# Sticky  Emergency Supportive Care



## kyle1745

*Emergency Supportive Care**

Introduction*
Commonly encountered medical problems of dendrobatids include nutritional and metabolic disorders, infectious diseases (protozoal, metazoal, bacterial, fungal, and viral), as well as other idiopathic syndromes (edema syndrome, prolapse). If you suspect that a frog is sick, the first thing to do is to contact a veterinarian, ideally with amphibian experience or expertise (see below for finding a vet). However, there are a number of things you can do to reduce the stress on the frog until veterinarian care can be administered. 

_NOTE: The following information is not a replacement for the necessary treatment for the specific condition of your frog. It is only a recommended regimen for maintaining the frog’s condition until it can receive the appropriate attention by a veterinarian._

*Signs of a sick frog*
The signs of a sick frog are often non-specific to the illness, and are best described by the acronym ADR (Ain’t Doing Right). Signs may include decreased movement, lowered body posture, soaking in pools of water, and remaining in an abnormal tank position (out in the open). Other more overt signs may include “bloat” (edema), or the observation of prolapsed (everted) tissue from the rectum, cloaca or mouth. Signs are not limited to those listed however, and if you suspect that a frog may be sick, observe it closely for any further evidence.

Golden Mantellas with edema:








Atelopus zeteki with bacterial septicemia, resulting in retension of fluids that caused eversion of their stomach and turgidity.








A. zeteki with rectal prolapse secondary to bacterial septicemia and associated fluid retension.









*Supportive care*
The first thing to do is to carefully remove the frog from its vivarium/container and place it in an isolation container. Isolation containers can easily be constructed from a small Sterilite container or deli cup, lined with moist paper towels. Paper towels serve the dual purpose of both a neutral substrate as well as allowing for the easy collection of a fecal sample (to be submitted to the vet for analysis). The isolation container should also contain cover to offer security for the frog. Crumpled paper towels or disposable containers with doors cut into them serve the purpose well. If using more conventional hides (i.e. cocohuts), make sure to discard or completely disinfect after use. Keep the isolation container in a place where the temperature will be within the recommended range for the particular species, typically mid-70s (º F). While in the isolation container, observe the frog for worsening of signs. It is important to use separate containers and tools when working with an isolated frog. Always assume that the signs were caused by a transmissible agent which can be spread to the rest of your collection. The use of gloves and hand sterilizing soaps is also recommended.

Osmolality is a measure of the amount of osmotically active particles in a solution. Amphibians maintain hyperosmotic plasma (osmolality of 200-250mOsm), while “fresh” and distilled water have osmolalities of 20-40mOsm and 0mOsm, respectively (1). Given this large difference, amphibians expend large amounts of energy maintaining their osmolality in the environment. Providing an ill frog with an isotonic environment (same osmolality) allows the frog to reduce the energy expended in maintaining osmolality and utilize it elsewhere (i.e. fighting infection). This can be achieved by soaking the frog in an appropriate solution. Ideally, the frog should be soaked in Amphibian Ringers Solution (ARS). ARS can be made with the appropriate ingredients (see below), or purchased from a veterinary/scientific supply company (prescription not required) (see links section). If ARS is not available, then Pedialyte, a common electrolyte solution for children, can be used. 

_NOTE: Pedialyte is hypertonic when compared to the frog’s plasma, and is therefore not considered ideal, but is better than soaking with pure water. Pedialyte also lacks calcium, and shouldn’t be used when hypocalcemia (low plasma calcium levels) is suspected. _
[list:1nveczn0] Amphibian Ringers Solution (1)

*1 Liter*
Distilled Water - 1 Liter
NaCl - 6.6 g
KCl - 0.15 g
CaCl2 - 0.15 g
NaHCO3 - 0.2 g

*1 Gallon*
Distilled Water – 1 Gallon
NaCl - 25 g
KCl – 0.57 g
CaCl2 – 0.57 g
NaHCO3 - 0.76 g

*Mix solution thoroughly to ensure that all crystals are dissolved. Agitate thoroughly before use. Keep in a closed container to reduce evaporation.
[/LIST]

To soak the frog, place the frog in a container with sides high enough to prevent it from hopping out. Pour in enough of the solution to allow the maximal amount of contact with the frog without submerging it. If the frog is so weak that it is unable to support its head, place the frogs head on top of a soda bottle cap or something similar. Success has also been observed when maintaining debilitated frog on paper towels soaked in ARS, thus eliminating any risks of drowning. Frog should be closely monitored while soaking. Soaking can be done for a couple of hours at a time, and can be lengthened after consultation with a vet. The solution should be changed regularly (between soaks). 

