Introduction

• It is assumed that reptiles feel pain as they possess the anatomical structures considered necessary for the capacity to experience pain. However, it can be very difficult to recognize pain in reptiles, and so it is not uncommon for veterinarians to give limited importance to analgesia when treating these patients.
• In some cases, antialgic postures  can help us identify pain in reptiles; in other cases, veterinary surgeons will need to assume that what is painful for humans is also painful for reptiles.
• Conditions considered painful in other species, such as mammals, should be assumed to be painful in reptiles.
• Analgesia in reptiles is a developing science and has witnessed significant advances over the last two decades. More work is required regarding pain evaluation, species-specific drug efficacy and duration of action, pharmacokinetics, routes of administration and side effects.
• Different groups of reptiles tend to respond differently to an analgesic drug, and extrapolation across the diverse reptile species and orders is limited.
• Drugs typically used to control pain in small animals may not work in reptiles, as appears to be the case for buprenorphine Buprenorphine and butorphanol Butorphanol.

• Currently, no analgesic drug have demonstrated efficacy in snakes, although transdermal fentanyl shos promise in some snake species.
• All analgesic drugs are used ‘off licence’ in reptiles, and appropriate owner permission should be sought before use.
• Analgesic recommendations for reptiles are likely to change in the future with further research.
• Multi-modal analgesia is likely to be the most effective strategy, along with non-pharmacological options such as splinting unstable limbs or providing appropriate hides within enclosures to limit movement.

Opioids

Non-steroidal antiinflammatory drugs (NSAIDs)

Local anesthetics

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Thompson K A, Papich M G, Higgins B et al (2018) Ketoprofen pharmacokinetics of R- and S-isomers in juvenile loggerhead sea turtles (Caretta caretta) after single intravenous and single- and multidose intramuscular administration. J Vet Pharmacol Therap 41 (2), 340-348 PubMed.
• Duvall A (2017) Tramadol. J Exotic Pet Med 26 (1), 74-77 JExoticPetMed.
• Sadler R A, Schumacher J P, Rathore K et al (2016) Evaluations of the role of the cyclooxygenase signaling pathway during inflammation in skin and muscle tissues of ball pythons (Python regius). Am J Vet Res 77 (5), 487-494 PubMed.
• Sladky K K & Mans C (2012) Clinical analgesia in reptiles. J Exotic Pet Med 21 (2), 158-167 JExoticPetMed.
• Divers S J, Papich M, McBride M et al (2010) Pharmacokinetics of meloxicam following intravenous and oral administration in green iguanas (Iguana iguana). Am J Vet Res 71 (11), 1277-1283 PubMed.
• Olesen M G, Bertelsen M F, Perry S F et al (2008) Effects of preoperative administration of butorphanol or meloxicam on physiologic responses to surgery in ball pythons. J Am Vet Med Assoc 233 (12), 1883-1888 PubMed.

Other sources of information

• Carpenter J W & Marion C (2018) Exotic Animal Formulary. 5th ed. Elsevier Saunders.
• Sladky K K (2014) Analgesia. In: Current Therapy in Reptile Medicine & Surgery. Eds: Mader D R & Divers S J. Elsevier, USA. pp 217-228.
• Gutwillig A, Abbott A & Johnson S M et al (2012) Opioid Dependent Analgesia in Ball Pythons (Python regius) and Corn Snakes (Elaphe guttata). In: Proc Association of Reptile and Amphibian Veterinarians. pp 66.