| Dystocia is a relatively 
        common malady in reptiles, occurring in lizards, snakes and chelonians.. 
        There are many different causes, and in most cases, the cause goes undetected. 
        DeNardo (1995) states that in his experience, dystocia occurs most often 
        in first-time breeding females, females who have previously retained eggs, 
        and female bearing infertile clutches. Dystocia can occur in live-bearing 
        and ovoviviparous species; these are less common perhaps only because 
        at this time there are fewer such species being bred in comparison with 
        oviparous (egg-laying) species.  One general cause of 
        dystocia may be due to the inability of the eggs to pass through the oviduct 
        and cloaca. There may be an obstruction, the eggs may be too large or 
        malpositioned, the pelvis may be misshapen, or there may be obstructive 
        masses such as abscesses or cystic calculi. Two or more eggs may be bound 
        together, or a single egg may be exceptionally large or misshapen.  Dystocias can occur 
        in the absence of obstructions or malformations. It is theorized that 
        such retentions may be the result of one or more factors including poor 
        husbandry, improper nesting site, improper temperatures, poor or inadequate 
        diet (malnutrition), dehydration, and poor physical condition of the female. 
        This latter is easily caused in, and remedied, in captivity. Captive reptiles 
        lead a very sedentary lifestyle compared to their wild counterparts, thus 
        lack the muscle strength or tone to get all the eggs into position for 
        laying and expelling them in a timely matter (from first egg to last). 
        It is not uncommon, for example, for the last egg or two to be retained 
        despite the successful and apparent ease with which the rest of the clutch 
        was expelled by oviparous snakes. (In my experience, egg-binding in iguanas 
        happens most frequently to females who are enclosed in cages that do not 
        allow for sufficient climbing, being either too short or they are fed 
        at their basking sites and often physically removed by the owner for defecation 
        elsewhere. Iguanas housed in enclosures at least 5-6 ft high and who must 
        climb up and down for eating, drinking and defecation appear to have fewer 
        incidences of dystocia.)   Diagnosis  SnakesIn smaller 
        snakes, recent oviposition (the repositioning of the eggs prior to laying) 
        and the visible appearance of the swelling caused by the mass of eggs 
        is a clue to the presence of eggs. In larger species such as pythons, 
        eggs, especially retained eggs, are more difficult to see. It is more 
        difficult to determine the retention of fetuses especially since entire 
        clutches may be retained rather than just a few. Prolonged laying or birthing 
        efforts and cloacal or oviductal prolapse (eversion of cloacal or oviductal 
        tissue through the vent) are other signs of dystocia. Recently, improved 
        ultrasonography techniques have been successfully used to determine the 
        viability of fetuses in viviparous snakes, enabling the veterinarian to 
        take the steps necessary to alleviate the situation by removing the nonviable 
        tissue.
  LizardsThe most common cause of dystocia in lizards is the absence of a suitable 
        nesting site and media. A lizard progressing normally through the period 
        of carrying gestating eggs or fetus will not be eating, but will be alert 
        and active. Their usually physical grace may be compromised, especially 
        as their lower half becomes swollen with the developing eggs or fetuses, 
        but they are able to move around, climbing and roosting as usual. A lizard 
        suffering from dystocia, on the other hand, will become lethargic, depressed, 
        nonresponsive. If the laying media is not of the right consistency, the 
        lizard may spend hours kicking the dirt out, then wandering around, making 
        digging attempts almost anywhere. This latter activity is more frenzied, 
        and the lizard grows weaker and more visibly stressed, as the pressure 
        to lay the eggs mounts. Straining may be seen, as may the prolapse of 
        cloacal or oviductal tissue. Lizards can tolerate dystocias for considerably 
        less time than can snakes, often only a matter of days, and so should 
        be evaluating medically soon after such signs are observed. Many lizards 
        can produce and lay eggs, just as can chickens and humans, without being 
        mated.
  CheloniansEgg masses are all but impossible to detect by the inexperienced, 
        and the presence of one or two retained eggs may not be felt even then. 
        Retention is very difficult to detect in chelonians due to their being 
        hidden not only within the turtle or tortoise's body, but the whole covered 
        by the shell. X-rays are often the only way to tell that eggs are involved. 
        It may be difficult with radiographs alone to tell if the eggs are being 
        retained or merely not ready to lay yet; the presence of other signs must 
        be used in conjunction with the radiographs to determine whether dystocia 
        is occurring and the urgency for resolution. Depression, straining and 
        cloacal swelling or prolapse, even respiratory distress, are signs that 
        should be watched for, and action taken to remove the eggs started.
   TreatmentInstigating 
        treatment before it is necessary may cause more harm to the female and 
        to the developing clutch. Conversely, withholding treatment, or delaying 
        getting treatment may be injurious to the female and developing clutch, 
        especially in lizards. Once the female begins--but does not complete--laying 
        or birthing, treatment should be started within 48 hours. Females will 
        sometimes complete laying or birthing after a pause but generally within 
        the 48 hour window.
 Physical 
        ManipulationOne common 
        way to induce laying is to gently but firmly massaging the eggs out, one 
        by one, by running the finger down the abdomen. This method is risky, 
        however, in that it may rupture or cause a prolapse in the oviduct, could 
        rupture the egg, and thus possibly cause death. If the egg can actually 
        be seen at the vent extreme care may be taken to try to remove the egg, 
        but such attempts may result in a broken egg with disastrous results for 
        the female.
