A general physical exam of a lizard is almost nothing like evaluating a dog or cat. Because health problems are difficult to detect in reptiles and amphibians in general, a problem may not be noticed in a lizard until it is too late. Learning how to identify small problems could mean life or death in the long run. This guide is not only for pet owners and breeders, but is also useful to veterinary technicians and nurses, and pet store employees who are not familiar with reptiles.

Taking a Good History
Whether you are a vet tech working with a client, or a pet owner that is trying to figure out what could be wrong with your lizard, a retrospective look at the animal's life so far can be extremely useful. The following are questions you should ask:

• Is the lizard captive bred and born, farm-raised, or wild caught?
  Wild caught and farm-raised animals are much more likely to harbour parasites and suffer from maladaption, although this cannot be ruled out in captive-bred animals, either.
  
• How old is the animal, and how long has it been cared for by its owner?
  Relatively few captive lizards get old enough to start having typicaly signs of old age, and potential long-term problems from poor captive care can be compared to relatively acute health issues.
  
• What is the lizard's enclosure? Include type of enclosure (material's its made out of), substrate, and cage furniture.
  Enclosures that are too small can be stressful and restrict thermoregulatory behaviour. Materials that are abrasive can cause lesions, or if transparent may provoke "escape" behaviour. Particulate substrate may accidentally be ingested, and could be a source of irritating dust. Sheet substrate is generally safer, but carpeting may have fine fibres that could wrap around toes or tail tips, and species that like to burrow may be stressed without substrate that suits them. Everything in the enclosure should be evaluated for irritating fumes. Hiding spots are necessary to allow the lizard places where it can feel safe from the eyes of predators and competitors.
  
• What is the temperature range in the enclosure?
  The temperature gradient must suit the species, a warm end and cool end must always be provided to avoid hyperthermia and hypothermia.
  
• Is the enclosure indoors or outdoors, or does the lizard spend any time outdoors?
  A host of potential dangers can be found outdoors, from stress from local wildlife, to hyperthermia and hypothermia, poisonings from objects/animals/plants in the environment, and even parasites. (Exposure to natural sunlight is beneficial for many species, however.)
  
• If the enclosure is indoors, what is the provided photoperiod? Is UV-B lighting provided?
  Too many or too few daylight or darkness hours can severely stress an animal; a suitable photoperiod should be respected (this includes having the animal in a room where there are frequently lights on after daylight hours). Wide spectrum lighting (including the ultraviolet-B, or UV-B wavelength) is an absolute necessity for many species, and severe calcium-related problems will follow if not provided.
  
• What is the ambient humidity in the enclosure? Are there any humid hideboxes provided?
  Humidity levels must be suitable for the given species. Humid hides are required by many species, and not providing them may lead to hydration and shedding issues.
  
• What is the lizard being fed, how often, and how much is eaten? Does the animal ever regurgitate food? How is the food stored, and what is the frequency the food is supplemented (if at all)?
  Anorexia is a symptom, not a disease, and is always important to investigate. Regurgitation is a serious problem and warrants immediate veterinary attention in lizards. Nutritional problems are often overlooked in all reptiles; prey should always be gut-loaded (or if bought pre-killed, from a reputable source) and supplemented regularly, and frozen or non-animal food should be stored so that it will not spoil. Parasites may commonly be passed from prey to the lizard. Injuries from unsuitable or improperly offered prey are not uncommon. Many owners either underestimate the appetite of their lizard and underfeed them, or feed calorie and fat-rich (or even too-easy-to-catch) prey that results in an obese lizard.
  
• How often does the animal eliminate? Do the feces and urates have a normal consistency?
  Most species defecate at least once three days, if not less (depending on the frequency of feeding and that species' particular metabolism). Abnormal feces may be caused by parasites, improper diet, or improper thermal gradient, and include particularly bad odour, runny consistency, discolouration, presence of blood or mucous, visible parasites (which is rare, parasites are more reliably diagnosed using a microscope to examine for eggs).
  
• How is the lizard offered water? If it is a dish, how often is the water changed, and how often is the container disinfected? If there is a filtration system in a larger water area, what type of filter is it, and how often is it cleaned or changed?
  Some species have particular water needs that they developed from living in a certain environment (ex: licking dew off of leaves, or only recognizing water that is moving). Water should be changed daily (or whenever soiled) and the container disinfected routinely. Filters should be mainted accordingly.
  
