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Lizard Prolapse

My reptile appears to have a prolapse. Is there anything I can do to keep him comfortable before his vet appointment?

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I have a young male leopard gecko about 4 months old and weighing approximately 30 grams. He has developed what appears to be a partial prolapse. He has a red round bulge protruding from the left side of his vent area. At first I thought it was that his hemipenis was not retracting, but the shape of it does not look like that organ. I’m wondering what could have caused this condition in an animal so young.

Feces look normal. The humidity is correct, and he is housed on paper towels. I will be seeing a vet. Is there anything I can do to keep him comfortable in the meantime?

The best thing that you can do for him is to gently clean the prolapse with sterile saline (you can use contact lens saline with no preservatives) with a squirt bottle. Then, the tissue must be kept moist; otherwise it can dry up and become necrotic. The easiest way to accomplish this is by using sterile water-soluble lubricating jelly, such as K-Y Jelly. This can be applied as often as necessary to keep the tissue moist and clean. Maintaining him on paper towels is your best bet to prevent trauma to the prolapse, which can occur with other substrates.

I’m not sure which tissue is prolapsed, but it does sound like a hemipenis (and I applaud you for knowing that one of the copulatory organs is called a hemipenis, and together they are called hemipenes) as many people get that wrong all the time. But the hemipenes are not round, so I agree that it doesn’t sound like that is what is protruding through the vent.

He may have prolapsed a portion of his bowel. That might appear to be round, and it should have a hole in the center. He might defecate through this. If he does have normal feces, it would be unusual for him to prolapse, unless he was very constipated. Other causes for an intestinal prolapse would be diarrhea, parasitic infestation (Giardia, Entamoeba, Microsporidium, Cryptosporidium, ascarids or other types of worms), intestinal infection with the Salmonella bacterium or other organisms, inappropriate husbandry, nerve damage, spinal damage affecting the cloacal nerves or perhaps a congenital abnormality (although this would be quite rare).

Your vet will most likely perform a complete physical examination, fecal parasite examination (bring in a fresh sample, if possible), bacterial culture of the stool, and perhaps radiographs (X-rays), cytology, Gram’s staining of the stool and blood work in an attempt to uncover the cause.

Your vet should be able to ascertain what tissue is prolapsed and then replace it (as long as the tissue has not died). If the tissue is quite swollen, sometimes sugar, which is hygroscopic and draws fluid out of the tissue, will be applied to the prolapse to make it smaller to be replaced more easily. Usually, some sort of suture is applied to the cloaca to keep the prolapse from popping back out. This remains in place for several days, usually. Hopefully, testing will uncover why this occurred so that appropriate treatment can be instituted. If this all falls into place, the prolapse would hopefully never reoccur.

Good luck with your gecko. Hopefully, he’ll have a long, healthy life ahead of him once he is diagnosed and properly treated.

Margaret A. Wissman, DVM, DABVP has been an avian/exotic/herp animal veterinarian since 1981. She is a regular contributor to REPTILES magazine.
 

Need a Herp Vet?
If you are looking for a herp-knowledgeable veterinarian in your area, a good place to start is by checking the list of members on the Association of Reptilian and Amphibian Veterinarian (ARAV) web site at www.arav.com. Look for DVMs who appear to maintain actual veterinary offices that you could contact.