Snake Neurological Emergencies: Stargazing, Tremors and Loss of the Righting Reflex

Quick answer

Neurological signs in a snake are read from posture and from how the animal moves, which means you need a calm, well lit look at the whole body.

Snakes do not have seizures that look like a dog's. There is no collapse into paddling limbs, because there are no limbs. Neurological disease in a snake shows up as posture and coordination going wrong.

The two presentations to know are stargazing, where the head and neck are held raised, twisted or corkscrewed upward and the snake cannot bring them down normally, and loss of the righting reflex, where a snake rolled gently onto its back fails to turn itself back over.

• Check the enclosure temperature first. Overheating is the one cause you can reverse in minutes, and a failed thermostat is a common trigger.
• Look for anything sprayed, fogged, hung or wiped in or near the enclosure recently. Insecticides and fumigants are a leading toxic cause.
• Do not restrain the snake, do not put anything in its mouth, and do not attempt to straighten the head or neck.
• Film it. A short phone video of the posture and movement is the most useful thing you can bring to the vet.
• Separate the snake from other snakes and stop sharing hooks, tubs, water bowls and hands between enclosures until a vet has assessed it.

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Never put your fingers or any object into a snake's mouth during an episode.

The advice to protect a seizing animal's tongue comes from human first aid and is wrong even for dogs. In a snake it damages the glottis, the fragile jaw structures and the teeth, and it gets you bitten by an animal that has no control over what it is doing.
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Decide in 60 seconds

Why the mammal seizure protocol does not transfer

There is nothing to cushion.

Mammal first aid is largely about protecting a thrashing animal from furniture and from falling. A snake in an enclosure is already at floor level with soft substrate. The equivalent risk here is a snake on a shelf, a table, or in your hands, which is why you put it somewhere low and enclosed and then leave it alone.

Timing an episode is less useful than describing the posture.

In a dog, seizure duration drives the decision. In a snake, neurological signs are often continuous or fluctuating rather than discrete episodes, and the diagnostic value lies in the specific posture and in what else is happening: regurgitation, breathing, shedding, feeding history.

Cooling and warming are diagnostic, not just supportive.

Snakes are ectothermic. Their nervous system runs on the temperature you give them. A snake that is far too hot or far too cold looks neurologically abnormal for reasons that have nothing to do with disease of the nervous system, and correcting the temperature is both the treatment and the test.

Mouth interference is more damaging.

Nothing goes into the mouth. Beyond the general point that it is wrong in any species, a snake's glottis sits at the front of the floor of the mouth and the lower jaw is suspended on mobile bones rather than fused. Both are damaged easily.

Human medicines are not an option.

There is no home anticonvulsant for a snake. Do not give any human or canine medication, and do not use a dose scaled from another animal.

The two signs worth learning properly

Normal for reference: head carried in line with the body, eyes clear, muscle tone even along the length of the animal.

Stargazing.

The snake holds its head and forebody raised with the face angled upward, often twisting the neck so the head rolls to one side or corkscrews. The defining feature is that the snake cannot correct it. Ordinary alert posture, in which a snake lifts its head to look at something and then lowers it, is not stargazing.

Confusingly, a snake with respiratory disease may also rest with the head and neck raised, because that position opens the airway. The difference is that the respiratory case can still lower the head normally and usually has audible breathing or mucus.

Loss of the righting reflex.

Gently roll the snake onto its back on a flat, soft surface. A neurologically normal snake rights itself immediately, often before you have finished. An affected snake stays inverted, or rights itself slowly and partially, or rolls in a disorganised way.

Do this once, briefly, and only if the snake is calm enough to handle safely. It is a test vets ask about routinely, so it is worth being able to report the answer, but repeating it stresses the animal for no additional information.

Other neurological signs.

Head tilt held persistently. Tremors or fine twitching. Waves of muscle contraction unrelated to movement. Inability to strike accurately or to constrict properly. Dragging part of the body. Sudden loss of muscle tone. Pupils of unequal size.

The causes a vet will be working through

Temperature.

Hyperthermia from a heat mat or lamp running without a working thermostat, from a hot spot the snake cannot escape, or from an enclosure left in the sun. Snakes overheat quickly and the neurological signs come with a real risk of thermal burns on the belly scales. Hypothermia produces its own incoordination and lethargy. Verify both ends of the gradient with a probe thermometer before you assume disease.

Toxins.