• Does the lizard have any cagemates? Were the animals quarantined before being housed together?
  Lizards are solitary creatures, and many are aggressively territorial. Cagemates are a source of stress, injuries and parasites. Dominant individuals may prevent others from eating or thermoregulating properly. A strict quarantine period of at least 60 days should be respected when introducing new animals to an established enclosure, and only after a clean bill of health has been assured. But, even healthy animals may have stress issues when housed together.
  
• What is the lizard's shedding schedule? Are there any difficulties shedding?
  Shedding varies greatly with species, age and health status. Young animals typically shed more frequently than mature individuals. Difficulty shedding (dysecdysis) is usually an environmental problem, but could also be related to poor nutrition.
  
• Is the lizard a breeder? If not, and the lizard is female, is it exposed to males?
  Only healthy animals in peak condition should be bred. Reproduction is a huge strain on the animal's body, and will seriously debilitate already less-than-healthy lizards. Females exposed to males may be stressed by their urges to mate, and the presence of males could stimulate egg production even if no mating occurs. Females that are not exposed to males may also produce infertile eggs (which happens regularly in some species, like green iguanas).
  
• Has the lizard had any illnesses in the past, and are there any other reptiles or amphibians in contact with the lizard's caretaker? Have any of these other animals been sick previously, or currently?
  Past illnesses may reappear if husbandry is poor, and new illnesses could be the result of previous ones. Owners may unwillingly pass disease from animal to animal within their collection, especially if they do not wash their hands or instruments thoroughly between animals, or recycle uneaten prey with other pets, or even by housing sick animals near healthy ones.

General Appearance

At first glance, the experienced herpetoculturist may be able to rate a lizard's general health. A healthy lizard should be bright and alert (unless disturbed while sleeping). It should respond to your presence, or at least to being touched. Many species will tongue flick to investigate their surroundings. Most lizards will hold their chest off the ground when alert (with the exception of skinks, whose bodies are built to be close to the ground), and will not drag their body along while walking. A lizard that lies flat against the ground with its eyes closed, and barely responds to being touched is seriously ill and needs immediate veterinary attention. Lizards that are active and responsive but cannot hold themselves off the ground, or drag their hind legs when walking may have a serious health problem. Lizards that tilt or lean to one side and cannot right themselves may have a neurological problem, and must be examined by a vet. By many people's standards, a healthy reptile looks "fat." This may be because plenty of us are used to seeing underweight, emaciated individuals. Healthy body weight in reptiles is not well defined, but a few guidelines can be followed when evaluating lizards. No bones should be visible through the skin, particularly the ribs and pelvic girdle (at the base of the tail), but should be palpable. Limbs should not be bony, but excess fat will give them a rounded, chubby appearance. Excess fat may also be seen around the armpits and neck (large jowls are normal in males of some species). Overweight lizards have just as many health risks as those that are anorexic or underweight.

This Dumeril's monitor (Varanus dumerelli) is extremely ill. Monitor lizards are typically bright, active and curious. This lizard is extremely emaciated and lethargic, and cannot even hold its own weight off the ground.   This hypomelanistic leopard gecko (Eublepharis macularius) is alert, responsive and eating. However, it drags its whole body while walking, has a bowed appearance to its limbs, a receded lower jaw, and the tip of its tail is bent. It has a metabolic bone disease. Even though the lizard is acting normal, it is seriously ill and needs veterinary attention. This green iguana (Iguana iguana) has a severe spinal deformity resulting from a calcium deficiency and lack of UVB lighting at a young age. Although the husbandry was corrected, this iguana will always be deformed.

From Head to Tail In Detail
Examining every external aspect of the lizard is important.

