How I treat Tail Necrosis in Lizards

Tail necrosis is a common condition of pet lizards and can have devastating consequences if left untreated. The condition can spread up the tail and eventually lead to systemic illness.

Tail necrosis can be easily recognized by your veterinarian (and yourself) as there is a noticeable colour change to the tail and the area affected becomes inflexible, hard and dry.

The colour change is very obvious in most reptiles with tail necrosis, Image from LafeberVet

There are multiple possible causes of tail necrosis including:

·         Trauma

·         Infection

·         Embolisms (blood clots lodge in tail and restrict blood flow)

·         Dysecdesis (abnormal shed causing constriction)

·         Hypothermia

The treatment for tail necrosis needs to be aggressive to prevent it spreading further and unfortunately surgery cannot be avoided in most cases.

Surgery

First step is anaesthetizing your patient. I like to use alfaxan in reptiles and once sleepy I intubate and breathe for them every 10-15 seconds. I also like to give subcutaneous or intracoelomic fluid therapy to help support them under anesthetic as well as using heat pads to keep them warm. I would also consider giving meloxicam and tramadol (or an opiod) before surgery for pain relief.

Once anaesthetized perform a sterile prep like you would any other surgery. I generally incise the skin just in front of the colour change or abnormal tissue. It is very important to remove all of the necrotic and unhealthy tissue, healthy reptilian tissue has a similar appearance to fresh tuna – if it is very white in appearance it is likely not receiving proper blood supply.

Once the skin and muscle have been incised you can use the natural break in the vertebra to bend the tail back and forward and essentially snap it off (you can also cut through vertebra but many vets believe it heals better by snapping). Rongeurs can be used to help smooth out the bone if needed. I try to have the vertebra sitting around 2+mm back from the cut edge of muscle to help protect it.

There is a lot of debate about whether to close these wounds or leave them open. The benefit of suturing the tail closed is that it can help prevent debris lodging in the wound during the initial stages of healing – if you do use sutures it is very important to remove the sutures after a few days to allow the tail to regrow. I personally like to apply flamazine and use a simple bandage for the first 3-5 days. Once granulation tissue has started to form over the wound it can be left open. I still like to use flazamine until it is scabbed over.

Blue tongue lizard tail four days post-op

Medication

Getting your tail cut off probably doesn’t feel good, and although lizards don’t show signs of pain like mammals might it is still important to provide pain relief. I generally use meloxicam (0.2mg/kg) every second day, and tramadol or another opiod can also be continued. Antibiotic cover is essential in these cases, particularly because some cases are caused by systemic bacterial infections. I generally use ceftazidime (20mg/kg) every second day until the tail has healed, if I am concerned about a systemic infection I may treat for 30 days or more.

This is a generalized overview of how I treat tail necrosis in lizards. It is always important to investigate the underlying cause which may be husbandry related. If you have a specific case you would like to contact me about please feel free to email, message or facebook me. I hope this gives you some insight into the wonderful world of reptile medicine!

This bearded dragon had her tail sutured for the first 5 days after surgery because it was becoming very dirty in her enclosure, the sutures where then removed to allow the tail to regrow and heal.