Development of a Standardized Coelomic Veterinary Point-of-Care Ultrasound Examination in Multiple Snake Species: Pilot Study

Abstract Veterinary point-of-care ultrasound (VPOCUS) has been underutilized in zoological animal medicine, with no published protocol for use in snakes. This study assessed a protocol for coelomic VPOCUS in 13 healthy snakes in five colubrid, two boid, and two pythonid species. Sonographic examinations followed a standardized protocol to locate and evaluate coelomic organs and answer binary questions focusing on organ-specific ratios and presence of intracoelomic fluid. Intracoelomic fluid was not present in any snake. Lung parenchyma and expansion with inhalation was appreciated in all snakes. Air sac movement was appreciated, although the caudal border of the caudal air sac was not identified in two of 13 snakes and was misidentified as significantly more cranial by 8% ± 9% (mean ± 1 standard deviation) of snake length compared with radiographic location ( P = 0.018). No significant difference occurred between colubrid and combined boid and pythonid organ ratios. Mean ratio of right atrium to pulmonary trunk was 1.27:1 ± 0.47:1. Mean ratio of ventricle wall to lumen was 1.11:1 ± 0.2. Mean percentage of hepatic vein diameter to liver parenchyma height was 19.8% ± 7.4%. Mean percent gallbladder diameter to snake diameter was 35% ± 13%. Mean ratio of vena cava diameter to aorta diameter was 0.97:1 ± 0.17:1. There is a need to validate normal organ ratios and determine the significance of these ratios in diseased snakes. This VPOCUS protocol takes 26 min to 38 min and can be used to systematically answer binary questions to evaluate coelomic organs for potential indicators of critical pathologies and presence of intracoelomic fluid.