Skin: The lizard's skin should be appropriately coloured for the species, so reference books with photos of healthy animals are always useful because of the variety of colour and pattern found in various species, sometimes even within conspecifics. Heliothermic (basking) lizards will normally turn darker when warming up, and lighter when cooling down. Lizards that are constantly darker than normal may be very stressed and/or sick. The skin should be clear of cuts, scratches, bumps, burns and discolourations. Cuts and scratches should be treated as potentially infected wounds, and large wounds must be seen by a veterinarian to be closed. Burns should also be seen by a vet to determine their severity and if the animal needs intensive care. Bumps and lumps could be any number of things, from abscesses to parasites to broken bones, and should be seen by a vet. Discolourations may be bruises, stuck shed skin or fungal infections. The scales should have a smooth feel to them- if there are patches that feel rough or dry, it is most likely stuck dead skin that has not shed properly. A skin turgor test may be done to gauge the lizard's level of hydration. Pinch a small section of skin on the lizard's side so that it tents, and release. If the skin takes more than a second to return to its normal position, the lizard is dehydrated. If the skin is very wrinkly, this may be an indication of dehydration, as well. Some parasites, such as ticks and mites, may also be seen on the skin. Mites are often found in pits and folds: Popular spots are around the eyes, ears, neck folds, arm and legpits, and vent. Mites range in colour from gray to brown to red, and are usually very small, often less than a millimeter in diameter. Ticks are much larger, rounder and more easily noticed. They are often found in areas with softer skin such as those frequented by mites, but in large lizards they will sometimes infest the nostrils.

The patch of dry-looking scales on the top of this Chinese water dragon's (Physignathus cocincinus) head is dead skin that should have shed, but didn't. The lizard is darker than it should be because it is very stressed and sick. These water dragons are normally bright green. This flat-tailed house gecko (Cosymbotus platyurus) is infested with tiny, red mites. The lump on this iguana's tail should be seen by a vet. It was revealed to be an abcess.

Arms, legs and toes: Once again, it helps to be familiar with the species when you are examining its limbs. Some species have shorter, stockier limbs than others, and some have long, slender limbs that would look sickly on a different animal. A reliable indicator is the lizard's pelvic girdle (hip bones just above the tail): If they are prominently sticking out of the lizard's skin, the animal is severely underweight. The arms and legs should feel fleshy, but not bony. If both limbs have a bloated, "overmuscled" look, or you can feel stiff lumps on the long bones of the arms and legs, this may indicate a severe calcium deficiency, which needs to be treated. If an arm or leg is swollen or lumpy, but it is not symmetrical with the opposing limb, then it may be a break, fracture, or even an abscess and must be seen and treated by a veterinarian. Fingers and toes should be straight and nicely coloured like the rest of the body. Fingers that flop over to one side and cannot be held straight may indicate a calcium deficiency. Lumps and bumps may be breaks or abscesses and should be examined by a vet. The toes should be carefully examined for any shed skin that has failed to come off- shed skin may constrict around the toes and cut off circulation. A missing toenail or two is not really a cause for concern as long is the wound has been cleaned and is not infected. The lizard's enclosure should be re-evaluated for its safety, however. Any notches, cracks or grooves in cage furniture should be filled or removed so that claws cannot get stuck and torn out.

The hind limbs of this water dragon may appear to be muscular and healthy, but their swollen appearance is actually indicative of a severe calcium deficiency.   This juvenile green iguana's toes and arm were burnt from hanging underneath a hot basking light. There is a lot of dead tissue on the toes that must be debrided by a vet. Leopard geckos need a humid hide so that they may shed properly. The stuck skin on this gecko's toes should be removed gently before she loses them completely.

Tail: Tails are pretty important appendages to lizards. They are fat storehouses for when food is scarce, are a means of defense through caudal autotomy (tail dropping), a "false head" in some species, spikes and spines or as a whip, propel a lizard through water, contain the male copulatory organs (hemipenes) and help balance many arboreal species. Evaluating a lizard's body condition may sometimes be done just by looking at how much fat is on the tail. A plump tail indicates that the lizard is well-fed. Since many species may autotomize (drop) their tail, re-grown tails (partial or complete) are encountered frequently. It is perfectly normal for a regenerated tail to have a different colour, pattern, scale texture and even shape as the original tail. Occasionally, a re-grown tail may fork into multiple endings (this tends to happen when a broken tail is not completely severed, and both the old tip and a new one grow back). Tail tips should be carefully inspected for shed skin that has not completely come off. Stuck shed can cut off circulation to the tail tip, and the portion will eventually die and fall off.