 Hormonal StimulationPosterior pituitary hormones have been used to start oviductal 
        contractions. It is not effective, and may be dangerous, in females who 
        are suffering from malformation of the pelvis or oviduct or who are carrying 
        malformed, misshapen, enlarged eggs or fetus or who are suffering from 
        an obstruction of the oviduct. Use of oxytocin (or the new experimental 
        arginine vasotocin or aminosuberic arginine vasotocin) in such cases may 
        cause egg or oviductal rupture or hemorrhage--and death.
  The overall efficacy 
        of oxytocin, the most commonly administered hormone, varies between species, 
        and can be hampered the longer the retention; it is most effective when 
        administered within the first 48 hours. Oxytocin is administered by intramuscular 
        or intracoelomic injection (5-30 IU/kg, but reports of efficacy in doses 
        as low as 1 IU/kg have been reported in turtles). A second dose is often 
        given 20-60 minutes after the first injection. Oxytocin's effectiveness 
        is increased by the provision of the proper temperatures, so the female 
        should be kept at the preferred body temperature for the species. Oxytocin 
        is most effective in chelonians, less effective in lizards, and not as 
        effective in snakes, with DeNardo attaining less than 50% success rate 
        in snakes, more than 90% in chelonians.  Arginine vasotocin, 
        and aminosuberic arginine vasotocin, a less effective but more stable 
        form of arginine vasotocin, is the natural reptilian oxytocin. It is thus 
        more effective than oxytocin, but arginine vasotocin is available only 
        as a research drug and is quite expensive than oxytocin. Other hormone 
        treatments have been tried to increase the efficacy of oxytocin including 
        the administration of progesterone and estrogen; there have been no studies 
        to verify their usefulness. One recent study did show that pretreatment 
        with propranolol may increase the efficacy of labor-inducing drugs. AspirationA common treatment 
        for dystocia involves inserting a needle into the egg and aspirating the 
        contents. The result is a far smaller egg which may be more easily passed 
        through the oviduct and cloaca; oxytocin may be used to start contractions 
        if they do not start on their own within a few hours or even a couple 
        of days. Caution must be taken to not allow any of the egg contents to 
        escape into the coelomic cavity. Aspiration must be done within the 48 
        hour period after cessation of natural laying attempts. After than short 
        time, the contents of the eggs themselves begin to harden, making aspiration 
        impossible. If the eggs are not expelled within 48 hours of aspiration, 
        they must be surgically removed.
  SurgeryIf other attempts 
        at inducing laying have failed, the reptile must be anesthetized for surgical 
        removal. Before cutting, a final attempt at manually manipulating the 
        eggs may be tried owning to the reduced risk to the female due to the 
        relaxation of the oviductal sphincter from the anesthesia. As before, 
        care must be taken to not push hard enough to cause a prolapse or rupture.
  Depending upon what 
        is found when the vet goes inside, the eggs only may be removed, or some 
        or all the reproductive tissues may be removed. If there is no intention 
        of breeding the female, the owner may wish to have an ovariosalingectomy 
        done at the same time to prevent future incidences of binding.  Chelonians present 
        some additional difficulties. Egg extraction goes more quickly when done 
        through the shell: part of the shell is cut off, epoxied back into place 
        after surgery. Entry into the coelomic cavity can be made by going in 
        near the hind leg but the restricted maneuverability makes it difficult 
        to find and extract the eggs.  Viability of Removed 
        Eggs/FetusesFertile eggs removed with oxytocin from non-dystocic females have 
        been successfully incubated; eggs from females suffering from dystocia 
        have generally not been successful. Fetuses removed through salpingotomy 
        have also been successful.
   Down the lineThe biggest 
        factors determining female post-retention survival is her overall physical 
        state. Most are severely weakened as the result of the dystocia. Those 
        who started out healthy, in good nutritional, hydration and physical states 
        are more likely to recover. Reptiles who have had only one of their reproductive 
        tracts removed may often successfully reproduce in the future.
  Personally speaking, 
        if you are concerned about dystocia, if you are not sure if your female 
        is gravid or not, if you are not sure if she is in distress or not, I 
        strongly recommend that you don't guess and try to wait it out: get her 
        to a reptile vet and find out exactly (or as much as possible!) what you 
        are dealing with.    Stephen J. Divers, 
        BSC, CBiol, MIBiol, BVetMed, on reptile dystocia:"If there is no 
        indication of infection, metabolic disease, or obstruction (as determined 
        by radiography, digital palpation, and direct visualization of the cloaca, 
        and a limited hematological and biochemical assessment), conservative 
        treatment should be attempted. Provision of a suitable environment and 
        nesting site may be all that is required to persuade the reptile to produce 
        eggs or young naturally. If shell gland inertia is suspected, medical 
        treatment using oxytocin is indicated-1-5 IU/kg, IM, repeated after 60 
        minutes. In the author's experience, slow IV or intraosseous infusion 
        of oxytocin at 5 IU/kg, over 4-8 hours is more effective than a single 
        injection." The Capsule Report, January 1999
   Sources include: DeNardo, 
        D. (1995) Dystocias. In Mader, D. (Ed.), Reptile Medicine and Surgery 
        (pp. 370-374). Philadelphia, PA: W.B. Saunders Company. 
 Related Articles  Iguana 
        Egging and Incubation Reproduction 
        Disorders of the Female Reptile  Metabolic 
        Bone Disease  Pain 
        and Analgesia in Herps  Glossary 
        of Reptile Reproduction Terms  |