Dichlorvos pest strips, sold and often recommended for snake mites, are a recognised source of poisoning when misused. Pyrethroid and permethrin sprays, household foggers and bug bombs, mothballs, fresh paint and solvent fumes, and strong cleaning products used in or near an enclosure all reach the snake through a respiratory system that is far more permeable than an owner expects. Ask what has changed in the room, not just in the enclosure.

Inclusion body disease.

A viral disease of boas and pythons associated with reptarenaviruses. In boas it often runs a long course with regurgitation, weight loss and later neurological signs. In pythons it tends to present more acutely and more severely with neurological disease. Stargazing and loss of the righting reflex are the signs most often described. There is no cure, diagnosis needs laboratory testing, and snake mites are implicated in transmission between animals. This is the reason for strict quarantine of new arrivals and for aggressive mite control.

Nutritional causes.

Snakes fed a diet composed largely of certain fish species can develop thiamine deficiency, because those fish contain an enzyme that destroys thiamine. This mainly affects garter snakes and other fish eaters, and it is treatable when identified. Calcium and vitamin D imbalance can produce tremors, more often in lizards than in snakes but not impossible.

Trauma.

A fall, a heavy lid, being trodden on, or a door closing on the animal. Spinal injury in a snake can present as loss of coordination in the part of the body behind the injury.

Systemic illness.

Severe infection, organ failure, dehydration and septicaemia all reach the nervous system eventually. This is why a snake with neurological signs gets a full workup rather than a single test.

What to do while you arrange the appointment

1. Measure, do not guess.

Put a probe thermometer at the warm end and at the cool end and read both. Record the numbers. If the warm end is far above the range for your species, that is your immediate action.

2. If it is overheated, cool gradually.

Move the snake to a clean container at normal room temperature, away from any heat source. Do not use ice, ice water or a refrigerator. Rapid chilling causes its own crisis on top of the first.

3. If a toxin is possible, get the snake out of the air.

Remove pest strips, sprays or anything recently applied. Move the snake to a clean container in a different, well ventilated room, with clean paper substrate and fresh water. Keep the packaging of whatever was used so the vet can see the active ingredient.

4. Make the environment safe and small.

Low, enclosed, soft, and secure. Take out water bowls deep enough to drown a disoriented snake, tall decor it could fall from, and anything it could become trapped under.

5. Film the posture.

Thirty seconds of video showing the head carriage and how the snake moves is worth more than any description. Neurological signs fluctuate, and a snake often looks better in the consulting room than it did at home.

6. Isolate.

Until a vet has assessed the animal, house it away from your other snakes, handle it last, and do not share hooks, tubs, water bowls, substrate or towels between enclosures. Wash hands and change any clothing that contacted the animal.

7. Do not feed.

A snake that cannot coordinate a strike or a swallow should not be offered prey, and a snake that may need sedation or anaesthesia should not have a meal inside it.

Probe readings, weights and dates written down turn a vague history into something a reptile vet can work with in a single appointment.

The routine that catches problems early

What never to do

Do not put fingers, spoons, cloths or anything else into the mouth.

Do not hold, straighten or unwind the head and neck. The posture is generated by the nervous system and forcing it causes injury without changing anything.

Do not give human or canine medicines, sedatives or anticonvulsants.

Do not plunge the snake into cold water or use ice to cool an overheated animal.

Do not offer food.

Do not return the snake to the same enclosure if a toxin or a heating fault is suspected, until you have found and fixed the cause.

Do not house it with, or handle it alongside, your other snakes before a diagnosis. In the boa and python group specifically, an infectious cause has to be excluded before you risk the rest of the collection.

Do not wait to see whether it settles. Neurological signs in a snake are a same-day problem in every case.

A neurologically normal snake: head level with the body, smooth continuous movement, and an immediate correction when its balance is disturbed.

When to get help

Any snake showing stargazing, persistent head tilt, tremors, loss of the righting reflex or uncoordinated movement needs a reptile-experienced veterinarian the same day.

Go immediately if the signs follow a suspected overheating event, a fall or crush injury, or exposure to an insecticide, fogger or fumigant, and bring the product packaging with you.

Go immediately, and isolate the animal first, if a boa or python shows neurological signs together with regurgitation or weight loss.

Bring probe readings from both ends of the enclosure, the humidity, the feeding and shedding records, recent weights, the quarantine history of the animal and of any recent arrivals, a list of anything used in the room, and video of the abnormal posture. Transport the snake in a secure, escape-proof container with soft lining, kept within its temperature range, and tell the practice before you arrive that this is a neurological case so they can prepare appropriately.