, a low PCV and raised uric acid, suspicions were raised about kidney involvement and a reduced erythropoietin production. After ethical review, a homologous blood transfusion was performed following initial stabilisation. Two large male reticulated pythons were anaesthetised, and blood taken from the ventral coccygeal vein into a blood collecting unit. Blood was administered to the recipient slowly via the intracardiac route under anaesthesia. Administration intravenously, via a surgical approach to the jugular, as described in a previous case report in a Green Tree python was not possible due to patient instability. Vitamin B12 was administered to the recipient snake.
ResultsDemeanour greatly improved after the transfusion. Erythropoietin EPO (Epoetin beta, NeoRecormon), an erythropoiesis-stimulating agent, was administered to the snake at 100U/kg via the SC route, three times a week.It is a synthetic, recombinant form of erythropoietin, a protein that promotes the production of red blood cells. In the literature, canine EPO was given to sea turtles with success, administered subcutaneously at 100U/kg three times weekly over a 2-week period (Perry & Mader, 2015). The snake deteriorated again two months after the transfusion, and due to underlying conditions was euthanised on welfare grounds. Bloods taken prior to euthanasia showed a regenerative picture with a PCV of 24%. In a study using bearded dragons it was found that homologous transfusions had an erythrocyte lifespan of 65 days (Stoehr, 2020).A post-mortem of the snake revealed an abscess within the cloacal and an overwhelming clostridial infection. Histopathology of the large intestine identified colitis with ulcerative and necrotising, heterophilic and granulomatous lesions described. It is likely that the anaemia was caused by a combination of factors to include blood loss, anaemia of chronic disease and metabolic disease.
DiscussionBlood transfusions can be lifesaving for all exotic species but in snakes can prove to challenging. Indications for a blood transfusion in this case included clinical signs, in addition with laboratory findings (Lichtenberger, 2004).The snake had a PCV of 2%. Two donors were selected and were young, healthy animals of appropriate weight (35kg and 22kg respectively) and were of the same species and sex as the recipient snake.Both the donors and the recipient snake carried the platinum gene ensuring similarity between the individuals was as close as possible. The donor snakes were long-term individuals within the same collection and were housed individually. Strict biosecurity protocols were in place to avoid transmission of any diseases between enclosures.