Learning what a species' tail looks like is important. Top: Most iguanid and agamid lizards, like this Hatian curly-tailed lizard (Leiocephalus schreibersi) have a tail that should be thick at the base, then taper. Bottom: Some lizards, like this leopard gecko (Eublepharis macularius) have a tail that should be plump near the middle.   Notice the different texture and colour of the regenerated tail on this green iguana (Iguana iguana).

Eyes: The lizard's eyes should be bright and clear. Crustiness or a goopy residue may be an infection and needs to be treated. Swollen eyelids may also be an infection or caused by a vitamin A deficiency, so the animal must be seen by a vet. If the eyes are recessed into the socket, the animal is probably severely dehydrated. Geckos with transparent eyelids (called brilles) should be checked for shed skin stuck to the eye. If layers of dead skin are on the clear eyelid, they must not be pulled off as this may damage the eye. Soak the animal in lukewarm water for 10 minutes, then place a drop of oil (mineral, vegetable, etc.) on the eyelid; the spectacle should come off with the lizard's next shed. If it doesn't, a weak piece of masking tape gently pressed to the eye may remove the stuck spectacle, but do not hesitate to seek veterinary help if needed. It is entirely possible to accidentally rip off the eyelid that is still living, which can cause severe trauma to the eye. Nostrils and mouth: The nostrils should be clear of residue, including crust, bubbles or mucous. Note that some species excrete salt by "snorting" it out, so a bit of whitish, salty-looking crust is normal. The mouth can be examined by either gently pulling down on the skin of the throat, tapping the nose or corners of the mouth so that the lizard gapes, or by using a speculum to open the mouth (but only if you're experienced with using one). The mouth colour should be appropriate for the species, which is usually pinkish. Pale or discoloured mouth tissue may indicate a health problem. Sheething mucous, excessively bubbly saliva, brown and black spots, or cheesy yellow pus should all be examined by a vet. Does the tongue appear normally-coloured? Is it swollen? Are there lesions? Also, lizards that have weak gums that bleed easily during the examination are not healthy, and probably have some kind of nutritional deficiency. A swollen but receded (appearance of an "overbite") jaw is indicative of a metabolic bone disease.

The white fleck in the corner of this leopard gecko's (Eublepharis macularius) eye is not normal. When flushed out, it was revealed to be a piece of shed skin. Leaving it in the eye may have irritated or abraded the eyeball, which would leave a wound open for infection.       Knowing what is normal in a given species is very important. The purple and yellow colouration in the mouth of this mountain horned dragon, Acanthosaura capra, is completely normal for this species... But the yellow and brown colouration along this Chinese water dragon's (Physignathus cocincinus) gums is indicative of an infection. The pussy growth on this iguana's tongue should absolutely be seen by a vet.

Belly and vent: The belly skin should be paid particular attention to because it tends to be a prime spot for thermal burns. In all respects, it should be examined like skin elsewhere on the body. The abdominal region should also be palpated for hard masses, which could be anything from ingested objects to tumours to impacted feces to eggs. Any lizard with an unknown lump in the abdomen should be seen by a vet. The vent, also called the cloaca, is the opening of the digestive, urinary and genital tracts. It should be examined for swelling, discolouration, and caked-in feces. Fecal matter that sticks around the vent could mean that the animal is too weak to properly eliminate, or it is kept is very unsanitary conditions. Pink or red tissue popping out of the vent should be considered an emergency and the lizard should be brought to the vet immediately (keeping the tissue moist with a clean cloth covered in warm water). This is called a tissue prolapse, and can happen for any number of reasons. Males will occasionally have a temporary hemipenal prolapse after mating, but should be brought to the vet as soon as possible if the hemipenes do not retract.

This is a mild prolapse of the proctodeum, the most caudal portion of the cloaca, from straining to lay her eggs. It needs to be evaluated by a vet.

A thorough physical exam is only a small part of what must be done to diagnose any illness, and the vast majority of possible health problems cannot be diagnosed at home or over the Internet. Whether you are a beginning herpetoculturist or an expert, there is no shame in bringing your animal to a reptile vet to have a second opinion over a physical, and have other tests done if needed.

Last modified: Tuesday, January 10, 2006