Offer small amounts of food (fruit flies, termites, RFB larvae) to the sick frog. Use caution to not add so much food as to cause the frog stress. If the frog shows no interest in eating, remove the food from the isolation container. An additional supplement, calcium gluconate, can also be given. Calcium gluconate offers both the benefits of calcium as well as glucose, than can provide a boost to an anorexic frog. Calcium gluconate can be purchased from veterinary/agricultural suppliers (see links section). It is most commonly sold as a 23% solution, but should be diluted down to ~2% for use. To do this, dilute 1 part of the 23% solution to 10 parts ARS or distilled water. Make sure the frog is sufficiently moist (following brief misting or soak), and apply several drops of the 2% solution to the frogs back (2). This can be done up to a couple of times daily to provide energy to the frog. 

_NOTE: When dosing with calcium gluconate, the paper towel substrate should be changed regularly as the glucose promotes bacterial and fungal growth (2). Both stock and diluted solutions should be stored in the refrigerator and regularly checked for bacterial growth. If the solution (stock or diluted) appears cloudy, it is most likely contaminated and should be replaced. Allow the refrigerated solution to warm to room temperature before administering_

*Find a veterinarian*
Perhaps the most important step is contacting a veterinarian. As previously mentioned, the care described below only helps alleviate the immediate crisis the frog may be in, but does nothing to cure the problem causing the signs. For that reason, a consult with a veterinarian is essential. 
Finding a veterinarian with amphibian experience is often very difficult, but very important. The two main resources for finding such a vet are other amphibian keepers and the Association of Reptile and Amphibian Veterinarians (ARAV). The ARAV website (ARAV redirect) has a listing of all its members. Use the list as a jumping board to find ARAV vets in your area, and then call around to see what their exact experience regarding amphibians is.

If a veterinary visit is necessary (as determined by the urgency of the frogs condition or a consult with a veterinarian), then care should be taken when transporting the frog to the vet’s office. Small deli cups with a moist paper towel substrate are ideal. Transport the frog in a lunch cooler or Styrofoam box to maintain constant temperatures, with the addition of a heat or cool pack in temperature extremes if necessary. If available, bring a fecal sample. It is important to tell the vet as much about the husbandry and history of the frog as possible. The vet, with the proper information, may then be able to offer you more insight to the nature of the problem, and any treatments that may be necessary.

In the unfortunate event that the frog dies, much information can still be gained through a necropsy. As soon as you discover the deceased frog, place it in a small container, and then place that container within another container containing ice or ice packs, and place it in the fridge. DO NOT FREEZE THE FROG. Contact someone willing to do the necropsy, and ask them how they would like you to handle the frog. Necropsies can be performed by veterinarians with experience doing such procedures, or by a local university – particularly those with veterinary schools. Emailing or calling the pathology department of a veterinary school is a great place to start. If your local vet is unable to perform the necropsy themselves, they may be willing to send it out for you to Northwest Zoopath (www.zoopath.com), who can then perf...&catCode=SE_SC&x=0&y=0"]Fisher scientific ARS
Electron Microscopy Sciences ARS

Calcium Gluconate:
Ebay
Farmvet.com Calcium Gluconate
Allivet.com Calcium Gluconate

Dendroboard threads of interest:
Froggy First Aid Kit
Seizure ? Yet Again !
Bloat
Emergency Rescue, Force Feeding, & metabolic needs
Leuc emergency
HELP! Rectal Prolapse!!!
Bubble coming out of butt

Other Resources:
ARAV redirect
Amphibian Diseases
Melissa Kaplan's Herps: Amphibians
Amphibian Medicine and Captive Husbandry – Wright & Whitaker
*Amazon listing for textbook – expensive, but filled with information
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References:
(1) Wright, K.M., & Whitaker, B.R. (Eds.), (2001). Amphibian medicine and captive husbandry. Malabar, Florisa: Krieger Publishing Company.
(2) Ed Kowalski in Seizure ? Yet Again !
(3) 2000 Report of the AVMA panel on Euthanasia (2001). JAVMA, 218 (5): 669-696
(4) Kowalski, E. Euthanasia for amphibians.

Contributers: 
Oz (rozdaboff)
Ed Kowalski (Ed)
 
If you would like to see any updates or modifications to this care sheet please let myself or a moderator know.

Last Updated: 11/29/2006


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